Section 1

Introduction andBackground

er 1

Outcome Competencies

After completing this chapter, the user should beable to:

1. Define underlined terms used in this chapter.

2. Describe the contribution of key individualsin the development of the industrialhygiene profession.

3. Explain the role the history of civilizationplays in the development of the industrialhygiene profession.

4. Discuss the role of governmental entities inthe history of industrial hygiene.

5. Describe how the public health professionrelates to industrial hygiene.

6. Implement the code of ethics in the practiceof industrial hygiene.

7. Explain the industrial hygiene paradigm ofanticipate, recognize, evaluate, and control.

8. Recognize the conflicts around "whom dowe serve?"

9. Recognize the need to continue to grow as aprofessional, not only to survive but also tobe of greater service to those in need of ourtalents.

Key Terms

Agricola American Academy of IndustrialHygiene American Board of Industrial Hygiene American Conference of Governmental IndustrialHygienists American Industrial HygieneAssociation certified industrial hygienist Codeof Professional Ethics for the Practice of IndustrialHygiene Ulrich Ellenbog Dr. Alice Hamilton Benjamin W. McCready Mine Safety and HealthAdministration National Institute forOccupational Safety and Health OccupationalSafety and Health Act Occupational Safety andHealth Administration permissible exposure lim-its Pliny the Elder Sir Percival Pott Bernardino Ramazzini Charles T. Thackrah threshold limit values

Key Topics

I. Origins of Industrial Hygienehap

tPrerequisite KnowledgeNoneC

II. The U.S. Experience

A. RecognitionB. EvaluationC. ControlD. Education and Professional

Organizations

III. Public Health Roots

IV. Professional Recognition

V. Professional Code of Ethics

VI. Whom Do We Serve?

VII. The Future

HPIn i

rPH, CIH, CSP, PESe

other author prior toRamazzini.(2, p. 1)

In 1713 BernardinoRamazzini publishedthe first book consid-

United States, in the Production of Disease, is generallyrecognized as the first work on occupational medi-cine published in the United States.(4)

The recognition of a causal link between work-disease was a key step in the practice of industrial hygiene.y physicians, from Hippocratesxtending into the twentieth

tionship between work and dis-tion of the profession. Butrds without intervention andhout prevention of disease,one as an industrial hygienist.n of the practice of the profes-o simultaneous developments the United States in the latey twentieth centuries. Althoughered a complete trea-tise on occupationaldiseases, De MorbisArtificum Diatriba.(3)From his own obser-vations he accuratelydescribed scores ofoccupations, theirhazards, and result-ing diseases.Although he recom-mended some specif-

place hazards and development of theThe observations bto Ramazzini and ecentury, of the relaease are the foundarecognition of hazacontrol, that is, witshould not qualify

The crystallizatiosion can be traced tin Great Britain andnineteenth and earl

Figure 1.1 A portrait ofBernardino Ramazzini thefather of occupational istory and hilosophy of dustrial Hyg

ction 1: Introduction and Background

Origins of Industrial HygieneAs with most professions, identifying the origin

of the practice of industrial hygiene is difficult, ifnot impossible. Might we designate as founders ofthe profession the early chroniclers of occupationalhazards and control measures such as Agricola,who, in 1556, described the prevalent diseases andaccidents in mining, smelting, and refining andprevention measures including ventilation? If so,the contributions of Plinius Secundus (Pliny theElder) should also be considered, who, in the firstcentury AD, wrote minimum refiners . . . enveloptheir faces with loose bladders, which enable themto see without inhaling the fatal dust.(1) If theirworks were read, thus influencing others to con-trol work hazards, they deserve the title, at leastposthumously, of industrial hygienists.

But what of those who simply identified prob-lems? It has been suggested a special honor in thefield of occupational medicine is owed toHippocrates (c. 460-370 BC). His writings includethe first recorded mention of occupational dis-eases (e.g., lead poisoning in miners and metallur-gists) and provide more frequent allusions to this

class of ailmentsthan those of anyic as well as generalmedicine.1ene

Vernon E. Rose, D

preventive measures (workers should cover theirfaces to avoid breathing dust), most of his controlrecommendations were therapeutic and curative.Although he had a vast knowledge of the litera-ture of his time, it has been suggested many of theworks he cited were of questionable scientificvalidity, and some were more myth than scienceand should have been recognized as such even inRamazzinis time. Because of his prestige thesefanciful notions must have received wide accep-tance . . . and because his book was so admired,Ramazzinis influence may have stifled progress inhis field during a period when great advanceswere being made in other branches of medicine.(2)

Nevertheless, his cautions to protect workersand his admonition to any doctor called on totreat patients of the working class to ask Whatoccupation does he follow? earned him theappellation Father of Industrial Medicine.(3)

For more than 100 years following Ramazziniswork, no significant additions to the literature onoccupational medicine were published. In the nine-teenth century two physicians, Charles T. Thackrahin England and Benjamin W. McCready in America,began the modern literature on the recognition ofoccupational diseases. McCreadys book, On theInfluence of Trades, Professions, and Occupations in thelegislation controlling working conditions was

4 _________________________________________________________________ Section 1: Introduction and Backgroundenacted in England beginning in 1802, the earlylaws were considered totally ineffective, as noproper system of inspection or enforcement wasprovided.(5) The British Factories Act of 1864,however, required the use of dilution ventilation toreduce air contaminants, and the 1878 versionspecified the use of exhaust ventilation by fans.The real watershed in industrial medicine andhygiene, however, came in the British Factories Actof 1901, which provided for the creation of regula-tions to control dangerous trades. The develop-ment of regulations created the impetus for investi-gation of workplace hazards and enforcement ofcontrol measures. In the United States in 1905 theMassachusetts Health Department appointedhealth inspectors to evaluate dangers of occupa-tions, thus establishing governments role in thenascent field of occupational health.

It has been suggested industrial hygiene didnot emerge as a unique field of endeavor untilquantitative measurements of the environmentbecame available.(6) But in 1910 when Dr. AliceHamilton went, in her own words, as a pioneerinto a new, unexplored field of American medi-cine, the field of industrial disease,(7, p.1) workerexposures to many hazards (e.g., lead and silica)were so excessive and resulting diseases so acuteand obvious, the evaluation step of industrialhygiene practice required only the sense of sightand an understanding of the concept of cause andeffect. This champion of social responsibility forworker health and welfare not only presentedsubstantial evidence of a relationship betweenexposure to toxins and ill health, but also pro-posed concrete solutions to the problems sheencountered.(8) On an individual basis Dr.Hamiltons work, which comprised not only therecognition of occupational disease but also theevaluation and control of the causative agents,should be considered as the initial practice ofindustrial hygiene, at least in the United States.

It should be appreciated many of the earlypractitioners of industrial hygiene were physi-cians who, like Alice Hamilton, were interested

not only in the diag-nosis and treatmentof illnesses in indus-trial workers, butalso in hazard con-trol to prevent fur-ther cases. Thesephysicians workingwith engineers andother scientists inter-ested in publichealth and environ-mental hazards tookthe knowledge andinsights developedover several millen-nia from

Figure 1.2 Dr. Alice

Hippocrates toHamilton.Ramazzini, Thackrah and McCready, and beganthe process of deliberately changing the workenvironment with the goal of preventing occupa-tional diseases.

What or who then can be designated as repre-senting the origin of the profession? Is there anyone person who deserves the title Founder ofIndustrial Hygiene? Certainly, if the name of oneindividual is sought, Alice Hamilton shines like abeacon. But think back to more than 10,000 yearsago at the end of the Stone Age, when occupa-tions began to form with the grinding of stone,horn, bone, and ivory tools with sandstone, andwith pottery making and linen weaving. Envisiona thoughtful worker who suffered from the mus-culoskeletal problems associated with grinding,made adjustments to his working conditions, andpassed the ideas on to co-workers. Recognizingergonomic problems and solving them wouldqualify him as an early industrial hygiene practi-tioner. If this scenario can be imagined, perhaps itis also conceivable that tens of thousands of yearsago there was a huntress who recognized thesigns and symptoms of anthrax in the bison hergroup had killed and who made the connectionbetween earlier kills of diseased animals and sick-ness in members of her tribe. If she then warnedher companions of the hazard involved andsought to avoid diseased animals, would she notqualify as one of the founders of the industrialhygiene profession?

