Good afternoon. Our next speaker is Dr. Al Pormet. Dr. Pormet holds a Bachelor of Science in Chemical Engineering from the U.S. Air Force Academy. He was awarded his M.D. degree by the University of Kansas and his M.Ph. degree from the University of Texas. He completed residencies in aerospace medicine and occupational medicine and has completed toxicology training at the University of Kansas and a fellowship in space medicine at the Johnson Space Center. He served in the United States Air Force from 1968 to 1992 with many aviation assignments and declarations. He holds board certification in aerospace medicine and occupational medicine. He is a fellow of the American College of Preventive Medicine, the American College of Occupational and Environmental Medicine, and the Aerospace Medical Association. He received the Tamisee Award from the Aerospace Medical Association in 1999 and was named Clinical Physician of the Year for 2009 by the American College of Occupational and Environmental Medicine. He is also an academician of the Académie Internationale de Médecins Aéronautiques et Spintels. He served as president of the American Society of Aerospace Medicine Specialists in the Great Plains College of Occupational Medicine. He is now a senior aviation medical examiner and adjunct professor at the University of Southern California, Gratera B. School of Engineering. Dr. Pourmet is a native of Kansas City and he will tell you some interesting things about the World War I Museum and the World War I's role in occupational medicine. Without further ado, Dr. Al Pourmet. Welcome to Kansas City. As Warren said, I live here. I'm a native. I'm happy to be back here. One of my major activities these days is being a docent at the National World War I Museum and Memorial, which you see pictured here. Looking out over our memorial bricks where there's one for one of my grandfathers, one for one of my wife's grandfathers, who are both veterans of the First World War. Do drop by. It's only 20 blocks north of here. If you have tomorrow afternoon free, we're open and I'll be there. Come down. The merge of my talk today was how did occupational health and since we're going to do aerospace, I'm not going to do aerospace today because that's a whole nother one, but aviation medicine gets started here during the First World War. It's not because of the First World War, but it's it's the driving force. And so what I want to do is take you back to where we all got started. What we do today in preventive medicine and occupational and aviation all got started 100 years ago, 120 years ago. And it's driven primarily by what happened during the First World War, which was a tremendous world shaking event. They called it the Great War because they didn't know there was going to be another one. Although some people did. As they said, you're leaving Versailles. We'll see you in 20 years. So. The advance looks like that doesn't work. We'll try this one right here. It's kind of a trap. The batteries tend to go. This will click what? It works. It doesn't. Yeah. Pushing all the buttons. Push that button. There we go. I got one to work. All right. It's good. I'll just use this one. Sorry, boss. Yeah, no worries. Let me fix that one. OK. Nothing to disclose. My paying job is still working for the disaster medical assistance team. We're still looking for extra bodies. So if you've got nothing else you want to do and you like to go camping and eat MREs, do give us a call. It'll take you to sometimes take you to strange places or sometimes just a job in Missouri. So going back to the turn of the century, that is between 19th and 20th. What did we know about occupational health? And the answer is very little. There was almost nothing. We had my hero here, Theophrastus Bombastus von Hohheim, better known as Paracelsus, who gave the first real occupational health descriptions of diseases, particularly of minors. And a few years later, we have Ramazzini, thank you, who gives the diseases of workers. They can describe the diseases. There's nothing about preventing them. There's nothing about treating them. But at least you know what they've got. Or as Ramazzini said, tell me where he works, I'll tell you what disease he has. And he was pretty much accurate. Because there is nothing in prevention, and there's nothing in treatment. And nobody cares about workers anyway. I mean, they're there. They're going to do what we tell them. And the rights of workers are virtually non-existent, which is going to lead to social upheaval starting in the late 19th century, and it will culminate in revolutions in the 20th century. The workers are being tired of being oppressed. There's tremendous advances in industry, though, in the second half of the 19th century. And these are some of the individuals who drive that. We're going to look at some areas of industry that become major drivers behind occupational medicine. And these in turn are driven by the First World War. You'll recognize probably three of the four people here. Certainly in explosives, we have Alfred Nobel. He came from a family of explosive manufacturers in Sweden. He's known for, quote, inventing dynamite, which is just a way of stabilizing nitroglycerin. Because nitroglycerin is a little bit on the touchy side, you might say. It's not good for war, because it's even so, dynamite's