Document 44OdLQ0xy6jDy5dj2VVjQgqYa

Castleman File: American Petroleum Institute w/c = with cover letter or memo If DATE = 0, undated CD-ROM Document #:API DATE published article frorrv&srete journal published advertisements newspaper article published government report government inspection results unpublished or internal report unpublished presentation from conference letter memorandum industry warning labels industry sales literature industry recommended practices meeting minutes (with attachments) membership list BC notes E MEDICAL BULLETIN mm. #T JULY, 1939 No. 2 CONTENTS jjitorial ' L J# Fgi*6xiczi^ MD# ; OEIG-IML AETICLES ^j^dioal Statistics for 1938.................................................................. Y8 HP i ig|: l A. W. Sohoenleber,M.D. Office Lighting.......................................................................................... 75 James M. Adams, M.D. ' jgsisff "mfeipia - Always a Tropical Problem.............................................87 P- Tekelenburg, M.D. jtsi.f,*v' ' Jjjjg Food Handler as a Transmitter of Amebiasis......................92 ij,) 1 '#!*,' A. . Schoenleber, M.D. ANNUAL MEDICAL EEPOETS Standard Oil Company of Louisiana, Manufacturing Department 98 ,, Summary of Medical Activities 1938 I. L. George, M.D. and C. M. Allen, M.D. ') r iBtomational Petroleum Company Limited, Medical Eeport .. for 1938 .............................................................................. 110 v#*- Lewis H. Fraser, M.D. Hlf CASE EEPOETS Xhfcdetinal Infestation with Taenia Saginatum ...... .118 B. B. E. Burns, M.D. '-t`Mo lB.ight Year Old Mother................................................................. 120 F. Ovalle, M.D., et al. Hpjte Gonorrheal Endocarditis.................................................... 12k !|f, K. E. Fourcher, M.D. '0)y S;tlire of Ileum Due to Direct Violence............................... 127 B. B. E. Burns, M.D. MEDICAL -BULLETIN 98 STANDARD OIL COMPANY OF LOUISIANA MANUFACTURING DEPARTMENT SUMMARY OF MEDICAL ACTIVITIES 1938 I.L. George, M.D, and C. M. Allen, M.D. Baton Rouge, La. Organization 6 Medical Department is organized for the purposes of sting periodic examinations of all Refinery employees; employment and lay-off examinations; conducting special ations for retirement "or retention in service, special Stions for illness that might "be created Ly industrial and foreign service examinations;, treating of all ,and major injuries that occur on the job; supervising, feasible, giving advice to our employees who are on report; attempting to build up a better and more efpersonnel in the future by means of various psycho'v"` tests; treating at the Refinery Hospital conditions nature received off the job that will aid the emJto stay at work; supervising the sanitation of the Re mand the placement of men in positions which they can 5 atly fill because of various physical or mental disLes; conducting immunization against colds, boils and !$: and frequently giving vaccines recommended by out- :s in order to keep the men on the job (many paringing their own vaccine prescribed by physicians to ``going to town for treatment), and in general serving JlL advisors to the employees and the Management in j,am they may present. Personnel irsonnel of the Medical Department consists of fourividuals; two full-time physicians, who do examina` supervise in general the entire work of the Medical -tj two nurses, one who spends practically her entire road visiting sick employees and giving them whatJi.ce she can to aid in their early recovery, and the .,"80 duties consist of general supervision of the hos" ?ing up supplies and giving intelligence teste; one j who takes care of all laboratory examinations as 99 MEDICAL BULLETIN veil as the x-ray department, and is the official photographedfor the Refinery; one secretary to the doctors, vho handlea all the records going into the New York office, has charge of the vriting up of all sick cases and register cards, and ig. in charge of all general correspondence for the department;., one chief clerk, vho handles all routine records in the do partment, notifies all employees vhen to report for their ex< aminations (periodic and special), takes care of posting transfers, has charge of keeping time records and making o the schedule hy vhich the first-aid men vork, and is ava: able for first-aid vork vhen necessary; six first-aid men,fo' of vhom are on Bhift duty, one, vho assists in posting min: treatments on the MD-5's, has charge of preliminary hand! of all examinations for the doctors, such as testing eyeB hearing and doing urinalyses, vhile another, is assigned the physiotherapy department and is kept "busy all day givi diathermy and Infra red treatments, massages, vhirl