If the basic philosophy of the profession isunderstoodprotection of the health and well-being of workers and the public through anticipa-tion, recognition, evaluation, and control of haz-ards arising in or from the workplacethen therich tapestry that chronicles the history of indus-trial hygiene can be imagined. It began when oneperson recognized a work hazard and took stepsnot only for self-protection, but also for protectionof fellow workers. This is the origin and essenceof the profession of industrial hygiene.

The U.S. ExperienceThe events presented in Table 1.1 illustrate the

history of industrial hygiene. Although the con-cepts that formed the art and science of industrialhygiene flourished in many countries, the UnitedStates provided the fertile ground for the devel-opment of the profession as it exists today.

As the industrial revolution, propelled by theCivil War, progressed in the nineteenth century,individuals began to observe serious health andsafety problems (recognition). They also consid-ered the effects on workers (evaluation) and madechanges in the work environment (control) tolessen the effects observed. Although these effortsmay have resulted in improved worker healthand safety, their application was not recognized

as the practice of industrial hygiene until the

___________________________________________________________5History and Philosophy of Industrial Hygiene_____

early 1900s. In addition to this chronological list-ing, these activities also illustrate the concepts ofthe professionthat is, recognition, evaluation,and controlwhich may help to better describetodays practice of industrial hygiene.

RecognitionRecognition, as well as anticipation, of the

potential for occupational health problems is aprerequisite for the implementation of industrialhygiene activities. Therefore, early attempts atdefining the scope and magnitude of occupationalhealth problems were very important to the subse-quent efforts of evaluation and control. The IllinoisOccupational Disease Commissions survey of theextent of occupational health problems in the stateof Illinois in 1910 was the first such survey under-taken in the United States.(9) Dr. Alice Hamiltonwas a member of the commission and served as itschief investigator. Two years later she presentedher survey of lead hazards in American industry.Although other states formed commissions toidentify problems, it was many years before therewas an organized effort to develop information asto the scope of the industrial health problems inthe working population in America.

The Division of Industrial Hygiene in theUnited States Public Health Service (USPHS),later to become the National Institute forOccupational Safety and Health (NIOSH), revivedinterest in assessing the extent of health hazards.Beginning in the 1960s the USPHS conducted sur-veys in a number of states and metropolitan areasfor the purpose of identifying the extent of work-er exposure to occupational health hazards. Theresults of these studies were used to determinethe need for occupational health specialists in thegovernmental agencies and for setting prioritiesfor government inspection and consultation pro-grams.(10) These efforts culminated in NIOSHsNational Occupational Hazard Survey conductedin the early 1970s. This project involved walk-through surveys in more than 5000 randomlyselected workplaces in the United States and forthe first time provided a comprehensive assess-ment of workplace hazards and the extent of theircontrol for a large segment of the working popu-lation. A subsequent NIOSH study, the NationalOccupational Exposure Survey, provided addi-tional insight on the magnitude of worker expo-sure to hazards.(11) These studies were used byNIOSH to set priorities for research and for devel-oping recommended standards.

Concurrent with the development of occupa-tional hazard information was the recognition thatinformation on the incidence of occupational ill-nesses in the U.S. work force was not available.Prior to the passage of the Occupational Safetyand Health Act (OSH Act) in 1970, the sources ofoccupational disease incidence data were limited

primarily to the information developed in severalTable 1.1 Historical Events in Occupational Health and Safety

1,000,000 BC Australopithecus used stones as tools and weapons. Flint knappers suffered cuts and eye injuries; bison hunters contracted anthrax.

10,000 BC Neolithic man began food-producing economy and the urban revolution in Mesopotamia. At end of Stone Age, grinding of stone, horn, bone, and ivory tools with sandstone; pottery making, linen weaving. Beginning of the history of occupations.

5000 BC Copper and Bronze Agemetal workers released from food production. Metallurgythe first specialized craft.

370 BC Hippocrates dealt with the health of citizens, not workers, but did identify lead poisoning in miners and metallurgists.

50 AD Plinius Secundus (Pliny the Elder) identified use of animal bladders intended to prevent inhalation of dust and lead fume.

200 AD Galen visited a copper mine, but his discussions on public health did not include workers disease.

Middle Ages No documented contributions to the study of occupational diseases.

1473 Ellenbog recognized that the vapors of some metals were dangerous and described the symptoms of industrial poisoning from lead and mercury with suggested preventive measures.

1500 In De Re Metallica(1556), Georgius Agricola described every facet of mining, smelting, and refining, noting prevalent diseases and accidents, and means of prevention including the need for ventilation. Paracelsus (1567) described respiratory diseases among miners with an excellent description of mercury poisoning. Remembered as the father of toxicology.All substances are poisons . . . the right dose differentiates a poison and a remedy.

1665 Workday for mercury miners at Idria shortened.

1700 Bernardino Ramazzini, father of occupational medicine, published De Morbis Artificum Diatriba, (Diseases of Workers) and examined occupational diseases and cautions. He introduced the question, Of what trade are you?

1775 Percival Pott described occupational cancer among English chimney sweeps, identifying soot and the lack of hygiene measures as a cause of scrotal cancer. The result was the Chimney-Sweeps Act of 1788.

1830 Charles Thackrah authored the first book on occupational diseases to be published in England. His views on disease and prevention helped stimulate factory and health legislation. Medical inspection and compensation were established in 1897.

Figure 1.3 A portrait ofParacelsus (1567) who isremembered as the fatherof toxicology.

6 _________________________________________________________________ Section 1: Introduction and Background

1969

1970

1977

1992present

1995Coal Mine Health and Safety Act.

Occupational Safety and Health Act.

Federal Mine Safety and Health Act.

Efforts to significantly amend OSHAct.

Revised Professional Code of Ethics adopted by all four industrial hygiene associations.the OSH Act gave the U.S. Department of Laborthe responsibility for developing a national occu-pational injury and illness reporting system. Thesystem includes a requirement for employers torecord occupationally related injuries and illness-es with separate categories for dermatitis; lungdisorders due to dusts; lung disorders due tochemicals; systemic effects; physical agent disor-ders; repeated trauma disorders;, and all otherillnesses. A sample of employers report theirexperience, which is used to develop state andnational estimates. For many years skin disorderswere the most frequently reported illnesses, but inthe late 1980s repeated trauma, which includesmusculoskeletal problems such as carpal tunnelsyndrome and back disorders, became the leadingcategory of illness.

It is widely recognized occupational diseasesare underreported in this system for a variety ofreasons beyond a conscious decision not torecord. Many occupationally related diseases alsocan be caused by nonoccupational exposures (e.g.,lung cancer and tobacco). Also, when a diseasehas a long latency period before it can be diag-nosed, its relationship to early work exposuresmay be obscure. In some cases work factors mayworsen a preexisting condition. And, as a relative-ly new discipline, the recognition of workplace ill-nesses can be hampered by a limited knowledgebase. It is unlikely a workers illness will be rec-ognized as work related if epidemiologic or toxi-cologic studies have not documented cause andeffect, that is, exposure to a toxin and illness.

