OCCUPATIONAL DISEASE

any illness associated with a particular occupation or industry. Historically, the study of such diseases can be traced to the 16th-century writings of the metallurgist Georgius Agricola on the problems of improper ventilation in the metal-ore mines of Saxony. His contemporary, the physician Paracelsus, reported in 1567 that the so-called miners' disease was not, as was commonly believed, a punishment for sins but rather a malady caused by the inhalation of metal vapours. The publication in 1700 of Bernardino Ramazzini's treatise on diseases of workers (De morbis artificum diatriba) established industrial health as a concern of medicine. Ramazzini himself was later considered the founder of industrial medicine. During the 19th century the Industrial Revolution provoked the first serious awareness of diseases associated with the workplace. Long working hours, dim light, lack of fresh air, and potentially dangerous machinery took their toll in physical injuries and decreased resistance to such diseases as tuberculosis. The entrance into the industrial work force of women and children heightened society's awareness of the health hazards faced by all workers. In the late 18th and early 19th centuries, observers began to associate certain diseases with specific occupations; scrotal cancer among workers exposed to copper smelting, mercury poisoning in hat makers, and lung disease among textile workers were among the first such cause-and-effect relationships to be convincingly established. In the 20th century, innovations in manufacturing and the introduction of new and more toxic raw materials and chemicals compounded the problems of occupational health. Particular dangers, undreamed of by workers of the 19th century, were associated with exposure to radioactive materials; to the wide range of chemicals used in the manufacture of paints, plastics, herbicides, and building materials; and to electromagnetic radiation, notably in the form of X rays, ultraviolet light, microwaves, and infrared radiation. Many human cancers were shown to be related to occupational exposure: bladder cancer by exposure to aniline dye; lung cancers by inhalation of chromium compounds, radioactive ores, asbestos, arsenic, and iron; skin cancer by regular handling of certain products of coal, oil, shale, lignite, and petroleum; and skin cancer, leukemia, and bone cancer by exposure to radium and X rays. Pneumoconioseslung diseases associated with the inhalation of physical or chemical irritantswere also strongly linked to occupational exposure: asbestosis among mine and quarry workers; anthracosis, or black lung disease, in coal miners; byssinosis, or brown lung disease, in textile workers; berylliosis in persons working in the aerospace industry. Physical conditions in the workplace, such as extreme heat or cold, prolonged loud or high-pitched noise, and vibrations caused by tools and machinery, have also come to be recognized as contributing to the development of specific diseases or chronic health problems. Finally, emotional and psychological stresses associated with work, and their medical consequences, have taken their place in the growing list of diseases labeled as occupational. See also industrial medicine. any illness associated with a particular occupation or industry. Such diseases result from a variety of biological, chemical, physical, and psychological factors that are present in the work environment or are otherwise encountered in the course of employment. Occupational medicine is concerned with the effect of all kinds of work on health and the effect of health on a worker's ability and efficiency. Occupational diseases are essentially preventable and can be ascribed to faulty working conditions. The control of occupational health hazards decreases the incidence of work-related diseases and accidents and improves the health and morale of the work force, leading to decreased absenteeism and increased worker efficiency. In most cases the moral and economic benefits far outweigh the costs of eliminating occupational hazards. This article discusses general occupational health hazards and the disorders they cause, as well as the role of occupational health services. More detailed information about specific disorders can be found in the articles dealing with human diseases and the structures of the human body, such as cancer; infection; and respiratory disease. Additional reading Georg Agricola, Georgius Agricola De Re Metallica, translated by Herbert Clark Hoover and Lou Henry Hoover (1912, reprinted 1950; originally published in Latin, 1556), an illustrated 16th-century study of working conditions in the mines of central Europe; Bernardino Ramazzini, Diseases of Workers, translated and revised by Wilmer Cave Wright (1940, reprinted 1983; originally published in Latin, rev. ed., 1713), a classic; H.E. Sigerist, Historical Background to Industrial and Occupational Diseases, Bulletin of the New York Academy of Medicine, 12:597609 (November 1936), a brief account of the recognition of occupational disease; Donald Hunter, The Diseases of Occupations, 6th ed. (1978), a historical overview of occupational medicine; R.S.F. Schilling (ed.), Occupational Health Practice, 2nd ed. (1981), a detailed account of industrial hygiene and disease prevention practices; and Luigi Parmeggiani (ed.), Encyclopaedia of Occupational Health and Safety, 3rd rev. ed. (1983), a comprehensive reference source prepared under the auspices of the International Labour Organisation. Other comprehensive works include Marcus M. Key et al. (eds.), Occupational Diseases: A Guide to Their Recognition, rev. ed. (1977); Linda Rosenstock and Mark R. Cullen, Clinical Occupational Medicine (1986); and John C. Bartone, Occupational Diseases: International Survey with Medical Subject Directory and Bibliography (1983).Specific problems are studied in G. Kazantzis and L.J. Lilly, Mutagenic and Carcinogenic Effects of Metals, in vol. 1 of Lars Friberg, Gunnar F. Nordberg, and Velimir B. Vouk (eds.), Handbook on the Toxicology of Metals, 2nd ed., 2 vol. (1986); W. Keith C. Morgan and Anthony Seaton, Occupational Lung Diseases, 2nd ed. (1984); David F. Goldsmith, Deborah M. Winn, and Carl M. Shy (ed.), Silica, Silicosis, and Cancer: Controversy in Occupational Medicine (1986); Michael Alderson, Occupational Cancer (1986); Arthur F. DiSalvo (ed.), Occupational Mycoses (1983); Richard R. Weeden, Poison in the Pot: The Legacy of Lead (1984); A.J. Brammer and W. Taylor (eds.), Vibration Effects on the Hand and Arm in Industry (1982); and Diana Chapman Walsh and Richard H. Egdahl (eds.), Women, Work, and Health: Challenges to Corporate Policy (1980). Preventing Illness and Injury in the Workplace (1985), is a survey on the prevention and control of occupational disease in the United States prepared by the Office of Technology Assessment. George Kazantzis