Document 5kX9J9p6NM0w63J32e3pwYBDJ

Vol. 5, No. 4 USTRIAL MEDICINE Page 179 Depmion 01 umber Tuner Angie 5S9901. 591573.. C.3... . C.3.... 516114. 659966. 516467.. 516467.. 591330.. 589592.. 515992.. 515856.. 5S3370. 515844.. 518809.. 714629.. Healing with no evidence of injury Osteoporoeie___ Oeteoporoeu----- ___ * ----- No further X-Ray* taken No deformity... ___ Fracture line oUitented Total* Table IT. Final PsilMiocr- Number 589901 591578 C.S. C.A 516114 659066./ t) 516647 516467 ,91830 19592 18992 5156.56 5*5370 515844 518609 714629 Defect in Defeet ia Literal Thicken Flexion Motion ing Permanent Defect a C/iraaw 45% 20% a Still undetermined a Still undetermined a None 20% a 20% 30% a a Comm. 45% a a Comm. 45% a . . * ... 40% a a 40% Como. 20% aa 25% None Normal. None Totiia 13 12 10 Average 23% it) See X-Ray. Table V. Permanency. Conclusion AN ATTEMPT should always be made to obtain reduction. ' 1 Boehler's method is perhaps the most satisfac tory means of reduction. 3'. Prolonged physiotherapy is an important part of the treatment, and the whirlpool bath appears :o be the best agent. 4. Fractures do not necessarily produce a per manent defect. _ 5. A permanent defect of more than 50% is not to be expected. Bibliography; 1. Bochux. I_. Diagnoaa. Pathology and Treaancm af Prac- rurei of ifle Oi Calcia. J. 3o*r U Jatitt Surf., 12:75.59, Jul, 1921. A. Comm, H. A: Fracture* of th Oa Gaia* Ohio SUU Af. J., 25:429.433. Augmc, 1929. 3. Foeaisrr*. C. R. G.: .Acute Fractures oi tbe Oa Calcia. /Jim. J. Surf., 25:404.413. September, 1914. C. Fuxttok, R. V.; Treatment oi Fractures at the Oa Calda. J. Wic/rifaM if/J. Sue., 24:102.104, February, 1927. D. CAaor, H. and Burtrr, H.: Fracture* of ch( Oa Calca and Aserasaiua. .Jnn. Surf., 45:51,52, 1907. H. Cla*S30j, W. C. and 3a* M*. .A.: Fractures of the Oa Cal as and Astragalus. Iwii. Af. J. 27:J97.402. Mae, 1914. 2. Mac.mjsox, P. A: Fracturea at the Oa Calcia, Af-Vf-.f., 10:1511, May 2, 1923. _ I. CJTTO*. F. J. and Witaox, L T.: Fracturea of :he Oa Cal cic 3anon M. 3 S. J, 159:559, October 23, 1901. a Wrunv. P Da Treatment of Fracturea of the Oa Cola* Occupational Disease Com pensation Data Indicative of Cost, for Occupational | Diseases in General, and of Silicosis, Asbestosis and Dost Diseases in Particular By F. Robertson Jones, General Manager, Association of Casualty and Surety Executives, New York Massachusetts Experience ALTHOUGH the Massachusetts Workmen's Z-i Compensation Law has from its inception-- -L it became effective July 1, 1912--literally covered all "injuries" arising out of the employ ment, it was not until the decision, in 1929. of the Supreme Judicial. Court, in Sullivan's Case, 26S Mass. 497, that pneumoconioses (including silico sis) were held to be covered. Until then the cost of the few cases of occupational diseases thereto fore held to be compensable was too low to affect the rates materially. But that case, and Fabri- zio's Case. 274 Mass. 352, decided several years later, caused a widespread claim consciousness re quiring modifications in rates to meet an acceler ation. both actual and prospective, of occupation al disease costs -- most immediately in the rates for stone cutting and foundry hazards. The fol lowing is a rough outline of the subsequent de velopment of the rates for such occupations to October. 1935: Stone Cutting IN THE Manual the risks in question originally came under classification: ' "1803. Stone Cutting and Polishing (N. 0. C.) excluding quarrying." As of March 1. 1934. that classification was dis continued and the following was substituted: "1308. Stone Cutting or Polishing--Granite-- including Drivers, Chauffeurs and their Helpers. (Quarrying to be separately rated)." * Under Classification 1803 a rate of S4.77 per 5100 (covering ail "injuries" under the law) was in ef fect from December 31. 1928. to June 1, 1931. and. though omitted from the Manual after the iatter date because of application for official approval of a higher rate, continued in effect for about a year longer. However, in the meantime, various car riers requested and received approval of a SI 0 rate for many risks. Later, because of wage reduc tions, a S12 rate was approved for a period begin ning June. 1932. But only one company would write the insurance at such rate, and it discontin ued November 1. 1932, because of unwillingness of its reinsurer to continue. Thereupon, as a result of conferences between the Insurance Commissioner and actuaries repre senting the Rating and Inspection Bureau and leading carriers, in November, 1932, it was recom mended to establish a rate for this classification of S3 per $100 payroll, with a "Supplementary Oc cupational Disease" rate of S300 per employee per year ($25 per month for any employee on the Page ISO INDUSTRIAL MEDICINE April, 1336 ir, uihiwuii-?i**r year later. to take effect December 1. 