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FILE NAME: Abex (ABX) DATE: 1947 June DOC#: ABX078 DOCUMENT DESCRIPTION: Journal Article - Industrial Hygiene Association Quarterly Castleman File: ABEX w/c = with cover letter or memo If DATE = 0, undated CD-ROM Document #:abex 7<P DATE published article from trade journal published advertisement from trade journal inspection results __ unpublished or internal report __ unpublished presentation from conference __ newspaper article letter memorandum __ industry warning labels __ industry sales literature __ industry recommended practices __ meeting agenda __ minutes attendee list __ legal filing of defense __ legal filing of plaintiff __ legal deposition O R __ legal testimony of; legal deposition summary / index flUtfifflu*-> ? AMERICAN . INDUSTRIAL HYGIENE ASSOCIATION QUARTERLY i* j ourna K ivriE ^A Medical Literature Volume 8 JUNE,. 1947 Numbr 2 A Medical and Industrial Hygiene Control Program In Widely Scattered Plants ' L. E H A M L IN , M. D., M edical Director, and H. J. W EBER, ' .Medical Department, American Brake Shoe Company, . Chicago, Illinois MEDICAL and Industrial Hygiene pro grams today have reached a stage of high efficiency in many large industries. In this paper we do not propose to discuss a stereotyped program but rather to touch on some of the high lights in our own experience over the past six years. T he American Brake Shoe Company or iginated a complete Medical and Hygiene Program in 1941 to service its (H) plants in 23 states and Canada. T he number of employees in these plums varies from (50 in sonic to 1,000 in the largest--with an average of .250 to 300. There are 10 separ ate divisions, each of which is engaged in the manufacture of a different product. Six of the divisions, which include some 44 plants, conduct foundry operations pro ducing grey iron, nickel and chronic alloys, manganese steel and brass castings. The other plants manufacture such products as upset and. drop forgings, railway switches, frogs and crossings, special alloys, auiomo-. bile brake linings, paint sprayers and com pressors. T he Medical Department had its inccpr tion in 1941 thrqugh the efforts of the late 1`resimted before its Chicago Section. American Indohtriac IIic ien b ASSOCIATION, Chicago, Illinois Donald E, Cummings, then Professor of Industrial Hygiene at the University of Colorado. From a modest start with a staff consisting of a Medical Director, Industrial Hygiene Engineer and X-Ray Technician the department has grown to its present complement of ten and the company lias recently approved a complete new building to take care of our expanding needs. All health hygiene activities originate from the department in Chicago, These consist of pre-placement and periodic health examinations which include chest x-rays, blood tests and urinalyses. Exam ination forms, x-rays, etc., from all plants are checked and filed here as well as results of industrial hygiene surveys. Periodic plant health surveys, are directed by the department and we have our own field x-ray equipment. Recently wc have added a new mobile photoroentgen x-ray unit similar to that used by the public health and tuberculosis associations. We also have a comprehensive industrial hygiene pro gram with a well-equipped laboratory for carrying out field surveys which are cor related with medical findings. In addition we have an industrial nurs ing service which began with one full-time //; . I- yuA n\ K 11 Page SO INDUSTRIAL HYGIENE QUARTERLY June, i'n nurse in 1942 and now employs 25, In a few locations a single nurse takes care of two plants while in one area a very satis factory arrangement allows a nurse'to ser vice two plants in other industries in'close proximity. The type of program matters little as long as it is effective and demonstrates the points of attack. Adequate records are es sential but there is danger of going over board on details in our enthusiasm to do a complete job. At one of our locations recently a personnel manager devised a very detailed form for prospective employees which contained a great many questions concerning background, previous exper ience and personal attributes. One ques tion asked was "What .hobbies do you have?" An applicant for work answered-- "Chawin' tobacco." Perhaps he was serious and possibly the question was in order but the reply illustrates the point that if co operation is desired in obtaining authentic information some thought must be given lo the matter of intelligent questions. Not long ago a pilot told me of a similar form which all employees of.his airline were required to complete. Many, of the ques tions were so absurd that the routine reply to most of them consisted of a stogie word "Wheattcs!" So let us keep the records straight. We have revised ours at least four times in the past six years in favor of sim plicity without sacrificing necessary details. Management Support ONE of of the first any health essentials in the success hygiene program is co operation and support from top manage ment. Plant supervisors must be made to understand that the .recommendations of the Medical Department have to be given serious consideration. Most progressive superintendents "catch