Document 4J632vpG0GL9LeYBOZ58NgkRN

FILE NAME: National Safety Council (NSC) DATE: 1938 Oct DOC#: NSC158 DOCUMENT DESCRIPTION: Excerpt - Transactions of the NSC Pamphlet - Silver Jubilee Safety Congress C H IC A G O OCTOBER 10-14 N 1938 NATIONAL SAFETY 1938, N tlto tu l Sflv Courcil, Inc. PnnUd tn th U. S. A . COUNCIL, in c . areword T ill-'. Transactions of the Silver Jubilee Congress and e x position of (lie National Safety Council, October 1U-I-I, IOSS, ate published in two volumes. Volume I contains the general and subject sessions and the sessions of the various Industrial Sections. Volume II contains the Street and Highway Truffle, the Commerci.nl Vehicle, the Transit, the Child Mdncaiion, and the Monte Safely sessions. Volume I is distributed automatically to all industrial mem bers of the Council. Volume H is sent to members who are bHeoliweveevder,toobtheerintCeoreusntceidl cmlieiemllbyerisn tmhaeyseosbstiaoinns Vit oclounmtaeinsII. i upon ivi|iiest. Many members have found it of benefit to distribute copies of the Transactions volumes to both executives, foremen ami supervisin':}, who have used the practical information they contain in safety programs and for general reference pur i poses. Kxtra copies of the Transactions may he obtained as follows: <>nc to 10 copies of Vol. I, at $2 each ; 11 or mote copies. $1.75 each. Kxtra copies of Vol. II cost 75 cents each. T IIK Transactions are a condensed record of the pro I ceedings of the Silver Jubilee Congress. The papers and addresses have been edited to delete extraneous matter, ab i breviate the less important portions, ami emphasize what t may he of particular usefulness and value in promoting ef \ fective safety organization and other accident prevention ;t measures. These volumes, therefore, are a somewhat abridged version, compact, practical ami of particular value to the student and executive interested iu achieving more thorough accident prevention success. The original manu scripts are available for additional reference, if desired, iu the files of the National Safety Council. T IIK National Safety Council, at its Congresses, seeks to eliminate from discussion matters which are not pertinent to the aim.- of the Cong res- or which may he contrary to the Council's policies. It cannot accept responsibility, however, dfoerlivaellrevdieowrs ienxpthreesdsiesdcucsisthioenrsinbatsheed puappoenrs thwehsiechpahpaevres.been f , NATIONAL SAFETY COUNCIL,Inc. 20 North Wacker Drive t Chicago i $ Council Ofl'icers and D ir e c to r s.......................................... 4 Council Purposes and P o l i c i e s .......................................... 9 Annual Meeting of M em bers.............................................. 11 Annual B a n q u e t ...................................................................... 31 Special Subject Sessions-- Agricultural Safety ..................................................... 33 Dusts, Fumes, Gases and V ap ors.............................. 45 Falls of W ork ers............. '.*................................... 59 Fire P r e v e n t i o n .............................................................. 69 Governmental Officials ............................................... 85 Health Service in In d u s tr y ..........................................101 Industrial Accident In v estig a tio n s....................' . . 1 1 5 Industrial E xplosion H azard s..................................... 125 Industrial N u r s i n g .........................................................139 Industrial Safety L e ctu r es..........................................163 Maintaining Interest in S a f e t y ...............*.............. 185 Midwestern Rehabilitation M e e tin g ........................ 201 Occupational D i s e a s e .................................................... 211 OlT-the-Job Accidents .................................................. 229 Safety F u n d a m e n t a ls ....................................................249 Safe Use of E le c tr ic ity .................................................. 257 Safe Use o f Petroleum P ro d u cts...............................269 Aeronautical Section .............................................................281 A. S. S. E.-- Engineering S e c t io n .....................................295 Automotive and Machine Shop S e c tio n .......................... 301 Cement and Quarry S e c t io n ...........t ................................. 313 Chemical S e c t i o n ..................................................................... 339 Construction S e c t i o n .............................................................373 Food Section ........................................................................... 385 Marine S e c t i o n ......................................................................... 407 Meat Packing, Tanning and Leather Industries Section ....................................................................................455 Metals Section ......................................................................... 473 Mining Section ................ 521 Paper and P u l p 'S ectio n .........................................................555 Petroleum S e c t i o n ................................................................... 613 Power Press S ection .............................. 665 Public Utilities S ectio n .........................................................671 Refrigeration S e c t i o n .............................................................691 Rubber S e c t i o n ..........................................................................703 Steam Railroad...........................................................................733 T extile S e c t io n -....................................................................... 753 W ood Products S e c tio n ........................................................ 775 Safety Exposition-- List o f E x h ib ito r s.......................... 799 I n d e x .......... ................................................................................. 805 .u ir to r iis l afefry Council, Inc. HONORARY MEMBERS V.-tn ia ii n \ n r Ikon anii S u m . Kn c in u .k-; Is*ml Kl` \\ . C a MI'IIKII. I. 1 Is. I'a IMI.K OFFICERS (1938-1939) D l> KlxM.il., IVcddcut ( . \ \ . Di m i t y , \ ice-l'rcsitlcnl to r Kinancc and T r e a s u r e r I i; \ nk li. II a Klitsox. \ ice-Pivsidrnt for Industrial Safety 1hi. M u.ii k Met j.I.viiuK, Vier-1 'resident fur I'uMU: SatVty W m.ii k S. P.mni:, Vicc-PrrMtkiil for Kni*in:criiii' A. V koiiwt.t'r.u, V uv-P rcM dutt for Safety Councils K. T. Sni.r.Nsnx, Vice-President for M rinbirslnp A. \ \ \ W mrxi.v, Viee-I'resideiit for balneation \V. II. Cami.kon. Secretary and Manai;inj; Director EXECUTIVE COMMITTEE (1938-1939) i i . .i. \i .iiKitil. Spencer Killn;:" iX Sons, Inc. .1. 1. IH.nasII. I'.isI I'rcsiilcnt C. \ \ . I'.i Knoi lsr, Past I'rcsidciil II. W . r.ma.r.ss. Sinclair Prairie Oil Company ( . 1!. Iloi i.i;r, \ \ iscoiisin Pulilic Service Corporation Koi'.i i'i W. C amiiii.i.i.. Past President \V. II. Camikon. National S afety Council, Inc. 1.. I'. ( AMi,nt:i.i., Mining Section Kulicrt I.C.vn.tN, Aetna Casualty & Surety Company 1.1. is A. I ti.P.i.ots. Past President C. W. I )i Mi'i.sv. T h e l.ii|iiid Carliotiic Corporation Is. If. HonmVa.n, ASSlf-Iftiy'inccriiiy Section M akccs A. Dow, Past President W aitiu A. Fat.uson, Lehigh Valley S afety Council If aki. If CiKovrit, Safety Council o f the Cohimhns Chamber of Coni merer I). I). li.N.Ni.t.i.. Coiisitlliiijr Ifoeiiuer IIakuv i.ni.iiKnr, The Pnllnian Company hu \ nk II. I I ahhimin, International H arv ester Company H aK'H.o ti. H o n MAN. I'ncmployinenl Compensation Commission X'' J e i-ry S. 1!. I IoiikiM.. Food Seeliou II. 11. Kr.ii.v, Interstate Commerce Commission 4 I! OFFICERS AND DIRECTORS, Continued W .m.tiii <1. k'tNt;, 1*;i>t I`rc-sicU-nt UM. C. K noi.i k, M ilw au k ee S a f e ly C um misM on J ohn !.. l.oNC, f a s t f r e s ilie n t T im s. II. M . u l Ionai.u, L'. S. P i pai Inn nl o f A p r i i u l l u r e A imikmi \V. M acia-:, ('n uiniissiniier u f Mutui- \ ehictvs, N e w J e m e y I )|i. M i i i .i.u McCl I M ih K, Yale l Tiiversily K. S. M k'iy.iuh, fiililie L'tilities S ellim i I. W . M ii.i.aiiii, Ind u strial C lo v es C o m p a n y II. MIIII.II I.. M iniai, I''.. I. dll f u n i ile N e m n iir s iX C o m p an y Ki hit Ness, D ire cto r o f fiililie S a fe ly , ( levelaml K. I. O 'lim t.v, In., I.imisville S a f e ly Comieil W ai. i i i ; S. I'a ini., A etn a l.ifc sv Ml'dinled C o m p an ie s l a w l\. f ai.Mi n, f a s t P re sid i nl K. fmriiiuNK, f a s t f r e s iile u l II. O. I' li "KAli11, M a rine Seeliuii A i.iii-.iit S. K'laan.A, Imliislrial Kelalimis l'u iiiis elo rs. hie. I.r. (.'in.. I I iimiy A. Ivi'.NlNin li, f a s t f r e s i il e u l I'.. A. Kmuaiis, T e x tile Seeliuii A. V". K'umvianai, Dululli, Missaht- iX- Irmi k'a n a e R a ilw a y C o m p a n y (iinia.i: IX S ani-timi, (eneral ICIi-ftrie C o m p a n y ( 'u Ahi a s 1!. S cott, f a s i fr e s iile u l l-'niVK T. Sui IMS, f u r l lami Cenienl A s su e ia liu n I ii n. J ohn II. SlliainiiKSi-:, M a ss a c h u se tts S a f e l y Council C. W . S mith, S t a n d a r d Oil C o m p an y ( I n d i a n a ) M' m i in I )i:.\r S mith, D elaw are S a fe ly Council \Y. A. S now, C onstruction Seelimi IT T. S oi.knstiim, E lliott S e rv ic e C o m p a n y l.ist.n: I. Sui(i:.\son, City T rallic Knipueer, Chica::n Cm.. J ohn S iii.wki.i., C onsolidated Kilismi C o m p a n y o f X. Y.. Ine. ('. f . T oi.ma.v, f a s i f r e s i il e u l ( d u i n a . ( i. T iiauti, ( i r e a l e r Chicaipi S a f e l y Council. Inc. I Hi. li. I,. Ynsrannni, Cenerai Eleetrio C o m p a n y l>n. C. II. W atson, f a s t I 'resident A. W. U hi intv , N ational C o n s e rv a tio n l i i i n a n I >. A. li mi in ,t, Carnet;ie-Illinois Steel C o m p an y A htaii.ii II. Yiii.ni;, P a st l 're sid en t DIRECTORS.(1938-1939) fi. I. AuiRH.'ii, Spencer Kello^i; vV S ons, Inc. A. !.. A k.vj'`Tu o n i Kas tm a n k o i l a k ( A n u p a m I. I. It.w a s h , I'ast PieMilent ( aki. I.akki k, St. Lout* S a f e t y (ornici! I.i o 11. I5k.\u . u \ Bku*k<lune V'alley S a f e t y Council \V. A. Ih.cilti.l, A u to m o tiv e & M achine S h o p Section Kunint \V. ItKCK, L'nited S ta te s Ktihher F'iaulnels, Ine, 5 Vf ICERS AND DIRECTORS, Continued (', W. I hRc.oiilsr, l 'a . I Ptcsid eu l I'.. !. I`.I \NK, Jo u r s f Lauc.hfiu Steel Corporation II. W. It u o . I.ss, Sinclair P ia i ri e Oil Company Il 1C. I'm.I, S o u th I'.cikI Civic S afety Council ' (. . l. Itot a I V, Wisconsin l 'til.lir Service, Corporation I*. S. ICoWN, Standard Accident Insurance Company J. II. IIrown, I'vlrolrtim Seetion W. A. Iisuwn, Sa le Iy Dept., Nashville Chamber o f Commerci: K. A. IttM.i.oi K, Ruhher Section W. II. Cami.Ron, National Sa let}- Comici), lue. I.. C. Camiui i.i.. Mining Section Roiii.im' \V. C ami'iiiXI, Past President Raymond A. Caria', Evanston Safety Council Ray Cak.np.y, Kenosha Safety Council Roim.kt 1. Cati.in, Aetna Casualty & Surety Company M u rici: C iiaii.M.t, Rahway Safety Council L. O. Chixvkk, Employees' Publication Section W'm. M. Ci.ark, St. Joseph (M o.) Safety Council I\i:n m :t/[ P. Coi.man, Seattle Traffic Jfc Safety Council .1. If. Ct_'U-iNi;v, liethlehcm Steel Company Frank f. 1)i:.ty, Kansas City Safety Council *1.i:\vis A. D i.-Ri.ois, l 'ast I'resiilent C. W. D i.mit.sy, T he Li<|uid Carhemic Corporation R. E. Donovan*. ASSH-Eiigiucering Section J amks li. Douia.AS, The l 'liilailclphia Cas Works Company Marcus A. Dow, PaU President I lit. L o n s I. Dutu.lN, Metropolitan Lite Insurance Company O. M. Howards. J r., Safety Div., Syracuse Chamhcr o f Commerec \V. A. E verson, Lehigh Valley S afely Council D. D. Fennki.i., Consulting Engineer Donai.u A. I'inkiuant.R. Toledo Safety Council D r. H art E. F isiikk, Chicago Rapid Transit Company Ctu.su:i< C. F isk, I'erkcley T rallie Safety Commission H oward P. Fonda, Purroughs Wellcome (c Co. (U.S.A.) Inc. A rthur C. F ri:v, Worcester Safety Council John li. Gmso.v, Western Electric Company L yix If. Girr, Peoria Association o f Commerce Safety Council H oward F. G iuikrT, Elizaheth S a fely Council E doak H. GorsL'cii, Grand Rapids Safety Council W. A. Grimin', American Telephone it Telegraph Company E ari. If. Grover, Safety Council o f the Columbus Chamber o f Com merce H arry Guimkrt, T h e Pullman Company C. H. H akit.r, Refrigeration Section D. T. H arrington, United States I'urcati o f Mines F rank H. Harrison, International Harvester Company 6 V1 c OFFICERS AND DIRECTORS, Conlinucd Cuts. I-). Mill., Now Ymk (Viitial l.inr^ I 1 \u o | U ( i. 111II I .XI \N , l'n c u ip lo v m ctit C u m p cii-'A tio n C o m m D sh n , N'n v J e r s e y ' Kvi ill rr i 1>id>, Mudhoti County Salcly Council S. 1. 