Document VKNBVgyDMQdMDZbXjYg4kJgwZ

Industrialflealth J (\ \ TUESDAY MORNING SESSION ` October7,1941 Presiding--D*. C H. Watsox, Medical Director, American Telephone & Telegraph' Com pany, New York Gty.and Past-President, National Safety CotmciL * .. rN *' National Defense Brings an Imprpyed Industrial Hygiene V; ' Program ' By C. D. SELBY, 1U). Detroit; ICch. ' ` The World War gave us a good indus- trial health. program-rat hast, the funda mentals were sound.. Whh.tbe strengthening that came ont xjf tbe researches andmore matiirc c^erlnee jfanng the interval of peace;- most hi-the firid of Indus* trial hygiene engineering and toxicology, tins program is prtmng; basically adequate to the' heeds of die national .defense emer gency-- . ha June, 1940; Surgeon General 'Parian, U. S. Public Health Service; requested the appointroentof a committee ty .the American Assodatmoof Industrial Physicians and /Surgeons to.adrie with the Division of ; Industrial: Hygiene of the National Insti tute ofHerfthdaiodnstrial hygiene services fof the" national defense program; ' Seine of the objectives of tins proposed coordinating , agency were specified as fol lows: :t , I. The. development of a joint approach to the problem with Federal, State and other, agencies concerned with industrial health. ! 2. The selection of important industries for immediate medical and engineering con trol of emstmg.and potential health hazards. 3. The determination of 'present health service facilities in indnstry. 4. The developmentof a directory of qual ified pert/witwd 5. The training of personnel & An apprafeal 'of the fatigue statutes in relationship to the national defense program. ' Under; the chairmanship of Dr. R. R. Sayers, - thib committee' sensed; the tremen dous burden that would be pot on industry by siwTfwfulwafinitf11 defense yyt the con*' sequent need of folly maintaining the health and efficiency of tbe workers. It recom mended the creation of a coordinating agency within, or advhoty to, the Division of Indus trial Hygiene of ':t&`' National Institute of 7. The determination of methods for the absorption .of handicapped persons into vital industries for national defense. & To mobilize all existing laboratories for the purpose af^n^tigatfog hazardous material*'to be frapjoyedm industries con cerned with national '. r 9,Preparatioo and dissemination lot infor Health, fortibe purposetif malting, available mation on various toxic materials and proc all iritiocalresburces related tothe mainten esses for the practical protection of the ance of hdllth in tbe defense industries. . health of the woricers. ' $.' C 145 r .mi 146 30th National Safety Congress 10. To investigate the problem of personnel Most large Industries have well organized in industrial hygiene and medicine being medical departments, equipped and manned mobilized for services other than the above. for health maintenance on an adequate-basis. 11. To promote measures for control of syphilis, tuberculosis, and. other commun icable diseases among-industrial workers. The Army, and Navy, two large and ex ceedingly Important employers of civilian labor, are preparing to offer the same type of service in their establishments. It was the sense of the committee that THERE IS A SAFE j6B FOR EVERY The problem still. remaining unsolved is WORKER IN THE DEFENSE INDUS in the snjall plants, which in the aggregate TRIES, provided we utilize the knowledge employ about two-thirds of the workers and already developed in the field of industrial must necessarily depend upon the general health, medical practitioners. It is believed that these latter can do the job, acting jointly A coordinating agency was created, the with the industrial hygiene engineers, either Subcommittee on Industrial Health and* through the facilities furnished by state in Medicine of the Health and Medical Com dustrial hygiene bureaus or private con mittee, Federal Security Agency, with the sultants, and aided by suitably trained nurses. director of the Federal Security Agency;' Hon. Paul V. McNutt, as coordinator * of The American Medical Association &w all health, medical, welfare and related activ- ` this problem some time ago and wisely ities in relation to national defense. created its Council on Industrial Health. The subcommittee designated the Division Acting on its own behalf, and through of Industrial Hygiene of the National In committees in the component state and local stitute of Health as the appropriate Federal societies, the council has done modi to pro instrument for the administration of the pro mote knowledge In industrial health methods gram. and to make it available to the general medical practitioners. Under its stimulus and guidance, the move toward the creation of industrial hygiene There is similar activity in other pro bureaus or divisions in the health depart fessional organizations as well. Last June, ments -of the various states and important the American Association of Industrial industrial centers, already under way prior Physicians and Surgeons and the American . to the emergency, has been greatly, broadened Industrial Hygiene Association jointly 'jran until now there are such agencies in thirty- a week of post-graduate work in connection four states and several industrial commu nities. All told, there are approximately 250 professional personnel engaged in industrial with their annual meetings in Pittsburgh. This was well attended and proved exceed ingly effective-as an educational effort. hygiene in state and local health departments, with expenditures of about one million dol lars a year. The Division of Industrial Hy giene, National Institue of Health, alone has a total of approximately 140 persons, with an annual budget of $500,000. Without attempting to mention all organ izations that are working in this direction, it suffices to say that the professions which ' are concerned with the health of the workers are concentrated on the problems' of the defense industries. Interest Spreads Concurrently, with this activity in the Federal, State, and local levels of govern ment, has come a considerable increase of interest in the subject of industrial health--- equally evident in manufacturing, labor, med ical, industrial hygiene, and nursing circles. This has been gradually growing during the past live or six years and now, under the incentive of national defense, it is spreading with amazing acceleration. It is particularly encouraging to note that this interest is not limited to the professional fields, but has the support of both manage ment and the workers. Witness the accom plishment^ of the National Safety Council, the College of Surgeons and, more recently, the Committee on Healthful Working Con ditions of the National Association of Man ufacturers. It is also believed that the U. S. Chamber of Commerce is planning some thing along , these lines, which promises to be of importance. Industrial Health 147 tPerhaps most significant of all is the fact finding agency and, as such, is beginning to .that .labor unions are concerning themselves assume a very important part in the further with the health of the workers. The interest Control of that disease; of the individual workers is beyond question. . Syphilis. The campaign for the con Intereet Inspires Progress trol of syphilis, initiated by Surgeon General Parrairr, is also showing results. Whereas It is seen from the foregoing that there formerly certain industries in the northern is a suffident' background bf interest in in-, states' had a syphilis rate of about 3 per dustrial health to inspire progress, and the cent, many of these are now showing a rate professions are taking advantage of it to of only 1J4 per cent improve their program. Defense Promotes Cooperation. This cam Occupational Diseases. The most notable paign in particular exemplifies the impor advance in this direction is in the control tance of cooperation between the. medical of .occupational disease. Researches in the departments of industry, the public health toxic effects of the newer chemicals and departments, and the - general practitioners materials essential in defense manufacturing ' of the communities in which ..industries are are expanding. Industrial hygiene engineer located. Further cooperation can be ex ing, methods are coming into more general pected to come .out of the national defense use and' industrial physicians are becoming program. In fact, it is now realised that - better informed on conditions in their plants. the only way in which results can be ob The net result of this growth of industrial tained in the reduction of sicknesses due to hygiene and-toxicology is better, control of non-occupational causes, must be through a occupational diseases. united effort of this nature. Sickness Absenteeism,. As a by-product of their studies of: methods ahd procedures for the control of occupational diseases, in dustrial physicians have been impressed by the'great amount of disability resulting from ordinary sicknesses. The Division of In dustrial Hygiene of die National Institute of- Health for some years has attempted to arouse interest in this aspect of industrial health, and has succeeded to such'a degree Through their physical examinations, the plant physicians serve as case-finding agen cies. The medical professional treats the cases. And if, by^virtue of early diagnosis, researches in the field of preventive medi cine, or by a little better care in' the handling of cases, . disabilities can be shortened by one or. two days in each case; the saving in lost time will be enormous. that studies of sideness absenteeism are now. Immunisation. It has always seemed un becoming a common practice in industry. wise for industrial physicians arbitrarily to- Although these have not gone far enough administer cold vaccines to large industrial to show results, they do permit some groups. It has also seemed unwise for them tentative conclusions. The'most outstanding . to administer vitamins to all workers on of these are that 60 per cent of ail absentee- the theory that afl are undernourished. These : ism is due to - non-occupational sidenesses are important medical procedures and should and, not . counting short-term disabilities, not be indiscriminately applied to masses. about 10 per cent of all workers lose an On the contrary, they should be given only average of something like 40 days each year according to indications in each individual because of them. The principal sources of case. absenteeism of this nature are in diseases of the respiratory tract--one-third of all cases. .These are preventable. At the moment, industrial physicians are importuned to give the workers cold vac cines and vitamins. As these .are medical Tuberculosis. ' Parenthetically; it is of treatments, I am convinced Ihey belong in value to know-that tuberculosis causes but the field of private practice. However, there a very small., fraction of alt disability, and is. no objection - to putting vitamins back this is a tribute tothe effectiveness of the into food products from which they have anti-tuberculosis program. Even though the been removed by refining processes in manu prevention of tuberculosis is a public health facturing. Nor is there any. objection to . function, industry is serving as a case discussing balanced edicts with the workers. f' " ' A 148 30th National Safety Congress Mental Hygiene. There are frequent dis cussions regarding mental hygiene in in dustry, the general assumption being that industry does nothing about it The present seems an appropriate time to take stock and outline a program, if possible. This, the Federal Government is doing through a special, Committee on Personal Relations, which sprang out of the joint action of the Neuropsychiatric Committee of the National Research Council and the Subcommittee on Industrial Health and Medicine. . This b particularly important in connec tion with the defense program for the very obvious reason that workers are needed in defense industries. Figures released by the Selective Service System show that a rather high percentage of selectees are rejected, or accepted for limited service, because of physical conditions--some 40 per cent True-, enough, many of these causes of rejection^ are of a minor nature 'and do not predude'' employment in industry, but eventually many; of them result in disabilities. The special committee has undertaken the study of the problem and is effecting suit able measures for initiating a practical mental hygiene program ifl industry. As in dicated by its name, the committee b de veloping its research along lines of personal relations. With such a sound approach, I feel optimistic of the results. All industrial physicians use mental hy- Therefore, it is important in developing a rehabilitation program, that industrial doctors take(steps for cooperation .with the medical profession in the correction of remedial impairments. It b equally impor tant that they exercise great care in the recommendation of impaired individuals for* employment. This does not necessarily im ply outright rejection of large numbers of . workmen or prospective workmen. It does - giene methods to a considerable degree, mean careful placement. either consciously or, unconsciously, and in very much the same manner as does the - general medical profession in the pursuit of private practice. Every patient who consults . a doctor has in some degree a mental hygiene I problem. Although it may be only a very minor worry, it has considerable influence As this function of industrial medidne is asstuning importance in the national de fense program, there b reason to bdieve / that the experiences will result in a proce dure that will function with justice to both workers and management upon the patient and the outcome of his ail Physical Examinations. Because of the . ment. spread of interest in industrial health and Usually, during conference between phy sician and patient, these worries come to the surface. If the patient has an appropriate opportunity to tell