The birth of modern industrial hygiene and occupational toxicology. A historical reconstruction through the analysis of the contributions of three protagonists.

BACKGROUND: The Clinica del Lavoro of Milan provided several contributions to industrial hygiene and occupational toxicology during the twentieth century. OBJECTIVES: Describe the first years of the laboratory of industrial hygiene of Milan through three figures who played a leading role: Enrico Carlo Vigliani, Nicola Zurlo and Gianmario Cavagna. METHODS: Scientific literature of the period 1948-1970 was investigated, also interviewing first-hand witnesses of that period. RESULTS: Enrico Vigliani was the first European scholar to understand the importance of a laboratory of industrial hygiene within his institution. Thanks to the support of private (Montecatini) and public (INAIL) institutions he succeeded in creating a laboratory in 1948. Nicola Zurlo, who directed this structure in the first thirty years, conducted innovative studies on chronic mercury intoxication, lead intoxication and silicosis, designing and creating instruments for capturing and analyzing atmospheric dust and protection devices. He conducted analysis of the health effects of organophosphorus insecticides and started to study the air pollution. Zurlo also provided an epistemological and methodological content to the discipline. Gianmario Cavagna, one of the first Italian toxicologists, contributed to the discovery of the origin of fevers caused by the inhalation of metal fumes and to the studies on the pathogenesis of byssinosis, hypothesizing a role of bacterial endotoxins in the genesis of this disease. CONCLUSIONS: The contributions provided by these three protagonists to industrial hygiene and occupational toxicology were relevant and made in those years the Clinica del Lavoro of Milan as a landmark, not only in Italy but also abroad.

Urban penalty y reforma sanitaria: el caso de una ciudad minera: La Unión (1870-1913) / Urban penalty and health reform. The case of a mining city: La Unión (1870-1913)

Este trabajo consta de tres partes. En la primera, proponemos analizar la urban penalty desde la óptica de los fallos de mercado. En la segunda parte, ofrecemos datos que evidencian que La Unión sufrió urban penalty entre 1870 y la Primera Guerra Mundial. En la tercera parte, cuantificamos el gasto que se invirtió en la reforma sanitaria de la ciudad y documentamos que no se instalaron cámaras de condensación en las fundiciones de plomo que existían en el casco urbano pese a que la legislación así lo exigía. Para terminar, sostenemos que La Unión sufrió urban penalty hasta la Primera Guerra Mundial porque el gasto en reforma sanitaria fue insuficiente y no se instalaron esas cámaras de condensación. Uno y otro hecho se explican por razones políticas. La ciudad estuvo gobernada por una oligarquía de empresarios dueños de minas y fundiciones poco sensibles a los problemas sociales que invirtió en salud pública menos que otras ciudades españolas de población similar y que utilizó recursos públicos para fines privados. Esa misma oligarquía no cumplió con la legislación que obligaba a introducir en las fábricas de plomo cámaras de condensación

In the first part of this article, we analyze urban penalty from the perspective of market failures. In the second part, we offer data showing that La Union suffered urban penalty between 1870 and the First World War. Finally, in the third part, we quantify the expenditure invested by the city in health reform and document the failure to install condensation chambers in lead smelters in the city, despite this being a legal requirement. In conclusion, we support the hypothesis that the Union suffered an urban penalty up to the First World War because spending on health reform was insufficient and condensation chambers were not installed, which both have political explanations. The city was ruled by an oligarchy of business men, owners of mines and smelters and insensitive to the social problems. Less was invested in public health in comparison to other Spanish cities with similar populations, and public resources were used for private purposes. This same oligarchy did not comply with the state legislation requiring the introduction of condensation chambers in lead factories

Resurgent lead poisoning and renewed public attention towards environmental social justice issues: A review of current efforts and call to revitalize primary and secondary lead poisoning prevention for pregnant women, lactating mothers, and children within the U.S.

