Chapter 8 of my upcoming book Public Service Exemplars: “A Finer Spirit of Hope and Achievement” portrays a pioneering health advocate, Alice Hamilton. Physician, scientist, researcher, and author, Dr. Hamilton is remembered as a champion of occupational health and safety. Her expertise was in an emerging field, industrial toxicology, which became an important area of scientific research in the twentieth and twenty-first centuries. She was also the first woman appointed to the faculty at Harvard University.
Alice Hamilton was born on February 27, 1869, in New York City to Montgomery Hamilton and his wife Gertrude. Montgomery was a graduate of Princeton University and Harvard Law School. His wife, Gertrude, was the daughter of an affluent sugar importer. Montgomery was a partner in a wholesale grocery firm, but the partnership dissolved in 1885, causing financial hardship to the family.
The Hamiltons were a large, accomplished family. Alice was the second sibling. Her older sister, Edith, was two years her senior. A classical scholar known for her best-selling books on Greek and Roman history, Edith eventually became the headmistress of a prestigious college preparatory school, Bryn Mawr, in Baltimore, Maryland. Alice’s younger sister, Margaret, also became an educator and headmistress at Bryn Mawr. Sister Norah became an artist and lived at Hull House, a famous settlement house in Chicago designed to assist poor residents in rising above poverty. The youngest sibling, Arthur Hamilton, became a professional writer, professor of Spanish, and assistant dean for foreign students at the University of Illinois at Urbana-Champaign. Arthur was the only sibling to marry, although he and his wife never had children.
Aside from the immediate family, the Hamiltons had an extended network of aunts, uncles, and cousins with extensive ties to Fort Wayne, Indiana, where Alice grew to adulthood. Her grandfather, Allen Hamilton, was a prominent land speculator, and much of Fort Wayne was built on land that he had owned. The clan occasionally traveled to Mackinac Island, Michigan, for vacations. In this sheltered environment, Alice Hamilton came of age. Hers was a family that encouraged girls and young women to acquire the best education possible.
Alice was homeschooled until she followed the family tradition and completed her education at Miss Porter’s Finishing School for Young Ladies in Farmington, Connecticut. Although she led a privileged life, Alice resolved to contribute to society rather than simply enjoying a life of leisure and comfort. She eventually decided to become a medical doctor.
Female physicians were rare during the nineteenth century, but Alice Hamilton was nothing if not tenacious. After she returned from her schooling in Connecticut, she studied science with a high school teacher to compensate for the lack of science courses at Miss Porter’s school. She also spent a year mastering anatomy at the Fort Wayne College of Medicine before enrolling in the University of Michigan Medical School. She graduated from medical school in 1893.
After graduation, Hamilton completed internships in Minneapolis at the Northwestern Hospital for Women and near Boston, Massachusetts, at the New England Hospital for Women and Children. The internships provided Dr. Hamilton with clinical experience, although she had already resolved to forgo a medical practice and pursue medical research. She returned to the University of Michigan to study bacteriology and began mulling over a career in public health.
In 1895, Alice and her older sister Edith decamped for Germany. While Edith studied classical literature, Alice studied pathology and bacteriology. She returned to the United States and pursued postgraduate studies at Johns Hopkins University the following year.
By 1897, Hamilton was ready to begin her career. She accepted a position as professor of pathology at the Woman’s Medical School of Northwestern University in Chicago. Not long after she relocated, she took up residence at Hull House, where she lived for more than 20 years. An indefatigable worker, Hamilton taught at the medical school during the day and worked as the Hull House physician at other times.
Her interests and energy were legendary. She taught English and art at Hull House and directed athletic clubs along with operating a clinic for infants. She also served as Jane Addams’s personal physician. Addams was the legendary founder and director of Hull House.
Hamilton lived side-by-side with poor residents, and she observed first-hand their various maladies, some of which appeared to be related to their workplaces. The working poor frequently accepted jobs that exposed them to dangerous chemicals such as lead and carbon monoxide. Their employers seldom if ever provide safety equipment or trained them on techniques to minimize negative health effects. Moreover, if poor workers were injured on the job, they could not count on compensation while they recovered. As a result, a workplace injury led to the loss of a job along with impecuniousness even when the employer was responsible for the injury.
Hamilton believed that she needed to find a means of combining her interest in social reform with her medical concerns over occupational health and safety. After the Woman’s Medical School closed its doors in 1902, Hamilton moved to the Memorial Institute for Infectious Diseases to work as a bacteriologist. While investigating a typhoid outbreak in Chicago, she recognized a causal nexus between the poor living conditions of patients and the severity of disease. Her efforts led the Chicago Board of Health to replace the chief sanitary inspector in the area.
Naturally curious and always interested in research, Hamilton began studying the relationship between living and working conditions on incidences of disease. She found studies from other countries, but little research in the United States on industrial medicine. She published her first article on the topic in 1908, and soon became well known for her expertise.
