Education

Washington’s state hospitals grew rapidly between the 1920s and 1940s. By 1930, Western and Eastern State Hospitals housed thousands of patients, many of whom lived in appalling conditions. Despite the increased scale, there was no corresponding improvement in cleaning practices or worker protections. Institutional housekeeping remained a custodial function assigned to patients or underpaid staff without training.

Cleaning methods focused on visible tidiness rather than microbial safety. Chemical use was unregulated, and tools were rudimentary. Staff and patients were exposed to pathogens, toxic substances, and unsafe physical environments. There were no systems for reporting workplace injuries or exposures. Institutional goals prioritized containment over care, and the human dignity of workers and residents was largely ignored.