Document QXqqz6wzQMVagXQ5Eex6Ko8bo

I I i .! I ** INDUSTRIAL HYGIENE FOUNDATION OF AMERICA, Inc. SEVENTH ANNUAL MEETING OF MEMBERS I* * PITTSBURGH, PENNSYLVANIA . NOVEMBER 10-11, 1942 I(- . ? . i; . ; V. * ' ' !t r- I i" ? - i. *' \ h * i i .>* *.**A , ^ PROCEEDINGS ' OP SEVENTH ANNUAL MEETING OP f ! I t " ! 1L ' ;^ ; t . -O' INDUSTRIAL HTQIENE FOUNDATIbN OP-'AMISItlUA.'lNC. ' * November io-u,' 1012 : I `'tiitmUsinn ilrfit r ftK llif* . *I 1 produced JM -83 CONTENTS The Foundation in Wurtimo-- Andrew Fletcher ................. Annual Report of the Managing DirectorJohn F. McMahon ................................ Manpower Conservationlion. Paul V. McNutt r \ V4 & r FATIGUE IN WARTIME INDUSTRY Hours of Work and Rotation of Shifts (PANMI. PIHCUBHHiN) C. I). Selby, M. II., W. A. .Sawyer. M. II., Nnllmoh-I Klcitmun, Pit. I)., William II. Forbes, Ph. II. ........ INDUSTRIAL HYGIENE FOUNDATION An Anociation of Indmtriei A Scientific Solution of the Multiple Shift Problem- Nathaniel Kleltnian, l*h. D.......................................... Type* of Fatigue in Industry-- William II. Forbes, Ph. D........................................... for iho Advancement of Healthful Working Coru/ilium lieulth Hazards in the Use of Artificial Abruaivu Grinding Wheels-- I W. Irving Clark, M. D.......................................................................... ' Further Studies of Aluminum Powder in Coinlmling Silicosis * J. I,. Illaisdell, M. D........................................................................... ,. I Pruclicul X-ruy Techniques for Musa Physical Nxaiuinullous` ' E. P. Pendergrass, M. I)...................................................................... I 'j II : ,, / Occupational Dermatoses In the Wur Industries-l.ouia Schwartz, M. D.......................................................................... Measurements of Rate of Air Displacement on u Basis far Dctennining Exhaust Ventilation Itoquiremeuls -- MaJ. Theodore F. Hatch, Sn. C.; and lit. Robert It. Walpole, Jr., Ho. C.................................................... Keeping Score on Toxic Materiulu und Pronmmm in llio I'liiut - Edgar ('. Iturnes ............................................................. .................. What the Foundation Plant Surveys are Dha-lnslng- Francis It. Ilolden, I'll. D......................... ...................................... Health Problems in Suddenly Expanding liulualriul l.'oioinunilius-- llnnlinglon Wiltiuma, M. 11., Ilr. P. II............................................... Report of Legal CommitleeThcodoro (!. Waters ....... 00011765 i* The Industrial Health Program of the Organized Medical Profession-- Stanley J. Secger, M. D....................................................................... A f Action of Mugncsiuni Upon the Dungs-- l.eroy U. Gardner, M. I>.; and Anthony It. Delahanl........................ Disability in Silicoties-- George W. Wright, M. D..................................................................... produced RM - I IX* . ... / . t; y.' CONTENTS -- Continued ' .! . Mir MORE MANPOWER THROUGH REDUCTION OP AD8ENCE3 ,, (I'ANUI, D1UCU8HION) Absenteeism in the Coal-Mining Industry-- * R. R. Sayers, M. I>..................................................-.... .......... ............ iilck Absenteeism Among a Sample of Member' Companlea of thojji. lmluairlal Hygiene Foundation, 1041-- .. '. , /Aj ,'JKJ Some Health Aapeeta of Putting Women to Work In War InduatrleaV;.' ' - k-Cfc Mery Anderaon *....... ................ ......... ................. .J........;.......1.......... . lflfiC C ..,.M, <i. If! . The Health Problem of Women In'Industry-- 4, M. Carlisle, M. 1. E. K. A. Merewethcr, M. D. Discussion r.'v 1HI/U7V The Indu--a-t-riiaall Feeding Program-- ' ` Robert. Goodhsrt, M. 0.................................. I................................. 80VI Manpoweltr Survey to Delcrmlno Baala of Industrial Mobilization--*<?' v;X< i jlueaellI J. Greenly, Ph. 1)..................................... -............................'104',$}] i...., PROCEEDINGS OF SEVENTH ANNUAL MEETING OP , INDUSTRIAL HYGIENE FOUNDATION OF AMERICA, INC. NOVEMREIl 10-11, 1912 Tuesday Session November 10, 11)42 THE FOUNDATION IN WARTIME ANDREW FLETCHER* It la certainly a pleaauro to welcome you to tills our aocoiut annual t ing of tho Industrial Ilygitmo Foundation, lit roulity It ia tho suvunth ui meeting of our group, which was formed, ah you proliubly will rocall, u Air Hygiene Foundation. Wo changed tho niitiio in nrdur that our numo might better convey tho purposes of our organization. It is with very deep regret llmt I have to announce la you tho res tion of Dr. Mcller, because of IIIiioms. I am happy, however, to say tin wilt be able to benefit by bis views und thoughta relutivu to tho problei induatrial hygiene, ua ho will still lie with ua uh a consultant. I am also happy to auy that Mr. McMahon, who you will romemhe boon with us for a number of years, will carry on In Ihu work. Mr. Mck In a few minutus will submit a short report to you of our activities, I, ever, would liko to say Just a few words. There nru probably tow associations In this country who have representative members, and I do not think t.hsru are any associations .have as licuds of their committees such capal.lo men ns ours. In this cr. tion I think that you should rcullze that theso gentlemen have coni: year after year, to aid us, und in turn industry, by serving withou compensation other than the satisfaction of rouliziug tlmt tho help tin giving to industry is lessening the problems'of industrial health. We are also very fortunate in this Foundation in being so closely ciutcd with Mellon Institute,' and in that connection I feel that you : roulizo that Mellon Institute extends to tin housing nud this iiodit' and at no liiumr.ial profit whatsoever--ahsululely none. For n mini! years muiiy peoplo thought llml Mellon lindilule was malting mom of tho Foundation, but instcud of making money, in the Hint years wo started, nctoully made very hig flnam ial eoutrlhnliouii What receive from os is possibly a little good will ihrough our aelivltlus. t I am also happy to say to yen that yom Ponmhilioii is not in del in fuct that our linanclul condition today hi heller limn it over wus. . . ........... 4 Vic# t'ranldunl, HI. TruiUM. l.eiul iNmtjtuny, ilntlmiiiii, |i*> ooo r! 7(jii1 PRODUCED  sooslly would like to ace us try to raise, through special solicitation, a fund ot possibly $26,000 or $60,000. 1 think that many of our members are enjoy* In* satisfactory turnings now, and they eould probably includo In their curruni operating costs any contribution to the Foundation. If we were able to secure a fund of say $26,000 or $60,000, we would havo definite assur* tncts tlmI we could carry on tluring tho lean years which are before ua, But more Important still, with a fund of this kind we could increase our , research activities. I hope that the Foundation will never become purely an organization to gather statistics. ^ Let It rather be a place where Indus* try can come and we in turn can ald them In lessening the hazards of occu* putional diseases, and thereby do our part In Increasing the production of our country, which s so sorely needed, today, and which in my estimation will be just as much needed in the peace which is to follow. In closing, I would like to say a few words as to the Foundation's ohli* gution during this war time. All of us today arc facing a situation wherein democracy and personul freedom are fighting to survive in competition with a way ot life in which the rights of the Individual are being completely dis regarded. Under such circumstances it seems to me that tho.obligation of the Foundation and the obligation of each ono of ua la to subordinate our Interests to the nalhnal interest. And 1 think our national interest can be very easily describeJ as winning the war. A few weeks ago I was asked a question; Do you not think that it is industry's obligation to improve the working and living conditions of its employees ? I replied that I consider it no obligation, but rulher a privi lege, und an excellent investment from a dollar and cents angle. Your investment in the Foundation Is an excellent investment if you will use it, and I certainly hope that you will. f*. f .-i VI * JOHN F. McMAIION Lost Workdays - Precious workdays lost' In war Industries through absenteeism, In faee of manpower shortages, constitute the gravest problem of the yoe the field of Industrial health. The main causes of absenteeism are sickness, accidents, and volunl unavailibility. Sickness is by fur the greatest singlu cause,, claiming estimuted eight workduys per worker yearly. With more than 17 mil men und women war workers, wur industries ore losing manpower ut rnto of 130 million workdays pur year, or an uverugo of more thuu million workdays weekly, through Illness alone. Because of absenteeism of all kinds, a substantial portion of wliic certninly preventable, tons of coul are unmlncd and tons of steel arc produced. Planes fail to fly, ships to sail, and guns to fire on the al wur fronts. One encouruging sign can bo reported: Tho problem is lieginnini receive sorious attention. There is a lessening of tho "nothing can be i about it" attitude. More and moro companies are keeping uccount of nb cea. Adequate records reveal the causes of iihsunces end nn uiiderslum of causes helps toward solution. Collaborating with the U. S. Public Health Service, Industrial Hyg Foundation and a group of its member companies are conducting a si to help reduce sick absenteeism in the industrlea. Statistim mio now i plcto for 14 of the participating companies fm; the year of ItMI, covu absences of B days or over. An individual analysis of ouch company's pcrionce, prepared by W. M. Gufafer, Sonlor Statistician, Dlvlilor Industrial Hygiene, U. S. Public Health Service, has recently bean tr milled to participating companies In the mining industry, where the problem lias hucii acute, both and in England, District 2 of the United Mine Workers and thu Cui Pennsylvania Coul Producers' Association are working together for "in mum production and maximum efitciency.'' They seek to "eiicoiiruge r lar work on behalf of the miners and maximum ellleieney on the pur management........... " ' Women in Indualry Chairman I'uul V. McNutt of the War Manpower Comniissions re| lluil "Of the 6(1 million women, age 14 und over, listed in llm 1040 rei nearly !6 million nro already ut work." The swift influx of women industries, many of them lilting jobs prcvlomdy regurded as "men's wi lias been another major development of the year in the field of oecupati hygiene. Tho auccessfill employment of women imposes new reiipunsihil on management respecting health und safeguards. ' The campaign to promote proper nutrition for war workers, with phasftt on "pack n lunch that pucks a punch," hua keen stressed as r before nnd promises to accomplish lasting good. 000 1 7o.` Ii *\J\ /I 3 pRfinn'*1 New Member* . ' 1 . *#4**f%. > *. During 1042, It more companies end association* affiliated with Indus trial Hygiene Foundation in tho organization's effort* to promote .healthful working conditions, namely: Qantrtl Motor* I'.otptnlUn Koppor* Company ffoiifcoi* Company O*narat Rafrooterlaa Company Ow*n*.Corning 'Iborglto Corp. Domora Chair Company , . ,- Employara Mutual Mobility Inourapco CgrJj'. Slrolhmoro Paper Company it1 Drtiiir Mtfiulx.lurlng Ctwptny . , Oavlaon Chamloal Company '/- l ", Pacific Coaat Attoclallo. n Pulp and Paper M,anu<faotu` rtera i . . . yH*, There are now 246 company and agsoelntion members in the Founda tion. These organizations, practically all of them directly engaged ln.warj production, emplo r between 2 *nd 3 million war workers. < partotecneTsthisoeens,ItnostroompdleauncwttiiothhnygloiietftnleeuI'nlkmafnaneomtawsiHnluiaryetrgosi.xeainncedMeeSfnfieunecrwiwvtseh,cylhlsIosemtdhiecemaldsas-en* rjdIm!ninagtmoseaevesnnucgofrnaetiacn tuteeu'r frl*inlg-j|rdgr* `*' J, f^'l -< | if to l>e the most common of ull occupational diseases. . The Foumliiti >n Inis conducted more plant hygiene surveys tliun in any' pretloua year. These investigations, supervised by Frank It. Holden, chock , on the possible existence of health hazards in the workplaces. If hazards y era detectod, effectual measures are devised for their correction. Resides , fostering healthful working conditions, the Foundation's plsnt surveys';^ sre proving to ho an increasing fractor in advancing hnasnrmmoiniouusii lmabiTMor,-,..A, -:^- relation), helping to eliminate working condition* which arc of"ten sources"^.- of discontient, such a* nuiaance-dusts and fumes.. . '/S': The Foundation collaborates actively with governmental agencies, both atate and federal, which sre interested in Industrie) health. One evldonce^., of tliie cooperation is the subscription pUasiftcelloni. started early In tliedL Ai year whereby govermnenUl agencies-can secure atl^PouipUllon publlce-Wu I A-i-1 |ioni at less then cost. Since this arrangement wak Initiated 12 monthsTOf.,*:-i.V, j i *. ego, 4 federal agencies including Army and Navy, 22 states, and 6 clties^'V have subscribed for Foundation literature. Meanwhile, 3 universities and 4 private specialists have also availed thumsselves of this inuterial. .. Itesearch rh'S -i.-J i ! 2. Effects of Exposure to Welding Fuiiiiim find (Snsca upiiii Nornlnl and Tuberculous Animals. 3. Air Flow Measuroment by the Dilution Method. ' 4. Measuring Air Flow in Industrial Ventilation. In additiun to ttieso contributions. Urn Foundation has publish* proceedings of the 1SI41 meeting, two educational bulletins, two special cles, and Ite monthly fnifustrtuf ffppfens Dtps*f. More than 1,000 abel of articles, legul decisions, and nows items relating tu Ituluslrlul health been carried during the year in that periodical. As a wartime measure, the Foundation'll Hoard of Trustees has uu ized the extension of the services to non*mmnbor compunies on u cosl basis. This uid includes plunt hygiene surveys which fhn Foundsti Milking In increasing mimhers in all types of manufacturing. Tho value of Foundation membership is, in a large measure, what member niakeH it. Companies can utilize their membership or neglei benefits. Call upon the Foundation more frequently in 1043! Your i hersldp can help you keep your workers well. DR. EDWARD R. WBIDI.BIN (Director, Mellon Institute): Mr. C . man, Members of the Industrial Hygiene Foundation of America; it Is al a pleasure to welcomo you to Mellon Institute. When I look back ovc years of association that we have had with this organization, it has in vary satisfying one. When we realize that we started out sovon yeari with a small group to try to bring about a hotter cooperation and an u rj-'-i- stundlng hotwoon labor and industry anil management, through th|s Ii trial Uyglane Foundation, In Improving health Conditions of the worki ' think wo can all bo gratlflod with the progrnss lliut hue boon tnude. Wo not only had splendid support from labor and Industry in working on n limn Imais for general improvement of working conditions, but we have bud splendid cooperation from evory scientific and research nrgnnlzuli the country, which is demonstrated in the ropnrl Unit Mr. McMaiuu just given you. Thesu advances have led to constant improvumunl in health cotuli If In Industry and to a better understanding uf our problems. And tho ' today ia going to prove more valuable than It aver lias In the past, whe realize the importance of the 'conservation of tho licallli of (lie working especially while we are so short of labor, while wo hove in conserve in way possible. I'ublicalions . . , i'wo medical ami two engineering bulletin* have'been issued to hers during the year. These publicntiona, giving the results of.rosenroll.'fii^vjjprjy' ere s follows: 1. ('omparHcii of Btereoscoplc Miniature Cheat Fllma, Slngls'..^: Jyl Hocutgenc-grama on Caper, end Single Roentgenograms on'vv ' (.srge Filina. ft I ilniiT know uf a heller tribute that is lining paid the Foundation I Hutu to have the Honorable I'uiil V. McNutt come from Washington, an extremely busy office, us you know the problems he is facing, und to the. time to address this gathering. I think it gives uu otto t>{ tho l supports uinl eiicoiirsgiimonts that wo have uvur had In liui Foundation I tako grout pleasure In Introducing tho llonoriihlo Haul V. McNi (}()()! I 708 *1 lSA' PR0DUC'r .i lb,y ,i. > / n ou) MANPOWER CONSERVATION PLAINTIFF'S I exhibit HON. PAUL V. McNUTT* . , . ' (', ' (I*. 1' . A*- f-?;a . "What la the ihape of total war?" asks Stuart Cbaao in hia new book, HWfW"Goala for America.'' . . . "It la a eontli.ion," he saya, "where every man, woman and child baa1 " Aspecific duties to perform on behalf of hia country." (,s| .. That definition, mark you, anchora our hope for survival In human. . ;. life and human effort--not in materials and machines. 1 ^ Vt';*1?- fy,f We need to he Id that concept, because the incredible changes in Amcr-` '* v- -' ican industry over the past two years present a vialon of physical accom- \ ' pliahmcnt ao dszxling that the motivating force of It all--the manpower and ' tho womnnpower--is obscured. ' 'V.-'"' i`$ K; Here is a plant where the time for making an antiaircraft gun has been J' j/- , cut by four months. Over there is new equipment which beuts the old in j /. . making machine guns by 20 to 80 hours. . ' ' (> j( Welding and the use of light metula hue revolutionized shipbuilding and aircraft construction. rj/ r: Our new plast.cn industry has become a Paul Bunyan overnight. Raw materials deposits are being newly put to use. New processes--new ways . to do are introduced with miraculous spued. ' ' One industrial plant alone has expanded to the tune of more than nine ' billion dollars. We have also more electric power, more machine tools, iron and steal mills, mats) refineries, and chemical works than evor before. ' { & . H Yes, we have the physical resources. But to send the ships down the >' . /.ways, to roll the tanks and bombers off the assembly line, we must put t ' every man and woman to work--and we muat keep them on tho job. ' * This conference then gains deep significance to our nation's drive' to: .--j, '" victory because yoj lira here to conaider how to keep workera on tho job-- j.jjJ .^>api| what you can do to aid In that herculean laak. V. i You know far better than I do how costly the rapid changes in indus-2 ,? try may be. A nuv' materia) or process careleaaly Introduced in a plant may! . suddenly result in illness or injuries which keep men ofT the job. And know how to deal with these problems--as your excellent progrum Indicates i " The responsibility of the employer and the industrial hygienist for dis ability clearly occipational in origin Is well defined. You and I must nowr iii'- ' < consider other factors, both inside end outaldo the plant, which affect the ' A health to our and efficiency of the country, it likewise worker. teaches For If total war teaches us our duty ^ government its duty to every citizen;^ V. and it tenches each of us our duty one to another. . * Ek'i Frankly, our situation in war production today Is such that we cannot ! afford lo discard ll e services of one single mini or woman who can bo con- - idereil a pnlcntiiil worker. We cannot afford In lose one aingli! dny of work ' Jri1' llisl can possibly I u saved. Tlui totals of armament to be produced In III*) be measured by the ('resident's call for 10 million tons of shipping 126,000 planes; an I 76,000 tanks. .. t bilrnim. Wsr Minponsr Commission. :-Sift30WfP^7f! f ^f- VI lil ' 'r If we were dealing with mere figures, we could safely predict tl shall have enough munpower to do the job. But this is more than a ticnl exercise. ' - The feat of uctuiilly getting the right people, in tliu required nu into tho right jobs at tliu right lime--tho font of supplying munpow one of tho gruntest problems of personnel manngeinunl tho world hu seen. And it is not one nutionnl problem. It is n network of locul pro It is a vast complex of individual towiiM ami individual pliiuta tlml special challenges to meet, special difHculllna lo solvo. Within tliu impressive tolula of workura ocoded me plaulH which workers ut leas Ilian top skill uml thus crenlo for tlminaelvuH orlilleiul shortages. Within them are other plants which wuatc (lie vigor am duclivcncss of good workers bemuse they do not follow aoiiml udvi health and safety. Within tint totals, loo, arc (owns like New York, where there ni tons of thousands of unemployed. There nru I owns like llnllimoru there are few unemployed und less housing and when* morn lliun . additional workers must bo found in the noil twelve monlha from ai employers did not consider or un-ept a your ago when limy lulkud < "labor supply." Nevertheless, tho totals are Impressive evidence ef (tie gigantic leugo which fuces us. By the close of tho year, our total labor force will uiindiur more 69 million. Over 6'A million will be in the armed forcua. About 18 n men und women will be in war production Joba---more than twica us us wera in war work at the tima of Pearl Harbor. In another year's If the war continues, about 80 million people will bo in tho war Indui Tills meant that we shall have fewer unemployed; fewer people In ag lure; and fewer to man the essential non-war aurvices and Industries. One of the most notable changes In imlnalry is tliu Incrcasu in w workers. Of the 60 million women, uge M and over, listed in tho census, near 16 million arc ulreudy ut work. The remaining HR mlllio tliu nation's principal remaining labor reserve. Bui not more than 13 ir of them will iicliiidly be available lo industry. Age limitations, the for farm labor, maintenance of homes, and Ibe military and voluiitar) vices restrict hoiiicwIiiiI the use of this potential supply. Youths draft ngc, over-ugo men, and pbysiciilly hnndicniipuil workers mu: counted lo supply the remaining needs both in wur industry and ess> non-war work. Ilow do these vast shifts to tliu composition of Hie Inhor force nffui conservation of manpower T Women lire going into occupations where only men were fori employed. The proportion of women employed in am li imhialries us nvi. iiiiinitiniis, I mil ami die, ami iiiaimfaeliire iff prei-iainii Inal rinnenl: id ready increased by leaps and bounds. Kniplnyns are faring new prol willi respeet In Hie Itcnllli and efficiency of women workera. In my opinion, the conservation of womaiipowcr should offer no of n problem Miun Hut conservation of manpower. If wn givu the w healthful working conditions, adequate training in sofn practices, am) medical service, wo cun expect iih good reiailla in reducing tliu tliu- 000.1 l-l J. I I () 7 PRODUCE due to Industrial disabilities among these new employees aa we know can be obtained among men. High sickness rates recorded for a few thousand oftlc* workers who grab a soda for lunch should not be a critorion for . * refusing employment to women in plunts where Industrial heulth has been given an A-i priority. L True, we must make sure that untrained workers--the teon-age boy on ; '; , , ^U!/rst Job--and o<der workers who have lost their former skill are given -.vjfi*|14 protection than the average man has been given in the pnst. And JjljnuU make sure that they are carefully trained |n good work hubita. But`.JtxMvX.?. jf forget our peace-time fears that the young and the old and the - `Iphyslcally handicapped will send up our insurance and compensation rates.#7^ ^*^*4 It jjjjie ordor of the day ia manpower first. . ,1 ' I might add that, even though there is a differential us compared to 'Jjr* ,,, ''Ihe luxury physical aiamlards some employers have enforced, they must t, , " still use wonim-thcy n111.1t still use the handicapped--they must still use. Jjj ''l- . (, j: the aged, and the iiiilriiiurd. In total wur we use all our people. We must' not disqualify them for their limitations. We uee them for what they cun do. `r; . '5 i I hope that this war will outlaw tha term "pre-employment'' In favor .Jf'* v -.i of pri--plari,menl" examination. The old idea that an Industrial worker ' must huve the physical requirements of a 1-A or 1-B aclcctee must he thrown overboard. Mnnugcmcnt and labor can no longer regard the pre placement examination as a means for rejecting the phyeicully handicapped or any other worker from employment. Your job Is to make the health appraisal an effective tool for piecing sll workers in jobs which they can do safely and efficiently. Men end women with minor and major defect* can ba given an oppor tunity to maka a substantial contribution to the war effort. The Federal';..