Document OEkQpOGOYb6KNVqpLqygZM8Xw

Industrial Nursing WEDNESDAY AFTERNOON SESSION . October 9,1940 s The opening session (Or the discussion of industrial nursing problems was called to order by Joanna M.Johnson, &N., Super* tyisor. Industrial. ZoningDivision, Employ* ers Mutuals, WajisatvWis^ and Chairman, Industrial Nursing Section, N.O.P.H.N., who presided. The Chairman called attention to the importance and breadth of the pro* gram that had Keen scheduled, and then introducedtbe speakers in order. " .."O' . . New Concepts oi Vl&ial Performantein Industry ,'V ^ By HSDWlO 8. KUHN, M.D. "5 . Hinmyni^ c. Perhaps the most(dangerous person, in to their .obligatioos to the interests of industry day's complex economic set-up1 is the uncon as-a whole^to develop vtod; and adhere to scious saboteur. In iodustry^man orwoman, poHcyand to seek ways and means of adding this employeeis theeye cripple. Hisnumb^ thra ferial sidlls' to.serve the actual prac i^leghm.,. Bis bckof yiml co-ordinatiou tical needsof industry, : . makes of him an^unwitting and usually . The productivity of the individual worker totally unconsdoos so-called "fifth colnm- and the.hiaxasaig ^ .jiiist." *. > ", ' 'V- " chinery has forced managemcnt to evaloate Industry most give ' recognition to this aHfadors thatcoatribute orddractfrom employee becanjefae isa potential threat the precision of the*human bring in die to .both safetyand progress, a* weseehin performance of his specific last Industrial tte effort to/Obtain maximum efficiency in ' efficiency nowdemandstbe utmost of human oar national defense^efiort He can wreck efficiency. are-ermaincntprogram jnst as ea^lyastbe It is important tobaycv this background faulty depth register ofhis vision can cause in-order to understand w% medical findings him jo misjudged* dump spot loir a crane in physical examinations are. now seat- to ladle of moilttninetal and .snuff out Jthe Hyps have a direct relationship to production and ofa'do*rcn.w/:*oricmm., , .. \r . O TfceOoorinoUs cmpptetifies inherent in the understanding of' the ax*^--industry-- efiidehcy,. as weUas*to health and safety. Let me ootline wfaiis meant tv the phrase; "risualp^orDMite.'* ^n&es]hecM^:^ : subdK. . Eye etendnpiiw to be geared vicn*' ywift lnvvrlw1p>-ynit? Cmall to given.' pair of eyes worlds. love growntofeedtte-n^ of can. mect the requirements of a given job. indirsfo.'^ An ayUrtiead craneoperator may have to - nafjfai!fo:'ffi ' efforts; ' drop a load on anexactspot atan exact mo transpoiw training.,. ment, -lSd ^eet tfroip^iwherOHfaeVpulls vthe has.v;to; havedejpth leadership: in'^ - perception. A girt at a lpppiug machine in the hosieryindustry.working iat-a htw^nrgniwluif <n rtudy sah^f hazards, oltighi inthwfrra has to love . factories goggles, - a perfect hnxxularcoQrffinatf^ acid-ocular maste/'aml: 'muses''mid;ddSUns^tb';ineet the - balaircjmortteto^^ ii rttarp focus for eight5 Iwor&'TO oneyes.' pertly, but-always seri^r;'to>'tmdendahd' How do we analyze'an individual's vismtl f> 129 PLAINTIFF'S ll EXHIBIT 130 29th National Safety Congress -- performance in onlCT.,to,determine whpfcan: .. the.plantas aiwhokand 9.6 per cent in,ac- be a crane operator, dralobper, bra steoog-` rapber or a machinist?" . The. ititaMBtation, progranb.fpr^ en* Whereas the usual industrial eye examina ployees found directive in a yisiial survey tion has consisted in die pastof vision taken. of a given plant, and for a^hcanis jscddng^ on a 'wall chart, one eye at a time, it jdw ' training for sltilkd jobs in indnstry. is 'stiUindudes four main factors,--visual acuity another great field of sdUedJ'srinted^-dmd taken binocularly, (which after all is the rehabilitation does' not..confine ;ifSd$b get-, m|y` a workman' walks around .a plant), tingan employee tobuya pairof glassesor measurement of stereopsis, ordepth percep have cataract operation;perfoimei jRetion, determinationof ocular muscle balance, habilitation/as wellasadvance; correction and color tests. A person: may have' per* of exiting;befc^-1^ feet vision and no depth pcrceptidn-he js bilitiesin trainingprograms. ^You dmtram not a candidate for'the job of crane oper . rirrtintt wgiaraftihiitej'jpi^' rff. ator. A.girl may have perfect, vidon and : partments train ywylf m- a marked anusdc.imbahmce-rShe 'malces^a' ifabhees ahdJbft^n. minor .dtfoctsofstere-. poor inspector .and a poor comptometer, ' opsis' ewibe corrected byorthoptic training. operator: . 'This `cairfasitjbbfiJnsbated lor atiitgtbe A modem visual program and technique of examining eyes' in industry, which is based on .evaluating these four..visual apti-,, tude factors contributes a great; advance to" safety. (The man on-the .ground .whose shoulder is broken by acrahe loaddropped on him is studied not ody in regard to where he was and yrhat doing, but theman at the levers of the crane is studied alsoi) case,ofa y(m^^r^^bf^end^,.'He::pune'. to us with headache? and tfonfrlc. He had perfect virion butamarked 'muscle; irabalance,and hadjnstcornpleted ~program of orrabptielvtra&ng<on tbedaybefoue Clinstinsfc:-He's^ -The fellows working nnder me do nbt!$n6w jt:bat tb(y faye a goodreasontb celebrate: When Istarted training here^ I could not teQ vtithinlOfeet of how dose.I was to.tbe spot wbere I was It contributors new item, in the .deter to.drop inyload exceftaa I jndgedjhypilmination ofmierit'featings, and promotionsr lars, stationary machinery. ,vrindbvre,ete. where qualitteatkmsyixrw include, physical Now l cah dropmy load ona dime,without aptitudes. It cOHtributes a saving of dollars any sod.a$mla^"i'y!iiaKTn tins -.story and cents in such t**parfm-n>c as inspecting is ..told, to the" SafetyPirectors, stbpr; hair and assorting where direct statistical corre rises.'ctT'tiidr ltd^-Jn^iu/ymirs.aid mine lations have been shown to existbetween would if 'yit-'werefljying; w^th apdotwbo visual perfection and accnracy. It contributes could DDt.jodge how:Jd^h ten to the size of the pay envdope in indnstries sion wire. be.was whitelandihg/his plane. where piece work is done. '. It cootribufesinformation on which to fax rehabilitation needs in setting up the great .training p>) grams for national defense. TfieGovernmenf will not want to finance the training of an individual who, when trained will be sure to be rejected by injury. ' Now, bne more yital 'fact' just*beginning to seep intovtix:tihdb?|faading,.b|( manage ment According.:tb''.ieciefii;^s6&TO^'..,if'.tiie. efficiency of theimesentinbpkm^ drifted prexntiicfcof skfikdi.kdmr ;such' -a It contributes directly to safety as we shortageoccurring. Job tnuning. inside in- . have ,been able to prove jcoodusively.'' In a duptry.bibs'jue'properri^'ii phystealex- special study where we analyzed tbe'visual amiration CuKfadingviwal preiormance, defects in 80 pier cent of the men involved which indudesmonre information thanacuity in lost time accidents in a veiy large phot fata, as well Mother!aptitndetests) would in 1939,' we found a dtrject correlation in aU accomplish ,this 3 to 5>;p Cf^iii>areax in five visual defects which makeupyisual efficiency.; Itwodddp thiswitboutany of performance atid lost time accidents.. The the personnel problems arising ^wbm it is plant average, .of acuity tmcorrccted. was neiptsss^^^^ &8 per cent; whflethe acuity pncorrected causing * anitt:'r<tlith^''- and ' in the lost time accident-cases was l9J2 per . ^ikear;JAioi^^Qf^'fa^tK^.>l^'faai'` cent! Color vision, whidiineaus the read geared to abbuf90 per -cent of tb posable ing of red-green signals was 3.1 per cent in : efficiency, hut to date, himian power has only  {S-r.-::---. ;^3*fe'! y-.'. ** va -...-V...-' :**. ;**.. a industrial Nursing > : i^. ^'^1 ; -:- 131 beeri'geaiirfto 50 or 60 percentPf its poi- especially ophthahnological consultants to ) sEIBnfwefiffi^twj^;^;'/:'' *?'::vAxi .* * industry ihave ohly:bei^tb\ tiiditiesofs^mc^ poten- i?eededbut's<^^ be^demanded pn^le^i'bye examhiatk^^ imfividaal -.' oftfa^bymra a programso^asdisdc^^ preven- ranjge'jpjfcttwi' ' tive oFtroubte, analytical' of particular job datoXSefcurtd ;ra^f80ch':;lW''ex^inatiOn`'-is., problem^ and also the real basis of rehabili- basic to3dieproper of onplqyecs, to tatiohlobjectives*mside mdustryas weH^as 0w?effiaiqf andf"ln^ of:prodnction| and among trainee applicants. "to thersafety^thirdly tlut medica! and * - -,<v l^bv^Up ofFindings :oV.^^# Exiu^t^ B^OA.SANDra.MJX :-,0 Milwaukee,- industrial work- ring becanse of thefailure.of the human era. havebecncalled' the,: rstoneof Indus-' trial health vfiwk.>,, to.I rccognixedas a.-majpc.f: ..in .the imp ing.health o the industrial population. factor.';- .--' .* . ;- '-. ,' i ActjSfcpt-prone persons usually are not so ?of innate cardessnessbotbecaiuseof some pby&al frnpaiitoent which . prevents Theguldingprindple of any soccessful the necessary coordination between;-their examinationprogram is that it must mutu mental and mustularfmkdjons. Those per ally benefit both femplpyee and employer..Its sons whor lose much time from their work duei;iitBpgwjMW^'to pncvicat-accidents be-c-a--u-s--e---o`f Iiltltn"e*s--s--, s*i--Id nbt be togged' as and illiKS^^^bid^ never becarried on mere weaklingS.^>ddiscardeA. Sbme physi- ^'^^^<ijy^.()ot.tl^:tnSt orof cal defect ocdgSpjse usually. canfefoand as > ridding' va^^B^^ffmdenr^le employees. a cause ofrepeated Alness, whicbwben cor- Labor las ,objected to such motives in in- rectedwO! nalce.