Since its founding in 1636, Harvard University had remained an all-male institution. Then, in 1919, Alice Hamilton was appointed to the Harvard faculty. She did not seek the post. Rather, she was actively and enthusiastically recruited by leaders in the medical school. The 50-year-old physician had amassed expertise and an international reputation unmatched by anyone else. She was simply the best person for the job.
It was quite an accomplishment for a schoolgirl who had avoided science and math. And she was only halfway through her extraordinary career.
Early Years
Alice Hamilton was raised on her family’s estate in Fort Wayne, Indiana.1–4 Along with her three sisters, she was home-schooled because their parents were not satisfied with the local public schools.3,5 Her enlightened father wanted the girls as well educated as their brother. Her mother encouraged outdoor physical activity, where they studied nature first-hand.4
Most of Alice’s indoor hours were spent reading books from the family’s vast libraries, mostly the classics and history.4,5 She learned a “smattering” of math from a governess, her father taught her Latin, her mother spoke to the children in French, and she picked up German from their domestic servants. She taught herself Greek and Italian.5
At age 17, the Hamilton girls were sent to Miss Porter’s School for Young Ladies in Farmington, Connecticut, for two years.3–5 The curriculum was entirely elective, and Alice chose Latin, Greek, German, and philosophy. No math or science.3
Changing Course
While Alice was at Miss Porter’s School, Mr. Hamilton’s business ventures failed. He would still fund his children’s education, frugally, but he could no longer support the girls’ privileged lifestyle.4
Women had few professional options: teaching, nursing, or practicing medicine. Alice did not want to be tied to a school as a teacher, or work under a boss as a nurse. Instead, she chose medicine, because “I could go anywhere I pleased—to far-off lands or to city slums—and be quite sure that I could be of use anywhere.”5 Unfortunately, she lacked the science prerequisites, and her father doubted her sincerity. He was unwilling to invest in a pipedream. But Alice was serious and determined.
She studied physics and chemistry with a Fort Wayne high school teacher and learned biology on her own. Then, she enrolled in the local Fort Wayne College of Medicine, a “third-rate medical school,” where her father was on the Board of Trustees.2,3 It was one of the many small schools that flourished before the American Medical Association set medical education standards.
After a year there, where she took biology and anatomy courses, her father was convinced.3–5 He supported her admission to the University of Michigan, one of America’s leading medical schools and one of the few that was coed.3 Michigan’s rigorous curriculum emphasized science in both the clinic and laboratory. All of the professors, including pharmacologist John J. Abel and physiologist William Howell, had trained in Germany. (The following year, Abel and Howell moved to Baltimore to launch the new Johns Hopkins Medical School.)
The small Michigan university hospital was the consultation center for the entire state, and cases “were worked up with great thoroughness.”5 Throughout her career, Hamilton would credit her training in Ann Arbor for providing the scientific foundation for her work in toxicology and industrial medicine. She graduated in 1893, one of 14 women in a class of 47.6
Research Skills
Although Hamilton had decided on medical research, rather than clinical practice, a professor advised her to take a hospital internship to round out her training.3–5 Unfortunately, few internships were open to women. She spent two months at the Hospital for Women and Children in Minneapolis and nine months at the New England Hospital for Women and Children outside Boston.4,5
At that time, German universities offered the world’s best medical training and research. In 1895, Hamilton sailed to Germany, intending to study bacteriology and pathology—only to discover that the German universities did not admit women.3
After long and elaborate negotiations, the University of Leipzig professors permitted her to attend lectures, as long as she remained “invisible” to the male students. In Munich, all lectures were closed to women. However, because she wanted to do lab work, “no one objected to that.”5
When she returned to the U.S., she could not land a job, despite her German training. “The only thing to do was to keep on fitting myself for a career and hoping that some day an opening would come.”5 She enrolled at Johns Hopkins University, working under Simon Flexner, a young pathologist.2–4
Flexner assigned her to two cases and both were published. In addition to research, he taught her to thoroughly and critically review all relevant literature and ensure that those references were appropriately cited.5
The training at Johns Hopkins qualified her to teach pathology at the Women’s Medical School of Northwestern University.4,5 To maintain her research skills, she went to the University of Chicago 2–3 days each week, where she was assigned to study neuronal regeneration after injury in newborn rats.5
In addition to medical research, Hamilton had always been motivated by social issues and wanted “a life full of human interest.”4 She accepted the Northwestern post because it provided the opportunity to live and work as a resident volunteer in Chicago’s Hull House.2,3,5
Hamilton accepted the Northwestern post because it provided the opportunity to live and work as a resident volunteer in Chicago’s Hull House.