a little too touchy to be used as a wartime explosive. But that wasn't Nobel's only project. After one of his factories blew up, killing his brother, he decided to focus a little on safety and looked at stabilizing items and stabilized nitroglycerin to make dynamite. Made him a lot of money. But he also invented a lot of other things. So one of these was called smokeless gunpowder, although it isn't gunpowder at all. But it generally doesn't produce as a smoke that gunpowder does. Have you ever been on the Fourth of July? You know how smoky the fireworks display is. Well, imagine that multiplied by a few thousand times on a battlefield where everybody's firing gunpowder, black powder muskets. And you realize that pretty soon a battlefield, the visibility's down to 50 meters. And you have to wear brightly colored uniforms so you can tell who's your friend and who's not your friend. Well, with Nobel, he's going to develop a form of smokeless gunpowder. There'll be some other people who do it as well. And that makes him a whole lot more money. So he becomes known as a merchant of death. But he's created a battlefield where you can see a mile. And that's not good if you've got a brightly colored uniform on. But we'll come back to that point. Because we're going to go into the Great War dressed for success in the 19th century. Andrew Carnegie, who doesn't invent steelmaking, Messimer makes the modern process, but he makes it better. He industrializes steel, creates U.S. Steel, the greatest steel manufacturing company in the world, and makes the United States the leading manufacturer of steel. And to make steel you need iron, and you need coal, and you need people to do that. So this is a huge industry in the United States. And we're the leading manufacturers. We make more steel than Germany and England put together. We've got William Perkins. If you've never heard of him, I see some of you are dressed because he creates what's called the moth age. What's moth? Man, tell us what moth is. The color sweater you have. There you go. I mean, I'm a guy. I see in sick colors. Because he develops this out of aniline dyes, coal dye, coal oils. And all of a sudden the dye industry is born. We're no longer using natural dyes. It's from coal residue and a massive dye industry, which actually really takes off in Germany. And the German chemists developed this. And now women dress in all kinds of different colors that you could never do before, because color was very expensive. Well, now it's cheap, and it's common. The dye industry is massive. And it's coal products. So coal becomes even more demand. And then we have electricity. Thomas Edison, everybody thinks invented electricity and the light bulb. He is an industrial laboratory, is what he does. And he really makes patenting a natural process. Edison has two great rivals, by the way. One is Nikola Tesla, who most people forgot about. And Tesla, he fought forever. Actually, Tesla won, because Tesla was the advocate of alternating current. And that's what our lights are today. AC, not DC. The other one, you probably didn't know, was a gentleman named Hiram Maxim. Maxim actually invented the light bulb. The incandescent bulb. But Edison patents it. And to get rid of Maxim in the patent fights afterwards, he buys him off. He gives him $10 million and tells him to go to Europe and stay there. So Maxim does. He's a great inventor. He's invented a lot of things. Automatic sprinkler systems. That's Hiram Maxim. He got them right in the room in front of you. He invents this. So he tries practical inventions while he's in Europe, and he doesn't get anywhere until one of his friends said, look, you're in Europe. Invent something that will kill people. They'll buy that. So Maxim says, okay. And he invents what becomes the machine gunner. And every machine gun today that isn't a Gatling gun is one of Maxim's inventions. Better living through chemistry and industry. That's setting the stage. Because American industry before the First World War is kind of brute strength. We make a lot of steel. We produce most of the oil in the world. The majority. We're an exporter, thanks to a gentleman named Rockefeller. But we make straightforward stuff. We make iron for railroads and ships. We don't have much high technology. And most of our chemicals are actually imported from Germany. We'll build the very first dreadnought battleship. It's not called the Carolina, because while the British follow suit and lay down HMS Dreadnought, they finish it first. The Carolina takes two years longer than the Dreadnought, even though it was started first. But it's the same technology. What we don't have are German guns. So the guns aren't as good. And we don't have German armor. The steel we don't make is not as good. It's half again as thick to do the same thing that German armor does. We don't have that technology. That torpedo is there because a British inventor named Whitehead, who moves to Austria and develops the automotive torpedo. And we can't build the pressure vessel that makes these run. It's just compressed air. There's no engine inside this. It's just a compressed air tank. And we can't build a civil pressure cylinder that will hold 1800 psi. So we've got to import those from Europe. Our technology lags Europe. It's not for lack of trying. And pretty soon when the war