Health and safety issues in the Victorian workplace: An example of mandibular phosphorus necrosis from Gloucester, UK

Abstract

Working conditions in factories during the Industrial Era in Great Britain have been linked to numerous occupational diseases. In this paper, the authors present a case study from Victorian Gloucester, where skeletal remains of a young male recovered from the Southgate Street 3/89 excavation exhibit osteonecrosis on the left mandibular ramus, a condition known as "phossy jaw." The case is examined in terms of macroscopic characteristics, distribution and severity of lesions, and differential diagnosis.The lesions consist of extensive bone necrosis with periosteal reaction and subperiosteal new bone formation that affects the left side of the mandible. Conditions that may have produced similar changes were considered and include various forms of neoplasms, actinomycosis, and taphonomic alterations. However, these are rejected as they are not supported by the lesion characteristics.Additional supportive evidence for the case of phosphorus necrosis is offered by the historical context: In the 19th century, Gloucester was one of the main centres for match manufacture, and it is well known that individuals who were directly exposed to phosphorus fumes developed a condition known as "phossy jaw."The potential contribution of the current analysis in our understanding of working conditions in Victorian Gloucester is evaluated.

The evolution of healthcare towards patient‐centred care and the need for systemic approaches

“…In the pre‐industrial era, the availability of simple technology and limited knowledge drove whatever care was able to be provided. In the industrial era, awareness of safety and environmental issues led to immense improvements in health (Valoriani, Eliopoulos, Irish, & Borrini, 2020). The post‐industrial era saw significant technological advances.…”