Life at Hull House
Founded in 1889 by Jane Addams and Ellen Starr Gates, Hull House was modeled after the settlement houses that originated in England in 1884.3,5 It was located in one of the poorest sections of Chicago, surrounded by dirty streets, poorly maintained sanitation, and bad streetlighting, and was home to many ethnic groups including Italians, Irish, Jews, and Greeks, among others.3
Addams’s goal was to give the House’s well-educated middle-class residents a chance to use their education in a socially beneficial way. In turn, poor immigrants received educational benefits and social services not otherwise available.1,3 Rather than direct relief, Hull House assisted their impoverished neighbors with developing skills, broadening employment opportunities, and gaining an improved quality of life.4
Northwestern provided Hamilton’s income, and Hull House’s residents and visitors gave her companionship, exciting new experiences, and intellectual stimulation.4,5 She had the opportunity to try her talents, to fail, and to build her confidence.4
Hull House also laid the foundation for her later achievements as a researcher, social scientist, reformer, and educator.4 “I should never have taken up the cause of the working class had I not lived at Hull House.”5
During the first five years, when she was teaching pathology to women students at Northwestern, Hamilton’s participation in settlement activities was limited to evenings and weekends.3,5
Her first contribution was opening a well-baby clinic, which soon expanded to take all children up to 8 years.3,5,7 She also founded the Alice Hamilton Club for teenage girls and a hygiene and nursing program.4
“I should never have taken up the cause of the working class had I not lived at Hull House.”
– Alice Hamilton
Typhoid Investigation
In the summer of 1902, Chicago faced one of its worst epidemics of typhoid fever.4,8 Most of the deaths occurred in the 19th Ward, where Hull House was located.4 Addams asked Hamilton, because of her bacteriology training, to investigate the possible causes. Hamilton surveyed the homes in the ward and found numerous outdoor privies, broken plumbing, standing water, and swarms of flies.5
She thought flies were the most likely vector, spreading the infection by landing on sewage and then on food. She collected flies from various locations, cultured the fly specimens, and found the typhoid bacillus.3,5
Hamilton reported her findings to the Chicago Medical Society and in a JAMA article.5,8 “I gained more kudos from my paper on flies and typhoid than from any other piece of work I ever did.”5
But, in fact, she soon discovered that flies had little to do with the localized outbreak. The primary cause was a broken 19th Ward sewer line, which contaminated the water supply for three days before the leak was discovered and repaired.4,5
Hamilton tried her best to downplay her report and explained over and over that her findings, though captivating, were not the primary cause.5 In all of her future research, she took an exceptionally cautious approach, drawing conclusions only when the evidence was irrefutable.4
Cocaine Contributions
On July 8, 1904, a distressed mother asked Hamilton to help with her cocaine addicted 13-year-old son.4 Unscrupulous druggists were giving free samples of cocaine to schoolboys, who quickly became addicted. Then, drug dealers would charge the boys, who were so desperate for a dose that they would commit crimes to get it.5
At first, the dealers’ defense lawyers successfully argued that they were actually dispensing alpha- or beta-eucaine, synthetic drugs that caused the same psychoactive effects but, unlike cocaine, were legal.4,5
To build a stronger case, a local policeman confiscated samples for analysis.5 In the absence of a definitive analytical chemistry test, a toxicologist at Rush Medical School taught Hamilton a sensitive bioassay. She took the results and testified in court that the samples were cocaine, because they dilated the pupils of lab rabbits. The eucaines did not.4,5
Soon, the defense lawyers began accusing Hamilton of animal cruelty.4,5 So, she tested the samples on herself. “I used to go around the laboratory with one wide eye and one narrow pupil till everyone was so used to it that they took no notice.”5
The defense lawyers began accusing Hamilton of animal cruelty. So, she tested the samples on herself.