starts, it's going to drive a lot of things because there's a lot of chemistry and steel and production that's going to go into the Great War. Starting with the explosives, you need at least four different chemicals to make a shell. An artillery shell is very different in the First World War from the Civil War. Civil War is a big bag of gunpowder and a steel ball. But a unitary shell from First World War, you need a primer to set it off. You need a propellant, which is, if it's gunpowder, it's processed gunpowder and it's probably a little more advanced like cordite. You need a high explosive in your shell because gunpowder is not a high explosive. It's a deflagrant. You need something that when it explodes, it propagates supersonically. That's what a high explosive does. TNT is invented in 1912. So we don't even have that one. We're still using nitrocellulose and gun cotton. Simpler stuff. Ammonium nitrate. And then you've got to have something in the fuse. And these are wonderful items because now you've got an artillery shell that can travel miles, can explode. A shrapnel shell can cover an area the size of a football field with lethal shrapnel. Where'd they get that name, shrapnel? Oh, there's a British artillery officer named shrapnel. Then you put it in hand grenades. They call them grenades because they look like pomegranates and that's the French word for grenade. Steel production goes up. We make stuff for the Europeans. We make stuff that they can't make because they can't make enough of it. And that increases oil and coal and iron production. We've got to bring in all these other metals we've never used before. Platinum. We've used a little bit of lead and mercury. Now we're producing massive amounts, which are a little bit toxic. And our workers haven't encountered them before. We don't know how to work with them. And now we're producing aluminum because there's a new electrolysis. Edison and his electricity. We're making aluminum, which was a vital, very, very expensive metal back in the 19th century. The Washington Monument has a two and a half pound pyramid of aluminum on top because aluminum was more valuable than gold when the monument was built. Now it's a couple of beer cans worth. And we start seeing diseases in our factories. Carbon monoxide poisoning, very common with cocaine. Silico tuberculosis outbreaks in the miners. And tuberculosis is bad enough because it's the number one cause of death in this country. Yeah. And of course, we don't have any treatment for TB, do we? We don't have any treatment for any infectious disease, except one, syphilis, because we've got an arsenical courtesy of Erlich in Germany. Chemicals are coming out. Europeans want lots and lots of chemicals. They've decided to use them. Believe it or not, there was a peace convention in 1899 convened by none other than the Russian czar, Nicholas II. And one of the things they do is ban the use of chemical weapons, sort of. What they actually do is say you can't drop a bomb with chemical weapons from a balloon. Well, they didn't include airplanes because there weren't any. So the French start using tear gas in 1914. But they said, that's not really a chemical weapon. You know, we've been using that for riots. And the Germans then unleash chlorine. Well, we didn't drop it from a balloon. We released it from cylinders. So technically we're okay. I think their lawyers got in on that one. And they're going to develop other chemicals. And if you're working on chemicals and you're producing them back in the factory, guess what? You get a lot of exposures. All these chemicals and pharmaceuticals, we were buying them from Germany. And we can't get them anymore because when the great war breaks out, all sorts of things stop moving between countries. Trade stops. Believe it or not, the two countries that had the highest amount of trade between them in the entire world just before the war were Germany and England. And they said, we'll never be a war between Germany and England because we've got too much trade going on here. Also the czar, I'm sorry, the king of England and the Kaiser were first cousins. That's correct. And the czar was their first cousin-in-law. Yeah, they're all related. They are all related. And the king of Denmark was the father-in-law of this person and that person. And that's why Elizabeth and Philip were second cousins doubly. The rules, the treaties, the international relations in Europe were based on marriages of royalty, which is why they didn't know what the hell to do with Americans because we didn't have any. We actually believed in a treaty and you had to follow those kind of rules. So this was a new thing with the Europeans. Greedies, scraps of paper. So we're dealing with a world that's going to change very rapidly when the great war starts. And what do we have in terms of workplace safety in this country just leading up to the war? Nothing. I mean, we had the very first survey in 1906. And in 1908, a brand new young woman physician named Alice Hamilton in Chicago will write the very first occupational health paper. The first one. We don't even know how many people are getting killed on the job because the very first survey isn't until 1906. We're just estimating what's going on. We get the first real estimated death rate in 1913. 