^sudi persons just as <bowever, hair cooperatedairiw^ tor co(9erite''withi^p . There is i:mbie;eKODMi.fpr.:fixiBr^anaccldent.or admess r^peafeith^ thW'^ for mnd(y^ based. - on* die idea:'' of prevention. scrapping an autotoolnle becanserone of its ..WoffeenloKrir^diat 4^ cylinders is nrissin^ Ihdess the. souixe o . widiunfriiiyor discriminated agfostwbcn the trouble is kx^ced for aiKi ciorrected, an dte principle1 of mutual benefit isrigidly ad- employerhas notnsed his human machiriery he*ed.ia--.. ";..* , V:'^','.:JV'.-.V\. to die bed adshudagts-;; : :; .'TfeWisoot^ Thatis dw<aandpnly.pnrposeofphysi- feoi^ntcd;'tt>e';,|heed:' of darifying die' por- cal examinations of mdustrralwbriarsunder ^o^ aihdoof ^ ' less ` . the Wisamsin Phm of 'Examlnatioos--to nmfOTm-roetbod rpf industrial examinations fiind the phjrsical defecto may be the :hy tsibing a 'Plan of Physical Examinations - source of iHnests:or accident, sothat thQr inlwlwtry. -11iea;..CSnti^N^`ii&lu^' diet 4 may be corrected^before the ddmess or ac Iengineering.metbodsof proventingaccidents cident develops. That necessitates examin i haye 'elnhinated many hazards which for- ing all employees in a plant or shop, not . I^ly^vw'^/sodipe of .'aerf'l^l r'/hifi ijti^ merely tho^ewhoappearto be.tmhealthy or those who are ^exp^ed to spedal hazards. s -^.s.. *.s * ^s. ^-*.i it.a ^ j Unkss an/iure exairiffl!k a dangerotis focus of ihfecd6h"<Mr' a:ser^^ handicap ; ^^lyrng^eing.flirec^ (m^hcicoftdy;,miSs^r-Irid^ an^'aftdr- alU<iio'^ffent;dnm othergirotms ........ 'of'a^r'Ti^'a^r^j(!^;h>'.thiiitoni^>diS^ too. tinsdi gmferd;'^dnira;'s^,''Viieto. occur- .-eases' ahiiv infumitie^ dud all msmldhd is $, -vP : -tAMl <t.' . :i ^ L- ** fiM`:. .t. .)!<&&; o- B' G B 8-56 StPS" ` 2 '2 K&,S7,,B,:& 5 ` 9 ' fr.Sfc T O * <8 . 29th National Safety Congress her to. Industrial physical examinations ssts that his. family's medical requirements are general health examinations whichbap-' be tokenjcaie.of first.. Inplantswith group pea to be made on a spedal groap of adults. Iwaffli'i inoir^nfip pbiMy ciy^ fffAlwii< *r There is no sxne nawfw.eanuiiiig^ drived:';moire rtodihrthan ;wlmre nosuch those exposed to sperial hazards'outinthe plan exists.: But regardless oftbecause, plant than there is for examining those physical. 'd^ecis/waKdly^are notcorrectedin - working in the shopoffice. An office deck" in the plant with open tuberculosis is a mndt greater ASSQBK5' tberespoasibflity, of seeing. that menace because of-contact, with. fellow- they^are.,Theboewh6 ft chargedwith this employees than is a fonodby laborer with responsibilitymtist not ooly fciVe isympatfiy silicosis. The fact has too often been over and understanding bat sbqold kncnr the sg- looked in planning health programs in in--, mficancc of medical findings. I repeat that. dnstry. no enie can carry out such a job qmte as Before enumerating individual defects effectively as the plant nnrsc; which can be found with the Wisconsin To yon who now have examinatiQnsin f. Plan of Examinations, I wahr to discuss yoor plants or who are ftxiffmplatingsocfa the general subject of correction ofphyskal . a program, whether or not yon ve the fat-,, defects, because; after ah, that is where the low-up worker/ I recommend 'a detailed industrial nurse fits into,the picture.. stodJyof rim Wisconsin Plan. The pro- I feel that you are rim only ms m yoor cedme oatimedin tbatpbnwas designed, plants who are equipped to properly follow as a completehealihsurvey to discover most up on examination findings to see that the of mmjwffi^adii^sdripnanl- doctor's recommendations are carried oat ities; .Too, many -examinations in. industry Your training in general medical knowledge have been tooderteby and-cnrsoiy to be of and in prevention of fltncss givcs yon`an any. value. Some actually lave been .barm-' understanding of physical findings which the ftd b^rai^f 'thfy erivfred afalse'sense of layman personnel directors can never ac security in bori> empkxyee.and employer. quire. If some of yon happen to,be unfor Every examination should be as ccmpUie tunate enough to be nrny in a .plant as ft necessary to discover all major ab where the persoand man has assumed.-rim normalities, yet hot too long and drtailed to responsibility of such follow-op investiga ^be inquacticaL In tbepasteigfatyehrsl tions, Ifedit is your doty to point out to have used' the procedures ootfined in' the your employer rim deficiencies in tlnsmost Wiscoosin Plan in the examination of over important phase of his examination program l&OOO industrial wurkrts and I am con and to show him how modi more effective vinced, riat it fa ah adequate and practical yon could he in getting- remofiable defects device for industrial health maintcnancr- .' corrected.' I have yet to seen plant in which The best way to study rim pbn is to see a layman is the follow-up'man where there how it proposes to discover rim more im is much foOow-up done. .Usually foe .doc portant diseases or phystcaf defects: tor's report is safdy tudced away in a iile; and forgotten--and .often has not been read. at alL Modi of the .benefit from such ex 1. Tnbercnlosis. It how ft well known rial physical^ examinations alooe .win not aminations has thus been wasted, and very, discover morel than half of the cases. of little of constructive value has resulted. ,, active tnbercnlosis. Some special - case-find-' If one of rim purposes of the examination of workers.;is to improve their health and efficiency, then painstaking follow-up of rim doctor's recommendations must be made in itig method is necessary, preferably a l4 x 17 inch x-ray film ofdmcfcest The Wiscbnsin Plan: suggests ^riot every employee be xrayednegardless ofwbetherornothis work each case; Experience shows-that most tmskilled workers and many who haveareputedly higher intelligence, kvel sbow the greatest nocoocem about remediable physical defects.- Often, of courseptbe reason-why involves a dost or fume hajsui^ Altlioagii rim: expense of siKhaprograinmight at first appear ..to beprofaibitivc'experience shows that x-raymg ofjarge groupscan be tkme at a fauriyndminal cost,; / 'defects are.neglected,is an economic cam. Active and.open tuberddotis persons mart, The bread winner,, who theoretically should - of'coarsc/be reoumi -irdm tb^ jobs and be rim most desirous' of. maintaining Ids sent to a sanatorinm.lt is hcrethat plant healA, all too often neglects himselfandin- nurse can be Of tremendoushelp msolying IT 2 B * ' * b o 'e -a m .0.0 mio tTM.* * * i Industrial Nursing 133 the .economic and, social readjustment prob- requirement . for wearing glasses should be lenas in tite Komes of sodi persons . Those a flpdble, one-and.^Aopld..;.d^d,~pn..the virlpo^^%xXiercauiIpm:.lemxs ,'isre'^lipai^dJlbP,<Eie visualacuity retpirrf': job . <ach ina&rve : after fimongh. ;clinical 'aind:;- lab- worker; has to da ObriohsIy. a inach^ . dratpry stnifies arelript at work, -Frequently requires more accurate yirital . correction theidjpl;niiist ^be:; daa^^ipartioalar^ thsmdoesageneralbbbrer.; if th& regwar work exposed tbemtodusts or fumes and Jftheuvwork wasunusuaHy heavy.' Here, also the nnrse can be ofmtich .. This follow-up work da .virion is. one of the .moist important jobs * 'plant nurse, can do. Piguresare available to show that a help in makibg these necessary adjustments; Such persoosare re-erammedat ratherfrequentihtervals--every;threejorsa months-- so as to detect any reactiYatioa&s earlyas' : visual correction project in. a:. plant will only-result in a rednction bf accidents, will actually speed-up productiou. not but . possible, oWith shdi a. plan' the danger of o 4- Teetk and Tolisils. The teeth- and |on- infecting other employees through contact sils are stillbelieved to be pbtent sources of exposure is reducedtb a. minimum add the = infection elsewhere; particularly^ of the incidence' of tabercnlosis. in Ate industry joints and lddneys. Industry generally has- w31 drop beloW that of- the general; popu pa^ little attentionft> the improvement of lation. ^ month .sfpri5. asa preventive; measure of genend ririmess. If' a reduction of: sickness .2. Hcart Disease, High, Blood Pressure, etc. Persons- found withbeartdisease re quiring lessened^ physical exertion- require absenteeism is ane of the results expected from ah examination, program, .then foe eradication- of Arise sputa of infection special placement at;mutable -workThose with high blood pressure wbenitisaccom- should be part of the general follow-up procedure.' . panted.by a damaged'heart must occarionaliy he shifted ^ kss responsible riork where St ImpairedHearing; ! Thishas been known thesafetyof other emptoyeesrinotjeopar-; for years to be a source qfaeddents and dried. Crane operators often areshifted to ' should, therefore^ beconsidered inanywell- jobs bn the floor for this reasdn^tBtofljy at planned hcalth . program- . The Wisconsin a redoctionin. wage-scale. Such; adjtist- Plan reqttires dnly Vrorigh estimateof mentsarc made wifoAm.Iearifcding^f hearing; but moreand more plants are mak- resentment where the plautnurse has. cd- . mg more thoroughrteris with an electric laborated wiAi .ite dbctor in reassuring the audiometer. When appreciable degrees of worker that.tbechange is necessary in foe ..lost of .hearing ajne fodhd, such. Workers, interest of safety to hiroself ahd hisieOow- should bd referred; to ;acompetent ear. workers. When spe^rfretanent is re- specialist' to .determine : if - improvement is , qtrired, nurses can be of invaluable help in' possible. When if/isnoti itocraskmally is steering fJri patient into awripetrnt medical' .iaecessaxy to change foe job of sucha man, hands 'jd in sering that Ari propar treat when Ids safety andtbatofothers depends ment is continued - as king 'as' necessary.. on Ids ability to'fo^ wdC On the other With such control, it frequenfly is un hand, lot; jobs nothavingsoch a hazard, necessary to require ' Aie ;woreer to lay .off deaf-mutes may be safely employed, asthey during the treatment courre .are jn a number of plants 'utrfer my siiper- 3. Visual Defects.,Under.the Wisconsin. virioo. ?' <- .