文章基本信息

标题：History of work-related diseases as a tool to protect the health of workers
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作者：Rajen N. NAIDOO ; Paul D. BLANC ; Kjell TORÉN 等
期刊名称：Industrial Health
印刷版ISSN：0019-8366
电子版ISSN：1880-8026
出版年度：2021
卷号：59
期号：4
页码：201-203
DOI：10.2486/indhealth.1-6
语种：English
出版社：National Institute of Occupational Safety and Health
摘要：Historical events and trends, despite being a cornerstone of public health generally, are often relegated to little more than a footnote in the biomedical literature. This is all the more so the case for occupational and environmental health, despite a long-held recognition that working conditions impact wellbeing, from classical Greek and Roman texts onward 1) . Indeed, attention to history not only has played a pivotal role in our understanding of how workplace exposures have affected the lives of workers and their families in the past, but also can better prepare us to intervene in current and anticipated future, emerging exposures. Recognition of workers’ health in the classical period was fragmentary and fleeting in medieval sources; texts that considered this subject more expansively finally began to appear in the 16 th century. In De Re Metallica, first published in 1556, Agricola describes the mine-dust related diseases of the miners, “… the dust which is stirred and beaten up by digging penetrates into the windpipe and lungs, and produces difficulty in breathing, and the disease which the Greeks call asthma” 2) . At nearly the same time, in 1555, a Swedish archbishop, Olaus Magnus, published his “History of the Nordic People.” In it, he states that harvesting farmers have to be careful of the dust, otherwise their lungs will be damaged and they will never eat what they have harvested 3) . A woodcut image from his book has been featured in Swedish currency ( Fig. 1). At the beginning of the 18 th century, Bernadino Ramazzini published (1700) and then later expanded (1713) his definitive text on occupational medicine, De Morbis Artificum Diatriba, which earned him the accolade of “Father of Occupational Medicine” 4, 5) . Fig. 1. An image from Magnus (1555) featured in Swedish currency The value of these seminal works is not just in their stories themselves, but also in recognizing the tools that they provide the discipline of occupational and environmental health. Passed down to us over centuries, they paved the way for a better understanding of how the nature of work itself, through the exposures generated, impacts the health of those employed, their families, and surrounding communities. In recording such observations these historical figures before us, and we today, can challenge conventional assumptions that all and any work-related ill-health is dependent solely on individual factors and personal risk. The inattentive worker suffers the accident; the smoking worker fall victim to disease. The observation that workers who may be experiencing adverse outcomes across a range of settings, linked by similar exposures, provides the impetus for collective interventions and allows us to build a generic framework to make work healthy. To a far greater degree than other fields of medicine, occupational and environmental health, is shaped by its technological contexts 6) . Changes over time in technology alter the risk that workers face: improved ventilation, engineering controls, or substitution to remove hazards provide the opportunity to reduce or eliminate risks, while the extraction or manufacture of new materials or the introduction of novel, hazardous technologies can increase risk 7) . For example, introduction of chlorine compounds in the bleaching process in the late 18 th and early 19 th century caused the immediate recognition of its associated adverse respiratory effects 8) . Steam powered machinery greatly increased silica dust generation linked to pneumoconiosis throughout the 19 th century and much of the 20 th 9) . Newly commercialized chemical innovations such as carbon disulfide in the 19 th century rubber industry and viscose rayon in the 20 th produced entirely new occupational neurologic diseases, from work-related psychosis to toxicant-cause parkinsonism 10) . Asbestos, a natural product, newly and widely introduced into commerce in the 20 th century, has left us a 21 st century legacy of mesothelioma 11, 12) . Despite the documented history and our increasing knowledge, epidemics of occupational lung disease persist 13) . The changing world of work drives ever-evolving worker risks, from slavery to forced labor to braceros and the kafala system for foreign workers, from feudal peasants to factory workers, from piecework to the “gig” economy. This evolution of work contributes to exposures in the broader environment, impacting on the health of the families of workers 14) . Furthermore, no biomedical field is as politically contested as occupational and environmental health. Because risk is modified through social processes that preferentially benefit certain sectors of society while the burden is borne by other sectors of society, this imbalance can only be redressed and optimal health achieved through social movements engaged in the political, legal, or public activist arenas 7, 15, 16) . Documenting and analyzing these social processes is as important to the history of occupational and environmental health as the time course of changing exposures and resulting injury and illness. Policies and services to protect the health of workers do not emerge by chance alone in different times and places nor do they subsequently weaken or disappear altogether, as illustrated in the case of the National Institute of Working Life in Sweden 17) . To ensure that there continues to be a systematic approach to documenting the history of occupational and environmental diseases, the International Commission on Occupational Health formed the Scientific Committee on the History of Prevention of Occupational and Environmental Diseases. The latter has been responsible for the organizing of periodic international conferences 7, 15, 16) as well as training programmes for researchers. In response to the COVID-19 pandemic, the Scientific Committee continued its activities through online platforms. The recent webinar with the intentionally ironic title, “Reconsidering the Politics of Occupational Health in a World without Industrial Work,” focusing on the theme of labour, health and the South African mining industry, past, present and future 20) . The Scientific Committee plans to host its next webinar in February 2022, provisionally planned to be hosted at Science Po, Paris and the seventh full and an “in-person” international conference tentatively to be held in Durban, South Africa in May 2024.