pc hatha, and ultra violet and galvanic treatments; and a ho pital porter. Reports During the latter part of the year three papers vere wri ten on vork done in the Medical Department of Baton Rouge finery. The first vas a paper entitled "PRELIMINARY ON SICKNESS AT THE BATON ROUGE REFINERY,"* in vhich it pointed out that the sick report had teen materially lease hy the use of a fulltime visiting nurse and close supervis of the sickness records.The next paper vas a report on "1' STOOL EXAMINATIONS AT BATON ROUGE REFINERY, " in vhich Itt shown that 5.33 per cent of the employees vere infested intestinal parasites. The actual treatment for the first cases amounted to $51.50, vhich vas paid for hy the Camps The stool examinations completed on December 31> 1938* 1539, vith 86 positive stools. This vork is to he conti:' until the entire Refinery has been checked; and the Mec Department suggests that this procedure he included in ^ preemployment examination as veil as, vhere indicated, inf employees. The third paper is on "THE USE OF EUCUPIN analgesic) IN THE TREATMENT OF CERTAIN TYPES OF LOW. PAIN." It is extremely interesting to note that vith treatment the Medical Department has been able to estimat seventy-eight per cent reduction in disability resulting this type of condition, and since the institution of ^ treatment there has been very little loss of time due back pain. cfficial photogpapjj actors, who hani, office, has charge; Later cards, and for the departmeii records in the report for their q| care of posting ;ords and making rork, and is avs Lx first-aid men,f )ts in posting reliminary handli i as testing eye! ter, is assigned busy all day givl ;sages, whirl pc tments; and a ho Intelligence Tests ,,, . Illfithin the next few months the Medical Department expects ^present to the ^Management the results of their experimental IpitiCVith intelligence tests. It is hoped that this research jUiil help establish standards that will aid in building a jptfghwr t^pe of Personnel in the future. ll- ' p*'"-'* I Syphilis f ,' Tnlee Medical Department is also preparing a paper on the jfpjaoidence of syphilis among the colored employees and will * pt to correlate the accident and sickness rates in those fitrtb are afflicted with this disease and those who are not. fejUffmo there is no Public Health unit in Baton Rouge, Doctor jfftjihoenleber suggested that the Medical Department make an ef fort to obtain medicine for the treatment of syphilis from the State Board of Health free of charge; and should this be P, (jocoplished, employees would then be able to obtain treatment fat syphilis at the Refinery Hospital without cost to them. ee papers were wrltl t of Baton Rouge Raj "PRELIMULARy REPO * in which it materially lesser nd close supervisio s a report on "12 Y," in which it were infested wit ent for the first for "by the Comps her yi} 1938, vex; is to he continue! d; and the Medlba e included in m re indicated, in ol USE OF EUCUPIW (e| IN TYPES OF LOW BAC te that with th able to estimate ility resulting fra nstitution of thi of time due to 10 Boils and Carbuncles , ' Recently the Medical Department has been using Allantoin -Ointment (2$) in which is incorporated Chlorobutanol 0.5 per Oent in the treatment of chronic ulcers, and during the pro0MB was rather surprised that it has an excellent effect in the treatment of boils and carbuncles; in fact, one patient V&B having so much trouble from a large carbuncle on his leg U to prevent sleep. On the first day of application of Allantoin the pain was immediately relieved and the sloughing *Wa began to heal. The Medical Department is quite impressd vith the use of this ointment and at some future date may have a report on its use in various conditions. Alcoholics f Recently the Management came to the conclusion that many Chronic alcoholics in the employ of the Company would be worth alvaging, if possible to do so. In accordance with this Jhought they have set up a program whereby any employee who -88 not as yet "gotten his business in a jam," so to speak, hut who feels that alcohol has gotten such a hold on him that ViU not be able to break it, may go to an institution for h Cure of alcoholism and during his stay there the Company 101 MEDICAL BULLETIN will pay him his regular sickness "benefits. At the presg-^ time five out of nine have accepted this offer from the Cc pany. Heat Exhaustion About July 1, 1938, the Medical Department was "being quired to treat quite a few heat exhaustion cases. It noted that "by far the larger percentage of these came from coke stills. Upon investigation it was found that the color* workmen on these stills were apparently not taking their sa tablets. Following the work done by the