Document RagRRV31ozxbbbwGdQX06MprV

TWENTY-THIRD A NN'V At SAFE TY CONGRESS NATIONAL SAFETY COUNCIL o 'I? W - -r- 'h\ Quarry, Section A Officers 1933-34 General Chairman--Oth.6 M. Graves, The General Crushed Stone Co., Easton, Pa. Vice-Chairman--Wiluam H. .Baker, J.jE. Baker Co., York, Pa. JS.__ Secretary-and News Letter Editor--V4 P. Ahearn, National Sand and} 'Gravel Association, Washinfgon, D. C. Poster Committee Chairman--H. F. Yotter, The General Crushed Stone Co., Easton, Pa.. ` ' : Publicity Committee Chairman--J. R. Boyd, Rational Crushed Stone- Association,, .-Washington, D., C. ! Statistics Committee Chairman--W. W. Adams, United JStates ^Bureau of Mines, Washington, D.. C. .^ Members at Lage-- ,, Norman G. Hough, The National. Lime Association, Washington, D. C. H. V. Gwens, Eastern Rock Products, Iric., Utica, N. Y. John Prince, Stewart Sand^and Material Co., Kansas City, Mo. . A. L. Worthen, The Connecticut Quarries Co., Inc.,. New Haven, Conn. ^WEDNESDAY MORNING SESSION October s, 1934' . ^ } The-opening session of the Quarry Sectiorrwas called toorderby John Carrip- bell, Director, Bureau of Inspection, .Pennsylvania Department of Labor, and Industry, Harrisburg, - Pa., who. presided. This was scheduled^to-be-a "joint ^session with, the Cement Section.' Chairman Campbell introduced P. ^. Mori, Works Manager, Cleveland Quarries Company, Amherst, Ohio, who made arbrief address' of welcome- tome delegates on theipart of the city of CfevelaMd.. . . In lieu of the annual report- pf the general chairman Otho M. Graves, who was -. unable to be present, a lengthy wire was read' from him expressing his -regrets.-. :Chairman .Campbell, then introduced the firstcspeaker. - r 349.. A O \,y PLAINTIFF'S EXHIBIT PLAINTIFF'S EXHIBIT 350 Twenty-third Annual Safety Congress--National Safety Council ,,. . \ The Dust Hazards in ltidustry By DR. R.-R. SAYERS Medical Officer in Charge, Office of Industrial; Hygiene andjSanitation,' . United StatesPublic Health Service, Washington,DiC. The speaker said, in part: -Realizing .the importance of the dust problem in industry, the United States Public Health Service in cooperation with the Bureau of Mines, began its first Study of. the health of workers in dusty trades in 1914, in "the mines of Joplin, Missouri; and later, in 1923;' -the Public Health Service inaugurated a series of dust studies. These later studies were all conducted in the same manner in order to permit as detailed a comparison as possible between the different-investigations. ' . - Briefly, these methods o;study may be divided as fallows: (1) examination to' determine the general physical condition of the workers under observation; (2)' special physical examination to determine the prevalence of specific diseases of -the'; respiratory system and the lung pathology resulting- from exposure to the particular dust hazard; (3) record of the nature and severity of the disabling illnesses; (4) analysis and detailed study of the ^occupational environment; - (5) occupational mortality statistics relating, to. the specific.-dust; and |6) autopsies. _ , The first six intensive investigations carried out'by the, Service dealt with the- health of workers'exposed to dusts in, a cement plaid, granite cutting industry," anthracite and bituminous coal, mining, silverware manufacturing plant, cotton cloth manufacturing, and in municipal street sweeping.- Brief studies were later conducted in certain slhte, granite, marble and talc quarries, while more recently-a rather' extensive study of the diealth of anthracite coal miners was completed. These' six dust studies, showed that the porkers in the granite cutting plants who were exposed to the highest dust concentrations vjere found to suffer from an excess of pulmonary tuberculosis after 15 years or more of exposure and developed, silicosis from 2 to 10 years.; -In the group-.exposed to a lesser. amount of dust,' silicosis developed only after-prolonged exposure, with- ho "excess of tuberculosis. ?It was .found that; a dose relationship^existed .between the degree of dust exposure and the extent ahd severity of the pulmonary damage. Anthracite coal miners suffered from dyspnoea and other signs of pneumoconiosis and experienced a high rate of respiratdiy sickness; in addition, an excessive-.mortality from influenza- pneumonia ahd possibly tuberculosis was found. Bituminous coal miners experi enced a generalized fibrosis of the lungs and an excess jrfSFtality from influenza and pneumonia. Cement workers showed some signs of early pneumoconiosis with an excess of diseases of the-.upper respiratory;-tract Omtheifherhand^,workers in the .cotton cloth and silverware manufacturing plants and municipal street-,sleepers were negative for respiratory conditions' and' other illnesses when compared) with the general industrial population. Rock-Drilling^;,For