61 workers out of every 100,000 will be killed on the job every single year. How much do we have in terms of workers' compensation and prevention at this point? Nothing. Yeah, nothing. Nothing. Our current death rate's around three to four. Now I want you to compare that to something else. Maternal death rate. What's the maternal death rate in 1913? 850 per 1,000. Yep. It's a lot safer to get a job than to get pregnant. That's still true because the death rate for women today is 33 per 100,000. It just went up. Just went up, yeah. Thank you. It just went up. And to be a minor, figure what those numbers mean. And that's just deaths because the maiming injury rate is three to four times that. But then there were all immigrant Poles and Ukrainians and, you know, those kind of guys you didn't worry about, right? Or better yet, they were children. So what are they doing in Arkansas this week? Besides dropping the age down to 14 where you can work in a slaughterhouse? Yeah, well, you know, they got a new governor down there. So where's our workers' compensation law? As we said, nothing. They will pass some workers' compensation laws and they're declared unconstitutional because the 14th Amendment says a business is a citizen and can negotiate a contract with a worker who's another citizen and it's just between those two and the government needs to stay out. One of the strongest work comp laws in New York is declared unconstitutional on March 24, 1911, and the next day is the Triangle Waste Fire. And 146 women burned to death in another 40 are maimed. What happened to the owners of the building? Nothing. Out of the goodness of their heart, they gave $50 to every family. They could have had a sprinkler system that Maxim invented 30 years earlier, but they didn't. And this does lead to the reaction of instituting workers' comp laws. Wisconsin will follow that year, so will Kansas, and by the end of the decade, almost all the states have workers' comp laws, although they don't cover agricultural workers. But it takes a long time to get the very last one in because, you know, the three common law defenses. You hurt yourself, your co-worker hurt you, or you know it was a dangerous job. And for these reasons, any worker who was injured on the job who had to sue their employer for an injury lost their case well over 90% of the time. Workers could not recover, and of course, they usually couldn't afford to sue in the first place. And of course, they usually couldn't afford to sue in the first place. Workers' comp laws got rid of this with the no-fault. And who's the first country with no-fault law? It's Germany. They killed von Bismarck. You wouldn't think Otto von Bismarck would do that. The Iron Chancellor was not exactly a liberal individual. But what he was doing was recognizing that workers and the great parts of the population were following socialist principles were causing trouble. So he was pulling the rug out from under them by doing two things, workers' compensation and socialized medicine. And Germany has these in 1884. It was literally eight years, I'm sorry, 18 years after they were formed. No, only 13 years, 1871. This is the empire of Germany under Wilhelm I. They're brand new, but they're much more progressive than anybody else. And that literally takes, if you will, the figurative wind out of the sails of the socialists. They won't be back really until the end of World War I. And in fact, the socialists become a great supporter of the German empire because of this, because the government is actually taking care of them, whereas we're going to fight it. We're going to fight it all the way into the 1930s. Because the only work comp law we have prior to 1911 is going to be FILA, and that is not no-fault. Some of you probably played with it. It's an interesting law. When the war starts, it doesn't go the way the big powers plan. They figure we're going to have a quick win, it'll be a short war, and we'll be home by Christmas. Yeah, what year? It doesn't quite work out the way they planned. There are things that happen that they weren't expecting, or they didn't know how to use the new technology. They didn't know how to use machine guns. They didn't know how to use gas. Even though they had it, they didn't know how to use it. They didn't know how to use barbed wire and artillery. And then there's the airplane, which is going to lead to aviation medicine, but that's another talk. But it changes the way they fight the war. Particularly aviation, not because of the fighters and the bombers. Those actually do very little, because aviation lets you look down and see what the other guy's doing, so you can't build up and surprise his attack. So nobody can surprise anybody. Therefore, you get stuck in what's basically a gigantic siege. There's a siege line that runs from Switzerland to the North Sea, 425 miles long. Crenches, barbed wire, and it just doesn't move for four years. But they slaughter five million men on that front line, and they get almost nothing. The big killer is artillery. And I mentioned some earlier, but here's really what's going on. They don't have the idea of what the logistics are going to be behind this. In the American Civil War, we've got a typical weapon, a 12-pounder cannon. If you want to see one, you can go about half a mile from here to Luz Park. That weapon takes about two minutes to load and fire. It fires an