-,'. Government and many private Industrie* ere doing eo today, , The doaf and&jt... hard-ctf-hesrlng are being trained as card-punch operator*'f-u- the Clvll1^,i` . .Service Commission. There are seven million physIcaUy'hendlcapped men In the United States Tha vast majority of them could go to work tomorrow, : without any special restorative help. Another million men need rchabilitn lion, but with careful placement could be used in a wide varloty of Jobe. Contrary to the belief of some men in public life, moet of our war work-ij ere --new und old--ore on the Job longer mid harder than thoy hnvo ever . brrn in their lives. They ure working longer and harder limn any group in Washington. . Fatigue ia the nost effective saboteur In the war effort. The military services rt-Kurd fal.guc as a major haxaril to auceesaful combat. A tired`vVj-.Kft man or womun on the to Ini fellow workers. production line Making planes, is a potential danger tanka, and munitions tdoemhlamnsdoslfskannil<dl1 `"-it. if*/ .ii'V ' ful und precise work with precious materials we cannot afford to wasttoo,. ' .v 'l You will lind n high percentage of wasted effort and spoiled materials at a tired w/.rki-r'u bciirli. And no one will In* more puzzled limn Im ns to why lie fumbles the job. . A short time ago, eight Federal agencies Jointly subscribed t<y the poUoyjg that for continuous, efficient production, the 8-hour day Inn 48-hour'week'!s^j the best liuslc schedule for war work. Those agencies Included the War' and Navy Departments, the War Manpowor Commission, Urn War/Prodoc turn Hoard, the Maritime Commission, the Department 0/ Commerce, I Department of Labor, and the Public Health Service. Thle agreement Is 8 r'nWp * r .1 OV-.'iv"' . line with a statement issued by the Surgeon Cultural of tlio Public ileal Service seven months ugo, in which tio pointed out ihal Industries oporatii on a 24-hour basis must now take stupa to miuiirir.c tint effocts of 'fullgi night work, und the roluting shift. " The day of reckoning will come. The eniilrnelor who thinks lio c beat the timetable and top tlio quotu by Ignoring heulth und safely requii ments is due for 11 shock. Ilcforc long, he will not he ultlu to replace eve sick or Injured worker. Army and Nuvy "B" |ienniinls won nl the ox pen ' of high sccident rates will have to he lowered to hulf-niust. Every war plant can and should be a safe mid healthful work p!u< But wlmt uboul tlio home nnd community! Them ure .'100 or more ''boom*' areas flung neross tlio country, h these places some B million new inhabitants liuvc moved--to work in w 1 plonlii or around inililury cuntoiimcols. The liesllli und incilical cure problems of Ihesu peoplu ure nculo. (I bcarublu and even dangerous living conditions ure common. Basic suni1 lion is inadt!i|iuilc to tha new demands. Hospitals nro Insufficient. A there ure not enough doctors, dentists and nursuM. That picture is black enough lo plunge I'liln conference of lifo-suvi Into stygian gloom. But I do not despair. Tlio old saw holds good- -it darkest before Urn dawn. . Slowly--I hope not loo slowly- public hoimlug, eiitergi'iiry ronslrucU and the resources of the Public Health Service will bring uhout linpro ment of the environment. As I see it, manpower conservation Is not 11 problem of *'know-ho but rather "Get on with the job." Management and labor need n great deal more Information about ' causes of ulumnlecisiii and the ways to consttrvn manpowor. Mmingomc labor committees exist today whirl* cun translate Ihul linawliidgo I , action. The story muat he understood and urcoplcd by I ho workorH v must put it into effect. It must ho understood and urccplod by ovon most tradition-hound hoard of diruclors. Few employers aeo the relation between Ilnur prodiii'lhm "headuch ami conditions both in and outside the plant, which directly affect the wo trs* lieallli and welfare. Itcccnl reports show that lack of dcccuL housing and Irunsporlut tangles ure high in tlio cuunoh of labor turnover. Poor winking condition exclusive of low wages--are given hy many workem as a reason for quilt a job. You know heller then uny other group how frequently "poor wt Ing conditions" meun crowding; cxrcsuive noiiio, tension anil strulri, medii sanilnlion--and even exposure to dangerous niihsliinccs. Not lung ugi war riiutractor was much surprised to learn Ihul his 2fi percent luhor li over was largely due to the uncontrolled fumcH of 11 poisonoiiu solvent. We have come far in the control of oceiipnllotinl hazards. Tlio new plants will speed this udvnnco, hernuso they are being ciuistruclcd to h< men and women as woll as machines. But even today, nil too tnnny cont tors arc grossly negligent of the most elementary practices for mnnpo conservation. As simple a thing as cleanliness In the workshop Is loo o neglected. Itcpair and maintenance of machines and safety cquipmen forgotten as the call goes out for speed--more speed. Mut^ |<|T^iji|jni^lc/i.,^uit had unenviable health records in the past PRODUCED ...: learning that they nuit correct their errors for the benefit of war workers , and old residents ai well. More of the American Ingenuity which gave n. J, the bombaigbt and inasa prodoctlon of ehipi ie needed on the home front- p -iV -c Every community must look about for new waye to use every available ^ resource for health protection. -- - Tens of thousands of doctors and nurses, and countless other profes- aionals needed More will go, for the conservation of manpower, are with the armed force:ess,, ___ I *w# *^*v*V'v;iu. l |,1t*K , 1 The problem that faces us now is a two-headed beast.. First, where and when to take tie doctors needed by the Army and Navy.; Second, how best to use our remaining medical atrength. '' With all tba power that has been given It the War Manpower Commie slon will endeavor to allocate the skill* and atrength of the nation more equitably than haa l>i-t*n done up to now. This would apply to our medical, cuglneeriiii;, and (crlmicsl manpower *e well ns to the labor force. .v The Procurement and Assignment Service, with the technical aid of (he Public Health Service, ia continuing its efforts to determine needs in war areas and to And the needed doctors. _ . ' Most of the Stales hava met their quotas for military doctors ment will continue in New York, Massachusetts, Illinois, Ohio, Pennsylvania, and California. Conferences with the Surgeons Genera] of the Army, Navy, and the Public Health Service are being held continually to decide the .V'ljjr' btst way to withdrew physicians. ' . ,.'j-'-i K\:A' j>3 :. The Procuremeit and Assignment Service reports that, to date, some. -'j.. 218 physicians hsvi- transferred to other communities, either within their stales or out-of-stale, for civilian practice, - j ... More dislocations are sure to follow, if we are to?maintain minimum medical service both in critical areas and non-war communities whore the^v drain has been heavy. To say that we can apare tens of thousands of doctors to the military mid still hsve enough to take care of tho civilian population on tho com- j.' i fopUble margin of one physician to 1,500 peoplo la juat juggling figures. ' 1 ' Our doctor* have never been parceled out evenly. And today the' parr'J" rcling seem* to have token little account of human needs or limitations, ` liters are many towns where there Is not one doctor per three thousand even four thousand or more. Thero are boom towns where the nearest ado quate medical service is 26 to 60 miles away. ... ... . We must now begin to ask the question: "Is this essential to the war '* iVj < , effort?" in our use of professional skills. This requires not only voluntary acceptance of demands but a method for rationing the akllla just a* wo aro ^1 rationing supplies. We must do it for all the rest of our manpower--and no profession is any exception. The problem of gelling doctors into hard-pressed war communities is aj'..^:, _ .. , manpower problem. The Procurement and Assignment Service of tho Wsr,''V..>^jT:: , Manpower Commiaiion is reaponaible for the equitable allocation of --meJdilc"a'l 'i'*- 'V -: ' manpower, so far iw is legally possible, and the United States Pubillic Hcnlth T U-V. >, ' -;>yI Sunite is responsil le for its equitable use in civilian areas .......i&sMk Rationing of medicu) services may be needed. The stamp-hook method would not work In-i ntise you cannot ration aickness. Misfortune hits unev, ciily. Some people need a doctor many times in a year; others, only occs in o PLAINTIFF'S EXHIBIT t v$-0 n sionally. Dut no one can predict "how much" or "how ofton." Tim I way to meet tho emergency would seem to bo to cxerclao some control c the movement of physicians both Into and out of civilian practice, plus rr "pooling" of medical aervlces, hospital facilities, and nurses In the c ' munlty. - The lack of medical facilities in the critical arena In u wur probl Therefore, the Federal Government has a responsibility to help In aoh it. If the war workers and their famillea uro left without modical c their health problems will increasingly Impede tho wur effort. How the needs are to be met is the constant coneom of the authorll Plans are being made and tried in different areas. The same plan will work everywhere. We must keep on trying, and meet situations as t arise. Tho shortage of nurses can hu met. Wo lisvu Inrreused the yet i-iimHnicul of student nurses by twenty thousand since MHO. Ily shorloi the period of ncndemlc training, wo can take on as many ns sixty-five thi and student nurses in 1049. ' But to supply tho armed forces and to stretch the romnlnlng nun skill fog civilians, we will have to uso nurses' aldos nioro often and In n places. Hospitals, health departments, clinics, and Industrial dispense have scarcely begun to tap this potential aourco of holp. Wo must all face this fact. Every profession Is losing both recr end practicing members to the armed forces. ' In any event, "non-profcasionula" are going to hove to toko on a lo jobs which only tho initiated formerly did. ; I wonder if the industrial hygienlsta have explored tho |iopsiblllt) ' Inducting non-professionals into some of your specific skills? ;The a health departments and the Public Health Service have 600 former sa men, teachers, and other "laymen" out trucing tho infectious contact! venereal disease patients. This Job was once dalegated to nurses and docf If an industrial hygiena servica has not enough doctors or engineer cover a large number of war plunls, is It economical--In it nocessury professionals to do all the legwork making contorts ? Hors It take a do or chemist to tell, on a first visit, that a plant iiiumIb a llioiuug|i going o\ Could laymen be trained to do that specific door-opening jab? The British huve made medical care ami cafeteria mirvlcn eompub In every war plant of 200 or more workers. In this rmmlry, Ilia nulrl program has brought.about great progress without compulsion, hut n moro remains to bo done. Industrial medical service also must be extended. lint If that Is t accomplished, medical departments must toko a wider view of Iheir res sihililles. Tho shortage of physicians will make ll hinder fur plunls In keep I full medical stuffs. New departments will mil find it easy In ohloin doc Too few Industrial establishments had fnll-lline modlrel ervlco lie the war. A larger number bud n doctor in n few limns a week In caro of accident cases. In fuel, ul) but a Imudful nf linlusliliil mn departments concerned UiemsolvitM with nothing but rumpciisslilo Injur ' I submit that In toduy's wur emergency such unrestricted conccp ; manpower conservation does not justify exempting the imliislrlul physi - from induction into the armed forres. 00 0117 7:; produced a OO rt-*WIFF'S Industrial med cal department! should draw . upon * local physicians ^ _ wherever possible. But under any circumaUincej' in-plant medical ilmuld Ireut nun-ciii i|icii3iilili* illness on the job, Preventive services should . '1 l.o provide,!. y;* It % >. . Ami in boom to-vn* where there are not enough doctors, industrial phye- inim und nurses alinuM give home care built to the workers nnd their .d.\ h|, -S ^/emllies. . t. , * .1 will go further. Where location pemilta, Industrial medical service should be spread to cover the employees of more than one plant. .-In one^'/jjtivjft^) *-' qswt shipbuilding town there are three plants. Only one baa hecn'able to \)' Kt. (loctors, und purses. The lucky coplrector cunnot.moct his sahedulos M?.v.V'i>V*PiJ - tiiiless the other two meet theirs. iProventahle time.loss from sickness In yV> the doctorless plsnts is holding up the war effort. Now why cannot oil Y'V-'Jv-eT;.:. three get together and inako some mcdicul coro avaliilable :for all the workers : aiplithelr families? ' ./ ni of the United States^f^ff^.^ , I*'The Public Health Service haa. been taking care Coast Guard families for aoveral years. Yon in industry and medicine have a bigger task than saving that amnll emoiinl of time lost lu preventable diseases and accidents. Your assign ment is total conservation of manpower. Like military medicine, your task means "prevention and restoration." Prevention has the high objective of throwing around the soldier every known health protection to keep him In action. If he does succumb to sick- item, accident, or enemy attack, the duty is to restore him to action os quickly as science, skill, and nature permit. Your task is to do the same for the men and women In our war Indus tries--our industrial army without whom the United Nations ennnot win. r` .. _ , . 'itV . LT. COL A. J. LANZA, M. C.: In accordance with the spirit of the times, the comments of your chairman will ho strictly rationed. Mr. McNutt referred to hours of work. Three or four days ago the fA. .M*-'; Washington Post, on the front page, hud two headlines. Ono headline stated thul one very eminennt gKeonntilieminuan, one oif the leeanddeersr'oolf our goverun- *. . . , inenl, wished to increuse houjrr#s of work. T""he ot"her heading wiih to the effect/, that another extremely eminent RonUemnn In nur government did not winlr. Jj,` \ ; Sf8* : to increase hours o' work In thut situation lien the crux of the matter of-KV ^ -v f Industrial fatigue, ind without any more ado I am going to introduce I)r. Selhy, who will lest h discussion on hours of work and the rotulion of shifts. vV ! sii O, 1 4 # t\ * :'v"i '''Vli,2?" i- 'm30 V ' i * : ' / i.i. dv*'J < FATIGUE IN WARTIME INDUSTRY (Flours of Work and Rotation of Shifts) - A Panel DUcitHaion with the following participants: * . C. I). SELBY, M. !>., Mcdicnl Consultant, Gencrul Motors Corp., Presidi W. A. SAWYEn, M. I)., Medical Director, Eastman Kodak Company NATHANIEL KLEITMAN, Ph. D,, University of Chicago WILLIAM H. FORBES, Ph. D., Harvard Fatigue Laboratory Dll. SELBY: The panel consistn of Dr. W. A. Sawyer, Prof. Nathni Kleitman, and Dr. William II. Forbes. They oro prepared to respond questions from the audience. The discussion will lie unrehenrseil and *p taneous, 1 hope. I wish it were possible to olTor you n reward of n mcml ship In the Foundation for the question which will stump the experts, can offor you, however, a competent answer. ) would like to have the panel of experts define fat(gue in a war im) try. Perhaps Dr. Forbes can answer that. DR. FORBES: I don't think that fatigue In industry is one singlo enl It should lie divided for purposes of discuaslun. In my opinion, Into at h three categories: first, physical fatigue; second, mental fatigue; and Hi what I should like to call nervous fatigue. Of these the last is by far the moat important. In modern Indus physical fatigue has become relatively unimportant tiy thu introduction very large number of labor saving devices and the use of electric po> Even when physienl follgun docs occur it is of far less importance than vans fatigue, purlly because it la so easily remedied. If ll Ih clear tie mun is out of breath all day from the work ha Is doing, something is d commonly, to make the work lighter. Mental fatigue 1 would like to skip over. II is n type Hint I tliie relatively nniniporlunl, coming only from long hours of application to i tnl tasks, without particular nervous strain. I would Ilka to Invito attention In nervous fatigue, that which makea a mun say at the end of day, "I'm tired." In the great majority of roses Hint is the reusou. U comes hi mild degrees, as is natural, ll conies in major dug however, from working under conditions of loo great slralii, omot strain among others, and in uncongenial surroundings. I think that is ulimit all I can do in tha way of denning fatigua. I DR. SELIIY: It is quite evident from wlmt thu Doctor suys that fatigue with which we are concerned Is that which results from entot conditions, or conditions causing emotional disturbances, I think that a very good question, by Hie way. DU. I,. D. BRISTOL (Amurinin Tcloplu.no & Tolngrnpli Company u mooting last night In New York n question was asked uio which I coi answer. I wish this meeting had como firsI The ipioalloii is, hew d< ineasurc fatigue, iiorvotm fatigue, short uf d.-rrensod pi eduction? !* have to wait for dcercasad output, decreii.n-d production for uvlden faligue? Wlmt is the best mciiHurcmeiit of II ? OOOt 177.; 13 produced PROP. KLEITMAN: We cen meeeure It by the number of mistakes the person makes, end also by the apeed with which he Y^rks, Speed and aecu-j racy are very good nicaaurea o( fatigue. You don't havo lo bo at the point nf .hoar exhaustion nr complete failure. If apeed deereaaoa and accuracy decrosses, then fatigue haa act in. Actually, of course, aloeplneaa la a pretty good Indication of incapacity for work. A person that la sleepy, i yawna all ihu time, is definitely not in condition to work. I)R. SAWYER: May I put in a word from the practical point.of view!, It seems to me there aro some other things we can think about. Tofliatltm!oj*iH'jl^l;?ii`jo`ff`eV^. tbe question of the number of accldenta the man has. The amount * ' be loses on the Jol may be related to the fatigue question, and his sipoillage ft i\lt v, * *, of work also. .V.-'-rM. Hit. SEI.I1Y: When I get tired or fatigued, I get Irritable, Is that something to ho considered? The panel says "yes." W, Mil. JOSEPH PAPPALARDO (Hawley Products Company) : How long do you think It is practical for a fatigue becomes quite a factor! man to work on, . say| the lost shift, whon 'ffi h * tI PllOr. KI.EITMAN: I would put It the other way. There Is more, I fatigue on the mghl shift to start with than later on^-.The worst,trouble .iwe have today is the rapid rotation of ahlfts. Most people are accustomed t'to aleep at night and work In the daytime. When they need to work ` night they are aleepy at qight and they cannot sleep in the daytime. A ^ person who cannot sleep in the daytime will naturally be aluepy at night Mr. McNutt mentioned the statement by the Surgeon (ieneral of the .P.' United States Public Health Service about work around the clock. He definitely expressed himself ua against rapid rotation of shifts. How many V people here have h uinl ubout it or know about it! I don't think very many do. In other words, there has been no attempt lo educulo both labor biuIJj management to the danger of rapid rotation.. t ' It takes wesks for any one, even the fastest, to adapt oneself to a new Vj routine. If you put a worker on a shift for one week, he is no good. Noxt ' ' week he will be belter. ' , So I would answer your question in reverse. The longer you have him on.; the shift, the less l.e is likoly to he inefficient during hia odd working hours/ I am in fuvor of so-culled steady shifts, unchanged shifts, hut that seems to bo Impractical for s variety of reasons, and so to compromise, 1 advocate Infrequent rotation of shifts. Not ones a week or two weeks, but once In ^ two or three or four months--aa long on one ahift a* Is possiblo under local'i'V-'-IS conditions. V 4 ;i! Dll. ANNE BAETJER (Johns Hopkins): I would like to ask Profesior^^^j^ j; Kh.-ilman: how do you lit that with Ilia experience of Great Britain.in thejr'*last war, where they found thut tho output did not decrunso nt any tlino^ when they had an r liernating shift, say, changing every two wnoks, whereas) if It was a continuous night shift llioy found thill the output doernasod, both'' (nr nu ll and women ? 14 . `-i* :-,o 'ki fits. i. ; '*'4 l- WV1 PROP. KLEITMAN: That Is news to mo. I do know thut they use two weeks rotulion, but from uxperlonco In tliir country itml elsewtu is the steady worker lit night that haa fower accidents thim the one rntulus very rapidly. - Dll. IIAETJKR: I was quoting from Voruun's bonk and also froi Industrial lleullh Research book, both the one published in 1021, nfte last wur, and the recent one. lie makes Ilia definite statement that on tinuous night work the output was lower thins it whs if they rotnted du; night shifts. PROP. KI.E1TMAN: There arc other elements there, prohubly the of worker employed at night. I would say the'important element I Inek of community arguiiizutioii of leisure for the night worker. I I rented more or leas us ii sociul oiileiist. Anil no rapid rotulion bus tl its favor. It gives u mini, iinilur the present orguiilzulion, some chan uoriiinl social life at two or three or four week intervals. But will present situation, in boom areas entirely devoted to defense work, it tainly should bu possible, and that Is the job of Mr. McNutt, to org social life on tho odd schedule to make it livuble and acceptable, it exactly dcslruhlc. DR. SEIdlY: Has the panel anything also to add to Hint? Por cxbi does the type of work have anything to do with it? DR. FORIIES: It seems to mo thut thu question originally asked cv he answered without knowing tho type of work involved, and that each of work has its own maximum hours, which is relutud lo its difficulty to the variety lo he found in the particular Job. A fiirinor, for liistniieu work very many hours, even prohubly on u night shift, in comparison pilot of uti airpluiic, who is probably inefficient if lie endeavors to work i than something like 100 hours a month. I think thut thu kind of work i lie tuken into consideration when uny such question is naked. DU. A. (J. CltANCI! (Union Carbide mid Cnrhuu Cnrp.); Just i observations bused on cxpericnco for sonin yours with u eonrorn Hull general mechanical work on a day and night shift binds. They ado finally a four week Interval of shift from day In night. It gave the uii opportunity to enjoy day life every other iiionlh and work nun full in on night ahift. Tlioy adjusted to It very readily. Tlioy had u 21-hour ii vul on changes nf shift. They adjusted very wall, thu men ull liked It, did well on it, and we hud no greater accideul experience at night Ihui hail on the day Hldft. In niiolher insluiice, the niglil shift was longer Ilian (lie day shift, u their set-up. It was u ill-hour shift agnlnsl n III hour day shift Thut bail. Thai was machine work, noil they had a inimhiir of vury sovere dents on the night shift us compared to the duy ahift. The men wmili careless toward the end of the shift mid overlook onllniuy preenu whieli the day men seldom overlooked. Another tiling was Hint IIiiihii night uliifl turn, to u largo extenl it permanent, not abiding- did wunl lo enjoy eorlaiu diiyliiuo nelivilies. 1C PRODUCED Wfc. a''i ): time came out of their period for sleep. They'vers 'sleeping from four'to' live hours out of the 24, working 19 hours, and it was not good. I know (hiil this did not w* rk out well. , PROF. KI.EITMAN: I would repeat that monthly rotation is bettor ) limn weekly rotation. Hut as a matter of feet, when you change from one.. ;* routine to another, it doesn't make any difference whether you ure a workori* ^.`4 or s'non-worker, a'. Arst you will be sleepy during your regular sleeping!)! hours- A sleepy wirker naturally is a danger to himself and his machine.; j It lakes time to adapt himself. There is absolutely no question uhout it. The i fact that people wib accept weekly rotation or bi-weekly rotation or monthly rotation because of (lie social element involved is absolutely true. They will pay for it, just us <ve piiy>for othor things by making sacrifices, llut it is : ngt yooil, physiologically, to havo n man rotute rapidly. . ,. Tha only diflicully, it seems, here, is what we call "rapidly.*' Sonio1'...!j',*`;. .y! , schedules rc<|uiro ri lalion three times in one week. That, of course, is too ' much. But two or throe or four months, 1 would say. Is probably the best compromise between steady shift and rapidly rotating shift. Wthehasiilhsel'rviI'ltiJwuuldu'iilIbselPavdlviliTsMubHluliHtoiil'Vchl/oaosituiXtJhIalllayoIuunIAgiseIrWumtnp..l.o..y..u..u..a.. 1 (niug .bine younger employees would not bs fatigued as soon as the older ones, and ' yet the younger employees are more unxious for a social life than the older;' ; ,i . workers. '' And may I ask another question while 1 am upT It has boon my ohscr- T-'ystjpn In certain localities that the provisions made'for cafeteria and lunch !>. fooip facilities at night aro not as adequate as those provided for the day, ,^! shifts, which of course lire larger.' I am wondering whether poorer lunches j' art qot a factor in the production of fatigue. . * ': j.'1'nOF. Kl.EITMAN: I would like to s*y:aom'et)ilng>oh"both questions!!! ' ;Dj\ I.ipman ssid younger people are more anxious for social life, which* usually goes on in the evening. For this reason it has been found Hint older ' . , people are more willing to work at night and will do so especially if a little ., < ox|ra pay is offered. In mnny plants they hava found that their older work- '' ers do very well on the so-called undeairahle night hours. ?'jl'!)' ;v ; V V. .. DR. FORBES: We endeavored to make a laboratory study of the o of age upon capacity to continue work for long periods, hut wo used pi cal work, because physical fatigue is the only otto that we have bean to measure with any degree of accuracy. Wo were surprised by the ' that for long continued physical effort of low Intensity the peak of ofllch - seemed to be reuched at a much older age than wo had expected. Sonietl probably in the neighborhood of forty, rather lliun aa we had expectei . the twenties. That applies, of course, only to physical futlgtiQ. I d know whether nervous fatigue follows the same pattern. - While it is certain that tho very old get tired easily, I am not at convinced that the ago group of furly to fifty Is easily fatlguahle unless rate of work la very hard. I think a young person, It Is fairly clearly sho can work more rapidly for a long period. But if you atop down thu rul little, the oldor person will perlmpa outstrip thu very young. 1 don't It there is uny advuntago over people over twenty-live, hut I think thut man of 40 Is often better than a man of 20. MR. J. G. WRIGHT (Maesachusetta Bonding and Insurance Go.): Forbes hns mentioned something about enjotlonal, fatiggeiIu.!I<arn. vf<>b.O mMM'bfflll'ifWA IMMUI K iHi'lMtMVS niif tie sin steady going. | woondsr If that typo of sltijjy Isn't neptsssry. , DR. FORBES: The studies that Professor Roethllsberger carried ' and which are reported In his book,``Management and tha Worker,"-|nd|ea : on tho whole that It was not the typo of man ao much as the way the n fitted into tho particular group In which he wua working which was Imp tant in the alleviation of or the causation of fntiguo. If ho fitted In pool . If he woe III adjusted to his group, if he didn't work with them as a team, got tired Irrespective of almost any other factors. On tho other fiend, I '> man or woman felt that he was a necessary part of an organization In wh ho took some pride, he could do moro work, under almost any reasona conditions of environment, than he could In tho best possible conditions environment if he did not fit into the group. I was referring to this when I said that emotional strains were probu' very.Important in the causation of what 1 culled nervous fatigue.. ' . i ! The second item you menllonod is n very important one, not only uaan t'o . i^t. `ri`. . 