Harvard Fatigue CL mission at the Youngstown Sheet and Tube mills and Bould Dam, the Medical Department requested that a level teaspoon ful of table salt be placed in each gallon of drinking wats this being a .1 of one per cent solution of salt water whi when taken internally would replace the amount of salt loi in sweat. Following this there were no further complain;' from heat exhaustion and the foreman stated he was able get much more work out cf his men without their becoming ne? ly so exhausted. During the latter part of the year thirty six portable sanitary pressure drinking fountains have be: distributed to the various gangs and it is contemplated ne' summer using sixteen thin salt wafers of 15- grains to a fo: gallon sanitary pressure drinking fountain instead of measp ing the salt by teaspoon. I Periodic Examinations There were 2,452 periodic examinations made during year, 1,911 of which were done within the last six months an effort to bring the schedule up to date. During July 1938 the records of the entire personnel checked and dates for periodic examinations set up tjy; method developed by Dr. Jas. M. Adams, which is as folic Employees between the ages of twenty to 'thirty are to be amined every three years; employees between thirty and fc would be due an examination every two years; employees betws forty and fifty would be due every eighteen months; employsf between fifty and sixty every year, and from sixty to Btzbt five every six months. According to this schedule the dep "* ment is due to complete 1,945 periodic examinations durl the year 1939. This does not include special examinatio11^ These examinations are so arranged that five men report the hospital at 7 = 30 in the morning, five at 8 o'clock, fl. SUMMARY OF MEDICAL ACTIVITIES 1938 102 'g.jo o'clock and usually by 9:30 or 10 o'clock the day's ujta of periodic examinations i`s comp~ le'ted' , allowing the iootors to direct more time to sickness cases, first-aid "tijrfc 8114 industrial research. Bnployment and Lay-off Examinations During the year 1938 a total of 663 employment examinations : made and in the early part of the year no intelligence be were given to those new employees] however, starting ring the month of August each new applicant was given an litude test, using the Otis General Intelligence Examina tion. By the end of the year approximately 125 of these Bte had teen given to new employees. This, in conjunction _____ 568 teste given to old employees, makes a total of 693 intelligence examinations given during the year 1938. All men leaving the service of the Company in 1938 for any Mason were examined hy the Medical Department at the time of their leaving. When the examination showed a major or minor Injury that had not reached maximum improvement the employee IBB not laid off hut kept on the rolls until maximum improveMat was reached, at which time he was then approved hy the Radical Department for lay-off. It is the feeling of the Radical Department that the handling of cases in this manner fill materially curtail the number of industrial controver sies, There were approximately 912 such examinations made during the year. >$tv Lost Time Sickness Cases A very detailed report on sickness statistics for the past five years was just recently compiled and forwarded to those Interested. The last two months - November and December -- of 2938 Were not included. Briefly reviewing the report made OVember 25th, it has been found that there was an average of employees in the Manufacturing Department during 1938. was a total of 2,044 sick cases during the year who _ *Bt a total of 30,486 days. In addition, there were 101 UOn-industrial accidents who lost a total of 1,920 days, the sickness and non-industrial accidents being **2A5 cases losing a total of 32,406 days. 103 MEDICAL BULLETIN Daily Ineffective Rate Per 1000 Employees from Sickness 1933....................................................... 14.9 1934... ................................................. 13.2 1935....................................................... 16.5 1936............................................ 17.7 1937....................................................... 13.6 1938....................................................... 14.4 Frequency Rate The 'frequency rate (number of employees off sick per 1 for the year 1938 is 46l per 1000 employees, the rate 1937 being 536 per 1000. Days Lost Per Employee 1934......................................................... 4.8 1935................................................ 6.0 1936..........................................................6.5 1937.................................................... 7.4 1938.................................................. 