James Joseph Magennis VC Frances Elizabeth Clarke Stewart Parker Samuel Beckett Sam Hanna Bell William Carleton John Hewitt Rosamond Praegar Bernard (Barney) Hughes

Dr Jim Smiley OBE (1907 - 1988):
Medical occupational health pioneer


James Anderson Smiley, or Jim Smiley as he was known, was born on 20 April 1907 at Castlewellan, County Down, one of a sibship of four sons and one daughter. The father, Samuel John, was local chemist/apothecary. It was a strict household with medicine and Methodism pervasive: the eldest son, Sam, became a chemist and helped to run the family business before emigrating; Tom, a surgeon in the war-time army, was captured at the capitulation of Singapore and had a harrowing time as a prisoner-of-war, but on return became a consultant thoracic surgeon at the Royal Victoria Hospital, Belfast (RVH); while George and Agnes became dentists.

Jim was educated locally and then, from 1920, at Methodist College, Belfast graduating in medicine at Queen’s University, Belfast in 1930. After serving as a house physician at the RVH he entered general practice locally as an assistant, then at Todmorden (West Yorkshire) before marrying a former RVH nurse, Elizabeth McGahey, in December 1933, and they were to have five children (three boys and two girls). Now settled to practice in east Belfast, Smiley became that area’s Certifying Factory Surgeon (re-invented in the 1938 Factory Act for Northern Ireland as Examining Factory Surgeon and subsequently Appointed Factory Doctor). When the aircraft firm of Short Brothers relocated from Rochester to Belfast on the approach of war he was appointed medical officer to the company (1939) and also to several other industries both local (such as the Belfast Ropeworks, the York Street Flax Spinning Company) and satellite (such as Hughes’ Tools, or Standard Telephone and Cables ). Disturbed by the poverty of the “depression thirties” and the outmoded, hazardous and unhealthy working conditions in local industries, frustrated by the limitations of doctors and medical services to cope and driven by humane compassion and strongly-held Christian beliefs (he was to become a leading layman in Ulster Methodism), Smiley aimed to draw attention to, and where possible help to improve, the working conditions and lessen the hazards faced by the industrial workforce. He planned to use three means. The first was through influence by establishing and enhancing his professional credentials and commitment and setting an example by being very much a hands-on industrial doctor spending time in the factories with the operatives to study their working conditions and practices. (He even on one occasion lodged with a miner in south Wales to spend time at the coal-face to study “beat elbow” and “beat knee”). Second, by working to develop a more active and imaginative national professional body for doctors working in industry; and third, by conducting research and publishing lectures and articles. The fourth traditional means, viz. teaching opportunities when influence on tomorrow’s doctors can be strong, were in his case limited since he was merely a part-time lecturer at Queen’s University in industrial toxicology (1952-56) and in industrial medicine (1959-72), mainly to postgraduate Diploma of Public Health (DPH) students - when there were any!

As regards his first objective, Smiley obtained by examination the Diploma of Industrial Health (DIH -1948), then available from the Conjoint Board of the Royal Colleges and from the Society of Apothecaries, after study in Manchester under Professor RE Lane, the British doyen in the specialty, though this required some commuting. He also (1946) obtained the MD degree from Queen’s University “with high commendation” for a thesis on the industrial–centred “accident proneness” concept which led to an invitation to deliver the Milroy Lectures of The Royal College of Physicians of London, which he duly accepted (in 1955), and which brought his name and work before a larger and more influential public (see also below). He also practised what he preached.  

As regards his second objective, he was active in the Association of Industrial Medical Officers of the United Kingdom and in encouraging local initiatives, efforts acknowledged in his award of the OBE (1960). He became a council member of the Association and then (1967) the first Irishman to become President, and when the Association was restructured as the Society of Occupational Medicine (1969) he became an Honorary Fellow. He was also a driving force behind the creation (in 1976) of the Faculty of Occupational Medicine of the Royal College of Physicians of Ireland and was a Founding Fellow and its Vice-Dean (1976) and Dean (1981-83), and he became an ad eundem Member (1976) and then Fellow (1978) of the Royal College of Physicians of Ireland, its parent body; and in 1982 he was elected an Honorary Fellow of the new (created 1978) Faculty of Occupational Medicine of the Royal College of Physicians of London. All these bodies had direct involvement in, and influence on, his professional objectives.