1' 'cafeterias hut health service. Nurses may not be on duty for first aidi UUWr&tf.'i*' Mil. IIARMON SWART (K and 3 Restaurants): 1 would like'to psl question on nutrition. What investigation has been made of the effect you work around the clock you liuve to organise all the services around il'o clock. That has dclnitcly not been done. That Is another reason why the : .j proper employee feeding In preventing fatiguo, nervous as well ss otherwie : night shift is undesirable. it DH. FORBES: I can merely say that various people have worked on lilt. SAWYER: It seems to me tliut the older individual may suffer -, possibly, than the younger penpn on.certain types of- jobs, ti u ^proposal was expressed In Toronto tho.other.dayj, which 1 thought wai*4 jj'fpiljier Interesting, namely, that it might bo well If wo would tako some of i ithise older people Itml we are now taking Into our'organisations and koop ' their boors to pcrlo-ps half lime. l<el aome of tlio women work four honraS-'pyfrJi-T) a iluy Instead of eight, because many of these women coming out of homes ' *' not accustomed to routine factory work. Couldn't we use a great deals;if`' .1/ofrcman-hours or W( muii-hours in thut way! / Vic ' 18 ' 1` Huggaril anil Greenhurg published a hook uboiil three or four yunrs ago dlut and tho worlcor. I believe the title la "Illel and Physical Kfflelunr. Then Professor Roelhlisherger'a book that I just mentioned, "Mnnpgemi and the Worker," describes a series of experiments at tho Hawthorns pit m ` of Western Electric Company, In which they tried n large variety of fm Inga. They gave workers two or three meals u day and then tlmy atepp It tip lo nix, and they nnulyzed thu results. The differencial with dilfort miin hers of feedings do not seem lo ho closely minted lo tho feedings, pi vildecod tlhnut thlio meonil get eonnough food at the incuts thuy do luke. Ilowcv Wrii! -:'t- i-nsu.f.fi.c..i.e..n..t..f.e..e..d..i.n..g....Is very productive of fatigue. ffe. &fll''iv:. - dMUil Ui t l,i ,*i'i~i ;".i i-rf;'"'" 17 ^^Knltnl 4* ' ' MR J. DEWEY DORSETT (A*in. Casualty'1** Surety Executives): : What psrt does our present day thinking play In the matter of fatigue and r.'short working da) a? I am told that the farmer works'from sun to sun and "`certainly the boys in the vicinity of Guadalcanal Island anil the Solomons , . flay on the job fur several hours per day. Have we been coddled in this ..country a little t"0 much in the pust several years? . ' |*' |t . ** * '* I PROF, KLEITMAN: I don't-, think you can compare a farmer-with a 'b'factory worker.1 He very often, works for himself. He takes things easy. . lie Vorks in the open. It is an entirely different type of activity than fac* , lory work at a bench or machine, which is rather monotonous, very often . ' Involves repeating the same thing fur hours at a time. S ' . DR. SELBY: Did lie nnswer your ipiestion, Mr. Doraetl? r\"* !' ft * . MR. DORSETT: No. Having worked in a factory for more than eight-x'VV. ';v `. mu' h'oijrs per day, it doesn't. . ; DR. SELBY: Will the panel venture any other response? Have the vjrprkers been coddled, 1 think Is the question. VN,: v MR. DORSETT: Not only the workers, but all cf us. ^ .: ! ; . V1.' X .DR. LUDWIG TELEKY (New York State Department of Labor): I *,> .'Jfnad* *n investigation many years ago about day and night shifts, and woJ'.l fll yi found that physiological changes in changing the shifts are mostly evident irithln one week, mostly in a few daye. I agree entirely with Professor.*/ ; /..* Kleitman that chonging of the shift every week Is too much. I think every. ' 't'r Ihrte to four weeks certainly may be the most nearly perfect one, because,j *. . '^fll conforms with certain English findings. . . W;*- I think it is well to change the shift at 12 o'clock at night. I believe K tyjflhiil in lliis'way two shifts have an advantage. I think it would he vory ' Interesting to see which one Is better, to change the shift ot 12 o'clock at eSy9j 1 Ij I I . . ' Wght or to change the shift at 10 o'clock at night. . A third question is the question of the meals between shifts, Tnhreeriet areit-? (:>? i/;^uch.very Interesting investigations of Haggard and Greenhurg, but thosovj. ; \ ^wo men have forgootften something, Hint is the same meals andil the saainmssp^J| ',,' j.. I ' pest time. We Imvci! a `lot of Investiguliona which show us that short rests the working timtee are very useful for the efficiency of the worker. ;\`.bb.e)lieve that this comnbinatlion <of short rests and email or largo nionls betwoen 'the shifts is very efficient for increasing production. I. * ;.i ( S'1.'I j ( ,, DR. SELBY Tlutnk you, Dr. Teleky. I regret that there is time for no 'I t*>. Ir 'Snore discussion. . I v 'i- (<* ' Manuscripts wliirh wero prepared in connection with this panel will be^'i 4 ' ; rpnuu b' lished by the Fnumlntioii. % v-', I ' .j: >%'1 i-m. . ; -'/IJT|ct1 || tfHv ' ' ' "WMP M: u A SCIENTIFIC SOLUTION OF THE MULTIPLE SHIFT PROBLEM NATHANIEL KLEITMAN, I'll. D.* In the ordinary routine of existence certain hours ure cuatomari allotted to sleep, work, ntenls, and leisure activities. By following such routino for innny years one becomes nttuned, us it were, to u cycio of exi tence, which is reflected in his rcudiness to work well during (lie workii hours and to Bicep well during Urn hours UHiiully devoted In nloup. Ti present emergency has necessitated Ihe employment of twu or three, or ovi - four shifts, in currying out the Prusident's request to kuup lliu plants goli twenty-four hours a day, seven days per week. Thu Introduction of imillip shifts has brought up a number of problems with respect to work ul unusii hours and the necessity of adapting one's other daily ncllvlllim lo Hut tie schedule. A variety of practices have been adopted In varlomi uslablis ments, the extromes of which are very frequent rotation of shifts on oi hand, and tho maintenance ot so-called ''steady" shifts mi Urn other, muny cases the practice was the deliberate chnh-e of the workers Ihuimiclvi in others, the shift system chosen was wlml Ihe management or bib leaders thought would he best for greatest productivity. When n night worker complains of his Inntdlity to :<l-iqi well in || daytime, he thereby unintentionally conveys Hoi Information that ho la vci sleepy ul night, when he should bn witle-awnha at his hooch ..i inucliin This is becuuse sleep and wukefulnous are mutually coniplonienlary, cousl tuting the two phases of the cycle of existence, like the trough and crest a wave. The sleepiness of the unhappy night worker is not only due to h working during the customury hours of sleep, Imt also to ilia fact that I slept poorly the day before. Thus, an acceptuldo solution of ilia night shi problem should have a two-fold effect: Greater wakefulness and efficient during thu new working hours und better sleep during lliu odd sleeping liaui To solve this problem intelligently we must know something about ll working of the humun machine, the manner in which we adjust ourselves a schedule of living, and the case or difficulty with which this itclicdulu ci bo changed. At birth we apend most of our time in sleep, and there is i evidence of any twenty-four hour cycle in our bodily activities. We at however, horn into world which Is run on Ihe routine nf daytime war evening leisure, und night sleep, nnd we very early in iifn are subjected an enforced schedule of hours in conformity with the huhils of our eltlui As n result, already in thu second your of life we have ji well establish, twenty-four hour or diurnal cycle of existence. We furlhur fortify lb cycle by regularity in our daily schedule of living. This is especial noticeable in children whoso hours arc controlled by their elders, in that th. gel sleepy (the advent of the sumlniun) at a very definite hour and, If ke up beyond that hour, show themselves to ho rather mimuiiagealde, ulilimii they are well huloived daring their osuul waking period. If you look at a clinical or fever thermometer you will ootire an urn at the SIH.h*' F. mark. All Ihe lines above Unit mark are in omiuouH n These markings have created the utterly fulse impression that the norm temperature is something quite fixed. Actuolly it. is no more constuut thu for Insluncc, the pulse rale, the twu incidentally varying in same niaiiio * I iiipurtiiii'iil of I'tiyi'foloi;)', 11 ul ouui t ii Ilf lit on0Dl)CfT1 I m. PLAINTIFF'S ' ` *. fi,,* ", mj t f. Indeed of normal body temperature, we have'a temperature range, very EXHIBIT Ing for different people, and for the came peraon at different times. Tlii range la about one, two, or even three dcgreea F, over u twenty-four hour period, and the change in body toinperulurc from hour to hour la such aa to . create what wo call n twenty-four hour body tomperature curve. Under }: ordinary routine conditiona nf existence, thu peak or plateau of the temper- jfj-` store cui-ve is reached some time during tho afternoon, usually betwoen ' 1:00 and 7:00 I'. M. At that time our efficiency la greatest, The minimal, body temperature ia reached during the early morning houra,' aomewhera between 2:00 and 6:00 A. M. If one ataya awake Overnight, those are the' houra of worst inefficiency and greatest difficulty of ; remaining awake. When one edjusts himself to e now routinea of existence, with other thn(W}( customary houra of sleep, work, meala, and leisure, one gradtially acqnlros j/. a lowly temperature curve, with the highes>tt efficiency end lose sleepiness'M...r.....5?'*:;'!'j during the now activity boms and just the opposite during tho now alcopliig.njPf,,.r hours. . Jr; . A variety of physical and mental testa have demonstrated that hardly'.** anyone It at his best Immediately on waking up In the morning. In fact, / performance at that time may be aa poor or poorer than Juit prior to going ' to bed the night before. However, from thla low level of performance, one^.' . hows a gradual improvement, reaching a peak or plateau of greatest effi-'s. doncy aoroetime between noon and evening. Beyond that, efficiency again";- , ' falls off, and at n certain hour. In people with regular hahita, a state of -`i - drowsiness develops, mid the Individual uaually retires at that time. If, ... <' however, one la kept awake during the entire night, he will show an In- ijj; . creased progressive drop in performance between 2:00 and 6:00 A. M., but !.jj from then on will show an upward turn so (hat at tho tlmo of his usual > awakening, his performance will he nearly as good aa It was nt the hedthno .) the night before, liecuuse the twenty-four hour eyelo of steep, work, menla, ! and leisure ia not inborn, hut Individually developed by following a definite .i, '. routine, it can bt displaced forward or backward by^fsithfully following <i. How can them facia lie applied to tho aolution Of tho multiple shift , pruldeml * y,< The application of these facts to tho aolution of the multiplo shift proh-.'^i (V Inn has two aspects: (1) rotation or maintenance of shifts anil (2) shift ' distribution or ti tiiiig. Ml . , $1 Notation or Maintenance of Shifts: . . < It takes several weoka for a new 24-hour sleep-work-meala-lelsure cycle# to hu properly established. Such achievement le wholly Impoaalble under the l.'l system which prevails In some establishments of weakly or hi-woekly shift V rotation, because thu individual Is not given a chance In adopt hitnself to a new routino. He essentially remains on the customary eyelo of duytline york and night-time sleep.> This makes him dlallke work,at odd hours,. It causes him to he ideepy at a time he should ha wide awake anil wakeful when he should be Bleeping; it leads to a dccrcaso in production rplo.and a grantor'; tendency to accidents. The way to overcotno thla effect , la to kop'ea^ji tvnrkrr on a given shift for expended parimla of |jme.' Hlnco .rotattyiy, olj shifts Is very often adopted aa a measure of fairness lo' all workers,'(ho principle of wpiii ily of treatment can ho preserved by having the workers^ change shifts once in sovural months, Instead of weeks, or.oven days. .The 7. ;K * * 0'S > t.. tr, 20 . '1 '* f'l-tj_fJj fV, / I. , ai i liange in shlfte can he staggered and made to colticido with short perlodi Jbt vacation, in line with the suggestion that vacutiot's should be distributee around the entire eulendar yuur, insloud of concentrzted during the summer months. Where the workers tlicitmelves prefer it, the iiiiiinLenaiico o: "stcudy" shifts, with no rotation wlinl soever, cuu liu accomplished'with dui regard to seniority rights. Whcthor the shifts uro "sleudy" or routed tomo effort should bo mado to modify community llfo to (ho extent of nutk Ing leisure activities ut other than customary luuirs possible. For Instance . broudeasling companies might bu induced to initkc transcriptions of the! .popular evening hour programs for rebroudcasL during thu afternoon uni late night hours. Moving picture shows could he extended either way hy i few hours, ond parties, group meetings and lectures organized with an ey^ to the leisure hours of each third of the working population. Shift IMalrlhiilinn or Timing It is cleur enough that a porson working from midnight to 8:00 A. M which is the customary night shift, makes hlu now work porlml colncld almost completely with his old sleop period. It Is easier to adjust one' self to another ahift timing In which tho displacement of the cycle la smallei Taking, for example, three eight-hour shifts, tho following la suggested: Ited (Sunset) shift. Working hours from noon to 8:00 P. M. Evenin and curly night free for leisure activities. Sleep from 1:00 or 2:00 to 0:0 or 10:111) A. M. White (Victory) shift. Working hours from H:00 P, M. to 4:00 A. V Sleep from uhout 6:00 A. M. to 1:0(1 P. M. Afternoon ami early evenin freo for leisure. Blue (I)uwn) shift. Working hours from `1:011 A. M. to noon. I.oisnt in tho uflcrnoon. Sleep from about 7:00 <P. M. to H:00 A. M. This shift timing has a number of advantages. Ono of thu dlsthn advantages is the relatively amalt displacement of tho customary sleepin hours, ns no ono is compollcd to Hlcup in thu afternoon hours, when It hurdesl tu sleep. Another udvunlago is that II uluo makes shift clutngin full at hours which aro not general community nnili hours. If suvcral plan arc located in tho siuiie vicinity, llm transportatloii problem eroulod mi require the WMle-lllim shift change In he staggered from uhnnl. !I:,'I0 to 4:.' A. M., nml the others correspondingly. , Tho special advantages liu in the uppuul nl mieli of tiieue shifts to <:c tain groups uf workers divided uccordlng to ago, Intcrosls, family slu'.i and recreation Imhits. It may lie pointed out llmt each of thu three ihlf should appeal to tlx: following groups: Thu Ited shift will appeal to young unmurrlud men mid women who li to huvu llieir recreation lute in the evening, us It would eniihlu Ilium to st up to or beyond midnight mid sleep Inter in tho morning. The While shift will appeal to mlddlo-ngod Individuals whoso social I: has altered. As llieir children have ull grown up they would not be d turhed while sleeping during the forenoon hours. They would hnvc t nflernoou free, iih they would not he duu to begin work until K:II0 P. M. Tho Illue shift Ills in very well with the nchedulos of fiunlllcH of t intermediate gToups, whore lliurc lire small children. The father could to hed early in thu evening nl the children's retiring time. Ho would reti from work shortly after noon und have the afternoon true. (!0iUi","i 7 21 punnucF'' ,1/* t: Of course, several members of the seme family, even though of different ages and intcresU, will probably choose to work on the same shift. With five eight-hour working shifts per week, the weekly holiday of ..ip i.YA two days may have an upsetting effect on the establishment nnd mainten ance of t)>u ilisplitrcini-nl cycle, in that it la too much to uxpcct workers to slay up during the odd hours which thuy dovoted to work during tho five days preceding. One answer to this problem Is to decrease the week-end break to nnc day, nnd (he forty-eight huur six-day work is coming, whore it has not yet been adopted. The effect of the common tendency to revert to "community" s coping hours on free days Is minimised. If the sleeping a hours on work-days are displaced in one direction or another only four huuri, instead of eight (aa necessary under tho graveyard shift system). Another solution >( (he week-end break problem la to have the workers continue without i iterruptions on a seven day per weok basis for a number of weeks and then lie given one week's vucution, but that ia n matter that hst lo he settled locally, with the cooperation of the workers themselves, and ie certainly mure feasible in certain types of work than In others. In special aitcations an acceptable solution of this problem is to insti tute four six-hour shifts, each worker putting in seven days per week, or a total of forty-two hours. After twenty weeks of work one would thus put In BIO hours, which is the some number that he would put in in twenty-ono weeks at forty hours per week. He would then have earned nnd receive a v week's vucatiun, and if rotation of shifts is adopted, the chungu cun be made : after the week's -uculion. Ily having twenty twenty-lirsls of the whole 1 force working, onu twenty-first can be off on succeaaivc weeks. With the , four-shift arrangement, the distribution could be as follows: ' \ ) ; &9: V A. The fled shift: working hours 3:00 P. M. to 9:01) I*. M. Sleeping hours as in the Red eight-hour shift. ( 11. The Whits shift: working hnura 9:00 P. M. to 3:00 A. M. Sleeping hours as in the While eight-hour shift. ` ' The lllue iliifl: working hours 3:011 A, M. to 9:00 A. M. Sleeping hums little earlier lliun in the Illuo clght-lmur shift, j, ?!v; I). . The Gold (Sunshine) shift: working hours 9:00 A. M. to 3:00 P. M..-pli Sleeping hours, as usual, at night. ' T Some industries may find it impossible to run their iinichincry contin- .... uously and may have lo adopt two ten-hour shifts, These shifts could bo distributed as follows: fr i '.V A. The early shift from 4:00 or 6:00 A. M. to 2:00 or 3:0(1 P. M. : j II. The late shift from 2:00 or 3:00 P. M. to midnight or 1:00 A. M, " ' Hy ibis arrangement no one would be expected to work during the early morning hours of greatest inefficiency. Tho shifts could he "steady' or of inlrt-uuenl roiahnn. In sum, the siientilir solution of the multiple shift prohli-m is not hound >ti up with the number of shifts and the duration of each. The Important (' .;h doments arc a minimum displacement of the normal cyrlc of activity nnd ' K'f * ' ( oullicirnl lime on the odd schedule of hours to enable the individual lo adjust himself by not only developing, hut also keeping the newly estab- .',1*].' lishi'd rycle. IU!ik .1 >* i.- oc I wish to acknowledge with thnnks the aid received from members ` the Staff of the Division of Labor Standards of the U. S. Department Labor In preparing this outline. ,, Tim obaervutioiiH und experiments upon wide!', those reconiniendatir aro boMod aro descriliod in detail in Chapters XV, XVf, und XVIII of i book, "Sleep and Wakefulness" (University of Chlcugo Prose, 11139). Appendix: A Form of Appeal to llio Workors A. Rotate shifts once in several months, If ut all. '. . D. Abolish the "graveyard" shift by 4 A. M., nooii, und H I*. M. sh changes. C. While on a certain shift, aleep during tho same hours every di including your duys off. Select a schedule of meals corresponding to yo working hours and maintain It at all times. D. Induce your family to adjust their uctivltius to your schedu Crcuto "neighborhoods of lime"--associate with others on your time routii Develop community activities, club meetings, tournaments, lectures, a movies to coincide with your new leisure hours. ' E. Above all, observe regularity in your dally roullno of work, mea leisure nnd sleep. Remember that a sleepy war worker is inefficient a likely to harm himself and his machine, but ie a big help to Iho enemy. oi)ui i PLAINTIFF'S EXHIBIT 2 tu - 83  * I TYPES OF FATIGUE IN INDUSiTtRrYv;.- ' tliS-yi, r . WILLIAM JL FOHUES, Ph. D.* .. : *<V..' S? ` . , .. |I li li a xerloux and common error to think of fatlgua.as a alngta entity.S^-,i It U,.on the contrary, a general term covering very diffprent condltlona"ffl^^^Y^,*,'* , VI)lch.ario from different cauaea and require different .tteatnient.. .For theJ^F^fl ' * purposes of }hla d acuaaion I ahould like to distinguish'between 'three ninlnViyyjn * H mjlypti: physical fa.lgue, mental fatigue and nervooa fatigue. j" . i-ikyj'*' iW; 5J1 ' , Phyaical fatigue la due to continued end hard muacular exercise, When' C, 'prqnounced, it la i.lways recognisable, end in a rough way measurable,;byy>j- ii 'the jncreaaed ventilation and heart rate and the various well-known changea'*i^-!': ' In the blood (Increnae of lactic acid, etc.) which are found Immediately after C';';' J ' , 1 violent exertion. It is of great Importance In troops, and formorly was^jj.Pt.' >' - , inipofUnl in induitry--probably still Is in China and other heavily popu-^jQ.v! Utfd but non:induntriallsed areas., It Is not of any Importance In the mod-/J#&'.,V,> ' em Industries of this country, where for ten cents enough electrical energy'"`?'tf|'fty`if? can be purchased to do the foot pounds of work which a strong man can ' ot,' barely do in a week. Relatively few men in industry do more than twenty percent of the physical work of which they are capable. In the rare clrcum-.;S,( nances in which it does become an important factor the cause and treatment ; / of the condition are so clear that the ailuation is remedied as soon aa possi-' ;I` ' . ' ble snd without expert advice. Even whon aevere and repeated this type of ',8. , ' fatigue has not been proven to have harmful effecta when uncomplicated - by *othe r types. I . , .. Tf!* r \' ` Mental fatigue Is a condition"which ariioaafterjlong-continued mental. t ; i. * ' wofk which does not involva any. emotional strain,,, It ia' of very minor , {mpdr^ance In Industry. It will oefur, for example, In e men who la writing '_ % ' /jpt'hlf leisure * book or report In which ho .la Interested but upon which rjjjV J v ,,,-u. ''rnqllilng depends, it is of'rio consequence to )\lm wheq pr whether the book.r^yVIIIJ-iv f'|s pnishsd. Tjty type of fatigue'cannot be me**urod,objectively, '" .1. > . i li - " Nervous fatigue Is the type which occura whenever there la great prea->j(. . sure on a person to get as much-dona aa possible In a given timo, or when-('. i.V ', ' ev*r there Is much emotions} strain accompanying the work. It is of cnor--fiojL^; fv, mous Importance In industry, inJfact, It Is this kind of'fatigue that almost ji ' everyone refers to when, at iha end of a day, ha aaya, "I am tired." It Is .* ( ' cult la the provlaion of an emotionally satisfactory life outside of the facto Supervision cun play no purl in this--it will defeat the object. About thul coil he donu is to try to ussure good housing and good surroundin Sometimes n personnel director cun hu helpful. Other steps which should taken, lliuugh they are of less Importance thun the two preceding ones, i to provide rcauonubly comfortablu working conditions, adequnte lunchi plucus und periods (und in some industries other rest periods), and whi possible to sea that the facilities for transporting people to and from w< are reasonably quick and adequate. I have aasumed that the pay and working hours nre satisfactory. 'I experience of the English has shown that in most industries It is probal unwise to allow men to work over 55 hours a week ns u regutur thing. S< days off and occasional longer holidays nre csHvntinl. Women do not dif markedly from men in their ability to stnnd long hours, hut It must remembered that many of them must do a considerable amount of hou work, cooking, or marketing In addition to thulr work lu a factory. In short, there Ih only one typo of fatiguo which is of paramount Imp tnnee in industry. It cannot be wholly avoided, hut it can ho minimised anything which will get the men working together contentedly ns an inf mal anil spontaneous teem. LT. COL. LANZA: We will now hear from Dr. Irving Clark, who . many yeara has been identified with the Norton Company, and Is une of pioneers in induatrlnl hygiene In this country. .and liatlessness nr) rommnn aymptmiis. rttl . .Slight degfect. of this condition ore normal, harmless mid uuavoldnbl 0,AUAf`^^'at )h end of a day's work. -Marked degrees),howevey, pro ypfy undpcIraida, fcL ' Mos(i|ng to dlsegntoot, accidents, Illness, snd InefDelency.' llie hioft lmportant-rjl' .single step wh|?h <*ii ho taken to mfnlmlxo this type of fatigue la the veryJ^jj St V'||iRjcult Un of developing and fostering a'spirit of. spontaneous cooperation!) aiid frlsndehihiwlihin tha group.of workers, and harmonious relationships' 00 ()| ii. onnnUCP' VV'f. ' M . s -# , . HEALTH HAZARDS IN-TIIB USE OP ARTIFICIAL! ABRASIVE GRINDING WHEELS . W. IRVING CLARK, M. D.* Grinding wheels are very Important cutting' tool* in modem Industry. _ They are u*ed to cut, shape and smooth pieces of atoel. They are versatilo,. < being capable of removing quantities of stock or of producing a mirror '' finish. They are to be found in every shop where steel is fabricated into machines. The total weight of grinding wheels shipped In 1041 by all American wheel makers was approximately 70,400 tons. During the first 7 months of thin your tlio production whs at llio rule of 125,000 tons n year, an increase of CUT*. over 1041. This Is a good indication of the widespread uso of the grinding wheel in the war Industries and of its vital importance In the armament sch'dule. Grinding wheels are used both wot and dry. When used dry a cloud of dust is produced unless the wheel is provided with a properly designed hood and exhaust. When used wet there ie little duet produced. , Dust is the health hazard in the use of grinding wheels. The duet pro* ?' ilnced in industry by the use of artificial abrasive grinding wheels may be divided into the dust of the abrasives themselves, the duet of the bond, and the dust arising from the object being ground. The ahraeives constitute'c > approximately three-fourths of the grinding wheel, the bond, one-fourth. :v,The artificial sbraslves in common use in Industry are aluminum oxide ' and silicon carbide. The bonds vary from complex alllcates to organic aub- r:f stance*. The materials ground are mostly metatile and the duet innocuous. The effect of the dust of the abrasives and bonds will be discussed In this 7 ' . paper. J .. In considering any dust, its effect upon the tissue* of the experimental; 4; A animal Is of great importance. The dusts in question have been thus studied at the Saranac La >oratorles by Dr. L- eroy U. Gard-ner and---h-la assoc'iates; -In j , ' '! the laboratory of the U. S. Public Health Service In Washington, and in laboratories In Europe. As a result of the study of the effects of many dif ferent types of duit upon the tiaaues, pure Inorganic dusts have been gener ally divided Into ahsorbltiva, Inert and proliferative dust*. Absorbltlve dusts are those which disappear rather quickly from the^. 1 tissue* and which cause no Injury. !< , .;} jj'- ) t.i'7' ` JM Inert dusU tc;id to remain In the tluuea but may be graduaily rcmoved/VA They provoke a 1 light renclion hy their presence but tills la not severe i'- enough to cause iIbmihkc of any Importance and la what might ho expected in Die esse of uny non-irritnting foreign body. Aluminum oxide, silicon csHu'ile, mid the wheel bonds belong in this class. Activo dusts produce-'.-' delinile pathological coiidiliona in the tissues and their action lends to Injury ;|: of llu- tissues. Du- fnriiiitlinn of iibnormnl niiiounts of connective tissue and, in llu- ruse nf fr.