Hamilton received public recognition for her efforts and recommendations. A Chicago Tribune story quoted “Dr. Alice,” along with the Illinois states attorney and a judge, as authorities on the need for stricter state drug laws.4 New legislation was passed, restricting the use of eucaines and providing more severe penalties.4,5
Hamilton’s cocaine work solidified both her role as an investigator and her reputation for integrity. And she was growing increasingly comfortable with it.4
Turning to Toxicology
In 1907, Hamilton became interested in industrial hazards. Hull House visitors shared their findings, such as the industrial exposure and toxicity of white phosphorus in match factories. She also met working class laborers who had been permanently disabled by carbon monoxide in steel mills, palsy from lead exposure, and pneumonia and rheumatism from stockyard work.4,5
She read everything she could find on the dangers faced by industrial workers and the innovative toxicology research that minimized those hazards.5 Those authors were all German, British, Austrian, Dutch, Swiss, Italian, or Spanish. None were American.
In 1908, she published an authoritative review article describing the various European countries’ safeguards to lower disability rates in industries that used lead, mercury, arsenic, and phosphorus. She also noted the lack of industrial research in the U.S.4
That article brought her to the attention of key social reformers who recognized the detrimental effect of industrial poisons on laborers’ wellbeing. One of them was Charles Henderson, professor of sociology at the University of Chicago. He knew Hamilton through his frequent visits to Hull House as well as her articles.4,5
Henderson persuaded the Illinois governor, Charles Deneen, to create the Illinois Commission on Industrial Diseases.1,4 In December 1908, Hamilton was appointed as one of five physicians, along with Henderson, an employer, and two members of the State Labor Department, to the Commission.5
The American Medical Association had never held a meeting on industrial medicine. It was not a recognized branch of medical science in the U.S., and no physicians in Illinois specialized in the field.5 No data on American industrial poisons existed.
In March 1910, the Commission directed a group of experts in bacteriology, chemistry, and pathology to survey industrial poisoning and the high industrial mortality rates in Illinois. It was the first such survey in the U.S. and was to be completed in one year.3–5 Hamilton served as the Illinois Survey’s medical director, and by her own account, this marked the beginning of her work in industrial toxicology.2,4,5
The Illinois Survey
Because no one knew which industries in Illinois used industrial poisons, they began by investigating the occupations that were obviously dangerous and hoped that, in the course of their work, they would discover others that were less well known.3,5
Hamilton chose to investigate lead, which was by far the most widely used toxin. The other team members investigated arsenic, brass, carbon monoxide, the cyanides, and turpentine.3–5
For the lead investigation, Hamilton was assisted by 20 young assistants, doctors, medical students, and social workers.5 They borrowed some methodology from previous researchers, but mostly, because of the complexity of the work, Hamilton developed her own “shoe leather epidemiology” methods.2,4
First, she studied the technical details of each industry. Then, in the field, she observed all the factory processes, carefully checked hospital and dispensary records, and interviewed labor leaders, doctors, and pharmacists. She also drew on the social and interpersonal skills she had honed at Hull House: meeting with workers in their homes, union halls, and even saloons, if necessary.2,3,5 Out of their bosses’ earshot, the workers spoke freely and candidly.5
Hamilton drew on the social and interpersonal skills she had honed at Hull House: meeting with workers in their homes, union halls, and even saloons, if necessary.
The team had no authority to enter any plant.5 But being a woman, she said, gave her a distinct advantage. “When I would go to the factory gates as a woman, and say, I am interested in the health and welfare of your workers and your children, they’d let me in…If a man showed up with the same request, they would not let him in.”6 And, she was usually treated courteously.5
Her team identified more than 70 industrial processes that exposed workers to lead poisoning.3,6 Some were already well known: paint manufacturing, enamelware, and pottery.1,4 But other hazards had not been reported in the European literature. These included freight car seals, coffin trim, brass founding, polishing cut glass, and wrapping cigars in “tinfoil,” which was actually made from lead.1,3,5,6
No quantitative blood assays or neurological tests existed to confirm lead poisoning. Remembering her typhoid fever investigation, Hamilton adopted a rigid standard. She counted a case of positive lead poisoning only if workers exhibited a clear “lead line” or a doctor had recorded the diagnosis at the time of an acute attack.5 (The lead line is a narrow blue line at the gum line produced by lead sulfide.)