The recent Colorado Gold King Mine waste-water spill and Michigan's water supply re-routing program catastrophe, has directed renewed public attention towards resurgent environmental lead contamination threats. Leaded environments present social justice issues for children and mothers possessing blood lead levels (BLLs) > 5 µg/dL. Childhood lead exposure remains a continual U.S. public health problem manifesting in lifelong adverse neuropsychological consequences. The 2007 Inspector General Report demonstrated low BLL screening rates across the U.S. and this study examined the regularity of children's BLL screening rates. The Centers for Disease Control and Prevention (CDC) Lead Poisoning National Surveillance 2010-2014 children's BLL screening rates, were examined to assess BLL screening regularity in states traditionally known to have regularly occurring BLL screenings: New York, New Jersey, and Pennsylvania. The results extracted from the CDC data showed that < 50% of children were BLL screened by six-years of age across the states that were sampled. The findings highlight that without a "clear map" of lead exposed areas through accurate and consistent BLL screenings, how the potential for such disparities within - and between-states within the U.S. could arise due to environmental social justice issues in relation to BLL screening barriers. Barriers preventing children's BLL screenings were considered, and public health interventions recommended to improve screening rates included: routine BLL screening for all pregnant women, lactating mothers, and children; while, removing known lead exposure sources within communities. This study calls for action during a time of renewed public attention to resurgent lead poisoning within the U.S.

Art is long, life is short. Francisco José de Goya y Lucientes (1746-1828), the suffering artist.

Francisco José de Goya y Lucientes is one of the major figures of European art. From royal portraits to bizarre, grotesque illustrations, his legacy demonstrates a tortured genius, generating some of the most compelling art ever produced. His story is also the story of Spain during one of the most tumultuous passages of its history. In the winter of 1792-93, Goya experienced a mysterious illness resulting in lifelong deafness. After that, his work became more negative, with thick, bold strokes of dark colour. Scholars have suggested various diagnoses on the basis of Master's symptoms, but the exact nature of the illness has never been identified.

American pediatric society's 2017 John Howland award acceptance lecture: a tale of two toxicants: childhood exposure to lead and tobacco.

This article summarizes the presentation of the 2017 Howland Award to Michael Weitzman, MD, at the Annual Pediatric Academic Society Meetings. It summarizes the remarkable advances in understanding the effects and pathways of exposure of the two most common and pernicious of our nation's child environmental exposures, namely lead and tobacco. It also summarizes the profound effect of the translation of these findings into prudent and effective clinical and public health policies such that exposure to both has dramatically decreased over the past 40 years due to the tenacious activities of pediatricians, other child-related professionals, government agencies at all levels, and the American Academy of Pediatrics. Research and clinical activities, although essential, were not sufficient to produce these successes, but required extensive mentoring to produce a generation of academic pediatricians capable of conducting the requisite research, and extensive advocacy by pediatricians and others to overcome the formidable inertia and outright opposition to efforts to protect our children from these exposures. Moreover, the article highlights that both of these environmental exposures have roots in social and environmental injustice and neither is solved, and that there is no safe level of exposure to either of these toxicants.

Jack Aviv and brains of children.

Both lead intoxication in early childhood and deficient bilirubin-binding capacity (BBC) of blood in jaundiced neonates indicate risk for brain damage. Zinc protoporphyrin (ZPP) is a biomarker for lead intoxication (PbI) as well as well as for iron deficiency. Under the leadership of Jack Aviv, Aviv Biomedical, Inc. developed robust hematofluorometers for point-of-care assays of ZPP in blood and for the high-affinity BBC of blood. These assays use just drops of whole blood and are simple, fast and inexpensive. ZPP by hematofluorometry has been used world-wide as a primary screen for lead intoxication since 1979. Recent clinical studies enabled by an Aviv Biomedical, Inc. bilirubin hematofluorometer have renewed interest in BBC-based assessment of neurotoxicity for improved management of neonatal jaundice. This article sketches Jack Aviv's contribution to the development and application of hematofluorometry.

Historical documentation of lead toxicity prior to the 20th century in English literature.

Lead is a heavy metal that remains a persistent environmental toxin. Although there have been a substantial number of reviews published on the health effects of lead, these reviews have predominantly focused on recent publications and rarely look at older, more historical articles. Old documents on lead can provide useful insight in establishing the historical context of lead usage and its modes of toxicity. The objective of this review is to explore historical understandings and uses of lead prior to the 20th century. One hundred eighty-eight English language articles that were published before the year 1900 were included in this review. Major themes in historical documentation of lead toxicology include lead's use in medical treatments, symptoms of lead poisoning, treatments for lead poisoning, occupational lead poisonings, and lead contamination in food and drinking water. The results of this review indicate that lead's usage was widespread throughout the 19th century, and its toxic properties were well-known. Common symptoms of lead poisoning and suggested treatments were identified during this time period. This review provides important insight into the knowledge and uses of lead before the 20th century and can serve as a resource for researchers looking at the history of lead.

Rome's urban history inferred from Pb-contaminated waters trapped in its ancient harbor basins.