-. -?. Plan, the.vision of all. emjjdqyees is tested &Heridas,andYkose/Veins. I am both at. ft) feet and. at 14 iikhes.' Thosewith groupingtbese twodefects becausethey are inqairmCTt of 'fot>yhdbm'. reqtirie spedal; the cause'of more- rejectiais on: pre-em- exatnmatkmli!y;a:cc^^tttbenUst jfo d^teF> ptoyroent examinations today;than anyother smre;^.cause.Tlriprm^re<of findings. Tinder foe Wisconsin Phut they <^iriaM',fo''nBfa'.ih^.ea>ifewr^ ! , are not a caiise for' rejection ^ and in my is-to be .c_.o'nc?dgefWm9nEe|adie.;ef''r49>4>er*.iSxniStho.a;'ny oes they fitted 'with ;^ foedefect was 2 sbb^ lri ,ih mori .cal(L' lf ahernia is re- '. durirtp ` .doi^l^'auM;c^:^'.leid'rip3teioei^LvKaCh atruss, to;.aVoijrpecAd^eirafOA^;.;W^ -no^iiiail '-ys^ipii' Ikrerri...jbo^.Ciclaii^M^'ribUL'. :pemiKe.-a^^ welh to.'A^.ttitmecessa^ra.pracqhire^^^^ reliable oculist Wi^diri^ work withoht' difficulty. Moreover, the old: 134 29th National Safety .Congress bugaboo of strangulation is btrgidy a o^th. I^periencehassbown tbatit istmwise fo Follow-up is necessary witb sirfi cases,- so that they do a>t -drift ihtp. tbc haods bf quacks. Any rdiable applunce dealer usually for fokOusaousV gives a much more satisfactory fit than wiQ a mail-order, bouse:' ' ..... The same situation; holds with varicose veins. If the worker or prospective employee agrees to wear elastic stockings Orelastic bandages, he is allowed to do any land of work..-Out of thethousands of varicose veins I have'Seen, I have stiff to see the first one break down info an Ulcer where bandage or stocking had been wont. Intur- __________ idfol^ '_____________ ______ ployec infocompetentyharids fortreatroentand1 to inquhe; frbm time fo tinie!bow ;his treatment* is progressing. Curahave been muta more frequent in plants where the nurse carried btTsuch foltow-ap.woricln . plants not haying anurse, it)is,necessary, that foe - examining .physician assume' the - ance company claim departments have as TTOWHIMWIWy w* * UWUKSIUJIb 0tRfi jjjc. sured me that they ate not,cpocented about (Tplayee and "foe family physician from time liabilityfrom citberhenuasor leg ulcers totime to determine ifthetreatraerit Is be*' provided the special ,preventive measures are fog givenregularly. tWith the companies carried out The important thing is to dis whose employees I examine, not onecase cover them and support them. If that is of sypfolis is .loiowit to the empibyetv u? done, .they are'not a hazard either from perinteadents or foreman,yet approximately. a safety or liability standpoint SO percentof thepositivetestshave become* 7. Diabetes: Although diabetes is hot a very common finding among healthy work ers, |f; is found sufficiently often and the complications are sufficiently serious to.war rant looking for it in every examination. In my opinion^* routine ttrinalyus is a-,, negative, !. repeat,tbat if. a-ayphttis pro gram in fodustryis to, be effectiire, the re sults must remain^confidential1 mnd fo pro fessional :hands.lTlus is moreor^less .true for all physical findingswcmployccvbut is espedrily advteaNe for syphilis. necessary part of every health 'examination - Other diseases jii^def^^&fobt'be' and should not be neglected. When even a mcmxneOf sscsi. is. to gcncrii cofiyigiottf trace of sugar is found, follow-up analyses diseases, booeaodjoint ' deformities, etc, should be made. If these are repeatedly, bat the same general principles apply to positive, the worker should be placed' in the them; which' is,foOow-up on examination hands of his family doctor Jfor `control findings, have' remeffidifo defem'cmTected, treatment Here also, there is *no need for arid place on more suitable7jobs'if neces refusal to hire or for discharge of such' an. sary. employee,' because adequate, control of dia betes is such a relatively ample procedure "today. Iwantto makea spedalpka -for .a.-more couunon^seuse viewpoint on 'pfoentq^|aypKnt{.. rarnmatfousyfo senr- & Syphilis. No health program m'fodas- fog. industry, am ,do; to . dengt.;the try is complete today without a -routine ?gEneralafotrxfcofeg^^ employ-. blood test for syphilis. The Wisconsin Plan meat:.managers';on ;-.-fo^?.ig^d;>Bilb^iient, advises it not only for pre-employment, but. requirements.. Letthe' hiringdepeadroore for periodic examinations as weH.CAIthough ohtbeapptremabttityoftifori^ it is one of the most 'valuable procedures work expected bf hlmratber jfiUfouaLMlib-'- with industrial examinations, it `can be ratory ariddfo!cirifilihgs grossly misused, and has been all too often. no disafolily aiad 'witirii 'fo, all probability In our program, only infectious cases and witt not those with central'nervous7system, involve of view is advisable riot iratrilhmnanitarian . ment are. considered7'Unfit forempJoyment. The vast majority of cases-fotmd are' latent and without any open lesions Cr late compli- workers buve bcea cations. They are asked fo agreefoarryon a complete treatment regiine until they are cured, but they are hired or continued at their workregariUesi of their positive blood test. . the national defenseprogram. ..employtnent ...re-" The 'l^tndfljs^rial^eK- ere'- sempipyer m^>aJways" pe __s Ow^'lKIMBTOOCe' strictly .., d_to,; with*-p^^hS^kveia1as: iffiioi^(:ttiar iiaKf>.`rSB6dinki;-ff^inj^ejmilof. "wcU^old.! ,.Arv. -____ _____ ,,^___ atf-Btrire :,Jnffict(^i^ al^,' plant management tfae.WiscdinsyKiPhnof normalities;to'wiamtnt^their beingjrejected<= Examination^^ fo(s^SA^^ principle. Withit,help . bat intprove; ibVgenm-?en^ki^ee^ health, amuwtion program, regardless oftbe godd workjit may otfiehjise have accomplished. which crease in in turn will efficiency result in a general and'production. i,nrr 'O J o 0 r. Traunjatic Neurosit a By LEWI8J.POLLOCK, M.D. Chicago, IUtnola =- '_J \':u '. In'Anterica anfoti&doction to a mysteri- maybtYeparalysi* ofcne or more of the ous cotklitkn waS affbrded tlie medical pro- exftemitie$)'.npmiumwCo>^nic^uiM*rv oboiml-. fession when it was> observed, thah follow- dona,-, painor fern of sensation, diaxiness, .tag railway acchknts,aafly pectdiar syn^ blindness, djafoesaldfi of.speecb, voinltingv tomsoccmredin theabsenceofexternal 'diarihea,incontincnce 'or" retention of urine, evidcoccdf trammfc Tbe ccn&tkw was then and syropftrawitt^ termed frailwaar^ apbfc"^Eridsg^ .who ft fcnataral;fik.:if <*in confronted wteP llJ* mbiect jn :1866 :to l875, later- with one of these symptomyhow canit be termed it -coocnsaioo iof the spme.- Sub- sboWnthat itUnot doetbrealinjury? Ma m^ai>s acAnhri.^. ooiciiriiioo^* MviaQd .satSsaicd^il*vtwiwcQ/txt&t ho phys*l change.; wis present, even on - microicopic cxixnirimotvaaciit wwireCOj* nizcdtlmttlmpatiempreshhedth^sanie 1 symptomsas incases ofhysieria,at tbit ' BiseaSe "c)r.''iniuty^of;tbe.l)ody'0r-*.ifs''or-- gansprodocrf adistmiauKSoffunction of fmt particular pari Thisdistorbance of ' function presents signs,anditympipna pecuIhir^.tb-- itself;!. 'Thie-'signs'.iare/coMtSt, 'and ame ranarnpor oocniica.^ .bdq : areassociat4,doe with.t^ipl^&a.cqn- 2ma.sapaao^rSt,A; sAuafnfucktnd iron.* Loay^satcAraiJAL . sistehr-^uod^ <&tmnihed mixtotr. For, - o andl ^Pjnal c an^el'.'a.' pariljb^,..bfv.tlm^jh^l'due to an concussron"gradnally^ for : mjai^ of ^son^.;;.M^x^^si^rv^^fllscrpps.:.iaia "-' atn^y;mTce|tti&,musc^^a^ ' As.vtfaib: laa^tecK^^iwj&mw;^;^fii%:^BUsatse.;wm>9r. - ai:paRdy^^m';<Qn^^t^^'mus^ea;- a Joss^iof - . i3bo#ti*ed^tOT ;was.,cbm-y ^senntfqn :m^'^cerbufIconStartjart'jpf die. * /;;hjp*te^ "traumatic lumd ^and^^de&am dbatnges :|of, r^poose to. neurjstftenia'V mid.: ^runiihc^a hysfero- stimulation^~An hijmy :;to the 's3d^;'c^':prod)K^co^taih Owe, mightsubdivide the.nejiroses into - nite dhiaia^^:^p^ defi-. a groupsaspsycftsatiwm^ anx- shaxply^d^fiiied part of thel body,: loss of : kty states,-batata, etaThegreetest tram- wta>m '.'wjlh `[cyf*s*t* characteristic, and her eof .post .trumudfe.;.casesthoae of disturtNixm ihnu^ and q hysteria, and ^in^the:i^Um,opf cause redal fundion.. fSp with.;ev^ of the * andeffectare common'. to,all [the; neuroses..; body. 1 ^rteria dm w&be fdundabsent ';. Intheconir^ "trafrtowdk^ manysymptomy touowmgs>cciqcntsuQtDot sissdmtedl\witlt ^^^eindhnce&bf^4si(fiilih|iiry-;-; such as would^ peeesjipvily be fwiraent were thesysq>h)^'chAvart^ an injury:wwel'.wt^ .-/sighs:iahd symff- tams.%iddhfstfe`'ai^)entitidtht hot wwsiipmiwa^yva^..