It was pioneering work. “Everything I discovered was new.”5 And for that reason, she carefully checked and controlled every bit of data.2
The Survey’s Report of the Commission on Occupational Diseases was submitted to Governor Deneen in January 1911 and documented 578 cases of lead poisoning.4,6 It was the first report that proved a connection between occupation and illness.1,3
A few months later, the Illinois legislature passed a law requiring employers to implement new safety procedures limiting workers’ exposure to dangerous chemicals, provide monthly medical exams for workers in dangerous jobs, and report illnesses to the Department of Factory Inspection, which had prosecutorial authority.1,3
In a series of articles and speeches, Hamilton cited her lead results and pushed for recognition of lead poisoning as a real and serious medical problem. Other states soon followed Illinois’s example and also passed worker safety laws.5
The Illinois Survey was the first report that proved a connection between occupation and illness.
Making the Switch
During the Illinois Survey, Hamilton was selected by the governor’s Commission to present her results at the 4th International Congress on Occupational Accidents and Diseases in Brussels.4,6 While in Europe, she visited factories in Germany and England and saw that they had implemented safer working conditions than U.S. manufacturers.2,5
Charles Neill, Commissioner of Labor in the U.S. Department of Commerce, also attended the Brussels Congress.4,5 He had aided President Roosevelt in passing the Pure Food and Drug Act in 1906 and was impressed with Hamilton’s efforts to improve worker safety in Illinois.
When she returned home, Neill asked her to do nationally what she had done in Illinois: first, to document lead exposure, and then survey other industrial poisons.3–7 Thinking she would “never be more than a fourth-rate bacteriologist,” Hamilton eagerly accepted Neill’s invitation.5
“I have never doubted the wisdom of my decision to give up [the lab] and devote myself to work which has been scientific only in part, but human and practical in greater measure.”4
She became a federal agent under contract as a special investigator for industrial diseases.2–4 She worked independently, decided on the methods of investigation, and set the time devoted to each survey.5
Officially, she reported to Royal Meeker, Commissioner of Labor Statistics in the newly created Department of Labor. He never interfered or edited her work, was always ready to help, and always backed her findings.5 Hamilton liked that freedom and turned down job offers with larger salaries but more restrictions.2
“I have never doubted the wisdom of my decision to give up [the lab] and devote myself to work which has been scientific only in part, but human and practical in greater measure.” – Alice Hamilton
The Labor Department covered her expenses, but she received no salary.3–5 When each report was ready for publication, the government bought it at a negotiated price.5 Best of all, the work allowed her to continue living at Hull House, which remained her base throughout her extensive travels and investigations.3
The Federal Surveys
Her first federal investigation was white lead (lead carbonate), which was commonly used as a paint pigment. And she employed the same “shoe leather epidemiology” techniques that she used during the Illinois Survey.3,7
Hamilton would work with anyone, adjusting her strategy to maximize her effectiveness. She was also aware of the politics that influenced each manufacturer. When she faced pushback from owners or they concealed their factory processes, she solicited information from pharmacists, visiting nurses, undertakers, charity workers, and priests.4
As with her earlier findings, the main danger came from breathing air laden with lead, not from ingesting it.3,7 Meeker credited her lead poisoning studies with inducing manufacturers to eliminate or reduce exposure to lead.2
By 1915, Hamilton had become America’s foremost authority on lead poisoning and one of a handful of prominent specialists in industrial disease. She may not have been the first or only specialist, but she was the undisputed leading researcher in industrial toxicology and probably its only fulltime practitioner.3,4
After lead, Hamilton investigated specific products or industries that utilized multiple toxins, such as rubber, printing, paint, and dye manufacturing.2,3,5 Each investigation covered all states, taking one trade at a time. And always, she insisted on irrefutable evidence before drawing conclusions and making recommendations—the characteristic for which she was best known.4
Over time, her national surveys became more efficient, and her productivity was striking. She produced one federal report each year from 1911 through 1915 and a final one in 1919. They were all written at Hull House.4
The Personal Touch
From the beginning, Hamilton made it a practice to provide the factory’s decisionmakers with a summary of the dangers she had discovered before leaving the plant and prior to writing her report. Often, even with her limited engineering knowledge, she saw simple steps that could be taken and used the information she gathered to persuade them to minimize hazards.3,5
She dreaded conflict and, perhaps due to her Victorian upbringing, she was convinced that people of goodwill, once presented with the facts, would do the right thing.3 And they usually did. This same “personal touch” (i.e., verbal, on-site briefings prior to writing official reports) is still practiced by government inspectors and greatly facilitates implementation of corrective actions.