- ' hiliiii, m-livnte or iiirreiine susceptibility to tiiberciilouls. Tin' iii'lliui of Du iirliio dusts lias bci-u thoroughly covored In an oxcollont ft?: report by this nsi nrlnDoii.1 The reaction nf lung (issue to Innrgnuic minors) dust dopendsupon the ^|j.' > f. h1 < fi. Nul Ibll f *4llM |*I4 llV. 1 * * 20 I ' type of dust, tho size of the dust particle! In lint air imiallioil, and the number of dust purticlce of a certain size present III the ulr. Aa a result of experimental work with animula and of autopsies on human beluga it has been found that few duet particles larger than ten microns outer the lungs and that the great bulk of particles which reach the air cells lire less than five microns in size. A micron is 1/25,000 of ail inch, so thut the particles can only be scon und counted by using a high puwor microscope. The pro tective devices of tho body prevent a large number of purticlce from ever reaching the air ceils. These protective devices are the flue hairs of the nose, the moist mucous membranes of the nose and throat, the coughing reflex of the larynx, and the cilia of the trachea and large bronchi, which by their whip-like motion are constantly removing mucus mid Inhaled portlclca from the clinet to tho mouth. All theso hnrrlorM iiiiihI Im pnsacil liy llio entering iIiihI purticles beforu lliuy con rvucli tho terminal bronchioles uml the air cells of the lungs. Let ue imagine that the duet particles have at last reached the air cells and from there on trace their course in the body. The air cell responds ' to tlio presence of the dust by throwing off fiat cells from its lining or by extruding cells from the neighboring tissues. Theso cells are of a special type snd have as one of their functions the ability to move from pluce to place through the tissues, and another, of being able to engulf or eat for eign particles. They are culled dust cells. They absorb the dust purticles until eacli cell is almost saturated uml under the microscope appeura tilled with dust. The cells remain for a long time In the air cell, but aome slowly move out of the ceil, worming through the surrounding tissue and blood vessels into tho minute lymph channels which eventually drain into the large lymph vessols of the lungs. These larger lymphatics are true veseela and through them the lymph passes to the roots of the lungs or to the pleura. They run along tho sides of tlio blood vessols ami bronchi, but the flow of lymph Is from the air cell* toward the route of llio lungs. At the roots of tlio lungs Die lymphatic vessel* terminate In glands which act as Alters. The dust colls gradually are collected by the lymphatics and are carried hy tho lymph current tc these glands, whoro they are caught and deposited. This does nut by anj means occur to all the dust cells. Many stop in tlio lymphatics or In llu lymph Islands and perivascular lymph tiaeue, or they may ruinulii In thi tissue spaces. In such cases the dust cells evoniiiully disintegrate, doposlt Ing the dust along the lymphatic courae. Aa tho glands at the lung rooti become filled with dust cells there Is becking up of the lymph flow, so thu more and more duet cells romnln In the lymph vessels and lymph epscei to deposit.their loads of dust. The dust partlclo Itself provokes only a ver; mild reaction of the neighboring tissues, which results III thu formutlon o a small amount of fibrous tissue, often so little Dint It can only be dctcclei by a microscopic examination. This alight fibrosis docB not increase. Inhaled dust nppenra In gravitate to tho pleura and In any area of lot grade infection which may he present in the lung. TIiiim liliroiiM tiami which reHiitls from previous infection is morlicil hy ilimt deposits. 'I'lt deposit of iliisl Im-iicuDi the pleura follows the pleurul drift of Die lym plmtics. The low-grade runcDoo which follows la evidenced by vuryin. degrees of pleural thickening. If through gross negligence heavy clouds of linn dual hove been luluile over a period of many years thu amount of acnr tissue may he rmo)hlc-rabh ooimvwF pnnniir.FD The deposited dust ntuy fill portion* of the lung and provoke by Its median- Jffc .-y ick) irritation a reul fihrotlc reaction. Sucli a condition could not occur. '-' unless A the worker grout deal was doing dry grinding with no exhaust* of information as to the effect of dust for many years. on the lungs of &T?V ",vf human In-ings Inis been derived from the study of x-ray films of thoso exposed, and these .studies support the experimental studies previously referred to. . hjiuptorau ' ' , if- . , V.. ' Thu symptoms of pnoumoeonlosls from grinding whoel dust'are-nil 'unless the patient hss had enormous exposure to dust over many years. In '.'this cme the petit nt may complain of shortness of breath on exertion and of a dry cough. . &'*' ' Sputum is nol raised unless there (a a complicating bronchitis or othor . ' , Infection of the c lest. ' 'XI>lr'ihi7ysilccili Bmleipns* AMU# 4* . . .. 11 < There are no physical aim*`excepl'in*cases.which'have had extreme eiposore. Such cases show an emphysematous type of chest with general- , lied dullness on percussion and with prolonged expiration. There may be retraction above und below the clavicles, but this is rnre, as indeed is this type of case. A good functional lest is to see if the putienl can hold Ids ' breath for 30 seconds. If he cun he is usuully able to do his regular work. K'xpsnsion of the chest may be reduced, but measuring the chest in inspire- ~ , lion and expiraiioi requires cooperation on the part of tho patient, which : Is frequently quei tionsble. .. If pulmonary tuberculosis or bronchitis is preient tho physical signs ' are those of the complicating diseases. (. ' v ( Diagnosis '.fit >'V*. The diagnoseisxaims inmastdioun from* history consists, first, of of exposure a flat film and by an x-raylof .: taken In the poster..{*<-, i- /f) for anterior position, in order to determine whether the cheat shows algnaA-" " - needing further investigation. If the flat Alin Is suggestive a slcrobucopia ' sal of Aim* Is tulen. Frequently a picture which apparently shows pnou-}?'"-' r-` moconloiis in the flat film fails to show it in the more accurate stereoscoplo $ Alms. A lateral Aim Is nlso taken In questionable cases. Fluoroscopy Is ; Important to determine diaphragmatic adhesions. ' The rocntgcnologicul appearance of the lung* of those exposed to the ^ ' ( artificial abrasives is us follows: Irregular exaggeration of the linear tfM.lngs, with possibly some beading confined to the trunks and some Increased root shadow. Such findings, while frequent among workers having un Inert '. . ` dust exposure, uro also found in persons having no exposure to dust; and ore ` 4 elaNNt'd its being williiu the range of heallhy lungs end adnexa.? ': ' . 'I In- most iiiipiirliiiit I'liiuplii'iiliiii) of pnriiinoconinnia is piiliiumary tuber- " .. etilo.-is. It is m M.iiii tbut a worker exposed to the urlifirial nbriiHivo iIiihI* . is incupai-iliiteil fur work unless this disease is present, lull there appears to ^ ., I"* little more InlnTiolosis among I hose oximseil to this type of iIiihI than In jyWq V. A(* y , :Mhc gi'iicral community. ' ii " l',c `"""""'I '*,u Symposium on Tnhercplosls In Industry, hold ` * I Saraiinc l.iiboralr.ry in 1041, Gardner states; ''Of'the duals'only thoso hlghifirtftllAiH , In free SiOj ore known to ulter suHceptiiiility to tuberculosis appreciably."* \l - ' 2h . r? PLAINTIFFS EXHIBIT Tho author would agroe with this from Ids personul experiemfo. It other words, ono would not expect a high percoutsgo of tuburculosis amom workers exposod to tho artificial ubnuiive dusts. The Snrunac l.uborntoriea liuvo made a number of aluiliea 1111 unituul of thu activating effect of inorganic mineral dusts upon tho luliurclu buelllui In un experiment per/umicd several years ngn it wu:i fuiniil Hint III Inhululioii of silicon carbide dust activated an alleiiiiuled l.ulmri'lo bacillus i the experimental aiiiuial. There was no nctivalbm by nlmuimiiii imde iIiihI. Tlda experiment has not ao fnr been borne out by tho expoilonen of two u the largest manufacturers of artificial abrasives in the IJiillnd Hiatus. I both companies the incidence of pulmonary tuberculosis was approximate! that of the population of the community. In one company thu Incidonc was a trifle less and in tho other a trifle more. Thu author believes that those cunea which linvo occurred aid due to III breaking down of n previous inuctive lesion as 11 result of tiiua, or to Intel current infections, nod represent wind muy bo expected III uny eoinmiiuit . of workers. Pneumonia, bronchitis and similar chest infections do mil appour to li more frequent umong those who are exposed to thu nrtificiid ubruslvo dust These workers do not appear to bo more susceptible nor does their dlscar appear to be more suvere or protracted than among men employed ulsowlicr The only treatment for pneumoconiosis hi preventive. Once tho dm is lodged in the lungs it cannot he displaced but, us bus been pointed ou its presence is in most cases harmless. The basis of prevention Is removi of the dust at its source, by the means of hoods mid suction. This Is u engineering problem end will not be discussed here.* Thu next best preventive measure is the wearing of respirators. Th is difficult to enforce, aa workers find them hot und in soino types heav llowover, tho respirator affords excollent protection und Intelligent workei cun be porauudod to wear them. They are of particular vnluo when II workur must do Home special piece of grinding work in which there I* great deul of iIiihI, und no cxhmiBt cun ho provided. It must he reinemberi that the fine inhuluble dust particles remain In Hie air ns long as three lion aftor 11 dusty operulion Iiuh been completed, so that workers in the nr< should wear respirators long uflcr the visililo dust disappears. There has been e great deal of discussion au to whiit is permlsslh dustiness in the nir of n dusty department. Hatch4 hns set the figure 60 million particles under 10 microns per cubic foot of air as being t' . upper limit of non-siliccoiis dust ulluwuhlc. The amount of dust Is dcti \ mined by a dust count made with thu slandurd iinpiuger and counted 011 .' specially ruled slide with light field illumination. Dust counts, as an ini cation of the health lioxurd, arc on tho whole unreliable. They are weatli vanes only, aa they represent the conditions existing ut the time of t count anil at no oilier time. A high count poinlii to the need of engineer! rorrerliiin, hut 11 Imv count dues not mean uhscuro of hazard unleiis obtain again ami lignin. The amount of vii ible dust in a gniul Index of tho omen of invisible dust preHcnl and may well he used 11:1 an index for tho nccijsai of u dust count. There hns linen a tendency in llio pust to confuse llm pumuuoconio cuiimoiI by inert dusts with slllcoiiin, 11 disease raiised only by ftoo sillcs. 1`nciiimiennlotilH Ih n general term to indicalo lluil ttio lungs have liiluil some type of dust. Hilicosin means Hint the type of duHl inhaled contain 29 j*v< I-!).!.! 7;~> | produced set i - V : - i" " certain percent of free bIIIc*.,';,A* the inhalation of duat containing free , ( h Iv . allica ia known to be harmful, and alao to render the aubject euaceptlblo to Vf pulmonary tubereuloaia, It ia Important to obaerve the diatinetlon. The dusts 1 l,i1t ' >.of the artificial abraaivea do not appear to be harmful if the exposure Isilf'* V'v.Vl reasonable, nor dc they appear to Inereaae the ausceptlblllty to pulmonary tubereuloaia, ,; I In order to check these generally accepted beliefs concerning tlio artl- ' , ficisl ahraaivu dui.ts, the author has written to the phyaiciana hoading up fa il i;i , the medical depaitmenta of twenty-two companies which are the largest stii Iuaera of grinding wheels In the country, to And their experience with pneu- vYV` moconloaia caused by the duat of grinding wheels. Eighteen replies wero !> , ft.:-. received. In no case was pneumoconloals a problem and the Incidence of ' tuberculosis was bw. Naturally these companies uaed the usual protection nf iIiinI fiilmiiMl* i ml rosplratiira for special types of work, but It Is extra 1 ordinary 4o obis I a the same answer from su many illireront Industries. . Several iiianrume cninpxiiius which are among the largest and which insure gainst industrial accident made similar reports. They found disability arising from the ise of urtiAclul abruaive grinding wheels was not one of ^ their medical problems. V The author hsa followed employoos for over thirty years who have been exposed to the ini.elation of artificial abrasive dusts In amounts very much , ' greater than occurs in the use of grinding wheels. Tho mnnufacture of . these wheels abounds in dusty processes, many of which hove tuken yenra of engineering experiment to eliminate. From this It would appear Mint the experience among the workers of hia company would bring to light in r, dramatic fashion uny severo health haxard duo to tha Inhalation of artificial '* abrasive dust. Several studies hacked by continuous observation, exumltia-'!? lions, and x-raya have fallod to disclose any deAnlto health hazard to tho healthy worker. Aa a further check, all thoaa who have been exposed for * ii5 year* or more have been reviewed with the following rcnulla: Total number reviewed.............. BO .. i. s In good health end working............ .. 87 M>(.' s. . . Pensioned but In good health..;.''. B ... ; .* * V: ' - l' v None of these men appear to have been effected by their many yenra of *','' ,'.'. exposure to the conalituenta of the artificial abrasive grinding wheel, . fji-V ' Of deaths from pulmonary tuberculosis during the past 28 years one. STl ?$'''* M third have occurred among men having had exposure to artificial abrasive IlM'/i 'i. ' -' duals, two-lhirda among thoao having no such exposure.; Tho proportion o/.^*-iV'f'4.V; '* men working in such exposures to those working elsieewwhhere ifa about 26%. 'y'-/'' I '$,! .(ll\ : This docs not give a complolo picture. Almost all the men in tills group J ;? IisJ had exposurt In dusts other than abrasive dust at somo time durlnir' i their period of ei iploymcnt. . In Iwn eusi:N where niitopsles were obtained ,v*A1' . '.**$ win suggested, wuirJi hud not heen suspected nor llimjil history. To ipiotc from the .Saranac report . "Ilather I linn ettrihuto ilia nodular llh the action ol Sit', it would scorn prcfernblo, In view of prevlou experience, to UHsume that enough quartz (0.3%) was present to1.!.,'; cause u slow reaction. The source of tho fr allies cannot bo'-vife: ` established." ` .*10 'b i \S, ' and from the other: "In view of the multiplicity of factors Involved In producing this advanced disease now suon in a terminal stage, It would not seem proper to draw uny conclusion as to Uio eliologlc role of SIC as a cuuae of fibrosis. Judgment will liavo to ho reserved until somo simpler coses, uncomplicated by Infection and coincident exposure tu free silica cun bo studied." In this case the lung ash showed 6.7% free silica. Wo were unuble And from his occupational history or from his work where this exposu occurred. I quote these two cases to show how diAicult It Is to get secure Information and to show why it is aa yet necessary to depend upon co: piisite experience here and abroad, rather than upon statistics In determ lug lint prtdmldo hazard of tho inhulalion of urllAciiil abrasive dust. 7 Journal of tho A incrieuii Medical Assntdullon hiiiiis up lint hazard as follows "Only hIHcu (SiOJ is capable of inducing silicosis bill any other . mincrul duat under conditions of prolonged and gross oxposurc may enuso some Increase In pulmonary fibrosis. If the relative potential burin of silica Is raluil as 100, lliimii other nmi-ltixle min eral dusts may be rated only on an order nf li or 10. Moreover, the fibrosis Itself Is not pathognomonic alnco many other dusts, alkalies, acids or vapors mny induce somewhat similar, If not Identical, x-ray markings." The artlAcinl ubraslvos belong to tho group of non-loxir mltierul du referred to above. ' REFERENCES t'a.,I. Plllrnsls nod Allied Tdanriliirx: Mmllcnl Serli.n, lliillutlo No. I. Air Ifygl Foundation of America, Pltlalnirali, 1937. 17* Iuim. J. I.anxa, A. J.: Blllcoala and Asbsstoala, pp. 114-125. Oxford Uulvsralty I*r 1931. 431 puses. a. (Inrdnnr, I.. If.: Tufioroolosla la Indoxlry, ims HO. ` Nollonxl Tnbarcul Aummlullun, Now York, N. Y., 1941 174 PSK" 4. flnrdntr I,. II : Hlodlrs In llio llnlntlon of MUoirnl Duals in 'folmn-.oloxlx. Itev. Tulierc.., 7: >44. I9Z.7. I. Atiinrl<'ii Unndurd for llrlndlng, Polishing noil linmng l*nil|.ini>iit Hiinllui AiiHtrlrnn a. llnlcli T : Hninn Fliniliiinniilul lints oil Mrclniiilciil I Mini .Aionrl'.nii liistUnls of Mining anil Melnllurslcol Hoiflmonn. Trails, pi*. Nnw York: I| I Pali. No. 637-A. 23 pages. i. Jnorlinl of Ain. Moil. Asnnc., Nolcs nod Queries: 103: 1172. 1934. 4 .. I*.. FURTHER STUDIES OF ALUMINUM POWDER IN ` COMBATING SILICOSIS . J. L. BLAISDELL, M. D.* ' '" ' A year ago at this meeting 1 sulnnitteit preliminary report on lhe: '. tffocU of the inhalation of metallic aluminum duat In silicotic individuals, being applied aa a form of therapy in individuals with already establishedj)j! ^lillt-oaU. This work has been carried out in Timmins, Ontario, which is the t ^ comer uf the Canadian gold mining Industry. ' a' : Briefly, to review the story, theae mlnea have been engaged In researchUr .1 work over a considerable number of years In conjunction with researchftj 1 '^workers in the Bunting Institute, notably Dr. Dudley Irwin, the work bctng% . '`parried out under the direction of the lute Sir Frederick Banting. r'-i far* ' H was found by threo Canadian observers, Drs. Denny, Robson, and . I inOn> Gist the experimental production of silicosis In animals could be pre-S __ ` * X ycplei] by tbe use of fine metallic aluminum dust. If the silica dust to whlch^'Sj^/i' jbeif animals wero exposed contained one percent of finely particulatefjjHy-7 ' aluminum, the animats did not develop silicosis, whereas the control animals receiving silica dust alone developed silicosis quite comparable in character ;: to the human disease. These observe.ions were published by Drs. Denny, Robson and Irwin i&) Yi , in IV39. I>r. Crornliie and I were asked to form an Independent committoe'. <),V . to investigate these claims and to determine whether or not the inhalution of metallic aluminum duat would be of any benefit to those who already had - / the disease. " 1 might emphasize the fact that these research workers that I hovo'^lrV ' '*mentioned did not suggest, in their communication of 1030, that aluminum dust was of sny particular benefit in the treatment of silicosis. It was ..-advanced merely as s preventive or prophylactic measure. Y&, For this purpese we established a clinic in Northern Ontario, and seloc-?r' Sited a number of cases of established silicosis that we considered suitable* : ftor this form of treatment. Although in title center there are approx!*',, V..mttcly 300 esses of silicosis, we selected only about 60 at lioing suitable forw ! treatment. We attempted to And cases of ailicosis that were uncomplicatedyt ); U j.y infection, cases thol did not have too much emphysema, eases uncompli-.>i Vacated by other diseases such as nephritis or syphilis,,and men also whojl: iifhsvs been exposed to dust recently. We did not select any.cases that hadF been out of dust fir any considerable period of time. As a matter of fact.v v'v'Lthe majority of thi cases that we have treated were exposed .to dust contin-^j '"* jsuouily, curried on their ordinary oeeupstion as miners, and had a certain^1 _ amount of exposure tn silica dust all through their period of treatment. ` ` The theory behind this work, of course, is that metallic aluminum, when. jijt f inhaled into the lung, in the presence of tissue fluids forms a coating of ono Jri 5, 'vof the hydroxides of aluminum around the silica particle, thus rendering lt'ts^ ^'Aiinjolublc and prexenting tho formation of silicic acid, which we feel Is tbe}^ .Tujnnjuriou* agent. . `fe V*-Jf v Rcfors treating these cases we studied them very carefully by clinical; spd x-ray cxsinlmtion, carefully taken history, and by;resplralory function*;1 jftyiCtekjj described by Professor McCann at the University'of Rochester and byJ|: '* y.ty`*tf'"orkera lh sre. l: . -I . -ijp The dust that wc used In this tToatment Is specially prepared In a mlliijl >&& ppp*un" A]>u* n4r Banltorium, London, Ontario. { 82 l ."1. JI. , !.jr'I j.\ i- PLAINTIFF: EXHIBIT of this sort. There is an aluminum cylinder imclored in a box lined wit soundproofing material. The aluminum cylinder contains 26 pounds of sms pellets of metallic aluminum. Tho cylinder Is rotated by a motor, with reducing gear, at about 80 revolutions per minute. Tho uluminiim pello grind against each other and produce an extremely fine black dust; near all tho particles of which are undor five microns in size, n great many them under one micron. Wc have Imd this dust exumiiied with the electn microscope and have been surprised to find how fine ttiuso particles aru. , The mill Is onelosed, and an ordinary glass bottle acts as a sedlmentii chamber. The sir entors the mill through perforations In the sliuft, whl is hollow, flows through tho mill and becomes laden with dost. Tho larg . particles of duat settle out into the sedimenting botllo and the subj< | breathes from tho top of tho bottle. Thera Is a two-way vulva which pi 1 vents re-breathing Into tho ayatem, and a smull, short moutliplecu. Treatments woro given daily, beginning with five-minute periods n gradually increasing to thirty minutes daily. Periodic physical oxamii itlons und x-ray aludies of theao men were mndo throughout the course |: treatment. We also carried out n large numbor of tests of respiratory fui tion, including lung volume studies, studies nf total pulmonary cupuci ventilation tests at rest, during a standard period of cxurciac, and followl exercise. Of the fifty cobgs selected, only 34 have completed a satisfactory num of treatments to date. Some of these men iiuve recuivcd as many ns : treatments. Tho majority, however, have received about 261) treatments. I may say that a similar investigation linn born undertaken recently Dr. J. W. G. Hunnon, of Washington, Pennsylvania, uml his results so ,1*. obtained tend to confirm our own. if . Summary and Conclusions ' f'l-l J This investigation has shown conclusively that the sdminialrstior aluminum powder in the manner described is untiroly harmless and proven definitely beneficial In a number of casus under our observation, of 84 esses studied, 10, or 60 percent, have shown clinical Improvetn appurent chiefly In the lessening nr disappearance of slmrlimiiH of hre of cough, pain In tho chest, and fullgue. A reduction in th Incidence of e and a gain in weight have alao been noted in many of tho ruse*. > ' While 14 cases have remained stationary, It must Im emphasized ` they are no worse and their condition has mil jit-ogressed, In spile uf 'tlnuous employment In silica dust during tlm period of our invusUgulii ' The respiratory function tests, repeated at intervals of ovury I f months, have shown improvement in 13, or about oao-ttdrd of the tri cases, while 22 remained stationary but sre no worse In spile of cent! exposure to siliru dust over a period of about two and a half yours. A group of controls, untreated by aluminum, have shown progro their diBcnsc in 06 percent of tho rases, while they wore under ohservut Aluminum dust cannot be regarded in any mmso mi n cure for nil so far a* restoring normal lung tlasuo whirli Iimh aliimily undergone fit change is concerned. Its use, however, appears to ho followed by bum results in a significant proportion of cssen, chiefly in (he nmelioruti symptoms end in the Increased enpneity for work. 1 In view of these findings, und the experimental work of Penny, it and Irwin, we hctlevo that the Inhalation of finely pnrticoluto inctalli minom powder will prevent the development of liuniuu silicosis. -1/-V > , v S3 v 00.117S PRODUCE! IM - B3 a;.-:.* A, PRACTICAL X-RAY TECHNIQUES TOR MASS I'll Y8ICAL EXAMINATIONS ' i * E. P. PENDERGRASS, M. D.* ,t : r V During the psst few years roentgenographle, surreys(of the'cl)6itr of :.'4,U|-ge group* of Individual* has(becom* an Importantinewf addition,',to'the practice of medicine and public b'ealth. Under tbe'etlnralurof the wipVUil , method ha* been *o extensively employed, both by the military senrleesTand t, by Induttry, that it hu* already acquired refinement* and established a repu-' talion for reliability, which in ordinary time* might have taken many years', (o attain. > listmFcrnolmantdhepreex-pini-driui-cntcioenofrotehnetgmeniloitgarrayphseicrveicxeasmIinnaatieovne*ruol fmlliiloliocnh_ep_aart,oitL-hee.E^nf^l'vjwitf&i following fact* may be stated: 1 1. At least 76 to 06 percent of early active tuberculosis can be ,i ',1 discovered only by x-ray examination*. . . '>-'ir.! 1 <*v*v* About one percent of the male population of military age in the ` i, United States huve uctive tuberculosis, and most of the cases can be deleted only by x-ray examinations. . , V S.! , A high proportion of case* of early tuberculosis detectable only . Vi-; fi 'by x-r*y examination are likely to break down'under such.- StJgt**!',' fi ' strain as that entailed by military duty, Incapacitating lherr\ V. j fr further service und making them menace through conta-^.-.^.if 1 glon fa their comrade*. 7. .1 1 4'.1 | Roentgen ordinary e lamination of the chest Is'much m.'thods of phyilcal examination, quicker a* well than the'! as being 7/!.' more reliable. ,^ '.Oi; Roentgen examination furnishes an authoritative'and permaJ-qV^^Q ,.'*.hrgij^V}'nent record which may be'lndlspensable In'future med1co-1ega1. , J . ' adjustment That refers not only to the 14 by 17 paper, but ` flSK? it refer* particularly to the smullor methods, that la, the 4 by." .*"* 6, the 4 by 10, it by 4, or 16 mm. film. ' ``r.-tr ( Many othci discuses in addition to tuberculosis may be tliseov^ *yrrd in mass surveys. . i , j ,.' '>' . '.7. The procedure will amply repay the initial coat, by the saving^/?. . j'-'. of effective military manpower and the reduction of the ultl- male coal to the Federal Government In pensions. ' . . These principles me just ns uppliciihlv to industry us to the militaVr'y$- iW ' services, for in these days when the maximum in human clfort ia needed, lhe^&&!v$jjlkl / , indur trisl worker must lie healthy and protected from the ill health of tlie , ..ifniati hy his side. Furlliermore, industriul management imisl be kept fjom ' .'IQbearing the burden nf futuru liability llirongh ignorance of the state of ujV .