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* * ABOLT ~'-*E / 1288579 33l,StY\3l5 :gress and Ex- October 10-14,? I contains the; of the various' ;e Street and; e Transit, the; Council Officers and Directors.......................................... Council Purposes and Policies.......................................... Annual Meeting of Members.............................................. Annual Banquet..................................................................... Special Subject Sessions-- Agricultural Safety .................................................... Dusts, Fumes, Gases and Vapors.............................. 4 9 11 31 33 45 5 .dustrial mem-* Falls of Workers........................................................... 59 Fire Prevention............................................................. 69 nbers who are; Governmental Officials .............................................. 85 ns it contains/; Health Service in Industry......................................... 101 'n Volume II; Industrial Accident Investigations...........................115 Industrial Explosion Hazards..................................... 125 tribute copies* . foremen and; :rmation they! jfcrence pur>c obtained as! h; 11 or more* cost /5 cents-iv - Industrial Nursing....................................................... 139 Industrial Safety Lectures......................................... 163 Maintaining Interest in Safety.................................185 Midwestern Rehabilitation Meeting........................ 201 Occupational Disease...................................................211 Off-the-Job Accidents .................................................229 Safety Fundamentals...................................................249 Safe Use of Electricity.................................................257 Safe Use of Petroleum Products.............................. 269 i of the pro-* Aeronautical Section .......................................................... 281 he papers ar.di A. S. S. E.--Engineering Section.....................:.............295 s matter, a!)-i Automotive and Machine Shop Section........................ >hasizc what Cement and Quarry Section........................................... romoting ef-; Chemical Section............................................................... t prevention Construction Section ....................................................... ; somewhat Food Section .................................................................... ticular vak:-_*. Marine Section.................................................................. loving mr-rc . Meat Packing, Tanning and Leather Industries Section ........................................................................ i desired, in Metals Section............................. ................................ Minins Section.......................................................... 'Os. seeks Paper and Pulp Section.................................................. Petroleum Section.......................................................... not pertm-wnc u.-ary to .y. houx-v ,-r. :i nave n.-.n . .papers.-....-T- Power Press Section...................................................... Public Utilities Section............................. Refrigeration Section...................................................... Rubber Section.................................................................. Steam Railroad ................................................................. Textile Section.......................................... , i r. c. Wood Products Section.................................................. Safetv Exposition--List of Exhibitors.................. Index . ............................................................................ Dusts, Fumes, Cases and Vapors WEDNESDAY MORNING SESSION October 12, 1938 Assembling in the Grand Ballroom of pany, Hartford, Conn., and Vice-President The Stevens Hotel, this meeting was called for Engineering, National Safety Council. to order by Chairman Walter S. Paine, Chairman Paine briefly outlined the session Manager, Engineering and Inspection De objectives, and then introduced the speakpartment, Aetna Casualty & Surety Com- ' ers. Recent Developments in Detecting Hazardous Dusts, Fumes, Gases and Vapors By WARREN A. COOK Superintendent, Engineering Department, Zurich General Accident and Liability Insurance Company, Ltd., Chicago In discussing the determination oi injuri ous dusts, fumes, gases and vapors, I am very sure that you are not interested so much in a meticulous dissertation on such phases of the subject as whether the loga rithm of the reciprocal of the hydrogen ion should be 9.5 or 9.0 for the determination of lead by the dithizone method, but rather in a discussion of this matter along broad tines, pointing out what types of potentially injurious materials should be looked for, whether determination of them is in order, a brief discussion on some of the more im portant and common methods oi determina tion, and interpretation of the results ob tained. Foolhardy to "Work in the Dark" Working in the dark without