on" quickly but al ways there are some who refuse to see the light. They resent fancied interference or what they feei is being told how to run their plants. The approach should be one of "selling'' industrial hygiene and medical care rather than anything savoring of a dictatorial effort, otherwise one need not expect permanent results. A su p e rin ^ dent who carries out industrial hygien; recommendations because he has to cartne be expected to cooperate and he can fin numerous apparently valid excuses f<j procrastination. Occasionally such an a t| tude can only be changed by pressure from top management but a threat to shut dowjp! a plant until corrective measures have beery carried out, while it may be effective, not productive of future industrial hygiene] happiness. Perhaps the biggest single factor in sac? cessful operation of an industrial hygiene plan is the need for thoroughly-.convincing! the plant operating head of the obviousf| advantages of good hygiene and demon%| straung how these can effectively result iifj better production, satisfied workers, lesO absenteeism, fewer occupational disease'! claims and lowered production costs. T h e J superintendent is a key man who can make jr or break your program. Once he is coni, vinced, the major part of your difficulties^ are over, "* Sometimes the man from whom you leastjj expect cooperation turns out to be youy most ardent disciple. A pat on the back in the way of bringing his good showing , to the attention of top management not] only pleases his ego--a very human reaction; -but'm akes him more determined than, ever to surpass his already excellent record.. Such an individual permits no slovenliness' in his shop, tolerates no shortcuuing or-^ bypassing of established hygienic practices and insures appreciable results, which in: ,, tidentally reflect credit on the Medical and Hygiene Department. M any Aspects to industrial Physician's Part in Program ' THE part played by the doctor in indus trial health and hygiene is an important. one. Aside from his responsibility in direct* ` ing the program he should never be un- ] mindful of the necessity for cooperation ; with management and plant personnel. He must be familiar with the various plant ? operations and should display an intelli gent interest in local procedures and VL. 8, NO. Z INDUSTRIAL HYGIENE QUARTERLY Page SI methods. Superintendents greatly appreci- aK a visit from the doctor and too many industrial physicians fail to realize the necessity of periodic tours of the plants they service. How can they evaluate a man's ability to perform a specific job un less' they know exactly what it emails? Employees, too, notice the doctor's visits. This interest in them and their work in spires confidence add discourages fraudu lent claims. It also increases management's respect for its medical service. In this way the doctor not only adds to his practical knowledge of industrial operations but finds a new interest which can become most fascinating. T he importance of this familiarity with industry cannot be over estimated in the proper evaluation of occupational disease and industrial hazards. A most important aspect of the doctor's work in industry is frequently the one which is most often neglected. I refer to the psychological side of industrial medi cine. One of my most important duties is to give advice on problem cases,- both to personnel directors anti to the employee himself. The busy physician either can ' not or does not take time to talk to an injured employee to tell hint about his condition and explain why it is taking longer than anticipated for him to get well. He treats the ailment repeatedly and asks the .man to conte back again and again for dressings. Soon the employee becomes discouraged and wants to see another doc tor. His dissatisfaction is reflected in the plant management which is greatly con cerned about the health of its employees and very jealous of its safety and lost time record. , I have been impressed with the results of a half hour's or an hour's talk, if neces sary, with,numerous workers in our plants who have been dissatisfied with such treat ment. i have seen them return to their jobs with a different outlook on life and renewed confidence in the doctor all be cause of a sympathetic hearing and explan ation of their difficulties. Some of our operative heads feel that this is one of the Hf. !< Industrial hygiene laboratory best services our Medical Department ren ders. T he industrial physician can and should include these practices as part of his medical service. His reward will be satisfied plant workers, the high regard of management and an inner feeling of com pensation which cannot be evaluated in dollars and cents. If he does these things and makes an honest effort to keep abreast of the latest developments in industrial medicine he will not make himself ridicu lous by doing such tilings as diagnosing a case of lead intoxication on a single stipple cell count or a ilin g a man totally disabled from a mild, uncomplicated degree of oc cupational fibrosis simply because he lias worked in a plant where there is some degree of dust in the atmosphere. Employee Participation W E IN American Brake Shoe like to stress the human side of industry and often go .far afield in this respect. Some times there is danger in going to extremes in such policies and results arc neither ap preciated or desirable. One of our plants recently invested a tery considerable sum of money in a new shower and lunch room for its employees. It filled a long felt need and was modern in every respect. While the management was not looking for any great amount of credit for providing such ade quate facilities, it did anticipate some fav orable reaction on the part of the eni- Page 32 INDUSTRIAL HYGIENE QUARTERLY June, ISM? ployees. Imagine its surprise when the only peculiarities he should. Joe says nothing*] response was a grievance to the effect that but he has his own ideas which not un.