1Inin.'i i,i , I'*iKnl Sn'lii'ii Imu i> 1!. 11unt. Cement iK' fJ ii;i 11 y Si-elion \V)l. I'. J ami-:s, i'liiladcf|i|ii:i Safety ( '<nim il I", li. Johnson, Commercial Vehicle Section T homas I'. Kearns, Industrial (.'ommissiuii of ()liio II. II. Kr.l.l.v, Interstate Commerce Commission. W ai.tek (. K ino, Past President W m. C. Knoki.k, Milwaukee Safety Commission \Y.\t. S. K nOdskn, Detroit Imhistrinl Safety Council Otto C. Km tier, Greater Springfield Safety Council C. C. I.aFoi.ntaine, Great Northern Railway Company J. If. I.r.K, Wood Products Section Mi u .aiu) C. Lei-t.er, Child education Section John E. I.o.\r., Past President Titos. II. MacDonaid, United States Department of Agriculture Roman1 A. McA rthur, Transit Section a Du. Mu t t: McCi.ixtock, Yale University A m inat \V. M ac.ee, Commissioner o f Motor Vehicles, New Jersey1 !'. W. Matson', Minnesota Safely Council R. S. M etzuer, Public Utilities Section I. \V. Mit.t.ARn, Industrial Gloves Company H akoi.0 C. MtN'r.u, E. I. dn Pont de Nemours & Company R. II. Mori.ev, Industrial Accident Prevention Associations P rof. Koitt'.u L. Morrison, Street & Highway Traffic Section E rnest Murphy, Albany Safety Council C. L. Murray, Mason City-Cerro Gordo County Safety Council Knot N ess, Director o f Public Safety, Cleveland E. J. OTIrien, J it., Louisville Safety Council Gtcouc.r: C. A. O ft', The Detroit Edison Company W ai.tek S. Paine, Aetna Life & Aftiliated Companies Lew K. Pai.sier, Past President David A. P atton, Newark Safety Council C. K. P eacock, Chattanooga Safety Council Ciiaui.es \V. P endock, Safety Division, Milwaukee Association of Commerce C. E. P i.ttiiionk, Past President It. O. I'lCKAitn, Marine Section Ai.tu.ttT S. Rkf.ui-A, Industrial Relations Counselors, Inc. Du. A. R. Rkinku, Contra C>sta County Safety <`mncil Lr. t - u.. IIeniiy A. Kknincer, Past President Pint t te C. R hoads, Meat Packing. Tanning i\- I.father industries Section 7 OFFICERS AND DIRECTORS, Continued A. C. kissm.Ki.i.ii, Kochc-'tcr Safety Council M.\i;l.vi:s kmai, Paterson Safety Council E. A. kour.KTS, Textile Section . Bi:stok Kom.xso.x, Easthay Safely Council A. Kouinsox, Paper & Pulp Section 1!. K. UncKtiniT, Power Press Section k.u.rtr l.. koniais, In.. Cltetnical Section A. V. kouwi-or.it. Duluth, Missalie & Iron kan.ee kailway Company W ai.iiik kosi:Nii.M'.u. Western Pennsylvania Safety Council Ci. K. S aniiiiu!, Ccncral Electric Company H unky Ct. SciiAPKNiat, Eric Safety Council IIakkv A. S oiui.tz, United States Steel Corporation of Delaware ( Itiam.its I. Scott, Past President Kaki. S. S iiaktzkk, Utica Safety Council Ekank T. Snr.KTS, Portland Cement Association Crx. J ohn H. SitPKmutNK. Massachusetts Sfete- Council D k. I,. A. S iioi.'dy, lielltleiicm Steel Company Kknp.t I.. S imnos. N o v Haven Safety Council liana- l.r.r. K. SKtaa., Cleveland Safety Council C. W. S mith. Standard Oil Company (Indiana) \ \ Ai.ri'.K Dr.NT S mith, Delaware Sfete- tlotmcil W. A. S now, Construction Section ic T. Soi.i.ns ipn. l-illiott Service Company Lr.st.ii: 1. S okkn.so.v, City Trntiic Engineer, Chicago t-1. C. S pkini., Pliiladelpiiia, Pa. Ciiima-. is. S tiu'mkns, Safety Bureau, Buffalo Cltatnlicr of Com merce Cm.. J ohn S i ii.evi.t.t.. Consolidated Edison Company of N'. V. Inc. AuTiim M. T ook, Consuiiiue Marine Enttineer (". I*. T oi.MAN. Pa st President Mian. K. T kam.mi.i.i.. Metals Section (itanua: (i. T kaviu, Crcater Citicaeo Safety Council, Inc. M.ejou Is. !). TltiMiu.r.. k ir h m o u d S a f e ty Council Ekank K. Virz. Superior and Dnelas County Safety Council Du. I!. L. Vosiinu.it, tienerai Electric Company D k. David E. Wtan.KiN, Baltimore Safely Council Du. C. II. W atson, Past President (>. Wist: WitscorT, Safety Dept.. Auto G u h of kliodc Islaml S. E. W iim so, 1-iherty Mutual Insurance Company A. W. W hitnky, National Conservation ilureau Ciiaki.i.s K. Wtt.sn.x, Ceucral Motors Corporation l-\ 15. W insiow, Safely Div., Birminyham Chamber of Commerce W. E. W urth, International Harvester Company AitTiint H. Yop.no, Past President E. J. Z a i t t , Safety Bureau, Duluth Chamber of Commerce C ( Tiu purpo Tin limit preve plies direct iiiatir ket condit diseas accid live T'm profit lion, it reset of tl -IID t herd mdil oUiet '.tolls and arc s;<-/ im it i impo V the limit I rot wan taut the in N of licr. Tl ran tumct devt 1 mak  ' Itavi- to In- a (ittnl agencies noil ways tig opportunities ior t the physically dis-t he stintine'! up by o cipial quantities of pplicnnt's ability and add an intiimited iTsevcrance. interest, 'o rk and success wili Occupational Disease THURSDAY MORNING SESSION October 13, 1938 i 'I lie session for the discussion of out standing problems in the field of occupa tional disease was called to order hy die Hon. I'. J. Angsti-n, Chairman, the Illinois Industrial Commission, Chicago, who pre- sided. The Chairman emphasized the im portance of the selected subjects to he pre sented by eminent speakers, and promptly introduced the first scheduled speaker. The Trend of Occupational Disease Legislation By HENRY D. SAYER Manager of the Casualty Department, Association of Casualty and Surety Executives I.et us consider the -differences between the accidental injury and the occupational disease. For these distinctions are important ami must constantly he borne in mind when u e consider cither legislation oil, the sub ject of disease, or engineering methods of prevention or control. Cicncrally speaking, accidents occur at a spcciiic moment in point of time, and, from the standpoint of fixing liability under any policy of insurance, it is in-the future; that is to say. at the moment of the acceptance of liability under any insurance contract the accident for which liability may he as sumed has not yet happened. That fre quently is not so with the occupational dis ease. insurance hy its very nature can only assume liabilities that have yet to ari.-e--not those that have already accrued. Again, speaking generally, the industrial accident is something that can he seen-- even though unforeseen, it may he visual ized and described in words, setting forth specifically the. time, place and manner of happening. It can then he determined, after the happening of the event, whether it was preventable o r inevitable; blame, if tiny, can he assessed; the worker involved, or his foreman or superintendent, can lie shown tlie fault, anti effective measures can he taken to guard against a like future hap pening. But some will say. truly, not alt accidents happen in the manner described; that not always are they held to occur only at a specific moment or under circumstances here they can he visualized and described, lly administrative and court decisions, it s true in some jurisdictions that the definition of "accident" lias hern greatly broadened. Vfc find the entrance of disease germs into the human system without visible trauma, with resulting sickness or death, and even the specific time and place not definitely known, except that it is shown to have probably occurred in the employment, being held to he an accident. i!Iicr'i v. Hull, ITS App. niv. i'li. X.w <Y.r. .-in anthrax cn*e; Vcunr v<. \Yw I I Lum ber Co., 1M \Yi. 370, a typhoid ra** ; and oilier*.) Poisoning of the body through the effects nf. a deleterious or toxic substance used ill the employment, llu: danger* of winch were unknown to the worker, llu: employer hav ing been negligent in safeguarding properly llie u>c of such substance has been held to he the result of an industrial accident. (V ic to ry S p ark ler & Specialty (*>. v>. Franck. N " M aryland. 363; and the very recent ca*e '{ UtacU vs. CrcMim Auto C'u . Imva Suprem e C ourt, A ugust 5. 191S. X .W . 1&9.) And where negligence of the employer has been shown, an injury to health, even though not occurring through a happening at a given time and place, but by repealed 211 %urc< over months o t time, lias hein r* h r ;iii aiVhlvMt. Vr*ly s *. I'.trnliiM '.lina Y.M, .m .*0<V, Xottl* ,,<e and other va-cs I might cite arc exceptions ami nut (Ik1 general rule > what roii-liltile- an accidental injury, ink < may laiilv assume that the I;: nf .-idmiui.-lratois n f the law ami Contis have hern direetly inspired by belief in the ue.c---ity o f finding a !y for an imlu.-lri.il ill for which no remedy had been provided hy specific. :.cge of the statute. M ay wc consider as straws in the wind, showing a I toward industrial disease liability? ay nh-.erved that the tendency of the ts is to con-true the term "accident" more limited manner in those states e there is .specific provision in the law mg occupational diseases. Thus, wc clear instances o f what has been d ``judicial legislation." that is, the s broadening the meaning o f the lawover situations not clearly included ' n the term ' of the law by the duly con ed legislative authorities. : u< now consider what we mean o r inby the term "occupational disease." we find a more difficult field--difficult the standpoint of administration and al interpretation; and difficult from landpoint o f the doctor and the cn- at is.disease? We think we know, and .'l to" laymen the term eonjtircs up : minds Munclhiug of a rather d e n ature. W hen wc pause to consider it, ursc, iutim'te i|italilieatioiis o f the term 10 us, and wc arc confronted with conditions that fall into the zone of --such as, for example, w hether hcra disease. At any rale, we say it is 'normal condition, and let it go at when wc come to add to the doubl et "disease" the even m ine indefinite 'occupational" o r ``industrial," we find ves in an area of highlight sur-(1 hy a vast and increasing zone of it S.lading off into F.rehiau night, row then shall we define the term ational disease" ? diseases stand out in our minds ns and definitely occupational. As to c have no great difficulty, cither Icg- islativclv or administratively. These include the well-known metallic and chemical poi sons that are so definite and characP ri-tic a part of some industrial processes. Were the diseases arising f rom the use of these substances the only occupational diseases with which we need concent ourselves, the legislative difficulty would he largely re moved, and we could safely entrust the problem to the doctor and the engineer. ( Hut we have seen that the legislative problem is not so simple. X or is it simple administratively. W e find ourselves floun dering in a veritable morass, either berati-c of the inherent difficulties of the situation, or because we have not or cannot agree on our objective. If all parties would rec ognize the dillienlties ami the limitations on what iudu-try 'can do, or can fairly be e x pected to do, we could much more con fidently face the future. If wc could agree that provision for "occupational diseases" is not synonymous with general health and lifeinsurance for industrial workers at indus try 's expense, then I am sure wc could get somewhere very definitely. lint has there riot been too much loose thinking oil the subject? W c are met with a curious situation. W e find the advocates of so-called "all-inclusive" statutory cover age deliberately seeking indeliniu-m-ss. This is unlike them, for when they know what their objective is, and are willing to dis close it, they have not refrained front pr ess ing their advantage with definite and spe cific, purpose, and with exact language- to accomplish that purpose. That, at any rate, is correct legislative procedure. Hut in this field, e-vxti where- the liability of the employer is made inescapable, the constant suggestion is pul forth that it is futile for the legislature to attempt a defi nition or delimitation of occupational dis eases, anti, therefore, words o f the most general character should he employed, leav ing to the courts the interpretation of the law as they see lit. I submit that it is not the function of the courts to make up the legislative mind; that is the function and the right and the duly of the legislature. Xor should the legislature seek to avoid and evade responsibility by transferring to courts and commissions (be determination of questions of liability which the legisla nte c finds loo difficult fo r it to determine for itself. ( A 'i . i j ' i l t I t l t n i t t >i.