^wnw^-wmra^u. *NSvmo*aw '^wwaqr^aytiijldisS^^ ^afiiSwig^amriwidwyj I A V ! .., Statedthat a*'Cyftd oh-.' server esn serve to mffehmtiate ah Organic '. Jn 136 29th National Safety Congress from a fractional condition, a real dikak Such rigns.as lossof knsation, oria cibn- orinjury from hysteria. , centric dimimitioaof titefieMof vision.may Naturally, ooeaskshow is-it possWeitb < racitinraaecL; have a symptomsochas aparaJtysis or even 1 the patia^'hM;i^'of a pain, andyetnotbave any disease b the body or its organs? Ifa<risque story be told in tiie prcacnccof ladies, it is common even now-a-days to.'Observe them; blush. . aide <feu?&;.or: " . fi^^.Whiea'ra;daro^'.bdo:.ten';Tdd' ybti^ fed this?7\the mfekjmikXie tiud if ah in- jury or dikase!irpttoeht,tbepatjents^^ . This blush Is not imagined, we ..see- it, it is physical; rad yet it is caused by an emotion. SimSarly. if one is frightened, he may not- be .'able; tofedthe ;toads ofIcbtton or pruk of a pm 'whkfeever> stimulus. may.be used.; This patient is Ekdty toIresporridomrt- be stricken speechless or motiohless,Ms hair stand on end. Ids heart beat fast,.bemay burst oat in iedd sweat; and he may even have a diarrhea.' Here, too,we are dealing - fultythat beffeefeitaBttl^titenejrtstiniultulessaixlfinal^jhie wM. be^tmijble to ' fed overan area usually tcTurcd toapart - injured as beknir tbe dbbw or tiiigl^ eitc.. with physical changes not doe to hnagina- - The same is true of /other examinations. tion, injmy or disease, but to emotion. The' greatest care must be octitisd liy ill who come ^ pt****1* - Some years agoamnseracnt was.afforded .new'i'signs:. or symptqn&W^ ns by viewing tbe sbrtffng feats of1 hypf* notists. A common enough trick-was;-to make the cheek insensitive so that the sub What is-.fbe'.r:causevof-.hysteria^li it ject felt no pain wIms a| needle pierced it; tnm^or mjtuti' b itd)^ great qno* or to produce a rigidity of tbe body suffi- tional disturbance, over-exertion, totifH*, or- dent to perrmt ooe to breal^ witii a siedge privatiou?;Among;/tiknai^rJeSktomt^ht hammer, a'rode pbcedon the. body of a by the late wary manymay>be gleaned rda- man whose' head and feet. cmly.were sap- treeto. hysterias Inthuwara new-typeof. ported^ by chairs, hi such afjypnotic state destructiveXagetow^ any duaUlity suggested to thesubject would shens. TlKT^ were observed many cases of. cause him to suffer from it pecbHar Dervous maiwfestatioiis wlikfa were Hypnosis is produced by suggestion and. just as a hypnotized subject may accept'd. attributedtothe ccxxnssioaresaltmg Horn cjc{feision-'pf-diiE&^dbk^.hra^/-Tbese. cases tfwrrfnw inaWii suggestion'rad fed and aid. accordingly, so does an hysteric. ; Some of tiiese suggestions Careful observation by trained,^ comejxem the patient' himsd. If he fears gists soon showed tiiatgrocped juiwiig. sudi disahiEjy he becomes introspective and at- . cases' were patients .^suffering/ fran 'various tehtive to -Ms general sensations. None of wdl you felt the coHar about.ydor nedc'until X> .77 ^rfirktiteTna- now mention it; now.you aff.fed.-fe Our skin is so sensitive that we can fed the jtoiierriteyfovrme,re'.w^ a^a'1.......f_.r.--.bc.-..ma.r.yhcyusu.tei.f.nr..i.ia>..'..9.i.1n...H..iei.yres,-i . .lightest wisp of cotton; yet it is sddom that teria. The firk pr^lem vto we fed our dothes.,We become inattentive wbetiier ajpgr'.'^orable.;,pb!j^Bcal'-.dM2ige`'ik^ to sudi fe^ii^.as. ^experience teaches us dmxd by jw.ii^.';e^ob'd^i.:a- are of no conseqaencd If I were to assure / pfesive shdls;-kk rekbaNe fdr^tite-ihys- you that the fedmgofa collaraboct your; fcria. 'EyidtotiyV'nt^'i M ; tiki ^nii>toms, neck is indicative of impending insanity; tremor,;paidyris; 'inutismjptc, fedWf" rad you believe me, you .would, fed your to bave ^deydpped:to in training collar.all day long. . affipap m cie uimeQ^oiaiea,' <m; ifaiBtpciCTs^ Much of tiie suggestion comes from with out Consoling, anxious; and bver-sofidtpus friends and relatives, injodkkras examina tions by physicians, ,'andj re-cxammations without end, conversations withattorneys, repetition of symptoms in coortjobserva- - eu'rpute<to;'Etoe^'ih:jtik;&0^'todcCpf. the linesandbu ;mrway;badttpvbak hos- pitals froimftiie even non ^cydopmy^ittoooy* roldkr^-IttolkwKLtoattiw of: sbdls alboe.ins.udt;n%onsiMe:npr. ^was^tbe' tira of and acquired knowledge nmyemiiy other patients, all contribute to the hypothe- Was it .einoiiimf Appairent^ i^ . cated picture.. were paralysis or otiier major hysterical 29th National Safety Congress for pension to assist infivelihqodar by amid fosterstfac neuroses. Protojnged jUiga- vengefnl spirit, stay provpfcic, eogeader or: "doti.. prolong a,.lotttisi;;;.w^^>]ga^'j|Ssj's ./.aiid-f to be true? [ -tpF spiteof is/greater tban'Itwasi^ days. Before' .the^etiKaiwid^l^^ed'^;":______ surance, the Geinuiaw6rkinginan.-l6ok -/ tiyinSt^fe-d^l^Sf much longer tp recover tmm ooe mjaream----- ^--41L"4^" " *- the same way in Bcrwem;__,____ ..... die-Netberianib-ada^ oflas/awnsa/sml ance^ the doratjoh pf the illnessso&knlyro- creased. In Penraarkit is'the cnstoiiftppsty - insured woriong-anthi lump. isetttembitsfat v a very catty stage oftbeirincaisMstiyand. 93.6 per It as however, jpeasoq, only 9^ per ceirt mver fromthe seemedto same disease. -The introdnction pf/d>e: acci dent law inEngbndinl9Q7sawa-ro increase'in niimWinf affiHwiit ratM:;Tn fifth 'and'the dhnitkio df temporary dis xr. nus itasonc ability is dcadedlykiiger tbanbefore die operatkooftlttlaw.' /, ' ' - Someifinminalingobservatiops retains to these considerations may. bementibnttl/Frye^ or six months after/the'Messina earthquake -.*v there was not a sm^e person sofferingfrom a nenrods can^^ijr/dK/pidpiialBe^lio. JOB; sonree.of compensation was availabJe.Whav some years agtvrailroad employees werenot :w5Md'/j^v^$w^fiB^/diej compensated fOT injnry. thiiy were eagerto retain to. work-foQowingan accident and it beSodal was die passenger who was afflkted with ^. feaiilfjt traumatic nettrosas. TheavaDability of com pensation, however, has caused,die employee ' mon observation among social workersdeal- iqg with the poor, that if foOowing illnes^. cumbleltdoesri^p^^ prolonged pension is carried out and return to work not encouraged or enforced, tbfc individual becomes nchrcnic invalid and a ward of the charities. Ithasbeen found Sterdian/'^SSerwmsovnFtotro*m^sb..a..v..e."noreb'mo'"nto that in a certain group of people investi* gated, scene 75 per cent of pauperism re- isdaBlteJd.tfrroom iIlflnteyssa.n*d tOhtias state was fos tereda boy constant .assistanccee., withoot -linottecdlli- i4 a gent direction of rdmbiUtatkn by laboniAt first aaswsisstbancne1 is aMbhinomrred., iavvnridiMed, crdtliiiicis-. - tandy received; then the morale weakens and assistance is soqgfat, next it is expected and finally demanded. litigation holds out promise ro \sS ;*I ail '. ;i ;:1 'M 'as d Vfl :M 'g ' '$ 16 //* 3 * :;tf --'tt -si .`I ' -*? id .f'B /i H ''^d y.^0 -* 'c/a d /:"-Zv4?-<!.a.* '' --i?i '& * ` '* . /.*'\**'!i .*'' * *t.=i.;>*,:.k, ,.v ;:;*''*f 1 *-; . i.1 >'V- "* . .;..>.' *,'./.. $. : /. :*-'*,,*,*'.';. r^;' '*:<f ;T'-..a/.s-/v - ' v;^*'rV^ ** V'^v ; .`-'f ;** >>*;* ;-'* /.:. . 11 '.''V'- ''$'. , ' '.' ;''.j>,/v :* ' .' .......... -,& ...> . .vr:^ ' .-r . ' , J*; \f " a i: ; ri'i"'''f* V'*' "V `J. ' x '; : ^`r;, . * < ` '-y. , - j tf , . * * * 29th National Safety Congress o o w f*< m o e re .a erw s*er o .e 3 ar# star s r e r i . w w w o a ` Tfc* Industrial Nurse's Perspective By MALCOLM T. MacEACHERN,M;D. Associate'Director, American College of Sturgeons, Chicago The trained nurse in industry tap. the ing on ar program, of health conservation same motive as any other nurse--service^ to is unlimited. Management also believes that sick and injured humanity.= Her- position the. nurse has aTreal function to perform in as an .employee of an industrial concem.does the modem program of industrial relations. not alter that primary purpose, although she - Sue is important in establishing and Main enjoys with the public health nurse more taining good will toward the employer." possibilities for preventing illness and acci dent than the nurse who works in a hospital. The Nurse's Part Also, a financial evaluation U placed on her.' services that adds to them a direct economic aspect Only in recent year* has relationship be tween management and workers readied the: print of systematic organization and plan In'a)recent.jisue of Factory Management ning. Service in this firid is a byproduct of' ,,an article bore a headline in large type read- toe nurse'r regular work; hot apparently .it (_ytng "Small Plant Hires Nurse--Saves." It is a main consideration to the industrial re- continued: "Lost time was cut 90 .per cent . lations department, for someone in outlining when this 300-man plant gave up its hap- - an industrial relations program, recently . hazard first-aid practice, acquired a resident listed eight divisions---employment, educa nurse, set up a regular first-aid department tion, health, safety, welfare; sanitation, re Lost time due to injuries or richness totaled creation and rehabilitation--and the nurse 23 pedes in the year previous, compared with was a prominent figure in every one of two weeks in the first year following the them! ; J- acquiring of a resident nurse in the Bull Dog Electric Products .Company in Detroit And this didn't tell the whole story because workers' efficiency was improved by prompt treatment for colds and other minor ail ments." Itt industry it is extremely important how the nurse 'treats this patient,. for foe era-. ployer-employee relationship is affected try her manner, her receptivity to- confidences, her ability