five years, the United States.Bureau of Mines studied lead and zinc miners xi the Tri-State District Oklahoma. The ore here is high, in free., silica. Of the 7,722 men examined; a group of 1,647, -or 21.3 per cent was definitely.], diagnosed as having silicosis, not including those jdiagnosed as having tuberculosis. All the men diagnosed as having first-stage silicosis had worked an average of 13 years, but those men starting in file mines after 40 years of age worked an average of only 8 years. The work of rock drilling in subway and tunnel construction in New York City is in some respects similar to that 'of .some of the activities in the hard rock-, .mines, at least in so far as the manner in which dust.is evolved, the type of dust and the resultant hazard. Recently the result of a study of rock_4rill<Sfs^. blasters and excavators was reported by the New York (Tuberculosis and>Hea3th Association. An examination of 208 rock `drillers, blasters ahd excavators-,,showed that 118, or 57 per cent of the men had silicosis, in various stages -of progression. The exposure of most of these tnen (75 per cent):.had been for 20 years or more. Sandblasting. No study of the health of sandblasters has been reported in the United States; however, a study of the'dust exposure of. sandblasters was recently completed by the United States Public Health Service in cooperation with the Quarry Section = ' ' . 3J5JL National Safety Council. This inyestigaiion indicated that, judgol 4>y. .thV^^ire^ of the.fdust*.arid degree of the exposure, a real hazardsexists ifi\tiiis peculation. .This study also brought out the fact.that,it is possibfeito conduct sandhjjstini with safety, provided properly designed and well maintained equipment is usfed. DtaVotnaceous Silica Workers'. Most of the data' on silicosis have been gathered from sjmdies- made bot&Jn. industry and experimentally. on dusts containing free ^silica in die form of quartz. ,S.uchi; studies have been made in the granite iftdustry, , pbttery trades, hard rock drilling etc. . There are other'-free silica minerals in. existence that are-not crystalline ui nature but of an -amorphous composition. In Santa Barbara County, California^. there exists the .largest and'purest'.diatomaceous silica'deposit'in . the' world. This' substance o consists of about--85. per. cent-free silica^ Recently an examination was made of 108 workers selected among those. employed less ..than 1 year,. 1 to 2 years, 2 to_. 5 years, and'more than: 5 years. .All of-the workers were Mexican laborers and the examinations consisted-of x-ray 'determinations,'social and medical.histories, and clinical examinations, of. the chests. . Dust.'determinations were als.o <made but these were-not? reported. The outstanding .. feature revealed by ther examination was die splendid physical condition of the. men.. a,Eighty-four per cent of die workers were reported in excellent physical condition.. It was found that 60 rmed sffowed'signs >of early-pneumoconiosis; 15-'were in'-the . moderately advanced stage and 6 in the advanced. stage.. This latter finding was among workers with a history.of exposure of more than. 5 years. ' - Dust' Hazard in the Granite Quarry Industry. It. is arcommon belief that granite quarrying -is not so- dangerotis an industry as granite cutting in enclosed > sheds^ quarry work is .done outdoors and hence may jnot be attended .with very miicH dust : exposure. However, Certain. quarry operations require . the' use of pneumatic tools, whichare usually' associated with the formation of considerable quantities, of dust It was thought that a. studyCmade in a representative granite . quarry might- cast , some light on our problem. Accordingly, a> study of a clinico- radiographic nature of 63 quarriersJwas made and occupational dust exposures were . also obtained. -The. dust determinations sh6w that nearly 38 per cent of the workers (drillers) were exposed to many^times the amount of dust' considered safe at the present time! Drillers were-, the only-persons showing pathologic lung changes. ; Half of these workers with an exposure of 5. to 19 years had silicosis, and 4 of the, 5 men-with more than 20 years of such; trade. life showed this condition. This..study suggests that^'quarry drillers may=experience as high a death rate -from pulmonary tuberculosis-as do pneumatic-tool workers in granite cutting sheds. Effect of Inhaled-Marble Dust. -The pulmonary fibrotic changes due to the, inhalation of marble .dust appear to be slight in comparison, with those caused by stone dust containing a high percentage of silica in the. form of quartz. . A. recent /study made by us among marble workers showed that-.although .-marble, dust,. when,, inhaled in concentrations averaging aboutc.25 -million particles-per cubic'foot of air, produced; a mild bilateral, linear fibrosis in a certain number .of the . 