1933. In the The situation in Massachusetts in regard to in meantime, insurance of risks in this classification surance of foundry hazards is complicated by was almost entirely suspended. emotions aroused by the so-called Glenwood The 3300 per capita rate was based on the fact Range Company case. In that case, a carrier that the experience under Classification 1803 for which had insured the range company, cancelled the polio.' years 1926 to 1930 inclusive disclosed its policy because of unfavorable experience. a total of 92 pneumoconiosis cases, with an incur Thereupon another carrier took the risk, but. first, red loss of 3288,075, the average claim cost being some 42 employees were discharged because re 33,131. It was estimated that many employees ported. upon medical examination, to be already then in the industry would within the next* 10- affected with silicosis. Generally these men were year period develop the disease, making it neces not disabled, and a violent public agitation was sary to collect over that period the sum of 33.000 aroused in their behalf. In consequence they were per man. Hence the necessity for the supple nearly all taken back eventually, the retiring car mentary occupational disease rate of S300 per year rier compensated them for their lost time, and a or S25 per month of employment exposure. third carrier took the risk upon being reinsured However, the Supplementary Occupational Dis by a pooi of other carriers. Although experience ease rate (of 3300 per employee) may be reduced is yet too brief to demonstrate conclusions, it in J ` *1 405T. provided that specified conditions relative to dicates that the S2.0Q rate is inadequate--especial the health of employees, dust suppression and per sonal protection, are continuously effective: and may be entirely removed if more stringent condi tions be maintained. On the other hand there are special conditions applicable to the writing of risks in this classification--relative to inspections, ly in view of the fact that, since such rate was es tablished. the period of compensation for perma nent total disability has been lengthens! (by Chapter 364, Acts of 1935) by the addition of a life pension after the termination of the former limit of 500 weeks. -- 4 5 '? m r I approval by Rating Bureau, audits, experience rating, commissions and engineering require Silicosis and Asbestosis ments. The rating provisions above outlined now apply British Experience Sto Classification 1808 (which on March 1, 1934, was substituted for Classification 1803, as explained above). UCH British experience as is available is diffi cult to analyze and explain without a thorough knowledge of the British compensation law--that While these rating provisions were developing, part of which relating specifically to this subject the payrolls in the stone cutting industry in Mas consists of many complex provisions in each of*six sachusetts were shrinking, as per the following different "schemes." ' table (furnished by the Massachusetts Rating and The schemes do not cover all industries broadly, Inspection Bureau): but only those industries enumerated in some one of five trade schemes. (The sixth scheme relates Policy Year Payroll to "Medical Arrangements." which apply to ail 1929 1930 53,033.200 2.657.600 the other schemes). These schemes are all reiativeiv new, and their collective scope has been 19312.046.100 much enlarged in very recent years. Consequent 1932 1933 ...... 786.300 ly the experience is not broad and has been too 421.400 brief to be definitely instructive. Under each of two of the trade schemes, insur Of the payroll for 1933. 5342^48, being Sl^c, ance is monopolized by a compulsory Trade Fund. was represented by one large risk which is not Under the other three trade schemes, stock com insured. These figures indicate that the cost of panies and mutuals provide the insurance, and occupational disease coverage is either causing many establishments '*seif-insure." unemployment or causing men to continue at The risk insured against is practically three work without compensation insurance protection, fold: (1) of primary liability for disease contract or both. ` ed during the term of the policy; (2) of liacility Foundry Hazards to contribute pro rata to the cost of compensation to ex-empioyees; (3) of liability for compensation IN OCTOBER, 1933. the Massachusetts Rating to employees "suspended" on first official periodi and Inspection Bureau submitted for official cal medicai examination after the earner goes on approval a Supplementary Occupational Disease the risk. The stock companies cover these risks rate of 34.00 per 3100 of payroll to be applicable to --one, two or ail -- variously; but their quoted all employees exposed to a foundry hazard. This rates, it seems, generally apply only to the first rate was computed upon Massachusetts' experi coverage and there are extra charges for the oth ence with silicosis losses in ail classifications