Concurrent with studies to estimate hazard dis-tribution and incidence of occupational illnesswere specific epidemiologic studies designed tolink cause and effect. Two key studies firmlyestablished the specialty of occupational epidemi-ology first practiced by Sir Percival Pott in the lateeighteenth century. One study could be consid-ered an extension of his work, which linked abyproduct of coal combustion (soot) with scrotalcancer in chimney sweeps. In the twentieth-centu-ry study the epidemiologists who looked at themortality distribution of U.S. steelworkers founda population whose health was better thanexpected when compared with the overall U.S.population (the healthy worker effect).(12)However, when subpopulations, specifically cokeoven workers, were considered, excesses of respi-ratory and kidney cancer deaths were uncovered.The complexity of environmental exposures sur-rounding these workers precluded the identifica-tion of any one specific causative agent and led tothe designation of coal tar pitch volatiles as thesurrogate hazard to be controlled. Documentationof excess mortality in coke oven workers led topromulgation of the Occupational Safety andHealth Administration (OSHA) regulation oncoke oven emissions.(13)

The second major occupational epidemiologicstudy focused on asbestos. Reports of cases ofstate health and labor departments such asCalifornia, New York, and Michigan. TheCalifornia reports of occupational illnesses werethought to be the most comprehensive and reli-able; consequently, they often were used for pro-jections of the national problem. The passage of

Table 1.1 (continued) Historical Events in Occupational Health and Safety

1900s Dr. Alice Hamilton investigated many dangerous occupations and had tremendous influence on early regulation of occupational hazards in the United States. In 1919 she became the first woman faculty member at Harvard University and wrote Exploring the Dangerous Trades.

19021911 Federal and then state (Washington) legislation covering workers compensation. By 1948 all states covered occupational diseases. First survey in the United States of the extent of occupational disease conducted by the Illinois Occupational Disease Commission. Massachusetts appointed health inspectors to evaluate dangers of occupations.

1910 First national conference on industrial diseases in the United States.

1912 U.S. Congress levied prohibitive tax on the use of white phosphorus in making matches.

1913 National Safety Council organized. New York and Ohio established first state industrial hygiene agencies.

1914 USPHS organized a Division of Industrial Hygiene and Sanitation. American Public Health Association organized section on industrial hygiene.

1916 American Association of Industrial Physicians and Surgeons formed. American Medical Association held first symposium on industrial hygiene and medicine.

1922 Harvard established industrial hygiene degree program.

19281932 Bureau of Mines conducted toxicological research on solvents, vapors, and gases.

1936 Walsh-Healy Act required companies supplying goods to government to maintain safe and healthful workplaces.

1938 National (later American) Conference of Governmental Industrial Hygienists formed.

1939 American Industrial Hygiene Association organized. American Standards Association and ACGIH prepared first list (maximum allowable concentrations) of standards for chemical exposures in industry.

19411945 Expanded industrial hygiene programs in states.

1941 Bureau of Mines authorized to inspect mines.

1960 American Board of Industrial Hygiene organized by AIHA and ACGIH.

1966 Metal and Nonmetallic Mine Safety Act.

1968 Professional Code of Ethics drafted by AAIH. Code adopted by all four industrial hygiene associations by 1981.

History and Philosophy of Industrial Hygiene________________________________________________________________7lung disease due to asbestos exposure began toaccumulate beginning in 1906. By 1938 the USPHShad studied workers in asbestos textile plants andhad recommended a tentative limit for asbestosdust in the textile industry of 5 million particlesper cubic foot (mp/ft3), determined by theimpinger technique.(14) In the late 1940s workersmanufacturing asbestos products in England wereobserved to have a frequency of bronchogenic can-cer greater than expected as compared with thegeneral male population. These findings led to thestudy of U.S. insulation workers exposed to air-borne asbestos fibers and the documentation of anexcess of bronchogenic cancers in this popula-tion.(15) These and other studies led to the promul-gation of OSHAs first emergency temporary stan-dard in 1971 and first complete health standard(16)in 1972. The hazards of asbestos also firmly estab-lished toxic tort (product liability) lawsuits as aforce to control workplace hazards.

In occupational epidemiologic studies, one testfor concluding the existence of cause and effect isthe presence of an exposure-response relationship.When industrial hygiene exposure data are notavailable, substitute measures such as high,medium, and low are relied on. However, wherehistorical exposure data are available or can beestimated, risk-assessment evaluation can be moreobjective and lead to occupational exposure limitsthat define the expected reduction in the incidenceof illness. Use of risk-assessment tools to estimateillness reduction from lowering workplace expo-sure limits has been applied by OSHA since thebenzene standard(17) was promulgated in 1987.

At the present time industrial hygiene efforts inthe United States are guided by hazard ratherthan disease considerations. At the national andstate levels information on worker exposure tohazards by various industry categories is avail-able and is used to set priorities for governmentalinvestigations and research. Within industry theconcept of hazard recognition vis--vis illness isseen as important in developing programsfocused on prevention. Consequently, the empha-sis on anticipation and recognition of potentialoccupational health problems primarily involvesthe industrial hygiene practice of hazard or riskdetermination, in which hazard or risk combinesthe inherent toxicity of a substance or agent andthe likelihood for exposure.

EvaluationAlthough the use of the senses, including sight,

smell, and sometimes taste, were important in theearly years of the practice of industrial hygiene,the transition to a science required the develop-ment of more sophisticated sampling methods toaid in the evaluation of problems. One of the firstsuch sampling methods, developed by researchersat Harvard University in 1917, was the detector

tube (color-indicating device) for measuring air-borne levels of car-bon monoxide.(18)Dust exposure inmining and otherindustries was anearly industrialhygiene concern andgenerated the needto measure airborneconcentrations ofparticulates. In 1922Greenberg andSmith developedtheir impinger, andin 1938 Littlefieldand Schrenk modi-fied the design anddeveloped themidget impinger.(6)The subsequentdevelopment of thehand-operatedpump for dust sam-pling with midgetimpingers gave theindustrial hygienistflexibility in collect-ing breathing zonesamples to bettercharacterize occupa-tional exposures.The associated ana-lytical method ofcounting and sizingparticles with amicroscope, thusyielding concentra-tions of million par-ticles per cubic foot,was the standardmethod for charac-terizing particulateexposures until the application of the membranefilter in 1953 allowed exposures to be evaluatedon a mass per volume basis.(19)

The early application of impingers, using wateras the collection medium, was for dust sampling.Gas and vapor monitoring required the develop-ment of a variety of sampling media for use inmidget impingers and later in the more efficientfritted-glass bubblers. In 1970 a major break-through in sampling methodology occurred whenNIOSH developed the charcoal sampling tubeand provided support for development of the bat-tery-operated pump.(20) Concurrent with thedevelopment of these active sampling deviceswas Palmess work in 1973 on a passive dosimeterfor nitrogen dioxide. Subsequent commercializa-tion of the passive dosimeter concept led to amodest revolution in the scope of industrialhygiene sampling. These technological develop-ments greatly enhanced the art of personal sam-

Figure 1.4 A London chim-ney sweep (mid-1700s).

Figure 1.5 A Germanchimney sweep (mid-1700s).Note the tight-fitting, person-al protective clothing. Therewere no reported problemsof scrotal cancer among theGerman workers.

8 _________________________________________________________________ Section 1: Introduction and Backgroundpling and allowedthe industrialhygienist evengreater flexibility incharacterizing work-er exposure to haz-ardous conditions.(21)

At the same timesampling methodswere being devel-oped, the applica-tion of new analyti-cal technology to

industrial hygiene assessments was taking place.In the early 1930s technical articles described theuse of gas chromatography for evaluating sam-ples of airborne organic vapors. In later yearsother forms of technology were employed at arapid pace. Today hygienists use atomic absorp-tion, high-pressure liquid chromatography, massspectroscopy, and other sophisticated instrumen-tation and techniques.