any means or illumination where there may be hazard ous conditions serious enough to cause loss f life or severe injury would be considered most foolhardy; yet every day men conduct their operations in atmospheres containing dsts, gases, and vapors which may cause death or severe injury to health without be ing able to see or otherwise perceive the potentially hazardous condition. Most gases and vapors can no more be seen than the well-known black cat in the coal cellar. Some of them cannot even be detected by odor, though odor is itself, no reliable criterion as is evidenced by the gas, hydrogen sulfide, which has a most ob-f' noxious odor but has caused many a case\ of poisoning. . / How, then, are we to know whether the' atmosphere in which we work is safe or injurious? Are we to wait until we see the effects of unhealthful or irrespirable at mospheres on our men or is it not more intelligent to determine, within^ka-iisyi&w. lions of modern methods and practical ap plications, just what sort of atmosphere we are subjected to? The importance of having tacts before us is well illustrated by an atmospheric con dition where a life could be snuffed out in afew minutes, even though the more com mon situation is where excessive exposures may require weeks, months or years to cause their injurious effects. 46 Silver Jubilee Safety Congress Thirteen years ago this month a powder case of carbon monoxide poisoning, was crew was walking down the tunnel of a the ready availability,of a simple means of new water supply system of a Connecticut determining the carbon monoxide concen city. Their duty was to inspect the roof tration on the job. and the face, to see that all the shots were fired. On approaching the tunnel heading immediately after the blast, they found that flying rock had broken the compressed air line, which had been left turned on in order to blow the smoke and gas away from the face of the tunnel. The crew, consequently, ran into a heavy blanket of smoke, but they' were hardened workers, used to smoke and gas, and a little smoke, even though they knew it contained carbon monoxide, did not hold them back. The present tendency in development of methods of determination of injurious ma terials in air is toward such simple, quick acting devices. As many of you know, the Hoolamite carbon monoxide detector op erates merely by pressing a rubber bulb ten times and comparing- a purple color which develops in presence of carbon monoxide with a standard color scale mounted on the instrument--an operation which requires about a minute. Instruments of this type are especially important for gases which They found the roof intact. But four of may cause acute poisoning such as carbon the holes had not fired. Caps with 3-foot monoxide, hydrogen cyanide, and hydrogen fuses were inserted in sticks of dynamite, sulphide. one for each of the holes. The gas condi tion by the time this work had been ac complished was beginning to make these men feel a bit groggy. Following the usual practice, the powder foreman sent the rest of the men back down the tunnel before he lighted the fuses. An instrument tor determination ot hy drogen cyanide, similar to the Hoolamite carbon monoxide detector, has recently been developed by' the United States Bu reau of Mine workers, and, together with a number of other of these simple detec tors, is now available commercially. De The men walked back through the smoke termination of such materials can accord to the car, about a quarter of a mile down ingly be made much more widely than the tunnel. There they waited for the fore formerly when laborious chemical labora man. Seconds passed. The time stretched tory methods were necessary. to a minute. Down the tunnel came the boom of the blast--but no foreman. The men rushed to the heading and found the foreman stretched on the tunnel floor, nearly covered with rock from the blast, where he had collapsed from the effects of the carbon monoxide. This is a true story up to a certain point, but I have omitted a part of the story, and the ending, I am glad to say, is pure fiction. The part of the story wltich I omitted was that carbon monoxide determinations were being taken when those men got lip to the heading, and a concentration of .3 per cent carbon monoxide was shown to be present by means of the Hoolamite carbon monox ide detector. With such a high concentra tion, it was realized by the man making the determinations that it would not take long lor exposed persons to collapse. He in formed the crew of the condition and hur ried them back to the car to wait until the smoke and gas had cleared enough to per mit them to work safely and fire the blast. Potentially Hazardous Materials The first step in an organized endeavor to avoid environmental conditions which may cause injury to health is a listing of all materials, used or produced, which may under certain conditions be deleterious. It was found in a study by the United States Public Health Service of potential hazards in a typical industrial area (I) that a considerabic percentage, nearly 20 per cent, of the workers were exposed potentially to carbon monoxide. The