iron ball, got a range of, you know, a little over 1,500 yards. Fires gunpowder. Whereas the first modern cannon, the Canon de 1997, we know it as the French 75, not the cocktail, which probably is just as powerful. Try that sometime. Try that sometime. It fires a shell 5,000 meters. It's a shell. It can explode with high explosive or shrapnel or gas. The standard rate of fire, 10 rounds a minute. And you could increase that to 20 rounds a minute, which means a battery of six routinely is going to fire 60 rounds a minute compared to a Civil War battery of 12, which might get six rounds off. And that Civil War gun, you might get 200 rounds off before it's done. You're going to have to throw it away because the barrel's worn out. You fire 600 rounds with a modern cannon, then you replace the barrel because you're carrying a spare barrel back on your case off, which has got dozens of horses. And you got to keep reloading this thing, which means millions and millions of artillery shells are being fired across the slines at the poor bloody infantry who's sitting down there in those trenches. Millions of shells. And they hadn't figured this out. The British Army, which was the smallest of the five major armies, went to war with 91 artillery pieces. And the plan was to fire up to three rounds per day for six months, at which point you would, the six months of shell production back home would supply you with another three months. At which point the next three months would supply you with six weeks. Well, diminishing returns there. They just had not planned on what they were going to need and use. By 1918, the British had 35,000 guns. And again, they're the smallest of the armies. The French Army is four times as large. The German Army is bigger. They're firing a quarter of a million shells per day. Their peak, they fired 800,000 shells in one day. Some areas were hit with an average of 40,000 shells per square meter over a four-year period. When you think about that, 40,000 artillery shells in an area this big, and by the way, 15% of them are duds. Some of the secondary shells are going to make the first ones that were duds go off, but others are just going to drive them deeper down on the ground. And that's why the ground starts looking like this. The United States comes in, but before that, we're producing shells, we're producing guns, and we're selling them because we are getting rich. Well, the manufacturers are getting rich. People are getting employed. The manufacturers are getting rich. People are getting employed. Our industry is really cranked up. But when we join, we're going to have to do a little expansion because our army is theoretically 80,000 men. We probably had 20,000, the rest were in the National Guard as the National Guard was. It's not the National Guard of today. And you not only had to produce the weapons, but the clothes, the gear, everything that goes with them, the logistics trail, and somebody's going to make that. So entire manufacturing businesses switched over. Industry in the United States entirely does a turnaround to support this war effort. It's pretty massive. And there's everything's cooking with this as well. That all those shells, hey, nobody planned to make that much artillery shells and explosives and all those things that go bang. They ran out. They literally were running out of stuff to go back. But courtesy of modern living in chemistry, they have a couple chemists, Fritz Haber on the German side and Frank Weitzman on the British side who invent a process to take air and turn it into ammonia, condensation process. Haber's also going to dump chemical weapons for the Germans, better living through chemistry. And they get through this crisis. Otherwise, everybody would have run out of shells in 1915 and had to go home because they were out of toys. But aren't we fortunate? They were able to keep fighting for another couple of years. Because where had they gotten their ammonia from? Bird shit. Yeah, there were guano islands all around the world, mostly Chile, if you're a British. The British grabbed that. The United States grabbed these little islands around the world that had bird shit on them, like Wake Island, Midway Island, and Johnson Atoll, and a little place called Iwo Jima. We got tired of that one, gave it back. But we owned them, courtesy of the Guano Islands Act, because we needed it for fertilizer. But now they needed it to make explosives. Massive. All this logistics trail to make millions and millions of artillery shells. If you're going to fire off 800,000 in one day, you better have a couple million in your stockpile. And we're making them here, too. For some reason, the Germans did not appreciate the fact the United States was neutral, but was producing large amounts of artillery shells and explosives and then selling them. I mean, if they could have come here, we'd have sold it to them. Very happily. But they had a little problem with getting back and forth. They managed to make two trips, but that was it. And interestingly, since men are being drafted for all this, or they're busy doing steel and hard work, most of your explosives workers will be women. Drafting massive numbers of women into the workplace for the first time. Women have been working in the workplace, in the industry, mostly in textiles and places like that. And they