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Accidents at Work: the diagnosis

It has been known for a very long time that some occupations imply risk and cause injury to workers. Agricola (1494-1555) noted the incredible death rate in the Joachimstal silver mine in the Carpathian mountains. The silver was minted into “Joachimstalers” or “talers” from which the word “dollar” is derived. After Agricola, Ramazzini (1633-1714) noted and catalogued the illnesses associated with various occupations. H.A Waldron, in his book “Lecture Notes on Occupational Medicine” quotes a surgeon, Percival Pott in 1775:

“It is a disease which makes always its first attack on, and its first appearance in, the inferior part of the scrotum; where it produces a superficial, painful, ragged, ill-looking sore, with hard and rising edges: the trade call it the sootwart. I never saw it under the age of puberty, which is I suppose one reason why it is generally taken, both by patient and surgeon, for venereal; and being treated with mercurials, is thereby soon and much exasperated. In no great length of time, it pervades the skin, dartos, and membranes of the scrotum, and seizes the testicle, which it enlarges, hardens, and renders truly and thoroughly distempered; from whence it makes its way up the spermatic process into the abdomen, most frequently indurating and spoiling the inguinal glands: when arrived within the abdomen, it affects some of the viscera, and then very soon becomes painfully destructive.”

The illness was scrotal cancer and the victims were chimney sweeps. The cancer was caused by contact with soot.

The list of occupational illnesses referred to in the Occupational Injuries scheme of the Department of Social Protection is further evidence of the extent of the knowledge available about occupational disease. However, the medical profession in general is slow to attribute fault to occupation when diagnosing illness or even injury.