`'worker's bi-alt h upon einployiimnl. It la n fuel that soleclive nervlce hoardanj . vf.aro turning down men with heart ami lung lesions who may ultimately upplyj .'J|,|o various industrieu for juhs. It is likely, in tho present nmnpnwor scar 1 * 4 - --;---------' f |>*[-ar<m. nt ul ;. . Ilelii.fil of Msillclns, llnlvaralty of l'simsylvanlu, m- ; . - '< : city, thut u great intniy fndlviduuls with cheat lesion* will find emp/oymen And it Is a foregone conclusion that the nature of this employment In man Instunces muy tend to fan the coals of a pre-existing disease that may I lime incapacitate not only the new employee but lend to an unnecessary an hnzardou* exposure of the previouely healthy, the older und more axpei ienccd worker at his side. Now as to the title of my presentation, "Practical X-ray Teehnlqui . for Mass Physical Examinations," I do not propose to burden you with sue :a discussion at this time. Instead I would propose that the Trustees of th Foundation appoint another committee, or uae one of its present committee whose function it would be to act as an advisor to thosu of you who have problem concerning the Jnalilutinn nf a program nf iiiiihh surveys of tl chest. Such a committee would be in a position In help hiiuiII uh woll t large industries in these difficult days. OOl'l I ; 1*1 ft ! t .V 1)6 It PLAINTIFF'S EXHIBIT PRODUCED I I ll- > . . i ' .t - i- I i ... * nr liftV*ir-$.! I A< !/!., . OCCUPATIONAL DRRMAT0BE8 IN THB.WXB INDUSTRIES 2 PLAINTIFF'S EXHIBIT 'J r.ouis scnwARTZ, m. d.* oiii'ft' . ...... iV* ,. Introduction *. *i.* t;- . 'y> . , For simplicity, thii paper I* restricted to | dermatoses affectlnglonljr)! U>oi engaged In manufacturing materials for aotual combat. Includsd'or* airplanes, tanka ind otln.r armored vehicles, motor*/ firearms, explosive*/1 ^and vesicant and Incomndiary agents of chemical warfare, .; ` '-it&'im r.enecal Considerations, ' Worker* muy be affected not only with occupational dcrmatoa"bvbut, like Die general public, with akin discuses not of Industrial origin;' Since tbs ( iiuso I* a factor in both the trentniont of a dermatitis as well aa ln the .l prevoutlon of recurrences, every effort should be made to determine ithslffl causative agent. 11 is essential that this etiological diagnosis be established;? whenever possible in all dermatoses occurring among industrial .workera^; In order to do thin, consideration must be given to the history of the derma-'' litis, to its distrit ution, and to its appearance. These must all point to th$;, worker's occupation in order to confirm tho diagnosis of occupational dor-; matltis. In many doubtful cases, tho patch test must be employed to differ-', entiate the condition for dermatitis of non-occupatlonal origin, and some.;1 . : time* to discover the actual irrltant.i . .( ^ Treatment J'A. 'F^- ^ . Once tho diagnosis of occupational derraatlUs^la.M|^b)jglie'd, the'tr^tt.^' . ment should be directed toward protecting tho akin jjrofn ur|J)Ofinjury ' Only the mildest medicaments should be employed In'n^ute pjaaoaT ;Jn'.veslcu. lar dermatitis, wet dressing of boric acid, BurowV solution, pr^ptlamlao !' lotion may be un d. When the lesions ere no longer molflt^I ' * " ' ` ' !>V;or jjorlo acid ointment may be applied. '.. . 'i ,|rf .ij(\ i . Mild case* should be permitted to work*whJlpl|ijt|aVVv|fca^pn' often become Immune or "hardened" after they recover,^8|Ysrorpa(f .... ; bo removed from the irritant while under treatment^'RppiitTept'caieg ahdul be transferred to jobs where they do not come In contact with the Irritant. 1,` Prevention For individual protection personal cleanlinesVj'lf Af{ prime,. Sufficient washing accommodations should ba provide^ and sufficient1. r allowul for the workers to use them adequately without fear of,missing transportation to their homes. ' v Protective Clothing ,, Protective clothing made from Impermeable materials is preferTM t'hiixc it runnot l.j saturated with irritants. Rubber, synthetic rubber,-li . thetic resins, Icitber, oilcloth, and other lmperv|ou* fitbr>< , qu|t*l{]e _ protect against tho particular Irritant should 'be.'pgedjtfnr'glpvgg^lalej uprons, or coveralls. The clothing should t;e olegped'dMIyj^'-^' ' When glqvos nrc used, sleeves fastening ovyrtho^glaves -W" Mtfllr*! Ulttclor, 1 >cr mu tuuea liiVMtl(llun Uv^(|upr Hcltwaru, LouU, *nd Tultpan, hou'*'.A lh Skin. Philadelphia, Lea St Feblfer, 1119, L* * will prevent the irritant from entering the glovoa. The Impervious sleevi should reach well up the arm. Vent holes near the topa of the sleeves wi permit the perspirutlon moisture to evaporate. Leather glovea should I made of soft, wushuble leather or chamois. They should havo no rouj seams to irritate tho hands and Angers. All protective clothing should I Individual and should not be used by another worker until it Is wash. . and disinfected. ' Protective Olntmente , .Protective ointments,should be used only when protective clothing Impracticable. Only such, protective ointments of which tha composition . known should be used. In this way It is possible to evaluate the protectl , value of the ointment.9 There are two types thnt may bo used against cutting oils and solvent tho water-soluble (invisible glovo) type und the innocuous fut typo. T ' . Arst lends to ropol oils and petroleum solvents; the second prevents tin from entering tho pores and also buffers their action on the skin. The washrooms should have a good industrial soap available for t use of the workers. , Such a soap should be freely solublo in hard, soft, hot, or cold wat It should not contain abrasives or irritant scrubbers. It should not contr , added free alkali. Special cleansers should be provided for workers who ha . dormntitla or who cannot use the ordinary soaps without damaging tho sk Sulphunatcd castor oil neutrsl In reaction, to which 2 percent of a syntlie wetting agent is added, makes a good sonpless cleanser for such workers Culling Oils ' Cutting oils are tha chief causes of dermatitis In tho inauufucluro motors, tanks, shell casings, projectiles, aiid airplanes wharovor cult and turning of metals Is performed. The oils ura divided Into two la: groups, the soluble and the Insoluble. . The soluble cutting oils rarely causa donnalllls, despllo tho fact t they are usually teeming with bactorla. - Tho Insoluble oils are usually sterile, yet limy are tho principal cau of culling oil bolls und dermatitis. Tha mstal silvers In Ilium may wo< the akin; tho sulfur, chlorine, and Inhibitors they contain may Irrltato akin; the petroleum oil Itself muy plug the pmiis, causing cumcilonu* wl nmy form bolls if infected by bacteria from dirty clothing or unwashed s The hydrogen sulAde and sulfur dioxide generated in milling ells the heat of the cutting operation muy also Inltule the skin. Seme cut' oils contain organic chlorine compounds. Tlieso urc particularly Irrltst causing acno not only on the arms and thighs, as do other culling oils, ulso on the fuco, neck and body. Kspecially Is lids tlm ease If (boy vapo or give off o mist, its tlioy do under heuvy culling conditions. . Tha petroleum portion of tho oils also lias a defutting action on kin, which after prolonged use may cause drying. Assuring and crack Somo petroleum oils also hove tho property of causing keratoses and rnro cases, akin epitheliomas. i"l 9, Schwarts. Ixmts: I'rotsctlvn Olnliomils ami loilestrlul (.'Inuiisois Tli Mo An>Clinics of Norlli srlca, July, 1HI, p|i. IISI-IIIZ. I'lillsdolphls, W. B. Baui produced , .. , . .# ; ^ , The treatment of comedones,' folliculitis 'and bolls consists of cleanliness ' ' i'1 end mild sntiseplics, frequent changes of work clothes, frequent washing' of I ',j the skin, and surgical evacuation of pus. For dry, defatted skins, an emoN ' 1; llent such as cold cream or lanolin 70, castor oil 80, perfume 1, may be given .'to the worker to rub Into the skin after work. > ' *.j.i I'retfollon , ^ /ij.*-i' \-ys l*revntion consists in cluanllness of persons, clothes^piaclilnps,' and oils filequste Washing and bathing facilities; suitable soaps and cleansers; atjflT / jVyflpnt clean towe a and waste to use at work. Frequent change ;of work' clothes, intperviois sleeves, and aprons on some jobs where there Is-excess'* ji'flte contact with the oils. Protective ointments should be ueod only aWi '' other measures lire Insufficient. They should be of the type that Alls the ' 1 pores with an innocuous vegetable or animal fat, thus preventing the entrance of the rutting oil. The weter soluble "Invisible glove" type of *. . ointment mey also be used. 4 .. ' . .( * , 7 -, * ,| *i- j. Dopes, Paints, Thlnnere, Degreasers and Other Solvents * V5*t 4 " ' Solvents produce dermatiti* by defetting the ekln. They may also cause* .. . | allergic dermatitis. .... :<['< fi; - ' "Dppei" used on fabric parts of airplanes can cause dry, chapped handa ' ` . t PJF ecute ocreinaloid vesicular dennalitia of other portions of the body. - > '\~f j Paint thinners, petroleum solvents such as ksrosene, and Varsolact'' t.Vnln a similar manner. iy (; * 1,19 ?un'a ot lhc solvent chlorinated hydrocarbons used In.dogroaislng^ #* fev ISP*** ao,netimes esuso severe allergic eczematold dermatitis. . : -,v ; . .'4 / I **: The treatment of dennntltla from these solvents js the same a'*de^ , < scribed previously. . ' < ;t, The preventive measures consist chiefly of Impervious protective sleevesi^ iLXdc fprjms, and gloves. Gloves for painters may.be of leather orcanvae^byp1* ilHH* H*' petroleum solvents should wear aynthetjq rubber gloves, -Pro-} frifjil lefHw.pintmenU-. of the type described under cutting oils may:be used oil ;V*VD; ,g 5f |'[he face end neel: of sensitive workers. . t ; "H-v* '-' Electroplating . !<: ,'P \ '] j 1.' '/' Electroplating Is primarily s rust preventive process.-, Chromium I oj| cadmium are the principal materials used, but sliver, sine, copper, .-i nickel are also frequently employed. In additlop, there aro a number.o (lj|Ji' rust preventing p. rocesses: .porkerlzjng.., chronindiz|.ng..,..a..n..o..d..i.z..i.n..g.., etc?.' ITn.>' ir \ jbese processes .he tanka contain strong alkaline or acid fluids which giro i' off Irritant fumes. (Ilcera of the nasal nop turn resulting in nose bleeds, and? | / . even |nrforslion. arc common. Dermatitis is frcqunnt from rniat nnd fumes . -j coming off the n'kuline, cliromic ucbls, diebromate, and cynttblo solutions In ' 1, ttie plaling tanks. Dermatitis also occurs among those who clean tha metals . ' with strong acids and alkalis prior to electroplating, and among those who' | humlie the wet melnl from Die plating plants. . - .. Thu workers miaul mucosa should ho protoctod with olntmontq^UV,' ' }r lanolin or vstoli ie, (never earholuted, heenuao of possible harmful feacUo' 'front the phenol). Protective garments should be worn. (See soeoottllon-t V.lV`7 protective clothing.) Welding Welders anil aolderera are exposed to irrllnling fumes. Welding tainleis steel and aluminum alloys requires fluoride fluxes, which svol fluoride and hydrofluoric acid funtos. If not properly removed by auctl vents, fumes may Irritate the nasul mucosa nr sklit. The uuatrlla anil al should he prolcrlud with non-carbolntcd vaacllim nr luunlhi. Thu skin rni .also be protected. (See acctlon on protection.) ' .. . Tetryl .. Trinilromethylnltramlne, commonly called tetryl, will eenaltlze a cause dermatitis in from 10 to 15 percent of all new workers, one to t weeks after they begin handling it, although In a few cases It may requ several months for sensitivity to become manifest. Workers coming contact with the ilusl from dry grulns of tetryl urn) from tetryl pellets i more frequently affected than those handling wet tetryl. Those exposed the dust may first develop nose bleed or bloody discharge from the nc The nasal mucous membrane becomes turgid, und amutl superficial erosi, may sometimes he seen. Distinct ulceration of the mucosu has not h> observed. On those exposed to dry tetryl, the durinalilis usuully begins the face. The naso-labial folds und the skin under the lower eyelids first uffecled. There may be sufficient edenm to close the eyes. The s may he blistered nnd liuve the appearance of a second degree sunburn, isolated cuses or where the history of working with tetryl is not known may be attributed to coemcticB used on the face or hair. The hands i other portions of the body coming in contact with tetryl will bo disco)o to a yellowish brown. These purls may also be inflamed. In some opt lions where email amounts of tetryl ora handled und where there Is but li dust, the hands and arms may be first alfectod. The huir Is etalned a i dish brawn In brunettes and a yellowish red In blondes. In some cases genital und anal regions become stainod and even inflamed bocuuso they touched by tetryl soilod hands. Points of friction such as the collar I the wrists, and the areas on the hands where tho coarse seams of heavj poorly fltting gloves rub the tetryl Into the skin are favorite sites dermatitis. Prevention ' Operations where there is much tetryl dust should |>u properly veil Workers at those operations should he supplied with soft, wusliuhle leugloves and impervious sleeves und aprons as well us with u prolec ointment. The fallowing formulae liuve been found In he good protec ointmentu against tetryl: ' ' No. I Shellac ............................ I'! Isopropimol ........................ Ill I,inseed oil ......................... 4 Titanium aside .............. I'd Soiliiiin perhorule .......... Ill Taleiiia ................. ... . HO (,'ui'hitol .......................... :i Allow to stand for 4H hours and decani Ihe fluid accumulated over tlm surface. 80 produced t.i-r Vi- ( I' , , I* : !{'. ,N '. )>/- 11 ' -,!*" 1 " - .. : %:Me>;!- , \ -tr ` Casein t Zinc Oxide ....................... 20 Yellow oxide of Iron....... 2* Water .............................. 68,-. , The ointment can be applied to the face and hands` be*f' ore goln'g l-t*o' wqVrkrwy removed at lunch and re-applled after Innoh. The workaniflUlpHraqre,^ y ' (lelonetors, and boosters with tetryl should be supplied with light'chamois'll ; washable gloves ns well as with sleeves 'and aprons. If for any- reason''/ gloves cannot be worn, the protective ointment can be'used. All-workersjffl - need not use these protective measures. Only new workers and those who; are sensitized to tetryl need to take all these precautions. Tho worker whoi*!^.. ... has been exposed for a long Unto without taking these precautions and haaiCijLiiflTiSlt not h>nl dermatitis tiood mil do so. Neither need the worker who has become .. . I'lisrdeuud" or Iiiiiihiiio following an attack of tetryl dermatitis. II ;work. e,rsA!;' - 1 Sunervlsoil showers lifter work should he compulsory for a J i posed to tetryl. ( All workers in the nitrating, refining, drying, and packing housea should provided with protective ointment for uae on the face twico dally. Th should also be furnished with soft, washable leather gloves and impervio sleeves and aprons. The sleeves should fasten over the gloves at the wrls' , In the packing, boxing and drying houses It may bo of advantage to furnl . the workers with transparent impervloue heed and face coverings to proU '! the faco. ' To perforin patch testa with tetryl, place u siimll nniouul of tho powd on un iicetone-moistcned piece of gauze about 14 Inch aipiare und 4 pll thick. Apply to the normal akin, cover with n pluco of cclhipliiiiiu 1 in square, end this with u 2 inch square piece of nillivsivo plusler. Allow remain on for 2-1 hours; end then read the reaction. Item! again !l ilii later for delayed reactions. Tho gnuzo may ahin ho niuliiloiiml with saturated aiilutloii of tetryl In ucctoou and applied us a pntrh teal. TNT . VM'v Treatment of Tetiyl Dermatitis . . ' . -.:,l i..viP, Mild cases of talryl dermatitis, that la, where there la but littlejedemajK . Sid of face and eyes, may lie permitted to continue work and cap be given wety'vi^t^j^tfj dressings of boric arid or uluminum acetate to uae at home,'and boric scldijjRwrljJ^ile] ointment or zinc oxide ointment, to use while at work. .Only sevore caafla!r,'J^4i...te!'^s , or those who cannot get wall while at work need to be removed from the,Job,! - Most cases get well while working end (hardened) can .continue work wltb , out further troubli. About 60 percent of thoae who; arq,-taken-.off ithejob In order to get well can also return to work without.further, trouble.| The# others must be kept awsy from tetryl. . +j *? i*_ . t ; , T * Tetryl indelibly stains the skin, but,the talns cijjiha)a|njpstijuitIrj!J; by, continued washing-twp.pr ttyefr s /fftfong'sodlum salJu solution, anif'thJsIfolJowsJiby^sosb^p^J^t^'IjiT)' ' * ' stslnlng of the heir can be prevented by wearing:lm^fl^fqqfcdaii>4l'ilp]YvVqe<> I4 the heir Is stained, jt Is best not to attempt to restorerUs eqJ.qr.UItUb'ett .t.o...|.i.r.c..v. e.nt .f.u..r.t.h..e..r....i.t.a..ining *b-y--w--e-"ar*in*g---t-h-e---I-m---p-e--r-v-lou* s-os-p-,-aandJ)ho' h:e-wM-Ji as H grow* out wi J not be stained. , . 'iTv-'-ni - In it workroom where there ia TNT dust, tho newcomer experiences bitter taste. Trinitrotoluene causes sensitization dermulllls In a smeller porcantu; of new workers then does tetryl. Tho dermatitis usually huglus In from to 14 days after work with TNT Is begun. It usually ultacks the ham wrists, and forearms, but the points of friction, cullar line, belt line, ai . . ankle are also often affected. It la unusual to find TNT dermatitis on t faco, but the genitals and the aubmammary area are sometimes affect from soiled fingers. A generalized eruption inuy also occur In rare cast Tho lesions on tho palms arc characteristic In appearance. Tliuy are dee seated sago-llke vesicles and are accompanied by considerable edema a1 discomfort. As the dermatitis subsides, the akin on the palms pools In lar ijV '.'thick pieces with new skin beneath. Hie lesions on other parts aro not 4 ' characteristic as those on the palms, consisting simply of papules, veslcb and crusts, followed by flaky desquamation. TNT also atalna tha skin a ' discolors the hair but not as much oa tetryl. Cyanosis or hlua lip la full frequent among workers exposed to TNT whilu It Is rare from totryl. Thu preventive measures, including protective clothing, olntmen Telryl Manufacture ,, j, , . . showers, etc., and treatment given for tetryl dermatitis, also apply to Tt i ' - UW,o"r-kLei!risi at the oiienliigs.of retdrU 'used /or splfaUpg are.'exp^Mq, ,, dermatitis. ' ' fumes and splaslu'i of sulfurlo acid, dlniethyl*nl|lqaend-anl|Jno(iulJ*k;*nt should be provided with impervious yleevea, aprons/' *n^ '8*oyes.^'i,V^jjd^^ In the nitrating building worker* at the nitrating*.refort *wi| axfeqaiid] to hoi tetryl, tin; adds, ami nltroua fumes. Blen stlrrlngwet tetryl CrystalsJ In the tubs, ami tluso whu transfer tbo wet tetryl fronvthe ^pba to'Vwoodoni carrier* In wliich it is curried to the refining buildings^ gi^f.lweT tjptyylL'oz' llifir clulhe* and hands, and wli^u the tetryl dti^^spifjevpf Uy^ * r ! tfcyulop dermatitis. .In the refining-building ths wplkMjJ|J((}j)(r%( to wot tetryl ae the refined wet tgtrcl'll1 s*hoveled;f'lWljvjlprJqH.C1transportation to the drying' JiQuse.j |ii the.dr^ngHi^f&l^iin ( c' '** TNT Manufacture Men working over the nitrating retorts ore exposed to fumes a spluslics while inspecting and sampling the progress of the reaction. Th should l>o furnished with Impervious slacves and aprons, and with Icatl or cotton lined rubber gloves. Tim workers in the work bouse, flnki house, mid packing house should also he provided with wusliahlc, -chamois or leather gloves nml impervious sleeves mid aprons. Patch testa with TNT limy lie performed in the sumo niniiiier us i scribed for tetryl. is t)ijck on the floors; walls, largest percentage of totryl 4emgUtiivoccura.atnquVq>^*V*fl Wntf of the workers In the drying house develop tetryl dermatl^sSt.!Ijtl,.-, Ing end boxing buildings there Is considerable te^Udu^jronijqt^'by screening operation, and dermatitis Js fair ft Fulminate of Mercury This sensitive explosive Is used In detonators and primers. Moat of t dermatitis from fulminate occurs in making detonators, ospoclnlly In I 'woollier. In making primers, the fulmlnelo is used in wet farm, but It dr ^^.^Hlon thCe cOlothOes al.pdf-tsOkin -fand will esuso41dcrmatlllH oven on the covered pai A* . -- ><ArD as It seeps through the clothei.* The dermatitis l'allergic In character an' occurs chiefly on the face, neck, and arms. Inhaling the dust may eause> nsssl mucitls; an erythematous, weeping, crusted dermatitis In the perlnaeal;, area is not uncon.mon. Conjunctivitis and dermatitis of tho eye lids also^ir occurs. The other ingredients of the primer mix, such as antimony aulflde>jK may be added causes of the dermatitis. The treatment apd prevention aroTrfr the same as described under tetryl. . . ... ?NT . 1)NT, or dlnitrotoluene,1 also'causes 'ensitiiaVra'.*Uez7nat|tl'(^but^[paU; In as high a percentage as TNT. There Is no characteristic appearance-to` the dermatitis caused by DNT. It Is the usual ecsematold dermatitis--ery;\wr theina, papules, vesicles. The sites are usually the WTlsts, collar lino, belt-aft lino, fun-arms ami hands. The prevention and treatment arc the same oe!yv/| given for TNT. The palrli test lcchni<|iie is also the same. ' .'jU Amiminium nitrate ean cniiao dermulitls, but even in a smaller percen-;'St*, tage of workers ban does DNT. Usd Aside h. .-'&*} _ Uad aside a hich like mercury fulminate, Is'uqed In detonators iand primers, is manulactured from sodium oxide reaction with, leud nltrato ortM acetate. Fumes (iven off from this reaction produce headache If Inhaled. Unlike merct.ry fulminate, lead azide rarely produces dermatitis bnj! those exposed to It In the manufacture of detonators, primers, etc. One- patient has been observed with dermatitis who handled a primer mixture:^ containing both had uzido and mercury fulminate. Patch teats with both^ explosives were rosllive. , . / Since dermatitis occurs sorarely from ,exposppe to,1 lead azlda,jep;l#J measures for protection of the skin are not Indicated,';,> - 4 ; '? The patch test technique Is the same as described for tetryl.' m Shell and Bomb Loading *' 'Workers* In plants where shell loading, bomt>k'l6ading, trenob'fvhorlaWl loading, and renovating of projectiles are performed, are oxpoaed*to`akin-'ll hazards from all tho explnsivos used as well as from solvents; used focjtt degreasing and for piiint thinner*. j( . Tetryl may cause sensitization dermatitis usuallyVon the. fgoe.'jjftvcr* days to several months after work is begun. It will stain the ekln' smn half/, a yellow color und will cause epistaxis. Workers engaged at wolgf)lng,T. screening and blending tetryl are exposed to large quantities of tetryl'daotHj$ end should be provided with clesn work clothes dally. They ehpuld Insert M lanolin or vsseli.ie into the nostrils several times a day to protect thee niucoiiH membrane. 'l'liey hIioiiIiI he provided with a protective ointment to* me on the fuce, units, and hunds. If rubber gloves or soft, washable leather gloves, impervious sleeves and uprons ore worn, the protective nlntmont need not he applied to the hunds and arms. Showers after work should be pomjj? pulsory. if V'lV Workers engaged in making tetryl pullets ere exposed to tetryl<dus|. when filling end (leaning the hoppers and when handling tho finished potletafi They should he protected with protective clothing, olntmonti, and compulj'* sory showers as described above. .. ' q V 4$ 42 #>. v' Workers loading boosters with tetryl pollute or filling small bags'wil tetryl, and those placing the boosters Into shalls, as woll as thoao plsclr tetryl into hand grenades and into fuses are nil exposed t lutryl duet ui should be protected as described above. - TNT may cause sensitization dermatitis after five days to sever months of exposure. It altio stoma the skin and hair u yellow color, hi not so pronounced as does tutryl. While TNT does not cuuse iiohu bleed, often cuuscs cyunosie or "bluo lip." TNT usually attacks tho hands, b cases of generalized dermatitis muy also occur. Workers enguged in welg Ing, screening, and sifting TNT are exposed to considerable TNT ihiut. Tin should he furnished clean work clothes duily nod showera should bo cor pulHory and euperviacd after work. Impervious slcuvcs and aprons and eof washablo chamois or leather glovus should be provided and wushod doll (Steeping tho gloves in a 10 percent solution of sodium hisiillltu followi by several rinsingH in walur decontiiininolos llieni.) A protective ninlmci (as described under lutryl) may hu upplied to tlio fucu und olliur exposi parts. Workers melting TNT and those pouring it into shells, bombs, eh as woll as the tappers and drillers, should be given the same protection 1 described ubove. . Folliculitis and boils sometimes occur on the hands und arms of workc with molten tetryl. These are caused by tho crystallization of the tetr as it cools and the enmeshing of tho hairs. When tho crystals nru pulh o(T the skin, the huira arc palled mil and infui'linn may roniill. Protect! clothing will provunt this. DNT Is used in smokeless powder. While It causes senHltlzallnn derm tills, it does not allcct as many as does TNT, nor are the casus as seven The preventive measures are the same as for TNT. Fulminate of Mercury is used In detonators and ]irimors and afTocts considerable percentage of tho workers. Even wlion haiullud wet, lie It Is detonators, it will dry on the clolhos, sift through, anil i-iiiiho dcrmntil on the covered parts--tho nbdouiun and tho cheat. Moiled lingers nr carry it to tho gouilnls and rauso dermatitis on those purls. Kuliniuuto is iilsn uacil in primurs. Hero II la mixed with antimoi ollldo, poliiHHiiim chlorate, und ground glasa. Tim ilcrmulills noioog wor ere filling primurH may bo caused by the fulmlunlo or the imlloiouy snllli or both. Patch IcmIh with tho primer ingredieula will didenoloe thu nclt irritant. The eauio protective measures aro reromnumded an those f tetryl or TNT. Ammonium nitrate used with TNT to moke umnlul Is enmpurativi only a mild skin irritant und workers protected uguinst TNT arc protect aguiosl ammonium nitrate. Lend azide is used only in snutll quantities. Dermatitis from It m occur, hut is rurc. In performing patch tests with these explosives they run ho applied the skill In powdered form on u piece of gauze and ullowcd to remain on : 48 hours. I.ato reactions should ho looked for up to 3 days lifter romovi the patches. Solvents are used to a large extent In cleaning and dogruuslug she In epray gun stenciling, und ill renovating old projectiles. Kurusuno, pet loom spirits, Stoddard solvent and oakltc aro some of the solvents us produced JM-83 PLAINTIFF'S EXHIBIT They *11 can came demialitl* by their defatting and karatogenle action on __ tlio skin. Workaia In contact with them thould wear eolvonl proof gloves, t(jyTy>i leaves, and aprone. If for any reason these cannot be used, protective jiilWit' * oinltiiunlt, special clcunaors and emollient creams should be supplied the'.' " " workers. (See pr ileclive ointmciita and clenners.) Workers tdiould not bot( permitled to dip tno unprotected hands in theao solvents. ^ Cirls using snpliall paint on primer* should be provided with synthetical rubber gloves; or if this is not feasible, a protective ointment and a ipeolal^Hj y-C 'jV|p cleanser to remove the paint from the hands. * . Finger cola nhould bo provided for workers .loading cartridges wHhfji( 'imokeless powder and for thoso spring arming fuses, to protect theni-from!