As industrial hygienists learned more about theenvironment and further refined their techniquesfor measuring hazardous exposures in the work-place, the need to compare measurements withunacceptable exposure levels became apparent. In1929 several industrial hygienists in the USPHSrecommended upper limits for exposure toquartz-bearing industrial dusts based on studiesin the Vermont granite industry.(22) The publica-tion of workplace exposure limits was greatlyenhanced by the formation of the AmericanConference of Governmental Industrial

Hygienists (ACGIH)in 1938. In 1939ACGIH, in coopera-tion with theAmerican StandardsAssociation, devel-oped the first list ofmaximum allowableconcentrations(MACs) to limitworker exposure toairborne contami-nants. In 1943 Dr.James Sterner pub-lished the MAC listin IndustrialMedicine, followedby Warren Cookspublication (also inIndustrial Medicine)in 1945 of a MAClist for 140 sub-stances with sourcesand bases for therecommendations.In 1947 ACGIHbegan publication ofits MAC list and

Figure 1.6 A woodcut ofGeorgius Agricola, author ofDe Re Metallica.

Figure 1.7 Woodcutsdepicting foundry workers at

a smeltery.converted to the term threshold limit values(TLVs) in 1948.(23) Today, even with majorresponsibility for standards-setting vested withthe federal government, the role of ACGIH indeveloping exposure guidelines is a valuable toolin protecting the health of workers.

ControlControl of occupational health problems can

take several forms. Industrial hygienists mostoften employ the technological approach, that is,engineering measures such as substitution withless hazardous substances or local exhaust venti-lation. When these techniques cannot eliminate orreduce the hazard sufficiently, administrativemeasures and personal protective equipment alsoare relied on. These concepts, which can also bereshuffled to the categories of control at thesource, in the environment, and at the worker,were first introduced, in a comprehensive form, in1473 by Ulrich Ellenbog.(6) He suggested threemethods of control still applied today: Use drycoal instead of wet coal to avoid production oftoxic fumes, work with windows open, andcover the mouth to prevent inhalation of noxiousfumes.(6) The history of two specific controlmeasures, industrial ventilation and respirators,should be of special interest to practicing industri-al hygienists.

Agricola, in his 1561 publication De ReMetallica, emphasized the need for ventilation ofmines and included many illustrations of devicesto force air below ground.(24) The first recordeddesign of a local exhaust ventilation system, how-ever, was by the Frenchman DArcet in the early1800s. To control noxious fumes, he led anexhaust duct from a hood at a furnace into achimney with a strong draft. The induced airflowcarried the fumes away from the source.

The British window tax of 1696, which was notrepealed until 1851, resulted in dark and under-ventilated factories. The first legislation regulatingconditions in factories was the British Factory andWorkshops Act of 1802, which required ventila-tion in workplaces. The Act of 1864 required suffi-cient ventilation to render gases and dusts asharmless as possible, but it was 1867 before aninspector was given authority to require fans orother mechanical devices to control dust.Although the British Factories Act of 1897required the use of ventilation for certain opera-tions, little was published on techniques until thelate 1930s. It has been suggested the main reasonsfor the lack of published information probablywere attempts on the part of industry to keeptheir trade secrets, and the lack of interest on thepart of universities and colleges.(6) In 1951ACGIH published the first edition of IndustrialVentilation: A Manual of Recommended Practice. Themanual, now in its 23rd edition, is a compilationon design, maintenance, and evaluation of indus-

History and Philosophy of Industrial Hygiene________________________________________________________________9trial exhaust ventilation systems. The manual hasfound wide acceptance as a guide for officialagencies, as a standard for industrial ventilationdesigners, and as a textbook for industrialhygiene courses.

As noted earlier, the concept of respiratory pro-tective devices (e.g., animal bladders) to reduceexposure to airborne contaminants dates back toat least 50 A.D. There is no record of workeracceptance of these early respirators nor of theireffectiveness as personal protective devices, but inall likelihood they did not score high in either cat-egory. The same can probably be said for otherdevices that have fallen by the wayside over thecenturies: scarves, shawls, handkerchiefs, magnet-ic mouthpieces, magnetized screens, wet sponges,and breathing tubes. It should come as no sur-prise Leonardo da Vinci (14521519) consideredthe problems of respiratory protection when herecommended the use of a wet cloth to protectagainst chemical warfare agents. He also devisedtwo underwater breathing devices, one being asnorkel consisting of a breathing tube with anattached float.(25) Ramazzini wrote a criticalreview of the inadequate respiratory protectionavailable in his time (c. 1700). Shortly thereafterthe first descriptions appeared of the ancestors oftodays atmosphere-supplying devices, such asopen- and closed-circuit self-contained breathingapparatus and hose masks.

In the 1800s the realization of the separatenatures of particles and gases or vapors led togreat advances in respirators. In 1814 a particu-late-removing filter encased in a rigid containerwas developed and was the predecessor of mod-ern filters for air-purifying respirators. The abilityof activated charcoal to remove organic vaporsfrom air was discovered in 1854 and was almostimmediately put to use in respirators. The mostrapid advances in respiratory protection grew outof the use of chemical warfare agents in WorldWar I. Research on gas sorbents for use in militarymasks and high-efficiency particulate filters wasaccelerated by the introduction of different gasesand highly toxic particulate matter on the battle-field. Since the 1920s the major advances in respi-rator design include resin-impregnated dust fil-ters, which use electrostatic force fields to removedust particles from air, and the ultra high-efficien-cy (HEPA) filter made from paper containing veryfine glass fibers.(25) Other advances include theuse of more flexible and durable (synthetic) mate-rials for facepieces and the combination of a bat-tery-operated air mover with a respirator for useas a lightweight air-supplied respirator (i.e., thepowered air purifying respirator).

A different approach to control involves theapplication of governmental powers to assist,motivate, and require employers to maintain safeand healthful work environments. In the UnitedStates, legal protection of industrial workers was

for the most part, until 1971, the responsibility ofstate and local gov-ernments. The devel-opment of state gov-ernmental responsi-bilities in occupa-tional health tookplace as early as1905, when inspec-tors in theMassachusettsHealth Departmentinvestigated work-place dangers. In1913 the first formalgovernmental pro-gram, the New YorkDepartment ofLabors Division ofIndustrial Hygiene,was established. In1914 the Office ofIndustrial Hygieneand Sanitation wasformed in theUSPHS and subse-quently underwentmany reorganiza-tions before becom-ing NIOSH in1971.(26)

During the 1920sand early 1930sindustrial hygieneactivities were initiat-ed in five state healthdepartments(Connecticut, Maryland, Mississippi, Ohio, andRhode Island). The Social Security Act of 1935 madefederal resources (money and industrial hygienists)available to states to aid in the development ofindustrial hygiene programs.(27) By 1936, 12 morestate health department programs were initiated,and the USPHS recommended a large industrialstate should have at least one chief industrialhygienist with a salary of $6000. The minimumqualifications of this specialist called for a chemicalengineering degree; 2 years graduate work inindustrial hygiene; 3 years of experience; and, inaddition to a wide range of scientific and technicalknowledge, the ability to establish contacts withplant executives; ability to enlist cooperation ofplant executives, foremen and laborers; initiative;tact; good judgement; and good address.(28)

World War II provided significant impetus forthe development of state and local governmentindustrial hygiene programs. By 1946, 52 pro-grams were operational in 41 states; however, thewithdrawal of federal resources after the war ledto a steady decline in both number and activity ofthese programs. By the late 1960s, although therewere a number of states with programs, mostinvolved only one or two professionals. The excep-

Figure 1.8 Woodcutsshowing ventilation systemsfor mines.

10 ________________________________________________________________ Section 1: Introduction and Backgroundtions to this situation were found in the largeindustrial states such as Massachusetts, New York,Pennsylvania, Michigan, and California.

As in most countries, national legislation to con-trol hazards in the workplace first focused on min-ing. The U.S. Bureau of Mines was establishedshortly after the turn of the century, but it was 1941before the bureau was authorized to conductinspections in mines. A number of miningtragedies in the mid-1960s led to the passage of theMetal and Nonmetallic Mine Safety Act and theCoal Mine Safety and Health Act in 1966 and 1969,respectively. These mining laws were supersededby the comprehensive Mine Safety and Health Actof 1977. This law created the Mine Safety andHealth Administration (MSHA) within the U.S.Department of Labor. MSHA regulates and con-ducts inspections in mines and related industries.