80 men examined, no serious lung changes were noted a'nd there-was no disability^due to the dust, even after* many jrears of exposure (more than 40. years ih-some-'cases). The marble dust-under consideration consisted ;of 98 per pent calcite and 2 per cent .dolemite, with no.silica present.. c ` Dust Hazard in"Abrasive Inditstry.. -Artificial abrasives are widely used in industry and for this reason the effect of the inhalation`of dusts: produced in the manufacture pr preparation of thes.e- products is of great importance.: In 1925, 1929 and again in 4931, Dr. Clark of the ,.Norton Company'at Worcester, Mass., made investigations of workers, exposed to aluminium oxide and silicon carbide dust produced in the manufactured, grinding wheels, which showed that during a.period, of-13 years-there were, proportionately twice as many rases of pulmonary tuber- Jmlosis .among those working in the' abrasive dust departments as in departments. \ where ho abrasive .dust occurred. In. 1931, Kessler, of New Jersey, reported the /occurrence of over 100 cases of alleged,silicosis; ip the.abrasive, powder industry, in which the-dust consisted of 9 per cent free silipa. 'Z- r- .- ' EJeposiire to Silicate Dust. It .has been the belief that the inhalation ,of dusts, composed of ^silicates (combined, silica)/ in .comparison with silica (free silica ip . the form of quartz), was" innocuous. Of recent years many investigators have, become cognizant of the hazards of silicate dust exposure. Asbestosis, a fibrosis -<55 ' r?` 352. Twenty-third Annual Safety Congress--National Safety Council , * y? * A , of the lungs caused by-the inhalation of asbestos dust, has already been described, both in its clinical and roentgenographic manifestations by investigators in" other countries, but to date no studies have been reported in 'the-United States.^ Cement dust, which contains about- 22 per cent combined silica, has.. been studied,- and die effects of-the inhalation by workers has-been discussed here. .In March; 1933, Dreessen, of the United States Public Health Service, reported the results. of a study conducted among, tremolite talc and slate workers.. The slate-dust to which- these workers were exposed consisted mainly of. silicates, there being, less than 3 per cent of quartz irFthe dust. The 'talc-was a hydrous calcium-magnesium silicate, being 45 per cent talc and 45 per cent' tremolite, with sio quartz present. The results of the study seemed to indicate a relationship between the amount of dust inhaled and the effect of this dust on the lungs of workers. Statistical Studies. Recently,' Lanza and -.Vane -estimated that there are some S00,000 workers engaged in the mining,,.quarrying" and manufacturing industries in this countryv in which an exposure to silica dust to a harmful degree is en tailed. Their analysis of mortality experience of- twelve life insurance 'companies for die -period 1915-1926 showed that the actual mortality from respiratory tuber culosis . among the silica .exposed persons was aboufcKthree- times 'that of a non silica dust group. If one considers their data for certain occupations in metal mines: and granite and sandstone quarries, occupations known to be'exposed to high concentrations of hazardous .dusts, then the comparison, is more striking,, since the actual deaths 'among these workers was found to be ten times-, that of the'ex- Sected deaths. More detailed statistics on occupational mortality as reported by the legistrar-General of England and Wales (1921-1923),; and summarized by Britten,show the high rate of 1,886 per 100,000 for tin and copper miners, while-vthe rate im "all occupied and Retired males" was only 150. Other occupations with silica1, exposure showed an excess. <--S. Fft>m the. evidence just presented concerning.'the injurious effects produced by the inhalation of certain dusts,a it is. apparent that, a knowledge -of the properties of a given dust which determine its capacity ^to produce pulmonary pathology is essential. Numerous investigations of the industrial dust problem indicate that these properties are the chemical and. mineralogical composition of the dust, its concentration in the industrial atmosphere,-and' its particle size.' In an earlier portion of this' discussion evidence was presented which-indicated that a dose relation existed between .morbidity and mortality rates from various respiratory diseases and the exposure to certain dusts in industry. In the' study, of the dust hazard in the granite cutting industry, it was definitely proved that ,, there is a direct relation between the magnitude of the dust exposure and sickness and death resulting irom tuberculosis. It' is' quite evident, as a "result of these - studies.