to allay fear and to .give helpful advice, her skill in teaching; and her general The trend toward appreciation of their exhibition of interest in- everything that value to industry in dollar* and cents should promises to promote the employee's welfare. remove the feeling that some doctors and nurses might have of bring aliens in buri-' ness, of constantly having to, try to justify their presence in the industrial scene. They belong, and are an important aid in gearing industry to maximum efficiency under the demands of periods of national emergency such as we are in at the present time: In a talk on the industrial nurse and per sonnel work at the first annual Symposium for Industrial Nurses, sponsored. *hy the Illinois State Department of Public Health, Mr. George B. HaOett, chief of the hospital department of the Western Electric Com pany . told of experiments With unproved lighting. With better light, production rose. Nurses have helped to transform our hos But when bulbs' were changed "witl no pitals from gloomy havens for the side and change in voltage, production rose anyway. dying to cheerful bouses of recovery. Ches The experimenters were forced to the con ter S. Johnspn of the Quaker Oats Com clusion that the very fact of being experi pany, in a talk at the Safety Congress two mented upon was the stopping-tip influence. years ago said:.. There was* improved attitude by employees "Management of industry believes" that when interested observation was introduced. v .* - the industrial nurse'morethan justifies her This discovery led the company to in self in the saving of money which results augurate a systematic interviewing system. from proper care and treatment of people Trained, interviewers encourage employees who are injured or sick. These savings ac to discuss their grievancroj)and .problems. crue, not only to the employer, but to the The interviewing process itself--the relief employee as well The industrial nurse's it affords--is significant in . their opinion. opportunity to take the initiative in carry Grievances seem to shrink in 'importance v r r a < - v . t o rr.fl < e n *t when communication throws a more objec tive light on tfaan. Since thenurse it..dealing, constantly with (a) Reiterating safety principles to. em people who have, some complaint, mental, ployees at the. timie.of dispensai emotiooad,-or physical, which mayeitlier be . (b) Re-explait^ig ^smd - iitor$ caosbiby^be tbecause ofmaladjustment .. toemployeestiie progriun ih plan^ sani to Xvroinc stration.thcy believeber capable tation when indicated., of mjilring animportant eontribution'if she (c> Reporting all 'accidental injuries acquires good interviewing technique. Mr. and occupational diseases ..that should ' Hallettsaid:... T o be -investigated from tbe standpoint of - "Nurscsare particularly `well placed in .carnal relationship and preventjon.. the imh^riM stnictare io^ this .becadK (d) Reporting to the phystetan for ex- of their profesiionalstanding, their non- ... ; animation, and also to the safety direc aulhoritative relatioiuhip with employees tor, -those emplqyees who are accident and- supervisors, and their neutral mediatory repeaters or who setm to be accident position in the complex irnfastriaUtructure." prone on account of mental or physical That statement lcadsa doctor to lay defects^ .greater stress than^otberwisewotildnpon ^'Cooperating inpronmlgating an accept the industrial relaticmsaspect of nursing in able program in health preservation and industry.The natural inclination Of a doe-* health education by- tor untold beoto deprecate the trend toward the nurse scattering her energies by acting as a personnel adviser on all sorty of prob lems. He might contend that, industry hires nurses because they waatf nurses, and nurs ing.itwbat the none is peculiarly fitted to da But itmay be conceded^that her very training as a nurses ^aaFthe position w ` . m whidi\tt-phces her. in industry, .riKmld k peculiarly fit herfor thisbroader field. Cer tainly if she can help to relieve employees' mental ahd emotional as'well as physical,distress, she is, thereby, also improyingthdr .. (a) Giving appropriate advice to indi vidual employees. (b) Giving talks to groups on proper nursing subfccts. (e) Distributing literature on health subjects. (d> Encouraging workers to have pe riodic physical examinations where such examinations are not already being made.' (e) Assisting ut developing adequate recreational programsand facilities. (f) Assisting in maHifqtnlng wrlarn health, and is .thereforei still inttei the nursing sphere. We are simply making that sphere more comprehensive. , ." pisses of the. sanitation - program by inspecting the plant cafeteria and kitchen and other places where sanitation is an SpecificFnnctions Within tl& seppetof theIndustrial' nurse's work; consequently, are functions that <firectly' and. indirectly ;bear on- health and'1 safety: important factor. .(g) Cooperating with private physicians and. with toda! health and welfare agen cies; in -activities designed to benefit .the health of the worker and' of the community'as a whole. 1. Helping the physician inmaldng prer employment and periodic physical examina tions. & Rendering first aid andsubsequefit care ' of oidiistriil fojuries and occupational dis eases as directed and supervised- by the physician in charge. r 6. Keeping adeqnate records by: (a) Recording all industrial injuries and. occupational diseases. (b) Recording all employee visits to the dispensary for non-industrial in juries and illnesses. (c) Maintaining physical examination 3. Rendering reasonable first aid and ad-.,, records as confidential; information. vice to employees, suffering from non-fat- - (d) Compiling statistical summaries, at .dustrial injuries and illnesses while on duty -``intervals, of the injury and illness ex according to thepolicies and^tanding.orders perience, and reporting It to the Indi- for such sendee. For furtho* professional ' cated officials. . .- service dnpkyeto should Wmerred to thrir , (e) Computing or obtaining annually private physicians. the injury frequent and severity rate. O' \ 142 29th National Safety Congress la this list of functions is indicated the 4. Registration under the: laws governing limits beyond whidi the norte should not trained hurrihg .service iri 'tia;stat _ go in tendering medical service. .It.is also -5. For the nurse in-a supexvisoryjwrition, indicated that beropporttmities are limit- successful experience in industrial-muring, - less in improving industrial relations, and part of which :].is;jpreferablyvin. the^lypfc: of even public relations, through her'health industrial( work fa which the 'ntux is;^ and safety efforts. The public relations pos . actas.si^peiniririm'.r-'.,'.''^.. sibilities may be realized through the func tion that involves "cooperating with private physicians and with local health and welfare agencies in activities designed to bepefitthe health of the worker and of the community & A woridng.knowhrige of the principles - of teaching; sodri caw work conmunib' organization and refourees, pubhchealth administration,, industrial relations/ personhel ''indumigl hazards,. nur - as a whole." trition, communicable ''drstaaea;/ mental: by- , The duties of the. industrial nurse vary gierxv and personalbygicne, astbeyaffect considerably with the size of the industry the indhidoal and hisfamity. ' 5 ... and the type of community in which it is 7.An interest mandaNhtytoworkwith situated. Some larger plants have nurses all -lands of people;., good physical health exclusively for home calls. In the small and emoti6nri stalffity?; init^ve ; , good plant, these'may come under the functions lodgment; resourcefulness. of the same nurse who assists with first aid and other work. In making home calls, it is sometimes possible to aid'jn .improving con ditions and attitudes, thus rendering social - & Qualities* of leadership, executiveand teaching ability, vishm-and itaagiaatiaa for the supervisor.of othernurses,y.-.:'. . service. In addition;' a spedal attribate the Indus-f' trial nurse1 heeds' is nesponrivieriess to- the Qualifications stimulation of industrial acfivity. yot every * iCourse would have tins.- Some feel more rim What .qualifications should the nurse have sponsrve to surroundings that reflet the to be successful in industrial nursing? We attitudes and ideals of medical_science, such at the American College of Surgeons have as we find m tbehospitaL Perhaps only by a strong predilection for minimum stand .. trial could it be discovered whether tiie re- - ards. There should be a minimum standard action to the industrial situation promised for nursing in industry, to supplement the to bring out the. best that.was in a person. minimum standard for medical service in And ,certainly a muse amfeveryindividtnf industry. This suggested' minimum/stand-* should. seek a sphere .of activity that dial- ard for purring service in industry is based' knges her of him to rojmeane effort. ;... upon qualifications formulated a yearor so ago by tfae executive and education divisions of the National Organization for' Public Health Nursing: . The Organization for PabticHroith Nuts? ing declares that thettnmber of nnrses who . through anil ^rjn.rj>OT nn nwf . aU of ilwraM^'tptalifirafvni^ i^ Inaited. 