7.0 Days Lost Per Case 1934.......................................... 12.9 1935.................... '..................................14.8 1936....................................................... 12.5 1937....................................................... 13.7 1938.................................................................... 15.1j f The days lost per case increase in proportion to the case prolonged illness. A Comparison of the Last Six Years of the Amount Paid in Sickness Benefits to Salaried. Employees and Wage Earners Year 1934 1935 1936 1937 1938 Total Benefits $ 37,460.89 38,440.28 47,845.11 76,312.46 113,747.50 Av. Per Month $ 3,121.74 3,203.36 3,987.10 6,359.37 9,478.95 SUMMARY OF MEDICAL ACTIVITIES 1938 .104 -p><: Full-time "benefits vent into effect in August, 1937. For * first seven months of 1938, $74,305.90 vere paid out and the institution of a full-time visiting nurse 441.60 vere paid out the last five months of the year, average for the first seven months vas $10,615.13 said average for the last five months vas $7,888.32. The above fla indicate hov important it is that the Medical Departmaintain a full-time visiting nurse. This nurse urges !'feanbjolatory cases to report to the Company doctors* office odiibally until they are able to return to vork. Sickness Cases Not Losing Time During the year 9,718 sick and non-industrial accident as vere seen a total of 23,426 times for advice and treat"t. The Medical Department made no attempt to treat cases Tier than those vho vere ambulatory or vho had been pre yed some type of treatment by the Stanocola Medical and pital Association or their family physician vhich could be in at the Refinery Hospital vhile they remained on the "job. Y*"' life . Plant Sanitation " "-^The sanitary squad organized in 1937 continues to function itn taking care of the bathrooms and toilets in the Refinery. .w.Stohnoereersbtoixlelsrevmhiacihn a number of old bathrooms under are gradually being eliminated the by conthe Management. IllThe program of the prevention of athlete's foot infection ||pbeing continued by the use of Penchlor. As stated previously, thirty-six portable sanitary pres ' drinking fountains have partially replaced the vater towels and buckets. If these prove successful, no doubt, pre vill be used. ..v7 At the present time it is a practice to deliver ice to <:?arious points in the Refinery and this is handled by employ- in being placed in the portable sanitary drinking fount- ins. This seems to partially defeat the idea the Medical Iteps^tment had in mind in recommending the fountains. In .Order to prevent handling of ice and placing the ice directly ,1a the vater, the Medical Department intends recommending a .ooil at the ice house vhere the vater vill be kept at the jWopor temperature and it vill not be necessary to place the Iffies in it. In viev of the size of the Refinery there vill 105 MEDICAL BULLETIN probably Be some objections; however, it is hoped that the can be overcome and at no place will there be ice in drinking water. An attempt will be made by the Medical Department to lo the 'malaria rate this summer and to eliminate mosquito bre^' ing areas. It also hopes to reduce the rat population at: Refinery by cleanliness and the installation of covered bage cans in areas where employees eat their lunch. Occupational Disease Hazards Solvent Dewaxing Plant Prom time to time there is an occasional complaint nausea by an employee working at the Solvent Dewaxing plau however, the Medical Department has actually seen no evide of illness caused by*the fumes at this plant. It was usu found that the men who complained either had not been foil, ing the safety regulations or they were using those complai in order to be transferred to some other department. When" man complains of his work around the Dewaxing plant.Medical Department has made every effort to have him tr:' ferred to some other part of the Refinery. The plant is ning at reduced capacity and permits a better control front1 medical standpoint. Phenol Plants There have been no serious injuries to men working as these plants; however, the hospital has treated quite a superficial burns which seem to happen more at the time a turn-around. Lead Special examinations continue to be made on men handilead, on painters, litharge handlers, laboratory work| handling tetra-ethyl lead, colored employees assigned- V cleaning tanks, and also lead burners. These examinatiare made twice each year and there has been no evidence any toxic symptoms. Benzol Benzol examinations have been continued but no evidence! toxic absorption found. " SUMMARY OF MEDICAL ACTIVITIES 1938 106 loped that tj he ice in lartment to lj 3 mosquito hr| copulation at| of covered