his whole story, the mere telling frequently serves to assist him in the solution. So one of the important func tions of the doctors in industry b to listen sympathetically to the ..workman who con sults them. This is being done more and more, and if the doctors are not too busy in serving workers of the defense industries, they will have an excellent opportunity to develop what seems to be a vety practical approach to mental hygiene in industry. It is my opinion that they are doing this. ' the consequent recognition of its importance by management and workers, as well, as by. the medical profession in general, the exam ination of applicants for employment and the re-examination of employees is assum ing a better status. In the first place; its importance b being . recognized, hi die second place, the value of more complete examinations is becoming apparent Medical departments in industry ; are being equipped with x-ray apparatus for chest work, facilities for serological tests, and. in some instances, for electrocardio graphic stndies, metabolism studies, etc. In . short, the .standard of the physical examina tion b rapidly rating. < Rehabilitation. The employment of handi capped workers and the rehabilitation of disabled workers is a perennial problem in industry. While most plant physicians, with the cooperation., of employment managers, Inddentally, thb b symbolic of the status of industrial medidne. The general profession b coming to recognize it as an honor- . able and important specialty in medidne. supervbion, \and. other officials, are doing Women in Industry. Women are gradually . a satisfactory job, methods are not yet on displacing men in the defense industries. a scientific basis. That happened in the World War and it is already happening in this emergency. Fifty per cent of the manufacturing in England ., today is done.hy women. They work in tool rooms, operate cranes and electric trucks and various other types of machinery. ; They have become so skillful on these jobs that they are often more efficient than men were. In Canada; they are running trucks and operating gas stations and taxicabs. I am not: prepared to discuss the wisdom 'of this practice, but as a physician, I am ` prepared t6 offer a word of advice.'' Sick ness absenteeism among women in .industry is very high, a daily .absence of 10 per cent is not* unusual. Their annual rate exceeds that of the men by approximately 200 per cent and their disability periods by- more than 10 days. They must be thoroughly examined before employment, which is not conunon practice, carefully ^placed, and have conscientious physical supervision. If this is done, their rate of sickness absenteeism can be brought down somewhat--but it is still very high. Working Environments. Thus far, .the medical aspects of industrial health only have been considered. There are others of sufficient importance to mention, notably, general ventilation, heating, lighting, and other environmental conditions, all of which bear importantly on health.' ^ Fortunately, industry is progressing just as rapidly and as soundly in respect to these as it is in die purely medical field and, incidentally, this progress is comparable with the progress in manufacturing methods. Effective Industrial Health Education ' . By DR. J. J. BRANDABUR Assistant Supervising Surgeon, Chesapeake ft Ohio Railway Company, Huntington, W. Va. One of the greatest problems of any indus- his energy by changing His habits of-living . trial health unit is how to reach the: groups or work so that he will not be a hazard to for whom certain preventive measures are himself or his fellow employees. The average necessary, and how they will be most effec individual has a tendency to change bade to F tive. I shall attempt to show what measures old habits as soon as he begins to fed we fed have been effective in the education therefore the periodic physical examination of the employees in our organization, namely is a constant reminder or check rein on --through the medium of the pre-employ ment and , periodic physical examination, with a follow-up by his family physician. By this means there is a direct person-toperson relationship which is so necessary ,in order to make the public appreciate the. value of good health so that it will accomplish the most good and the patient will fed tfa^t he has hot1 been misdirected because he . has confidence in his family physician. Briefly, health education is best accom plished by informing the employee or the public with relation to matters of health and so to "Merest and motivate them that the results of 'our labors will be a change in conduct toward an ideal which we hope to attain. The primary object of all educa tion is not only to inform but to influence In the matter of the pre-employment ex amination, which some industries term place ment examinations because the idea behind them is not to reject those with physical defects, but to place men at work for which they are physically fit. Those who are re jected1 are'turned down simply because tbdr particular defect makes them a hazard, therefore unsafe in that particular type of employment either to themselves, to their fellow employees or to the general public. Very few of us who are perfect human specimens from, a physical standard, there fore industry must of necessity accept its share of less than perfect applicants and teach them to become perfectly useful em ployees. an. individual. For.example: it does not good Naturally, therefore; you are interested in for an individual to. know that he has an what means we use to make industrial health abnormal heart condition if he is not in education effective. Because our system ex fluenced by. his family physician to conserve tends over a vast area we cannot have fall : > Cl 150 30th National Safety Congress time men; therefore like most small indus tries our examinations must lie made by com petent medical men located anywhere along our right of way. The report of the exam5 ination is sent to our office and on review-of the report the applicant is accepted or re jected. Iff he has a minor defect we may qualify him temporarily and send a letter to him notifying him about his defect and ask ing that he place himself under the care of his family physician and to be sure that he does this we request some type of answer from the physician whom he has consulted. ) In case fie has a major defect which ^is remedial, if be is sufficiently interested he is notified regarding this defect and told to have it corrected and.we might then be able to qualify him if he can come up to our stand ards: # Example of Case . REJECTION OF APPLICANTS Causes No. Defective vision ............................ '.....158 Abnormal Blood Pressure............... ...... 88 Abnormal Heart......... ................. i.........85 Hernias .............. 52 Diabetes potential ....................... 29 Nephritis .:..................................................24 Color Blind.................. ;r......................... 19 Luetic ....................... 