Manufacturing disease: Experts and the ailing American worker.

摘要

This dissertation is a history of occupational disease research in the United States from the late nineteenth century through the 1920's. In contrast to their German and British counterparts, American physicians and scientists paid little attention to occupational disease until the turn of the century. By the twenties, they had turned the study of occupational disease into a clearly defined professional field and developed methods that made possible a much more complete scrutiny of the causal link between environmental chemicals and disease. Paradoxically, the greater scale and intensity of their studies helped render their reports too technical for the untrained, even as their work reflected a magnified public concern about the health of workers. Lay people thereby lost control over the issue precisely when they were becoming more interested in it.; These developments took place over two generations. The earliest occupational disease researchers, including David Edsall and C.-E. A. Winslow, embraced their subject as one that led them out of the laboratory, into the social and political dramas of their era. The social scientists and physicians like Alice Hamilton who institutionalized these investigations aimed at a science accessible to all, that would foster legislation, social action, and ultimately, harmonious relations between the classes. Workplace controversy, the burgeoning chemical industry, and the growth of workmen's compensation helped shape the second generation of researchers. Exemplified by Cecil and Philip Drinker and Joseph Aub at Harvard, they headed back into the laboratory, intent on enhancing the certainty of their knowledge. The researchers aimed to purify the science of occupational disease by detaching it from political and social projects and rendering it incomprehensible to laymen. Through the resultant purity, along with the greater certainty of their methods, they hoped to maintain the authority and influence of their science. Though highly successful in applying the tools of chemical physiology and analysis to occupational disease, their ideology of objectivity undercut the practical effectiveness of their science and left it vulnerable to manipulation by scientific researchers with corporate sympathies, such as Robert Kehoe.