report bv no means intimated that this percentage of workers were being poisoned by carbon monoxide, but rather that if things went wrong and 3 concentration of._the gas built. up_ jurious proportions these men might be come poisoned. So I suggest that you go through your plants and see what operations involve po tentially injurious materials. Of the dusts, those which may produce silicosis occur not only in the well-known industries where major studies of conditions have been con The difference between fact and fiction in ducted but in other industries as well, tiiis case, between a brief delay and a fatal though usually to a lesser extent. In silver* ware manufacture may be exposed dust in making u for use within th; tries in which sc exist is given in t: Silicosis Conferem The toxic dust: readily spotted. V against lead expo plants, but often o^ as where red lead vehicle by a work top floor of the pic steel part. It is r pound of lead or but the extent to v. air breathed by the Carbon monoxk hydrogen cyanide i examples of gases, curs where produc. used The last nam where fumigating r to time. Where dr or fermentation pt carbon dioxide is l; deaths usually at : areas such as ships' tanks. Vapors are pre: solvents are used. where high concent: curred when a drum on a basement store open, and again \vh* was being used for and the fumigator hhe basement as his his last. Injury from cont. vent vapor at cone, their effect after wc mre common cor solvents differ wide, vapor necessary divided into grotheir toxicity in a the Xonhwestcrn Ur Occupational Disease Where Should T Mi v>'Juert potential: Present, it is mv Tnak|ng actual deterrr '(,i>oniiiir. was nplc means of oxide concern- i-vciopnient of injurious masimpic, quickyou know, the detector opubber bulb ten e color which '.on monoxide ounted on the inch requires of tins type gases which uch as carbon and hydrogen :ation of hy:c Hoolamite lias recently I States Uu:ogcthcr with simple dctcc-rcially. De.> can accord- widcly than mica) labora- Materials 1 endeavor ons which 1 .ting of all hich may erious. It ted States : tl hazards :at a conr cent, of .1 ntialiv to no means workers r.onoxide, ng and a p to inieht be- ro tgh your in olve po' i :e dusts. - CCVv--,VO t ri< i where i ;en con- is well, I i silver- \ | I Dusts, Fumes, Gases and Vapors 47 ware manufacturing, for example, one man may be exposed day after day to tripoli dust in making up a polishing compound for use within the plant A list of indus tries in which such dust exposures may exist is given in the report of the National Silicosis Conference.* The toxic dusts and fumes are more readily spotted. We recognize and guard against lead exposure in storage battery plants, but often overlook such an operation as where red lead is being mixed with a vehicle by a worker in one corner of the top floor of the plant to color lettering on a steel part. It is not so much whether a pound of lead or a ton is used in a day, but the extent to which it contaminates the air breathed by the worker. Carbon monoxide, ' hydrogen sulphide, hydrogen cyanide have been mentioned as examples of gases. The first of these oc curs where producer gas or water gas is used. The last named should be looked for where fumigating may be done from time to time. Where dry ice is used in quantity or fermentation processes are conducted, carbon dioxide is liberated and has caused deaths usually at the bottom of confined areas such as ships' holds and fermentation tasks. Vapors arc present wherever organic solvents arc used. Death may result quickly where high concentrations exist as has oc curred when a drum of solvent was dropped on a basement storage room door and split open, and again where carbon tetrachloride was being used for fumigating a flour mill ar.d the futnigator sprinkled the liquid in the basement as his last operation. It was Ms last. Injury from continued exposure to sol vent vapor at concentrations which- cause their effect after weeks' of exposure is the more common condition. The various solvents differ widely in the concentration or vapor necessary to cause injury. These are divided into groups in accordance with their toxicity in a paper delivered before the Northwestern University Symposium on Occupational Diseases a year ago.* Where Should Determinations Be Made? After going over your plants and learn ing where potentially hazardous materials are present, it is my suggestion that, before making actual determinations of concentra tions in air or instituting control measures, you make a thorough survey of the condi tions and divide the various operations where these materials are present into groups r (1) those which are obviously safe; (2) those which are admittedly caus ing injury to health or are worse than good industrial practice dictates; (3) those conditions where it is not readily discern ible by general observation whether the ex posure is within safe limits. Certain conditions we know definitely and can say definitely will not cause injury to health. I would not say that those arc to be forgotten, but at least they need not be the subject of initial action. If, for ex ample, a