15 Defective bearing....................................... 10 Gonorrhea....................................................10 Tuberculosis .................. '......... ............. 5 Skull injuries........................... 5 Deformities in extremities............. 4 Thyroid ................................ .........i........ 3 Total 507 From 1934 up to Jan. 1941 out of 6,104 applicants 507 were rejected. An applicant was examined Jan. 17th, 1941, at whick-time it was found he had} a hernia, he was notified regarding the defect which causedL his temporary disqualification and had the emuBHon corrected and was re The primary point I wish to bring out. here is the fact that the-majority of these individuals * never knew they had anything wrong with them, therefore were probably making no effort to overcome the defect examined and qualified as soon as his condi tion-permitted: . Doctor Parran stated recently that it is wasteful for industry to train a highly skilled \ Immany cases we have found that this was employee over long months, only to have him the first examination these men had, and break down .suddenly with tuberculosis, men they had thought themselves to be in perfect tal disease or some crippling condition; there health and were thankful for the defect hav fore, the periodic examination at stated in ing been discovered. This matter of sending tervals or. examinations made at the request them a letter is more productive of good re of the employee or his supervisory officer sults than merely telling the applicant he has are likewise of great value, in that they con a defect and taking a change that he will tribute to the health and efficiency of workers present himself to his pnysfciatk because he in several ways. merely has to present hV letter tb his physi cian, and it is not necessafyr foryvt physician 1st. Employees exposed to hazardous con ditions due to their type of work may con to do any guess work as regards his defects. In this , way also he retains that personal contact with his family physician in whom he has utmost confidence and learns to know that die particular industry is anxious to ac tract somfe occupational disease or due to an aging process develop a condition which makes them unsafe to the public, themselves > or theirfellow employees. cept him if he is a good physical risk and not a hazard and it gives an' opportunity for the physician to explain how important it is to be in good health in order to.be most beneficial to himself, his family and the industry he represents. 2nd Employees showing evidence of oc cupational disease can thus be removed from exposure and appropriately treated and at the same time necessary steps made to con trol the occupational hazard. The indusion of the executive personnel, is That the examination has its safety fea beneficial from two standpoints: tures from the standpoint- of. our industry ft* might well be noted from the accompanying a . . . You are prolonging the life and chart: efficiency of men who are harder to replace; v Industrial Health 151 Defects . 1934 1938 Overweight ................ No. ....277 % 13.1 f No. 116 Teeth (Pyorrhea, Dead teeth).............. 317 15.0 162 ' Tonsils ................................. 83 4.0 10 Glycosuria ...:............................ ....... 33 IS 33 Albumin ................................. 139 6 32 Hernia .................. 79 3.7 30 Abnormal Heart ___ i'................ ........... 99 4.7 78 Blood Pressure ( above normal)............421 20j0 268 This chart represents the results in a group listing of approximately 2200 men. 6 7.6 0S IS IS V4 3.7 12.6 b ... It has a psychological effect of also seeks to promote the health and prolong selling the benefits .of the examinations to. the life of the worker we are attempting to the other employees, therefore, aids in prov educate the employee to realize that good. ing that the measure is not discriminatory. health is an economic investment to himself In this regard it should be stated that the --for instance--the man in poor physical records must be a matter of strict confidence condition is-neither likely to do good work between the members of the medical depart and therefore fails to merit promotion, either' ment. All that is necessary for the super because he does not get along with other , visory officer to know is -whether the em employees or because be is indifferent, tem ployee is safe for his particular work. po-mental, tactless or dissatisfied. It is diffi- . colt to evaluate just how effective any pro- These are precisely the ideals followed in - gram of health education is because we have our methods of carrying on the periodic no measuring stick as it were to note our physical examinations. progress in the matter of efficiency or ben The examination is .carried out by one of our examining surgeons along the nearest terminal point The history form constitutes direct questions regarding any illnesses, in efits accruing to the individual However, in the middle .years of life - modifications in our mode of living and working are exacted by the laws of .nature. But being human juries or operations. The physical examina tion proper covers all systems of the body. In this way most- of die chronic illnesses are detected that- rank high as the causes of dtatlr among industrial workers. Unfortu nately this type of examination does not al ways exclude some conditions which may produce sudden death--for example--such as may happen in coronary heart disease and . for this reason some people are apt to frown beings most of ns believe that nature will not take its toll on ns and we all carry on with increasing activity until some vital structure fails leaving some of us invalided if we are left to our own.. Nature has endowed us with a physical reserve which enables us to carry on in,the presence of the early stages of disease. For this reason defects have not been discovered until they have. advanced beyond the possibilities of relief in this way on the results of these, examinations, .but these are rare conditions. How often have you taken your automobile to be checked producing man failure possibly at a critical . moment. The periodic physical examinations are primarily for the purpose of discovering before starting on a trip and then have some breakdown develop which was not anticipated. these defects in the early stages, when there is a possibility of cure or amelioration of ' the condition so that the progress of any de In an effort to avoid this type of. emer- . generative conditions delayed and the safety gency after the Report of the employee's ex factor is thus augmented as well as the amination is reviewed in our office a letter economic activity prolonged. is sent to the employee even on the slightest We feel that our-program-has beciyffet- defect ' tive if there has been an improvementsalong If his condition warrants it we may re quest an examination more frequently. these lines particularly. The accompanying chart .shows that