^ cuts from the silk cords and scratches from the spring. , 7;. ` ; V.f . . Dermatophytosls ... i;rt; ).i Of Importance because of its frequent confusion vnth or as a compllca-^tffca,7'" tioq of industrial dermatitis is dermatophytoais (athlete's foot). The aalientjf ' symptoms are Itching between the toes, the Instep, and on the eolea, or oni, ' the palms and the sides of the Angers. Small vesicles, some of which may '3/^ he deep-seated, appear on the sites of the itching. Later there muy bo a; mass erosion of the akin between the toes, especially the 4th and 6th, wlth.,S^$.! soggy desquamation and a characteristic odor. The eruption on the handa^^flH^k.^; is thought by some to be a sensitisation from an original focus on the feet,i?^>/;|li^V^ and are called dermalophytids. They go on to erosion and scaling. I* " . There are many effective methods of treatment, If use.da wiuthn shOrvQoodv*' 'iJfTi * , . Judgment, depending on the location and stage of the .diseasea. ~Trea`t the ' - ' pstlent, not the case. Moro harm la done by overtreatjnent thinnq by undor-STi'l ' (reatmepL The moat frequent sources of overtreatment are the Impropor&W^'^M^ j uees of strong medicaments, the commonest of which Is Whitfield's Ointment ^ . Principles of Therapy--In acute vesicular cases, soak the foot for 16^ ;5',-mjnutes twice a day in an antiseptic solution, such as 1:8,000-6,000.pota's ` * slupt permanganate, fullowed by thorough drying and powdorlng with' a^ ;V blend talcum powder. With a more chronic condition; the use of child (H" - strength) WhltAel I's Ointment Is helpful. If full strength WliltAold's 01nt-1 s'" merit is used, it ihould not he need for more than a wjek, or until tljetoi. ' ' epithelium ia peeled off, und then followed by a bland ointment, such.ua tlncS^ ' ^ oiide, until the inf ammution eubsides. The antiaeptlo.coal tar dyes, gontluuMcW-rc-.; /'violet snd hrllllsnt green In 2 percent solution, have also given goodJresulU.ifl|(|j! It Is usually Impossible for the hands to recover until the Infection lias beenf*"*' i1 eradicated from the feet. Often treatment of the feet alone will be followed by disappearance of the lesions from the hands without any dcAnltlve local] y therapy. Put In most cases, the phytlds on the hands are beneAted byl Lunar's paste with 2 percent salicylic acid, or some mildly stimulating-^ i > ointment or kerat.dytlc. f i,' Secondary infectioonn in scratches or in llie Assuring hetwenn the toos< ' i|igy occur snd Is usually controlled by wet dressings and rcstj t Vi Important In nrophylnxls and prevention of reinfection is foot.byglqqoJ V 'TIdj I'onsLIs of i.at going barefoot, and of thoroughly drying1 (haffeol,! (V'. especially between tlio toes after a hath, and the application of dryings powder. Powders which contain a mild antlseptla are useful and ava|lablp,l ^ 'bi^( (borqugh drylrg and the use of any bland tale Is helpful. I It is ImportabtJ tL'lq hsvetworkers wear wooden ssndsls or somo form of lnd|v|dual:foot,pTU^9UJS&3^ . . . - 44 5 ;v.;n lection while walking from'locker rooms to showers und hack, and not 'take them off even in the showers. In this way the infection cannotbo co traded or spreud. It Is useless to have antiseptic foot liutlu In front of tl showers If the worker is to walk barefoot to and from the unlleuptlc troug The Importance of weuring clean stockings dully and diiiiufectiug old slia which may harbor the fungi niual not lie overlooked. Selection of Workers ' A considerable proportion of skin troubles muy be avoided by tho prop, election of workers. Thus individuals with a known hypersensitive skin i shown by neurodermatitis, allergic manifestations, or history of atopy i infantile eczema should not be employed in skin hazardous occupation Neither should those with dry skins be employed at jobs whero they mui wet the hands in solvents. Nor should cases of marked ueno ho aubjecL to conluct with cutting oils. Negroes ore usually mure resistant to innti akin irritants than aro whites. In the rush of war employment It la often Impossililu lo ho us sclecllv as ono would wish; but whenever selection according to typo of skin bei suited for the particular skin hazard is possible. It should Ini nttcmptci An actual trial of the employee at work might lie made, hecauan many ind viduals are able to work when clinical judgment suggests Ihul they mn not be uhle to. Pre-employment patch testa are not advocated because the workera d not become sensitized until after they have worked, and a negative prs employment patch test doea not mean that the worker will not become sonsl tlzed. Neither will it tell whether tho sensitized parson will liccomo immun or "hardened." Besides, there are logal complications to pre-omploymen patch testing. DR. NAOMI VISCARDI (Aero Purls Mfg. Co.): I work with girls li the airplane industry. I want to know whether 4n put In liquid sunp or pow dered soap. Wliul is your opinion os to the kind uf soap T ' Dlt. SCHWARTZ: The question is whether I udvocnlo liquid soap oi powdered soap in the airplane industry. It depend* on tho type of soil yoi wish to remove from the hands. If It la just ordinary, easily romovahli dirt and grime, un ordinary hand soup is all right. Ivory aonp Is as goo< as any. Tho same liquid soup is a little stronger In Ita net Ion. Hut whoi you hove tenacious grime, a powdered soap is In-Hcr, lu inune (L eniitnlns a scrubber, und the scrubber helps to remove the ilirl. I mn mil going to gi into tho composition of these imliistriiil cleuncni, heenuao it la a long story hut the powdered anupa thut contain aeruhbers are heller for nonliving soil tliun those which do not contain tlio aeruhbers. ' Mil. WUICIIT: I have a problem with chrome tunnurlea, whore they are using chromate solution, 60 porvunt. We linva tried protective creams, but most of bbo creams on tho market are waler soluble, and thus# things wash olf and give no protoctlon. Do you know of n wutur Innolulile cream! {)[} (i -j (> - 46 i. t rrj produced , ill 07 T ' V w 'i i> ", ){ * r- DR. 8CHWAHTZ: Indeed I do. There ere number of water Ineoluhle crpam* on the market. A creem, top Instance, that conilite of 70 parte of jjbS anhydrous lanolin and 30 parte of olive oil, to which you might add eomoif perfuming agent to take away the odor of lanolin.- Lanolin and caetor oil1 ji a very good water-repellent cream. Alao the cream we prepared against.'.' tetry 1 le u good vater-repellant cream, becauae It cpnelata of ahelluc rein-.; forced with zinc perforate. Now ahellac is soluble In alcohol but insoluble I* i" wu`rDio I'ublic lliullb Service tome time ago publiehed an article entitled, '.lift "Indiulrial Cleaners and Protective Ointments." If you-wlll write-to myjj _ office 1 will eend you a copy of that, which dieeuesea theie creams and telW^wj the names of the firms who manufacture them. . ' ' . . , - Ijf > Mil. 1-1 O. K( M(-Kit (Amcricun Steel A Wire Company): Do youI'flnd'.-'. from your experience that people that bundle a develo.per containing_ a mnetoil hsio and a hypo fixer nre senisitivvee,, not necessarily to contact with. theVftphnr insicrial but perhaps to the fuminees from it! . . 1 *; Dll. SCHWARTZ: Dermatitis among photographers from metol I say Js fairly cornu.on, because It doesn't occur very often, but I should that metol Is one of the principal sensitizers that cause dermatitis In thej'^jt^uf** photographic industry. Now whether a person will get dermatitis from tho ifJV,.;' i; | I fumes of metol will depend on the degree of sensitivity which ho bus. Most-l^v- 'tT; of the dermatitis comes from direct contact with the developing solution but 1 can.conceive of a worker boing so sensitive, that:perhaps even.the \apors of the metol muy alfect him. I have known'pqople who wore ao sen sitive thst if they even went into the grounds of tbe factory in which'the chemical to which they were sensitive was manufactured, they commencod^ to itch. ' I f. tr-A? vt? v. A MEMBER: Would you tell me how elToctlve'in:the prevention' dermatitis from cutting oile ia the Alter which uses. f|i)ler'q! earth,, and. i has an an-angeniei t to heat the oil aa it is being Altered through the full earth T ` t-y ! V . i= . f-';*v'V.i;- *: <, DR. SCHWARTZ: The question le, how effloUnti In itlje prevention derm__ailtiitli.s II.s >thLe ._n__a__clh.ll,,ne_ which fh.e__akta- itth.e cutting-.o-lIIlJf_t_w__H>1fMlltUe_r_a__.IfIcf.cUa*-f.cjxrne time with fuller's earth! j Now the terilizution of cutting oils, * I ifildjTvylth ` taboo, becauae they ore sterile anyhow. So why. sterilize* them with" beat!1 However, in view of the fact that at the National Inatltuta of Health '' ' have cultured dozens of tlivso insoluble cutting oil* that came from sources' of cutting oil dermatitis, and which were supposed to be Infected,.end:we hovc fuiloil in any rase to obtain n culture of pathogenic organism, It aeems| to urn to denote that Die sterilization of cutting olla even by heat Jsiurinj However, tli tiltrntion of culling oils to rflni9vj't'the'if||i'i)nisi'fcijd'^>>u'Kbi particles of metal It very necOsskry.' ;Thereforp,:thi'#pil*j;'*'darlW' I approve of. I eluo do not disapprove' of pasteurising, iVriojvevar/Ii^ueatlb'i iv bet her It (lot* vary much good In the prevention of dermatitis.*............ . , jl i.itiiilb.,/ '' '" , "' : " ' rtf MR. A. C. FUNKE (Michigan Mutual Liability Company): I woulo lll to aek whether you have had experience wlth unpolymerized and polymerlzt synthetic reaina that might cause dermatitis from a dust point ef vie' phenol formaldehyde particularly. . DR. SCHWARTZ: Yes, I think I have had experience with most of tl polymerized resins, and referring to the phenol formaldehyde type, it is most frequent cause of dermatitis ninong the synthetic resins. We hai mnde extensive studies and found Unit it was thu formaldehyde fraction tin caused four limes as much trouble us the phenol /ruction, as far as tonsil zation is concerned, and that the more unpolymerizcd, the more uncured . wus, the more dermatitis it wus liable to cause. For instance, thu powder: resin mnde for moulding contains four or livu percent of licxamcthylci tctruminc, which is used to furnish udilitionul formuhlchyilu in the mnuhlini You all know that hcxumclhyleno letrumlno Is a powerful skin irrlluu and there is even some free phenol In it. I would say the unpotymerized resins eautm u grout deal more dermi titis than the polymerized, and completely cured rosins cuuho iio dermatit at all. 2 PLAINTIFF'S EXHIBIT i 000) 171)0 produced `stHTOHS Afternoon!1 [November 10, J pnOF. DRINKER: The Preventive Engineering Committee during tliq . ' pael year haa leaned one bulletin, under Major Hatch, and another Is about; / to appear by Mr. Ilcmeon of the Maaaachuaetta Division of Occupational! V,"-; Hygiene. Hcrelofore, aa you know, the engineering' group has'issued f ' bulletin* from litre to time, on aubjecta of apecial Intereat, such aa problem* 'j jJ in air analyala, duet meaaurementa, and the like. We aland ready to conr ,<V |inue that aervice, but condition* have *o changed.alnce our meeting of a1 ' year ago, due of courae to the war, that we feel a little reluctant to suggest)! ' topic* or to atari new project* unleaa we are certain that they are onca of' . tpreial intereat to the nicmlterahlp. ui.; IN l A We would welcome auggeallpna from the tnenjber* ek,lo project* .that! -|v think need *| ecial aUidy or project* which they think*could be described}^ >jr \ja now in the form of brief bulletin*. Thoae auggeatlona would moeti Conveniently be made through the Foundation itaelf, through the Director,^ ' * and Dr. Holden. ;j*t . ` The Engineering Committee haa no elaborate reaearch program for the'*; 1 forthcoming year. We have no apologiea to make for that, but changing conditions have altered our program and moat of ua, like moat of you, htivijj ki\ ' more work than wj can handle. If we are to take up or aupervlae any special*- reaearch project* we want to be aura there la a really urgent noed for themH Nri rCpud we would atill like to limit quraelvea, If we can, to atudie* of auch a( nature |hat the benefit will be a laatlng one. You can, however, arrange for*N -2 ' I iii-iov* from the Fnundation. I know that they will bo ready to help you;7 . Pi i .. v ! i.: Therefore we look to you tytfuggeat to ua.iby.questions today, od. by iwririug, questions that you.wpnl^anawered and, reieqrch tpplc*1 tbet ybo ( lllnjc are worthy of conelderatlon by the Foundation through any'of rits^j .i.\* :i ` .'U ,V| , ' . . * ** * 2PLAINTIFFS f EXHIBIT * MEASUREMENTS OF KATE OF AIR DISPLACEMENT AS A DAS FOR DETERMINING EXHAUST VENTILATION RICO II IK KM ENT MAJ. THEODORE F. HATCH, Sit. 0., uud LT. ROUERT II. WALPOLE. JR., Sn.C.* Objective of Study Tho objective of this atudy waa to develop, mo fur ua poauible, a fun mental basis for determining tbo design requirements of oxhuust syati which would aervo in placo of tho emplriciil procedures now comrno employed. Factual llaaia for u Fundamental Mctlmd uf Hood Deaign (u) All atmospheric contaminants roleased by Industrial processes disperaed into tho plant ntmoaphero by air movement only. If there w no air motion paat the offending procoss there would bu no distribution the contaminant beyond the immodiate zone of rclonso. (b) The function of an exhaust hood, therefore, la not to cupturo contaminant but to collect tho air into which the contaminant Is diapers (c) The rate of air flow into an exhaust hood, as a .consequence, nr equiil or exceed lha rate of flow of ulr past the process. (d) The extent to which the hood ventilating rule inuat exceed I rote of air movement depends upon the hood efficiency, I lull la, upon I amount of clean uir which must be exhausted In order to cnpliiro all of l contaminated nir. Meaaurcment of Rate of Air Displacement aa a llaaia for llood lleaigr (a) Sinco it la the air movement uway from the nine of contoinlni release which the cxliuust hood iniisl prevent, it is clear llml one shot know the role lit which air is flowing through liio urea ill order to ilolenni the minimum rutu of uxhuust ventilation required. (Ii) The primary recommendation resulting from this invustiguti< therefore, is that, preliminary to the design of an air exhaust ayatoni, I ruj.es of air displacement existing at the vnrimiH processed he inenaurcd (c) Rules thus obtained will nerve, with tuiilnhlo fnctors of anfety, determine lliu air flow capacity of lliu exhaust system. (d) This procedure contemplates the dirrrl study of lliu actual pi cesses to he controlled and does not depend upon assumed similarity wi oilier processes and experience with them. (u) The proposed method does not liuve universal applirallmi since requires that the pattern of uir Row past tho process Imi rnlliur cloui defined. It also requires ii cerluln degree of eni-lnsure of tlm process. I application is believed to be wide, however, ami experieuro with it In t design uf a large-aeulc system bus demunalruled its prurlirid value. IV,) IMt,uAokr**a'|(*ultHiidi*i*ol*i*\aflilHiny|t on III* llm University KouiiiUIIhii. of I'uHiisylvimlii nluili of Ktlmiiiil Von III Formerly of Daiiitrliiisnt* of I'nlille llnllh uml I`ii>vi<iiUvh Mrilli'liiii. Helmol ' Mmllcluu, Mnlvomlly ot PuminylvanU; now with 11 II. Army. 40 Cf * Method of Measuring Rate of Air Diiplitintnt (a) Air mo Ion around an Industrial process may result from a nutu-i'fc?*', a! her of causes which may he divided, according to source. Into two classes:;" external and internal. Examples of the former are: normal room convection \ f:' l currents, action of neurby bells, flywheels, movement of reciprocating parts.' Interna) sources nclude those which are Inherent In the process and others o'i7`-)''ii which are only Incidental. Inherent sources include the strong convection,]^,*.'S currents set up by hot bodies (such as a casting, steam bath, welding opora-^jl\? lions), by the expansion and contraction of a stream of falling rock as It'Jjwiwtf leaves a belt and falls into a bin, the fan action of a grinding wheel or of a hamme:r mill, itc. , mMm (h) The air flow established by sueh sources Is not confined to it dooful J.it:Jgi nite path and can tot, therefore, be measured by the nsnal methods of metoT-'.'-*jjf;j>.*' *} ing. In the present study use was made of the well-known technique of.?; ' . 1 iiirasuring the dilutinn of u suitnbla test substance. In this casu a tost gas ^ introdnccil into the air stream. Knowing the rate of Introduction of tlio gas and its equilibriun concentration in the air Stream, one can calculate directly tho rate of air fow from the relationship *: Q =Z wC r J .l.. . Where Q = rate of elr flow . P = rate of feed of teit gee , ; . t. .. p C = concentration of teat gas in air stream ' discussodl J- > The method has been described and ita errors and limitations discussed* iq a recent Foundation to use but has the serious cenlralions which must placement Is not continuous to s maximum value place of the chemical gas concentration, a direct-reading meter ahould bo uaed. No aueh instru nient Is now available for carbon dioxide. In certain studies toluene has.'^ been employed as the test gas, alnee It can be measured Instantaneously Inlhg a direct-reading photometer. For obvioua reasons, solvent vapors eouldV^ -,r, not be employed in industrial plants. Itecent dovelopmcnta In the u*t). Infrured photometry for measuring curbon dioxide ere promising. AnotherjttKjp,'^.j&a possibility is to employ a test gas containing a radio activo aubstanco, theufjj^j i-.n'i concentration of which could be simply measured. These and other augges-'-^M^ijvlu Ilona should ho Investigated further, since tho basic Idea of determlnlug^frg/ig-|*| ventilation requirements from measurement of the rate of air dlsplaeomentn^KwKT! appears to hsvs .-onshlerable practical value. .. Suggested Steps In Hood Design (a) Study the process with a view to determining the source sources of air motion whirl) is established during Ita operation. , #3) v. J-."J (It) If a source is external and luilopondcnt of the process lake eyeryjpractical means Vo eliminate It. Should the source of air movement; bo'] within the process but only Inriilentul to it, every consideration should altqj) bn given to its chininullnn. For example, n flywheel or other rotating part' muy be sliiehleil; convection currents rising from a hot tank can be mini-' mized by insulating the side wulls; leu king parts jn compressed-air oper steil machine should lie repaired. Oil t rLMiimi'i a EXHIBIT (e) Even a aouree of air movement which la inherent In n process mi be reduced In strength. For example, the amount of air ilinplneud hy fullh rock Increases with tho height of fall. By substituting a aloun luildor for i uninterrupted chute the total drop la broken Into aevornl slops will' together will producu less uir displacement. (d) In tho caao of aemi-enelosed processes dcteriiiiue llm points entrance of tho air as well as tho escape opunlngs. In many eases t opportunity for air to get in can lie greatly reduced, thus minimizing t rate of displacement. For example, the airflow resulting from tho strut fen-uction of a Iminmer-mill can hu reduced hy rurefully resl riding t inlet. The air movement into an eurloaed acmiiii may lie riiilurnd hy pr viding a atorago chumber between thu acreen uml feed rliulo so I hut tho n cannot gain cntranco front the chute. (e) After identifying the sourcos of uir ilkiphicement ami ulimiiialii or minimizing ull tliul are subject to control, thu next step is to study II pattern of air flow. For this purpose a visual smoko gononitor may employed. (f) Next, construct a temporary enclosure (If one is necessary) of publern that will confine thu flow in the manner desired. (g) Using the temporary enclosure, measure the rats of air flow I the dilution technique. (h) From the rule of air displacement tluiH determined and the know edge of air flow pattern obtained by smoke testa mi estimate may be muof the factor of safety to be employed. Thus, the rale of ventilation determined. The time required to make the tests outlined above Is not great and is believed that tho Information thus obtained will result, in many insta ces, In improved design and performance of exhaust systems. Application to the Study of General Ventilation (a) For the control of a number of industrial operations, general roc ventilotion is employed. The rate of ventilation should he determined so to dilute the contaminant down to a safe level. If the rate of production tho contaminant is known, then thu minimum rate of room vunlllution sliou be . Where Q ~r minimum rale of ventilation required . F* -- rate of releasu of contaminate Cll(-I = muxlmum permissible concentration of contumlnute (h) The value of Q ohlaineil in the nhovr manner can Im safely ci ployed only if the coiiliimiaaiil is completely mixed with tho ventilating u Snell a fuvnruhle situation rarely exists, however. On the eniiLrnry, zoo of low ventilation and even dead pockets frequently occur. Ily menus the dilution technique the veutilnlion characteristics of tho room may evaluated and a quantitative basis for Improving the .system of genei venlilution obtained. The steps are os follows: 1. Feed the test gas at a constant rate into the zone of relearn' of the rnotiiiiiiiiiud. 2. Determine the equilibrium eniiccnlrnthuiii of tho lesl gna at oi)on.,;,!)2 Cl -r./sniiorr* , .' : " > r ,* 1 * tlie various working: location* and in theair aa 'finally dls*. V8.' charged fro n the room. , Under cond.lions of complete mixing tha concentrations thus R fq obtained would lie alike. If, at any sampling point, the con centration is higher then at the final outlet, one know* that the PLAINTIFF'S EXHIBIT 1 I KEEPING SCORE ON TOXIC MATERIALS AND PROCESSES IN TIIE PLANT EDGAR C. 1IARNK.H* * rate of effective ventilation in thin urea is less than for tha room aa a whole and in reverse proportions to tha conccntra-^* lion found. . j . i ,. ? ; \t-, r:j- 4 - From such a survey it will lie possible to Improve tha system^ so as to effect more uniform ventilation and, porhaps, without any actual increaao in tho total ventilation. . W If, in addition to the equilibrium concentrations, tho rntos of) buildup of the test gas concentrations and tha rata of decay h after tho gns feed Is shut olf sro nhlninnil, one can predict tho cycle of coucuntralions of the contaminant which will obtain, 'at tha various points of expoiura for a given cyclical release', mof the contiminant. The mathematical relationships will be! considered in another report. i'Vw Acknowledgment* u ii- . ... To give you briefly the background for our methods controlling th< 1 ?; use of toxic materials, we aro a relatively large manufacturing industr; using hundreds--yes, thousands of different materials, many of them toxi> materials. It Is not u coso of controlling one or two or three types of hex . ards, but hundreds of hazards, and thousands of people exposed to thosi ' hazards. Wo have In our heudquurlora medical department nn luduatrio hygiene laboratory, which hus functinned over a period of III years, ami i number of systems have heou developed there which are iirobaldy af intnres to you. , We soon found that we hud to disseminate llm fuctunl information, sucl as you have been hearing today, to tha proper porsonnul in our plants it order thst It could he properly applied, worked Into the design of equipment and processes developed utilizing that information. It was necessary to gol that information in the hands of persons who dual with the dlireraut mater ials and processes Involved. it;5 vjjt Grateful acknowledgment ia made to the Industrial Hygiene Foanda-1 fit-' tlon and to the American Air Filter Company for their financial assistance]^ 'which made this study possible. It Is regretted that, because of the war,J^ ?] '/.the work had to i top while still In the preliminary stage. A full reporter! f>. ! will he mude of tie work und especially of the application of the proposed!' ft?' (*. i technique in the design of a lurgo exhaust system. It is to be hopod that 'jAPthe method will receive further field tests and that a simpler and more?v / V flexible test procedure will be developed. C f'u\ ' V' / '!( i'Vv' ,iA S< ,M t.O'V - The industrial hygiene laboratory is also interested in obtaining udvanct ' notice front engineers, plunt personnel, superintendents, etc., so that wo may have a knowledge of what materials they are thinking about using or plan ning to use, so that wc may at least try to keep nhund of them. Our heudquarters engineering department ill Hires a card system for keeping truck of these dilferent materials in nan In the plant. On those cards, four hy six, they record the name and assign n number to the mater ial, record the suppliers' names, the engineering characteristics of it, and other pertinent dntii which would hu useful to tho various engineers and shop personnel who use it. That seemed like a logical place to provide some Information nn the toxicity or possiblu effect on Ihu health of tha workers from the use of the inatcriul. Wo have added, at the top of each of these cards, under the name of the product, n very brief stiitameiit regarding tlie toxicity of tho materiel or precautions that should hu taken In iiHlng It. As nn exumple, if wo liuvo a t -'.j ^ *.:*> .1 1 > i .. >:t card on benzol, it wilt definitely stale at the lop of each of these cards that tills material is toxic; its vnporH should not he breathed und excessive con tact with the skin should bo avoided. i'-'v' l/'t' These curds serve the useful purpose, Aral, of keeping the laboratory informed, and second, of transmitting Information from our Industrial hy- gleno group to the shop supervisors, the engineers, nnd other persons in the organization who work with these muteriiils. \ 4\H 4 f rtiij 'lfc i i IV 211 As stated, only generalized information is phiccd on these cards. It is impossible to determine heforchunil all the applications that may he mude. It may go Into a hundred diflercnt processes, and you can't anticipate all of those uses, so that It is impossible to provide specific information. We do 00 V) S 1 rin#y/ \> givo a general Indication of the. toxicity of each mixture or substance. It hns been our feeling llmt if wc can satisfactorily control tho ubo of mnlorinls in the plant, nnd then prove that tho control is satisfactory by periodic physical examination of the employees, wo will not hnvo cases of 62 V;y *: I' 1 Wsstlnslinnsa Kloclrli: A Mnnufiictarlas Cnmimny. 