gas containing 30 or 40 per cent carbon monoxide is used for hot plates, and those hot plates are connected with rigid conduit rather than with rubber tub ing, you can feel reasonably safe that the carbon monoxide exposure is within safe limits, and I would not recommend that determinations be made. Where spray painting is being done in a well ventilated booth in such a manner that there is no excessive rebound into the face of the sprayer, determinations of vapor or pigment need not be made even though the odor of the solvent is detectable. From time to time it may be well for state authorities to check some of these lesser exposures, but there is a considerable number of such ex posures which can be accepted as safe. The second group of exposures--that where conditions arc admittedly severe--is another where determinations are not es sential. Institute control measures immedi ately. If there are clouds of dust contain ing free silica in your plant. Zj to work on them. If excessive lead absorption is shown by development of symptoms or by high basophilic aggregation percentages, reduce the lead exposure. It may be desirable to make determinations even ir. these cases either to provide a before-anc-after picture of exposures to show what improvement is effected or to obtain a clear picture of just what part of an operation is responsible tor the excessive exposure to the tr.d that con trol measures can be more specifically ap plied. This latter use of air analysis data is of especial value where" the materials are invisible as is the case with gases, vapors and even some of the more toxic dusts such as quartz and lead. The principal use for determination of 48 Silver Jubilee Safety Congress injurious materials in air is where general observation does not give the necessary in formation. Suppose exhaust ventilation and partial enclosure have been installed to reduce exposure to a dust high in free silica. You might learn whether control measures are effective by waiting ten or a dozen years to see whether silicosis devel ops among those exposed. It is much more economical to run a group of dust de terminations. A recent series of such de terminations indicated that exhaust ventila tion was adequate at an operation where pulverized silica was being transferred to the hopper of an elevator, but the manipu lation was at fault - --------- -------- Where fumigation with cyanide has been conducted, it has long been the practice to depend upon a time period of ventilation and upon the nose of the fumigator to establish that the premises are safe for occupancy. Xow that a simple hydrogen cyanide detector is available, it is in order that determinations be made in every case before re-occupancy and, further, that every municipality where cyanide fumigation is carried on enact an ordinance' covering such fumigation with the provision that deter minations be made, especially in any dead air spaces, before the premises are consid ered safe for occupancy. Hydrogen sulphide determinations are today being made routinely in the spinning rooms of viscose rayon manufacturing plants. Carbon disulphide determinations involve a more laborious procedure but are regularly made in a number of departments of the larger plants of this same industry. Operations are regulated so that any ex posures to these materials are within safe limits, but the continual checks permit de tection of any excessive exposures before injury to health develops. A good general rule to adopt is to make determinations of concentrations of injuri ous materials in air wherever there is any question that these may produce deleterious exposures. Methods o: Determination Discussion of methods of determination will be limited to certain general considera tions, reference to complete descriptions of available methods, and comments of timely interest on a very itw methods. In the collection of samples, it is of ut most importance that these samples are such as to provide the desired information. It has been pointed out that one set of conditions exists today, and quite a differ ent set of conditions may exist the next day; that if air analyses show conditions to be satisfactory on the first day, our eyes may be closed to the fact that conditions are much worse on the second day. So, rather than encouraging the Installation of safeguards, we are setting up obstacles to them. My plea is that methods of determination be used intelligently and honestly. If it is desired to show exposures under the most severe conditions, be sure to set up these conditions when you make the test; if rep resentative conditions are desired, see that they are truly representative. Whether you yourselves make these tests in your own plants, whether you bring consultants in to make them, whether state departments, in surance companies, or some other agency makes these determinations, make a real effort to see that conditions are as repre sented when these determinations are made. For a comprehensive discussion of equipment for conducting determinations of dusts, fumes, gases and vapors, may I refer you to a paper entitled "The Industrial Hygiene Laboratory."4 This paper includes descriptions of both field equipment and laboratory apparatus, together with a dis cussion of their applications. References to the methods themselves may be obtained in the reports of the Com mittee on Methods of Determination of In jurious Materials in Air.