Nothing in Alice Hamilton’s middle-class, midwestern upbringing hinted at the leading role she would play in the progressive movement as a pioneer in the field of occupational health and safety. Yet at an early age, she resolved to become a doctor because, as she wrote, “as a doctor I could go anywhere I pleased—to the far-off lands or to city slums—and be quite sure that I could be of use anywhere.”

This desire to be of use prompted Hamilton to earn a medical degree at the University of Michigan and to study bacteriology in Germany and at Johns Hopkins University. In September 1897, she fulfilled a longtime dream by moving into Hull House, where she, like most of the residents, worked a day job (at Northwestern University’s Medical School) and participated in settlement activities in the evenings and on weekends. Hamilton soon focused on the area of public health, particularly the link between occupation and illness.

Through her work, Hamilton came to believe that the poor health of many immigrants resulted from unsafe conditions and noxious chemicals, especially lead dust, in the industrial workplace. Employers insisted that lead poisoning resulted from workers’ failure to wash their hands before they ate, or they blamed workers’ ill health on alcoholism, but Hamilton disagreed. As she noted, the United States was far behind Europe in the field of industrial toxicology and in the regulation of dangers in the workplace. “The employers [here] could, if they wished, shut their eyes to the dangers their workmen faced,” Hamilton observed, “for nobody held them responsible, while the workers [largely immigrants] accepted the risks with fatalistic submissiveness as part of the price one must pay for being poor.”

In 1910, at the age of thirty-two, Hamilton was appointed to the newly created Occupational Disease Commission of Illinois, the first investigative body of its kind in the United States. For the next decade, she relied primarily on “shoe leather epidemiology” to explore the dangerous trades. With her assistants, she visited factories, read hospital records, and interviewed workers in their homes to discover instances of lead poisoning. “No young doctor,” she wrote, “can hope for work as exciting and rewarding.” Lead poisoning builds up slowly in the body, leading to colic and convulsions. Lead harms the nervous system, causing paralysis and wrist drop, a condition in which the hands and fingers cannot be extended. In cases of chronic lead poisoning, victims suffer from weight loss, constipation, high blood pressure, anemia, abdominal pain, fatigue, and premature senility. One of Hamilton’s case studies tells the grim story.

A Hungarian, thirty-six years old, worked for seven years grinding lead paint. During this time he had three attacks of colic, with vomiting and headache. I saw him in the hospital, a skeleton of a man, looking almost twice his age, his limbs soft and flabby, his muscles wasted. He was extremely emaciated, his color was a dirty grayish yellow, his eyes dull and expressionless. He lay in an apathetic condition, rousing when spoken to and answering rationally but slowly, with often an appreciable delay, then sinking back into apathy.

In 1911, Hamilton prepared a report making clear the connection between occupation and illness, leading to needed reforms in Illinois. In 1913, the U.S. commissioner of labor asked her to undertake a national study. “I had, as a Federal agent,” she wrote, “no right to enter any establishment—that depended on the courtesy of the employer. I must discover for myself where the plants were, and the method of investigation to be followed. . . . Nobody would keep tabs on me, I should not even receive a salary.” Using her intelligence and charm, she was rarely denied entry, and her experience at Hull House led her directly to the workers in their homes when she wanted the facts. Her powers of persuasion prompted several employers to institute reforms in their plants to cut down on lead dust.

By 1915, Hamilton had become the foremost American authority on lead poisoning and one of a handful of prominent specialists in industrial disease. When the Harvard Medical School began a program in industrial hygiene in 1916, Hamilton became the first woman invited to join the faculty. Until her retirement in 1935, she alternated a semester of teaching at Harvard with her field work “exploring the dangerous trades.” In her long retirement (she lived to be 101), she continued to blend her commitment to social justice and civil rights, political activism, and concern for the poorest workers. Hamilton died on September 22, 1970, three months before Congress passed the Occupational Safety and Health Act, institutionalizing the reforms she had fought for her whole life.

Questions for Consideration

Connect to the Big Idea

What kinds of social reforms did workers in other settlement houses address?