we have effected som^im provement in the health of our employees Since industrial hygieiieis not limited to therefore the periodic examination isan effec the prevention of occupational diseases, but tive method of industrial health education. Essentials of Healthful Industrial Environment By MYRON A. SNELL Supervising Engineer, Hartford Accident ft Indemnity Co, Hartford, Conn. In 1940 occupational accidents were re- \ ployees through die elimination of unhealth-. sponsible for 17,000 killed, 16,000 penna-1 ful conditions at home as well as on the job. nentfy disabled, and 1,350,000 temporarily T They receive a large return on the invest disabled. ; ment, not only through the reduction of time Although the recognized diseases of occu- i lost: from the job through sickness but also pation are responsible for only a compara-: from the redaction in the cost of industrial tively small proportion of' these industrial! accidents and diseases. injuries, many other factors in industrial: environment are partly responsible for them, j Industrial Health The personal habits of the individual as well w as the nature of his home environment mustl also be charged with their share of this' responsibility. * ' Although progressive employers recognize the importance to them of healthy, satisfied, employees, it is unfair and unjust to impose upon them the legal liability for any Hineses j It is known that the incidence of the com- : or diseases among the employees that axe mon diseases of life which are not due to the: not actually caused by die employment. Oc occupation is higher among industrial work-[ cupational disease laws should be carefully ers than among the balance of die population.'' enacted and `justly administered so dot. the Consequently, the life expectancy of the in-^ employer .will not be expected to provide dividual employed in industry is approxi-' general health insurance for his employees. rcr%.-.* mately eight years less than for the non-' The industrial environment is actually re industrial worker. There is no doubt but' sponsible for only a small 'proportion of the r.. a4:;:* that considerable improvement would result- time lost from the fob by employees. through' the elimination of all of the unsatis-- lit'i factory conditions to which workers are ex-! Every employer'should, of course, be re-, posed in industry. ! quired to provide his employees with a safe and healthful place in which to work. Such k The Metropolitan Life insurance Com-- an environment can be achieved only through party conducted a study which revealed that- a study of every condition of. industrial life approximately 2 per cent of all workers are! followed fry an ~ adjustment of these condi incapacitated all of the time on account of! tions to the health requirements of the indus illness. This means that the estimated 50^ million workers in the United States lose! tria* l worker.*v four hundred million days annually on at-! count of injury and- illness, resulting in am AtmoaphericCcmtaminanta average direct loss of wages at $5.00: per , Employees should not be subjected to the day of two billion dollars. *v The Air Hygiene Foundation of America! are engaged in a study of."Side Absenteeism! in Industry." Their records show that morev than eight days are lost per male wage, earner per year and more than twelve days' per female wage earner per year because of' sickness. A considerable proportion of this' cost is assumed by the employer through* lower pr*oduction and poorer earnings. -t . inhalation of atmospheric contaminants in sufficient concentrations to cause disease or poisoning, nor even in concentrations suffi cient to cause any narked degree of dis-. comfort Polluted air is undesirable even though the foreign material in the air is not present in harmful quantities. Workers who are satisfied and contented with da working environment are not only happier and more efficient but Healthier as well. Many indi viduals imagine ail aorta of ill effecta even Many companies have already discovered' from trivial induatrial exposures, and may that a large proportion of the employees" even worry themselves into ah actual case with poor health records also had poor of illness which was not caused hy the en- safety records. These employers are spend- viromnent but from the mental attitude of the ing money to improve die health of the em-' worker. I hy Tyi era ing and Mai fry the veg and pro or I dm im] inh bel' the SCO in' age dis mil dei enc ext sol in evi the ha! reg 1 cor tab yet for piM for Pir , wo pre for SO lesi ii~ l i . 4 Industrial Health 153 Atmospheric contaminants in industrial plants* may consist of solid dispersoids, liquid dispersoids or gases or vapors. Solid' dispersoids may be divided imo dusts, tones and smokes.^ Liquid dispersoids may be di vided into mists and fogs. Dost* ,. Industrial dusts are mechanically generated by many different processes and operations. Typical examples are drilling, blasting'and crashing' in mining and quarrying; polish ing,- buffing, and grinding, in metal finishing and stonecutting, polishing and abrasive .blasting in the granite and monument indus try. The dust'generated in every case is of the inorganmtir mineral variety. Animal and vegetable dusts are known as organic , dusts and are generated by such operations as die processing of cotton, die working of wood, or the polishing of skins. costs Conference in 1937 suggested that the maximum permissible concentration should be found by multiplying the percentage of free silica by the total'dust count If the result is under five million, die condition may be considered permissible. If the result is over five million, the condition may be considered too highi , California, Connecticut and some other states allow ho more than five million partides of dust running high in free silica. New York States in the Industrial Code adopted September 1,1941, for the control of silica dost in the stonecutdng and stone fin ishing industry, allow five million parddes if the dost contains more than 70 per cent free silica, 10 million particles if it contains from 10 to 70 par cent, ahd lOO million partides if it contains less than-10 per cent free silica. The State of California has established a permissible limit of 5 million particles per cubic foot of air for asbestos dust. From the health y standpoint, industrial dusts of above, ten microns in size are of no importance because they are too large, to be inhaled into -the lungs themselves. , Dusts below ten microns in size are not visible to the naked eye but can be seen with a micro scope down to about two-tentbs of a micron in'size. Dusts containing sufficient percent age; of free silica and asbestos.may cause diseases known as s&oas-asd asbestosis if Inhaled in .sizes below ten microns in suffi ciently high concentrations over , a "great enough period,of time Other dusts, with die exception of the metallic dusts, do noJ/re sult in diseases, but many of diem do result in ^certain-changes in the lungs which-are evidently