* These reports are available on application to the Amer ican Public Health Association. f The Preventive Engineering Committee of the Air Hygiene Foundation of Amer ica has recently developed a bulletin on Methods of Determination,* and in that bulletin are included only those methods which have been satisfactorily used in this country. The trouble with many papers on methods of determination is that they are woefully deficient in their practical qual ities and simply do not work when put to _ihe> test. - - __ You are all interested, I believe, in a brief discussion of the methods available today for dust determination and some of the up-to-date viewpoints on collection and determination of dust. It is my opinion that where it is desirable to know whether a condition investigate try. it is ' 0f the imp the advant: at the pre> tion to the oped at the able comm the bulkim It is to pinger wil. the differ methods c a duplicat: by the use other instplers, whi. a second value for impinger > an hour exists, we erations c concentra: meter, a I some ins: concentra: obtain pre tions whi dust. Further condition sampling as a cont has a du desirably methods they com not is of tant thin? at levels If dustir dust pro and cont Collect timely i: ability o: tator. M lead in impinger This ins collectio: material given o: Pinger c less tha: Dusts, Fumes, Gases and Vapors 49 i ormatioit" * :ie set of a difrCr. the next ditions to our eyes conditions day. So,' Ilation o( stacies to rmination . If it is the most up these t; if rep- see that * :ther you our own nts in to cnts, in agency - a real is reprere made, sion of itions oi y I refer ndustrial includes ;ent and h a dis- -mselves .e Coma of Inreports Amer- nmittee Ameritin on :n that methods in this oers on :ey are ! qualput to , in a ailable me m and pinion nether a condition is or is not safe in the light of investigations so far conducted in this coun try'. ^ well to collect samples by means of the impinger method. I will not go into the advantages or drawbacks of that method at the present time beyond bringing atten tion to the micro-impinger set-up as devel oped at the Bureau of Mines and now avail able commercially which largely overcomes the bulkiness of the original equipment. It is to be emphasized that only the im pinger will give impinger results. Due to the different characteristics of other 'methods of determination, you cannot get a duplication under a variety of conditions by the use of other instruments. However, '"other instruments, such as the grab sam plers, which take a sample over a period of a second or two, are of very considerable value for a number or purposes. If an impinger sample collected over a period of an hour shows a high dust concentration exists, we may know what particular op erations during that hour caused this high concentration. If we have a Zeiss konimeter, a Bausch and Lomb dust counter, or 'some instrument which will give us the concentration at any given instant, we can . obtain precise information on those opera tions which are contributing most of the dust. Furthermore, after we know whether a condition is safe or not, one of these quick sampling instruments is extremely valuable as a control measure. Wherever a concern has a dust condition, determinations may desirably be taken by some of these quick methods regularly as a control. Whether they compare exactly with the impinger or not is of no great consequence; the impor tant thing is whether conditions are holding at levels shown by the impinger to be safe. If dustiness is on the increase, a survey, of. dust producing operations should be made and control measures instituted. Collection of lead dust and fumes is of timely interest with the commercial avail ability of the portable electrostatic precipi tator. Most of us who have been sampling lead in this country have been using the "upinger for the collection of these samples. This instrument is highly efficient for the collection of samples where lead dust is the material of ir.teceit. Where lead fumes are given off, we have evidence that the im* Pinger collects these fumes at appreciably css than 100 per cent We feel that the electrostatic precipitation method, which is about the most efficient method of collec tion, is a preferable instrument for mate rials of sufficiently fine division to be classed as fumes. This type of instrument has long been available, but only recently commercially; and I feel that where lead in the form of fume is encountered, the electrostatic precipitator should be used. The facts which we have'in the literature today concerning the production of lead fumes in workrooms where high tempera ture melting pots are used are based on the results of impinger samples, and so until we get further data from the electrostatic pre cipitator, we have a big question mark as to whether there is more lead fume in