and er two--the charge for coverage of the third risk upon silicosis claim frequency from foundry haz being commonly an extra annual premium. ards in other jurisdictions, the Massachusetts ex-, The charges for insurance--which are the only perience with foundry losses being yet too brief indicia of loss cost available--are rated variously*: and inadequate to serve by itself as a basis for On total payroll (with exclusions); on wages of rate makmg. However, such proposed rate was named employees or of employees engaged in spe not approved, and. instead, a Supplementary Oc cified processes; per capita; per grindstone raced: cupational Disease rate of S2.00 per 3100 on the per millstone dressed; etc, etc. payroll of all employees exposed to a foundry haz Note that the rates in question are for insur ard in any risk, howsoever classified, was approv ance of compensation only for silicosis or asbesto ed to take effect December 1. 1923. and is still in sis (including cases complicated with tuberculo force. This premium is in addition to the normal sis) and are additional to the rates for accidents premium for' the classification. and other occupational diseases. Vol. 5, No. 4 INDUSTRIAL MEDICINE Page 1S1 Is the "Sandstone Industries Scheme" the rates assessed by the Trade Fund for 1933 are reported to be as follows, in percentage of wages: Grade .4- 4.16*1:; Grade B. 108%; Grade C, L04%. In the "Refractories Industries Scheme," the Trade Fund assesses a uniform, "flat" rate for ail establishments alike. That rate is reported to have been recently increased from 5% to 6.23% of wages. The industry subject to the "Asbestos Industry Scheme" is largely controlled by one large organ ization which is a "self-insurer" and does not re port its experience. The stock company rates for risks subject to this scheme vary from 74% to 10'!. where strict precautions are taken, with a soecial rate of 115% for the making or repairing of asbestos mattresses. The following are some illustrative rates re ported to be charged by the stock companies for occupations under the "Various Industries Scheme" and the "Metal Grinding Industries Scheme"--in percentage of wages unless other wise stated: SncJc manufacturer _______________ .03 Potteries--China ) 26 Potteries--Earthenware)3.123 Plus 1 per capita to cover suspension on Ant medical examination. Suilder--Stone masons only7.3 Plus 7.10 per capita tor coverage of named ex-employees or an additional annual premium lor coverage ol all ex employees. Puolic works--dressing pavement stones or curbs10 per capita Racing grindstones--per grindstone raced-1 Com mill--per pair ol stones dressedIQs Manulaccunng and packing scouring powder _____ ' sE..ini Metal grinding______S%-10% foundries and metal works (general)_____ 2% - The inadequacy of the British experience needs :o be emphasized. Asbestosis became compens able only in 1931; and the same is true of silicosis in coal mining. Experience in the coal mining in dustry is especially significant in this respect. There are three or more large coal mining areas in Great Britain. In one area. South Wales, the cases of silicosis certified have been increased pro gressively as follows: 1931, 61; 1932. 161: 1933. 230. In the other areas there have yet been almost no cases. There is no known reason for this increase in one area and absence of cases in the other areas, except increasing claim consciousness in the first area and unaivakened claim consciousness in the others. In connection with the above-cited rates for in surance of compensation for silicosis and asbesto sis. the benefits under the British Workmen's Compensation Acts should be considered. Roughly they are as follows: * For incapacity: 50% of average weekly wages, or of the resulting wage loss, maximum 30s. per week, during incapacity--subject to commutation by agreement. " For fatal injuries: lump sums, varying accord ing to number and relationship of dependents: maximum for widow alone. 300; maximum for widow and dependents under 15 years of age, 600. Medical benefits: none. i.e.. the employer or Ln- Silicosis New Sooth Wales Experience IN NEW South Wales there are two "schemes" for compensation for diseases caused by silica dust. For oae of these schemes -- "Workmen's Compensation (Silicosis) Scheme No. 1"--the cost experience has been distinctly and adequately re ported. That scheme applies to stonemasons, quarrymen, rock choppers and sewer miners in Cumber land County. Die compensation is payable out of a public fund, maintained by levies upon employ ers and substantial subventions by the state. Ac cording to the figures published in the "Eighth An nual Report of the Worker's Compensation Com mission." the losses incured. plus expenses of ad ministration. from the inception of the scheme in 1927 to June 30, 1934, amounted to about 10% of payrolls in the occupations covered. This cost, it should be