1. Graduation' from an accredited school A do^ of cppoTtiimfy is thrinrfofe open inr of nursing, as a prerequisite to employment - this fidd feu rnany who Seek a Cafoar pf in an industrial medical department~- - service. Replies to^i repent questionnaire ?> * /. 2. Instruction and experience in surgical nursing, including operating room mid first aid, or supplementary instruction' in these types of nursing if thorough preparationwas not included period. in the baric muring education- lent out by 'the National '^Safety Council showed tint 213 membd*. plants had 565 full time nurses and '58 part time.-rmrses.The ' Hawtlwrae Plant of the Westeni EJectric Company, empk>yi^son13^XX)people, recently reporteda staff of tcngfaHtimenniscs,two tcchniciansand three .clerics, in addition* 3. At least one year of experience under toninerdoctors.. qualified nursing supervision ' in a public health muring service, to succeed an~ aca Opportunities 'V . demic year of study in public health nurring in (me of the colleges or universities whose Graduation from an' accredited nursing program is approved by theNatkmal Organ school. is essential. 'The;'ziact.'sikp isspecial ization for Public Health Nursing. ' training in the subject, and thf Natioriai , Industrial Nursing 143 or oniycrsitics;foreooi^.of.stu^ health nursing^ of whKii'-~^" costs , t- Of qjafsft ^ d*ujgej- in such a- situation 1TMr; 'isthaf^h^aurK^ perform .T^rfe'. ^` iwtitmes:;foiv>Jtidit^ La5tall,in Chicago, /.^f-th^lIlinmaSf^ ___-Il-m f -J">['Jrr *:uau^cr ayinwi wuicu wc mudi kmiu,,uu , :y'&foyi%e sore to have.tnedical advicebefore . csbe^ith&rtakesvaiiqr"' but nurstna Procedures and ordinaryfirstai . - * :. :-'--v ; ;.: Advance*iiliinnlnon iinn Industry x Nursesskooldattendasnsu^ oftte^ ' %ttm:MIMp;'lojpV't; jrtoffc / In1915rrb^^ ago--the fCTences ; average acpendibire formedkalworkin in- '. - tni^.caii.rT&(y<^liotildutti^'se^^'bj[nr^^i^t^^!^vffifdaib',pK^(ca^t(' Now it is., - ' tional arrf local industralnursing^ over$fc00per <apita. ^ " ' i: ' tions/dr' thb*'bf^ o^ new d>nmuttee mtdkal assbdati<iis ttatiwpB^^ dostrial pnAl^ Know^ acxpdred in^ Bearerheads, theforination tins ` * Sa^efforta df^cAmerican Association " tpaJtai of *ra*iniante^^ oIIndtBtnal and-Smgeoss aud .'**&** 1 ' -? -' for-public Health - dnstry m general, and.of^tbe I*rtoilarm- Ntm^ tfe cbotimnn^bopperafion dtfae ^ ^dst*y"*d :5**P?y> ' * National Safety.' Coonciiairt ' vWhors ^-. v byiihe Goxnmkfa*^ . bpttbat^ . ) Conditions,rpf;`-the.;.yjbf ?' c^n~fabre_;advanccthan the past'in-indus- . mdiM;:^.ci&in^?sta&tBjeib^iS^^j|s^C/;;E|pradl^^ini^.;figttttt':^fce tboae'^ven .two;"Canjwe^ord ;a;il(^^plpgitsun^|,,.' 'l^^':tKt^''Sfc^;yiljc''Hibiai^era(% _. ^ to'ttiit be affopacd y utilizing Bcr^payt-fini^g/bi1v /.icbrogiiy^f^jy^atiySglycs' ear to that lind^ otberdeparta^tswheres^^ be^ ofCa^^ ofus do in this practical' aroilableinyiaseof age.- *-' ,/ te/;;-::-*-1..' V-V y~\Q' v..: O \: O.- , ' . ' v: , ` `-`k V -Vj -O''"- . :? ' * * . .,* ''''.ft'-y '.:'---4'. ',.' * '" ' ' A * / V- ' '* V ':*> '^'vv .* . &^-i^:i940^;;r:;.r v.'-:;, . `':Tte^s^on;.^^-^alkd|^5^^^ Christ^vSeabw^^IiJ^^^ > Ddiani^ c^/Unn^^^ ;;t^g^gBden^PMjq^^ladfe^t^:;r':irei^i^ Nortfawest- pr;J;Bowie Milter, ' befonjgtlie -dehs Spabn^vlnhn(m^,;^|^ o. o * -\ : i. 144 2Pth National Safety Congress i ... Hie Heart and Heart Disease in ladu^y '' . . ByJ.ROSCOE MILLER, M.S, MJD Chicago, Illinois W Heart disease leads all others as a cause Today many of .these Infections, diseases of death in.the United States. Its morbidity are either partiallyor completely.caotreBed. rate can^ccdy be estimated but it is, of The control.'of fyphoid few.-his-become course, enormous. Cardiac ailments account an important measure in every community's not' only for days lost from industry hut sanitation program.' An enlightened people also considerable curtailment of activity. m> longer must fear small pax or diphtheria,, Ttte'300,000 deaths recorded each year from and the death rate from pnehtnonu has heart disease mthisconfctry represent count fallen to a level undreamed , of ..by' our less days.-of partial^or complete inactivity fathers. The result is that people are living for a much greater- jjumber. to an age where arteriosdexosis ahd its at- These facts are'^quoted to point oat that tendingcomplkationsare oUr chiefproblem. we are not discussing a rare or unimportant The cattses; .of heart, disease'are marry entity but the - foremost problem fating mid fertile sake of cdntinmfjr it might be medicine today. Despite this dark picture well todiscussthem.fromtite.staiidpoint there is a bright ride and the cardiac should of the age at onset This necessarily makes not be looked upon as a burden on himself, ns begin until congenital heart disease. This industry or society. We are rapidly learn phase cari. be passed. over rather rapidiy ing more about the prevention and manage because of the fact that it is. relatively ment of heart disease and the regulation of uncommon and it does not offer a serious those who are so afflicted. problem to industry. Since the heart is such . The main reason for the ascendency of a complicated structure it .is little wonder heart tremble in oar mortality statistics, is that defects in development do"occur. Hie that medicine has. not yet understood, and wonder is rather that they'occur so seldom. therefore has not conquered the degenera If the defect is slight such as incomplete tive diseases. We have learned much about closure in the septum, between the two " their care and methods of prolonging useful aurides it may go unnoticed arid present ho u), life but until we understand the underlying particular problem. If on theotherhand ti: causes we will be triable to prevent^them. the defect is great it is rridnmpatiMc with It is all writ and good to say everyone life and the child does not strivlvc. Diag most grow old, but there is-'a reason wiry nosis is usually easy and is made eartyr. Its some people age faster than others and why. treatment can be dismissed from a discussion . this aging process is more frequently seen such as this. in one organ or set of organs than in an The second laftge classification whhh m- other. Why -do these tilings, occur? The nof be dismissed is heart, disease which re answer is the biggest challenge to medicine sults from infection.. Since the heart 'is today. When it is-answered .we may again called upon to propel all the blood dreutat- take the ceiling"off'the life expectancy in,, tng through tim body it hatnraliy follows man. that it is particularly susceptible, to infec-' A child bom a hundred or more years tions which enter the blood stream, in feet ago had to run the gauntlet of the diseases ' this is practically the .only way bacteria may. common to infancy;, namely the dysenteries, enter fee heart Accidents resriUmgin pene food and vitamin deficiencies, and the acute trating wotmdsrqf tire, chestand spreading - infections. Then came childhood with its infections fronorthe fangs and pleura may . diphtheria, small pox and meningitis.- Suc atwf do ocw but they-are wiwuhmw. Heut' cessfully through theses the young adult infections are ttsnafy 'blood borne;and^ tip could expect typhoid fever and pneumonia. per respiratotyinfcctionytonsatitiy bron- , Onlyafter surviving these and many other chitis, and rheumatic fever are the common acute infections would be enter the degen offenders Their effect isusually inridions erative period where heart- disease takes amichtiMucTO fee snch a heavy toll. : chambers of fee heart, or- the: licart 'and . Industrial Nursing 145 great vessels, hecometovohred, and.thebody infections. atf the time of' employment may .sets abodt to heal Jhe^dantigedniend^ prevent serious^coosequences later. In the TTIus it 'does admirably ^Iniop ja: scar, same manner, their0discovery by periodic tnttch as1 a scar is foraaed oo the sldh after ^examinations may prevent subsequentcardiac a cot tv8 * complications;. - , This znavlead' to otoer tofftculfies^ how- - When aperson is. found to havevalvular ever, First of*aIl the heart;and:its lining" heart disease, there isn reason why be or are thereafter 'more liable ^tosnhseqoent she eannotlead a fell and useful life, re infections iand secondly: *~ptic3b^^ place much as it doosciri scars 'dsevthere and as a result thevalves no fongerootne tightly together ,when; tbqr doseand aeonditian commcxdyknbwn as ^leakage of the heartn^resolt ; In Vadditk toevalv*. no membering always ,that tbecardiac reserve isdimimshedand that the'heart should not beasked to .carry hairy hardens: KA se dentary occupation is certainly more desir able for. these people, even though theyare having.no trouble-withtheir heart at.the' , longer is soft mjdpliablebntbecomes rigid and consequently &ii&iniig4tNd:.ii ob structed. ` That tins dbstrnctmi ^ptits an abnormal strain on the beartmusculatare time, of examination. . Already handicapped, it will perform better and last.longer if called upon; to.do'ho more than is abso lutely necessary. Sudden failure of such is obvious. The heartrespondsto'toeextea Itodi^ is intoal andthere is no reason why empfoyeeswithetolralaf.heart disease fpt its muscular wallxr- This process' can cannot.be placed in positions of respodtilnlcatenae to be elective,only to a certain' ity.jeven vihere they areresponsible for the point, hovrever, and wrea the time rs reached; welfare of others. when themwcle can ito"longer? stand tite Soch is not the case with heart disease strain, it dyate^ ofta snddehly, and-heart ^dde to arteHosBerotis. Tins form should failure results? v 1 lie differentiated`from the foregoing in that . Now a.heart so affected;, natanffljr-hai its caweaodeffect are different It is of its reserve. djmtnitiie^, and apatieot so course seen in an older age gronp, usually afflicted. can^compare toe. status of Ins appearing toward the end of *toe fourth heartwith his bank aocotmt E^ daybisc, decade.