Personal Reflections on Occupational Health in the Twentieth Century: Spiraling to the Future

Abstract

The history of occupational health in the United States during the twentieth century demonstrates pendular swings, with periods of rapid progress followed by periods of reversal. Happily, the last three decades have witnessed the most impressive gains, with establishment of a near-universal system for regulating conditions in the workplace, legitimization and growth of the occupational health professions, a marked increase in scientific research, most notably epidemiology, and the transfer of knowledge about occupational health to affected workers and the larger US population. Not surprisingly, rates of injury and illness have fallen.However, analysis of these cyclical historic changes suggests that extrinsic factors-broad social currents, changes in health care financing, and societal perceptions of health and disease-have dominated over enhanced scientific knowledge, technologic changes or professional achievements, usually the determinants of medical or public health advances. Practitioners of occupational health are not, and have never been, in a particularly advantageous position to fashion future events in their own field, and the current situation, however encouraging, is likely no exception.

Commentary

“…Neither most of the national authorities nor the European Union institutions are providing the right knowledge and the action needed to protect the health of all European workers. Even though we have been taught to think of progress in linear terms, the evolution of occupational health will not necessarily follow that path (35). Political events of recent years reflect the precarious position of occupational health in the health policy arena.…”

“…Despite the large numbers of professionals providing services and the high costs associated with them, the institutional role of occupational health is low. Today it is easier to investigate or close a restaurant after a case of food poisoning than it is to investigate or close a factory after an outbreak of an occupation-related disease (35). The implementation of a new occupational health agenda will inevitably face up to the power issues analyzed in this discussion.…”

“…It has been said that the most influential factor in the history of occupational health has probably been the emergence of class-based social movements (35). However, too often, labor leadership has focused on white male occupations and full-time permanent jobs and has neglected women, nonwhites, and new types of flexible employment, which are less likely to be unionized.…”

Development of Multi-Dimensional Action Checklist for Promoting New Approaches in Participatory Occupational Safety and Health in Small and Medium-Sized Enterprises

“…The lack of occupational safety and health (OSH) activities in small and medium-sized enterprises (SMEs) has been pointed out and countermeasures have been discussed worldwide in the last decade [1][2][3][4][5][6][7][8][9][10][11] . In Japan, occupational safety has been stressed mainly to prevent work-related accidents especially in manufacturing companies rather than from an occupational health perspective 1,9,12) .…”

Creating Environmental and Occupational Health: A Journal and the Field it Shaped, 1919–2009

“…11 In 1925, Alice Hamilton published what is generally regarded as the first textbook of occupational medicine in the US, although it would remain essentially ignored for at least the next decade. 12 By the 1930s, silicosis had emerged as a looming crisis for workers, industries, and industrialists in the US, and one that could no longer be neglected. 13 Factory safety rose in priority during the early to mid-20th century, as two World Wars drew attention to the health and safety needs of armaments workers in order to maximize production.…”