not of .great importance. Never theless, workers sfahuld not' be allowed to in hale high concentrations of any kind -of dust, regardless of its composition. Permissible limits or maximum allowable concentrations for these dusts have been es tablished .by various organizations, but as yet there has been no complete agreement for dust concentrations in workroom atmos pheres. The American Standard Safety Code for. the Protection of Heads, Eyes and Res piratory Organs recommends "that no worker be continuously subjected without a protector to an atmosphere containing any form of mineral dust in quantity exceeding SO million particles per cubic foot of a-size less than 10 microns." The National Sili- Metallic dusts may also be generated me chanically in such operations as weighing - and mixing red lead and litharge in the ^manufacture of paints or storage batteries. The permissible limits for such toxic dusts are the same as for the fumes of these metals. Fume* and Smokes Inhalation of the freshly formed fume of any., metal in sufficient concentrations may cause the condition. known as "metal, tone fever".also known as zinc chills.or shakes. Although tills condition causes a great deal of discomfort and may be alarmiifgto those who are not familiar with it, it is -actually not a disease and has no; permanent effect on the individual. The inhalation of the dusts or .tones of. the toxic idetals can also cause systemic poisoning if inhaled in sufficient quantities. As yet there are no definite standards established for most of the toxic metals. The American Standards Association's Sectional Committee on Allowable Concentrations of Toxic Dusts and Gases jis developing stand ards for cadmium, chromium, lead and mer cury. They also propose to develop standards for antimony, arsenic, manganese and zii All of these standards will probably be avail able in the near future. The Journal' of Indilustrial Hygiene and Toxicology in the June, 1940,-issue published O 154 30th National Safety Congress * a "Code for Safe Concentrations of Certain Vapors, and. Gases Common. Toxic Substances Used in Indus try." This code' was prepared by a group' of five expert industrial hygienists and con tained a list of suggested permissible limits to be used as a guide until the time that the American Standards Association's, committee While vapiirs are Composed of the gaseous phase of substances width , usually , exist in tiie form of liquids under ordinary: condi tions, gases exist only, in the gaseous state under ordinary conditions. had completed the standards fbrthe sub stances mentioned. The maximum allowable concentrations for certain of the toxic.metals were as follows: Cadmium 0.1 mg. per cu. meter; Chromium 0.1 tag. per cu. meter; Lead 0.15 mg. per cu. meter; Mercury 0.1 x mg. per cu. meter, and Zinc 15.0 mg. per cu. meter. Vapors and gases are frequently.butincor rectly termed "fumes." For example, "ni trous. fumes" instead of nitrogen oxide gases. A liquid organic solvent such as* carbon tetrachloride will evaporate from.an open tank in a workroom and the vapors of car bon tetrachloride collect in the .surrounding atmosphere. Thus the,carbon tetrachloride Very little,work has been done on .maxi mum concentrations of smoke which can be tolerated without impairing efficiency or causing marked discomfort, and no limits have as yet been established. can exist under the ordinary conditions of the workroom either as a liquid or a vapor. On the other hand, the. oxygen and carbon dioxide gases in foe ah* of the workroom cannot exist under aril normal conditions in any other state; Mists and Fogs Mists are formed by foe mechanical dis integration of a liquid by suck processes as spray coating of'paints or vitreous enamels. They usually range%in size from about 50 to 100 microns. There are a vast number of organic sol vents in use -in industry and the number- is increasing'each year throughfoe discovery of new- and better solvents in the industrial chemical laboratories. The extent of damage' to foe health of woikers through theinhala- Fogs are formed fay the condensation of tion of the vapors of many of these solvents vapors. They vary in size from 5 to about 50 Is not known. . microns. Wherever hot alkaline cleaning or American-standards have been established pickling vats are operated in a workroom in which foe temperature is quite cool, the water -this year for benzol of 100 parts per million parts of air, carbon disulfide 20 -parts per vapor is apt to condense in the form of a million, carbon monoxide 1Q0 parts per mil fog in foe room in the same manner that lion and hydrogen sulfide 20 parts per mil ordinary fog is formed hi the outdoors. A. lion. The American Standards Assodation's mist which may be inhaled in spray coating Committee on Allowable Concentrations are operations may be rather complex in Aature. at present engaged in'foe development of In foe case of spraying prints, it usually standards for acetone;, carbon tetrachloride, consists of a mixture .df organic.solvents of diethyl ether, formaldehyde, hydrofluoric a varying degree of toxidty together -until add, methanol,- nitrous gases.detrachlore- solid matter in solution or in suspension. thane, tetrachlorethylene, toIooI,trichIor- These fine droplets in foe form of mist may efoylene and". xyloL Tentative suggested hold in suspension lead oxide as a pigment standards for there as well as for about 23 or other particulate matter of a toxic nature. additional gases and vapors are given in the - In foe spray coating of vitreous enamels a June; 1940, issue of the Jouroal of Industrial water vehicle is used but foe particulate mat Hygiene and Toxicology, as rirtady men- ter in suspension may contain toxic metals in tionetL the form of oxide&such as cadmium, lead and manganese.'wa^Iition^foey sometimes contain finely divided particles of free silica Atmo^hritePoIlution in the form of quartz ior flint. The only definite rnetbod of determining The maximum .allowable concentration in whether' or nota 'concentration of atmos inspired air containing mist is foe same as . pheric contaminants exista in the workroom -that, for foe vapors, fumes or dusts of th$ that constitutes a herifohazard is ty.-means substances contained in foe mist of collection mid analysis of .air' samples. Industrial Health 155 These atmospheric pollution studies require paratively rare and tnbst.of the known toxic : the services of train^ indnstrial hygienists substances do .not readily enter, the. blood- . and the use ofproper fidd and laboratory stream hjr skm absorption. eqtupnient ' Maqy ptihratecompaniw as Midihls are e^ped to do. this, work for themsdves or. forotbers. Approximately two-thirds of all occupatiooal disease claims, however, are fordermatitjs. and 'other. sldn affectkms. Indnstrial In addition, there are at the present time employees come in contact with a consider 31 indnstrial hygiene amts located in that able number of substances which invariably raanydiffereiit states, who are prepared to result in the development of.