OCCUPATIONAL SAFETY AND HEALTH AT HARVARD UNIVERSITY

The history of the Department of Industrial Hygiene at Harvard University corresponds with the principal period of innovation and discovery in the history of industrial health in the United States and includes many unique achievements as well as an extraordinarily large number of outstanding personalities. Indeed, much of the earliest literature on industrial hygiene, industrial toxicology, and occupational medicine in this country originated at Harvard.

Environmental health and, specifically, occupational health have been major concerns at Harvard since 1913, when the Harvard-Massachusetts Institute of Technology School for Health Officers was established by Professor William T. Sedgwick, Dr Milton J. Rosenau, and Professor George C. Whipple. The curriculum included industrial hygiene and sanitation and covered the adverse effects of factory life on health, including occupational accidents, industrial poisonings, and the effects of ventilation and dusty trades on the widespread incidence of tuberculosis and other diseases.

In 1918 the name of the School was changed to the Harvard-Massachusetts Institute of Technology School of Public Health. Also in 1918, the Harvard Medical School organized a Division of Industrial Hygiene, largely through the efforts of Dr. Frederick C. Shattuck who secured from New England industrialists a fund of $125,000, and began providing training in industrial hygiene in the School of Public Health for factory physicians throughout New England . After the entry of the United States into World War I in the spring of 1917, the number and variety of hazardous occupations had increased sharply in the United States , and the School was prepared to offer instruction in industrial hygiene and facilities to investigate the problems of industry.

Numerous requests regarding pressing problems were received from plant managers and Dr Cecil K. Drinker organized a research facility. Cecil Drinker became a pioneer in industrial medicine and was among the first to emphasize the importance of the respiratory tract as the route of absorption for toxic dusts and fumes. He proved to be a strong advocate for the establishment of industrial hygiene and applied physiology as disciplines in preventive medicine. The first success of the modest research group in an extended series of investigations on dust and dust hazards was the investigation of an obscure condition of industrial poisoning on behalf of the New Jersey Zinc Company, where manganese was proved responsible.

In 1919 Harvard University 's first woman professor, Dr Alice Hamilton, was named Assistant Professor of Industrial Medicine in the Division of Industrial Hygiene. In spite of prejudices, she achieved major accomplishments in a professional world dominated by men.

In 1921 Harvard received an endowment fund from The Rockefeller Foundation which stipulated that the joint Harvard-Massachusetts Institute of Technology School of Public Health be dissolved. The new School of Public Health at Harvard was opened in 1922, offering studies leading to bachelor, master, and doctor of public health degrees. Dr Alice Hamilton administered an advanced course in industrial toxicology, and Dr Philip Drinker, Cecil Drinker's brother, directed a new program in ventilation that applied engineering principles to measurement of air flow, psychometry, the use of the Kata-thermometer, and the design of air conditioning in factories. Opportunities for studies in occupational medicine were offered at the Industrial Hygiene Clinic of the Massachusetts General Hospital , where Dr. Harriet Hardy later practiced occupational medicine.

In 1924 Drs Cecil Drinker, Katherine Drinker, and William B. Castle were the first scientists to investigate radium poisoning thoroughly. Radium poisoning was suspected among workers painting dials of clocks and watches in Orange , New Jersey . The hazard resulted from painting brushes by placing them between the lips and from the atmosphere in the work-rooms. Through a succession of other radium-poison investigations, the findings of this group became the accepted authority.

The effects of temperature and humidity came under intensive study at Harvard beginning in 1925 when Mr Constantin P. Yaglou joined the staff of the Department of Industrial Hygiene as Instructor. Mr Yaglou collaborated with Dr Kenneth Blackfan, Professor of Pediatrics at the Medical School and Physician-in-Chief at the Children's Hospital, to construct and operate an air-conditioned room for premature infants whose mortality was very high. Mr Yaglou's studies resulted in the formulation of a temperature scheme applicable to premature babies that stabilized body temperature and greatly reduced mortality.

Beginning in 1926 Philip Drinker worked under the auspices of the Rockefeller Institute to develop better methods of resuscitation. He sought to improve the old-fashioned pulmotor for resuscitating victims of electric shock or illuminating gas poisoning, and was aided by Louis Shaw, a Harvard colleague, in the development of a respirator large enough to hold a human. The first patient to use it was from the Children's Hospital. The child was unconscious from respiratory paralysis, but recovered consciousness in less than a minute after the respirator was started. This was one of the most dramatic discoveries in the history of industrial hygiene, and the Drinker Respirator, or “iron lung”, rapidly gained worldwide acceptance.

For many years Alice Hamilton taught industrial toxicology at Harvard and made significant contributions in research on the chronic effects of carbon monoxide poisoning in garages, printing establishments, tunnels, and mining in collaboration with Cecil Drinker, and on mercury poisoning in the felt-hat industry with Wade Wright, Philip Drinker, and others. She produced a significant number of papers on industrial lead and aniline poisoning.