\. i t S C To effect coverage tinder the compeii-alii.n law, IIn-re fore, In' any -lull general .uni vague 1.1'1 n :iir as llie term "any ami all o(Vii|>aliniial di-ca-c-," o r !<y adding In llie definition oi "acciih ntal injury" llie pltiu-c "am! -hall u n h id e oia-upal ional ifi>t-n-i.-s," is lo i i eale an iim i-i lain liability - one lliat may rt-*init endless anil pel Maps ili'appoinlin:; litigation - In lull: (In: meaning of lln- law is established; ami will mo-1 i i-i lainly he a ili~>ei vice In workers anil i-inpl.iyi i s. An eMi-lliiil rule--a cardinal rule--in statutory d ia llin g , is In Use wortls of deliniie, eerlain ami iimlerslaiulalile meaning, iisi-il in their common acceptance, rather than In result In vague, uncertain am! ineaiiirigh- -s \i mils, or words llie meaning of which may have the effect of distorting the oh jen iee that is sought. Controversy is hri-il hy uncertainty of language, ami controversy leads to litigation in courts. Litigation is ex(iensive for all parties; it causes ilelay; ami il freiiin-utly causes biller di-appointment. It hteeils rancor. It may even lireeil disrespect for the law and lor orileily process of government. Why then shimlil there he this continuing demand for ihe all-inclusive coverage? Is it unit the vague hope that satisfaction Huy result ill some c a-is o f misfortune to workers who fall victims of the disease that hen is u- all ami lurks in wailing for us in ntir play, in our homes, yes, and even in our sleep, as well as in our employment? I 'eih.ips mu- yet if that were the design, a mine simple v.ay of succeeding in it Could nol otherwise he contrived. Are in- to understand that (U/v disease of the uio-t common and ordinary risk of life may hccuiue an occupational disease if its .source o r supposed source had its origin in an ineidi ul o f the employment or a con dition then- pri-seni, or it claim was made that a prc.-i-xi-ting disease had hcen agitravaleil by such condition? T h a t is a large order. It would mean that industry would heroine liable for any ordinary di-ea-e of life, provided that disease could he, with a show of plausibility, related to a condition or incident id the employment. Such diseases arc almost too numerous to enumerate. Hut we know that claims have hcen made for tuberculosis am| heart di-ease, the two nio-t nimierims diseases ami the cause ot more deaths than any two other diseases. Ad d to these pni-uinotiia, a s t h m a , ar t h r i t t -. rheumatism, and a host of others ; and uo ilisei-in ill Ibis the begi nni ng o f a -y si -n o f health in-mallei- o f the liio.-t e o . t l y t i p e a system moreover that would diseriin. inali- bul er l y agai n-l t he ma n y inillimiwho c ont r a i l - n t h iii-i-.i'i;s in p e r h a p s a.-. Iiially the same na y, hut who h a i r no e m ployment at all attain-t w h i r h to n-:-e-s lia hilily. S h oul d not tin- m a n wh o tails \ie~ tim to a disea.-e ol ordinary life wluie -v.iriliing fur a j ob lie j u st as niueh the i-.ui-eni ol Ihe state as the m an w h o Ireiometlisahli-d from Ihe s a me disea-i: a nd who is so fortunate as to ha ve a j ob ? Let us lie realistic about this tiling called health ! Ill health is a deviation from llie normal, l.ut what is "norm al?" H ow great a devia tion is abnormal? Disease is of many ami varying degrees. To what extent does the mind affect the working status? O r what part in the situation is played by "will power"? These are not fanciful questions, they arc encountered and will obtrude themselves continually in determination of compensation for disease where we depart Irom the known and characteristic occupa tional diseases. From these rem arks perhaps some will say we are opposed to coverage of occupa tional diseases tinder compensation laws. Xot so! The stock casualty companies represented in the Association have not o p posed and ilo not oppose the principle of compensation for occupational diseases, if thereby is meant compensation for tlm-e diseases that arise from a "trade risk," or from conditions that are normally and usu ally present ill the particular employment, as distinguished from those oi dinars- h u man ills that beset all of us. O u r view of it is that the policy o f coverage under the law is a matter of local concern, to he dclet mined by local legislatures in the light of local demand and with due reg ard to local opinion of both labor and inilu.-try. No employer in this age can reasonably object to fair compensation for disease arising from such occupation.-Ll risks, any more than he can object to rca-unable- compi-usntiou for disabilities due to accidental injuries. This conceplion of industry's obligation is, how ever, quite d i tl c i e u t l r o i n the c o n ception oi a public obligation to care tor .;*>i 14 S i l i r r JuhUci- S a fe ty Congress m) t'<*rii[irli.ale tur .'ili ch'iics- ami deatll eder :> iimn ut liealth .imi fife iniiramv. he lattei ohligation, il il I- a valici mu-, Itir i.Me-alimi ni dir -(ali: ami th iialimi r ii lite ohligalinu ni iiiiliisliy alone. T he rr.i'oii.iMr, dir iiitelligent, Ila- sai' av Ini imlli.tre In di-t barge il- nhligalioti il'. n ik e r Ini inmliliniii ni Inalili i~ |imviili' ini' dir g i c a t o l reasnnable r e di riiieiils Ini' iinlu-.ilial hy girne, ami ( viilr l'niiijirii'.alinii mily 1or IliOsr enn!iou lltal ari.'.' ii'nm speeilic namril ili-c< limi are truly ciccupationnl, citarnetic ni, ami |n olii.ir In tln; pince-ses in '.irli dir wni'kri' iv engaged. .nlii'ti'y ili, I ani suro, meri die rlialw ni th ncrupatinnal discae prohlcm. it is presented nmlrr a law diat pre dir; dir liahililr ot iudustry in underimlalilr terni.. In die carie lay., Ilio arral m ie was In inclinili orrupation.il ra-rs in d ir compcnation law hy speriiv: die (i.'irliiiil.'ir dismise- o r th particu rnmliliniis kmliiig lo lisrases lh.it are nini In he nceni'.itinnai ami compensatili. : r rati a "schedule" law. It is tin n in hirli compensatimi for occupaIial di-en-e i ' covered in all o f dir nitrir o i Kurope ami o t Sondi A mer- It is su siniplr; it is mi sciisiMe; il is -a-ilv ailiuiiiisirriil, llirit ilio render is l d ir accrpiancc o i tlie iirinciplr is mu i risai. i w t ili k rr p ever h r i o r e trs die prinie tliat a diseae, lo he tlecnicd occupa mi ', musi he "characlrristic o f and p e lar to" die occupatimi, there shonld he great diiiicully in arriviug at a proper fulory selup tor tilt coverage of all irne iipational disrases. Xletallic poisonings charactcrislic of oca/pntious in uhicli li mctals are usrd. The tliscase cliaracstic of cliciuicals, of arisi, o f alkalics. rs ami innics, are charactcrislic of and uliar io lliosc occupatimi in nitidi dir iloyrt's are so ex posisi. T h e diseases of rrspiralory System, due to th inlialaof ilusts, are dir naturai accompamr and th chararlcrislir ol'fcct of work mh diists. ben sudi t i r a r and sjireific lartguagc is lahlr, liy s/uuild we Ite ask rd tu use le, limati Irrms, dir lise o f wliidi may d u n e th Rivinti o i a Mank check hy -try? l i die pnrpose is Hot lo charge Irv willi disrases svilirli are mu d iar- aclrristieally the obligation i^f in<liitry, why conlinually insist upon the u.c o i lan guage which is susreplililr o f iiiisintri prrtation? lie ell asslirnl, if legislature do not perform llicir duly and lay down I'lear definitions o f liability, industrial hoards ami roiuiiiisions tannnl in the pri-Mitce o i die idnWs, orphans, ami mhislii.il cripple, ho expected to exercise pun ier courage than the legislature. The law in the hands of snrli an administrative liodv ill he scanned, and I fear scanned in vain, for limiting word or language to stay the hand o i industry's self-constituted almoner. The legislative trend, I am happy to re port. in recent years has hern toward the definite, rather than the indefinite. Despite trem endous pressure, no legislature lias, in the past three years, adopted a hliml, "all-in clusive" occupational disease law, except Xcw York, o f which I shall speak more in detail presently, Michigan, Rhode Island, Pennsylvania, Delaware, X'orlli Carolina, anil Washington, among the states most recently enacting occupational diseases law, have adopted the "schedule" or priiiic method of coverage. T o years ago, Ohio amended its scheduled occupational disease law liy adding dust diseases to its existing .schedule. In two other states, namely, Illi nois ami Indiana, occupational disease laws have hern enacted in general terms. How ever, in identical language, these two states have undertaken to limit and define occupa tional diseases and have attempted therein to safeguard industry against liability for the diseases o f ordinary life. Although doubtless familiar to many, (Indefinition in the laws of those two states will hear repetition, as indicating the ex trem e o f difficulty in attempting to exactly define an occupational disease. " Sec. 0. In this Act (lie term Occupa tiona! Disease' means a disease arising out of and in the course o i the employment. Ordinary diseases of life to which the gen eral public is exposed outside of the em ployment shall not he compensable, except h e re the said diseases folio as an in cident of an occupational disease as defined in this section. "A disease shall he deemed (o arise out o f the employment, only if there is apparent to the rational mind upon consideration oi all the circumstances, a direct causal con nection bet ecu (he conditions under which rt Occupational fUsease 21. tin: work is pci formed ;in<l tin', tu'cii|>:i(i>n:iI di-va-e, all'! uliiili can Ik: seen to have followed a-, a natural incident o f the work as a result id the exposure occasioned bv the nature ol the employment and wliicli can he Iairly traced to the employment as tin* proximate cause, and which docs not tome from a hazard to which wnikmcn would have heen ci|iially exposed outside of the employment. The disease must he incidental to the character of the business and not independent of the relation of em ployer and employee. The disease need not to have heen loreseen or expected hut after its contraction it must appear to have had its origin in a risk connected with the e m ployment and to have flowed from that source as a rational consei|tiencc." Under this definition no industrial m an ager can, with any assurance, he informed what his obligation is to his workman, and assuredly no workman suffering from dis ease can surely know whether lie is e n titled to compensation under that law. Of course, as is to he expected, litigation over the interpretation of this definition is al ready in progress in both of these states. And situations will arise constantly in the future where the facts will he such that only litigation in the courts will determine the liability of industry, or the right of the worker to he compensated. T he claims actually filed with the I n dustrial Commission of Illinois already include unduhuit fever (a disease said to he Commonly eommuuieated hv milk and meat products), tularemia, rheumatic fever, arthritis, rheumatic heart, heart disease, amebic dysentery, varicose veins, flat feet, athlete's foot, cerebral hemorrhage alleged to lie due to overwork, syringomyelia, and nerve disorder. I have not mentioned the claims lor characteristic occupational dis ease-:. such as silicosis, carbon monoxide poisoning, and the various other toxic con ditions which dearly come under the Act. 1 have referred to the fact that New York, alone, lias in recent years enacted a law covering occupational diseases in gen eral terms. New York was the first state, I believe, to enact an outright compensation law for occupational diseases. It did so in 19?0, T h e law was a schedule type law. (It So happens that I had the privilege of being one of those who collaborated in the d r a f t ing of that law.) We were dealing