^.a dermatitis do tins workfor industrial concerns at their condition. In addition, there are a great i ' request:- In all hut New York and Massa- manyother substances used in industry which i chuselts these units are operated by State cause abnormal skin conditions , to develop in Departments of Heaftb in cooperation with certain few individuals. but notin others. l U. S. Public Health Service, jht addition'to This highly specialized subject has been e . supplying the plant owner with an analysis given a great deal, of ittention in recent of: the hcalth hazards in this .plant/ these years and much information has been pub- units make invaluable suggestions fior their f lished about it; s' a a correctioajor diTuhation through the use of proper engineering control methods;" There are two methods of prevention available. The first involves die Use ofskin tests to determine individual reaction to sub- : IngettioQof,Toxic Substances stances which aregenerally known to cause s f 1 e The vastmajorityof casesofindustiial poisoning occur through:'inhalation ;of. the' toxic substances rather thanby ingestjpaor dermatitis; lids: is dood before employment .in tiie exposure and employeeswhb show a -positive reaction are placed in other jobs. by absorption tiirotigh sldn, for tworeasons. The second method consists of preventing lit tbe first plac^ tbe prindpal exposure to contact between theindividtsal and the harm toxic substances in'industry is through in ful substance . through complete"! enclosure, halation airtiMtingestioaoralrarptiQa. In. exhaust ventilation,the nse of'rubber gloves the secoodplare, in those few^cases where or other protective clothing, or protective 4 poisoootts suhstaucesare swallowed, they are skin cream. Personal' cleanliness also is an a almost eptirdy eliminated through theali- extremely important factor in the prevention' r mentajry tractwithont being absorbed into ot industrial dermatitis.- the bloodstream and alaigepexce&age of the small amount absorbed into the blood Infectious Diseases s e i ft ci- stream . isfurther eliminated through the , Bwr. pocnjiieBfly wqr, fttfe-fli the in-, gested poisongets Into ..the general circula tion to cause damage,to the vital organs. In thecase of an employee whoisworkh^f with lead axide in the manufacture of dotage A considerable number of fndustrial ca1ses. of anduax, gIandere, nzKhilant fnv and tularemia are reported every year. .These diseasesof animals arcmvariably contracted by man through ignorance or negligence on -. the 'part of , the employees or their' super- ' d battery plates, he Is inhaling any drbt which . visors. Industrially tiKy are easily con may. contaminate the wo^bg 'area at the tracted through contacts with infected hair 3 e a rate of 16 times each minute during the en or hides orthe'diseased animals themselves. tire day.,On tbeotherhand, heustolly ;eats Practically; every such case, could haye been but once a ,day on the joh. In addition he , prevented eitber throughsteritization of tire may swafiow. at other times during theday animal parfsthemsehres or through tiie use - anamiotmt of lead which in itself could not of protective-'clothing on tiie part, of- the' cause poisoning. ' employees. SkinContact g Miscellaneous:Diseases k ' A few of the organic' liquids soch as tetra Theie are miscellaneous conditions to n ethyl lead med ia leaded gasoline and benzol which indnstrial workers may beexposed is may cause pdsohing by absorption 'through which .`are responsible J-fcar - a .considerable fc. tbesldn Snch cases,bowever, are com-/ number of actual cases of .disease. Com- iVt&kij i. 156 30th National Safety Congress f pressctf'air illness or caisson disease results from too rapid decompression after working under pressures greater than one atmos phere. Time and. pressure tables have been established for maximum rates of compres sion and decompression which should bejollowed in all cases. In some states this is required by-law. Radiant energy when used in industry may result in serious consequences if adequate safety precautions are not taken. Workers should not be exposed to harmful amounts of radioactive substances or X-rays.' In every case the protective measures published by the National Bureau of Standards should be religiously followed. Both ultra-violet and infra-red rays have certain beneficial effects on human beings if they are absorbed by the body in moderate amounts. Light rays produced industrially, however, may have a serious effect upon the health of workers if proper personal protec tion is not provided. Cataract may result from exposure to the heat and glare of molten glass. Serious eye and skin bums may result from undue exposure to the bright arc produced in electric welding. The use of goggles with properly colored lenses, face shields, gloves, and proper dothing afford adequate protection. Pressure, Motion and Shock Synovitis, or tenosynvitis, or bursitis, or cellulitis of any of the joints of the body may result from any occupation involving con tinual or repeated trauma, vibration, pres sure or friction. Examples are the diseases suffered by workers who spend many years in handling pneumatic tools used in such operations as riveting and drilling. If pos sible the employees of concerns engaged in such operations should be rotated so that no one. individual is exposed to the harmful ef fects of conditions such as these for long periods of time. Temperature and Humidify The average- comfort zone in the winter time is from 63 to 71 E. ,T. (Effective Temperature). ,66 E. T. is the most popu lar effective temperature as adopted by the American Society of Heating and Ventilat ing Engineers for individuals at rest wear ing customary'winter clothes living in the broad geographhal belts; across the ..United States in which heating of- the convection type is generally used during four to eight months of the year. It doesn't apply to rooms heated by radiant energy, rooms with excessive glass area or those .with poorly insulated or cold walls. In densely occupied spaces somewhat lower temperatures may be necessary. Satisfactory comfort condi tions for men- at work have been found to vary from 40 to 70* E. T. depending on the rate of work and - theamount of dothing worn. In hot industries 80 EL T. is consid ered the upper limit compatible with efficiency and whenever possible this should be reduced to 70* E. T. or less. i In the summertime the avenge comfort zone is from 66. to 75* E. T. with 71* E. T. asthe popular average. This it 4 to 5* higher average than in the wintertime. The temperature differential between in doors and outdoors which should be main tained depends on a number of factors. A drop in temperature of 10* F. or more may be extremely harmful if it ocfcurred suddenly, especially when the skin and dothing are wet with perspiration. No standard has been established for the proper amount of humidity. It -may vary from 30 to 70 per cent without discomfort The air should be diyrrother than damp. The common