-that .the remedy of the dust evil lies in the effective removal'-or suppression of the dust to concentration considered safe. However,- no set rules may be estab lished for the mechanical protection to be instituted in an attempt to control indus trial dust Specific conditions encountered in .a plant will, determine the .type of protection to be employed. ' The protection of workers against- certain (lusts known to be toxic may at times be accomplished by the substitution of a non-toxic material for the toxic , one. One example of such' a procedure is the possible .use, of a metallic or other type of artificial abrasive for sand in the sandblasting process1 in thos.e operations in "which it is not essential to use sand, a substance nigh in quartz content Again,, the mechanical enclosure of the .dustjereating process also serves'to protect the worker. An excellent illustration of this type of protection is- afforded by the modem sandblast barrel used in the cleaning of small objects. Sometimes it .is- possible to_protect the worker by the^substitution of^wet for dry processes, as wet -drilling instead of dry.. In one instance,'''in the granite cutting study previously mentioned, an operator using, .a diamond point tool worked the stone wet; the resulting dust amounted- to 22 million particles per cubic foot. The same operator was then requested to'work .the stone dry; as a result, the. amount^ dust reached the. high figure of'45 million, particles per cubic foot. In the weaving of asbestos cloth it has been- possible to redtfpe the amount of dust in the air by wet weaving' to one-foiirth-of the amount present when the process is conducted-by, dry-methods. ' Another example of this procedure in allaying dust is the use of a spray of water '' ' 1 Qmrry Section 353- . " H- in leyner and jack-hammer drilling, in'hard rock, although the new-type of Kelly - .--dust trap is now finding mucji favor for this , kind of worife .. The" Kelly, trap-consists of a metal chamber designed to enclose the-drill steel `at the' rock surface. No attempt is .made' to secure a .'mechanical'seal-with theO rock or between;the trap and the drill steel. The dust is remoyed by an air*- Escape of ihe trap.. . ....... .. . . _.. ____ on this trap "under actual working "conditions show that the dust-concentration at the worker's breathing zone may be kept , down to less than. 10 million particles per : cubic foot with a 60 cubic foot. per. minute rate of air flow through the hood. This trap is a step forward in the program of dust removal; however, in underground work, stich.as: in mines and subways,1 there is still the need to solve the .problem of compact dust disposal equipment. " In'certain cases, suchas in the sandblasting of large castings in sandblast rooms, the practical safeguard to -the worker is to provide him with a mask or helmet of the. positive air pressure^ type. vIn the sandblast investigation previously men tioned, it-was found that when from 5 to'6'cubic feet of practically dust-free air., per"minute pre supplied to the helmet, the worker receives, ideal protection. -How- e'ver,' one 'must always bear in mind that the ultimate criterion of protection should . b$ the dqst determination of .the air within the helmet during blasting and not the ' quantity of, the aic supply itself. ; In most dusty, processes,fhowever, the most effective means of dust elimination -V ^ are.by the use'of properly designed -exhaust -ventilation systems... Since in many, instances .it js difficult,, costly,' and at times an unnecessary procedure to remove all . the dust in the vicinity ora worker, wc need, first to determine the\.minimum amount of. a certain dust which the worker can apparently tolerate .with' Impunity. - Such information can be made available by the type of . studies carried out by,-the Public Health. Service.-, For example, in the granite study already referred to;' it dust-at the .breathing level oPabout 10 (million particles per cubic foot (35' per cent -. = free -silica)/- - .. * .. -Studies of-Hust removal devices .used in granite cutting plants, at the time this- work was''conducted showed that- a a linear yelocfty of . 1,500 feet per7 minute as - measured by an anemometer'at the face, of the dust-remioval hood, would keep-the . `dust, at the breathing level to an amount less .than 10 million particles per cubic foot. .-A word should be said' concerning personal-respiratory protection`against dusts. It has already been shown-that in the use .of positive pressure .respiratory devices ' in sandblasting, it is important'to have a' well-designed-device supplied with about 6 cubic feet ofidust-free air per minute to give full protection. to the-worker. / With reference tb respirators' of the filter type, there is still much to;be accomplished in .the design- of an efficient and comfortable mask for continuous use/. Of great value are standard methods for the" testing of. the. efficiency of . respiratory pro-; -tection^devices. Drinker advocates testing a, device against/the particular. dust , which the . respirator is to encounter, these tests to be made-both in the laboratory and'under actual 'industrial conditions.s He further suggested that somo^impartial -, agency, should conduct such tests''and certify the devices for industrial ^usCKthe work b.eing done, on a cost'basis: The U.S.