Some personal observations on industrial health in the United States of America.

Any account of industrial health in the U.S.A. should start with Dr. Alice Hamilton.t The autobiography of this remarkable woman records not only the author's life-long devotion to the cause of the American industrial worker, but gives a picture of conditions in American industry which, when she first began her work, were a veritable jungle of ignorance, prejudice, and suspicion. But if Dr. Hamilton showed the way out of these unpromising conditions, it was perhaps the alteration in American compensation law which provided the driving force toward change. Industrial health may have owed something in its early stages to the experience of other lands, but the pattern which has so recently emerged is wholly American. Receiving little but advice from the Federal Government it takes its inspiration from the State compensation laws. Since these vary from State to State so also does the provision for industrial health. Most States in addition enforce, through their health departments, minimum standards; but these also vary. Most characteristic is the stimulus which compensation law gave to private enterprise. The insurance companies carrying the new burdens of compensation for industrial disease enrolled the services of the engineer and the chemist to control the health hazards of industry. So too did individual firms. That these firms saw the new services as extensions of their plant maintenance departments rather than of their medical departments seems to have had profound effects on subsequent development. This outlook introduced industrial hygiene as a new profession and has resulted in a characteristically American approach to the problems of industrial health, not the least feature of which was at the beginning the separation of industrial hygiene and industrial medicine.