Federal safety and health activities in generalindustry were not initiated until passage of theWalsh-Healey Public Contracts Act in 1936. Thislegislation authorized federal occupational safetyand health standards for government contractors.The Department of Labor adopted existingAmerican Standards Association (now theAmerican National Standards Institute, or ANSI)safety and health standards and the ACGIH TLVsas Walsh-Healey standards.

In the late 1960s the U.S. Congress became con-cerned with the comprehensive problem of occu-pational safety and health in the workplace. After anumber of congressional hearings, documentationwas available regarding the seriousness of work-place deaths, injuries, and illnesses and the lack ofconsistent and comprehensive safety and healthprograms at the state and local level to preventsuch problems. Consequently, the OSH Act(29) waspassed in 1970 and created OSHA within the U.S.Department of Labor and NIOSH in theDepartment of Health and Human Services. OSHAwas given the responsibility to promulgate stan-dards and conduct inspections in most workplaces,whereas NIOSH was to conduct research and rec-ommend health and safety standards to OSHA.

The initial health standards adopted by OSHAwere the existing Walsh-Healey standards. Theseincluded the 1968 ACGIH TLVs(30) minus the 21chemicals for which there were ANSI stan-dards.(31) The exposure limits for these substancesare known as permissible exposure limits (PELs).Subsequent to these initial standards, OSHAbegan promulgating comprehensive health stan-dards for a variety of chemicals includingasbestos, benzene, coke oven emissions, and lead.In addition to a PEL, these comprehensive stan-dards include requirements such as medical mon-itoring, administrative control measures, respira-tor selection, training, and record keeping.

Challenges to the regulation of two hazardsultimately led to U.S. Supreme Court decisions onthe need for OSHA to quantify risk reduction and

the cost-benefit of its regulatory actions. OSHAs1978 regulation to reduce the PEL for benzenefrom 10 to 1 ppm was remanded by the Courtbecause of its belief OSHA did not justify that thePEL reduction would substantially reduce the riskto the health of exposed workers. The Courtrejected the notion that lower exposure is betterand required OSHA to quantify the risk at currentconditions of exposure and then document thatthe proposed standard would substantiallyreduce risk to an acceptable level. In describingan acceptable level of risk, the Court suggestedthe risk of job-related death caused by injury orillness over a working lifetime would be anappropriate level of acceptability. This risk wasestimated to be 1 in 1000, and this value hasbecome OSHAs target in determining acceptablePELs for chemical substances. In reviewing the1978 OSHA standard for cotton dust, the U.S.Supreme Court decided the OSH Act requiredOSHA to consider the technical and economic fea-sibility of new standards, but a cost-benefit analy-sis was not required.

In January 1989 OSHA promulgated a new reg-ulation amending its existing Air Contaminantsstandard.(32) This reduced 212 PELs and estab-lished 164 new ones. OSHA stated it hadreviewed health, risk, and technical/economicfeasibility for the 428 substances considered inthis rulemaking and found that the new PELssubstantially reduced a significant risk of materialhealth impairment among American workers andwere technologically and economically feasible.OSHA estimated benefits would accrue to 4.5 mil-lion workers and would result in the reduction ofmore than 55,000 occupational illness cases annu-ally. If not prevented, it was projected these illnesscases would eventually result in approximately700 fatalities each year.

Several industrial organizations and theAFL/CIO had a different perspective and success-fully convinced the U.S. Court of Appeals the reg-ulations should be vacated and remanded toOSHA. The court ruled

1. OSHA failed to establish that existing expo-sure limits in the workplace represented sig-nificant risk of material health impairmentor that the new standards eliminated orsubstantially lessened the risk;

2. OSHA did not meet its burden of establish-ing that the new PELs were either economi-cally or technologically feasible; and

3. there was insufficient explanation in therecord to support an across-the-board, 4-year delay in implementation of rule.(33)

The court stated that the inadequate explana-tion made it virtually impossible for a reviewingCourt to determine if sufficient evidence supportsthe agencys conclusion.(33) The court indicated itcould easily believe that OSHAs claim of goingthrough detailed analysis for each of the sub-stances was not possible given the time con-straints set by the agency for this rulemaking. The

History and Philosophy of Industrial Hygiene ______________________________________________________________11court determined OSHAs approach to this rule-making was not consistent with the requirementsof the OSH Act.

The end result was a major setback to efforts toformally update the PELs. However, benefits fromthe rulemaking effort remain after the court deci-sion and include (1) adoption and continued useof the revised PELs by several state health protec-tion programs; (2) informal adoption by someindustrial organizations; (3) sensitization by manyparties to the inadequacies and obsolescence ofthe existing PELs; and (4) plans by OSHA to initi-ate another effort to revise PELs for a group ofsubstances (fewer than 428) for which some com-monality can be identified and when the objec-tions identified by the court can be avoided. Adecade later, however, OSHA has yet to developand implement a procedure for updating the anti-quated list of PELs.

Reestablishing state authority for occupationalsafety and health was also an important goal ofthe OSH Act. States were encouraged to enacttheir own legislation and to develop programs atleast as stringent as OSHAs. State programsapproved by OSHA would receive 50% of theiroperational costs from the federal government.However, 25 years later fewer than half of thestates have reasserted their control over work-place hazards.

In addition to standards setting and enforce-ment the OSH Act also included a provision toprovide free consultation services to small busi-nesses. These services are found in all 50 statesand offer management confidential advice onsafety and health problems.

Although some may argue with the details ofthe content or the implementation of the OSH Act,most would agree with an early OSHA adminis-trator that its impact on working life in theUnited States cannot be overestimated.(34) Oneonly has to look at the growth in the membershipof the American Industrial Hygiene Association(AIHA) to see the impact on the number of practi-tioners in the profession. In 1970 AIHA member-ship numbered 1649 and within 10 years hadtripled. It cannot be scientifically proven theseadditional practitioners (as well as those whoentered the occupational safety profession) haveimproved the health and well-being of theAmerican worker. But we can assume the atten-tion paid to workplace hazards by this greatlyexpanded number of professionals is one factorcontributing to a safer U.S. workplace.

Education and ProfessionalOrganizationsDiscussion of the evolution of the practice of

industrial hygiene in the United States would beincomplete without a brief review of the growth of

educational programs and professional organiza-tions associated with the field. Although the firstcourse in industrial hygiene was taught at theMassachusetts Institute of Technology, HarvardUniversity is recognized as having developed, in1922, the first educational and research programleading to an advanced degree in industrialhygiene. Although other universities (e.g., JohnsHopkins, the University of Michigan, and theUniversity of North Carolina) implemented educa-tional programs for industrial hygiene in subse-quent years, the great leap forward came in 1977with the NIOSH Educational Resource Centersprogram. These centers stress interdisciplinaryeducation in the occupational aspects of hygiene,medicine, nursing, and safety. As a result of feder-al support for the development of an adequatesupply of professionals to control occupationalhealth and safety hazards, there are now 15 indus-trial hygiene programs at NIOSH EducationalResource Centers, with at least 14 more individualindustrial hygiene education programs being sup-ported by NIOSH. Industrial hygiene educationalprograms not supported by NIOSH can be foundat both the graduate and undergraduate levels atother universities. Twenty one of the graduatelevel and four bachelor level programs have beencertified by the Accreditation Board of Engineeringand Technology. A list of industrial hygiene acade-mic programs is available from AIHA.