- Bureau of Mines has prepared-such a schedule for desting and approving respirators.. s . I wish tq stress the importance of good housekeeping in the'effort to combat the dust hazard. Good- housekeeping should not only imply the removal. oPaccumu- lated dust about a workroom^ but should also embrace efficient' maintenance of . dust-removal'* devices, and respiratory , protective equipment. 5 Systematic inspection -. - of all dust, suppression equipment should be an axiomatic principle in .every ..dusty industry rather than the, casual Attention which it now receives in many" instances. . VI ( -v, .. ^Report* of the Nominating Committee . pr . |\ r-;, The chairman called for the report of-the Nominating, Committee at this point, . ' and new officers fof'1 the s&tion to serve'during the ensuing year were dominated .. and elected as follows: \-v. 1*5* CV n :,..Q K ..-a 7 O 354 Twenty-third Annital Safety Congress--National Safety Cou\ 4 .A ) Xipierdl Chairman--William H-^BSker, J. E. Baker Co., York; Pa. ,, Vice-Chairman-^William E. Hilliard, New. Haven Trap Rock Co., New Haven, . Conn. ' ' Poster Committee Chairman--H. F. Yotter, The General Crushed Stone. Co., Easton, Pa. ^. Publicity Committee Chairman--J. R. Boyd, National, Crushed Stone Assn., Washington, D. C. Statistics Committee Chairman--W. W. Adams, ,U. S. Bureau of Mines, Wash ington, D. C. . Members at Large-- V. P. Ahem, National Sand and Gravel Assn., Washington, D; C. .. Norman .G. Hough, The National Lime Assn., Washington, D. C. %'0. M. Graves, The General Crushed Stone Co., Easton, Pa. . A. L. Worthen, The Connecticut Quarries Co., Inc., New Haven, Conn. The Foreman's Duties and Responsibilities in Preventing Accidents . ' By GLENN. GARDINER . ..J>. Forstmann Woolen Company, Pabsaic, New Jersey The speaker said in part;. Qn.. my firgt job in. the'clay pit of a brick works, .1 witnessed a disastrous cave-in Which so' injured one of my fellow workers that he was totally disabled for life; The accident was' so plainly tjie fault of - the foreman in charge that he was discharged for his- carelessness.' That accident made an indelible impression upon my mind, and let me understand as nothing else could what die responsibility of the foreman is in accident prevention. The foreman who is responsible for getting out the work is. also responsible for the control of those conditions immediately surrounding the workers on his- job. He has an unexcelled opportunity -to observe' his workers and their habits... If he is a competent -foreman, he can detect those working habits which may result in acci dents. He should come to know his . workers so well that he will understand when worries and outside problems are taxing, their minds and powers ,of concentration. He may not be in a position always to do much- about the outside problems, but. he can, at least, govern conditions on The job. . The foreman-fs the one who is most likely to set up . conditions on the job which cause job anxieties for die worker. He can do much" to ease the worker's mind by keeping him informed about conditions which affect his job and the steadiness of employment He can help to reduce the fatigue his men experience and in so doing directly influence accidents , which are related to fatigue. ., ' =: '- `Every intelligent foreman realizes* the'importance of Hits'safety functions, and that safety should be^put upon the same plane of importance as . the other .duties his job includes. - If the worker is indifferent, to safety, it is usually merely' a-reflection of the foreman's attitude. On the other hand, if the foreman will stand for -nothing but safe working habits, the worker -will proceed very. rapidly to develop safe.' working habits. Of course, I recognize that_certain workers, have an attitude of recklesseness and.bravado about them which'mak^f*them slightly contemptuous, of i the dangers of the job. But it is up to the foreman to puncture this attitude and bring such workers down to earth. . r, - A recent study of a company employing 6,600 workers indicated that 48 out-r. of the 6,600 had had 10 .per cent of'air the lost-time accidents for the entire organiza tion. The accident frequency among these 48 men vi^as fifty times. a:s great as_that of the average for.all workers. ' The record also' indicated that those men having the largest number of; minor accidents were also the-same men having the lairgest number of lost-tinie accidents. Thus minor accidents are of . real significance to the. observing foreman because they point out to him the men who will most probablyJhave the lost-time accidents; K i. . .... .... .