^j instead of putting all that money into a commonly are more practical than th o s^ f building it should have been, handed out of the expert. So what happens! Joe'itf j to the men themselves. ' ' ' machine is fitted with some new device. Another plant, in order to improve con is told to use it, but he does not like i c f . ditions, installed a new Bradley fountain in All these years he has done the job his way'-'jr its shower room. Shortly thereafter the and it worked. Now they are going to em-^ superintendent informed trie that it was a harass him with some new tangled c o n t r a i l mistake and that they could not use it tion which he has resented from the start, S any more. On further inquiry it turned out He deliberately tries to circumvent the >1 that the employees insisted on using an whole thing and usually manages to do 1 ordinary bucket of water which they placed good job of it unless he is under preus^ in the fountain and instead of soap, they rigid supervision. -;j|| preferred to use small cores from the foun Now suppose the experts had come to dry with which to scrub their skins. N atur Joe and said "Our hygiene survey show s^. ally, the accumulation of sand in the foun that there is too much dust on this job tain soon stopped up the drain and put and we want to clean it up for you. Here's cedui an end to its usefulness. One might say what we have in mind, what" do you think that this was management's fault but re of it or.how do you think it will work?. member this was in the war years when the Have you any ideas about it yourself, you labor turnover was ;u its worst and strikes have been operating this equipment all were often called for very trivial reasons. these years!" Joe's attitude is entirely dif Perhaps the psychological approach to ferent. He feels that he is of some import . new ideas is wrong. Workmen resent ance and that consideration is being given paternalistic attitudes and a "mother knows to his years of experience of which he is' best'' pose. Providing the new shower and naturally jealous. Instead of being a rank locker room without taking into consider outsider he is now part of the team. He ation the fact chat perltaps the men would probably conics up with-a notion that has like to be consulted on what they might real merit and possibly on a point the want in the way of such accommodations, experts hast; overlooked. He sccs it in possibly produced the unfavorable reaction. cluded and, from here on in, Joe is the The same objection should be considered most cooperative employee in the shop. He when making recommendations for im does his utmost to make it work because proving hygiene or exhausting machines. an idea o his is in it and he wants to dem Too. often plant managers, engineers, yes onstrate its worth. Moreover he is con and industrial hygienists get their heads stantly on the lookout for more and more together and say "Now this is what has to ways of improving things and management gram ' be done on Joe Smith's job." Great care lias made another convert to industrial ly, dis and thought are employed in designing the health and hygiene. Perhaps the illustra and lai exhaust equipment and frequent confer tion is a bit overdrawn--! do not think so! kind ; ences arc held right on the job while the It will not always apply but in general the first ai machine is in operation. Joe listens but no psychology is so obviously right. Let us Jr giene t I one asks him any questions or what he might think of the idea. He is paid to turn out his quota of parts and is not supposed to know what is best for him. not forget to do a bit more of taking the 5. man on the job into our confidence. ;J | Periodic Industrial Hygiene Surveys . J fu naie mousl) ageme: main r n Of course Joe has only operated this par u r EALTH hygiene programs in widely ticular machine for a matter of twenty-five scattered small plants are sometimes effeaiv backin; years or so and if anyone should know its difficult to institute. A well-planned pro- June, 194t " says nothing. l | s ' ' :ch not un*: ` rti 'than those happens! Joe's l e new device. He does not like it, e the job his way.