with a new subject, We exam in'd the cxi-tue laws ill other countries ami adopted ihi torm that seemed hest adapted to m u c,.n ditions, namely, the Kughdi law on nivupa lional disea ;es. The. schedule was, i u .u time to time, enlarged a- new mdiiOii.d piocesscs developed new di-rn e .. I`>v lojo the schedule had heen enlarged to iuelnd every disease licit was a potential huzuo! to the workers in New York Slate, wit! the single exception of the du-t di-va-iof the lungs. In order surely and certain!;, to bring such conditions within the p u r view of the law, there was enacted an ad ditional item in the schedule, reading "an;, and all occupational diseases.'' The sched ule was not repealed, and the administrative provisions in the law with respect to the schedule were continued. One of the nr-: questions that arose un der this new law was whether the new classification super seded the schedule and the limitations set forth therein, or whether it was an ad d i tion to the schedule and applied only to those conditions not previously included therein. The legislature, having evaded the duty of defining the term "occupational disease," the Industrial Hoard, which administers the law, adopted a definition. T hat definition is well worth repeating: that the Hoard deems a disease to he occupational only when it is "characteristic of and peculiar to the trade, employment, or occupation" in which a worker was engaged. This defi nition was adopted almost verbatim in the Rhode Island and Michigan Raws. The Appellate Division of the Supreme Court, however, declined to follow it, and by a vote of three to two, held that any disease that arises out of a condition incidental to the employment must he deemed to he an occupational disease. (Itishup v*t. Comer it VoHoilc, J?1 D ivision, 49.2; ('iDlillit.T); vs. *)>4 M .itvy C orpora hnii, 251 Appellate Division 904.) The Goldberg case was appealed to the Court of Appeals--the court of last re-ort in New York. So complete!) do the facts in the Goldberg case hear out what 1 base said about indefinite liabilities under an all- inclusive law, that they will hear repetition. Shirley Goldberg was employed to sell tickets in a moving picture theater. Her booth was on the sidewalk^ It was kept heated, in cold weather, b y ^ ^ n a l l electric heater omw-io-.t f ' ' -' <>:/> noth. She contracted what she described . Motrhes o r a rash on tier legs. T h e .luteins or rash she claimed were <lue to he alternate healing ami chilling of her gs when lie su ilrlin ! on o r olT the heater. ,'liey .lid not ruii'tilnte a disability. Ilo w ver, on complaint to her employer, she was tld to sic her ilortor. While on her way i see her doctor, on h e r own lime, she I 'ipped on the sidewalk amt fell, fracturing ) n ankle. Although the day was rold and c testified there was iee and now on the lewalk, the claimant alleged that she fell lely ilm: to w eakness resulting from so hlotehes, and the Industrial l'oatd fonml; ami found that the eanse of the ill was an oeeupation.il dieae, eharaetertie of and peenliar In In i enipliAitH.nl. Tin: ('unit of Appeals, in an opinion that ,istle> with logic ami .otutd sense, struck is free-for-all system from the language : the New York Act. T h ey tmaniiuonly fused to eotwede that this \\a s an orenitional disease. To make every disease tat aru-e out of ami in the course of emioyment compcii-aMc a s an occupational iscasc. they sail. would he to make the unpenation law ''the eipiivalent of life id health insurance." T h e court further .id that to he "occupational," the disease ut he one which "results from the ua:re of the emplen incut'" : and that hy naire of the emphiymeiit is m eant--eouditions which all employees of a class are subject 1 which attach to tin- occupation--"a /aril which distinguishes. it from the ii-nul hi o f occupations, and is in excess o f the tzard attending employment in general." ol.iltll.cre is. Os.| M;,ixy Corpormiiin, riecitlint l.mu.irv 11. lO.ts, sn<i rsportcl in 270, .\. V. lit IJ X.K. 'ml. .111.) Thus, a fter n-.ore than two years of ear unceriainty as to the meaning o f tin: e, the Court o f Appeals has eliminated mi the New York Statute the diseases ordinary life which are only incidental speculatively related to the occupation, lust a word aUoiit hernia as an occupainal disease. Never heretofore regarded ail occupational disease, hut t|uile Kin dly recognized under certain ciretmimecs as an accidental injury--the Oecuioual |)irae I.aw of Michigan, enaeled V year, speeitieally included hernia in schedule of diseases. Not all lierniae, a ever, are so iududeil, hut only thoo irly.tif recent origin, as to which dis- ability follows immediately, and in which prompt report to the cmplover is made. T h is is not far different from the rule in regard to hernia as an accident. |!ut in N ew York, du rin g the past ycyr, il lia become Somewhat the fashion to rega almost every hernia as either an accident or an occupational disease. This followed on a decision of Ihe Court of Appeals, sustaining an award for hernia as an occupational disease wherein the In dustrial Hoard specifically found dial no accident had occurred. In the ease pre sented, the worker was reipiired, in die course of his employment, at frcipnnt intervals, to rotate his body on the hips. T h is man was employed in a glass factory, lie gathered molten glass on the end of a ptttmy, which ho, in turn, sw ung about and placed in a mold. T he weight was not excessive, being only matter of a few pounds. In affirming this award, the Court of -Appeals said: ``T h e finding, supported hy evidence, is that the continuous gathering and lifting of glass from a furnace invoiced a constant twisting and straining oi the body. This process, from gradual stretching, resulted in a hernia which is a disease (M atter of Alpcrt vs. Pow ers 22.1 N. Y. 97, 101.) There is medical testimony that claimant's occu pation would produce this disease and there are judicial decisions in other jurisdictions holding that hernia is ait occupational dis ease (M arathon Taper Mills Co. vs. hid. Comm. 20.1 Wis. 17; T ravelers Ins. Co. Vs. i.ocke 50 Fed. (2nd) 41.1, 444)." vs. O iH iiulcr H rotJuT i In c., 278 X, V. 3 IS I X. E. Jtnl .ICQ.) Perhaps the most controversial ipiestion invoiced in occupational disease legislation is the treatment of liabilities for dust dis eases of the lungs. lit no class of cases is the marked difference between accidents arising at a given time and piare ami occu pational diseases more pronounced. In this category of eases, we find silicosis, authravo silicosis, and ashestosis, all o f them f..rnitii pneuinoiHieoniosi'. While these diseases in some of their forms are among the most ancient, their ravages having been rec ognized generations ago, little has been Known until recent te a r s of their causation, of their pathology, and of their complica tions with other diseases. A vast fund of knowledge of these diseases has been gath ered in the past ten years, and intensive m  Yi*ify iJu/lr : .A . studies of their etiology and pathology arc -till going forward. One act stands out dearly, ami tliat is, tliat tliese diseases do not progress to the point of di-ability until after many vears of e xpo-n re to dust. '1 lie length ol time, varying from live to twenty-live or mole years, is dependent in large measure upon the concentration of dust, the com position of the dn-t, the time actually ex posed during winking hours, and the. in dividual susceptibility or lysislauce of the worker. Another l a d thajl stands out is that the fibrosis of the null's, once aripiited, is permaueul and incurahle, and, in iimoiiipliealed eases is not susceptible to medical It raiment. Main tlioii-uods of workers today, under no law lull the common law, have hevn employed iti employments exposing them to more or less heavy concentrations of dust for many years. In the event of the enact ment of an occupational disease law in cluding those diseases, industry will find itself, at the stroke of a pen, liable for conditions already acquired through long years o f employment, and which may liecome disabling at any moment, in this sit nation, the best guaranty against disable ment is continuous ami steady employment. Many a man, actually able to work and earn good wages, while he has a job, will be able to demonstrate by x-ray and clin ical examination the presence of a marked degree ut silicosis, when his job stops because of depression or otherwise. Hence arises the tpiestiou of the so-called "accrued .dubtiesi" This term which has come into common use is perhaps not an exact term, in that "liability" docs not occur until disablement, and the liability is only 'accrued" at that time. M'liat we have in mind when we discuss accrued liabilities is the condition of fibrosis of the lungs which has accrued and has been aopiired over a period of years. This condition, being permanent, remains with tlie worker, whatever and wherever may he his employment. I'erhaps a more exact c.xprv-siou would lie "potential liabilities," and yet they are more than potential; the condition giving, ri-e to them is actually rxi-tent. Industry tells Us quite truly that it can not now pay full compensation out of cu r rent income to all of the men employed in industry who may have in the past' in curred some degree of fibrosis of the hiegs. lint if industry cannot assume tlic-c lialiililie-. how nun'll Ic-s justification -. there to call upon insurance, out of tin- piciitiiiins of next year, to pay tor disablement- ac quired over the past lifteen jears, and for which it received no premium? In this difficult situation, it has been f ou n d necessary in many states, if cmplovmetU is to he continuous and tmiuter rupted, and if men are evciilunily to In. compensated for the libro-is acquired due tu future exposures, to absolve, to a great extent, industry from the obligation of coinper.-atiou for pa-t exposures, and to ba-e compensation upon the extent of expo-tinafter the enactment of an occupational disen-e law. Thus, there lias come into acceptance in several states the principle of graduated compensation benefits for dint diseases, limited to future exposures, and eliminating in largo measure the ex posures of the past. Under this system coiiipcn-alioii tor dnabiiity or death occurring during the ftr-t month under the new law would he only a nominal amount (it has been set ns low as >50(1 to start with). A person disabled during the second or third month after the enactment of an occupational disease law will have been exposed, to a small extent at least, under that law. The e x posure is perhaps in itself insufficient to actually result in any harm. Hut the m a x imum benefits will he increased, month by month by small increments, until in the course of two or three years the lull limit chargeable to industry in the particular state will have been reached. This sy-tein is not so complicated as it might seem. T h e effect of it is rather to po-tpoiie the going into effect of a dust di-va-e haw for a matter of two or three years, and experi ence under Ibis law lias demonstrated that lew claims arise where the compensation heneliis are so limiled, the worker- p:c ferriug to stay at work as long a- lie . can. It may he said that it wanks h.u-hl. in the ease of the person who become, really totally disabled in the early inoiubof law. When mea-ured by the liabilut null wbieh die employer may l.iiih 1" th,aigeit, it does not, in fact, w m k a hard -hip, and when compared with the exi-ting system ill states not now under on'ii- ?