63 DDnniicrn a occupational diaeaae develop. It has proved to be'sueh fver the years. Now these maieriala are used, aa I indicated, in many different types of * _ processes, so that we must give these people very definite and concrete In- ;<*"!' formation on euch of these different processes. Our headquarters engineer-.* Ing department provides our shop supervisors with a written process speclfl- cation. It describes what materials to use, how much is needed, what .V/j*. temperature to use, what kind of a tank is required, etc. They are very ; Jt. specific written initruclions on how to carry out oath process. . H . ' pj '' That again actins to be a very logical place to.transfer information.tWMfcfc Therefore arrangements wore made for all of these process specifications to come through the industrial hygiene laboratory /or thoir observation ond v;? f. tho adding of information about the toxicity of the materials Involved. /'':])?? i. J.'.'i 1 For t good many years we used general statements; however, they <$!{ 'tj. ' applied specifically to the particular process involved. Later there were.* c'it', requests from the supervisors for more specific and concrete Information.,; y-'j ' .'/..'i When we have occi.sion to make studies in their Individual deportments, we'; \,y ' provide data to compare against the information which we gave them.' v.f Therefore a tabula * arrangement was made, which does give them a rather concrete Information about the anfe limits of different materials. j 'ifl/vl'i In Figure I is shown the first type of csutlon clause which we used on our process specifications. The rest of the specification la not particularly useful In this discussion. The cuution clause on this one, for example, reads: j. "Varnish No. -- t.nd Solvent No. -- are infiommable. Keep all sparksL'-'jK \ and flame awuy. Do not breathe the fumes from these materials, Ado-iMr: quate ventilation shall ho provided. Avoid contact of Varnish No. r-- with f'r' * the skin." ' and That forth was very from the helpful, and again we different development hean>ddga.inetrearns,sfreerseoafrcinh. foernmgainteioenrshanncd.lc.*^i.wr,i*Y>if.'fn shop personnel, In thst'sll of these specifications come through our labora tories, thus advising us of what is being done in the plant, and we .In tum.M^ providu Information about the toxic material* that are Involved. c , "4 l.utor, at tho icqncsl of our shop supervisors, more specific-data [were Included, as shown in Figure II. f" 'frjj * This is the tabular heading, which Is placed on thq.first paga^bf each' of the process specifications. In the first column Is the name of the material and its materia) number. Then the chart Is divided Into two goneral head ings: Fire and Explosion Hazards, ami Potential Health Hazards, Under Fire and Explosion Hazards we give them some Information about the flash point, which is ve-y helpful in controlling the posiibilty of explosion or, fire hazards wherever the material Is used. For our purposes we have divided them Into three groups, lettered (a), (b) and (c), (a) being the slanderd ICC classificetiun of an Infiammulilq liquid with a flush point of less than 80* F. For practical control purposes that Isn't quite high enough ,, to he considered o dividing line between the rsistlvely safe solvent and the;*!}, relatively unsafe solvent at room temperatures, because your room tempera-iWq tores limy frequently go ahovo 80' F, We therefore made our dividing line'-' ^ at Hi)*, adding the si-i-nml classification (It), 80* to 110*. and (c) over 110*. 1 bus each potentially hazardous material which is called for in a speclficor lion is labeled (u), (h) or (c), depending nil He flash point. / ..{f; In ovens and work place* Iho fire and explosion hazard limited by con' II fillIng the percentage concentration of the vapor In the air, either`Inf J.'uj 'vr-f *>" ft, mmt$% W E STIN G HO USE Electric & M anufacturing Company exhibit 00 OO CO to 01 Ok cl a uV Xi i4na4aV-1* 4) XI B X p. < bc4<a>o B Xi 3 i P*84. 4> 3 Ooc4>) o Z C o ano Vdoc 8 4ao> 8 (X Vi W-2 Sc, WH l J3 A* w " in in oy. *-* H oaw. in"(iTJ TTTuy 06 Arn *1 M n iij I * cIobcif container or in an open (pace. Vapor concentration* are reatrleted to 26 percent of the lower explosive limit, a* we feel that a four to one /ac tor of safety I* necessary for moat of the operations involving the use of these inllanimahlc t spore. ' (linler the heailing "I'otcntial Health Hazards--Breathing Zone" wo _ tv specify the maximum permissible vapor concentration, using two different^ yj- column*. In some instances we have a relatively abort expoaure each day ` xA and in other inaUui'ea continuoua expoaures. For moat prncticul purposes Y, these two figures do not need to be the time. Aa Indicated In the table, the ` maximum permissible concentration of benzol is 100 parts in 1,000,000 for ' ' exposure of I to 8 hours per day, and for an expoaure of leas limn one hour A per day, 200 parts 1,000,000 was set si per 1,000,000. In the case of toluol, 200 part* per the top limit, even for the short time exposure. ' 4 V Under the seclbn entitled "llendllng," It le Impossible to give a specific ,i. : i statement. We have, by utilizing our safety manuals and our safety super- ' , '.visors in the plsnli, informed the shop supervisors of the different types "'.'of protection which can be applied to the use of these materials, such a* W rubber gloves, prottclivc hand cream or protective clothing, fn ono column it is Indicated whet ter the material ia corrosive, auch aa an acid or alkali, and in the other column the need for personal protective clothing is Indl- rated. If the chart indicates yes, in either of these columns, they have j information which can lie applied to the specific need. . ' ; This scheme of providing information haa proved exceptionally useful In times such as we ore going through today, when many substitute materials are necessary. The plan hus given us an opportunity to discuss the use of lha materials with the shop supervisors and the engineers, and to make eer* tain that proper protective measures are taken. ` H* - ' . Jfryr;-.;1 -r ; . . : . * $# : |V >f V|,` l-t x>drr . r *. I ... :' 66 >.V i If i' *tjj, * ^ rl a iZ 57 .mrn I > y ' &* &}/-i :i ju. >*s. ' V\ 1 * Hi;V.^pRp! DRINKER: I woould like (oV uMkk. MrjAftBapfnetet'';l|if he !:ha*e.7veevveerr;g^j V^tljmpted to get the Arms who eell these chemicals tydo'this labeling tot * Wb(i[y Do you thinl It would be practicable I ,, ''$'[ tr .,:5 >|-}.'i!^HR. HARNES: I think it might be Ideal, but I am not eo sure that ItjT :icn be done. . .. |.. .!!' ' . <**, ^{ftl-ROF. DMNHER: The reaaon l eaked that gusttloq If yiat I.am work:# jh)g nearly |I1 my lime now for tho'Maritlme Comnilaslon.jfvWch-is a voiyfai il^pge cpployer of labor. One of the,most serious problem. (we face from jbt)p][h standpoint is the use of paintj vehicles, thinnars andjthe like,'of SP9jvti composition. Usually they have only a tradename, and the palnt'^jj ........................ ' ............... "*H'[foreman hasn't the slightest idea what they are. Onlyoccasionally is there : f an indication given as to their chemical nature. We need to have some kind - of adequate labeling of those items. I was hoping that If sontobody like 7,.;'.r!v . Weitiughuuse started it Arst it would be a little easier for us. ''A [U. Wit. HARNES: It lias been our'experience that we have to And the', (ItWaogTrer to thesa problems ourselyoa, and-In tha'casoiof is4|vents,r;such-'sis V Professor Drinker mentioned, not .only the trade namesbutthe aotual rnator- <7|lli sometimes don't seem to be known. It is necessary to moke fractional I* distillations of the solvents and And their true chemical composition. I'Nsome instances we just haven't been able to And out any other way. We [j.'iinsk* practice of determining the composition of the solvents. J'-j MR, PAUL HARDESTY (U. 3. Chamber of Commerce): Do I under,.tjf ;'w|Up4 you, Mr. Darnes, to imply that you have some form of periodic physi- tf * c a I examination? , . : . ' ` ' , ^. ' ty, , % $* t r.:*.**tf *'.ii lt i: d' . / iMJt. DARNES Yess..; Itwoojd rojulre too long/a[ilme1to describe1 the .^Ils now; I will Just say that'each- job In the plant la clasalAed'for; the *VV|yp and frequency of the periodic physical examination.' I don't mean to `l|i\ply that all employees received a periodic physical, cxpinlpationy, How. pYpr,* all- employees working with hatardous materials/or!whcrc the .safety. pf.'Vljcmfelves or others is Involved, receive poriodic examinations on.'a defl-' |))|e schedule, which Is determined by the Job. That claeslAeatlon determines fl'btj,reeeive_ an examination and, In cases of disease.or:reaction to**-'* I tnit^risU, they become the pationts 'of the doctor ,and.are.followed .pndor l^|ljpss conditions.'' . j- * '`i'p. .' 4 DR, S. C. LONG (Atlantic neAning Company)':. May.I ask how;often rpal^e these physical examinations on ths men idle bepiq ^fMfilbijRl.fAnjiwNBEBn: _The freq. ii.en1c.y).of:(ox'a?m|natl6n^j)epSlids;Qn'eachiin^l J^prbcpsspr job. .'.We have'tledlfdown toeacli'JomJn,'the'! plants'll fisyp an operation where there is a benzt o`l e--x-p--o--s-u--re wh*'ic1h 'has *been :p;roved, hrough years of experience, to he relatively sufn, the examinations will be v| insjle every six mo itlis, or once a year. If we are going Into a new aitua- 119P<' where we don t know what the hazards are going to bo, we may make X |hu examinations once a month. Through experience, 'from determinations Mover'*'period of lime, we reclassify the job to overy alx months or a'year !.(oc'whstover is ncci-eLs-assury. F'UUNKE: In case you flml a deAnlte hi.1 in'-L 'Certain !ir.rrppeehiit, are aany of Ihosu men trained In Arst aid, promptly,to takoicare 1 JtPJ^ serilous condition that may arise at any time? ' ' MR. BARNES: Yes, I would say that something like 10 percent 6t our :otal employees are trained in Arst aid. MR. FUNKE: With apeciAc instructions on typical or possible condi tions? MR. BARNES: That Is right. That Ib a problem for the safety depart ment, basically, because it io a short time, accident type of exposure. The ; people in those departments understand what the hazards are and what Arst aid measures to apply. Frequently written instructions aro provided for them. MR. FUNKE: I was referring particularly to chemical accidents, MR. BARNES: That is right. PROF. DRINKER: To many of ua It la a pleasure to welcome the next speaker hare as a comparative newcomer to the staff of the Industrial Hygiene Foundation, who haa for some years been a colleague to many of ua: Dr. Francis R. Holden. oiJiurrLu; w PLAINTIFF'S i EXHIBIT T,; nnrtr\MAre !'WFIAT'THE POUNDATJQN/PI/aNT H* .. . 'j,: i, 8UBV E: nrflfl{AftB'D*riS' C.L08.lN0? * . FRANCIS R. nOLDEN, Ph. D* ... .. i/i ^ijcasivbere the wrong respirator la ueod, A.most common inlslak*. ! ; employment of duet respirators for protection agalnet vapors. Thaw are' " also many Instances whore the maintenance of rnapirutor* le hni(lui|uiito or negligible. Under such cireumatances It Is difficult In obtain tho nocossury - '... , F to V:, P j!- <1 .. Foundation surveys made this.ypar disclose an Increased appreciation1! .cooperation from workers. Wearing n respirator Is usuiilly n nuw cxpnr. . lencs for a recently employed workmun. lie muat he tuuglit tu olilaln a comfortable (It and the reason for Uio respirator should Invariably bu cx- by' (Management of the application of lnterpretlyqy*ndvprovontive''>heaUhjp*Hj .Vij plained. Diquures to condition! In the workpiece. Thla viewpoint'ls: especially true/Jraj (' '.of those companies that have active medical and safety.'departments,.evon^: t though they may have no trained hygienists.; ;.. *, t ' l )t; . Many companies have their troubles in getting workmen to wour respif ,, >m1>s.-0S_H_M ,&ratora. But a clay product* firm had tho opposite experience. A general order warned in effect that employees would wear their respirators "or * ` Industrial, midlcal and safety departments 'often-' detect' haiardous^j?$r'^^ ' 7 j. else." One wlrttry morning the plant manager coming to work found the exposures In time to prevent serious consequences',1 The extensive-educa-'*. .Sfr'A.'vty janitor busily sweeping snow ami wearing a respiratorl llonal program sponsored by governmental agencies, various societies and the Foundation aie showing rosults. Numerous requests for Information^^ and services from member and non-member companies allko pro lndlcatlonisW *jVof bdustry'j) efforie.to provent occupational disease and to foster employee^ ' ' . * . . Not all industrial health problems are solved by specialists. A rocont fdfl* v-ijj hazard Involved exposure to a material which is a skin Irritant. Glass plates lowers Immersed In a mixture of unpolymerized resin, and In spite of the \ .'.'utmost care some of the resin would .wet the clothes of the workor. The bf"P-. Vi ;ri: ' ' - liquid would then remain in contuct with the Bkin for several hours, pro Foundation surveys frequently show that equipment for exhaust ventl-. - ' ' ducing a dermutitis. Itukhcr and cloth aprons were of no value, as the resin Istion Is used Improperly. Often an exhaust system for controlling dust'; where batch ears nre loaded* *has been d*esigned, f-or reasons o*f economy, t-o'Apmjji'* penetrated them. The mother of ono of the girl workers suggestod that a sheet of tha polymerized resin itself would be Impervious to tho liquid. have only a few chutes exhausts In operation at any one time. Workmen,-.? Several thin sheets were then prepared and proved an absolutu protection. through improper instruction or supervision, will open all the exhaust^ jSjt, valves, resulting in insufficient suction at any point to removo tlio duet. "Criminal negligence" regarding one's own health and safety is an ever.< * present problem. An inspection of an add-pickling process In a steal plant Similarly, there Is frequently e failure to provide adequate air to eomti.IMyV'!,'' , ' disclosed what appeared to be complete disregard for the potential dangers pensate for that romoved by exhaust system. This neglect Is true especlally^j-AM^Y # V of the acids by the workers exposed. Nevertheless the accident and health in winter when windows end doors are closed. The result'll that the tyri experience in this department had been excellent with one exception. A : qulred amount of sir cannot be removed and unless theVsyplcra has beehx^|r-,'^>1 workmen decided to clean thoroughly hie dinner bucket after finishing Ills greatly overdesigned the health haxerd will not be cqntrollfd.' At 1w*t' , . tum. He dampened a cloth with concentrated hydrofluoric acid und pro- ''.V piuch sir should be provided as:,will be exhausted, and'th||]aly.'.ib6ald>)ielAM^jvAly^ eopdltlonod during cold weather;* B; .YrV't W- t ' '' cee(led with the cleaning. The next day his hands were in a very serious condition and grew rapidly worse. It wee Anally necessary to amputate -|i 11 Into'lhe room, uvoidlng draft*. > several of the Angers to srTcat the necrosis which reaultcd. , We have obsorved a number. . There Is needed middle ground between frighlonlng a workman to the exhausted by means of u fen loe . ...................... _ point where he ie of little value, and whore he shows a wilful dlsrogurd or portion of a largo window. Workmen desiring to {jnorMe?Uie;y'pntil*tlpnL , i -. Ignorance for tho dangors of his occupation. A continuous systematic pro will open the window, setting up a return air current that carries.the duit^fS! ' gram of education and supervision administered by foremen und super gas, vapor, or fumo back Into the workplace. The fallacy.of:this' proflpdure,TM visors, hocked by top management, hue amply demonstrated tin practical can be Illustrated ly means of a smoke bomb, whlch cleafljiehows. the ex hausted materiel leturnlng to the room through, the-.ppenj'wlfydowAyW| have also found cases where dangeroua gss,. vapor,v.dUft. or; fqm*" ' ` adjoining departments through open window* afte^' hVVlng been exhanitedft from an operation nearby. The obvious answer Is to `extern] the exhaust? duct above the level of tho roof. ,* Iti-ccnlly, durii g an inspection of a spray hooth^ department Inia.large t '4i ' "t ` ...worth. . ; T*1 need for speed In production today Is of paramount Importance, but It should not be at the expenee of forethought In the provision of safeguard* \ lor health and safety. Mr, Barnes, In his excellent paper on keeping score ' on toxic materials in tho plant, bus provided a practical, working method for accomplishing lliut tusk. All too frequently 11m Aral knowledge that the modieal or safety department luia of u new pruecHH, machine or mntorlul plant, it was seen that tho uxhaust system was not .opfatlng! It had .been Ji. ` . is when it ia in operation, perhaps in an obscure corner of lint plant. Fnre- shut down because of e complaint frpm a nearby department tlmt thq^yjiporf' made the mon si'ck1 . "T"he vapora were ex*haua`lei! In`to:'a cou` r`t,' qxpge.ln^-pisny workmen to e hazard that was not a #part of tliply Job. r Tiie use and care of respiratory continues itoj^V^J$p(pblem&|i o( tho know-how inforinallon published by the U.'i]|(Ilnfj(aif''of,Mjne3VlMi oilier orgenUetlons, Including our own. Most surveys d|cluso at least; ono| ' ' thought will prevent dangerous exposure. The cost Is higher for placing iIWAii rmakeshift ssfcgtiurds or exhaust equipment on it ninrhina j. f Time is lost and confldnnco In ninnogcment is endangered ning is neglected In supplying proper protective devices. lifter It In In iino. If iidcqiintn plan The Foundation Is now engaged In a study of tho toxicity of Ilia prod ucts of reliction from tho manufacture of n new climnieul by u ineniliur coin- " ~* " * . : r i A- l. ....i > . li.du|(l,l llrslfii* F'mds|tp/|tf.^i/i.i ii/`v? rjV'fh/WfrSf*'-' r ffifwnrm Uuriug tho laboratory stages of the developmental work on tills ,tH).n.T7 01 nnnnilCED . ..-jay ;! . ' '. ' ' ,P:V>;'c^fr"i^ th'r* 'me-`e.no lndlOoni"of;`d^jr^T(^y#^^r u'wii^plw^" rj/vlnTHot'plint protraction twovrorlanen were gtrieksn'/sBrjoasly fromllexpofJ . to the ehomleal or one of tho byproducts, 3. * .t; ' r . * By means of the data obUlned from animal studies-lt`will be possible^ l.'i n t Ijvold a recurrence of this tragic experience. Every neiv chemical or prod*? Jy VPet'rhould be Investigated as to ita toxicity before'it Is; prepared in.largqjl j-i |Syjoun|a and released to the publie. .This practical common-tense procedure! ir(t U followed by several larger producera of synthetic chemicals. At least two] fCLfiof the companies are members of the Foundation and can furnish detailsl ffigjfrlhtlfr experience to other Interested members. 1; ,-Jj. >)v, _ /jsjrjMJvTIierf >re still too many pates'of dermatitis cansedtbyfirorlanen^yvisiivl, e ln'Verosene, gasoline, or carbon tetrachloride. - Protective creams Will? ' prevent grease and grime from being ground Into the sldn. The protective? ;V,l cream and the dirt can be removed simply by warm water. In stubborn! C*'M * eefely soap may be nestled. ., . - ^ .- r* Restrictions on atrategie meterlala for our mllltaryfneeda havg results! TV1 In fhe Increased isverity of some common hazards^ *-Tbe.'amount ; of'tint Hi Prp*t' *n soldara hat been reduced, resulting In an Increased amount of) and occasionally the addition of other toxic metals such as cadralum.j ; Pjpoiarca to furots from solder should be re-evaluated in tbo light of these! conditions. Tiers will undoubtedly be eases where protective measures^ JJr'wldch were adequate for tho normal solders will fail to prevent lead or'] ifypadrolum poisoning. r, , J *a*7iPfg^conductetiJbyithe^Foapdatioi{i(so 2/^ri^e.jw 1942 is sippondod &|i&lg>pori;Tbo 'foduiWesatiiWL^ i>vjth|fvwgy eponprise large and email companies and include chemleal, steel,!? um. projinc^s, glass, electrical, and container manufacturer^. : ' y i ' ihf$km'* .............................. u ' uL* V 5, Typical Surreys Conducted by Industrial llyflenc Foundation V -- --;'>' - ----------------------------- Industry Type of eurvey Haxarde '. Cbsmleal manufacturer Toxicity atudy Oaaee and duel jfChemical manufacturer , Toxicity atudy ' Dual ; Coaled products manufacturer Spot survey Vapors . Eleotrloal equipment , % nii>nufn(urr Spotaurvey Dual EUotrlcul equipment . mnnufacturer Uenaral aurvey 1 lusts, vapors, Suees tc fumes . Qian manufacturer j; i , Spot eurvey l>i instills ' Ole>* manufacturer Spot aurvey Ituals, vapors * gases 'Olaia manufacturer t` Heavy chemicals manufaclurar | Metal container inenufeclurer Spot survey ' Duet A Spray Two weeks atmoeptierlo atudy Atmospheric pollution Spot aurvey' Vapors, gases A dermatitis Findings and Recommendations Hazard di`|rmlumf-- Iona lei mi alndy ret'OMintwiidad Study In progreae ' ' tlaxanl under onnlrol ' llatard iimtei mmtrol H|lOt MI||-VyM rcMUMiMniided flesard v*MilMdlid by pniUullvii in `nine 4k pritUdlvM cliillilny llazunla iitidm i iintnd eii'opl fot* liM rreui uniof ititmuat equt|Miint Check on previously Inalalled eoulpinent;-' found aatlefsctory '' Extent of liavard duttfi'mliied P'lhanst vunlllallon - - rocmninunded; oreems St protective clothing Introduced 1 Steel producer General aurvey Dusts, vapors, Spot stirveye gases A fumes reconiniumted . CtAbT f/ * Sleet producer ` Steal producer 1| l. ! ;-**-'**-/ i*r'T'h&tf .,f- Hteet producer - Steel menufacturer Spot survey General eurvey Dust Dusts, vapors, gases A lumes Bxheuet ventilation, ' uee nt water to * reduce duet; new raw materiel storage ' ' 0|Hl HUrVri) * auytfeated Spot eurvey Kunies S gases Kxtiiiiiat ventllatinn recommended Spot eurvey ' Dust Kihiiuat vnntllatlon recommended bt-f- r .1 ^V .\F?Mv:?5<; , : .Hf Vl . Stone producte company Spot aurvey (Imei A duet Stone product* company Spot survey Dust ICilmiiet veulllnttnn siiKKCHled wlmre ni'rded Kxlmiiet venlMntloti renmimendtid *i! / i vfr- I .< .1* 'i ' -.I |'A ' * (I* \ -..! * .> Wv jVrv.iKi*.'Crvivi?. '^ PLAINTIFF'S EXHIBIT l-e-.l \ |a Zinc end teed producer N?y, .____ : Two moiillim alnineplierlc atudy Atmospheric pollution Itaxard under rnnlrol 03 PRODUCED of'tb* Foundation could help the Foundation :janil eery 'materially help$rat$$ij themxelves by repirtlng any unusual problems or!new problems which nrlse.^Jn*jn|j.' . This practice would make It possible for other interested members to Immed-^BfjjKvWf lately profit by yojr experience. Here are a eouple of question! that were' put up to us, and l have an Idea that one of these at least can be answered by some member * ho perhaps is .not aware that others have the same prob-?'*"* ' 'ijt L. D6 fluoride fumes from weldtnf.operatlona'pressnt >.4i0rl^us;occapa'( : ' tloual disease hastedT . V. ;?, 'f\ * i 'o.'-.f.!*''/ .Many of us know that It Is a potential haiard]ln llgbt'alloy ,weldings',': , especially magnesium, and perhaps It Is also a problenuln certain, steel,mak^ j (nr processes. I don't think many people have any datalthat qxtend ovbr any long period. I wonder if any of the members would'cafe td comment'on the' r I( . 1 have no adequate snswev.to It, I will'adrplfjv* ' M't' ' . v iA'.' , ..! V C. FRARY (Aluminum Company of .America);ttyeihad^eipetrik . ; Icnces 'before the last war with .tbe welding of alumlnnmfj[not''duraIumln'> as somebody said this morning, because that cannot be torch-wetded. All-. fluxes contain small amounts of fluoride. We have large ahopa In which: ' i,' I suppose we have had as many as fifty weldors busy at a tlmo. So far-'JSV.jT " wq have never had any Indications of any difficulties due to the s__m_a_ll fl'J ' amPunts of vaporised salts, Our own experimentahave>liidlcated that raostnf' of tho salts which are vaporised are not fluorides but chlorides. I think thet$l'$ It Is very unlikely, unless you have extremely poor ventilation, you will havo.-' any difficulty with the fluxea which are commercially used or which wo ,3Wv.' . commercially use In the welding of aluminum. I can't say as to magnoelum,U^:,r.V !` although we have welded magnesium, also for the last.four'or flvo yoare T',^5;,`'-(lv. without, as far as l know, any Injurious effect,. ' ,i . ./hS)'-1.* i t ,f fl , t J. .'j , -* Vs.*. : ,`j'HOF DRINK Nil: p,rh.p, Dr. Iri,h ' 'VPR.' D. D. IRISH (Dow'Chemical CompanyfifOf'course we`.h*ven\ had nearly the exptrlence Dr, Frary has had with aluminum, I will, confirm that there are no fluorides evolved. We tried to maVe studies under actual ,we|(jlng conditions, snd we oouldn't find any. Tbat]l lnjUj^actuai^plant,' Vwfistw they are.weidlng. .^e don'tjhave'Cflnoentratlon^of^wt^k.'and'D'thero' -was plepty of apace for ventilation, fit la surprising tbo^nriall'amqqnt'glyer^ ' off. We made a careful study snd we didn't find H in ths'operallon, although - In the laboratory you can detect It7 When considerable heat and flux are', . ' used fluorides are present, but we didn't And them In the. actual welding'll operation. ` Dlt. VISCARDI: We have a plane factory and wq.Jioat/treat'VtiJMb degrees.wllh sodium sndipotaseiiiugmm''chloride. -"HasTaqyi study ibeen^roa*de^ regarding tho effect of exposure to th` i*s oper'ation!$.." ;"i My jc;V:. % IMtOK. UUINVKU: Tho esllon Is, la tbers j'any's,pecial .p..roc. a.uUq, n'jjr that need l>e taken from potassiua mmm .aAnMdJ sodiuma a.IIb, na chIlMoariidJkea'1.%;ua asmeJd.I)nn \ahae*ak ftf^ tr-e-aXtrIpl menl at a temperature of 060 degrees.'-' I can't answer that.V.1 am not per-] sonally ew*r that there would be any danger.. * .} J ti .' a. i. 64: .f. `-ai-.Vi-' Jw DR. FRARY: May I ask if that is the heat treatment of duralumin f DR. VISCARDI: No, it is aluminum. DR. FRARY: I think the bath used is not potassium or sodium chloride, but sodium nitrate with or without potussium nitrate. The risk which you (''have there Is that If you got the bath overheated you may got oxides of nitrogen, or If you got organic inatlor In It thero Is danger of lire or explo sion. Such baths should be in u very well ventllutod place, and extra care ahould be used to be cortnln that the workmen don't add any organic metsrlal which would reduco the nitrates, forming nitriles or possibly oxldss of 5 nitrogen. The fumes from the nitrates themselves would be harmless. . , . PROF. DRINKER: Another question that was asked of us: Is there any way in which immediate or rapid dariflcatlon could be aasured on controversial subjects such as the toxicity of carbon tetrachloride!. Elkins, formerly of the Massachusetts Division of Occupational Hyglonu, lies sug gested a safe limit of 2G to 60 parts par million, nnd Dr. Hmylli u limit of 100 parts per million. It is my own opinion Ihut if you got agrcenuml much cloMor limn that you aro fortunnto. I don't think that tho values ure far apart. 