Heavy metals from urban runoff preserved in sedimentary deposits record long-term economic and industrial development via the expansion and contraction of a city's infrastructure. Lead concentrations and isotopic compositions measured in the sediments of the harbor of Ostia-Rome's first harbor-show that lead pipes used in the water supply networks of Rome and Ostia were the only source of radiogenic Pb, which, in geologically young central Italy, is the hallmark of urban pollution. High-resolution geochemical, isotopic, and 14C analyses of a sedimentary core from Ostia harbor have allowed us to date the commissioning of Rome's lead pipe water distribution system to around the second century BC, considerably later than Rome's first aqueduct built in the late fourth century BC. Even more significantly, the isotopic record of Pb pollution proves to be an unparalleled proxy for tracking the urban development of ancient Rome over more than a millennium, providing a semiquantitative record of the water system's initial expansion, its later neglect, probably during the civil wars of the first century BC, and its peaking in extent during the relative stability of the early high Imperial period. This core record fills the gap in the system's history before the appearance of more detailed literary and inscriptional evidence from the late first century BC onward. It also preserves evidence of the changes in the dynamics of the Tiber River that accompanied the construction of Rome's artificial port, Portus, during the first and second centuries AD.

Did King Herod suffer from a rheumatic disease?

Herod the Great was appointed "king of Jews," to govern Judea, by the Roman Emperor and Senate. He lived from 73/74 BCE to 4 CE. He died with an illness and symptoms that have been the source of considerable speculation. Richard Strauss depicted Herod in his classic opera, "Salome." That opera was derived from a play of the same name by Oscar Wilde, which was based on an 1876 painting, "Salome Dancing Before Herod," by Gustave Moreau. The operatic Herod was afflicted with an illness characterized by dementia, hallucinations, paranoia, alcoholism (from drinking the Emperor's wine), violence, twitches, and sterility; different interpretations showed him also with falls, chills, shaking, thirst, forgetfulness, and sleepiness, for which we suggest the novel diagnosis of chronic lead intoxication (which can manifest to rheumatologists as saturnine gout). He had compatible symptoms (encephalopathy and neuromuscular abnormalities) and consumed excessive quantities of imperial wine, known to be highly contaminated with lead and likely associated with similar symptoms among Roman aristocracy. Herod's demented cruelties-an oppressive reign which including the beheading of John the Baptist-exacerbated the political climate and may have contributed to the subsequent violent 7-year revolt culminating in the destruction of the second temple. How different might history have been if Herod the Great had been abstemious?

The childhood lead poisoning epidemic in historical perspective.

A hidden epidemic is poisoning our planet and its people. The toxins are in the air we breathe and in the water we drink, in the walls of our homes and the furniture has it within them. We cannot escape as it is so indispensable in our cars. It is ubiquitous in cities and the countryside. It afflicts rich and poor, young and old. But this testing of chemicals on human beings is not new. For most of the twentieth century lead was tested on children and it produced one of the largest and longest running epidemics in the history of United States. This article examines that history.

More evidence of unpublished industry studies of lead smelter/refinery workers.

BACKGROUND: Lead smelter/refinery workers in the US have had significant exposure to lead and are an important occupational group to study to understand the health effects of chronic lead exposure in adults. Recent research found evidence that studies of lead smelter/refinery workers have been conducted but not published. This paper presents further evidence for this contention. OBJECTIVES: To present further evidence of industry conducted, unpublished epidemiologic studies of lead smelter/refinery workers and health outcomes. METHODS: Historical research relying on primary sources such as internal industry documents and published studies. RESULTS: ASARCO smelter/refinery workers were studied in the early 1980s and found to have increased risk of lung cancer and stroke in one study, but not in another. CONCLUSIONS: Because occupational lead exposure is an on-going concern for US and overseas workers, all epidemiologic studies should be made available to evaluate and update occupational health and safety standards.

On Corporate Accountability: Lead, Asbestos, and Fossil Fuel Lawsuits.

This paper examines the use of lawsuits against three industries that were eventually found to be selling products damaging to human heath and the environment: lead paint, asbestos, and fossil fuels. These industries are similar in that some companies tried to hide or distort information showing their products were harmful. Common law claims were eventually filed to hold the corporations accountable and compensate the injured. This paper considers the important role the lawsuits played in helping establish some accountability for the industries while also noting the limitations of the lawsuits. It will be argued that the lawsuits helped create pressure for government regulation of the industries' products but were less successful at securing compensation for the injured. Thus, the common law claims strengthened and supported administrative regulation and the adoption of industry alternatives more than they provided a means of legal redress.