*s i i !! ! . , . ' i i . y . i i t. t\i. l>:ition;il disease laws, it not only is not a hardship Imt is, in fact, a great boon. The principle of limited and graduated lialiilitv of the employer for (Inst diseases has hecn recognized lie enactments in N ew York, Michigan, IVmisylvania and Ohio. \ n umtstial provision has lieen adopted iii the state of Washington, providing under their schedule form of law that the cost of compensation for occupational diseases hall he divided eiptally between the e m ployer and his workers, and deductions dial! lie made from the employees' wages is coni rilmtions toward the insurance premiums involved. lint what, \oti mat say, lets all this to In with the safely engineer? It has mnrh. The safety engineer can no longer regard himself as doing his oh if he seeks only ways and means to eliminate the industrial accident. The in dustrial hygienist must liecoine the colleague of the indu-trial engineer. Medical science must give intensive thought and study to determining the effects upon the tinman system of various industrial processes, and exposure to various materials therein. AH exposures cannot he eliminated and still have industry perform its functions, ilu -t important, therefore, is the medical d e t e r mination of what are safe limits in e x posures--the so-called "threshold limits." The engineer cries aloud today for expert medical guidance on this subject. Armed ..ill such medical opinion and advice, the task of the engineer then is to devise prac tical ways and means for attaining condi tion.; where such threshold limits apply. Kvcry industry presents a problem or erics of problems in itself. No two in dustries are exactly alike. W hat is tolerible in one may he intolerable in another. What is good practice in one industry nay he totally inapplicable for practical reasons in another. The task of the en gineer then is to find how right principles nay he made applicable. Industry today, more than at any time in its history, must hear the burden o f responsibility tor tiic health as well as for lie safety of the industrial worker, and if is health and his safety are adequately afcgtiarded his happiness and the happiness if hose about him will he increased. T h e r e fore, it is of prime importance in the field ti safety that intensive and increasing in terest must be given to industrial health. The care for the health of the worker must not be confined to tbe guarding against those conditions that arc mentioned specifically in the law. The engineer's re sponsibility is a broader responsibility than is the legal liability for compensation. T here can he no doubt that the enumeration in the law of specific conditions for which liability is absolute will lie of great a d vantage to the industrial engineer in seek ing to en fo rce proper health standards. It is" far easier for him to obtain approval of his recommendations, if he can point out to management that the use of benzol or some benzol derivative is specifically men tioned, and point to the specific paragraph ill the law that cites the liability of the employer for that condition. No argument is needed to convinrc management of its obligation in such a case. T h e same is true with regard to all of the metallic poisonings and all of the other wide range of chemical exposures. Psycho logically there is great power in the printed word, and even the most backward manage m e n t may he made to respond when the d e a r mandate is set forth in the law. Not so easy will it lie, tinder a general, vague, and all-inclusive occupational disease statute, to convince management that it has specific duties with regard to the elimination of health hazards. Thus, we see there is a n o th er and potent argument for (lie schedule law, rather than the all-inclusive law. T here is perhaps yet another and even more compelling reason for applying the rule o f sanity and common justice to leg islative m andate in the complex field of occupational disease. Shall employment lie limited to those who are physically per fect? All humans arc not examples of physical perfection, nor can we by legisla tive fiat reverse the laws of nature which immutably decree tliat we shall grow older with the passing years. We b a te scfcn amt discussed the dangers inherent in the all-inclusive theory of stretching the law to cover every sort and condition of disease, and to try to make (hem employment-related. When that stretching is complete, when administrators of the law find it easy and possible to burden industry with the responsibility of health insurance under the guise of an occupational disease statute what of (hose wlm, wanting employment or seeking to re tain it, arc not physically perfect yet c e r tainly arc nut ili 'allied ? Much Is heard today of the dread lortyyear-linc for employment. Whatever the facts may he as to that, is it not possible -- if not probable--that industry, in despera tion and against its desire, will be forced eventually to accept only those anion;; whom the health hazards are hast uncer tain--the physically perfect, the young ami the strong? We may well pause to cott- sidyr the devastation mic/i a situation wouf produce. . . In the interest of all workers, the culm, and the old, the perfect and the impcr.cV: let us not embark upon legislati fc policythat can lead only to enlarging the tick of unemployment, and to closing the dnot of industrial opportunity to those skilln and faithful workers who, having passy. the meridian of life, are subject to thus, natural infirmities and ills ot the llesh P which all men, in lime, must bow. Handicaps in the Diagnosis of Occupational Diseases By CAUICY P. M cC O R D, M.D. Detroit, Midi. It is a popular medical belief that occupa tional diseases arc far more difficult to rec ognize and precisely to class as such than any oilier type of disease state:. So lirmly is this idea rooted in the minds o f some physicians that they argue that occupa tional diseases never should lie made com pensable because of extraordinary diag nostic ditiiculties. l.atcly, Kettering! has said, "The doctors tell us there are certain diseases that are incurable. Do von know what an incurable disease is? It is one that the doctors don't know anythin;; about. The disease has no objection to living cured at all." This may be paraphrased by savins: There are no luidiagnosahle occupational diseases. The only ones that appear undiagnosable are the ones the physicians have not learned how to diagnose. No occupa tional disease has ever offered any resis tance of its own to being diagnosed. The disease is perfectly willing to be diagnosed. At least one-half of all occupational di seases are almost self-diagnosing, particu larly when arising in groups; the remaining half present no greater difficult ics than attend the diagnosis of some other classes of diseases. To maintain that occupational diseases are beyond the diagnostic skill of the physician is pure defeatism. W'ith equal propriety, it might be suggested th at all neurology be abandoned because the m a jority of conditions arising in this field may not be diagnosed with ease. While it may be said that there are no uudiuguosahlc occupational diseases, it miibe recognized that many remain 111uIi;i_ nosed, or more often misdiagnosed. Tb prime reason for this is that tbc ii- ii. physician sees only small numbers of an one type of occupational disease. Takin Ohio as a typical industrial .slate, the tin: number of occupational diseases, compell able and otherwise, reported to the Slat Department of Health during the year 19.' was I,(Km. On the other baud, there aie this state 9.20(1 physicians. Tims, only on occupational disease arose lor every a doctors in the state. I lore then is the foremost handicap t the recognition and diagnosis of ocrup: tional diseases and at the same time back-handed compliment to industry. I: dustry, because of its prevention achii \ nients, has so limited the number of o. oupatioual diseases that day by day ti physician is ordinarily not spurred to tl possibility that any worker who seeks b professional guidance may have a disease > occupational origin. Here, too, is the fund mental reason why more medical sclim do not develop training departments in tb field or organize special hospital serve' for the rare of occupational disease i lienls. While there are reasons for rejoicing tb there are comparatively so few occupation diseases, we should recognize, th.il tb. are specific situations which introduce di. nnstio difficulties. A number of tliO'C . now presented, as separate entities. Definition and Terminology Murli confusion is caused by lack of iniforinily :nul clarity in definition Scarcely iiv t a n slati -s in their statutes accept the ..line definition o f an occupational disease. :i a lew states, hernia is by law specified . an occupational disease. However, in the' Majority o f states it is, when related to in- Instry as a cause, classed as a traumatic njury, in a few states, tbc definition of n' occupatii'ii il diseasi: provided by statute -iirli that certain items later appearing on liedulcs tbeniselves do not conform to :e (leliuitiou furuislied. Well meaning legislators might enact a nv declaring: tli.it two an d two make seven, nt the mathematical facts still might rclain other i-e. So w ith legislation in-. living occupational disease diagnosis, there ay lie demands for legal acceptance o f Main conditions as occupational diseases, lien elem entary medical tacts point otiicrisc. One group of physicians may reserve ie term " in jury " for exclusive use in cone. :iou with, tr aum a, w hile another with ropricty may assert that occupational disi .'s of many natures represent "injury'' the same extent implied by the term rminatisin." l.et tt-> consider, fo r example, the occurncc of an accidental in ju ry or- the one id and a cicar-cut occurrence of an orip.V.innnl disease on the other, both caused out one and the same substance. Imt under liferent circumstances. It might come out in a given factor)- that a workman tered a tank car, lately emptied o f ben', and in the absence o f suitable protec ts and precautionary m easures might, thin ten minutes, become asphyxiated as result of breathing benzol vapors. Man'tlv, surfi an occurrence as this would accepted as an accidental injury and no mpensation hoard would ever raise a cs.ion that such ms not th e case. I On the other hand, this same benzol. :ei. from this tank car, m ig h t lie utilized this same factory in som e productive I -.'ration, giving r iso 'to benzol vapors. ] )ay | day, another workman might inhale some I these vapors, hi due course, this work I insure might produce th e usual ami I rarlerislic features of that occupational I rase known as benzol poisoning. Here I in it is most unlikely that any pliysieian I compensation hoard would entertain any uncertainty that this condition represents a characteristic occupational disease. ttetween these extremes, there is some point nt which difficulties would arise in distinguishing occupational diseases fmm accidental injuries. This same siluation ap plies tri many other Substances anil many other occupational diseases. T here is per haps no warrant for any attempt at a hard and fast demarcation in terms of time, in dicating wiiere an accidental injur)' expo sure leaves oil and an occupational disease exposure begins. However, there may he some justification for the practice of many physicians, who hold that if the exposure leading to damage is less than one work period, the ensuing injury should he recognized as an accident. Conversely, if the exposure period extends for more than one work period, then the resulting damage may with propriety he ac cepted as an occupational disease. In gen eral, it may he claimed that one of the disturbing handicaps to uniformity, clarity, and precision in connection with occupa tional disease diagnoses stands in relation to awkward legal situations, iiiadoniate defi nitions, unsnited classifications and such. F a ll a c io u s M e d ic a l H i s t o r./i e s As a result of careful training, every physician is disposed to attach significance to the history statements given by a pa tient or members of his family with re gard to any disease. The less a phy-ician may know about the possible etiolugir farts in any situation, the more consideration he is likely to give to history statements. It is human nature to associate all of our ills with some particular happening or series of happenings. A cold may he associated with a particular period o f sitting itt a draft. A gastro-mtestuial upset is prone to he associated with some particular alco holic bout or food engorgement. in the case of industrial workers, there is an especial (ironcness to associate any bodily ailment lit some aspect of work. Inasmuch as almost every workman hopes, openly o r secretly, that any and all dis eases from which he may suffer may be laid at the do or of bis employer, he is most likely to stress and emphasize the