Document VjbgJ1pnD43v8gYxj27JMxN38

FILE NAME: Engineering (ENG) DATE: 1934 May DOC#: ENG011 DOCUMENT DESCRIPTION: Trade Journal Article - Occupational Diseases: Their Prevalence and Relative Importance vACCIDET PREETlTlOn H E A L T H C O n S E R P A T IO n F IR E P R E P E N T IO tt SA FETy E n g in e e r in g THE MAGAZINE CE SAEETy *" E"Sin,eH,,8. Conservation R ,, p,ev,,,,lo,,., A r t h u r C . C a r r u t h e r s, e, , H e n p v w . A leW ) der ^ ^ HARRY dcG. fA\*ram AMD DRustncss MV/<anager / V TH IS ISSU E ; EDITORIAL OBSERVATION = SPECIAL FEATU RES The New Responsibilities of Manage m e n t ............................................................... 185 Accident Prevention Costs and In surance Rates ................ 185 The Basis of Confidence . . . ]85 Law Enforcement Officers Who De feat the Aim s of Safetv . . . 1 sr; ACCIDENT: R equirem ents in goggles of the itnpoet type are discussed on page 187 by W . P. Elstun of the Bell Company. Sprinklers and other fire extin guishing appliances are described by C. B . L an gd on -- P a g e 2 0 1 . FIRE Fire Extinguishing Appliances -- by C. B. LAN CD O N 201 T o u n c d U '.SSeS. DlSCUSSed at F,re N B FU : The Initials of a Public c . Se,rvant ........................................................ 205 Fire Losses Reduced in March . . . . 206 Annual Meeting of N F P A ................... 206 HEALTH y u a u ry requirem ents in Eye Protectors-- by W . P. ELSTU N 187 1932 Cost of Compensation in New Yo rk State . . . . 190 Factory Inspection on Roving Commission . . . 190 Old T ires in Spring-- by M A X W E L L H A L S E Y . . 91 Tests for Class B Rubber Cloves ............................ ' ' ' ' ' ' ` , 92 Oc^uSprhot^'|SeD^sea'ses^e"LaI?dn ..anc! ^ n d r y ln d u s t n i 207 c A . J n1 a P,M d' " " 6 R" * ' ~ , Engineering and Medical Apects of Fvr^rt' V ................... 2 ,0 Casualty Insurance and the Recovery Program -- by RO BERT J. S U LLIV A N 193 Iowa and Virginia Pass Safety Class L a w s .................................. 196 Training the Mind of the Motor Vehicle Operator -- by ROBBINS B. STO ECKEL 196 A SA Safety Codes Play Important Part in N RA -- by C Y R IL A IN S W O R T H 197 The Importance of First A id in Safety Education . )98 Fifty Cement M ills W in Safety Trophies . . . . 199 Methods of Determining Dust Concentrations-- ................... 216 Cooperation Between A SA a Industrial Nursing: Infection A Bulletin . Occupational Diseases Collective Agreements n d T hof S?tanFdEaHrdNsE. L and for H^aTt^Protection.......... A NurseCon0the b8gravatio" by Exp0sure -- Manufacturers' Products- ............................................. 2, 7 220 221 221 ?V i 222 222 New A ccident Reduction Accomplished by Railroads' .' .' .' .' 199 Charles T . W ills, Inc., W ins Safety C o n t e s t ............................ 2 00 Flying Safety . . Uniform Motor Law ....................................................................... 200 Sturtevant Dust Removal Systems . ,,, Safety Fire Extinguishers . . 222 Bulletin Available on Purair Helmet.................................. 222 Conquering the Scourge of Poison Ivy............................ Accident Statistics in Ohio N f Sn ap p in g pia^te^fo/O thopedic Use'' ! ! ! ! '' f f * ^ Hi ..................................................................... 2 24 T H I R T I J - F O U R T H 1J E A R THE PIOUEER PUBUCATIOU IN ITS FIELD s a s - s Secretary. Editorial and General Offices 1 u ' Street, North r New a 1 York c? k' M o v . Y': d u c e s -- 45 John Publication offices___34 North Crystal Street, East Stroudsburg, Pa. W E DO OUR PART KTd,, "ff? i*TM; rWS'7, Co*ana/19 h r t "?- lb A Subscription*: $3.00 a vear- Canada. $4.00 ; foreign, $4.50. Single Copies. 25c.' EXHAUST FOR PNEUMATIC HAND-TOOL hood, the air ducts, the fan or exhauster, and the dust separator and collector. It is necessary, of course, that this^ apparatus be properly designed and located.* 1he Commission also discusses certain types of respiiators, and describes the need for comfort and effi- the* S f r " * B rackett ,n im e.e.ed m leart.mu further details of th d TM n tm i m e r t l h ' lu lo r .] ,ll0M May, 1934 ciency in their manufacture. Sandblast helmets, bag respirators and filter respirators are described.