- As las been said the heart's re- 'heart builds up a certainreserveand cadi spontiMlity0. isthe propulsion of . blood day be=adds Ids a^'tb'>lh''tomiit:; If his salary is. ent the amoant be addsPtohis account decreases'and:if-ln.:lieart;.is:'d^a-. a^fed. bis cardiac reserve:B likewise dimin throughout the body bdtat the same time it requires a .blood supply, of its own. Tins is supplied through system, known as the coronary arteries. :Unfortunately in arterio- ished. -If he lives| witidn l4s meamt lie will be aMe to opntinbe a happy existence bgt if he ovtfdniws, hankrtiptcyenspes. In a <jnn'|jir sense the patient wito heart difease can continpeVusefel life as hing ashedoes <Sdefosiv or bardadng o.f tire arteries; these conmary artermr are often the first vessels in. the body to'be affected.. If the walls'of the vessels become su^ciently. hardened the flow of blood to the heart muscle is lessened. not overtax, his heart; htt l^ of care m .Faun is the result llus pain,is.character c this regard will refelt in heart-failure. The ized by suddeu^onset and is usually located treatment thqir amounts to 'no more than under the ..breast bone. If it radiates it'is building up cnstially. to -toe left shoulder. and arm. It power of fee heart;is enormbt&ifitisghren usually comes as the result of unusual ex- half a chance,and ifa patimfs activities . ertion and goes away with rest. This ^ are cnrtailed-aod stimulating drugs; such as.; angtra pectoris. lt h the heart's way digitalis; are given am effective heart action trilmg ..IB; that it-, is not- getting enough can again beobtamed. ' -f\"-;. . _a nourishment ^ carry-on-toe work we sue * Now to aqrply .these facts p> the workman askmg of it and when we feel it is. tithe to: - in" .mdnstqr.';f ^miraR^iaeiifal^jnos to stopahdtake stock. which industry caninfloencetbe prevention -;;"':This:|ype o heart :discase usually occurs ofheartdisease to.) ittfectibu. IrirstbiF ' in Cl). men^who are wotidng uhdd' tension working cboffltk>os;;wfuch"'^help to . prevtnt . and (2)ytoose- who are overwei^iL Tkre* irate infectionsandsecoodly ^enumntioai tore i\n^ltitoih^:m tiutir:work and mode of employees -, Before-:and ;ditrmgi employ of living; Is necessary. The; prevention' of ment Discovery of hidden -or-umecogniied ' arteriosderosis is onerof the strongest talk- 0 v. 146 29th National Safety Congress mg points lor vacations. ? Freedom from What applito to beartdisease which is the work and worry fora short period of time result ofiimrdotiag'sbf -the' arteriesisalsQ is a ime prophylactic measure. - The mos^ appUcahto to tbat- remlting ^ ekvafisS important exercise for these patients is 006 btoodi>%sntiuItiodmrs' toessentiallyitite which is performed three times .each >day same age group and its ;tnanagmnent ies- and consists in poshing fhemselves. away . sentially tte.same.rcTte UodUnuu^iteUit. from the. dinner table some time before ca>:long withstand \rm^^te.'tienitions.of they have eaten att-{hey .can hold-. Redue-. blood/pressuraipUj^':^ tion of weight is essential and. sincci the denis placedopan heart sufferer, shouldmot perform-stitenmins 'sto\|ifrrakahi^^ ' exerdse there is only one way to'obtaintlus -time .`if ' redaction and that is faydiet. ' level-the:h Now suppose tins oondidoa docs develop in an individual, does it mean that he is iio longer useful in industry? ' results.; Whalhasbeensaid abom toirdeh- ing of tbearteriesfin^tesaid alsoaboat - hypertension. j j^ is; ccoipatiblcwith 'Jong' Certainly not! If he is -placed in the and nmM ^f^ hut it do requre^v some proper .position he1 will be useful to indus curtailment ofactivity. V:. try and himself alike. But . his. position should not require heavy exertion.and her should be under the; care, of his family, physician. In case he is indispensable to hU business others must bectrained to ceplaice him allowing the patient necessary vacations lor proper rest Lastly, it is unwise to put the phytical wdfare of others m his hands, since too often this form, of heart disease resnlts in sadden failare. If his jobisone which requires bis' constant. attention aid As todutypebf heart diseaserenting from toxins onlya"few"^ttisjKed'fcig; said., as these areinore often tban e*ix*- ternal. Thyrptoiacosiijuiy remit in beart disease but{as a' rale itlsa tonponuy re- ; - action. ;AsTbppn m.tiie^ti^rold.lb-.tontajMed - .the heart returns"to;its formeritote. prog . and chemical mjuries-to:^:;beah"are. on-- ushal and presenlsuch a rare'-probkm; that : they need potconceru tisrat this-titneV;V - where any lapse woald endanger his life or WithparVmod^metl^ . that of other empfoyees he should betrans- mmiogsnti^^l^w9^^wfbrad^;liert ^ fared to other wink. ^ disease important to V indostry ^Usually ~ Symptoms' of coronary heart disease vary and they might resemble' symptoms re- ferrable to otter organs of the body. When a coronary vessel becomes completely pluggol it is known as coronary tfaxomboss. Typically there Is severe opprcssivcpain in the chest; frequently radiating down the left arml This dobs notgb away with rest and comparativelyeasy.lsj?ite.alltoq.nii&itifias' to. - oar diagnostkra there ' is ' stituwiK^ to^aoe>n;CtoeM':lnstiny;^ad''' pbysicarexanrinatioa.Tbe sixeandshape of: ' tiie Jaeartr./.nfc4efcftpgyfltteiijfi^;4ritgcjfc^kai^j8>ndl-T- v therx-raywffl.m^ as to wbether^tixTOvis my almoniud^ . wtort tiiei'imderlj^,^ : - ; is accompanied by a fall in hlood pressure and signs of sfaodc. .-This is the usual but fay no means.the invariable picture pto;:. seated.. Often the symptoms seem to'come* from the stomach, particularly hi mild'at tacks, 'or the .sufferer. may" tirink-he has "bronchitis" or gall bladder disease: One most be ctfutious of die'man over dO who will resftt.in seen in hypertentioix.^:Iterec^(increase . in*x-ray cxamimUion;of toedtest-foroccn- pational Imjg dises^ shooM. ^ the repQgstitionspfsnKHre abntoaal^hearls. ^The pUlse ntoritsd is .ofte U^gobd gt^ ihb^ V taur^s^wsittiop.;'.-:.; complains of a sodden nmxsoal 'pain in Ks '' It' can' be stated-as a. geteluijFitie^tiiat a ^ stomach.-It may be his stomach, bnt again slow*heartis better than^x-fast(oot^Or^to* it may be his heart. An exaggeration whkhr put itanotiierv^wben^hmitl^ ; makes this point istbe statement that heart tim^ pervtnmuto it`^lis; oC.^the .'' in yonqg- nw*1 Is usBsJty - - time awl red&^^ of fi^ 'timle^in'-betweeh a trouble while stomach.trouble'infold men beab.' Wheii'it"beats'lOO-tioife'per- mhrate ' is usually heart disease. Overdrawn,of it ton rest on^ fialf pf tit'.tim^'-atid;vtiten'^ course;' but it cootains enough truth to make it worth remembering. rest as when. it bttto nort^ly' af TO w iud vi -. h "`t kf'i .o Industrial Nursing tit 4 mhuttelit ilq#nd^|(^{ h>cajpidto]Bd drqdatkn times are also qsbd imlv^lsan^in^aij^ an....................b..u..t...w. hile o&^ojto.^ ptilae^ratewhet at-.Te^:&;:0(^?pMSe|`cidir|y it ar&jQOC as(wdl adapted to routine exam- ....... - To 4|MMlci^laod;4a5d:'>=evalMteJtroe.^.dectn)-.. iainW'>aiypniySp, if thy lmiW ton~ ~aW af- r wife*rtfcard'fo'll^aim^t'dl?^xertiaQ'ih3> ,.. dfat-,jB;1KrAiil-.'tfa^ '&^-*udmr ttaoa^w^ tidu of 'these* enployeesare particularly - fafehaefee heartbeat tTbe Se^owdio- desirable; .; ~ ffiTtim& it . Lastly Iwanttosaya word about the m m;iteirjuiMi^ ** Hio&ftiat}#is***** jpu^ad^itmr. lie i : - failmgrbeamattc! heart ot a; coronary oc b"*3n feetreafeieat iscasartiallyfec sitae. ~ means: 1pruipftjmy .ntnlPAii4M:tlfe;nip^^_l\ww>i^ , HL-". W.T a ^oroiuiy. throm- gillptirs^ Morphine? -p. a t-kj- n .ti im a it;Wrff-.Tp.ttwm^1h^-OTOMPa n*ay mfe- ffc patfwit'g . life Do n^^jdrafer^ramutuicewOT^he pari^ fn ^nf W^tw. ^r nr jttnfciTatuf. >. : sav^wei^ai^ which " little . efen3t^ie tfHi--^iiaiiierit3riRK'cooditiaAi'its allbwed 148 29th National Sdfety Congress Nutrition for ^Industrial; Workers -By MAEY I. BARBUR ;Director of Home Economics, Kdlogg Company, Battle Creft, Hich. ,'.c. An observiuit personnel manager siresup with employ^problems. :Sb& acts as ad applicants at the first'glance. Subconsciously viser fo tiw cafeteria directs ;. his mind registersthe presence oirahsence of good posture; straight kgs, 'sldHful hands, bright eyes, white teeth. The lade ofany Here is a letter toemjrtoyees typical of a nutrition program explanation: of these qualiries -mpy-be caused by mal nutrition and the reason for it.nay date bade To the Vitamin Group .