high probability that this condition mifailingli was produced by the chemicals, gases, va por-., dusts, t-ic. that atten d his w ork op er U >. ii/'ii/i .iittl ! ' lA. iJ.i. ations. Tliis docs not necessarily repre sent dishonesty or cupidity on the part of tli<- initient and only may involve those Iminait frailties shared by all of us. N'o less, the history statement may u n duly imlueuee the physician in his diagnn-is, may lead to ini wliagnusiug, may |>avc the way lor unwarranted claims or law suits without any evil intent on the part of the physician. It is most unfortunate that the physician is all too often unable to appraise the worth of,-work history statements pro vided hy a patient. Let tts, for the moment, assume that a specialist in ear diseases is visited by a patient on account of deafness, in connection with the history, the physi cian may record that this patient is a drop forge operator. The physician may go ahead and make many carcftil examinations, looking for the cause of the deafness, from infection, from syphilis, from heredity, etc. If, however, he had obtained a complete work history, and was in position to evalu ate this work history, he might come at oucc to know that this drop forge operator is perhaps exposed to as much noise and con cussion as ever arises in ordinary indus trial7 work and that the deafness present clearly is an occtip&ional disease, resulting front sustained noise exposure. It may he asserted that well meaning physicians, without any evil intent, through their misunderstanding of patients' descrip tions of work operations have become re sponsible for a high percentage of the large number of unwarranted suits that have Hooded the country in recent years. In short, one o f 1the handicaps to the proper diagnosis of occupational diseases is to he found in the attaching of undue significance to the patient's statements as to work con ditions, when the physician himself is un able to appraise their reliability and merit. Some physicians need to make themselves more remote to the fallacy that just because a workman 'is employed in a dangerous trade, inevitably any ailment must neces sarily he the result of work exposure. There still may he a few persons who may believe that lead poisoning may arise from work in making lead pencils. Tinte as a Handicap in Diagnosis Too often the physician well qualified in the field of occupational diseases, does not see the patient or claimant whose condition is to be appraised until long a fter tli time within which the disease might hat been diagnosed with precision. Witlioi any purpose of condemning or finding faul tlier fact must he faced 'that in many ii statutes the decision of a patient to blam his ailment on w oik causes was not mad within that period w hin some or all o t/ie characteristic mam testations were prev ent. Then, at some later lime, a physicia qualified in occupational disease work ma he called upon to examine the claimant o to reach a decision based upon the exam ination of inadequate records of anodic physician who himself did not carry on any examinations with particular refercnci to that occupational disease for which ; claim later lias been filed. This is askitu too much of the diagnostic ability of an; good physician. On the witness stand, the charlatan a! ways makes the better impression on a jury, because he is unhampered by the caution and reserve that guele the up right witness. Being positive is often merely a matter of being w rong in a loud voice. 'Die point is that the time to make a diag nosis of an occupational disease is that periotl during which the disease exists. Otherwise, the most accomplished physi cian may be placed in an unfortunate po sition in the reaching of his decisions. Insufficient T rain in g and Experience An outstanding drawback to the proper diagnosis of occupational diseases may be found in inadequate training in medical schools for this aspect of medical work. This is not a thrust at the doctor, nor may any complaint be made against medical ed ucation today. It may not he expected that medical schools will markedly enlarge an already over-crowded curriculum to p ro vide extensive instructions with reference to occupational diseases when the number of cases yearly is so small as to ptovidc only one for every five or six physicians. Realizing bis own shortcomings in 11ti-. field, a good general practitioner may ho n estly slum this type of work, but this step on bis part may eventuate in even more undesirable situations. The patient, instead of being reerren to a better ipialilied physician in this field is given no advices, w hereupon he grave S i/ c c r J t t i n n A<(/ s t y C o n y r c s s ites toward an inferior physician, less courticd with the lack o f qualifications. T h e stem to which lack oi qualifications in ocipational di-ease work may go is rcllcctcd the. fact that recently a duly licensed hy-ician in the State of Michigan reported, i.'estinal peristal-is" as a diagnosis of an cctipalioiinl disease. While the unwillingness of a physician to cept responsibility for pathologic states ith which lie is not conversant is cotti'nilahle, there still rem ains a duly to d i et his patient into channels wherein adeuatc services may he procured. Industrial Terminology One of the most annoying handicaps in -tallishing the exact etiology of a possible ccupatiotial disease resides in tile widvircad practice of industry in using code . inlu.ls in the designation o f its substances, n inquiry, the patient may state to hi ivsiVian that his work consists of filling mtainers with " li-72." Hut, inquires the nysiciun, "W hat is P,-72?" T he patient intiitucs, "11-72 is a m ixture o f M-20 with : -10 and I.-07." Completely the physician left in the dark, hut if the truth were tw i t it might he shout! that this patient is engaged in the filling o f cans with a imih remover, which consists of a mixire ni wood alcohol, benzol and a syn d ic wax. Such situation* may become so cuufuu that it may he almost impossible for e physician to obtain proper information . to work exposures. Medical, safety, se al service n r insurance departments all ay have difficulty in obtaining full inrntatiou as to actual chemicals and mixres of chemicals designated in production - cations only by code numbers. The Absence of Records The majority of industrial plants fail maintain sufficient medical and work cords to serve the physician properly in uucctiou with occupational disease work. a given instance an afflicted workman ty give as his .occupation some innocus job as "elevator operator." He may rc.mber that the job before that was as "trit'-k driver." There his memory may .1. H is work record may show no item* ta transfer within the factory of his t employment arid no record of any prems employments. Although tin- x-ray of the chest of this workman may strongly suggest the possibility o f silicosis, nowhere on the w ork record may it he shown that for a period of seven years at some much earlier time this workman was employed a* a laborer in a pottery, fit this same connection it should be em phasized that one of the many handicaps to the physician in making an accurate diagnosis is to he found in the widespread practice of hospitals, of clinics, insurance records, etc., in merely naming the trade of a-w orkm an rather than describing his exact occupation. It is quite insufficient for med ical purposes for a record merely to show, lor example, that the patient was employed as an "automobile worker." I 'ndcr this heading, there arc perhaps not less than 201) different and dissimilar types of em ployment leading to dit/crent exposures; such for example as to silica in the foundry, cyanide in the heat treating room, chromium in the plating department, lead in body fin ishing, and on and on. Lack of Library Facilities . ' W ith some temerity the statement is inade that regardless of many honk publi cation in the field of industrial hygiene and occupational diseases, special maga zines, and articles appearing in general medical magazine publications, there is, at this time, no condensed, informative ma terial oil occupational diseases well suited to the needs o f the. family practitioner. It is of course impossible and undesirable that any attempt should be made to reduce all of the lore of occupational diseases to some thin hook to which the practitioner may refer and with certainty obtain all the guidance needed in the treatment and man agement of occupational diseases. Granting all this, there still is occasion to assert that a real need now exists for a book publica tion on occupational diseases designed for services to the neighborhood physician v. bo in the aggregate sees far more occupational disease cases than the small number of specialists in this field. A ttitude T ow ard Industrial Medicine In times long ago, when mine workings, sawmills, and railroad construction camps were established in remote sections of the country, far removed from the usual sources o f medical services, it became necessary that the management bring into these iso- m ' *k tilt.ft. 7 / \. latcd work places n physician who might carry out all manner o f medical services. These physician' set the broken arms of injured miners; delivered the babies of the miners' wives; treated the miners' children for measles and mumps and otherwise at tempted to meet the medical needs of these detached communities. Lsually the com panies contributed to the income of these physicians and every family and every single man was tasetl a stipulated sum each month tn - o r d e r to cover the physician's salary. Tims arose the term "Contract 1'liysician." This perhaps did not always represent the host of medieine and not in all installes were these contract physicians of the highest type. Later some of these communities became larger towns, or cities, and other physi cians sought to gain a livelihood, only to find th at the contract physician was in the saddle. This gave rise to complaint and out o f this " Pandora's box" have come innnmcrahlc evils that even to this day a t tend the highest type of industrial medical supervision under the most ethical and commendable circumstances. It has be come a tradition cm the part of many of the medical p ro fe ssa i to blame almost any manner of their economic dlficulties upon industrial physicians. So real is this dis affection that some organized medical groups have sought to legislate against al most any form of industrial medical prac tice and in some instances to deny m em bership in medical societies to industrial phvsicatis. As a result, industrial physi cians in some respects have been branded with a scarlet letter. This queer situation, strange to say, may serve as a handicap in the diagnosis o f occupational diseases, since some of the best physicians, ami particularly the more timid ones, fear lest they may become be smirched by cooperating in this type of medical endeavor and to some extent shun any close affiliation that might lead to lifted eyebrows by those regarded as the leaders of the profession. Now that the American Medical Asso ciation is somewhat alert to this situation and has organized a Council on Industrial llvallli, including some members with in dustrial medical experience, it is to he hoped that after all the industrial physi cian may hc'-mue respectable. New Chemicals A further deterrent to accurate d ag nosis of occupational diseases is linked mp with an almost endless llow of new chem icals into industry's processes. Year by year, a far greater number of new chem icals are introduced than the number of investigations referable to their toxicity. It is often true that nowhere in the entire literature concerned with industrial tox icology may any word he found aiding the physician in determining if a given chcniiial might he responsible for a series of objec tive and subjective symptoms in any patient. , One of the most desirable changes needed in connection with worker health protec tion is the requirement that no new sub stance he introduced into indu-dry on a production basis until it shall leave been established to the extent possible, through animal experimentation, that such a sub stance is without dangerous potentialities. Significance of H andicaps in Diagnosis A recital of the type just presented might be continued almost indefinitely, but perhaps without profit. The entire situa tion may lie summarized bv stating that whereas occupational diseases theni-elves are probably as diagnosable as any other difficult class of diseases, just about every stumbling; block that may be produced is laid at the door of the physician sincerely seeking to acquire sufficient evidence upon which to make exact diagnostic decision. The greater number of these stumbling blocks represent no willful desire to hamper the physician, but instead arise from the results of peculiar circumstances that in some measure separate industrial diseases from the general run of afilictions. As a consequence, large numbers of un warranted diagnoses of occupational dis eases have been made and are being made. Scores of suits have been instituted and some liave been won by claimants whose claims possess no whit of merit, chiefly be cause well meaning physicians unhappily implanted the seed of possibility that hidisease might have been cau-cd by work ami that the responsibility might be laid at the door of the employer. While the re sults may have appeared to work an in justice and monetary loss upon the e m ployer, in the long run the interests ol the w orker himself are not seivvd hv these r\ t .'i/cvc /ii/.'t'/i'i S a f e t y C o n yress. spurious cl:iims predicated upon improper badly needed tinder postgraduate auspices. medical advices. 