** Legislative and Administrative Recommendations in the way of legislation, the Commission recommends that preventive regulations be prepared and issued by the State Department of Labor and Industries; that a certificate of compliance with such regulations be re quired of every employer in an industry where the hazaids exist; that employers be made to provide insurance; that insurers carry certificated risks; that entrance ph>sical examinations be compulsory to all workers in dusty trades; that annual physical examinations of these work ers be required; that compensation for pulmonary dis ability be restricted; that all exposed persons be subject to preventive regulations; that a Division of Occupa tional Hygiene be established in the Department of Labor and Industries, and that a medical board of review be piovided for, which shall review' cases of compensation claims for occupational diseases. D epartm ent is s 'u ^ o f's ^ W ^ " throughout the H ealth section of this OCCUPATIONAL DISEASES: THEIR PREVALENCE by A . J. L A N Z A , M .D. Assistant Medical Director Metropolitan Life Insurance Co. and RELATIVE IMPORTANCE W E are not concerned, in this discussion, with medical questions as to the nature of occupa tional diseases; we are not concerned with questions of their diagnosis; we are concerned with the subject of what to do about them. Perhaps it might not be amiss to endeavor to define what is an occupational disease. When we talk of oc cupational diseases, we mean diseases that arise w'holly out of the nature of an industrial process; that is, a specific occupational disease, and that is what the law had in mind when it adopted the British scheme of de fining in a schedule what w'ere compensable diseases arising out of occupations. We are not concerned so much, in this series of dis cussions, with incidental diseases of occupations, but we are concerned with the true, specific occupational disease. That is a distinction that is readily compre hensible. If a man, working on a bridge as a bridge builder, falls into the water, and, as a result of his im mersion, contracts pneumonia, in one sense of the word he has contracted a disease arising out of his occupation, but this is not what we mean by an occupational disease. Compensable Diseases Are Usually Specified The majority of states--the industrial states--com pensate these occupational diseases on a schedule in w'hich is outlined what is to be compensated, such as poisoning by lead, mercury, arsenic, benzol, and so on. The important exceptions are Massachusetts, Connecti cut, Wisconsin, and California which have enacted socalled blanket laws, which laws simply stale that the state will pay compensation for a disease arising out of and in the course of employment, and, in the main, the diseases compensated in these states have been restricted to the specific occupational diseases. It is, perhaps, worthy of note that the one disease which is absolutely and strictly occupational in its na ture, which never occurs, to the best of my knowledge, as a non-occupational disease, and which is one of the most prevalent of all occupational diseases, is the one which no schedules cover, and that is silicosis. It is possible, and medical records bear out, that lead pois oning and other diseases covered in the schedules may be contracted outside of industrial processes. The Prevalence of Occupational Diseases When it comes to the p r e v a l e n c e of o c c u p a t i o n a l dis eases, we have very little information. In the specific sense, when you talk about the prevalence of a disease, you imply the rate, but obviously one cannot establish a rate if one does not know what the exposure is--how many people are exposed to lead poisoning, etc. Further more, another avenue of inquiry which theoretically is open to us is of little practical value--the reporting of occupational diseases. The law requires, in a number o s ates, that physicians report occupational diseases to the State Department of Labor and Industry, or to the State Department of Health. To the best of my belief the law is rarely observed. Two or three years agT, I had occasion to visit a community in which was a well known industry. The hazard was lead; the plant uas full of lead poisoning; the State Department had made a thorough study of the plant; employees were drawing compensation for lead poisoning; insurance companies were paying benefits to those same employees for ead poisoning; and at no time then or since had a single case of lead poisoning been reported by any physi cian in that community in compliance with the basic requirements of the law. Z1I Th e H A N D S of your W O R K E R S that assail them in y o ^ h o T s s , 5 ," and n U r US 8ubstan^ s SOAP is not enough . . . GASOLINE is injurious < cleans only superficially) (it prevents healing, ' ' ' dries the skin) BOON " The Glove Invisible" is an antiseptic cream that dries on the skin and forms an mvisdde, imperceptible film removable only by water When you take off your " invisible gloves," you discard ai the same time all the d ir, and poison of the day's work. BOON MANUFACTURING CO---- ISS FRONT STREET-- NEW YORK No Two States Use Same System I here is left to us, then, to try to estimate, from the number of cases of occupational diseases compensated and the relationship which these bear to the total num ber of cases of compensation, some idea of the prevaence of these occupational diseases. That is simple on fhe face of it State Boards of Labor and Industry publish annually, for the most part, reports in which are tabulated, at great length and with considerable detail data as to compensation paid, number of cases, number o days lost, amount of money paid, etc. The trouble .s that no two states apparently use the same system and the system according to which they are tabulated m the compensation reports does not bear too close a relationship to the compensation schedule. You look at the compensation schedule, note the diseases listed, and ,r^ t0 ldentlfy them ,n the annual reports and find it difficult, if not impossible, to do so. The data then, that we have to deal with are ex tremely faulty Since it would be utterly impracticable o attempt to bring together figures for all the states I have chosen to limit my analysis to the reports of two large industrial states which have occupational disease schedules---New York and New Jersey, and to two states which cover occupational diseases under a blanket law--Massachusetts and Wisconsin. New York and New jersey Compensated cases of occupational diseases closed in New York State in the years 1927 through 1929 amounted to 0.3 per cent of the total number of com pensated claims. In 1930, the number had risen to 0.4 per cent but dropped again in 1931 to 0.3 per cent This is an extraordinarily small figure. There were 306 cases of occupational disease compensated in 1931, and of that number, 132 were cases of lead poisoning. How ever, these figures do not include a large number of cases^ of skin disease which were classified e l s e w h e r e . Dr. Schwartz of the United States Public Health Serv ice in an article published in 1933, estimated that onehalf of all claims paid in the United States for occupa tional diseases were for skin disease. Possibly in New York, the proportion might not be so high. It is safe to conclude, however, that to the 306 occupational dis ease cases reported in 1931 should be added well over one hundred cases of skin disease. In New Jersey, the proportion of occupational disease claims was 0.4 per cent in 1927, about the same as in New York, but since that time, it has steadily mounted to 1.5 per cent in 1932. There were 303 cases of occupational disease reported in the last year of the series, of which 180 were lead poisoning. A large but unknown number of skin disease cases must also be added to the total figure for New Jersey. Proportion of Cases in Massachusetts The proportion of occupational disease cases in Mas sachusetts, one of the states having a blanket law, was but little higher, all things considered, than in New Jersey. In 1927, the proportion was 1.3 per cent, from which figure it has steadily increased to 2.3 per cent in 1932. Figures for Massachusetts, it should be kept in mind, include skin diseases and also poisoning by gas. Allowing for this, the figures do not appear to be very far from those for the state of New Jersey. In 1932, the number of cases of occupational disease reported in Massachusetts was 954, and of these, almost two-thirds were skin diseases--a very high proportion. There is this peculiarity in reporting, however, which must be borne in mind : Massachusetts records the number of re- MANUAL SAND BLASTING N CLEANING ROOM 212 SAFETY ENGINEERING ported cases and not the number of compensated claims May, 1934 How many of these skin disease cases were of short The Importance of Occupational Diseases duration and not compensated, we can not know. The Experience In Wisconsin w e i v ^ t0 the importance of occupational diseases, e have to consider from what angle we wish to con sider the question of importance. If We consider it on " to r thre tern yeafrfeprSeriSodmefromthe1r92in0tetores1t9i2n9&, oincfcourpmaatitoionnal. diseases amounted to 1.5 per cent o( the total eompeu- the basis of