the air where lead melting pots are present than .we had previously anticipated. A year ago, the A.P.H.A. Committee on Air Analysis mentioned above obtained in formation from all the laboratories in the country conducting industrial hygiene de terminations concerning what injurious at mospheric constituents had been analyzed, what methods were used and whether these were satisfactory. Lead was the materia! which was de termined by the largest number of labora tories. The next material of interest was hydrogen sulfide, and the reason being that most rayon manufacturers make routine tests for this gas. If any of you believe that a man will not voluntarily walk into a dangerous hydrogen sulfide concentration, let me recount the experience of one of the promising young Workers in industrial toxicology who walked into his laboratory one morning, about two years ago, found that a hydrogen sulfide cylinder had tipped over and the valve J}roken.off.. In trying to get the cylinder to an exhaust hood, he collapsed and was found dead in his laboratory by the janitor who arrived not long after. Certainly if an intelligent research worker, thoroughly aware of the toxic action of this gas, could so expose himself, we must not assume that the odor of hydrogen sulfide will cause the plant worker to avoid dangerous amounts of it. Carbon monoxide was next in the list of injurious materials place#'in the*'order'of' the number of laboratories making deter minations of them. In addition to the small Hoolamite detector, previously mentioned, 50 Silver Jubilee Safety Congress 'i several types of detectors and continuous indicators are available commercially, both portable and stationary. A home-made de vice has just been suggested' whereby air is drawn past the filament of a cigar lighter (or combustion and the COj formed by any CO present is determined colorimetrically. This ingenious device may solve the prob lem where the exposure may not justify the expense of the continuous indicator. Mercury was the next in line. Unfortu-_ nately we do not at the present time have a quick method for mercury. One method will give concentrations of vapors within injurious limits if the sample is of several hours duration, but we would like to be able to obtain the desired information with a ten or twenty minute sample. The list then includes sulphur' dioxide, hydrogen cyanide, ammonia and chlorine in that order. Of the organic materials, the greatest number of laboratories made determinations of hydrocarbons as such. The inflammable vapor indicator, orig inally designed to show whether an at mosphere was within inflammable limits, is of value for hygienic purposes in some cases, but just because an inflammable vapor indicator shows negative results is no good reason for assuming that the condi tion is necessarily safe from a hygienic point of view. One of these indicators has been sensitized so that it will give as low as 20 parts of a million of benzene vapor, but the minimum reading on most of these instruments is 1,000 parts per million. Carbon disulphide has been of much in terest. A method lias been developed, and is commercially available, for the determina tion of chlorinated hydrocarbons, such as trichloroethylene, with which we are be coming more familiar through its use in vapor degreasers. The chemical method will give chlorinated hydrocarbon concen trations in the presence of such otiier ma terials as gasoline, with which they are sometimes mixed. A rapid physical method for the deter mination of all vapors and gases having a density substantially different from air (and this includes most of them--notable excep tions being CO, HCN, methanol, and ethane) is the portable interferometer. The operation, after calibration, involves draw- * ing air through a cylinder, turning a dial? and reading the concentration. Unfortu nately the interferometer is not specific for any one vapor, merely measuring differ.,, ences in densities. The cost of the instru ment is high, but it is available through a number of investigators and some of the insurance companies, and, where many de terminations are to be made, amply juj-^. tifies itself. -------------- --Interpretation In the interpretation of results, there arc a number of important items to be taka into consideration. It is appreciated that the results must be referred to some threshold value such as 100 parts per million for carbon monoxide or 2 milligrams per ten cubic meters for mercury. There are sev* eral collections of such threshold values, that published by Bowditch* being one of = the most complete. In referring results of determinations to/$these standards, consideration should be'!?' taken of the duration of exposure of the;., worker and also the duration of the exposures used in developing the threshold ' limits. If a worker is exposed to a con--; centration of 20 milligrams of lead per 10 cubic meters of air for a period of an hour a week, we need have little apprehension that he will develop lead poisoning; but if a group of workers is exposed to this con- centration as an average condition^thcn we ; can anticipate lead poisoning cases. The conditions