The International Conference on the History of Occupational and Environmental Health was attended by Occupational Hygiene (Ashutosh Mani), Occupational Medicine (Stephen Adeji) and Occupational Health Nursing (Jane Christianson, Marre Barnette, Tigist Zwede, Denise Miller).
A summary by Ashutosh Mani of sessions attended by the student follows:
Approaches to Methods in the History of Occupational Medicine:
An introductory Overview:
The history of occupational health has been characterized by a broad spectrum of approaches and methodologies that have enriched the discipline, stimulated debate and advanced understanding, e.g.
· Nationwide & regional approach to workers health:
I. United States
II. Great Britain
· Disease orientered approach
II. Miners and dust related diseases
· Gender approaches
I. Women and femininity
II. Men and masculinity
· Radical / Marxist approach
I. Who is to blame
II. How can blame be apportioned
III. Risk assessment
IV. Medical and lay knowledge
· Post modern approaches
I. Discourse and language
Nuts and Bolts of Archival research, Dorothy Porter, US.
There was an excellent presentation by the UCSF Library Archivist. The Archivist provided a listing of the materials and special collections offered at the UCSF library and also identified several online data bases that offered historical medical material such as Online Archive of California and WorldCat. The presentation identified other items worthy of archiving such as stories, pictures, and journals since these items document why things change as they do for practice. According to the presentation, evidence of social activity is open to interpretation and arguments and one should be able to defend their interpretation as a lawyer defending their case. Therefore researched evidence is a means of defense and one should thoroughly research a topic, which is often not the case.
The archivist invited the audience to contact the library when conducting historical research, not that the library is holder of all the information but they may help with “finding aids” which can be used like a “key word” source to find the material one is seeking. The archivist warned that not everything is available online because of lack of personnel, funding, and HIPAA laws. Remember as well that historians only study small pieces of the puzzle and one must seek out other aspects relevant to the topic and pursue these missing pieces. They advise starting with what is known and relevant and read everything available on the topic, then use this knowledge as a spring board to try to identify missing pieces.
The archivist warned not to discount Google; they believe this should be the first step. They also suggest talking to archivist directly. Many of these experts are in touch with other archivists who have knowledge of other collections of historical documents.
Oral History Methods, Ronnie Johnston and Arthur McIvor, Scotland UK:
Oral history is the collection of individual testimony about past experiences. The information obtained is then subjected to verification, analyses and placed in an accurate historical context for archival storage.
The first step is to formulate a central question, and then you proceed by conducting background research after careful project planning. The bulk of the information is obtained by interviewing the subject and this requires interviewer training. The interview is usually recorded by audio, video or both. The information obtained in the interview is then analyzed and verified against written documentation and prior historical documents. The results can then be organized, presented or stored archivally.
There are weaknesses in this methodology largely due to the inaccuracy of human memory. In spite of this weakness, oral history is still considered a powerful tool for historical documentation and can be relied upon to fill in the gaps left by written documentation and also add a personal touch to the historical account.
The most important step in doing biography is the discovery, interpretation and reconciliation of information sources e.g. audiotapes, letters, diaries etc. The SOAPSTone strategy for analyzing primary source documents developed by Susan Hoffman Fishman is a helpful tool in this regard.
S: What is the Subject of the piece?
O: What is the Occasion?
A: Who is the Audience?
P: What is the Purpose or reason the document was created?
S: Who is the Speaker?
T: What is the Tone of the piece?
Three types of questions when analyzing the written material
a. What questions can be answered directly from the facts
b. Requires analysis and interpretation of specific aspects of text.
c. Open ended questions that provoke discussion of issues
KEYNOTE – Occupation, Environment, and Health: A history of Interdependence, Christopher Sellers, US.
The keynote address reminds us that history of occupational medicine is still relevant given our current environmental problems caused by the BP oil spill; one should not lose site of history and learn from the past not to make similar mistakes. We should use the history as a starting point to future endeavors and cautiously look at new initiatives and their potential impact on culture, health, and science.
1B: The discovery of the migrant workers by psychiatry.
The session gave a closer look at the relevance of psychiatric problems among migrant workers in Belgium. The researcher ‘s presentation was related to the discourse between practice and the cultural experience of the migrant workers. The researcher believed the historical reflections of the psychiatric problems of the migrant workers in the 70s and 80s in Belgium were not reflective of the actual psychiatric problems and is conducting a historical review to help understand the true medical and cultural problems that were experienced by these workers.
1B: Hopes for the radiated body: occupational exposure and transnational networks in African uranium mines
The session highlighted the exposure to uranium that workers have experienced since the 1950s. The problems were ignored because of the revenue produced for the country. Workers were not given privilege to their medical records; to some, the miners’ lives were not considered valuable. Only through secret monitoring have health problems come to the forefront and little compensation has come to the miners so far.