Largely through her investigation of worker poisoning in the Illinois lead industry, that state became the first in the country to adopt legislation aimed at safeguarding workers' health. This was the first comprehensive survey of occupational disease conducted in the United States . Hamilton and Professor Philip Drinker struggled to gain management and labor support for measures aimed at combating lead poisoning as well as silicosis.

Alice Hamilton, pioneer in industrial toxicology and occupational medicine, wrote many papers that are classics in the field of industrial health. Her productivity continued beyond her retirement in 1935, and her influence in this field cannot be overestimated. Her opinion was constantly sought by many large organizations, and her decisions almost always resulted in decisive action by the application of proper protective measures.

Leslie Silverman came to the School in 1937 and was named Instructor in Industrial Hygiene in 1939 while he continued doctoral work. Charles R. Williams also came to the School in 1937 on a part-time basis with the title of Instructor in Industrial Hygiene. He was employed by the Liberty Mutual Insurance Company to conduct dust surveys for their insured risks and became an expert on the identification and analysis of airborne dust.

By 1939 the Department of Industrial Hygiene was staffed with a significant group of scientists and engineers including Philip Drinker, Constantin Yaglou, Leslie Silverman, and Charles Williams. War-oriented work during World War II included the development of oxygen equipment for high-altitude flight and its physiological evaluation; a protective gas mask to meet the needs of chemical warfare; heating, ventilation, and air-conditioning systems; and a national health-education program for shipyard workers.

In 1946 the School of Public Health became independent of the Medical School , and peace-time teaching and research were resumed. Increasing numbers of students sought to extend industrial hygiene knowledge into the newer specialties of radiological health and air-pollution control. Drinker, Silverman, and Williams began serving as consultants to the Atomic Energy Commission, and as a result radiation protection, aerosol physics, and air and gas-cleaning technology gained greater prominence in the teaching programs.

In 1949 Philip Drinker initiated a study to determine permissible concentrations of sulfuric acid vapor for humans and animals. Dr Mary Amdur joined Drinker and Silverman in these studies and extended the research to other common acids. By the mid-1950's the Department of Industrial Hygiene had enlarged its curriculum and research efforts to include radiological safety and air-pollution control in addition to the more traditional studies of industrial hygiene, industrial medicine, industrial safety, and environmental sanitation.

The Departments of Industrial Hygiene, Physiology, and Sanitary Engineering were grouped under a single Division of Environmental Health and Engineering Sciences. In 1957 the Rockefeller Foundation funded a grant to the School of Public Health for a program in radiological hygiene. Leslie Silverman was responsible for the engineering aspects of this program and became the second Head of the Department of Industrial Hygiene when Philip Drinker retired in 1961.

New research laboratories were dedicated in 1962 and the Department of Industrial Hygiene was situated in new quarters with other departments in the Division of Environmental Health and Engineering Sciences, which had been placed under the direction of Dr James L. Whittenberger. Later, the Division became a part of the new NIEHS-funded Kresge Center for Environmental Health at the School.

The launching of a new field of studies on solid-waste management in 1962 by Leslie Silverman and Melvin First continued the enlargement of the scope of concern related to environmental health problems in the Department of Industrial Hygiene.

Leslie Silverman became ill in 1966, and upon his death James L. Whittenberger was appointed Acting Head of the Department of Industrial Hygiene. Under the leadership of Drs Whittenberger, Benjamin G. Ferris, Jr, John M. Peters, David H. Wegman, and William A. Burgess, continuation of the historic interest in the relationship between occupational exposures and occupational disease was reflected by a series of more recent research efforts aimed at identifying new job-related hazards and bringing them under control. These included studies of toluene di-isocyanate (TDI) and lead toxicity; evaluations of health hazards involved in fire fighting and rubber-tire manufacture; respiratory disease in granite cutting, talc mining, and meat wrappers employed in the retail food industry; and mortality in a number of different types of manufacturing concerns in Massachusetts. Morbidity or mortality studies determined whether excess disease was seen when compared to less-exposed populations. Industrial hygiene evaluations characterized exposure to specific chemical substances and were used in the development of recommendations for controlling identified hazards.

Although interdisciplinary teamwork had long marked occupational health research at the School, it was not until 1971 that another important form of collaboration was achieved. The School played a signal role as a non-partisan participant in environmental research of vital concern to differing societal groups: industry, government, consumers, and workers. A pioneering agreement with the United Rubber Workers and the BF Goodrich Company paved the way for similar three-way agreements with labor and management at the School and elsewhere. After careful negotiation, the Company and the Union agreed to make Company resources available and the University agreed to conduct research on occupational health, industrial hygiene, and occupational epidemiology in the rubber-tire industry. Over a period of ten years, the School's researchers created a detailed picture of health effects in the industry and proposed changes adopted by a joint labor-management team.

There has been continued interest in such collaborative studies, since joint labor-management sponsorship of occupational health studies carries with it great potential both for achieving cooperation from all parties and for having control methods suggested by the research results imple­mented. The meat wrappers project, which began in 1976 and was concluded in 1983, was another investigation that successfully adopted the rubber industry model. In 1984 members of the faculty and staff began studying the health effects of machining fluids used in the automobile industry. This project arose from the joint initiatives of the General Motors Corporation and the United Automobile Workers' Union . The Corporation provided funding for this study as a result of GMUAW contract negotiations.