It has been suggested one can date the emer-gence of the profession of industrial hygiene bythe formation of our professional societies.(35) In1938, 76 industrial hygienists representing 24states, 3 cities, 1 university, the USPHS, the U.S.Bureau of Mines, and the Tennessee ValleyAuthority convened in Washington, D.C., to for-mally establish the National (later to become theAmerican) Conference of Governmental IndustrialHygienists. ACGIH was established to coordinateactivities in federal, state, local, and territorialorganizations and agencies; to help the publichealth service carry out its mission; and to developstate industrial hygiene units in a rational man-ner.(36, p.8) By 2002 ACGIH membership hadreached 4200, and the association had a staff of 29with an operating budget of almost $3.5 million.

In 1939 AIHA was formed. At the first meetingof the AIHA Board of Directors, four major goalsof the association were enunciated:

1. the advancement and application of indus-trial hygiene and sanitation through theinterchange and dissemination of technicalknowledge on these subjects;

2. the furthering of the study and control ofindustrial health hazards through determi-nation and elimination of excessive expo-sures;

3. the correlation of such activities as conduct-ed by diverse individuals and agenciesthroughout industry, educational, and gov-ernmental groups; and

(37)4. the uniting of persons with these interests.

12 ________________________________________________________________ Section 1: Introduction and BackgroundAIHA membership has grown from 160 mem-bers in 1940 to more than 11,500 members in 2002.AIHA also has 93 local sections throughout theUnited States and in 3 other countries, which fos-ter the interaction of industrial hygienists. Theannual American Industrial Hygiene Conferenceand Exposition, sponsored by AIHA and ACGIH,provides the opportunity for members and othersinterested in the field to come together andexchange experiences and information. Both pro-fessional organizations also sponsor technicalcommittees, develop technical publications, andpublish journals. The American Industrial HygieneAssociation Journal first appeared in 1946, whereasACGIHs Applied Occupational and EnvironmentalHygiene (originally appearing as Applied IndustrialHygiene) debuted in 1986.

AIHA and ACGIH were also founding mem-bers of the International Occupational HygieneAssociation (IOHA). Membership in IOHA is lim-ited to occupational hygiene professional associa-tions, which by 2002 included associations locatedin Australia; Belgium; Brazil; Canada; Denmark;Finland; France; Germany; Hong Kong; Italy;Japan; Mexico; The Netherlands; New Zealand;Norway; Poland; Southern Africa; Spain; Sweden;Switzerland; Taiwan; the United Kingdom (BIOHand BOHS); and the United States (AIHA andACGIH). IOHA is recognized as a nongovern-mental organization (NGO) by both theInternational Labour Organization and the WorldHealth Organization. As an NGO to these twointernational bodies, IOHA serves as the voice ofthe occupational hygiene profession at the inter-national level.

In 1960 AIHA and ACGIH created the AmericanBoard of Industrial Hygiene (ABIH) to developvoluntary professional certification standards forindustrial hygienists and to implement a certifica-tion program.(38) The initial group of certifiedindustrial hygienists (CIHs) has grown from 18 in1960 to more than 6400 in 2002. In 1966 the diplo-mates of the ABIH certification program activatedthe American Academy of Industrial Hygiene(AAIH) as a professional organization. As statedin their bylaws, the purpose of AAIH was to

provide leadership in advancing the professionalfield of industrial hygiene, by raising the level of competence of industrial hygienists and bysecuring wide recognition of the need for highquality industrial hygiene practice to ensurehealthful work conditions in the various occupations and industries.(39)

The major activities of AAIH include promotionof the recognition of industrial hygiene as a pro-fession by individuals, employers, and regulatoryagencies and the accreditation of academic pro-grams in industrial hygiene in cooperation withthe Accreditation Board of Engineering and

Technology. AAIH sponsors the annualProfessional Conference on Industrial Hygiene toprovide a forum for exploring professional issues,especially those encountered by more experiencedindustrial hygienists.

In the mid-1990s an effort was made to unite thefour industrial hygiene organizations (AAIH,ABIH, ACGIH, and AIHA). After considerableexploration of options and their impact, ACGIHand ABIH decided to remain as independent orga-nizations. However, the membership of the AAIHand AIHA voted, with more than 90% positive ineach case, to merge the Academy into AIHA. OnSeptember 26, 1999, the Board of ABIH voted todissolve AAIH, effective December 31, 1999, for itsreformation as the Academy of Industrial Hygiene(AIH) within AIHA. In January 2000 AAIHmerged with AIHA, and the AIHA membershipapproved a change to the bylaws creating thediplomate membership category to recognizemembers who were both full members of AIHAand CIHs in good standing with ABIH.

SummaryThis brief overview of the development of

industrial hygiene in the United States has beenpresented from a chronological as well as from apractice point of view. Growth has been rapid,with at least three major phases involving theearly years prior to 1930, the dramatic increasebetween 1935 and 1945 due to social security leg-islation and World War II, and the more recentphase of growth resulting from the passage of thefederal OSH Act in 1970.

Over the past few years it would appear, atleast in the United States, industrial hygienistsare in the midst of a fourth period of change.There are at least three major driving forcesinvolved with this phase. The first involves thereinvention of much of the government,including OSHA, to focus less on a regulatoryapproach to problem solving and to enhancecooperation and partnerships with those consid-ered to be stakeholders. Although OSHA remainsa regulatory agency, the pace of regulation andinspection has slowed. The second force is thedownsizing of corporate America and increasedoutsourcing of services, including industrialhygiene. In 1986 approximately 15% of AIHAs6500 members identified themselves as consul-tants. By 2002, of the 11,500 members, 26% werelisted as consultants. The other major factoraffecting the profession is the shift of theAmerican economy from a manufacturing to aservice base. Although not necessarily less haz-ardous, service industries often have problemsmuch different from those of a traditional manu-facturing site. Although service industries havemany of the same chemical, physical, and biolog-ical hazards found in manufacturing, the aware-ness of the need for industrial hygiene services is

usually low.

History and Philosophy of Industrial Hygiene ______________________________________________________________13Recognition of the need to address occupationalhealth problems in nontraditional workplaces isnot new. Jack Bloomfield, one of the first industri-al hygienists in the USPHS, noted in 1938

industrial hygienists have concentrated theirefforts on the so-called industrial population-thatgroup of workers engaged in the manufacture,mechanical and mining industries. Although it isprobably true that the bulk of the occupationaldiseases occurs in these industries, nevertheless,the 10 million workers in agriculture, the 4 mil-lion persons employed in transportation andcommunication, and the large number of workersin domestic and personal services, all have healthproblems deserving attention.(27)

Public Health RootsIt has been postulated the [f]irst Public Health

Revolution unfolded in nineteenth-centuryEurope as that society sought to address theadverse health effects of squalid living conditions:poor sanitation, poor housing, dangerous workenvironments and air pollution.(40, p. 63)

The Institute of Medicine has defined publichealth as what we, as a society, do collectivelyto assure the conditions in which people can behealthy.(41, p.1) Thus, when industrial hygienistsimplement a control measure to reduce a work-ers exposure to a toxin, they are practicing theart and science of public health. Those whopractice in the field of public health are wellaware that throughout the history of public andespecially occupational health, two major factorshave shaped our solutions: the availability ofscientific and technical knowledge and the con-tent of public values and opinions. The Instituteof Medicine has recognized the lack of agree-ment about the public health mission as reflect-ed in the diversion in some states of traditionalpublic health functions such as water and airpollution control, to separate departments ofenvironmental services, where the health effectsof pollutants often receive less notice.(41)Although industrial hygiene functions are nowmost often found combined with safety pro-grams in labor rather than public health depart-ments, the concepts of injury prevention,whether on or off the job, have strong publichealth underpinnings. Thus, safety and hygieneare intertwined.

The first professional journal to address indus-trial hygiene concerns was the Journal of theAmerican Public Health Association. In 1914 thejournal announced a new department on industri-al hygiene and sanitation to put the readers intouch with the latest information in this veryrecently new field of Public Health work, and areview article on industrial hygiene and sanitation

(42)was published. In the same year the associationcreated an industrial hygiene section, and at theannual meeting a special symposium on industri-al hygiene was held. Alice Hamilton served asvice chairman of the new section and succeededto the chairmanship in 1916.(43)

As noted earlier, in 1914 the USPHS establishedan office of industrial hygiene and sanitation,which 57 years later became NIOSH. NIOSH ispart of the federal Centers for Disease Controland Prevention, which encompasses most of thepublic health functions of the federal government.Prior to the OSH Act of 1970 most state and localgovernment industrial hygiene units were foundin public health agencies.