would work for a few years until they were married and then they would leave. But now we've got massive numbers of people required to come in. And this is not safe work. But what sort of safety standards do we have? Yeah, none. Zilch. The munitionettes put in long days. You're busy, so you eat at your workplace, right? Eat your sandwich covered with a little nitrate, mercury, fulminate, whatever you got. Yeah. Whatever you got. Producing millions of shells. They became called the canary girls. Because things like TNT will be absorbed and you'll turn yellow. You will look like you're jaundiced. And if you keep it up long enough, you'll become quite ill and you will die. Canary girls died by the dozens. And that was without counting safety issues like, you know, explosives can explode. We blew up a couple of our factories in this country by accident. Or on purpose. I said the Germans objected to this. And working out of some interned ships in New York Harbor, they had a sabotage group. It would blow up the Black Tom facility, which is you can see it's right across from Staten Island there. They put bombs in over 100 ships. They set off a bomb in the Capitol. The Capitol building in the United States. And attempted to assassinate the Secretary of the Treasury because he was loaning money to the British. They'll do this again in World War II as well. The biggest single ammunition plant to go up was Silvertone in London. But in the midst of all these people getting sick in the workplace, there finally was an outcry because we expected the man to get sick and die, but we were killing women. That kind of annoys people. Their husbands get upset. And so in comes that young lady who'd actually done some occupational work and was working for the state of Illinois on lead poisoning. And the Army said, we need somebody to keep the workers in the ammunition plants healthy. Come in and fix this. And so they asked two people, Alice Hamilton, who actually knows what she's doing, and a young surgeon from Massachusetts General, who's a captain in the Army, to supervisor. Can't let a woman run around unsupervised. That will get you into trouble. And so together they go into the plants, investigate the illness, and actually institute some preventive medicine problems and processes. And this will be prevention in occupational health. How about having the chemical workers wash off? Don't eat your food at your workstation. Don't take your work clothes home. Wear masks. You don't inhale the dust. Basic hygiene, basic health care. It was rocket science for those days, I suppose. But it made a huge difference. And the Occupational Health Association was finally founded in 1916. That's the great grandfather of what we are today, why you're sitting here. It will eventually be us today. And basically it's Alice Hamilton's doing. When the war is over, the Army fires her, but Harvard decides, maybe we should teach some of this stuff. And she'll become an assistant professor at Harvard for the next 30 years. She never gets tenure, by the way. She's the most famous occupational physician in the world. Writes the very first textbooks. Still in print today. Hamilton and Hardy's Toxicology. She never, never got tenure. She had to be renewed every three years. That was unfortunately fairly common for the women scientists of that period. There was another effect on all these women going into the workplace. They were threatening to strike. And they would leverage that, not just in the United States, but in England and Germany as well, for suffrage. And Woodrow Wilson, who really was kind of an inflexible person, I think this is about the only instance I can come up with where he'd been. And he caved in and agreed to support what became the 19th Amendment. And it will be ratified in the last days of his administration in 1920. Because up to this point, the only place women could vote was, well, there's only two republics in the world, the United States and France. And women can only vote in the western parts of the United States, like Kansas, but not Missouri. It's a state by state thing at that point. Although Montana will send the very first woman congressman into Congress, a lady named Janet Rankin, who takes office on April 5, 1917. And on April 6, she votes against going to the war. She was consistent. She's a pacifist. She would do it again in World War II. But in World War I, there was 58 people voting against, including a guy named August Lindbergh. That's Charles Augustus's father. But in World War II, she's the only one to vote against going to war. She's consistent. So I give her that. Another thing that we're going to see, portable x-rays. The young lady there, Dr. Marie Curie, Nobel Prize winner, is going to create the first portable x-ray units. It's going to take chunks of radium and put them in a lead box with a little shutter on it and use that to take x-rays. And she'll drive her little cars around. She develops them for the French Army. When the American Army shows up, you can see her briefing the U.S. Army Medical Corps and training them here. And we have portable x-ray machines. And for the first time, you can identify where foreign bodies are. Saved countless lives. But they're using a portable chunk of radium. So it's Warren in there. And he's in the back with a with a Sam Brown bill. Well, we don't pick