The ensuing chapters explain how and why these views changed. Sellers analyses a complex of forces: worker activism; hospitals seeking profit (workers and employers had more money than paupers did); the growing industrial inspectorate; and the changing attitudes of the medical profession – or at least sections of it. In chapter 2, Sellers chronicles the activities of the earliest of these practitioners to apply themselves systematically to the problems of occupational disease. Sellers describes the efforts of one of these practitioners, David Edsall, to prise the profession away from its individualistic focus by moving medical research out of the laboratory into the workplace. It was this combination of the ‘social’ with the ‘science’, Sellers argues, which allowed the profession to flourish, not only in its science of industrial disease, but in terms of its influence over the working lives of those affected by hazards of various descriptions.

However, it is Alice Hamilton whom Sellers credits with transforming occupational medicine in the US. Unlike most of her colleagues, investigating industrial disease was not a hobby, but a life’s work. Sellers does not miss the intriguing paradox that, at a time when women, as a gender, lacked the right to vote, it was a woman who was instrumental in the emerging profession. Hamilton used her research on the white lead industry to spearhead a campaign to highlight the extent and nature of lead poisoning. In her hands, collection of data from factories became not only a scientific and social act, but also a regulatory force. Her charisma is well captured by Sellers, as is her increasing ambivalence as the profession develops with a ‘more exclusive, expert dependent knowledge – one with which she (Alice Hamilton) would never feel entirely at home’ (p. 74).

Over time, the immediacy of both the methods and conviction of Alice Hamilton were transformed into detailed laboratory studies focused on isolating and documenting which industrial chemicals were toxic and which benign. To do this, the profession directed research efforts away from the workplace back to the laboratory, thereby removing the ‘social’ once again from the ‘science’. Chapters 4 and 5 outline the demands for professional legitimacy that brought about this reversal. In the wake of Hamilton’s activities, doctors were being employed at an increasing rate within factories, ostensibly to improve health, yet often perceived by workers as tools of management. The problem lay in the need for the profession to prove the benefits of their skills to corporate profits. This could be achieved not only by improving worker health, but also by keeping the ‘unfit’ out of work and denying compensation to those made sick from work conditions. These latter tactics undermined doctors’ attempts to establish industrial hygiene as an independent and credible discipline. Not surprisingly, the relationship between the profession and the unions, in particular, was strained. Shifting research from the workplace to the laboratory was seen as a means to maintain the fledgling profession’s integrity and influence. Laboratory experimentation would provide neutral scientific ‘facts’ that could provide a way forward unhindered by poor labour relations. Chemicals showing no adverse effects in the laboratory could, thus, be considered safe and, so, ‘expert knowledge’ could distinguish between which illnesses of the workforce were ‘normal’ (that is, outside the employers’ responsibility) and which industrially caused. It was a turn that suited both the profession and the industry it served, since the laboratories no less than the company doctors relied on corporate sponsorship. Chemicals were not to be feared, their effects to be both understood and scientifically controlled. Sellers comments: ‘Ultimately, no leader of either scientific medicine or the modern corporation could have hoped for a better advertisement’, (p. 183).

However, the faith in the ability of laboratory experimentation to provide clear guidelines for the toxicity of chemicals was soon to be undermined. Chapter 6 describes field studies that questioned the directness of the link between levels of exposure to a given chemical and its clinical effects. Toxicological tests on orchard workers dealing with high levels of pesticides revealed toxic levels of lead in their blood – but few clinical symptoms. Quantification of levels of toxins in the blood was no longer sufficient to dictate safety or threats to health. Further, the ability of the general population to provide a control group for industrial exposure to given toxins came under increasing strain. Some began to see toxins not as abnormal, but normal since they were ubiquitous. Research teams headed for remote areas of South America came back with findings of lead exposure of local populations – and made the gross assumption that this indicated ‘normality’. Others, particularly in the fledgling environmental movement, drew opposite conclusions. Far from being normal, the presence of toxins within communities was an indication that the factory was not only poisoning workers, but all of us. Industrial hygiene thus turned towards assessment of the impact of toxins in the environment on health, encapsulated in the subtitle of the book From Industrial Disease to Environmental Health Science.

The above summary gives only a sense of the wealth of historical material presented in this book. Authors of a more polemic bent might have felt tempted to mould this wealth. The changing nature of the profession could be used as evidence of the total control economic considerations have over professional ethics, or alternatively the history could sustain arguments of the profession merely as a vehicle for the extension of social control in the workplace. There would be ample evidence (if somewhat selectively chosen) provided in the book to support either view, but both would narrow our understanding. Fortunately, Sellers’ empathy with his research material prevents this. It allows him freedom to explore the humanizing effect of the discipline, yet does not prevent critical analysis of the impact of professional dependence on proving to business that ‘good hygiene pays’.