Industrial hygiene graduate level academictraining in the United States since its inceptionhas been associated with schools of public health.In 1918 the Harvard Medical School established aDepartment of Applied Physiology, which in 1922became the Department of Physiology and theDepartment of Industrial Hygiene in the School ofPublic Health. In the late 1930s state public healthagencies used social security funds to train indus-trial hygienists in schools of public health atHarvard, the University of California, ColumbiaUniversity, The Johns Hopkins University, theUniversity of Michigan, and Yale University.Today industrial hygiene academic programs arefound in at least 18 of the 27 accredited schools ofpublic health.

There is ample evidence the roots of industrialhygiene are in the field of public health. The pub-lic health philosophy of protection and enhance-ment of the health and well-being of groups ofpeople through preventive rather than curativemeasures applies as well to industrial hygiene.

Professional RecognitionAs the profession of industrial hygiene and

occupational health and safety changes, so do theperceptions of what constitutes an individual whois qualified to practice industrial hygiene. Theissue has been debated within the profession formany years.

In 1994 the AIHA Board of Directors deter-mined the time had come to become more proac-tive on this issue. This increased interest was aresult of several events, most notably an increas-ing requirement by federal and state regulatorsmandating that all individuals have additionaltraining and certification for many single-sub-stance issues (e.g., asbestos and lead).

In addition, over the course of several years theprofession witnessed the creation of so-called cre-dentialing organizations, which seized on theopportunity to bestow new credentials to individu-als in almost every imaginable field of occupationalhealth and safety. Many of these new credentialscan be readily obtained either by submitting asmall fee for the honor or by taking a mail-order

14 ________________________________________________________________ Section 1: Introduction and Background

g

ietis

se a

pl

h

dn..legal recognition and protection. It also will be ofassistance in future regulatory efforts on both thefederal and state levels as AIHA seeks to have thisprofession recognized as a leader in the field ofprotecting workers.

The first states to actively seek some form oftitle protection were California and Tennessee.Both enacted legislation in 1993 that recognizedthe profession and were the impetus for AIHAssubsequent proactive efforts. In addition toCalifornia and Tennessee the state of Illinois enact-ed a form of voluntary licensing for CIHs in 1993that is still the most far-reaching and somewhatrestrictive professional recognition legislation.

In 1995 AIHA adopted a joint position state-ment on the issue with the American Society ofSafety Engineers. This joint statement promotescooperation between the two professions and sug-gests a cooperative venture, when possible, onenacting legislation not only protecting the titlesof industrial hygiene, but also the titles of thesafety profession.

Code of Ethics for the Professional Practice of Industrial Hy

At its meeting, Dec. 14, 1994, the American Industrial Hygmends to every member of AIHA, the following Code of EAmerican Conference of Governmental Industrial HygienAmerican Academy of Industrial Hygiene and has also be

ObjectiveThis canon provides standards of ethical conduct for Induexercise their primary mission to protect the health and wcal, microbiological, and physical health hazards present

Canons of Ethical ConductIndustrial Hygienists shall: Practice their profession following recognized scientificwell-being of people may depend upon their professionahealth and well-being of people. Counsel affected parties factually regarding potential health effects. Keep confidential personal and business information obties, except when required by law or overriding health an Avoid circumstances where a compromise of professio Perform services only in the areas of their competence Act responsibly to uphold the integrity of the professionIn 1968 the Code of Ethics for ProfessionalPractice was developed by the AAIH EthicsCommittee. The officers and councilors acceptedthe code and committee report without takingfurther action. In 1973-1974 there was renewedinterest in a professional code of ethics by notonly AAIH but also by ABIH. In 1975 AIHA alsobegan work on a code of ethics; the work ofAIHAs Law Committee was completed in 1977.

In 1978 the AAIH draft code was mailed to themembership for comment. Approximately 100responses were received and were used to pre-pare a redraft of the code, which was submittedto the membership for approval. Of the 743respondents (67.5% of all members), 712 (95.8%)voted to accept and 31 (4.2%) voted to reject. Thecode provided standards of ethical conduct to befollowed by industrial hygienists as they practicetheir profession and serve employees, employers,clients, and the general public. By 1981 AIHA andACGIH also adopted the code of ethics, thusextending coverage to most industrial hygieneprofessionals.

iene

ne Association Board of Directors adopted, and com-hics. This Code of Ethics was developed jointly with thets, the American Board of Industrial Hygiene, and theen approved by the other IH groups.

trial Hygienists as they practice their profession andll-being of working people and the public from chemi-t, or emanating from, the workplace.

rinciples with the realization that the lives, health, andjudgment and that they are obligated to protect the

ealth risks and precautions necessary to avoid adverse

tained during the exercise of industrial hygiene activi- safety considerations.al judgment or conflict of interest may arise.examination. Some credentials are even granted forlife, without requiring any demonstration of main-tenance of competency.

These attempts to confuse policymakers andthe public forced AIHA to become more involvedin protecting industrial hygiene titles. Startingwith the adoption of an official position statementon title protection in 1994, AIHA began workingto assist local sections and state governmentaffairs organizations with efforts to enact title pro-tection legislation in the individual states. AIHAsoriginal model bill includes definitions for CIHand IHIT (Industrial Hygienist in Training). Themodel bill adopted in 2001 also includes a defini-tion for the new title Certified Associate IndustrialHygienist and includes Certified SafetyProfessional. Although title protection will noteliminate new credentialing organizations, it pro-vides the industrial hygiene professional with

State legislative efforts since 1995 also haveresulted in legislation enacted in Alaska;Colorado; Connecticut; Florida; Indiana;Minnesota; Nebraska; Nevada; New Jersey; NorthCarolina; Ohio; Oregon; Texas; and Virginia,bringing the total to 17 states with some form ofprofessional recognition/title protection enactedinto law. On the federal level, AIHA works to seethat federal regulations and legislative efforts donot restrict the profession. All regulatory and con-gressional activities are monitored to assure theprofession is protected. When possible, AIHAseeks to add language recognizing the CIH as acompetent, qualified, and knowledgeable occupa-tional health and safety professional.

Professional Code of Ethics

History and Philosophy of Industrial Hygiene ______________________________________________________________15In 1991 the four industrial hygiene organizationschartered the Code of Ethics Task Force, whosecharge was to (1) review and revise the industrialhygiene code of ethics and to supplement it withsupporting interpretive guidelines, and (2) recom-mend methods to educate members about ethicalconduct and to recommend disciplinary proce-dures and mechanisms for enforcement.(44)

The task force determined that the original codeof ethics, although presenting general principlesof ethical conduct, lacked interpretive guidelines.Of special concern was the change in the scope ofindustrial hygiene practice since 1978, especiallythe increase in the number of consultants. Themost difficult issues considered by the task forcewere disciplinary procedures and mechanisms forenforcement. The task force surveyed 12 similarprofessional organizations and determined thatalthough the majority had developed a code ofethics, only 2 had charters to enforce their codes.However, it was recognized that 6 of the 12 orga-nizations involved professions (physicians, nurs-es, engineers) the practice of which was regulatedthrough state licensure.

The task force reviewed the pros and cons of sixenforcement options: no enforcement, education,mediation, arbitration, title licensing, and a formalenforcement procedure. The task force recom-mended that regardless of the choice made by theprofessional organizations, education in and com-munication of ethical concepts were needed, andthe four organizations should consider establish-ing one joint ethics committee.