* are going to ern-'. ' fangled eontrap" :d from the start, 5 ; circumvent the manages to do a< _ : is under pretty " i , i<-* -it ;rts had come to * ene survey shows dust on this job p for you. Here's hat do you think nk it will work? :t it yourself, you is equipment all :1c is entirely dif s of some import- ion is being given c of which he is' ' 1 of being a rank "--`Mhc team. He " -Ift 'Iion t,hat h.as . (>.. a point t.he "L, . He sees it in- ' m in, Joe is the e in the shop. H ey it work because^, he wants to dcm-.V cover he is con-1} r more and more.,, and management^ ert to industrial' haps the illustra1 do not think sol., nit in general the * ily right. Let US_ -Sii ore of taking the!?, confidence. Surveys M ograms in wdely| us are sometimes! well-planned pro-J: Vol. 8, Ho. INDUSTRIAL HYGIENE QUARTERLY P age S3 Interior of. brus toundry, Note pouring being ' done under hood cedure, directed from a central department, can be worked out but it must always be tailored to fit individual locations. An industrial hygiene program for an organization comprised of fit) widely scat tered plants presents problems which do not exist in "an organization having one large plant. Furthermore, our company is composed of ten distinct divisions, each having different processes. Thus we arc confronted with the following typical haz ards: Lead oxide Lead formate Silica Iron oxides Iron, steel, and brass welding Phosphorus Manganese Tellurium Asbestos Chromium Acrolein Various solvents Carbon monoxide To operate an industrial hygiene pro gram under a variety of conditions--name ly, dissimilarity of individual state health and labor codes, diversification of processes." kind and number of hazards--postulates first and foremost that the industrial hy giene department be given wide latitude in function, operating practically autono mously and responsible only to top man agement. While the department must re main an ancillary and advisory one. to be effective it must have the whole hearted backing of top management. Our company operates throughout on the principle of bottom-up management. - T hat is, each plant superintendent has full authority and full respohosibility in operating his plant. This means chat the industrial hygienist, while he can bring pressure to bear from above, finds his job to be one principally of selling the plant manager on control measures. This is as it should be and one finds, that once you have convinced him, you have control of your hazards in absentia. In our circumstances, and because of constantly changing plant processes, it be comes obviously important that all plants be thoroughly surveyed at least once a year and that those where the hazards are greater, at least twice a year. In fact, those plants in which we believe no hazard ex ists also should be surveyed annually be cause of changing conditions. An interesting example of this occurred in one of our brake-lining plants. Lead formate, which is used in the m anufactur ing process, was received in the plant in 18 lb. packages--the exact weight required lor a batch of lining. The only dust pro duced was during the actual emptying of the bags. This was done in an exhausted booth and hence no hazard was involved. During the war, the plant could get this material only in large drums so th at it was necessary to weigh out each batch. The ventilation was not designed for this change of method, nor was the industrial hygiene department notified. On a routine survey the hazard was uncovered and cor rected the next day. This condition could have gone on until real harm was done. Besides beating unsuspected hazards, the regular routine survey has other advan tages. To give an example: Asbestos is the principal ingredient in brake lining. A certain company carrying life insurance on the employees through their union classi fied all occupations in the plant as hazard ous because of asbestos being used. T he agent applying the rate did not investigate whether the asbestos hazard is controlled; Page S i INDUSTRIAL HYGIENE QUARTERLY June, lg , . Fig. 3. Cloth filter dust arresters with cyclone pre cleaner for asbestos dust a t brake lining plant took no cognizance of the fact that every individual machine has its own exhaust unit; disregarded the fact that the plant is a model of' excellent housekeeping. He .consulted his handbook under B for brake lining, foun'd asbestos listed and made an unwarranted classification of hazard with a consequent increase in premium. The union approached management with their grievance., A phoiostatic copy of the re port of the routine survey, showing dust counts of the order of one million particles per cubic foot and less, was sent to the in surance company and the rates were promptly revised. This had a chree-fojtj effect. It showed the union we were ther^' to help; it sold the industrial hygiene pyj's gram to the management of the plant; an<f4 it impressed us with the importance jf having quantitative records of hygienic 1 J|; conditions as drived from the routine su ^: vey- ' ' We also encounter humorous things in" our surveys. We have a plant in the souit* that makes only brake shoes--a grey iron4 casting. Our surveys indicated no hazard* However, during the war, wc had a woman working in the core room. W h a t ever her motive, innocence, spite, or pat. riotism, she wrote to the President of the,. United States and informed him that the4 American Brake Shoe Company was mak-f ing poison gases. Imagine the superintend dent's surprise when- he teas shortly after ' confronted by a Colonel from the Chemi-Jj cal Warfare Service. Actually wc did have'jv some acrolein furne as a result of the de-j compositio not core oil but it was below the allowable limit; and oddly enough,?