emphasized, was for compensation for silicosis alone, compensation for accidental injur ies and other occupational diseases being a separ ate matter. In this connection, it should be further noted that the scale of benefits under this scheme is not abnormal, the maximum total payments for in capacity, for illustration, being limited to 750. Occupational Disease Coverage North Carolina THE following table-gives the present manual rates for workmen's compensation insurance in North Carolina, for a few typical classifications in which there are silicosis or asbestcans hazards, with the total rate, and the total occupational dis ease element, and the specific silicosis or asbesto sis element in the rate, stated separately: Code Classification Asbestoua or Total OJD. Silicon Total Rate Element Element 1605 Rock excavation.- .__ SI 1.33. .S1.34.. _.51.32 LS32 Asbestos goods mi?--------- 5.48. ____ 3.00____ 3081 5-21_ 1.(10 \38 3085 Toundries--r.on-ferrous metals--N.O.C. __ __ 4.62. 3.04. _2.38 1164 Miair.x--not coal--with ihaits. tunnels, or drifts io.ea. ____ 3.00....... ...2.98 1203 Slone cutting ..... ........ 5.32.... __ 3.00___ ...2.98 4000 Sand and zravel.... ............. tf.55. _____ .27...... ._. .29 In classification 3085. the slightly higher total occupational disease element is due to the fact :hat there is some lead as well as silicosis hazard. In each of the foregoing classifications, it is pro vided that where the occupational disease hazard of the risk is abnormal, an addition to the manual rate may be charged, subject to the approval of the Compensation Inspection and Rating Bureau of North Carolina. . I: should be noted that these rates are highly tentative or speculative, being based upon esti mates in advance of experience. They are, how ever. predicated upon the specific provisions of Section 504 of the North Carolina Workmen's Compensation Act. as added by amendment effec tive March 26. 1935. which provisions clearly de fine the diseases to be deemed "occupational" snri ---on.ii.ra -Wo 1 in hi 1 i tv to eomnensate for Page 122 INDUSTRIAL MEDICINE April, 1926 Supreme Court of North Carolina, in McNeely v. Carolina Asbestos Co., May 23, 1934. wherein it was decided that an occupational disease (ashes* tosis) contracted unexpectedly and gradually dur ing many months of exposure, if due to the em ployer's failure to provide means of prevention, is an injury "by accident" and. as such, was com pensable under the Workmen's Compensation Act as it then read--which decision injected elements of uncertainty into the law that rendered the haz ards of occupational diseases, particularly of sili cosis and asbestosis, often uninsurabie at practi cable rates. At the time of this decision, the man ual rates then in effect, for the classifications above given, were as follows: t. Code Claerification Total Rato 1805 Rock excavation sa 1852 Asbestos goods sfg 2.38 3081 Iron foundries--N.O.C. _____ 2.34 3085 Foundries--non-ferrous --N.O.C. 2.13 1184 Mining--not coal with haf* tunnels or drifts 7.T3 1803 Stone cutting _________ 3.29 4000 Sand and grave* _ 5.47.10 O-D. Element j .45 J3 .40 .40 .40 .90 With reference to the occupational disease ele ment in these earlier rates, it needs to be explain ed that, although "occupational diseases" as such were not then compensable, yet there were risks, Le_ chances, of liability for occupational diseases at common law, which might be covered by the policies, and of some cases of occupational dis eases being compensable because arising "by ac cident." The McNeely case, above referred to, so con strued the phrase "by accident" as to magnify the occupational disease risk under the compensation law tremendously, thereby rendering the rates then in effect grossly inadequate for all classifica tions with asbestosis, silicosis or other serious oc cupational disease hazards. Dust Disease Coverage New York IN NEW YORK, rates and charges for dust dis ease coverage have been approved, effective September 1,1933. These rates cover the dust dis ease hazard only, and are additional to the man ual rates for coverage of accidental injuries and ail other occupational diseases. Since there "are two methods of rating the dust disease risks, it is necessary to show two sets of rates for this coverage. The two methods are: Rating Plan I: Under Rating Plan I, the risk is charged, in addition to the general workmen's compensation rate, a rate per $100 of payroll on those classifications in which the dust hazard is present, which rate is designed to provide prem ium to take care of dust disease losses only. In addition to these rates per $100 of payroll, the as sured is charged S300 per claim for each claim for disability lasting four months or longer, or for death, resulting from injury to the respiratory tract. These rates for the dust disease hazard may be eliminated, reduced or increased, subject to the approval of the Compensation