-a' , ... "--AaI <& Quarry Section 355 n Foremen have the duty and the responsibility .- of enforcing safety standards. "Failure -to do...so increases the number of accidents, and the~same laxity that in* '- 'creases accidents lowers efficiency. We can almost judge die general efficiency, of . a. foreman's department by an examination of his safety record. . Here arc some points at which every foreman'should check his own methods, , of enforcing} safety standards.^ Let each foreman ask himself these .questions ' 1: Are. safety standards clearly and completely understood.' by each and every one of my workers.? " ,, " v. ^ 2. Do> I give>-careful safety insfhjctions to every mari I hire,and to' every man ... whom I. put on a new job? 4 o' ' ... 3. Do I conscientiously attempt * to r, assign die least hazardous job ,, to those workers who are most accident prone? 4;. Have I ever attempted to sell; safgty standards to -my porkers by arousing C- their pride, on the basis that' the safest worker is^also the most efficient- one?.- .. 5. Do I rigidly, enforce the regulation that each- worker should report every accident, no matter how. slight? ^ In, the. last analysis, "however, management'itself is responsible-for the attitude- of. its foreineri on" die safety question.' Just as the indifference oi the worker can ( be traced to the indifference of tne foreman,, likewise the indifference ' of the. foreman can most often he Traced to a certain indifference on the part of the. top management with ..reference to this important safety -and. accident prevention function. w ~ The .Value of Competent First Aid 0O 'a 3 By DR. ,W. J. FEiNTON American National Red Cross, Washington, D. C. ; o ' '; -. The speaker Said in part: .The definition of Firs7Aid as givenOin the Red O Cross -First Aid Tp$t Book,.^ "First Aid is "the immediate temporary treatment. , given in a case of accidenF or .sudden illness before the .services of. a physician can. be securech" This definition, in itself, immediately disapproves any thought, what ever that a First Aider can ever take the place of .proper, medical attention.' A s further study of the definition, it appears to me,' should impress . upon; the mind of _ ari^ thoughtful person the necessity of proper First Aid training'.being given to . just as many ^people througliout^he' country as is humanlypossible, . " c-. Remember^that the medical not sitting around at the scene of the accident 4 with his equipment handy, waiting^for a chance to> do ^Something.. He is either busy, with his practice or may be in his office or laboratory studying^ out some baffling-case, and many miles from the scene of trouble!. In case of severe bleeding, .. . fatal results may. follow unless some-qualified First Aider appears cat the scene and ^' "immediately applies proper methods of control, long before the physician can'be .- secured. Imagine a crowd at a scene ,of an apparenfcdrowning, or standing around. the lifeless form of some victim just removed from a gas .filled room or garaged but only'standing there and looking on.. . -** ' There is seldom any excuse in^this day and age for anyone finding himself , or . -herself standing. helplessly about in-such a nredicament, because for: years how throughout the length aria, breadth of pur land there have been First Aid Courses - ' taiight, "First Aid demonstrations given'to literally thousands of atfdiehces, and jn each demonstration as' well as in the standard courses 'simplified methods of emer* . ! gency first aid-have been shown so that all who saw and all who heard might, be .! able tos rendeV competent wst aid atH the ^cene of'.an ^accident. >. . ; t I wonder how 'many of you > really know1* the proper way! to summon your.. physician in. case-of accident or illness.? Remember it is always well to tell the ' physiciah who it is that is calling, giving definite location where the -patient' is ahd - ' what you think is wrong with him,-as well .as' what-materials migbt-cbe at hand that a physician may use;-.and last but. by no means least, it' is always advisable., to tell what is being done to. relieve the patient and? also-ask the physician to - -advise you what further to do while awaiting his arrival. . <' - V- ;"d -.> 1 `4 * r I1:. ", .- I.; If. -- Neither vre;of the ed Cross; nor-any 'dth^r.sane^persbi^'.'.wotild; eyefc,. attempts, *: -I^L. jn___ A' _ *!____ l.i .- .i.- ____ st^dai^.^ te^'thatvhaye^tH^p^ . ' v?:'-vc r For the recbrd .of.the joint session with the Cement Section, held on Thuirsday morning. - October 4, tominvthis volume to the . general diwsio'n^ entitled Cement Section. *' ; ,/ * : v $ 7 V..0 ,3 / . *V : * X. ^ . rL. 4;^' u-;. ,j- * /* `T < y ' V ' .W- y.i