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H-NET BOOK REVIEW
Published by [log in to unmask] (March, 1998)
Christopher Sellers. _Hazards of the Job: From Industrial Disease
to Environmental Health Science_. Chapel Hill: University of North
Carolina Press, 1997. xv + 331 pp. Bibliographical references and
index. $45.00 (cloth), ISBN 0-8078-2314-7.
Reviewed for EH.Net by Mark Aldrich <[log in to unmask]>,
Department of Economics, Smith College
This is a complex, thoughtful, and meticulously researched history of
thought about occupational disease in the first half of this century that
is based upon a wide reading of the archival, primary printed, and
secondary literature. Although not an economic history, the work will
interest economists and anyone else anyone concerned with the evolution of
the American workplace during these years.
Sellers begins with a prologue informing us that he intends to recover
"this biological dimension to the workplace's past" (p. 4), and then goes
on to ground postwar environmentalism in the earlier industrial hygiene
movement. There follows a chapter on the discovery of lead and other
industrial poisoning in Europe and its comparative neglect in the United
States until the early years of this century. Sellers occasionally
provides glimpses of how nineteenth century labor markets dealt with
well-known toxins--fewer than fifteen percent of workers at one lead-using
firm stayed more than forty-eight weeks, and the foreman would encourage
those showing poisoning symptoms to leave. Managers, he argues, were
largely unaware of the extent of such disease--a rational result, perhaps,
of the low payoff to such information. Two chapters then trace the rising
concern with occupational health to the rise of militant labor and to
legal changes such as Holden vs Hardy- which seems implausible as states
had been regulating health and safety for decades. The industrial hygiene
movement begins with the revelations of phosphorus and lead poisoning by
the American Association for Labor Legislation and Alice Hamilton, and the
more formal investigations by the Public Health Service (PHS). Themes
include the development and meaning of expertise and the ability of
researchers such as Hamilton to wield "disciplinary power" to encourage
business compliance with researchers' prescriptions.
Chapters Four and Five continue these themes, tracing the complex
relations between scientists and the business community, the problems with
identifying occupational diseases, and the origins of a laboratory-based
study of occupational disease at such institutions as Harvard's School of
Public Health. Here again, Sellers argues that while company concerns
often shaped research agendas and publications, researchers were still
able to exploit the need of corporations for disinterested expertise to
carve out both independence and disciplinary power. Chapter Six briefly
discusses some of the occupational health studies of the 1930s and notes
the increasing interest in toxicology of large companies such as DuPont
and GM but says little on what stimulated this interest or what results it
had. In the remainder of that chapter, the focus turns to the non-work
environment. Sellers recounts a PHS study of environmental lead exposures
to apple workers and consumers that revealed the difficulties of applying
outside the workplace those techniques that relied on clinical findings of
disease. The conclusion links modern environmentalism to the earlier
hygiene studies. The author claims that the modern overemphasis on
synthetic industrial chemicals is a legacy of the industrial hygiene
movement, and he unfavorably contrasts EPA-OSHA regulation with the
earlier, more flexible approach, which he compares to right-to-know laws.
I want to raise two issues that relate to coverage and evidence. This is
a history of the development of scientific thought about occupational
disease. It is not, as the title suggests, a history of hazards of the
job if by that is meant a reasonably comprehensive assessment of the
extent of industrial disease, nor, as the author makes clear in the
preface, is it a comprehensive history of industrial hygiene. This
emphasis on scientific thought means we learn much less about business and
labor leaders' motives than about those of scientists. Similarly, the
coverage of hazards and regulatory efforts is spotty--there is little on
silicosis, byssinosis, black lung, and asbestos-related disease, perhaps
because their study did little to advance the science of occupational
medicine. The increasing coverage of occupational disease by workers'
compensation laws is noted but not discussed in any depth. Nor do we come
away with any sense of what worked: Sellers informs us that in 1910-1911
Illinois tightened regulations on lead, arsenic, and brass industries, but
the book does not discuss whether or not the new rules had any effect.
No one should be criticized for failing to write a different book, and the
above is not intended as criticism, but merely to clarify the book's
scope. But one aspect of coverage does affect the author's argument. Of
the broad themes Sellers advances, perhaps the most interesting to
economists is the power he ascribes to informal, expert-based authority in
shaping employer behavior. Early company efforts to reduce lead exposures
were probably not cost-effective, Sellers argues, but were done for moral
reasons or public relations, and he claims that "for [Alice] Hamilton, the
investigative enterprise became a regulatory act" (p. 73). Later he
asserts the "surprising effectiveness of this new professional form of
authority," and claims that it "exerted a new discipline over a growing
number of employers" (p. 180). Yet three pages later we are told
"preventive measures [urged by Harvard's School of Public Health] had
little impact on industrial processes" (p. 183). In fact the evidence on
these issues is exceedingly weak. Thus, there is little about the
prevalence of even such a well-studied disease as lead poisoning, or about
whether occupational diseases were reduced by the industrial hygienists'
efforts. Occasionally there are generalizations about the extent of
occupational disease such as "Barnes shared this kind of dilemma [the need
to accept an unhealthy job during the Depression] with tens if not
hundreds of thousands of others" (p. 189). But the source for this claim
turns out to be four letters written by workers, two of which date from
the 1940s.
While it is easy to nit-pick any book, there are number of places in
addition to the above where the author's interpretation outruns his
evidence. Occasionally causation is either obliquely asserted or
presented without much evidence. For example, Sellers asserts (p. 133)
that "By raising his wariness of patient testimony to such an extreme,
Schereschewsky forestalled the employer and professional criticisms
endured by Hamilton: no one could accuse him of falling prey to garment
workers' exaggeration of their ills." It is not clear whether this is
simply a statement of behavior or an attempt to imply motive as well. Or
consider the following problematic attempt to infer motive. Apparently
the author found few photographs of physicians with workers and so a
picture of a doctor reading physical examinations is captioned "Hardly
ever did industrial hygiene researchers _allow themselves_ [my emphasis]
to be photographed with worker subjects; they preferred to be seen at
their desks, with emblems of their science ..." Of course the absence of
photographs reveals nothing about the cause of that absence.
Finally, although it may seem inappropriate for an economist to comment on
anyone else's prose, Sellers' book is not an easy read. There are too
many sentences such as: "To tell this tale is thus to foreground the
centrality and importance to twentieth-century workplace history of
knowledge claims themselves--in this case, the conflicting representations
of environmental biology" (p. 8). Or consider this assessment of
middle-class reformers: "We may understand their discipline as a major
symbolic achievement: like the Protestant ethic whose Weberian reading
Jean-Christophe Agnew has lately recast, 'not simply an economic strategy'
for controlling both workers and employers, but a 'cultural strategy for
ordering a mass of meanings' incited by market-driven workplace change"
(p. 230).
Despite such difficulties this remains a valuable book. It reveals a role
for science in shaping production technologies that economists have
largely overlooked and a linkage between industrial hygiene and
environmentalism that has gone largely unnoticed. It will be the
definitive treatment of the early evolution of industrial medicine and an
invaluable source on the origins of health and safety regulation.
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