lunch. il complaint Dewaxing seen no evide It was usi not been fo] those comple ortment. Wheiil ixing plant tave him tra lie plant is control frcml . working ato ed quite a .t the time n men hand oratory work es assigned se examinatiO no evidence i t no evidence.! Welders (Eye Examinations) examinations of all welders have revealed nothing abHowever, after conversation with the Mechanical Su- atendent, it appears that the Medical Department should ie these welders at reading distances as well as distant Ion. 0x16 or two cases have shown up in which vision was feriipg with work, yet when checked for distance their |Were/normal. Placing of glasses on these employees corjd their visual difficulties. The Safety Department furqb electric welders prescription goggles whenever recomJd hy an oculist. p: Dust Hazards le vacuum cleaning system in the Lubricating Filter H&ing is now in operation. It appears, however, at this l^that adjustments will be necessary in order to properly 3l the dust cleaning up operations. The dust collection is in process of installation and will not be complet- for about sixty days; therefore, no comments can be made Ls time on the unit. revisions are being made in the crusher unit where cork Jl*asbestos are handled to control the dust by means of a 9r and duct which are connected to the feed hopper and pi,Charged to a point outside the door. study is being made of sand blasting operations at Baton Refinery with the view of locating a sand blasting shop I .point remote from where men gather, with facilities for |rolling the dust and preventing it from being liberated |he atmosphere. ctors and blowers have been installed in connection with #' tool grinders and abrasive brushes in the Salvage and Reation shop. Similar units are on hand and will be inLed in the near future in connection with the Yankee grinder and Universal tool grinder in the Machine shop. mgggMh has been indicated by various authorities that it would ^^Interesting to see x-ray pictures of men that had been emPpyed for many years as electric welders and we plan at the lamination of welders to take x-rays of their chests. |An estimation has been prepared and forwarded to the local ?ement covering the installation of a fume removal system tbe building where acetylene brazing and welding operaare carried out. fdetailed examinations with x-ray of the lungs of all men 1 107 MEDICAL BULLETIN working in dust hazards, including Filter Building emp sand "blasters and asbestos workers, are made each ye' some of these individuals there does seem to be some ed markings in the lungs, but it has not been found no to make any recommendations for removal of any of the" from their occupations. Chemical Plant The Chemical Plant has been out of service for sc until recently; therefore, at present it is manufs small batches of catalyst for experimental purposes an are no particular hazards involved. Laboratories Examinations are conducted on men in the laboratorie" handle lead, Benzol and other toxic materials. To da' one has been found to show toxic symptoms. Catalytic Polymerization Plant The screening of the catalyst prior to charging the at this plant presents a dust problem and adequate prot is provided in the open by the use of proven dust respiral When handling the catalyst in an enclosed area, such as'" in the towers, fresh air masks and rubber gloves are This catalyst when subjected to moisture will bum the and rubber gloves and rubber goggles are used in additlf a respirator whenever handling the material in a mol state. Proper Placement Of Disabled Employees i The Medical Department continues to have its pro among employees who suffer disabilities of varying de The Management gives their full cooperation in securing that is suitable to these disabled men. Equipment During 1938 three infra red lights were added to the e ment of the Medical Department. Also six tablet-chairs been added for the use of men taking intelligence tests, is anticipated and hoped that the Medical Department wil SUMMARY OF MEDICAL ACTIVITIES 1938 108 ach year. some incre| ound necesal of these 'or some t| manufacture loses and the w purchase a needed x-ray during the year 1939. The ll^ent machine has been in use for almost twenty years and Obsolete and inadequate. is hoped also that an electrocardiograph will be pur led which the department feels is very much needed in |.t.diagnosis, prognosis and treatment of heart cases. It is j||::that with this machine more defnite and detailed inforilsai$J,on can be furnished to the New York Medical Department as as the local Management in regard to the status of heart Is and, no doubt,will pay for itself in a very short time, have been many requests from employees that this type Equipment be added to the Eefinery Hospital, fct is anticipated that a new ambulance will be procured as goon as the 1939 budget is approved. :>oratories To date ging the tows uate protecti st respirator ., such as do yes are wo bum the si in addition _n a moisted rees 3 its proble arying degree a securing ' id to the equij Let-chairs 3nce tests, artment will M |fjr SUMMARY OF ROUTINE WORK 1938 rations - Periodic and Special..................................... 