The report of the task force was presented tothe four boards in October 1993, a final draft of arevised code of ethics was presented at the 1994American Industrial Hygiene Conference andExposition, and by January 1995 all four organiza-tions had approved the new code. In 1995 theindustrial hygiene organizations approved theformation of the Joint Industrial Hygiene EthicsEducation Committee, the purpose of which is toconduct educational activities for industrialhygienists and interested parties to assist in pro-moting the code of ethics. How the code of ethicswill be enforced is a question yet to be answeredby the professional organizations.

The new Code of Professional Ethics for thePractice of Industrial Hygiene (Figure 1.1) com-prises six canons with interpretive guidelines. Thecanons of ethical conduct require industrialhygienists to (1) practice their profession byapplying scientific principles; (2) counsel affectedparties regarding risks and protective measures;(3) keep information obtained confidential exceptunder special circumstances; (4) avoid compro-mise of professional judgment and conflict ofinterest situations; (5) practice only in their areasof competence; and (6) uphold the integrity of theprofession.

The task force emphasized that the interpretiveguidelines were not rules of practice, did not nec-essarily define right from wrong, were not intend-ed to carry the weight of law, and should not beconsidered to be all inclusive. The guidelines weredesigned to give professionals guidance in decid-ing what constitutes ethical practices.

Whom Do We Serve?One of the questions often facing occupational

health professionals is, Who are our clients?Simply defined, do industrial hygienists owe alle-giance to those who pay them or to those whosehealth and well-being they are entrusted to pro-tect? Ideally, the answer to the question is both.To those who pay for their services, as eitheremployer or client, industrial hygienists owe theirbest professional effort to anticipate, recognize,evaluate, and control workplace hazards. If theymeet these goals, they also discharge their respon-sibilities to the workers and those in the commu-nity who may be adversely affected by the haz-ards they address.

But what of those situations in which industrialhygienists are asked to compromise or at leastsoften or shade their findings? Although theymay not be asked by a manager to change theirrecommendations, what are the responsibilities ofindustrial hygienists if they believe neededchange will not be made? Do they say to them-selves, I have discharged my responsibilities byrecognizing, evaluating, and recommending con-trolsit is someone elses responsibility to seethey are implemented? Or should hygienistsbelieve their ultimate responsibility is to seeworker and community health protected? If thosewho create a hazard do not redress it, is it theresponsibility of industrial hygienists to informthose whose health is likely to be adversely affect-ed, so they can take steps to protect themselves?

What of those situations in which managementhas implemented controls, but hygienists seeworkers not following good work practices? Dothey say to themselves, I have discharged myresponsibilities by recognizing, evaluating, andrecommending controls. It is someone elsesresponsibility to see they are implemented? Orshould industrial hygienists believe they play apart in the implementation and owe it to theirclients and to the workers to see good work prac-tices are followed or workers disciplined whenthey are not?

To answer these and similar questions, eachindustrial hygienist must define the principlesthat guide their practice of the profession. Thecode of ethics does not come alive until it is usedto set the compass to guide professional lives.

But when industrial hygienists seek to define theraison dtre of their profession, the final words ofthe first canon of the ethics code could serve themwell, in all circumstances: (We) are obligated toprotect the health and well-being of people.

16 ________________________________________________________________ Section 1: Introduction and BackgroundThe FutureTo not only remain viable but also to achieve

increased recognition and acceptance of theirwork, it is apparent industrial hygienists must, asdo most professions, continue to reevaluate and,where necessary, redesign the scope and contentof their practice. Today in many organizations thehygienist is called on to provide support to theentire arena of environment, safety, and health.Hygienists must continue to expand the scope oftheir practice to include environmental healthconsiderations, especially those arising from theworkplace. The skills and knowledge involved inthe recognition, evaluation, and control of air, andeven water, pollution problems as well as those ofhazardous wastes are not dissimilar to the skillsand knowledge applied to traditional industrialhygiene problems. Indeed, many of the earlyenvironmental health practitioners, especiallyaddressing air pollution, radiological health, andhazardous waste problems, were industrialhygienists.(45) The first air pollution disaster in theUnited States, the Donora, Pa., smog of October1948, resulted in the death of 20 people and tosome degree affected almost 6000 persons.(46) Theinvestigation of the incident involved a multidis-ciplinary team of physicians, nurses, engineers,chemists, meteorologists, housing experts, veteri-narians, and dentists under the direction of aUSPHS industrial hygienist, George D. Clayton.Industrial hygienists must become more effectivein providing comprehensive rather than one-issueservices.

Safety also cannot be seen as some separate anddistinct area of practice to be avoided by thehygienist. We are aware of the significant overlapbetween health and safety in many of our activi-ties (e.g., confined space entry or product stew-ardship) and must recognize that protecting aworker from chronic health hazards does little ifthe worker is killed or seriously injured on thejob. In a walk-through survey a competenthygienist should be able to recognize electricalhazards as well as a potential exposure to anorganic solvent.

This concept of expanding skills and knowl-edge needed by the industrial hygienist under-scores the need to not only be technically compe-tent, but also to be able to communicate (verballyand in writing) effectively and to be able to devel-op effective and productive working relationshipswith management, unions, other health and safetyprofessionals and, above all, workers. Just as theywere in 1936,(28) these skills are essential for suc-cess, especially when addressing nontraditionalworkplaces and hazards.

Finally, as a profession and as individuals,industrial hygienists must demonstrate that theirservices, in addition to preventing industrial andenvironmental health and safety problems, pro-

vide a tangible, positive contribution to the indi-vidual worker, the community, and the employer.As professionals we must remember our job is notonly to meet minimum government standards,but also, and more important, to enhance theorganizations with whom we work or for whomwe consult. These organizations include manage-ment, stockholders, and workers and their fami-lies as well as society in general. Enhancementdoes not happen automatically or necessarilythrough chance. It must be a goal, with plansdeveloped with the participation, and as appro-priate, the approval of involved and affected par-ties (management and workers), implementedand then measured to determine the level ofachievement.

SummaryThis chapter reviews the history of industrial

hygiene with an emphasis on the U.S. experience.In addition to a chronological listing of develop-ments, the professions history also is viewed inthe context of its tenants of practice: recognition,evaluation, and control. The considerable impactof the OSH Act on the growth of the professionand its practice is described. A historical review ofthe professional organizations-AIHA, ACGIH,AAIH, and ABIH-is presented. In considering thephilosophy of the practice of the profession, itspublic health roots are apparent. The publichealth philosophy of protection and enhancementof the health and well-being of groups of peoplethrough preventive rather than curative measuresapplies as well to the practice of industrialhygiene. As the importance of the professiongrew, AIHA recognized that the need to ensurethe practice of industrial hygiene was limited toqualified professionals. AIHAs effort in titleenhancement and protection has resulted inincreased recognition of the profession by federaland state legislators and regulators. The questionof who is served by industrial hygienists-employ-ers or the people whose health and well-beinghygienists protect-can be perplexing. To help pro-fessionals answer this and similar questions, thefour industrial hygiene organizations developedthe Code of Professional Ethics for the Practice ofIndustrial Hygiene. The code consists of sixcanons with interpretive guidelines, which can beused by industrial hygienists to guide the practiceof their profession. Finally, as in most professions,industrial hygienists must look to the future andredefine their profession as the world changes.

References1. Patty, F.A.: Industrial hygiene: Retrospect and

prospect. In Pattys Industrial Hygiene andToxicology, vol. 1, 3rd ed., pp. 131. New York:

John Wiley & Sons, 1978.

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18 ________________________________________________________________ Section 1: Introduction and Background

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HelpTable of ContentsSection 1 Introduction and BackgroundOutcome CompetenciesPrerequisite KnowledgeKey TermsKey Topics

Chapter 1 History and Philosophy of Industrial HygieneOrigins of Industrial HygieneThe U.S. ExperiencePublic Health RootsProfessional RecognitionProfessional Code of EthicsWhom Do We Serve?The FutureSummaryReferences

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