Public Health Pioneer

Alice Hamilton crusaded against poisons in the workplace

This article is part of an occasional series looking at great achievements by Harvard scientists past and present.

By Andrea Shen

Special to the Gazette

The two men waiting for their train that spring day in 1916 were orange and yellow.

"Look at the canaries," somebody whispered. The two men's faces and hair and hands were stained with picric acid, an explosive used during World War I.

A middle-aged woman approached the men and engaged them in conversation. A few hours later, she stood in a blackened field and beheld a nightmarish scene. Huge orange plumes of smoke rolled forth from a shed, while orange- and yellow-stained men ran out to escape the fumes. The woman ran "choking and gasping" across the field Ñ nitrous fumes, produced in the making of picric acid, can burn the lungs and result in bronchitis, pneumonia, or death. By Christmas of that year, the woman would visit 41 plants that made explosives; she would identify at least 30 poisonous substances in the workers' environment.

That woman was Dr. Alice Hamilton, a pioneer in industrial toxicology for the first half of the century. Her studies of workplace hazards helped bring about safer working conditions for Americans. As a doctor, an industrial investigator, and the first woman faculty member at Harvard, Hamilton broke new ground for professional women, too.

The Dangerous Trades

In the early 1900s, industrial workplaces were extremely unsafe. In addition to mechanical accidents, workers were often exposed to toxic substances. They inhaled toxic dusts and fumes, ate their meals with poison-smeared hands, and wore clothing caked with poisons. Many employers considered their duty discharged if they told their workers to scrub their fingernails.

The effects of industrial poisoning were often severe. In the felt-hat industry, workers poisoned by mercury developed uncontrollable jerking of the arms and legs, and mental illness Ñ hence the phrase "mad as a hatter." In the many industries that used lead, workers had colic attacks, convulsions, partial paralysis, and premature senility. At the Carnegie steel mills in Pittsburgh, so many workers were sent to the hospital that the clerk grew tired of writing the company's name. He acquired a rubber stamp "which, appropriately enough, he uses with red ink," Alice Hamilton wrote to her mother in 1911. "All down the page came these red blotches, just like drops of blood."

Hamilton's interest in workplace hazards grew out of her life at Hull House, the famed settlement house in Chicago, where she lived for 22 years.

"Living in a working-class quarter, coming in contact with laborers and their wives, I could not fail to hear tales of the dangers that workingmen faced," Hamilton wrote in her 1943 autobiography, Exploring the Dangerous Trades. The people whose babies she tended, or whom she taught English, or joined on picket lines, were palsied painters, steelworkers gassed by carbon monoxide, and stockyard Goliaths reduced by pneumonia and rheumatism, Hamilton said.

Hamilton's interest in workers' health grew keener in 1907, when she read two provocative texts. One was a muckraking article by William Hard, which decried the absence of adequate workman's compensation. The second work was Sir Thomas Oliver's book, Dangerous Trades. Reading these works, Hamilton sensed her vocation.

Hamilton felt that tracing the links between work and illness perfectly wed two seemingly unrelated parts of herself: her training in science, and her passion for social reform. Hamilton received her M.D. degree from the University of Michigan in 1893. She studied bacteriology and pathology at the University of Michigan, the universities of Leipzig and Munich, and Johns Hopkins University. By the time she read HardÕs and Oliver's works, she was a bacteriologist at Chicago's Memorial Institute for Infectious Diseases.

But her work in the lab seemed remote from the needs of the people around her. Perhaps she could find in "the dangerous trades" a life that she would later call "scientific only in part, but human and practical in greater measure."

Her medical colleagues disdained her new interest in occupational diseases: "Here was a subject tainted with Socialism or with feminine sentimentality for the poor," she wrote in her autobiography. When she searched for American scholarship on the subject, she found nothing.

In September 1908, she published one of the country's first articles on occupational illness.

The working class is "a class which is not really free," she announced in "Industrial Diseases," printed in Charities and The Commons. The poor must take dangerous jobs, or have no jobs at all, she wrote Ñ and it was certainly not a new problem. Pliny the Elder saw the same plight Ñ and the same diseases Ñ 19 centuries earlier, but what Hamilton called "industrial diseases," Pliny the Elder called "the diseases of slaves."

A Gumshoe Detective

In 1910, having gained some renown as a social reformer, Hamilton was asked to lead the first statewide survey of industrial poisons, for Illinois.

"[I]t is starting out into a great unknown and nobody seems to know the first step," she wrote to her cousin Jessie Hamilton. Nobody knew which trades to explore, where they were located, or what methods to use.

Hamilton took a highly personal and labor-intensive approach to the study. Like a gumshoe detective, she walked through working-class neighborhoods, talking to doctors, labor organizers, and priests. She read hospital records, talked to sick workers at home, inspected their factories, and plied managers with suggestions. In the lead trades alone, she visited more than 300 workplaces and identified over 70 processes that exposed workers to lead poisoning.

