Alice Hamilton and The Illinois Survey 1910-1911: Shifting paradigms in documenting workplace disease

This presentation is an historical biography to understand the paradigm shift in occupational health in the early part of the 20^th century and its legacy in occupational health practice in the 21^st century.  Alice Hamilton, MD a physician and activist devoted her life to addressing human rights and social justice issues of workers in the United States. Hamilton employed a framework for associating and documenting workplace exposure and disease. In 1909, she made a commitment to the identification, control, and prevention of hazardous exposures in workplaces. As the principal investigator on the first comprehensive study of work and disease in the U.S., The Illinois Survey, her work became the model for characterizing workplace exposures which informs practice and is the foundation of the disciplines of industrial hygiene, occupational medicine and toxicology in the U.S.

Hamilton described the work as a “pioneering, exploration of an unknown field.” The commission overseeing the Illinois Survey was charged with defining and finding poisonous occupations and gaining access to workplaces to conduct exposure assessments. Hamilton’s knowledge of languages, and skills in community organizing and persuasion enabled her to access almost every workplace she approached, additionally, she never left a facility without reporting her findings and recommendations to the manager and getting some assurance that conditions would change. Her research skills resulted in the first comprehensive report in the U.S. on “the causes and conditions relating to diseases of occupations”.  During this period the social dimension for occupation was added to the cognitive dimensions of illness.