Insurance Rating Board, where, in a particular risk, the processes or products causing the hazard are non-existent or present a subnormal or abnormal hazard. Rating Plan II: Under Rating Plan n, there is charged for the dust disease hazard a rate per S100 of payroll, much lower than the rate under Plan I, but, in addition, a per capita deposit per em ployee is required. Under this Plan the assured is required to reimburse the carrier for 6/7 of all losses and allocated loss expenses arising as a re sult of dust disease claims during the first year, subject however, to a maximum charge to the employer of $6,214 per claim. It is contemplated that in each of the following six years after the first the proportion of the losses to be borne by the caiTier shall increase by 1/7, while the pro portion borne by the employer shall decrease at xyh-t-U1. L.fit ,H M Code .Nos. Hating Plan I Per 1100 payroll Rating Plan Per Per $140 payroll capita 1164 1185 1438 1439 1804-5: 1624 1710 1741 1747 -3 1809 1810 1852 1352 3081-2: 3085 3091 3122: 3128 3189:3883 4000 4021 4024 4053 4061-2 4101-2: 1411-14 5489 5508 6251-2: 8254--80 Mining--oot coal--with shaftsS 4.S3------------------------51.33------------------------ $ 84 Mining--surface ------------------------------------------- 2.89------------------------ 1.18-------------------------- 40 Smeiung. etc.--metals N.O.C___________ 2.39------------ 1.13-------------------------- 40 Smelting--by electrical process___ 1.74.-------------------- .71---------------------- 24 Quarries, rock excavation, etc 5.21--------------------------------------------------------------- 2.12-------------------------- 72 Stone crushing, no quarrying._______________ 5.79----------- 2215------ 30 Flint or spar grinding.____________________________ _____ 11-58---------------------- 4.70---------------------- 160 Emery works: abrasive aheei mfg........ ............... ............. 3.47---------------------- 1.41.--_-- 48 Stone cutting or polishing--marble and limestone only 1.16____________ -- .47--------------- 18 Stone cutting or polishing--ail others--__ ______________10.42---------------------- 403---------------------------144 Asbestos goods nifg5-35-- . 2J12--------------------------96 Asbestos goods mlg.--moulded products only_________ 3.47________________ 1.41-------------------------- 48 Founones--iron--steel castings--non-terrous metals-- 4.S3-------------------------1.38---------------------- 84 Foundry workers only (in various classifications!4.631-38---------------------------------- 84 Enameled ware (iron) mfg.................................................... 5.21....................... -- 2.12--------------------- 72 Cutler nig., tool mlg---------------------------------------------------- 2.32.34 32 Stove nig.: car wheel --g............ ................. ...................... 4.831.38---------------------- 84 Sand or gravel digging----------------------------------------------------- 1.16--------------------------.47-------------------------- 16 Buck or clay products nfg2.39------------------------------------------------------------------------ 1.18-------------------------- 40 Refractory products mfg---------------------------------------------------3.47------------------------ 1.41-------------------------- 48 Potteries china or table ware--__ 4.05---------------------- 1.85---------------------- 56 Potteries--glazed or porcelain ware3.47----------------------------------------------------------- 1.41-------------------------- 48 Glass and glassware mfg--------------------------------------------------- 1.74---------------------- .71-------------------------- 24 Ceamng. etc_ outside of buildings.----........ ..... 9.84---------------------- 4.00---------------------- 136 Road construction--rock excavauoo1--1---------------------------------------------------------- 2.12-------------------------- 72 Tunneling, shaft sinking, conduits, etc1.74------------------------------------------------ .71-------------------------- 24 7* _ . mmm J --_ ev '---*4----- ,* 111 1 1 talc, n rmm* t i ntto I nitMtdri rJtwee < ee S>eJw You 5, No. 4 INDUSTRIAL MEDICINE Page 133 <e same rate, so that after seven years the in- Let us go back to the first question: how large rance carrier snail bear the entire loss. The per should the plant be? As to the size of the industry capita charge under this Plan is in the nature of "requiring a nursing service, any plant employing an advance deposit guaranteeing that the employ* more than 200 persons could well profit by employ er will reimburse the carrier for his 6/7 or oth ing a registered nurse. This does not imply that er proportion of the dust disease losses. In the in a plant of this size there would be a sufficient event that this deposit is exhausted, the carrier umber of injuries to keep a nurse busy; rather, may call upon the assured for additional deposits. there should be