* acrolein is a war gas! However, wc do not^ make it; it just occurs and we arc glad to`jisj get rid of it as soon as possible. -i-- It cannot be stressed too much, that PS '`iy'siWi V.- FIr. (. K onim eter samples of foundry dust (a) Dust collected near shakeout. Note targe (b) Dust from grinding operation- in cleaning . sUe particles room. Note large number of very fine panicles June, INDUSTRIAL HYGIENE QUARTERLY Page 35 uad a three-fold lants must be surveyed, at least annually, lack of cases of lead poisoning show good )r -were ther* [ii this way we have found in so-thought hygienic conditions. - ' . .riai nygiene pro? "safe plant5: a potential beryllium hazard; In another plant, one inspector took of the plant; anc jead hazard in a plant melding "pure" samples of-foundry sand to analyze for lead e importance ol copper ingot: explosive hazards in machine content and then proceeded to take'.a two-, >rds of hygienic shops. We have even found lead in air minute impinger sample of a cyclic oper n the routine sur? in some of our offices in the brass foundries, ation,`timing it with a wrist watch. We morous thhi-ngs m* although in safe concentrations. Since we operate in 23 states and Canada, failed to see what information could be gained by either procedure and awaited slant in th south one can see the need for cooperation with interpretation of results with apprehension. hoes--a grey iron other health and hygiene agencies. How If the field technique was such, what of the icated no hazard. ever, if they wish to survey our plants, we analysis and interpretation of results? . we had a ese prefer to be present. This decision was When one realizes that in some areas the :ore room. What- arrived at after several experiences. recommendations of these inspectors have ice. spite, or pat : President of the In one of our plants, these hygienists the force of law, it can readily be seen why made quite an ado about a manual shake we like to be present for plant inspections. ned him that, the out. To the eye, it would appear that the This is not to be construed as a con ompany was malt condition is extremely hazardous. Our re . demnation of other industrial hygiene e the superinten peated analyses proved that the contamin agencies. We have had some good surveys was shortly after ants were principally smoke, steam! and done "by "them which checked very well from the Chemi dust particles too large to be inhaled. How with our own. Our recommendations to :ually wc did have ever, these same men failed to take cogni management have greater weight when i result of the de zance of a really hazardous operation be supplemented by a correct and represen but it was below cause it did not appear to be dirty. Here tative survey by these departments; but we id oddly enough, we were concerned with high concentra feel that we know our own plants better owever, we do not tions of fine pure silica. Their report to than outsiders because of the many investi nd we are glad to management was misleading, making it 'ossible. difficult for the company hygienist to rec much that tify faulty reporting. gations we have made in them, just as the family physician knows the idiosyncra sies of his own patients better than the Again, wo have a bearing plant in the casual specialist. ! northwest which formerly was hazardous, In many instances our maximal allow t Air concentrations of lead were as high as able concentrations arc set lower than those | 30 milligrams per 10 cubic meters and wc, of the organizations in question. Further | found sonic as high as 300 milligrams per more, we do x-ray diffraction and particle I 10 cubic meters. We had about 1-1 cases of size separation in addition to the gross dust | lead poisoning a month. By good exhaust counts. One should not, therefpre, be con jand excellent housekeeping we have re-' demned on a single dust count alone, o r Induced lead in air to safe concentrations be told a lead hazard exists because there band wc have not had a case of lead poison- is lead dust in the molding sand. ; ling here in three years. Wc are proud of 'the plant and its accomplishments. r * jCo-ordination wifh Other Industrial . Hygiene Agencies "D ECENTl.Y an outside agency surveyed Analysis of Urine for Lead in ' Evaluation of Exposure _ BECAUSE lead is our principal hazard 'those plants where it is processed are surveyed twice a year. But our best control I;-*-'" this same plant and wrote a report that . is urinalyses. With plants widely scattered. . Ij've felt was tinlair. Their report, of course, the 24-hour sample or the eight hour was based on air samples. W hether these sample becomes impractical. We there were collected in a representative manner fore resort to the use of spot samples. optracion in cleaning o( very fine panicles or whether their analyses were correct, wc However, there is a wide diurnal fluctu do not know. We do know that our urin- ation in urinary excretion rates, so that a ilyses, our air samples, and especially our' single spot sample has little meaning; one