1B: Hospitality workers’ exposure to secondhand smoke from 2006 to 2008 in Beijing, China
The session reported research findings from the WHO-sponsored smoking control program. The study of hospitality workers found that exposure to second hand smoke was somewhat reduced after governmental efforts to regulate smoking was implemented. Additional governmental restriction would be necessary to further reduce workers’ exposures; however, this important study could be replicated in the US especially in areas where there is a high prevalence of workers’ exposure.
1B: The health of sugar cane workers in Brazil
This occupational health nursing research study identified the occupational hazards workers in the sugar cane industry face in Brazil. Sugar cane is a very important industry in Brazil and the health of the workers is often overlooked. Workers are exposed to environmental as well as social factors as they perform their jobs. The findings from the study helped to identify a plan of interventions that could help to improve the workers’ living as well as work conditions. These interventions include work design, limiting injury exposures, reducing psychological stresses, and upgrading living conditions.
KEYNOTE TWO: Movements for Occupational and Environmental Health: History and Politics, David Rosner and Gerald Markowitz, USA.
The speakers’ discussion traced the history of occupational health from controlling accidents and
diseases through labor and union strikes to improve the working conditions to the newest focus
for concerted effort for the improvement of health. The current issues include the safety and health risks involved in consumer products.
3A. Pneumoconiosis Past and Present: Magic bullet or snake oil: aluminum dust and the prevention of silicosis in Western Australia, 1948-1963.
The presentation gave the history of the aluminum dust exposure and the enactment of the Mining Act in Australia to prevent quartz dust exposures of the underground miners. The presentation described how spraying aluminum dust was believed to reduce the miners exposure to quartz dust when actually the aluminum dust exposure brought about new carcinogenic risks; ultimately this was abandoned. The presentation also discussed black lung disease in the US and the development of federal compensation for those who suffered with pneumoconiosis.
3A: Grindstone city’s second product silicosis, the plausibility of export of dust disease
The presentation was of an occupational health nurse’s research into the history of the grindstone in Michigan. The researcher found little archived history about the making and exporting grindstones in Michigan. She conducted her research by taking oral histories from “old-timers” who had relatives who worked in the industry. The presentation was quite fascinating: dust diseases were not documented. The manufacturing was very important to the commerce of the city. The grindstone cottage industry was abandoned and the city’s connection to the production today is strictly as a tourist attraction.
KEYNOTE THREE: Occupational Health under the Nazis
The presented traced the occupational health and safety initiatives of the industrial workers in Nazi occupied Germany. Apparently, the Nazi government was very proactive in maintaining the health status of whites. Women were encouraged to perform breast self examinations and the health of children were also of great importance. Workplace safety of whites was also protected. Those who were considered inferior by the government were exposed to totally different treatment and little care was afforded to workers or their wives and children.
KEYNOTE FOUR: Working Life: A Poet’s Perspective, Philip Levine, US.
Philip Levine, a Pulitzer prize winner, read from contemporary poets whose work reflected the working class people. The readings were excellent and gave us insight into the struggles of those who work in situations that are detrimental to health and safety. Often workers knew their work made them ill, however, work ethics, religion, and society dictated their continued working to feed and support their families.
Through music, paintings, and poetry the plight of workers are often depicted. There were excellent examples of these venues displayed and one was reminded that these venues represent thousands of words left unspoken.
5A: Sea fevers: the management of infectious disease at sea in the British merchant fleet 1867-1967
Infectious disease has been well documented in the literature. In 1867 there was a requirement to carry a “Ship Captain’s Medical Guide” and a medicine chest on sea fairing vessels. Though quite crude by today’s standards this was useful. The ship’s medical guide experienced numerous revisions and the current guide includes diet, shore leaves, and occupational exposures.
5A: The history and impact of presumptive disability laws for Firefighters.
The researcher presented the brief history of federal level presumptive legislation leading up to the presumptive disability laws for firemen. These laws cover: Cancer, Heart Disease, and Infectious Disease. The presumptive status of the fireman’s exposures and high risks to these diseases afford them streamline payment and recognition of these diseases are work related. Since this topic is part of my dissertational work, I talked and networked with the researcher after her presentation.
5B: The struggle for lead poisoning recognition in the workplace in France: the turning point.
The presenter discussed the industrial exposure in France and the recognition of lead disease in workers. The turning point for recognition of lead as an occupational related disease began with what was termed the Penarroya case. The case was a seven year struggle of workers who sought compensation for lead exposures in the industry. The landmark case also opened the door to look at health from the viewpoint of the patients’ not just the practioner’s point of view.