---

THE PREINDUSTRIAL AREA

The first recorded observation of an occupational disease may be a case of severe lead colic suffered by a worker who extracted metals. It is described in the third book of Epidemics, attributed to Hippocrates, the Greek physician of the 4th century BCE. There were other early writers who also recognized the association between certain disorders and occupations. The Roman scholar Pliny in the 1st century CE, for example, described mercury poisoning as a disease of slaves because mines contaminated by mercury vapor were considered too unhealthy for Roman citizens and thus were worked only by slaves. However, physicians of antiquity in general were not concerned with the health of workers.

Furthermore, during the Middle Ages when the rise of metalliferous mining in central Europe inspired German mineralogist Georgius Agricola to make a detailed study of gold-and silver-mining operations, Agricola described the primitive methods of ventilation and personal protection in use in his De Re Metallica which was published posthumously in 1556, stating that common mining accidents and disasters and such miners’ occupational diseases as the “difficulty in breathing and destruction of the lungs” caused by the harmful effects of dust inhalation.

Not only that, however, a more comprehensive account of occupational disorders was written by Bernardino Ramazzini (a professor of medicine first at the University of Modena and later at the University of Padua). In his De Morbis Artificum Diatriba (1700; Diseases of Workers), for instance, contained the descriptions of the diseases associated with 54 different occupations from the mercury poisoning of Venetian mirror makers to the diseases afflicting learned men. Because of this, Ramazzini believed that a physician must determine the patient’s occupation in order to discover the cause of the patient’s disorder (he is generally regarded as the father of occupational medicine for your information).

---

THE INDUSTRIAL ERA

The Industrial Revolution of the 18th century had a profound impact on occupational diseases. Rapid technological progress and industrial growth back then had led to crowded, unsanitary working and living conditions, with a corresponding rise in the number of accidents and deaths caused by the new machinery and exposure to toxic materials. In 1775, Percivall Pott (a London surgeon), linked the frequent occurrence of scrotal cancer among chimney sweeps to the soot ingrained into their skin by prolonged exposure to flue dusts.

What’s more, Charles Turner Thackrah (a Leeds physician), further advanced the study of occupational medicine in Britain with his publication called “The Effects of the Principal Arts, Trades and Professions on Health and Longevity (1831)”, which described lung diseases caused by dust that commonly afflicted miners and metal grinders. In 1895, Britain introduced a statutory notification system that required medical personnel to report all occurrences of certain diseases to the chief inspector of factories. Consequently, other industrial countries decided to have followed Britain’s lead and legal provisions for the health of the worker continued to be instituted throughout the 19th and 20th centuries.

---

THE 20^TH AND 21^ST CENTURY

Although such classic occupational diseases as lead poisoning and anthrax have declined in incidence in industrialized countries, none of those illnesses have been entirely eradicated. This is because new diseases continue to develop as a result of advances in technology. For example, the X rays were discovered in 1895 and 20 years later, nearly around 100 radiologists were estimated to have died as a result of occupational exposures. Moreover, Asbestos-related disease was first reported in the first half of the 20th century and in 1974, the hemangiosarcoma (a rare malignant tumor of the liver) was discovered among workers who were involved in the polymerization of vinyl chloride monomer.

Perhaps, other occupational diseases related to the introduction of industrial processes and materials may well be recognized in the future. Paralleling the development of new technology and occupational hazards, this has been the development of occupational health services by far. Having no longer concerned primarily with the prevention of industrial accidents and diseases among manual workers, the industrial medicine now aims to protect and improve the health of all classes and kinds of workers.

In 1950 for example, a joint committee of the International Labor Organization (ILO) and the World Health Organization (WHO) defined the concerns of occupational health as “The promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations; the prevention among workers of departures from health caused by their working conditions; the protection of workers in their employment from risks resulting from factors adverse to health; the placing and maintenance of the worker in an occupational environment adapted to his physiological equipment and to summarize, the adaptation of work to man and of each man to his job”.