In 1983, Dr Richard Monson, Professor of Epidemiology, took over as director of the ERC and recruited most of the current faculty. Since the late 1980's new research initiatives developed by ERC faculty have involved combining molecular biology with epidemiology in the investigation of exposure-related disorders. Large-scale investigations now underway include genetic susceptibility to lung cancer and non-malignant respiratory disease, biomarkers of exposure and response after exposure to particulates, fuel-oil ash, bioaerosols, hydrocarbons, and heavy metals, such as lead and arsenic. The study of the gene-environment interactions has been the focus of many of the large research projects. In addition, occupational reproductive studies of textile, petrochemical, and agricultural workers are being performed and incorporate state-of-the-art biologic markers. International occupational health studies have expanded greatly over the past nine years and the ERC faculty conducts collaborative research in Asia, Africa, and Latin America .

Other current research spans a wide variety of occupational health problems with the broad objective to identify and reduce or eliminate job-related health and safety hazards. These activities include developing and evaluating methods of exposure assessment, evaluating control systems, evaluating surveillance systems, developing and evaluating worker training, developing and evaluating programs that combine health promotion approaches with health protection, and examining health and economic outcomes associated with occupational illness and injury.

In 1996 Dr David Christiani, Professor of Occupational Medicine and Epidemiology, assumed directorship of the ERC with Dr Thomas Smith, Professor of Industrial Hygiene as Deputy Director. Under their leadership research continued to expand in the areas they and their colleagues have developed through the 1990's: an emphasis on innovative multidisciplinary investigations aimed at defining exposure-related disorders and developing methods to control them.

Current investigations draw upon the expertise of epidemiologists, industrial hygienists, biostatisticians, toxicologists, cancer biologists, physiologists, engineers, chemists, physicists, and other occupational health specialists, as well as economists, sociologists, and attorneys. The School of Public Health 's role as a synthesizer of the efforts of scientists in many disciplines continues to be perhaps its greatest strength, for, as in its earliest years, its research and training programs in environmental and occupational health have lent breadth through the cross-disciplinary collaboration of many fields.

In 1977 the National Institute for Occupational Safety and Health (NIOSH) established regional centers of learning for occupational safety and health professionals within universities throughout the United States . The Centers were developed in response to the Occupational Safety and Health Act of 1970, which mandated that the Secretary of the Department of Health and Human Services ensure an adequate supply of trained professionals for this field. The Harvard School of Public Health was selected as the site of a NIOSH-sponsored Occupational Safety and Health Educational Resource Center (ERC) to serve the New England region. This award greatly enhanced the School's training capacity in this field and helped to strengthen the core of professionals conducting research as well. In 1997 the name of the center was changed to the Education and Research Center for Occupational Safety and Health, reflecting the Center's dual mission of professional training and research.

The ERC at Harvard offers interdisciplinary graduate-degree programs in occupational medicine, occupational epidemiology, occupational health nursing, industrial hygiene, hazardous substances, ergonomics/ injury prevention, and in other disciplines that come into play to solve occupational health and safety problems. The nursing core is offered in collaboration with Simmons College , a neighboring institution in the Longwood Medical Area. The educational programs target the New England states, but attract candidates for training from all areas of the country as well as from foreign countries.

Indeed, Harvard University has always been a global leader in research and training for many disciplines and occupational health is one of them. Many of the leading occupational health scientists in the US and abroad, who direct training programs, research programs, government agencies, labor and corporate health and safety departments, are graduates of the Harvard ERC.

The objective of the Center is to train occupational safety and health professionals to recognize and prevent occupational injuries and disease, with prevention being the primary orientation. This objective is being accomplished by directing the training effort at the development of public-health perspectives, the acquisition of skills and knowledge for prevention, and the creation of sensitivity about the political and social climate in which professionals must act. Harvard ERC graduates are serving in many realms: academia, industry, all levels of government, hospitals, occupational health clinics, and labor unions.

In addition to the full-time degree programs, mid-career training is offered through short-term courses, seminars, and workshops for physicians, nurses, industrial hygienists, safety engineers, and other occupational safety and health professionals, paraprofessionals, and technicians. Lectures are presented by faculty, staff, and students of the Center, supplemented by external experts for coverage of special topics. Some of the courses are structured so that institutions of higher education, public health and safety agencies, professional societies, or other appropriate organizations can utilize the information to provide training at the local level to occupational health and safety personnel serving in the workplace. The Center often collaborates in offering such training with professional associations, educational institutions, and other organizations committed to providing training opportunities.

Another innovative aspect of the Center's activities is its Outreach Program. This program impacts the New England region through efforts to spark the development of occupational safety and health training programs or the incorporation of curriculum content at other institutions. The Visiting Scholars Program serves as the vehicle for achieving this objective. A secondary goal is to create awareness of occupational safety and health in professional and non-professional communities. The regional networking system that has been developed by this program has been fostered through interaction with colleges and universities, agencies, professional societies, public health departments, occupational health clinics, unions, management, community associations, and other entities.

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