'Hie usual trial ul an oc cupational disease case is a travesty. The lioniliaslic statements of some physicians, unattended hy any iota ot" fact, bring into disrepute the entire medical profession and take away its time honored traditions of integrity and skill. (b) In every industrial community, or at least in every industrial state, there should lie available for cooperation with the general medical profession a numher of much experienceil and highly skilled occu pational disease consultants, who, through limiting thcir^protessionnl activities to this A further significance in the misdiagnosis one aspect of medicine, may become highly o f occupational diseases on the pa11 of proficient in the solution of oecupalioii.d pin sieiaus is to he found in unwarranted disease enigmas. hardships imposed upon employers. R e cently a physician made a diagnosis of silicosis in two woi kmen in a given d ep art ment. As a result, widespread appreulionsions arose among the remaining workers, strikes were threatened, talk developed as to demands for high wages because of un usual exposures ami the expectancy o t a short w ork life. T he employer was com pelled to spend some $85,000 in the installa tion of ait elaborate d u st control system. As a matter of fact, these two workmen did not suffer from silicosis, were not in any wise disabled, had never been exposed to silica; no silica or any other harmful dusts were created. There was no need for the expensive installation made and contrariwise other departments did present practical exposures to r which this $85,000 might have been spent to better advantage in procurement of needed protection. (c) In every slate and in some of the larg er industrial cities, there should lie maintained public institutions devoted to industrial hygiene and occupational dis eases whose technical services may he avail able lo the physician iu charge of patients who may lie suffering front occupational diseases, and these public bureaus should servo as fact finding bodies, equally inter ested in the worker and his employer. (d ) Much will be gained if all physicians responsible for the health of industrial workers in any capacity may make greater elTort to obtain precise work histories, both present and past, and may seek to gain an adequate understanding* as to the work en vironment, its materials, machinery and possible exposures. (e) Controversies should be eliminated in the largest possible measure from occu pational disease work. Many abler physi The Road to Betterment cians eschew all connections with this type This entire discussion would be without any value if present clay practices and sit uations only were condemned. More ac curate diagnoses as to occupational diseases are badly needed. These better diagnoses of medical practice because of the sad ex perience that nearly every case may he so involved in controversy, litigation, disaf fection, until the good physician may feel that he may be degraded. will come in proportion to the extent that ( 0 A need exists for greater disclosure the changes now listed arc brought to ac tuality. to physicians o f the chemical nature of work materials lo the harmful nature of (a) The genera! level o f knowledge o f which employees may he subjected. In occupational diseases on the part of the dustry may have excellent reasons for hid medical profession should be increased ing the nature of some of its chemical m a through the introduction into medical col terials under code terms, but more often lege training of a practical amount of in these c o d e . terms are designed only for struction on industrial hygiene and occu convenience and not for secret formulae pational diseases furnished by men who purposes. A greater degree of cooperation have bad first hand experience in this field on the p a rt o f the manufacturer will even and arc not wholly dependent upon textbook tuate iu the better health protection of his lore. However, it is emphasized that in workers thro u g h the more intelligent min undergraduate medical training this form istrations of the patient's physician. o f instruction necessarily must be sharply (g) Lastly, it may be pointed out that iimited because of a crowded curriculum, better diagnoses o f occupational diseases but conversely more extensive instruction is will come when the general medical pro- tVt'i iliU i fcssion, through its organizations, shall alter its attitude toward industrial medi cine, shall recognize this type of work as just tile antithesis of the undesirable as pects of state inedieitio, and may come to realize that industry, tinder the guidance of aide medical directors, is the meritorious source o f numerous cases to he referred to almost every specialty in medicine. '1 organized medical profession tvludcjie: edly should render its approval and .supp to the cliorts ol the physicians car/n seeking to protect w orkers from the in;, dangers connected with industry's (lioii.-a: of substances and work conditions. Necessity for Uniform Absenteeism Record In the Industrial Health Program By M IL T O N II. K R O N E N B ER G , M.D. Chief, Division of Industrial Hygiene, D epartm ent of Public Health, State ol Illinois, Chicago Yon are all aware of the value of acci dent statistics. Yon know that without fre quency and severity rates there would be no .solution o f the safety problem and we would he groping in the dark. But, since they are available, we know where correc tive measures are needed and this affords tis an opportunity to correctly judge the value of one method of prevention over another. These excessive rates are especially i. able for unskilled workers as shown the accompanying table. These death rates could only have ! prepared by statistical methods of an:, sis and, th erefore, clearly point out wi one phase o f o u r problem lies. If : nothing more than this we would hr plenty to do trying to uncover the men., to health among the unskilled g ro u p - Today, the ^rip of statistical methods workers. is closing down upon industry, medicine, public health and safety. Vital statistics, however imperfect, are one of the chief means now available for measuring health, longevity and the progress of medical services in the battle against diseases. The morbidity and mortality data down by uniform and adequate report of cases can also serve as a basis for ; volition and health education among v v ers, the same as is and has been done accidents. So well recognized is this fundamental principle that the effectiveness of a city or state health, department is judged, in a large measure, by the accuracy and com pleteness of its morbidity and mortality reports and records. It may interest you to know that Kastman K odak Company, Edison Isle. Illuminating Company, Hood Rubber < puny, Westinghouse, Metropolitan Life. > eral Motors, and several others have years made sickness studies with tin T he same principle obviously should hold of statistical methods. In this way true for the groups of workers employed were able to evaluate the different sic' in a factory, mine, quarry, public utility or problems confronting them ami those department store. ing attention, and at the same time The<e records are of value not so much these sickness records properly app' to indicate what lias been done, although and evaluated, they were able to id this is important enough in demonstrating their employees regarding digestive to management the value of certain work cases, colds, pneumonia, tuberculosis. ; and, therefore, the advisability of contin cer, skin disorders, as well as other uing it, as they are to chart future action. meats. Insufficient data have thus far prevented Furtherm ore, studies conducted in i the recognition of some health problems cilu: industrial undertakings have shoe 1 peculiar to wage earners and there is ample value of slati'tieal methods in rev, evidence to indicate that morbidity and the incidence ol such disca-es as mortality rates are higher for some groups. iiiouia, luhci'cuhisis, and degenerative *.<> Si/ivr Jubilee S u fe ly Congress Death R ates by Occupation ( Vi Uptttl'Ut tu rn SV ltlriJ t w r k f l % rV-r (/iw k ili< '(t W 'irlct't . 1// C u su r t 670 5 8 m .9 l(H I-)..l III- 7 7 'w .V r u / s i.i u i i h t t.U H iit Jti. 2 71.\ 10'. 1 .1 8 . H 59 7 7 1 .6 1.1 5 .9 ( \iH fs r utill 70 J 8 5 .-1 9 8 106 6 K ate* |s-t Uxl.tltltl -.ee-ijn-'l Ii.tl'--. t-ased on l '. S (V rijtis .1 in (i n select-si S tates. .a-cs to lie higher than the average for . entire indnstrial population. T h is a s .-arly iltmoiisiruled in a pneumonia study tilting steel workers >vIiicli a s conducted i the L.'. S. Public [leallh Service. Drury, some y ears ago, a s able to slmhigh rate of tuberculosis anions workers :i the ax-grinding industry, and the liarre, 'ermoiit, study revealed a high tuhercu-is rate among granite workers. No doubt, iher occupational undertakings would reeal data for prevention, control and editation ere it possible to have adetpiatc talistical records as revealed in the slide i-t >1m n yoii. Mr. Selby of t'leiieral Motors, in calling Uctiti-iti to his statistics sh o w s that about o <n" a day per annum is lost due to ocupaiititial injuries and that includes ocetiational diseases as well, whereas, eight, ine or ten days per year is the total -st time from all illnesses. In Mr. Newlist's report for the American College of urgeoiis, the figures are about the same, his slam s us that our industrial illness ohlcin is approximately (iftceti times the te >i our accident problem. It is evident that industry could well tird to coneeiilralc oil illnesses among ige-earuers, other than die occupational eases, because they are the ones that tsc tlte greatest amount of absenteeism 1 arc the biggest drain on industry, u the recent National Conference on altli Conservation, it was estim ated that nation's bill for illness an d premature ills amounts to approximately ten bil. dollars annually, and that on every rage day about four million persons in 'United States are incapacitated by 11:. No doubt many industrial workers in that last figure. lie industrialist of today should rccogthat a sick w orl.tr is |u o n e to acci dents, the ypialily o f his work is of a lower grade, team work is disrupted, fac tory processes arc dislocated, undue burdens are placed on other workers ami the worker himself become:, dissatisfied. If he is oc cupied with weighty matters of policy and production then someone in that organiza tion must assinne the leadership ami ac quaint him with the problem by understand able and intelligent facts and figures. There are progressive industrial organ izations who may anti have spent large sums of money for the improvement of working conditions and for the care of w o rk ers who become ill, hut without c u r rent plant information alunit the humait factor unit'll o f this money and effort has been spent on '"general principles" or per haps concentrated upon tin: elimination of only one or two publicized health hazard-, and only from the standpoint of existing compensation laws, as for example, -ilicosis. lint the extent of the health problem in a plant necessarily may not end here. W ith Ihc progress, o f industry CsprcialU on the chemical side, new health problem' will arise resulting in physiological and pathological upsets. T he effect on health will, therefore, have to he measured and evaluated. We must have data in order for one to judge the efficacy of method' employed to combat disease, so wc must first know where health is being menaced, the relationship of occupation to these dis eases and the causative factors responsible. T h e records you keep will he a guide to ac tion as well as a record of action. Therefore, I say, prove your value to industry since many a skilled industrial medical department has been limited in itbudget and activities because it overlooked the necessity and value of absenteeism re ports and record-, which could ha ce ! - ii used to enlighten manage: -cut tegai (lit .. its U c c i t l 'u iia iu il D is e u s e health problems. Perhaps in some cases the iiulu-trial establishment may fitul it d i f ficult to undertake a complete record system of ahseoteei-m. I do urge you, though, to make a start vitiif here. It need not he too elaborate. 