She was convinced that people of good will, once presented with the facts, would do the right thing. And they usually did.
Hamilton was a prolific writer and tailored the text of her reports and articles to maximize their impact on each target audience. The people she most wanted to influence were factory owners and managers. If they could be convinced to make the necessary changes, convincing physicians, politicians, and the general public would be both easier and less necessary.4
Physical Demands
Hamilton insisted on evaluating potential hazards from the workers’ perspective, no matter the personal risk. And her physical stamina was legendary. As one colleague observed, “At five foot three dressed in tweeds and black, she looked harmless, but she was not.”6
At an Arizona copper mine, she donned a helmet and overalls, stepped into a flimsy elevator cage without walls, and descended 800 feet into the mine. Then, she crawled on hands and knees across deep pits on an 80-foot ladder with rails “that were so far apart I felt sure I could fall between them if I slipped.”5
While investigating the fumes in a tank house that was used for leaching ore, she climbed to the third story of the crushing mill at night on “a sort of glorified ladder running up the outside wall.”5 The crushed ore was leached with dilute sulfuric acid in enormous tanks. She inspected them by walking on a narrow track that ran along the tanks’ edges, with “only a hand rail between me and that evil-looking, dark, bubbling acid.”5
In 1917, limestone cutters in Indiana and their labor unions demanded a federal investigation of a different type of industrial hazard. Although Hamilton’s expertise was industrial poisons, the Labor Department sent her to investigate the causes of stonecutters’ “dead fingers” when operating air hammers.5
Dead fingers syndrome (most commonly in the left hand) was a previously unknown medical condition. When she examined some of the stonecutters, Hamilton, as a physician, noted that their fingers did, indeed, look dead.5
So, she personally operated several air hammers. Holding the air hammer lightly with her right hand lessened the vibration. But her left hand, which was used to guide the cutting tool, needed to be continually held tightly, and this explained why the workers’ left hand suffered most from dead fingers.5
She concluded that tightly gripping the air hammer caused spastic anemia in the fingers. Vibration-induced vasomotor activity drained blood from the fingers, and cold weather worsened the condition by constricting the blood vessels.5
“At five foot three dressed in tweeds and black, she looked harmless, but she was not.” – Colleague of Alice Hamilton
War Work
When World War I broke out in Europe, the Labor Department shifted Hamilton’s priorities. U.S. manufacturers had largely imported aniline and other coal tar dyes from Germany for use in the rubber, textile, dye, and other industries.2,5 When the German blockade cut off that supply, U.S. manufacturers ramped up domestic production, creating a new set of hazards for American workers.5
Aniline was by far the most complicated industry Hamilton ever tackled, and she relied heavily on her organic chemistry training at the University Michigan. She said, though, that she needed to pick up even more chemistry to do a proper investigation.5
The U.S. government was officially neutral, but various American manufacturers clandestinely shifted production to picric acid, mercury fulminate, and other chemicals that were used to manufacture munitions and explosives.3,7
The government instructed her to investigate these rapidly expanding industrial practices. Hamilton’s dedication to social issues made her an ardent pacifist, and she struggled with how to work as a government agent investigating weapons manufacturers.2,4 She reconciled her views by focusing “not [on] the destructive side of war but on the saving of life.”2
As with her earlier investigations, Hamilton lacked formal authority to visit sites. Even more challenging, because secrecy surrounded the factories, she had no information on where to look.4 No one in Washington knew the munitions factory locations (or would reveal them).5 Her boss, Meeker, suggested that she rely on gossip. So, she followed up on rumors after visiting hospitals, bars, union halls, and peoples’ homes.4,5
For example, to investigate picric acid exposure, she gathered tips indicating a plant was located in the marshes of New Jersey. Once in the area, she looked for the characteristic giant plumes of yellow and orange picric acid smoke. When she spotted dozens of workers with yellow-stained work clothes, she followed them to the plant.5
In addition to picric acid, she investigated toxic exposures in munitions and airplane factories that were using potentially poisonous nitrogen oxide, benzine, nitrobenzene, toluene, ether, phenol, sulfuric acid, mercury fulminate, ammonia, nitronaphthalenes, and chlorine.4
