8287664 Work-related topics when the discipline of public health was emerging

<h3>Objective</h3> To understand how work-related hazards contributed to the emergence of public health as a formal discipline. <h3>Material and Methods</h3> A review of historical literature was conducted and key conditions summarised. <h3>Results</h3> The industrial revolution of the 18th and 19th centuries transformed working conditions. Workers were exposed to hazardous conditions including physical and chemical dangers, exploitation (especially of children) and unsanitary conditions with subsequent development of respiratory (and other) occupational diseases. In the UK, lawyer Edwin Chadwick’s Health Report (1842) documented links between occupational factors, poverty and health and led to introduction of the Public Health Act 1848. Medical literature evolved from case reports into descriptive occupational cohorts, with convincing patterns even absent formal statistical tools. Such examples include pneumoconiosis, which was described in coal miners in the 16th century, but which by the 19th century had been linked to coal dust inhalation. Miners’ ‘phthisis’ was prevalent and likely represented silico-tuberculosis—two conditions that even now are difficult to disentangle. The high mortality amongst miners led to employment of some of the UK’s earliest occupational physicians. In the Sheffield cutlery factories, metal grinders developed ‘Grinder’s Asthma’ – now known to be silicosis from high-speed grinding using sandstone or gritstone wheels – with high mortality from respiratory failure. In 1819, Sir Arnold Knight observed that almost no grinders lived beyond 50 years; subsequent analyses demonstrated their excess mortality compared to that of the general population. In 1832 Charles Thackrah identified ‘shoddy fever’ in textile workers who developed respiratory disease from inhalation of cotton and other dusts. Later called lyssinosis, perhaps mistakenly from ‘lyssa’, before being renamed byssinosis (from byssus from the fibres from which it arises). <h3>Conclusion</h3> Early observations of work-related lung disease laid the foundations for the plethora of occupational diseases more generally that we see today and the discipline of occupational medicine.