1 have heard it said that the best way to detect illnesses which are causative of absentcei-m from work is hy periodic phys ical examinations. I am not fully in accord with this type of prevention. It may he helpful where the illness lasts longer than a week or ten' days, hut something should he done ahottl the frequent one, two or three day absences, and I fear that periodic physical examinations will not help tre mendously. This, of course, docs not mean that industrial medical services should aban don or minimize that phase ot health serv ice. The industrial hygiene divisions of State Health Departments and that of the United Stale Public Health Service arc urging the employment and use of a uniform code for recording ami reporting absenteeism of the wother due to sickness. Forms and meth ods have been developed after a study of -nine twenty years hy the Public Health Service and also as a result of the recent National Health Inventor}' of chronic dis ease alTycting workers. T h e aforementioned health agencies will gladly assist and co operate with industries desirous of setting up and maintaining records of sieknetheir particular plants. An analyst* ; evaluation of thv.-c reports nil-! r e c o r d another service ottered by them to maun, mcnl. Ilefore showing you a term on which collect your absenteeism data, and which . he termed the "m aster sheet," I -hwnld !. to acquaint you with several import, items that must he had for your rccoi before they can lend themselves to ana!., and evaluation. The torm is self expla lory except for a few general remarks. A card should he made out for each a every employee on the payroll, regard!, of whether he or she gets sick or not. T: is necessary in order to ascertain the ra of those sick to the number on the payr. The workers' age, sex, color and oeeup.il: are important to record since they will ha to he related to the specific exposed po| lation. Under "occupation" state the work which the employee was engaged when i sickness began. The "date disability beg::: should only he recorded for one full d or longer. In the column "work days lowe refer to calendar days and thi- is nee, sary to put lust time on a Comparable lu for all employees. For "diagnosis" o: should list the sickness or injury when d v nitcly known; if there is any doubt ah the correctness of the diagnosis, a statenn Sickness Record Form .Vii#/; .V th-ft. Otl UftlfHMS lie- S tx Cot, ____ _ . . 0 * />./ Ih s. ul'tltlv n P 'i/f til' (lit V W/><o/vrkt . Loii if./tir .... ...... /:, I l/l>h.!m<n. I 7 no\tJ I _ J -j 'y emn TUESDAY AFTERNOON SESSION October 11, 1938 The first meeting of delegates to the Steam Railroad Sessions was called to order by Mr. W. \Y. Wood, Superintendent ct Safety and Welfare, Baltimore & Ohio Railroad Company, lialtimore, Maryland, who presided. Chairman Wood lnielly out lined the significance e>f (he programs of the two sessions planned, and then intro duced the first speaker. "Hidderf Causes" By FRED W. SARGENT President. Chicago and North Western Railway Company, Chicago We have seen the evolutionary growth of accident prevention work from its in ception, as applied to the American rail roads. /Many of ns here knew Mr. Ralph C. Richards intimately, and discussed his hopes anti ambitions with him frequently. ; Though he met from time to time with dis; couraging results, yet he never surrendered. He laid the foundation for safety work that : is vastly enlarged and is rapidly ripening ; into collateral lines that are of benefit not f only to employees and managements hut to , the entire economic and social structure of < the country. 1 In the beginning, and even until rather ; recent times, the greatest emphasis was laid upon working rules and physical conditions of plant and facilities; in other words, a safe place t'Twork. T h ere was every rea son in the world why the greatest emphasis ` should he placed upon these factors, and, ! indeed, we are not yet so far along that | tec can afford to lessen our efforts with ( reiatlon to these matters, j In the beginning, the idea of a surgical \ department was to care for men and women i after they were injured. Gradually this l conception has been enlarging and changing into a broader field and greater service, it i a greater service is possible. This depart- nt no longer lias as its sole objective the healing o f wounds and the saving of ' i human lives after injuries. Gradually, steadily, the whole conception of safety work lias progressed and evolved until to day it has become a nationwide activity, drawing to its cause the best minds and the finest characters in our social structure. And with this greater interest in the work it lias been but natural that the whole scope, theory and conception of the under taking should gradually enlarge to embrace the wider field of accident prevention, to which 1 am about to refer. In recent years many, of the railroads have enlarged their conception of this work and have conic to the realization that safety work involves not only safe tools, safe way and structures, and safe surroundings, but involves likewise, and with equal impor tance, the very physical and mental condi tion and attitude of the employee or officer himself. Willi this though! in mind we have changed the title of the head of our surgical organization from that of "Chief Surgeon" to that of "Medical Director," because if men arc to avoid accidents v.t know that they must not only be stirninded with safe working rules and safe working conditions, htu they themselves must be physically and mentally fit; and that the so-called human element, always and ever present, must constantly he reck oned with if we are to achieve the ultimate beneficial results so earnestly desired. And so it is that in all this work, whether .'I ' 7 ,t> 4 Ji A a'lVt~.y r ,,>\ `cw (on railroad right `>t lie permitted when feasremoved. J ing should lie liven of rains by sounding the n acrordnncc with the law ! regulations. ' of these requirements will .selves stop crossing acci only an aid to a general v Responsibility s arc involved in 90 per ng accidents, yincc there . automobiles and 2,'2,9(i2 adc. the opportunity for : * is apparent. T h e public, > definite responsibility in i and enforcement of such result in : lection of motor vehicles > cars will be barred from dntion o f the licensing ol those mentally and pliys.1 and those with a record ng will not be permitted to f the highways not only ils at grade crossings but niseives ti n t the way is opting to cross the tracks. h-arly show that the rai,las their opportunity per- ~<rmal progress in reduc)tts. 1low ever, they have <e motorists and they are reach in an ffcnivi- man. it is necessary that the the cooperation of state uiiir officers in policing the Tossings in connection with ttics on the streets ami plan of this nature--he als and the public--would effective means of check,md reckless driving over The railroads as a rule taxpayers in the cities and Inch they operate and are -operation. ics in education and law ication is merely a method S Icum Railroad r-43 of informing the public as to the number of accidents, their causes and how they may be avoided. W ith this limited application of effort, automobile accidents of all kinds have been constantly increasing. Wc have found in our efforts to prevent accidents to employees that we must supplement our educational methods with rules regulating the conduct of the 'dividual and that such rules to be effective must be enforced. It is imperative that a similar procedure be followed if wc arc to curb the recklessness inherent in certain motor drivers. Ninety-live per cent of the motor drivers of this country arc competent and careful. It is to them that wc appeal to aid us in the enforcement of such rules and regula tions as arc necessary to eliminate from our highways the one and one-half million drivers who arc reckless and incompetent. THURSDAY AFTERNOON SESSION October 13, 1938 Safety and Public Relations By ROBERT S. HENRY Assistant to the President, Association of American Railroads, Washington, D. C. The safety movement, which constitutes one of the proudest chapters of American industrial achievement, naturally falls into two main divisions. Safe conditions must he created, in the first place, hut there must he also created a safe state of mind. N'o doubt the pioneers of the safety movement encountered industrial managers willing enough to install sale equipment, hut skeptical as to the need or the value of the education and exhortation needed to instill safe ways of thinking. Every man knows that to get hurt will cost him time and money and mi tiering, these skeptics might have said, so w hat's the use of going to a lot of trouble to tell him so? H e 'll take care of himself! Fortunately. ti e safety pioneers realized that safety was a matter of the minds of men ji;t as much as a matter os machines, ami that the safes: equipment and the safest rules did not. in and of themselves, make a safe man. They fought their bat tle for safety on both fronts--safe condi tions, ves, but safe' thinking as well, achieved through constant iteration and reiteration oi simple principles. The early lenders of the safety move ment pioneered in a field broader than their direct goal of promoting personal safety. They pioneered in the field of se curing and organizing the wide-spread un derstanding and cooperation without which their movement must have failed of its full measure of success. How well they and their successors did the job is told in the statistics of declining accident rates, of lives and limbs saved. In these latter years, American industry is faced with the need for another sort of understanding and cooperation on the part not only of those employed hut of the whole public which our industry serves. In the short space of little more than a century, our American scheme of enterprise lias settled and civilized a continent, it has made possible a standard of material plenty and well-being unknown before :u the his tory of ihc world, and unknown elsewhere in the world today. We arc :.dd liiat one- third of the people of the nation are ill-fed. housed ami -clad, but it -iy-tiM }. borne in mind that when this American u.y. o f enterprise be can jn tt m ctk n century and a half ago. practically the !e pop ulation was ill-ud. ill-housed ni.d ill-dad, according to our modern standard-. Mis takes have been made, perfection i- a long way off, but tberc is in the. record of achievement much solid ground for pride. Today, as never before, tlfs best opera tion, the safe functioning, thc\> -ry exist ence of the vast and varied organization of our economy of free enterprise, depend upon public understanding and appreciation o f what it is, what it does, how it works, what it means to all of us. The safety movement is built upon sate