numbers, this will be the order :-sk in dl" a" f i.rSt' Slhc0sis second, and lead poisoning third w.th all the others far in the background. If you want ated cases settled 1,, more recent years, the proportion has been much h.gher, being respectively 1.8 per cent a,,,l TOl" ''lT hnd, Per in >'" rs ,92'J ' 1930, and 1931. The total amount of indemnity paid for all S-- dlS,eaSeS in Wisconsin iri 1929 was $97,- fr m tHe StandPint of what they cost ndustry ( m compensation), then we reverse the order and put lead poisoning first; skin disease second; and ihcosis hardly figures at all, except in the state of Wis consin. What the cost of silicosis may be through the common law suit, I do not know, but it is safe to state fctlaid0 Bv 19S it i ' addCd $25'222 paid for TM d- increased to $207 Z T T f indemnity Paid had was $22 027 $2A7d6\ whlle the for medical aid was $22,027. A very large part of this payment, it is tn ih t T i t0 n f ' WCnt f r SiliCOsis ComParable data sis OCCUPational diseases and for silico sis separately are not available from published sources and, theiefore, the exact percentage chargeable to sili- bC tCrmined- Some idea the importance of this disease, however, can be had from a special re{Mtr published by the Wisconsin Industrial Commission Between ,929 and 1931, ,we,,,y-,w,, cases were eompensated. Compensation costs in these twenty! hat there are suits on file to the amount of many mil ions of dollars. If we consider the importance of these occupational diseases from the viewpoint of the public ^ and ofTh nHe f the emPloyees themselves and of the reilected effect upon the community as a ffiirrsstt, l1ead^ poiWsConriCngVesreSceonlhdC. Srdileicrosaigsaiins 'fiWrsitt,hnsodticoonsliys because of its extraordinary predisposition to tubercu osis but because of the added hazard of infection to the families of sihcotics. Lead poisoning is fairly wide spread and is mostly of a minor type. Extreme cases of acute lead poisoning are uncommon but much time is st by industrial workers from mild lead poisoning m " rcasePr0Xima'C<i i220-00' " " f *>"- hich manifests itself as stomach or digestive trouble t is not jxissible, I think, to define any other of the f a c t o T ir f Certain COnclusions we can draw from these acts and figures, one of which, and the one which I rsona y elieve, is that a great many, if not the bulk of the occupational diseases are neither diagnosed nor oodd Tof/ftaabbulMatiothnCarnd reptoHrattiniSg ibnvit0hUeSviSartihoau`sthsetamteeslhis- ccupat.onal diseases as major public health hazards. i h respect to arsenic, mercury, benzol, and the other terns on the schedule, cases of poisoning from those sub s ances do occur. In the tabulation of compensation claims, they are so few that they can have little weight as far as the general public health is concerned unsatisfactory. Here is a problem whose importance L coming intensified with each passing year It does The Need for a Competent Medical Board and will cos. industry enormous sums o l money, a n d X t is impossible today, even with the help of trained sta tisticians actually to find out what is the extent of oc- The whole matter of dealing with the occupational diseases is now in a more or less violent agitation in all the industrial states. Additions to the present laws are mdPu !ry ^ m any SUte 3nd tHe t0tal CSt t0 PNEUMATIC HAND-TOOL OPERATOR' ANOTHER TYPE OF EXHAUST contemplated and entirely new laws are being proposed. ooff Tthhe 'drififTicuVltie^s t?haatt wSeUnadres laUbto' rainngd uthnadteris, 'inthatrtyoinnge to decide who is and who is not suffering from occu pational disease, ,s the absence of a competent official medical board. After all, the question of deciding whether a man is sick and, if he is sick, whether he has an occupational disease, and if he has an occupa tional disease, what is the extent of his disability-those are facts tor competent physicians to decide. If ffidus- rial workers are to be justly compensated for occupa- mnal discuses and if industry is to have the assurance at this complex subject is to be handled fairly and efficiently, provision must be made for cases by making available to the state authorities the advice and guidance of^a medical board whose personnel is composed of state t ht T' hT' D ` sease, under auspices of H ealth R elations o f the N. V ^ c u d e n i X o T v ' r Y C ,on,,! " tlee Public of Casualty and Surety Underwriters l d `Ct'i'C' tlle N atl`,n al B u reau Vork City. Match 1. 1934 uerw r" ers, and other oigam zations. New