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Occupational Medicine in the Interwar Period (1919-1939): The Birth of the Discipline

The history of occupational medicine, often overlooked, is closely linked to the economic and political transformations of the early 20th century. This pivotal period saw the emergence of concepts and medical practices in the professional environment, essential to understanding our current management of workplace health.

Estimated reading time: 3 minutes

Following the First World War, legislation on occupational diseases gradually took shape, despite a slow and hesitant start. In 1919, a law recognizing certain work-related diseases, such as those caused by lead and mercury, was adopted. However, its implementation was limited, covering only a small number of cases. The roaring twenties saw demands for the extension of this recognition to other diseases, such as cement scabies or plaster eczema, but these advances regularly faced opposition from employers.

The Birth of Occupational Medicine in the Face of Discrimination

This employer opposition, however, was not a systematic rejection, but rather a form of collaboration with the State aimed at influencing legislation. For example, the General Confederation of French Production (CGPF) envisioned the role of the factory physician as a tool for optimizing performance, even promoting a form of elimination medicine at hiring.

It is important to note that this period was also marked by discriminatory and racist practices in the workplace. French employers often preferred colonial or foreign labor, considered more malleable, for the most arduous and dangerous work. Maghrebi workers, in particular, were often sent back to avoid health care costs, especially in cases of tuberculosis. Strict sanitary controls were imposed on immigrant workers, reflecting a discriminatory approach to health in the workplace.

It is in this complex context that occupational medicine, as a discipline, began to take shape. Under the influence of international organizations, the concept of parity developed, and with it, the idea of an integrated and comprehensive occupational medicine. In 1927, a decree mandated the reporting of occupational diseases, although they were not compensable at the time. This decree marked a decisive turning point in the recognition of occupational diseases, even though the definition of what constitutes an occupational disease remained a topic of debate.

The Recognition of Occupational Medicine in the Face of Social and Industrial Challenges

The period preceding the Second World War was crucial for the evolution of occupational medicine. Dedicated training programs were established, with the creation of specialized courses in Lille and Lyon. These programs played a key role in the professionalization of occupational medicine and in the dissemination of knowledge about occupational diseases.

The strikes of 1936 highlighted the unsanitary conditions in which many workers labored. These events encouraged the development of medical services within factories and underscored the need for a more proactive and preventive approach to health at work. This period also saw the emergence of workers’ demands for better consideration of hygiene, safety, and cleanliness at work.

In Conclusion:

The history of occupational medicine is rich in lessons. It reveals how socio-economic transformations and political struggles have shaped the way workers’ health is perceived and managed. Today, these historical foundations continue to influence practices and policies in workplace health, highlighting the importance of this discipline in our contemporary society.

Philippe Casanova

Specialist in occupational medicine and forensic medicine.