After the U.S. entered the war in April 1917, the medical community’s interest in industrial toxicology and protecting workers dramatically increased.5,9 Hamilton’s workload also increased, and she needed help. The National Research Council appointed a committee, which she chaired, to study health problems arising from these poisons.2,5
For example, the committee provided resources for her to send a group of lab-trained medical students into TNT plants. They identified the earliest symptoms of TNT poisoning and documented the compound’s absorption, elimination, and pharmacokinetics.5
Hamilton’s reports on the dangers in war-related industries led to adoption of many new safe manufacturing practices.3,7 American medical journals began publishing articles reporting the effects of various chemical exposures, as well as methods to protect workers.5,9 The U.S. Public Health Service added a large division devoted to industrial medicine. “Industrial medicine had at last become respectable.”5
“A Very Unusual and Sound Person”
Toward the end of World War I, David L. Edsall, dean of the Harvard Medical School, invited Hamilton (now a widely recognized authority) to deliver a series of lectures at Harvard.4,5 Edsall also had an ulterior motive.
Harvard and the Massachusetts Institute of Technology had established a joint School for Health Officers in 1913. It was an interdisciplinary program that trained students on environmental health hazards and promoted public health. They soon realized that a major cause of disease and injury was the work environment, such as black lung in coal miners and silicosis from asbestos exposure. Industrial medicine and occupational health were becoming major fields, but the school had no one qualified to teach these subjects.4
For more than a decade, Hamilton had researched occupational health hazards, published a series of academic articles, and successfully advocated legislation to protect workers. Following her Harvard lectures, Edsall and his colleagues recommended that Hamilton be offered a faculty position.4 But the Harvard Board said, “no.” Harvard had always been an exclusively all-male institution.
Edsall and his colleagues stood firm. He told Harvard’s president, “Her studies stand out as being of unquestionably both more extensive and of finer quality than those of anyone else who has done work of this kind in the country. A very unusual, and sound person.”4
Harvard did appoint Hamilton an assistant professor of medicine, with three caveats. She could not enter the Faculty Club, get football tickets, or march in the commencement procession.5 For her part, Hamilton agreed to teach only one semester each year, so that she could continue her investigations and return to Hull House for part of the year.3,5,7
Hamilton began teaching industrial hygiene in September 1919. All of her students, of course, were men.5 In 1922, she moved to Harvard’s newly established School of Public Health, which continues to be among the top schools of public health in the U.S.3
Her years at Harvard were notable for her role as a mentor, colleague, and author. She later said that becoming the first female faculty member at Harvard was the highlight honor of her career.4,5
Hamilton later said that becoming the first female faculty member at Harvard was the highlight honor of her career.
Harvard Studies
Hamilton continued her official connection with the Department of Labor until March 1921, allowing her to complete the complicated study of aniline dye manufacturing and other studies begun during the war.5
During 1921–1922, she served as a factory inspector on a Harvard study of hat manufacturing. The industry had a long history of mercury poisoning, known as “Mad Hatter disease” (tremors, irritability, and other neurological symptoms). She found working conditions had significantly improved and credited the Public Health Service and industry leaders, who had already replaced mercury nitrate in most processes with nonpoisonous compounds.5
After her official connection with the Labor Department ended, Hamilton continued to monitor the “dangerous trades.” Previous poisons (lead, mercury, methanol, benzol, and carbon monoxide) were largely being controlled, but new dangers were emerging from the increased use of solvents.5
Her longstanding reputation as an expert on lead poisoning remained influential. In 1925, she prompted the federal government to hold a conference on the toxicity of the anti-knock gasoline additive, tetra-ethyl lead. She also continued to urge passage of worker compensation laws as “the best preventative measure for industrial diseases.”2 Employers would rather improve working conditions than pay large numbers of worker compensation claims.2
While at Harvard, Hamilton contributed articles to the Journal of Industrial Hygiene, edited at Harvard.2 She also wrote several books, including Industrial Poisons in the United States (1925) and her autobiography, Exploring the Dangerous Trades (1943). In 1934, she published Industrial Toxicology, the first textbook in the field.