2,796 rations - Applicants........................................................... 663 bside visits by doctor and nurse............................... .. 3,999 proved for return to duty....................................................... 2,l44 fiftoboratory examinations.................................................................. 4,9^1 t-ray examinations......................................... 1,184 srdhyBiotherapy treatments................................................................ 3*457 801`dents - No Lost Time...............................................................3*267 aoidents - Redressings.................... ...................................... .. 8,962 Ibk Cases - No Lost Time........................................................... 8,675 l-industrial accident cases - No Lost Time.................. 1*043 lick - Office visits.................................... 20,820 Hon-industrial accidents (Office visits) No Lost Time 2,606 ^Average number of employees..........................................................4,652 I^Jbtal No. of cases losing time (Sickness)........................ 2,044 jjptotal No. of days lost from sickness....................................30,486 `Dotal No. of cases losing time (Non-industrial acc.) 101 AL.Ibtal No. of days lost from non-industrial accidents. 1,920 k Belly average - number sick - losing time........................ 88.23 I Daily sickness rate per 1000 employees............................... 18.8 ? Dotal No. of accidents - Disabling - NEW......................... 25 '^Jtal No. of days lost from accidents................................ 1,188 " average - number accidents - losing time............. 3.25 accident rate per 1000 employees............................... .7 Jquency rate per 1000 employees (sickness)................. 439 |||Oquency rate per 1000 employees (Non-industrial acc.) 22 ^ lost per case (sickness)................. 14.9 m 1 ! iflilf'i. 109 MEDICAL BULLETIN f i '"li Jl ; H'Ml 1* h|i| SUMMARY OF ROUTINE WORK (Continued) Days lost per case (Non-industrial accidents)........... Days lost per employee (sickness)..................................... Days lost per employee (Non-industrial accidents).. Total visits to Refinery hospital by employees......... Average number of visits per employee............................ Visits to Ref. hospital other than Ref .employees... Total hospital visits-Refinery and others.................... Aptitude examinations............................................................... 19,q 6,5 39,12k 8,k 1,100 ^0,22!^- fic *See MEDICAL BULLETIN,Vol. 4, No.l, pp.7-13,April 1959, We have frequently called attention to the fact that factors other than actual sickness disability must be cco*j sidered when studying disease frequency rates. The followij|j extract from a monthly report submitted by Dr. Tekelerib of Soengei Gerong, Sumatra, illustrates the fact that religious holidays may have an influence on sickness ratefl< "As far as the Mohammedans are concerned, this month was their yearly Lent, ending with their New Year,., a time which a true native does not want to pass in : a hospital, and in order to avoid this "risk" they do not report for sickness during the days before. It is a regular event, that during the Lent and ; Mohammedan New Year, the hospital is at least half empty, but after the good time is over, patients will very quickly fill the empty beds. Some of these natives that pass their vacation in their na tive villages will come back with dysentery, ma laria or other diseases which they got there and others have been ill for a few days, but did not report." Editor's Rote. INTERKATK MEDICAL 3 |lhe most importanadapt himself to iiity and althoug ere the heated air and humidity ar Bed by the Humbol ntains on the oth ate, with diuma sky is often ove or slight showe during the day : et and sand and th |ee from clouds, al " at times quite '`Childhood diseas icken pox, and soijphoid fever were m than last. Th children and yo ldren of the fore (f Amebiasis in a ols, abdominal pa Physical examinat P or discharged, al tificates for mar using a gun, et Ho :The medical cente the company as we oil fields. He adle all hospital p|A large store-hou "built and put i All arti