belief that dry air in itself ex erts a harmful effect on the skin and mucous , membranes has -never been proved by convindng evidence, although there have been numerous investigations on the subject The addition of moisture to the air of occupied . rooms bf any'practical method has not been, shown to have any beneficial effect upon health and comfort Experiments have shown that the respiratory membranes of industrial . workers, exposed to bot, moist air are dis tinctly more abnormal titan -those of workers exposed to hot, dry air. The maximum air movement should be. 50 feet per minute with not less titan 10 cubic feet -per minute .per occupant of the room taken from an outdoor source. Mr. -Yagtow states that "an air movement of not over 40 f.pan. is permissible under present engi neering practice, when the temperature of. the air current Is 2* F. or. less below ordi nary room temperature. Current .velocities as high as 200 ipan. may prove desirable - xt in! tita aix '"I sib! me hat . use ind abi af < pet has pin del hat of qua to hal the 1 ent the for fac ten mo and roe tor res mg tioi cep eff< sul coo tab lev lev mg rep aI pos pai dis de be sue Industrial Health 157 in hot.industries, bat velocities jnuchhigher others, but no one is immune to long con than this are uncomfortable and irritating tinued intense sound. Noise has become more and mayblow dost off the fibor.M than a mrissmcc--it is a menace impairing the Work in the hot indnstries may be respon sible for a number-of physiological derange ments, the best known of which is heat .'ex* haustion or beat aina^ The. conscientious use of salt tablets by the employe&in such industries has largely eliminated the dis ability and discomfort which were prevalent a few years ago. .. hearing of millions, robbing them of quiet Insure, restful sleep and taking a toll of the general nervous system of mental work ers, neurotics, hospital patients, and others who are noise sensitive." Noise reduction at. the source may be accomplished by insula- tion, absorption or by reducing foe noire from machinery and equipment Most em ployees object to wearing ear stoppers but Since the amount of rise in. body tem perature of employees in hot atmospheres has been shown to indicate disturbances in Dr. Knudsen has devised an ear defender providing an insulation of 35 to 40 deribds which is very effective. physiological equilibrium, the American So ciety of Heating and Ventilating Engineers has suggested an avenge "temperature rise of one-half degree in the average worker qualified by physical makeup and experience to work in hot industries, or a one* and onehalf degree rise in an occasional worker" as the limiting factor. . -The A.S.H.V.E. state that "the thermal Tobacco Smoke and Body Odors, with the exception of toxic atmospheric contaminants, are the principal factors to be considered relative to comfort and efficiency. Such odors are not harmful but nevertheless have a profound effect on. individuals. In the same manner other disagreeable odors ad versely affect the efficiency of workers. environment cannot be properly adjusted to The amount of outdoor air needed for the requirements of.hmnan health and com- ` body odors should be somewhere between fort without control of all die four basic 10 and 30 elm. per person depending on factors concerned--temperature (hue air age; socioeconomic status, air space in cubic temperature free .from radiation effects) foot per person, outside and inside temper movement of the air, humidity of the air, atures and humidity. The minimum air and,mean radiant temperature of the sur change requirements for tobacco smoke has rounding surfaces.'' Their research labora . not yet been definitely determined but prob tories are at the present time engaged in a ably should be in-the neighborhood of 5 to research program with the aim of establish 15 dm. per person. These air require ing minimum requirements for air condi-. ments are in addition to those needed for tuning for industries which would be ac indoor recirculation in order to maintain the ceptable to everyone, concerned. humidity: and' temperature at the proper levels. Miscellaneous Conditions Abnormal noise levels han't profound effect upon industrial workers and may re sult in deafness or Other pathological ear conditions. The A.S.H.VJL 1941 Guide con tains a table giving the acceptable noise levels under various conditions. These noise levels vary from 10 to 100 decibels depend ing on the source and location. Dr. Knudsen reported that "long exposure to sounds above a level- of 80 fo 90 decibels or a brief ex posure to-more intense noises invariably im pairs hearing. Other results are vestibular disturbances, mental fatigue, loss of effi ciency, and extreme nervousness which can be traced to excessive noise. Some persons are. more susceptible to excessive noise than Space Allotments for industrial workers are of questionablevalne and minimum re quirements for them cannot be given at the present time because this factor is so closely associated with many others, principally that of the ventilation problem. Illumination of the proper intensity for the type of work to be performed should be provided for all industrial workers. The equipment providing illumination should be of the proper type and installed so as to give maximum efficiency with a minimum amount of glare, eyestrain, or other adverse effects. ' Improper lighting may be responsible for ac tual diseases of the eye in addition to eyestrain and eye fatigue. Improper ilfami- 1I 30th National Safety Congress nation may not only result in poor efficiency but also in a high accident frequency. The number of foot-candles for proper industrial illumination varies up to a point beyond 100. They are published in table form for various occupations in Safe Practices Pamphlet No. 22 on "Industrial Shop lighting." Other Factors which shonld be considered in the subject of industrial health are work ing postures, and the proper kind of floor covering. Standing or walking on concrete or other hard surfaces produce fatigue and may even be harmful to some individuals in prolonged exposures. The Gilbreth Inter national Committee on Industrial Fatigue place great stress on the^harmful effects of improper posture among industrial workers. The use of proper -chairs eliminates fatigue and greatly improves efficiency. The comfort and efficiency of industrial workers are also afrccted by the color scheme of the environment, the length of the work ing hours and the rest periods used in con nection with them, the general housekeeping conditions and cleanliness of the plant, locker, washroom, sanitation and eating facilities, medical facilities, and by proper provisions for recreation. Most of these, however, have little or no important effect upon the actual health of the industrial worker. ADJOURNMENT ! f ' Pm m Ind prof say tndn of .1 well ing vast then B to i undt to c out. the We broc for wori tilth thro to a .thro bettf then rea ctant ism affoi In heal walh */ Hi /