In 1911, based on her group's "shoe-leather epidemiology," Illinois passed a law requiring safer workplaces and monthly medical exams for workers in lead, arsenic, brass-making, or the smelting of lead and zinc. Only six states had such laws by 1911.

First Female Professor

"I often felt my sex was a help, not a handicap," she wrote in her autobiography. Raised in Victorian times, she believed that men and women were innately different, and she capitalized on people's assumption that women naturally cared about men's welfare. Quietly dressed with her hair in a bun, speaking in what one Hamilton scholar calls "an aristocratic and mellow voice," Hamilton was, in the words of her friend Supreme Court Justice Felix Frankfurter, "the finest combination of exquisiteness and expertness."

Hamilton next conducted a national survey of the lead trades, for the U.S. Bureau of Labor. Her reports were a clear indictment of American hygienic standards. These Progressive years saw a rising wave of national interest in occupational health. In 1914, Hamilton became vice chairman of the first professional organization of industrial hygienists. In 1915, the Public Health Service established a Section of Industrial Hygiene and Sanitation, to investigate occupational diseases.

"By 1915," writes Barbara Sicherman, in Alice Hamilton: A Life in Letters, "Alice Hamilton had become the foremost American authority on lead poisoning and one of a handful of prominent specialists on industrial diseases." Her fame was such that in 1919, the New York Tribune wrote an article with the headline "The Last Citadel Has Fallen." That citadel was Harvard University Ñ which had appointed Hamilton as its first female professor.

The press had a field dayÑ but Hamilton took it in stride: "I am not the first woman who should have been appointed to the faculty of Harvard," Hamilton calmly told the Tribune.

For almost the next two decades, Hamilton taught industrial medicine at the Medical School and, later, the School of Public Health. She continued doing field studies, learning about aniline dye, carbon monoxide, mercury, benzene, carbon disulphide, and other harmful substances. She wrote the first American textbook in the field, Industrial Poisons in the United States (1925); in 1934, she wrote another classic, Industrial Toxicology. By the time she conducted her last study, in 1938, federal funding and oversight for occupational health had grown significantly.

Dear ÔSirÕ

As a sheltered girl growing up in Fort Wayne, Ind., in the 1870s and Õ80s, Hamilton could not cross the yard at night without one of her parents waiting to hear her call back that she was safe. As a grown woman, Hamilton dropped 800 feet down a mineshaft in a shaky cage, crawled on hands and knees over open pits, tested jackhammers, and scaled three stories up to a vat of "evil-looking, dark, bubbling" sulphuric acid. She traveled to Europe several times for her work as well as for international political causes.

"She delighted in her newfound ability to go anywhere and do anything a man could do," Sicherman writes.

But Hamilton's sense of equality was tested at Harvard. Her move from Hull House to Harvard was, in effect, a move from a world led by powerful females (like future Nobel laureate Jane Addams) to "that stronghold of masculinity," as Hamilton called Harvard.

Hamilton was not permitted to enter the Harvard Club or to attend college football games. Her certificate of appointment was a beautifully calligraphed form-letter addressed to "Sir." Her printed invitation to sit on the dais at Commencement every year came with this special warning: "Under no circumstances may a woman sit on the platform." Hamilton also felt snubbed by her immediate colleagues.

"I have so often felt myself pushed into obscurity and passed over that I have almost ceased to fuss over it," she wrote to her sister Margaret in 1923. "I wish I could say, never mind, in the end you will get your just dues. Unfortunately often one does not get one's just dues, they are grabbed and one cannot grab back."

The previous year, for instance, Hamilton's colleagues had planned to give her a lesser role in a survey of working conditions at General Electric. GE's president, Gerard Swope, sidestepped their plan and asked Hamilton to lead the study. Hamilton wryly noted a change in her colleagues' behavior: "Dr. Drinker told me that things were to be quite different from now on, that Dr. Lee had put me on the executive committee and I would always be consulted. I said 'Well, great is the power and glory of the General Electric Company' and he got red and stammered and then laughed and said 'Well. Maybe.' "

After Hamilton's retirement in 1935, she served as a consultant to the Division of Labor Standards in the U.S. Department of Labor. She continued to write and lecture, and she maintained her longstanding interest in liberal social causes.

Just Dues

In 1959, Hamilton's colleagues established the Alice Hamilton Fund for Occupational Health at the School of Public Health. This fund has enabled trainees in occupational medicine to study at SPH. There are now 83 women faculty members at SPH, and 61 percent of the students are female this year, according to Traci Anderson, assistant registrar.

In 1987, 17 years after Hamilton's death at the age of 101, the National Institute of Occupational Safety and Health (NIOSH) named one of its major labs after Hamilton. The next year, NIOSH established the Alice Hamilton Science Award for Occupational Safety and Health.

In 1995, Hamilton's likeness appeared on a U.S. postage stamp, in the "Great American" series.

But perhaps her greatest triumph is what she did for U.S. workers. Hamilton made astonishing headway, in one generation, against what had been known for at least 19 centuries as "the diseases of slaves."