1 think you will probably And that most persons, when there Is any question from two sources as reliable as those two, will probably back tho lower one, although there are eases now, I am informed, In plants, whon the Jowor llguro Is really unobtainable. Would any one care to comment on this question of 25 purls par million for carbon telrachlorldo versus 100 parts! DR. E. R. HAYHURST (Columbus, Ohio): May I suggest that an important factor la the depth of breathing that the man hae to engage In on his Job, . HEALTH PROULEMS IN SUDDENLY EXPANDING . INDUSTRIAL COMMUNITIES ' '' ' HUNTINGTON WILLIAMS, M. D., Dr. P, II.* ' !j" j ' 'II. . .* . . <!... * \(V\ ' Ths them* of thie nmi'ling, "Keep Wer Workers Weill" la a joy to the* health officer. The wording: in IU apecUl Sold la Identical with the "keep! well" purpoae of all health departments, whether they be national, state ov} local; and whether the time la of peace or of war. What a thrill Ramazzlnnl|| For ThecUrah would get if either or both of these worthies, our intellectuals ;forbears In Industrial hygiene, could be with us In Pittsburgh for this-two * ".day ataeionl; ( ' . ..A: < fAtj| If I* only possible for me to aketch a few of the more Important healthf problems for you as they present themselves on the health officer's horizon In industrial communities that are czpanding rapidly because of war. Natur ally, the focus in order of importance in any such Hat will vary eomewhatj^ In different communities. We won't be far wrong in putting housing at the $ f ip of the list. The type of near-slum or overcrowded rooming house orj C trailer camp community that war workers are forced to live In ns a reault.^WT of boom industry it frequently disgraceful. Often through lock of sewer-'*1* or other primary si.nitary facilities there may be a health hazard of first, magnitude. Communities are usually doing the best they can with the ' housing puzzle and the health officer hopes that the Industrial manager will * be fully aware of its nuture and patient with the efforts being made to .V*';/' ' A Hr*' it-. . mThe he|tl^offlci'r thinks of his wartime population Increases as groups^ h: i afpnfe Ipdoptry families medlcal ^nr-vlcef than are the that are more In need of protective health end stabilized normal citizenry. A rapidly swollen -population with'many young families will create the noed for more maternity > lieds In hospitals tluui msy be available) for more time and attention ftom JjsMK* .... ^practicing physicians than is possible with shortages caused by current^''"1' a military needs, and the same applies to nursing and dental and related medl- ?fcical sefrvices. A health officer is most uwnssh..ap|#p|yj sisf ethisevrsev are large iniwusmusbiwesrsa v*.,sj (.1c.h11ild.1r-eIn- over six months old that have not been protected against diphtheriarj -by Joxold Inoculation. In a community where there Is compulsory vaccina-,J31 Jtlljfltfoe school attendance he Is distressed if an Influx,of out-of-state orfjjjbrar,,w <Y^orfl ^en,e workers Increases the ratio of persons not vaccinated agalnstiS. *V|] * '.ims'lnlp.oI-z.; or iift_n_e_w_ 1_o__f_f_ic__ia__l__h_o__u_sli_n--g projects .s.w..e.IlIl itthse. 1lo^ca-1l population In - t,| 'll v n area of his community with thousands of babios for whom no well-baby fa;l'* t'cj(p|cf are available; and he will go to work actively to aervlca these need*. rural familiea coming into cltlea aurely does create com-T^ t'd^oloa^le disease problems. We had lato last July a moat unusual case of . Pdlphtjicrla in a baby only 27 days old. City-bred children rarely get diph-V y (br|s>under six months of age. Their mothers are thought to transmlt/^WIjty J0 9wn blood antitoxin immunity, which apparently continuca for ome"*I ^montlii'sfter birth in their children. In thia unusual case the mother hod 'fhJiwVj ;^besn'|>|Ko)rn Iin a smsaull rural ltown in a neiKghnbnorming stuantes wwhnetre tluhcere proobuihiilyy``fJljhvusyl!v".'). Ck iI'1tt1l'e or until no diphtheria over tho 1041, wlinu sliu movod years, She had to llnllliuore no lived that in that vicinity nilV hor Imaliand could U fill eac]i f nip. lo..y.me.i.i.t....I.n. a war I..n...d..u...s...t.r..y. . .. - .; .|. .... . i Vi W The health department coneldora this type of iquestlon'as related to nnnlMloner of-lleellli. linldmoN, Md PLAINTIFFS exhibit <1 other wur worker problems of environmental sanltatlonT Rawer and toilet and drinking water facilities, of course, are never out of mind. Sanitation of the milk end food mippllee likewise pruaentn urgmil Hiluutlwna, for thore may ho un inudcquncy in lha local milk supply or In the portion of It that is pasteurized and safe. In the vicinity of shipbuilding plunls or other war industries there may he mushroom growths of rustauranta Unit have trouble In securing competent food handling personnel who know how to avoid the dangers that lead to food poisoning outbreaks. Now you are probubly thinking that first among the health problems In expanding industry would be those resulting from new processes or front plant conversion or expansion. Of course, any health department with an active industrial hygiene service Is prulty constantly In touch with matters of this kind, although many locul liculth depart munis leave iuduslrlnl hy giene to their state health departments or braneli units thereuf, or else cull on the U. S, Public Heulth Service for liulp. Apart from the gouurnl sanilury facilities of a plant such as safe and adequate (dumbing, ventilation and lighting, there are many opportunities for a health ilu|iiirtmimt to serve Indus ' try on a consultation basis for the purpose of studying and controlling health hazards due to potentially poisonous chemicals or ruw materials or process ing methods. Examples from our recent experience would include lead, silica and other toxic dusts, welding fumeB, benzol and other volatile sol vents, and dnngcrs from radium dial puinting. . Let me tuku a moment to picture for you two Instances to show tho type of cooperative relationship that may hu established hutween industry and a local liculth department after years of effort huvo boon expotulud on building a bridge of confidence in this matter of industrial hygiene. Small Plant A. Two to eight employees. Ilenxol an a solvent for robber. In November, 1040, u Mine Safety Appliances representative reported to our city health department an inquiry they had received regarding the use of benzol as a solvent for rubber in the preparation of insulntion coal lugs for small electrical switches, under a government contract. This wus a dipping operation and tho plunt executive was concerned with tho ox plosion hazard from possibly too much benzol In the utmoephoro. lie hud not considered the health hazard from the inhulatlon of benzol vapor. Wo sludiod tho air benzol content ut tho plunt and found H nbovc sufoiy for workor Inhalation. Wo nlso found that there hud been no provision for benzol vapor removal. There wero cartridge-typo rcspirutnra available but they wore not being worn regularly by the workers. Wo recommended that local ciliuusL venti lation lie provided. The father of the plunt manager happened In bo a well- known physician uiul through Dr. John M. McMouoM, niodirnl director of oor Ihircnu of Occupational Diseases, nrrnngcineiils were effected for us (o make more exhaustive studies in lliih plunt early In 11)41. These studies included nniilyscs of nir samples, und blood and inlno specimens finin llirco workers. A local exhaust ventilation system bad heim provided but bad not proven an helpful as (lie plant manager had Imped. Kveii ns, Homo was apparently no bad efferL from lliu iilmonpheru on the walkers up In March, 1041. A year Inter, in Morrh, I!) II!, we relumed to Ibis plant ami inora samples of nir and two series of urine specimens were examined. There hud liuon Increases in (he benzol content of the atmosphere und the urine specimens showed evidence of benzol absorption by lha workers. Them had apparently been a dccreaso below normal In the Inorganic aulfnlc content of the urines {.'iHUiSOIl 07' iircn . .i r.. tested. Chronic expisurcs of this' typo following ouch warnings would threaten the heolth of (lie worker* with a severe anemia that la commonly > he result of chronic benzol poisoning. The conditions we found apparently f hull resulted from a marked increase in the work expected of this small plant. Eight person* were employed in the process, five females and three !i 111 a lea. All eight wen exposed to the benzol vapor. It was clear to us that i`\ there was need for prompt corrective measures to prevent benzol poisoning . Mid the plant manager was most cooperative. j During the following month of April, 1042, ethyl acetate was substituted^' for benzol as a solvent although there still remained some benzol In thejrutiber base as received. Air studies in the plant showed a marked decrease . in the concentration of benzol vapor and improvement was also evident I nun (ho results of (nrlhrr urine analyses. Indeed, an entlra new building i being roiistrurtcd with improved ventilation to correct (ho former hntsrds. Our latest survey in August, 1042, showed that the work was being done hi tbe new building, that ethyl acetate was no longer available and eo bonzol was again being used as (lie rubber solvent, but air samples showed low oiircntrations of beirio) and the urine analyses gave negative results for any evidence of benzol ubsorplion by the workers. Here we have a splendid example of a stnull plant where the owner and manager was not fumiliar with the hculth hazard involved In the use of >niibl. When it wus brought to his attention he cooperated fully with the industrial hygiene ser/ice of our city health department in authorizing the todies to demonstrate Unit the hazard did cxiat and then in Inking steps for its elimination. barge Industry H. Five plants--approximately 4,000 employees. Dlvl- ,Ion of radium dial painting--10 amployeea. In this Instance the plant superintendent. In September, 1940, was first In touch with the Director of he Safety Department of the State Accident Commission, who telephoned Mr. Wllmer If. Schulze, In charge of our city health department industrial hygiene services. The plant waa about to 'begin operations In the radium fFftj painting of dials for use under government contract and was seeking all ''--i .diieluable information aa to the precautions that would be necessary. ' After s conference between the plant superintendent and Dr. Schulzo,i i he latest mimeographed information on the health hazards of radium paint- t,y. tig and their prevention was secured from the Division of Industrial IIy-|>l`( iene of the II. S. Public Health Service and supplied to the superintendent'' Mlh mi offer of assistance from the city health department. This was in bivcmhcr, I!) 10. The following month the plant began operation In this held with nearly oil control and protective procedures established. The city health department was thanked cordially for Its assistance and guidance. ; In April. 1041, the city heullh department and the plant In question ' ei|iiested and secured the assistance of the l). S. Public Ilcallh Service In *-. making plant studies of eiposure to radium emanation*. Following this, j*li rvri sl precautionary measures were recommcndod and adopted anil nrrango-^;r`j .Hants were completed for the periodic medical examination of exposed work.^fil rs by insurance company physicians. In July, 1941, further studies In the I'Unt and observations of tliu operations led to Ilia suggestion of additional :! . I'lecaotloui which wars promptly followed. The plant managnmont haaV^1 I'rcpartd and posted s series of operating regulations dealing with radium; 98 1 PLAINTIFFS EXHIBIT paint which are put up In the room where work of this type is carried on. Hero again we find that the monagement of u large pluut with a very particular health hazard sought guidance and before inaugurating the espe cially hazardous process established protective procedures in the closest teamwork with the national, state and local oAlclal ugencics interested in aiding industry in its efforts to protect the health of Uia worker. These aro examples taken from currant experience in a city health department whose interest In industrial hygiene goes buck to studies of carbon monoxide poisoning in 1922. These studies resulted In u strong locol ordinance for the control of gns poisoning which waa enacted In 11125 uml has been enforced under health department control witli iitcrcnaing effective ness ever since tliut lime. From this vital beginning tburit linn Imuti a fairly aclivu expansion in industrial hygiene in our health department ainuu |0.'I2. This was because industrial hygiene is a logical mnl inlogrul purl of liny general public heullh program; because of Dr. Schulze's personal Interest and competence and because no one else in our clly or slnlo was nfTIciully oclive in this field of endeavor. Our annual reporla since 1932 show a wido scope of service and an expansion into occupational disensu control under additional trained medicul and laboratory and field staff. Theao Inlor devel opments Ituve been associated with (lie more recent si ale legislation in Murylnnd that wus enacted under the wise leadership of Theodore C. Waters. Now in what way cun ull this be of some prucllrul interest to you who are responsible for tho direction and control of wurliinu industrial units in your own communities? What cun you do about mutters of this kind? It would seem that, hy und lurge, industrial plant managers, personnel directors and operating officials in Industry aro loath to mu lie use of tho sor- vIcos In Industrial hygleno thut are available for tho asking from health departments. Slow and laborious efforts have been made on both sides to build the bridge over which these services might llow. In mumi plnros, as In the state of Connecticut for Instance, firm and deep foundations huvs bean laid In a most satisfactory manner. Tho war of courao accentuates the tempo of llfo In every field; and I would Imvc you tuku uwuy from this meeting a feeling of dlHSiillHfiietlon and unhappiness over the slow pace, the trickle of survlcc, tho hnsllanrles and doubts that now aluiid in the way of maximum aurvlro in InduHtrlnl hygiene from hentth deportments, stale, local or national, to industries that aro called upon for almont superhuman wartime endeavor. Now, of nil times, Chambers of Commerce or Associations of Manufac turers, both big and small, need to know this desire for service on the part of health departments. There should not he the Htightest hesitation for a plant munager to pick up the telephone and cull the city or state health commissioner uml sny, "I want you to send over your inim mid study tills process and tell us whether thero is any health liuzard Involved in this or that new work we ure undertaking, or old work Uml. we aro expanding." I'laiil managers nurd lo upend an hour scrutinizing lliciiu niallni'ii. They lioril to fucu the fart, as aeeii III the cinin of Hiuull I'lant A, munlliinuil iilniva, that a plant malinger may he wholly unaware of I Im presenra nf any hculth hazard in his pliinl. Kuril a malinger may partleuliirly nerd In mill for a gonerul plant aiirvuy by a trained indentrlul hygienist, lie or Ills designated agent limy need to study tho type of uirdicnl service ho now sinpluys. A part-tJmo physician, Interested primarily In industrial surgery, a man Il. lhi.f ! o!) nit .. orfl ?$' fe'. already overworked perhaps because of war shortages of physlciuns, will notv; 1*5*1:. v always be in a position to take the interest needed in preventive medicine in ''/'$ ' the plant that employs him. And do not forget that the public is watching >.) vMnr$<? your performance in these matters. You may remember two presentations < " of tlio subject in the Reader's Digest, one in March, 1041, entitled "HI, Doc" Jj' ! and one in June, 1041 under the heading, "What Makes the Worker Like to Work ?" In large indjstries the plant manager may need some keen teehnl-, , toy cal assistant to serve as liaison ofllcer between the plant and tho industrialtR'k-j: hygiene service that ii available from the state or local health department. : ' It Is splendid for the 260 member companies to have the services of thefipy Industrial Hygiene Foundation with its headquarters here In Pittsburgh.'!r>< There will always he more than enough work for thie Foundation to do in' '' .* research and consultation and guidance, hut it probably can only scrulch the. ; Mirfsre in tin) great volume of Imlustrial hygiene und occupational disease r.iulr,.I work lliul needs to he done in the Ihuusiinds of industrial communi- ' 1 ties thut make up the mnnufucturing and economic lifo of our nulion. And . so, at long last, stutc und locul health departments are recognizing industrial ' hygiene to be an integrul part of public health service, as a responsibility l.fil^ r of stairs and communities that must he met if thore is to lie any well- ' rounded pulilic health program at all. We, in our city hcultli depurtmeut, have been pleased with the requests "c Imve received for pulilic health service from industry, but usually the . requests conic from old friends who have been working with us for years, ' I have in mind a printing plant who called up not long ago when one of their workers had developed typhoid (ever. They wanted to know what to do. ~ Another large plant, one of the biggest in our area, witlh whom we had also ' been in touch for yean, called us recently to ask if they could get a blood - lead test on one of their workers in whom they suspected lead poisoning. Now, we have been doing blood lead teste for seven years for industry, but the physician in this plant apparently never knew It or had forgotten it . and of course had probably tost Innumerable opportunities for letting ue ; , help him and his large corporation in this and In othor waya. (A> -" ,t -T*. ' We sense a reluctance on the part of induitry and Industrial physicians>c to call on us, although 1 think we have leaned over backwards In endeavor- ? Ing to heiray no confidence with management, to serve on a consultation'. ` slid not a regulatory basis, lo seek to serve employer and employee alike, : i j hut in a manner that would always leave the door open for further calls. : ' Ytl over the pest eleven years the Hnltimore City Health Department can ' muni on less than (lit ten fingers of two hands the number of industrial plants (hat have of Ihrir own volition come regularly to It to confer on their industrial hygiene problems. The other industrial units with which we have worked have, however, been receptive to approaches we have made to them. ' With only one exception all tho plnntn we have worked with have been friendly uml cooperative; hut by fur the greatest number in our com munity would appear lo ignore entirety lludr needs In this mutter and our ilrsirrs lu serve them, and this in spite of 11 cily-wiilo edueuliinnil effort to Midi our wares. State medical societies throughout tho country ore endeavoring to hi iisdiui the interest ami imagination and scope of information of induntrlnl physicians through institutes and training courses and by other means. In the past few weeks Dr. ltaymoml Hussey in our community lias secured the' Inauguration of a new and unique course known as Physiological Hygiene 70 V, 7--Industrial Health for Physlciuns and Surgeons, at the Johns llopkliis School of Hygiene and Public Health. The task ahead for 1042 and 1043 wus well described a abort wlillo ago by a great industrial leader as follows: "The number one job of ihe armed forces right now, brutul us It may sound, is to kill Maxis und Japs. The responsibility of the home front is to speed up production and delivery of material to our armed forces to do that killing with dispatch uml Ihialily. Tho only way our industrial machine can accomplish that task is to keep ' Its workers on the Job and working at high efficiency. Their health must he maintained. 1 am not being altruistic but extremely practical." And so, with an eye lo wluil bus been achieved thus fur, uml it deep appreciation of opportunities like this for us to study our problems together, it would seem that we should all welcome the present war impetus. With promptness we can and should build a better bridge between industry and health services and stimulate the two-wuy traffic over it for the purpose of ihnintnining it maximum of hcultli and efficiency among industrial workers. An uhsent worker is u loss, whether absence is due to illness or worry, uud whether the illness developed in the plant or at home. This means lliul tho problem is inore than Just ono of good plant hygiene; it culls for statesman ship in management ufter study and awareness of Ilia broader implications of community health, with more than it thought to housing, communicable disease control, medical services and related civic responsibilities. In this nutional endeavor to keop wur workers well it Is indeed forlunnlu lliul tho Industrial Ilyglano Foundation of America Is playing 11 leading role. PROF. DRINKER: We now havtf the pleasure of turning the meeting over to the Legal Committee Chairman, Mr. Theodore C. Waters. 3 PLAINTIFF'S I EXHIBIT 00 01.1.302 71 produced V. *i , i -i t V .-+'. t';*'1 REPOHT OP LEGAL COMMITTEE 'Ifft THEODOIIE C. WATERS* j .. .. _ *,fJ j t With the Increased activity In our war production propppm, meny.'natf^iJ lays) problems have arisen that are of concern to thoee executive* directing tfj-ption' production efforta. We have come to realise .tbat upon manage-* j; tnent: rest* the responsibility for the maintenance of .the health pf indue : - trial worker*, end in the discharge of that responsibility 4 Is'ossentlal thatr.^ _ 1 management ahould be advlied of and comply with the various laws, rnla,`,*;^SW'?r)i.*.jR ami regulations applicable therolo. This year our Committee haa been If requested by the Managing Director to include in ite report reference to}^ thu following aubjocta: 1 Summary of state and fadarel law* relating to the employment ofj.'J woman In. Industry. ~ , *1 IIt. An analyala of occupational dlaaaae compensation lawe Introduced at the 1042 aesslons of the elate legislatures. ; 111. Activities of legislative Interim cotnralaalons to atndy and recommend leglalation for occupational disease compensation. IV, Discussion of Important court decisions construing occupational die , S case compensation atatutea. .. . f*c>: . 1. SUMMARY OF STATE AND FEDERAL LAWS RELATING . TO THE EMPLOYMENT OF WOMEN IN INDUSTRY , t if In order that our war effort may attain It* goal at tho earliest poasl- Ida moment and with the minimum cost In human lives, it la nocoaaary that j'; 1 tba armed forces of our nation should have first call upon our. young able- tt >&<. l>odled manpower, To the ranks of'the armed service havebeen called the^.J'^ft^ .'' cream of the manpower of the naUpn-the type of men tha^ Industry haa^/.'Jtw'- hereloforp sought for employment.r. Oh the other hand, there has been tremendooa Increase in our induatrlal activity related to the war effort, -r * v with the rciulting demand for employee* to produce the good* that will, j (t.v.: . muke cifeotive the effort of our armed forcoe. There Is noy aufliclent man-?;< power available to All this need, and the womanhood of our country haa,fti been and la being called In Increasing nutnliors (o assume a moat Important |U 1 part In our national effort. 's'&V v' Many atatoa have various laws applicable to the employment of women in Industry, end I will summarise some of these lawe for your information. . - n,e Women's llureau of the United States Departmout of I.ahor hue rccontly published Hulletln No. 1 tS7 that dealt with "Stale Minimum Wage l.awa and . ' ultral Wage and Hour Law, which covers employees engaged In Interstate '.^pc ointnerce, and the production of good* for interstate commerce. ------ .it Si.Uulllkln, Siockbrldr., snd Wt*rs, Dalllmora, Ud.; Chairman, Legal Oommltla;;jr1 ,,dut[1| llyglaoa Foundation. ... ,i,` ; . udjpj ij(4/.>jwTt,)f. .. , . iU` J-'-7* PLAINTIFF EXHIBIT The U. S. Department of Luhor Iiiih sumniarLml Mtutn l.itbur l.ows fur Women, covering ilia following claeaus of laws: ."l i'i . ' i 1 -- Prohibitory and Regulatory I.bwh 2 -- Night Work Lana 3 -- Maximum Hour l.awa 4 -- Day of Rest Laws 1 Prohibitory and Regulatory l.ava . Twenty-two states' and the District of Columli u have no prohibitory or regulutory lawa regarding tho employment of wnimm. In anviuituen atatoa" women ora prohibited from working in niinoii; Oregon proliibilH their employment in mesaengur sorvicu; Connecticut, Muutmcliuscltn,' Mis souri, New York, Vermont und Washington require specified uiiumployod periods before and after chiblhirlli; Louiniana forhidu them cleaning moving machinery; California prohibits the lifting or currying of licnvy weigbta; Colorado prohibits their employment ill tliu operalio l of eoku ovoiia; Ohio prohiliila their employment as crossing wutchmen, moldera, workers in blast fornuccs, etc.; Pennaylvunia prohihlta their eniploymenl for inamliiin- lug fircH in hund-fired boiler furnaces, hundling iiitrutorH In the niiintifacturo of nitroglycerine, and the operation of crones, together with forma of weld ing; New Juraey ami Pennsylvania prohibit their employment in the tnunufucturu of nitro and nmhln compounds und other Muha'.nnces containing Icml in excess of 2 percent; Ohio ami Utah prohibit their work in smelters; Arizona, Netv York, Ohio, Okluhomn and Wisconsin prohibit llicir work in quarries. 2 Night Work Laws 'Eleven states* prohibit the employment of women ut night In mamifuctnrlng establishments. All of these states now provide for exemption in war manufacturing for women Iwcnly-mm years old, nml over. In aome of these slates tliu night work lows especially provide for exempli.... while In others the Governor or Rtnto Luhor Dcpurtinontx hove grunted nxuinplions under their general powers. il . Maximum Hour l.awa There ur five elutes (Alabama, Florida, Indiana, Imva. West Virginia) that do lint limit the length of the work day or work week. In twenty-one atntca' nml the District of Columbia the maximum work-week for employ- Montana, Niilinisliii, Navudu, Now Ilani|,nMio. New Mi ten, Nurllt i:,u,,|iim' i!f?r. J? .'I". 'skoal, Si.nlli Enroll..... flonlh liiikilu, Tuiun nawn Tinas Went VlrKliilit uiul UlMrlct of (!<t|iinililii. *. Alnlmiiia, Arlxntin. ArkatiHiia. ('iiliirnilii. Illliiiila, liiilluim, Minn..... I, Miiriliiinl New oiut Wyim!t'ii|',,,,,V,'1"' OI,,Hl"m,,l l`aiisylvaiilH, llluli, Wiii.hliiulini, WU.'iutaln S. r.'onnnrtleul. MiissaeliiiHi-tts Ncliriiaka, Nw .lursny, Niiw Vnrk. Ilrlawarii linll- aiia, I iintisylvunlu, CulUuriiiii, Kiiiisiim und Wlxconsiit. ' i. Connaetleot, l-oiilslstia, MusMiicImsatla. Nivmlii. New lliuii|ihliv. N.iw Mcic.i T.Tkl 1 T,;K,". Peiiiisylviiiiln, Utah, Vlralalii, .................... Calir.in.la, IIIIih.Ih; Ohio. ItlimJn liilanil. WnshliiKtoii. Arlxona, Ninth Oiiroltiia. Ninth Imh.itii, llimili Citronnu uiiu lilitnct of Colunibm.