fewer injuries because of the edu .4s "under Rating Plan L the rates may, with the cational work done in the promotion of good health approval of the Compensation Insurance Hating and in the prevention of accidents. Hoard, be removed, reduced or increased for a Time and money spent on prevention are far particular risk if the dust disease hazard is found better business and give far better results than to be non-existent, subnormal or abnormal. time and money spent on the care of injuries In the table (on p. 1S2) are given the manual which have resulted from the lack of educational rates for this particular coverage, under each of and safety activities. The hazards involved in the the two plans, and the amounts of the additional manufacturing of a product should, in a great deposits under Plan U, for some typical occupa measure, determine the advisability of a nurse in tions, preceded by notations of the code numbers industry. Where the women employees exceed in the New York Manual of the classifications af the men in number a nurse is invaluable, as women fected--for the benefit of those who may have and young girls hesitate to go to the foreman or such Manual available. the plant superintendent with problems which are High though these rates may seem, their ade common to their sex alone. Their home problems, quacy, under the present New York law, is gener too, are many, and can frequently be simplified by ally doubted, with the consequence that the pri discussion with a kindred spirit who understands vate insurance carriers are rejecting many risks, them and respects their confidences: whereas the State Fund (which is not bound by Following is a chart to indicate the manner in manual rates) is exacting yet higher charges, es which the cost of the nurse may be distributed: pecially for risks rejected by the companies. As a consequence of these very high rates, and 'be inability of some industries to get any kind of .surance at a price that permits continuance of -erations, many establishments are laying off workmen and either dosing down or sending their hazardous work out of the state, and an in sistent demand has arisen for drastic amendment of the law in so far as it relates to silicosis and oth er dust diseases. It is probable, therefore, that the 1936 session of the legislature may see important changes in the law and consequently in the insur-V ance rates. 1. Time allowed for clerical work: 15%. This may appear to be a large proportion of the Nursing Service for Industry total cost, but not when one considers that a record is to be kept of every .injury reported and every By Joajtxa M. Johxsok. RN., ailment; and that the nurse keeps all the records Senior .Vune, of physical examinations and their follow-ups, and Industrial Nursing Service, of all compensation cases, together with the Employerj Mutuals, Wausau, Wisconsin records of the payments of claims. In addition, if there is a welfare committee, she serves as secre T IS to industry's financial advantage to de tary of the safety committee. Likewise, if there I velop a more adequate industrial nursing is a group insurance policy covering the health of service.* A nurse's talents contribute so the employees she aiso is the logical person to take directly to the humanizing of employer-employe^care of those records and the following up of the relationships that even in moderate-sized plants payments of those claims. " her services are aiding industry to increase in 2. Accident Prevention: 25%. dividual production through well set up industrial A nurse has an unlimited opportunity to put health programs. forth an object lesson to the worker at the trine "How large should a plant be before it is neces when he reports an injury. He receives graciously sary to hire an industrial nurse?" "Are we of suf the suggestion from one who, he feels, is person ficient size to pay us for the additional expense ally interested in his welfare, and who is not ncurred?" "Can we cut our insurance cost by thinking of him merely as an efficient person to ring a nurse?" These and similar questions per turn out more work. He is the breadwinner of taining to nursing service in industry reach me the family, and as such has a responsibility toward daily. Very little thought has been given by the himself, his dependents, and the community. In employer to the amount of good will which may be my own experience in industry I have had many created through the employing of a nurse. This opportunities to encourage that pride in physical is due. no doubt, more to lack of knowledge than well being of the workman. * " to indifference. One or the strongest arguments I 3. Health Work: 20%. nave in favor of a nurse Lr. industry is for that very Lost time may be greatly diminished through . t ______ ______________________ *: j.j____- * ? *______ _______ ____________ _ ^ _ -i . S1*: >IS*i : rJ,y ! 9P * rV ; 4? ! ^3*2 :a f'-2