- many years. Nothing can be done to correct past mistakes or ignorances,- but something can be done to improve them in the future. The physical examination given to . new employees and die periodic check-up will disclose such obvious things as imperfect eyesight, dental caries, goitre or anemia. Many physidans send employees to,the den tist or family (factor; but possibly nettitermay give advice on die improvement in food . "Our tablets tins - winter -contain vitamins A,_B, D. and G instead of tbe ttsnal;A.and D;of formeryears. "Whyservieatablet wfackcontfoisvita- min B and vitamin0G? - Because-recent pad? ies . showfoat these^ vitamins, in right amount; help to:, make usphyskally fitlry keeping tirn digestive tract healtfaier, appetite^kieeftci; and nerves steadier. habits which will mean better nutrition. The There 'are foods rich fo these vitamins, nurse has a splendid opportunity to find out but; people do. :iiot -ahntys get- the .right about die land of menus served'in the homes jirmnnt in-their food.. Tp make.certain which she visits, or if she does not make the members of the Vitamin Groupare ade home cads, die can get this information by quately supplied, we include smalLamounts talking with the people' who come to her oftbemfotbetablete. office. "We .coaldgetfhe rest -from our food. People have an instinctive- confidence in a Isn't it fortunate that we can turn to the nurse. They do not fear her as they do common foods like m3k, greenleafy and the doctor :--he may find out that they need yellow vegetables, potatoes; oranges, toma their tonsils out and recommend a painful toes, eggs, beer, fiver, and whole : grain operation. The nurse does' not prescribe. She ...carols to furnish these vitamins?:At the listens sympathetically. If she is alert she "same time, we shafi be richly supplied with finds out math which , is significant and. vitamins A and . and tiie bestprotemsand which can guide die doctor in his diagnosis. minerals. A patient may be shy about talking to the doctor about being overweight--but not to "It yoor menus for the day-fodode in ap the nurse. An overweight condition may be proximately At>quantities' suggested 'foe a contributing factor to less than 100 per following .foods wifobotter, whole' grain cent efficiency on the job: aerials, arid breadstnffs;yoa'may rest as- Occasionally we find a factory where a nutritionist is employed. She, the nurse and surod yem vrifi have bfoter health and greata' vigor.- " the doctor are a combination ideal for Milk, wholes.... ....I.............................i.. pint carrying on a nutrition program. One large Egg.............. ..-a...:..,..-... manufacturing plant has such a set-up. The nutritionist has conferences with employees who have asked for this service or ban been referred by-doctors'or nurses. She directs Broccoli (or aiiy green leaf vegetable) ...........1 cup.steamed Carrots (or foiyyeilow vegetable) 2 or;3 small . certain experiments such as . the administra Potato; medinm rize...........1 tion of cod liver oil or vitamin tablets to . Orange jttice.(or 2 caps tomato juke) &cup certain groups, comparing their lack of colds to those of other groups not having Liver, or beef, or p^ weD codkcd.! serving vitamin therapy. The nutritionist gives "There would be no harro in doublmg the special courses for the nurses and helps them amounts of the itefos. ' r C\ ' Industrial Cursing 149 : vK:thereis ^ qq^doo^yoia wish .to ask pjoyees and has .proved this by providing about jmar tfe^fbe Af^lc^ such,things aslstidt^^i^ldnglcMdifioDs, will gladly discussyt wfthyoto-r> J medical service, nr^tionai.` udlities, etc^ * . 'e A. . "Gordialfyyours ^but.Tor:. the. most .part .a consthictive. nutri- Nutrition Adviser Plant Nurse" v r_ tiim .^program duis. been ;oniitted. ' Can itjbe ignored atty longer iftTwnfacturerswislito cooperate 'with. ^viBrnine!tf'l.agehdesand it is desirable to have a rniOc;dispenser or promptetheAmc^ of. living? The shade bar- available to all employees. This strongest,argumeht l can givexnurging inassuresfood apryed and eaten in asanitary /diisby ito include nutrition in its .titihlrijng way/Nothiiig looks worsethan^peopleeal- ' for . 1941 fe to quote lMiss Harriet EUiott, i^whihe. worhitifc' Cfamihs!hawe-nojplace Consumer Commayoner, National Defense in a factory work room. One factoty-which ' AdvisoiyCbmrnLssiimt..; used :to ^IjaVe;: * soft drink, dispenser was IxrsTx^d^ to sdLbotded^ milkalso, soare- frigeraltor was purcha5ed. Inmedkt^ the wcirkera ..-began to bay white aod diooolate ` ^ ^We have a everyone. Our icastrong^ job job totdo. is this: Yon, and To inake I, and Amer- ndOc.'Soonthe refrij^raihw (a, verjrlarge "We have oar IandS^to hold, our waters ooe)>wasmadequate, sola shcfctnrwib to protect our^ do^ to guard. We have est^llshe&Thls particular.~paSuai:~:yams diesipfNit. we have more. -We.:have people. hours a j"We are ridi in peopfe. Pebple whp love ployees. .Nereare die jHfo'fipinBr % Jtiitt; and cberidi our holds. Pec^te whb know 1940 oaooSlk products alone:/ how and wahiP to work.: People who have - Xjm to 2j000 persoos are sorvedperday. deep ftith that here we have- die greatest Milk..>.. 1 ./. V. .l,20Qbalf pint pottles chanoeffor ffiTev^.and liberty, and the pursuit ^400. pint bottles < . of h^ppinesi People who know the fight Ice. Cream.....-...............1,700 gallons for these is new won nhdl. it is won for .... . .Chocolate ltk.......1,800 half pintbottles everybody. :tv -a- . " Buttermilk............1 1 .180 gallons "Ddtense is pbmes and guns, it is equip-' .. ' Coffee, arealso 5 available hut'observation ;sbbyra..:that'.ti*e' dairyprodocts are die best sellers; Inoar ting an anny to man onr ndlitaiy weapons/ It is thu, and more. It is boildmg the health, the physical fitnesv the sodal well-bdng of alt onr.'PMjpIe^ land doihg it the democratic packages, ofour.ovnr cereals arid . interest* waor.fHhagry people^ andernourished people, inglytaoogb, a fairly large numberof'peo- ill pdqple^'do not-mailte for strong (fcfense pte sribo are wmiemg withthem day after - "TTus^ then, is oar job^ hot aifi'of it, bnt a daybojrthem. '. vibd part: Let tis make every American Somepublic school cafeterias serve a conn bination ..of cdeal strong stronger than ever before^ sturdier in body, steamer hi nerves,; surer in living." with* one-halfpirrtbottle of nd& for five Oat of 130 imllioa people^ 45 million live cents. If aii^g^aRd^b chosen this bdow the safety line becaase we do not get .is asgoodvaloe forthe money as any com-/ die food we nrod. The reasons are because filiation possible on a countcr.Many dub- die income is.too km; because of ignorance dreneat this as dessert. ; of how to buy. plan ahd prepare meals; be . 2 have watchedindustrial workers go cause onr interesthas npt bbm roused. along the.fine inacafieteria and often am Bdow the m/ety tine means: Bodies dot tire too easily. chywytiiv--a^| pU^an^ly nrprit*i< at"w^'.idk^sei.T.'^rfi^psithe. skriutiou' is .a.,. ''jfty-ptflif (ty1 (i|> .by'- pfayfd UP Bodies with minds tiiat are slow to think Bodies tob wakjto fight .^disease. Chi priabove fie safety line means: andma^-soadtiatifive arid jpricedso reason' ' Stron^ stnugfat bodies that can carry the ;e^bKsi^ - A. load of^i hard dzy's work; tyes that, are . well trainedfoodserv^ rttjif 'can', see; shaty and sure; nerves tiat are steady, firm jje of andhhaftiiid. - fered. .''I *>';. 1 You. can hdp to tipxild a food route to Industry feds its responsibility to its em- safety Ity an. educational program, in your 0\ 150 29th National Safety Congress organisation. This can be. under the per? feet Wehave dammed:gigantic rivers and sonnel, medical, nursing or Imme economics mSde thrir waters^do the work oftitilHons; department--or better, with the cooperatioo We have created dtliis andhU^wiyyfac- of all of them. Optimum nutriti^forevery tories aod faachfaes'that are the marvd of worker; helps for h&family besetting op *. the world. -h ; food: clinic to whichproblemscan be *We have.worked at~many things. We brought; distribution ofleaflets which jpye mtistdomore.(v,,\/; practical advice on spending money ahdgettins nutritional value for each fooddollar; "Wejntrt^ encouraging home gardchyhome canning or cveiybpdr a diiine;-fa.^eam? a ,livelihood cold lodcer-stmage of. 'surplnii.l frmts and that iododestbefood bejieedyy'We nurit vegetables; setting np of adequate' make menus for a day; posting oribulletin boards . abmitt&pttdia^ . items to stimulate .interestin nutrition* Thrn it some dietitian faeveryatywho will gladly help yon with a nutrition pro help tbey need to;keep. on ritismgfood aud/inuring soil. We most make onr.dollars buy foe test andsafest mealsfor all,/ `t*. . J I I > gram (I am sure that I can speakJormem- r-1 bers of the. American Dietetic ( ' .**We am. .start; fa'our. own , hqraes.;. Make The Food and iNatibnal Defaue^lssue of foodjfo'sUvthejobit can do*' Makecertain I t Consumers Guide fists dte^PMidy,. state and each ^mepber ol tiic fiumlyiK^^^ - A government agencies ready/ to give service, ItiBi'jliiBoy. sod ** on this"Food for J "We.Can lo^ at' oior owncommtmities, is Again let me qootefrom thissame maga zine: - ' disepy^ where Inh^.ire poori?why, they are pport--lidw roty mtist be enriched. r'', li "AMERICA can dream that want will disappear. America can- hope and,live'fa hope that none wilMack the food he needs. We can dram and hopt, but we faust also Wd ;^>ibiniiih;W: incomes and. waste, and' abc^ - . of fobdsfromfanns to homey v; * work. ^ "We' haw tiie' falebt'.tp doaHthis vig- "We can work. orocsly.persistently, anJih the-ways of a-' "With our lands, and handyandmachines demoaratiepfopfaf 1 -a we have built greatly. We have raised from "Wecaamake Americastroog by mak the earth, buildings that 'soar a thousand ing Americans stronger." S 1 ADJOURNMENT t\ : ; ' . I j. J t ,* I C