Sellers also both empathizes with, and critically analyses the claims of professional independence by, industrial hygienists. He sees such claims anchored alternatively in Edsall and Hamilton’s arguments of the moral responsibility of employers towards employees and in the scientific nature of the developing evidence of industrially-caused disease provided by research. This legitimacy of the profession rooted in morality (or ‘the social’) and science frames the book, which begins and ends with Carson’s Silent Spring. Sellers argues that Carson is indebted to the scientific knowledge generated by the profession. Industrial hygienists were spurred on by their own developing scientific knowledge, first to question the normality of toxins in an industrial context then to challenge the normality of toxins present in everyday environments. Silent Spring draws directly from knowledge base. It could also be argued that the way Silent Spring brings together moral responsibility with scientific evidence (the ‘social’ and the ‘science’) is also a legacy of the early traditions of industrial hygiene. In developing these themes, Sellers deftly crafts a narrative which is accessible and memorable.

Perhaps, though, he is less successful in developing broader theoretical links. The book alludes to theoretical themes that have become familiar across disciplines. Sellers recognizes how the observations of theorists as diverse as Marx, Schumpeter and Foucault resonate with his own findings. But Sellers is keen to distance himself from the determinism he sees present in many social theoretical accounts of history. Perhaps this rests, in part, with his selection of theorists. This reader could not help but be reminded of Weberian themes of status group dynamics and the tensions and interdependencies between substantive and formal forms of rationality. In particular, in this account the history of the profession was akin to the development of a status group. The preoccupation with legitimacy, the articulation of first public works and, then, scientific values as the guiding ethos of the emerging profession and the progressive stratification within the profession each reflect Weber’s notion of a status group (Weber [19448] 1991: 186–194). Viewing the profession as a status group allows an understanding of their influence as independent from economic criteria or as simply exertion of power or social control. In Weber’s understanding, status groups are committed to their own values as ends in of themselves – not as hollow receptacles or Trojan Horses. A clear similarity can be seen in Sellers’ view that the techniques of industrial hygiene cannot be viewed separately from the values and knowledge they sought to impart. Secondly, the development of the profession illustrated graphically Weber’s analysis of the process of rationalization, that is the development of an institutionalized form from founding ideals (Weber [1948], 1991: 117; [1947] 1964: 363–373; see also Giddens, 1995: 43–51). Weber was keen to point to the hazards of the process of rationalization, with its growing emphasis on rules and forms rather than content. Alice Hamilton’s growing dismay at some of the changes in the profession that she championed were a particularly striking example of this. In particular jeopardy, as the profession developed were the founding ideals of industrial hygiene as a truly ‘social’ science. Whilst ostensibly to bolster the independence professional knowledge, the eventual shift of research back to the laboratory was one that placed a priority on the need for standardization of procedure above the outcomes for which the research was generated in the first place – the improvement in working conditions. In doing so, the nature of the relationship between hygienist and industrialist changed, from one of Alice Hamilton using research findings to ‘regulate’ and shame organizations into improvement, to an emphasis on expert pronouncements tied up in technical language communicated largely to a privileged audience. Sellers’ comments that, the new industrial hygiene professionals displayed a distaste for politics and publicity that accorded well with the confidentiality they learned to keep with their corporate clients (p. 208). The saving grace for the profession lay in its association with state and to a certain degree academic institutions in addition to business, which allowed greater public access to the developing knowledge of environmental toxins. Through popularizers such as Carson, knowledge painstakingly gained by industrial toxicologists such as Heuper could rekindle the return of the ‘social’ to the ‘science’. The profession could regain if not its soul, then, at least, its social conscience. For Weber, the appeal to substantive values is essential for the vitality of any endeavour.

The advantage of developing such Weberian themes might have enabled Sellers to develop his material in a way that assisted reader understanding of the dynamics in the history of the profession and their broader relevance. The theoretical references in this book tend to be grouped at the beginning and end, rather than acting as a heuristic device that could allow comparison of the similarities and differences between this history and others. An illustration of how theory illuminates history, rather than drowning it, is provided by Espeland’s (1998) history of water politics in the American Southwest. In contrast, Sellers tends to refer to theory rather than actively use it. Those unfamiliar with his references to broader theory would not necessarily find themselves enlightened by reading this book.

These criticisms, though, are minor when compared with the value of the book. Comprehensively researched and written in an accessible, engaging style, it is a complex but fascinating history of which this review can only glimpse. Worker agitation, corporate attitudes and a growing professional knowledge underpinned by a legal framework all played their role in forming perceptions of cause, cure and responsibility for industrial hazards. It is a process that resonates with the development of professions to this day. Scholars from a diverse range of backgrounds and interests from history, medicine, occupational health and public policy amongst others would find many treasures within this book’s pages.

References

Espeland, W. (1998), The Struggle for Water: Politics, Rationality and Identity in the American Southwest, University of Chicago Press, Chicago.

Giddens, A. (1995), ‘Politics and Sociology in the Thought of Max Weber’, in Politics, Sociology and Social Theory: Encounters with Classical and Contemporary Social Theory, Polity Press, Cambridge, pp. 117–132.

Weber, M. (edited by T. Parsons in 1967, first published in English in 1947), The Theory of Social and Economic Organization, The Free Press, New York.

Weber, M. (edited by H. Gerth and C. Wright Mills in 1991, first published in English in 1948), From Max Weber: Essays in Sociology, Routledge, London.