HISTORY OF OCCUPATIONAL

MEDICINEDr A Adeniran MBBS, MPH, FMCPH

Consultant Public Health Physician

Lagos State University (College of Medicine)

Nigeria

introduction•Slave labour was rampant in the olden times to build many of the wonders of the ancient world in Egypt, Rome & other places

•They were subjected to harsh conditions and many died in the process

•Things remained the same until 16th & 17th centuries when the early medical pioneers in the field of health & safety at work such as Georgius Agricola & Bernardino Ramazzini appeared on scene

Georgius Agricola: 1494 - 1555

•Devoted to working conditions in mines & industries especially mining accidents & illnesses

Bernardino Ramazzini: 1633 - 1714

•Physician & a professor of medicine

•Known as the father of occupational medicine

Industrial Revolution in Britain

•Started in the 18th century

•Resulted in the employment of women & children in factories who had to work long hours under unhealthy conditions

•Both medical practitioners & laymen fought against these ills

•Dr Charles Turner Thachrah (1795 – 1833) & lord Anthony Ashley Cooper (1801 – 1885) were foremost in these fight

•Dr Charles Turner Thachrah was known as “father of British industrial medicine”

Sir Thomas Morrison Legge (1863 – 1932)

•A doctor for the first time was involved when in 1898 sir Thomas Morrison Legge (1863 – 1932) was appointed the first British medical factory inspector•He introduced the idea of occupational disease notification especially lead•He stressed the preventive aspects of occupational health practices = Legge’s aphorism

Legge’s aphorism

1. Unless and until the employer has done everything, the workman can do next to nothing to protect himself, although he’s willing to do his part

2. If you can bring an influence to bear external to the workman-that is one over which he has no control-you will be successful; and if you cannot or do not, you will never be wholly successful

Legge’s aphorism Contd

3. Practically, all industrial lead poisoning is due to the inhalation of dusts & fumes, and if you stop their inhalation, you stop the poisoning

4. All workmen should be told something of the danger of the materials with which they come in contact, and not be left to find it out themselves- sometimes at the cost of their lives

UK regulations

•Factories act of 1833: regulate the labour of children & young persons in factories

•Factories act of 1884: provided for the appointment of a certifying surgeon who will examine young persons and declare them fit for factory employment

•Factories act of 1948: changed the name to appointed factory doctor

International Occupational Health

•The oldest international body in modern times concerned with global health & safety of people at work is ILO

International Labour Organization (ILO)

•Founded in 1919 under the league of nations

•Headquarters in Geneva, Switzerland

•Tripartite body made up of reps of government, employers and workers

• Its health work includes safety & health of all types of workers especially from chemical & other industrial risks, hygiene of seamen, social & medical insurance systems and workman’s compensation.

World health organization (WHO)

•Founded in 1948

•Headquarters in Geneva, Switzerland

• Its major stride in the field of occupation health (OH) started with the report of first joint WHO/ILO committee on occupational health in 1950 which stated the purpose of OH:

•OH should aim at the promotion & maintenance of the highest degree of physical, mental & social wellbeing of workers in all occupations……

OH in Africa/Nigeria

•Started with employment of GPs on either parttime or full time basis in few organizations such as UAC, John Holt etc

• In 1969, the Nigerian government requested & obtained a technical assistance from ILO on the development of occupational health

Conclusion

•OH is still evolving in Africa especially Nigeria, and there is still a lot of room for improvement

Questions

Further Readings

• Asogwa SE, A Guide to Occupational Health Practice in Developing Countries, 2007