up at this point. We're just setting the stage as radium induced problems because we're going to find in the trenches, you need to be able to see something at night. And radium painted on a watch dial or a compass is wonderful. I had a compass like this back in the 60s. And let me tell you, in the rain, in the dark, in the jungle, that was the brightest thing around. You could see where you were going. Of course, the other guy could see it too. Yeah. And the radium dial painters, little ladies who would lift the tongue. So the unforeseen consequences were radium dial painters jaw. And they weren't covered by workers comp. It'll come up in the 1920s when the radiation effects of radium become apparent. And they're not covered. They're on their own and they're dying like flies, literally. Cure yourself is going to die of a plastic anemia from the radium. And the other long term effect is remember all those millions of shells that were dropping on the ground. You got a France today, it's called the record to fail the harvest of iron. All along what was no man's land today. Today, 100 years later, farm will go out in the spring, plow his field and up comes some iron eggs. And they'll just pick them up and put them on the side of the road and the OPAs come along and pick them up, take them out to the to the North Sea and blow them up about once a month. Not the only place. The US Army had a little place called Edgewood. Where's Edgewood there? North of Baltimore, right on the road to Philadelphia. And they had tons and tons of gas shells, particularly a lovely one called Lewisite and mustard. And what did they do with those at the end of the war? They just took them out in Chesapeake Bay and dumped them. And sometime later, somebody came up harvesting oysters and taking oyster shells off the reefs and grinding up all those shells and dumping them on the road for lighting roads. And we get live mustard gas shells showing up in somebody's driveway. Had that just a few years ago in Delaware. One of these old gas shells. Mustard was still in it because the EOD guy who went out to disarm it got a nice burn. It was impressive. The last little bit from the war is something else we don't think of. And that was when the war started, the United States agriculture was not much exporting food. Most of the Western Europeans, particularly England and Belgium and Holland, were getting their wheat from the Ukraine. But when the war started, for some reason, they cut off the shipment of Ukrainian wheat. Now that couldn't happen again. And so the supply of food, particularly to Belgium, which couldn't replace it, and Holland, which was limited, was very difficult. And an American businessman named Herbert Hoover, who'd already done food relief in China a few years earlier, establishes the Commission for Food Relief. And he's going to supply food, particularly to the Belgians, and to a lesser degree, the Dutch. And Hoover offers $4 a bushel for a barrel of grain in the United States. It's selling for 50 cents a bushel. So what do farmers do? Grow wheat. Let's get one of them newfangled tractors. We're going to go out to the Western Plains that are just grazing lands. And we're going to plow up Western Kansas and Western Nebraska and Eastern Colorado and the whole panhandle of Texas. That's covered with prairie grass, which is a perennial and full of cattle. And we're going to plow all that up, we're going to plant wheat. And they do, and they produce vast amounts of wheat. And it happens to be a wet season. They don't know what a leninfa and a lenino is, but we're in one. And we got 10 years of wet seasons coming up. And they produce vast amounts of wheat, and they feed Europe, and we start feeding the world. And American agriculture really takes off and becomes a world exporter. We still are today. But Hoover doesn't have a real good crystal ball about that, because he doesn't quite foresee what's going to happen when the rain stops. And when the rain stops, wheat's an annual. And there's no longer anything to hold the topsoil down. And everything in panhandle of Texas all the way up into Western Nebraska starts to blow away. And the Dust Bowl is a direct environmental disaster as a result of human activity precipitated by the First World War. And when you drive out through the Western Plains today, and you see contour farming and windrows, that was not there 100 years ago. That's our response to the Dust Bowl, which was our response to famine in Belgium. In Belgium. The Great War changed everything. It changed society. It changed modern politics. It created our modern world today. There was a tremendous amount of suffering and huge numbers of deaths, both from famine, as well as particularly influenza, the Great Influenza, because of the disruption. But at the end of the days, the feudal lords have brought in our modern world. The old empires were gone. We have democracies and fascist states and communist states will arise. And we're still living with all the disruptions from that time. But it also gave the opportunity for occupational health and medicine to grow and develop and be as where we are today. And with that, I thank you. Thank you for the opportunity.

occupational medicine

World War I

worker safety

Alice Hamilton

women workforce

industrial advancements

public health

preventive practices