Her most famous protégé, Harriet Hardy, later became the first female full professor at Harvard Medical School. In 1947, Hamilton decided to issue a second edition of her textbook but realized she needed help and asked for Hardy’s assistance.4 The book is now in its 6th edition (2015) and is known as Hamilton & Hardy’s Industrial Toxicology. It remains a comprehensive reference on all aspects of industrial exposures and toxicants.
Humanitarian Efforts
Hamilton traveled widely and was a strong advocate for humanitarian relief operations to address the widespread post-World War I poverty and disease in Europe, particularly in children. Although the U.S. did not join the League of Nations, Hamilton served on the League’s 20-member Health Committee from 1924 to 1930.4 She was the Committee’s only woman and the only industrial medicine expert.5
To address the desperate need for public health physicians and sanitation engineers, the Committee made arrangements for European governments to send selected healthcare candidates to the country offering the best instruction. The students pledged to return to their home countries and enter public health service.5
Hamilton had a number of these international students in her classes at Harvard, and “it was a pleasure to teach them, for they were so eager to learn.”5 In one class, she taught representatives from 13 countries.
Hamilton was never promoted at Harvard. She held only a succession of three-year appointments and remained an assistant professor until retirement at age 65.3,7
On September 1, 1935, she was appointed assistant professor of industrial medicine emeritus. Noting the “emeritus” designation (instead of “emerita,” the female form), Hamilton said the title was “a great honor and pleasantly ignores my sex.”5
Noting the “emeritus” designation (instead of “emerita,” the female form), Hamilton said the title was “a great honor and pleasantly ignores my sex.”
Senior Advisor
After her retirement from Harvard, Hamilton returned to the Department of Labor as a parttime medical consultant in the Division of Labor Standards. She conducted surveys, offered advice, attended conferences, testified at hearings, and brought neglected problems to the Department’s attention.5 Her most notable work during this period involved a study of poisons in viscose rayon manufacturing.2
Viscose rayon is pure cellulose and is produced by treating wood pulp or cotton fibers with carbon disulfide and other chemicals. In the course of production, fumes of hydrogen sulfide are emitted.
When Hamilton received inquiries from concerned nurses and realized that no medical data on affected workers existed, she decided to investigate the industry herself, at the age of 71. With the cooperation of state authorities and medical specialists in Pennsylvania, Hamilton compiled sufficient data to make a compelling case that carbon disulfide was a poison. As a result, laws granting compensation for occupational disease were passed, and Hamilton said “changes in this industry came more rapidly and completely than any in my previous experience.”5
By the 1940s, major reforms in industrial hygiene had been implemented. Hamilton claimed that industrial medicine had become one of the most important medical branches, and hundreds of doctors chose it as their specialty.5
Productivity
Hamilton remained remarkably resilient. When she and Hardy visited research sites that required climbing steps, the nearly 80-year-old Hamilton would “hop up the stairs as if she were about sixteen or seventeen, and I’d come panting behind her.”4
In her career, Hamilton published 15 federal government reports, 17 books and pamphlets, and 165 articles.4
In addition to the numerous advisory boards on which she served, Alice Hamilton was awarded five honorary degrees and several honorary memberships in professional societies. In 1947 she received the Albert Lasker Public Service Award for her leadership in industrial toxicology.10 She was Time magazine’s Woman of the Year in Medicine (1956) and inducted into the National Women’s Hall of Fame (1973) and the Connecticut Women’s Hall of Fame (1994).
Buildings at the National Institute for Occupational Safety and Health, Miss Porter’s School, and the University of Michigan were named in her honor. In 2002, the American Chemical Society installed a plaque at Hull House, naming it a National Historic Chemical Landmark, in recognition of Alice Hamilton’s pioneering work in industrial toxicology.3
Hamilton spent her later years in Hadlyme, Connecticut, where she died in September 1970 at the age of 101. Three months later, Congress passed the Occupational Safety and Health Act (OSHA).