In 1910, Illinois Governor Charles S. Deneen appointed Hamilton the medical investigator for the newly created Commission on Occupational Diseases. She began her long, productive career as a leading critic of toxics in the workplace by investigating industrial poisons that endangered the health of workers, most of whom were impoverished. At the conclusion of the investigation, the committee issued a scathing report detailing the dangers in an industrial workplace. Hamilton was the principal author. As a result of the commission’s findings, Illinois enacted the first workers’ compensation law in 1911. Indiana followed suit in 1915. The field of occupational safety was born.
Hamilton became a prominent authority on lead poison. As her reputation and expertise grew, she was much in demand to testify before state and federal legislative committees. She began cataloguing the various chemicals in common use in factories and workplaces as well as their negative health effects. In 1925, she famously called attention to the dangers associated with leaded gasoline. Despite her passionate pleas to limit lead, regulators refused to act. In the late 1980s, the U.S. Environmental Protection Agency concluded that more than 68 million children had been exposed to high levels of lead in the six decades since Dr. Hamilton cautioned against using the product.
Hamilton became famous for “shoe leather epidemiology.” She insisted on visiting factories to observe conditions first-hand. She also interviewed current and former workers while taking samples of substances. The science of toxicology was emerging early in the twentieth century, and Alice Hamilton was at the forefront of the new field. Her data was so compelling that she often influenced policymakers to institute major reforms in laws and regulations protecting workers. If factory owners and industrialists were less than enamored of her crusading reforms, they begrudgingly accepted the need to modernize their plants and businesses to conform with the law and attract new workers.
The United States Army used Hamilton’s sleuthing abilities during Great War of 1917-18. Workers at a New Jersey munitions plant were falling ill with a mysterious ailment. Along with a team of researchers that included Dr. George Minot, a Harvard Medical School professor, Dr. Hamilton investigated. The group eventually learned that workers were sick owing to their exposure to TNT. The investigators recommended that workers don protective clothing and wash it at the end of each shift. These relatively simple recommendations solved the problem.
Hamilton’s investigation of carbon monoxide poisoning affecting steelworkers attracted national attention. As she conducted these and other investigations, she continued her social activism, including campaigns to advance women’s rights. Hamilton viewed these efforts as complementary. Her medical investigations ultimately were designed to improve the conditions of people who had been victimized by strong, powerful forces.
As a peace activist, Hamilton traveled overseas on numerous occasions. She journeyed with activists Jane Addams and Emily Greene Balch to the International Congress of Women in The Hague in 1915. She also attended the group’s second Congress in 1919. During the first trip, Hamilton was part of a group that sought an audience with German leaders. In 1919, the group arranged for food to be delivered to famine victims in Germany.
Early in 1919, shortly before her fiftieth birthday, Dr. Hamilton joined the new Department of Industrial Medicine—renamed the School of Public Health six years later—at Harvard Medical School. She was the first woman appointed to the Harvard faculty in any field. Asked about her groundbreaking position, she remarked that “Yes, I am the first woman on the Harvard faculty—but not the first one who should have been appointed.”
Dr. Hamilton spent 16 years at Harvard. During that time, she faced gender discrimination. She was never promoted, nor was she invited to join faculty clubs or offered the football tickets generally provided to faculty. She also was not allowed to march with male faculty during the university’s commencement ceremonies.
Dr. Hamilton published much of her research, including Industrial Poisons in the United States in 1925, the first textbook on that topic. A related textbook, Industrial Toxicology, proved to be enormously influential. Coupled with her ongoing activism, Hamilton’s publications made her a heroine to some Americans, a villain to others. By exposing a series of dangers, she ensured that American governments and businesses would have to address problems, large and small, that threatened the health of workers in the public and private sectors. Yet her crusades opened her to bitter criticism. Her detractors denounced her as a “radical, “subversive,” and “socialist.” Because she vehemently criticized businesses and their normal operations, she was attacked for her anti-business attitude and her lack of patriotism. She weathered such attacks by pointing out that her criticisms extended beyond America’s borders. Following visits to the Soviet Union in 1924 and Nazi Germany in April 1933, she criticized the treatment of workers in authoritarian regimes.
After she left Harvard Medical School in 1935, Dr. Hamilton consulted with the U.S. Division of Labor Standards. From 1944 until 1949, she was president of the National Consumers League. She continued to write a series of books, including the 1943 tract Exploring the Dangerous Trades.
Alice Hamilton lived to a ripe old age. She died on September 22, 1970, at age 101 following a stroke.
Her legacy was large. Aside from earning numerous awards and honorary degrees during her lifetime, she was posthumously inducted into the National Women’s Hall of Fame three years after her death. In 1987, the National Institute for Occupational Safety and Health (NIOSH) dedicated the Alice Hamilton Laboratory for Occupational Safety and Health. NIOSH also offered the Alice Hamilton Award annually to recognize scientific excellence. In 1995, the U.S. Postal Service offered a 55-cent commemorative postage stamp of Dr. Hamilton as part of the Great American series.