As regards his third objective, that is. undertaking relevant research and through public and published lectures, Smiley’s first study was on “accident-proneness”, the concept whereby in any group of industrial workers exposed to similar hazards, some will incur far more accidents than will others, a concept much highlighted among workers in munitions factories during World War I because of their then national importance, but at the war’s end the concept was partly side-lined. This work was widely published, earned him an MD and delivering the Milroy Lectures, as already noted above. His next project was into “card-room workers’ asthma” in the Ulster linen (flax) and rope-making (hemp) industries where he and others demonstrated that this was similar to byssinosis in the Lancashire cotton industry and which led to their being classified as “prescribed diseases” under law with much advantage to the operatives. He also procured a grant from the Nuffield Provincial Hospitals Trust to study the health and accident record among public transport drivers in Belfast which was later published as a book (by Cresswell and Froggatt in 1963). 

Smiley was always interested in incentives to work and in the history and background of the Factory Inspectorate. He encouraged the present writer to mount a large-scale study of industrial absenteeism (“short-term absence attributable to sickness”), which was published as a PhD thesis at Queen’s University, Belfast, and as a series of articles. In retirement when he could no longer gain access to appropriate data, Smiley’s interest swung increasingly to the historical aspects of his subject which he published often as eponymous lectures, such as the Scott-Heron Lecture and the BMA Mackenzie Lecture amongst others. Four years before his death he was chosen to join Les Immortels of the exclusive Collegium Ramazzini, composed of internationally-distinguished practitioners of occupational medicine and confined to 25 members from each of USA and Europe, and in the year he died (1988) a handsome endowment from his family enabled the Irish Faculty of Occupational Medicine to establish a Smiley Memorial Lecture and accompanying medal.

Smiley was a man of high principles and complete integrity buttressed by a strong commitment to Methodism; indeed he was one of the foremost lay leaders of the Ulster Methodist community. Underneath his misleadingly austere demeanour lurked a warm heart, sharp intelligence, deep learning, wide culture and sincere conviction to his responsibilities, which, as he saw them, were ever-present. Intolerance was a stranger to him, and he was a prime supporter of ecumenicism in Ulster politics and a founder of the cross-party/religion PACE (Protestant and Catholic Encounter), and other such initiatives. All these attributes and more were tested when in 1957 serious disease struck several members of his family, and again when his elder daughter died prematurely, but his strength of character and belief held. He had played good rugby as a schoolboy and never lost his interest in the game, while he enjoyed his golf and its camaraderie and served on the club council of the championship course of Belvoir Park Golf Club in Belfast for some years including one year as club captain. In his will he left £150 for his three customary four-ball companions to have a “good dinner”; a generous thought and also an amount which easily at that time stretched to champagne! Easy to entertain he was a virtual teetotaller but for years a moderate smoker of cigarettes. His real relaxation, however, was found, as it is with many countrymen, in his garden and in the Mourne country from whence he had come. He was knowledgeable in all things horticultural; and was saddened when he could no longer care for his beautiful, hand-crafted garden at his home in Ballynahinch, County Down, and he and his wife had to move to a ‘Fold’ house in a retirement development in Belfast. His last few years were enlightened by the award by his alma mater of a second MD, this time honoris causa.  At the request of the editor he compiled for the Ulster Medical Journal a last article and submitted the typescript of some 6,000 words less than three weeks before his peaceful death on 31 March 1988 just short of his 81st birthday (‘The development of occupational medicine in Ulster – a personal memoir’ Ulster Medical Journal, 57, pp.184-194, October 1988).



Born: 20 April 1907
Died: 31 March 1988
Peter Froggatt
Bibliography:

Smiley’s published work including his eponymous lectures and his MD thesis are referenced in: Froggatt, P, ‘The scholarly work of James Smiley, OBE, MD, MD (hc), FRCPI, FFOM (hc), FFOMI, DIH’, Ulster Medical Journal, 60, 219-228 (1991). Other work quoted is - Cresswell, WL, Froggatt, P, The Causation of Bus Driver Accidents: An Epidemiological Study. London: Oxford University Press (for the Nuffield Provincial Hospitals Trust), 1963. Certain other facts are from personal knowledge.