under which the air samples were collected must be carefully considered. In some instances winter con ditions may be the more severe; in other, cases, summer conditions. If open windows adjacent to a chromium plating tank cause high concentrations of chromic acid to be blown into the plating room, the results of determination should be interpreted to in dicate the need, not of increasing the local ventilation, but of keeping adjacent windews closed. ------ ------- -- Careful note should be made of all opera tions which may contribute to the exposure. The dust concentrations near a group of molders in an iron foundry may be exces* sivc, but it is possible that the cause may be due not to the molding operations, but to an unprotected sand conditioning ma chine in the vicinity. Where conditions change rapidly, samples must be taken fre quently or over a long period in order to permit proper interpret; didons are essentially si sample may be adequate As previously mention such value to have ava collecting devices: one dnuous sample over a 1the other which gives t any given instant The able information on tin of the worker, and the dcular operation causing of that exposure. Th methods, used togethc cases much more cor. interpretation of existi* Know the limitaiior used and interpret the We must remember tV. a very convenient tool r it should not be emp mortise and tenon joir. tions have their defini try to read more into worth. Determinations extensively to great determinations, we cat exposure to dust, furr. is safe or dangerous hot see them. Let us . but rather, cast all lb otherwise invisible ha: Chairman Paine: portant subject, and I who would like to d: us make our questior A G. Speer (West thome): Are you (z connected with arc v and ozone, and mear. Mr. Cook: A stu iron oxide concentra'. arc welding, with th amount of iron oxid arc welder might in determinations have though the lungs 1c they were severely pretty conclusively does r.ot cause inj Dusts, Fumes, Gases and Sapors 51 turning a ^ ^'r^nennit proper interpretation. Where con- ion. Unforti]7 ^'dWons are essentially static, a single brief, *01 specific iQf ^sample may be adequate. ... ....... asuring differ -V't^As previously mentioned, it is usually of of the instn - 'such value to have available two types of able throu; ^collecting devices: one which takes a con- i some of ^ 't tinuous sample over a long period of time, here many jfcy the other which gives the concentration at :e. amply ju^ . . any given instant. The former gives valu* r able information on the average exposure of the worker, and the latter on the par tilts, there ar^ 5 to be taken' dated that the' ome threshold r million for! rrams per ten'- ticular operation causing the major portions of that exposure. The results of both methods, used together, permit in many cases much more complete and valuable interpretation of existing conditions. ^ Know the limitations of the methods here are sevvl `.--used and interpret the findings accordingly. :$hoid valued- r \Ve most remember that _a screw driver is being one of .a very convenient tool and It has its use, but 4rmm. ati.ons to i should be' osure of the'' t of the ex*' he threshold ed to a con*, t lead per 10 d of an hour apprehension'' oning; but iC i to this con*^ it should not be employed for making a mortise and tenon joint. These determina* tions have their definite value, but do not ' try to read more into them than they are worth. Determinations can be used more extensively to great advantage. Through determinations, we can learn whether the .exposure to dust, fumes, gases and vapors r jis.safe or dangerous even though we can Jnot see them. Let us not work in the dark, . but rather, cast, all light possible on these ; otherwise invisible hazards. tion, then we' tscs. References (1) Bloomfield, J. J., Johnson, \V. S., and Sayers, R. R.: The potential problems of industrial hygiene in a typical indus trial area in the United States. U. S. Public Health Bull. No. 216 (1934). (2) Summary reports of the National Sili cosis Conference. U. S. Div. of Labor Standards Bull. No. 13 (1937). (3) Cook, W. A.: Industrial `solvent ex posures and their control. Proceedings Occupational Disease Symposium. Northwestern University Medical School (1937), (4) Cook, W. A.: The industrial hygiene laboratory. J. Ind. Hygiene and Tox., 18, 623-636 (Nov. 1936). (5) Report of Committee on Methods of Air Analysis. 1935 Report available as reprint, 1936 Report available in 193637 A.P.H.A. Year Book. American Public Health Assn., N.Y.C (6) Routine sampling for control of atmos pheric impurities. Committee of Pre ventive Engineering. Bulletin in pub lication by Air Hygiene Foundation of America, Inc., Pittsburgh, Pa. (7) Make your own carbon monoxide test. Safety Engineering (Sept. 1938). (8) Bowditch, M.: Toxic Limits of Injuri ous Materials. Div. of Occ. Hygiene, 23 Joy St., Boston, Mass. jeh the air. be carefully winter conre; in other en windows : tank cause acid to be e results oi eted to in* ig the local ;acent win- i all opera* s exposure. - group of be exces* cause may ations, but oning ma* conditions taken fre* - order to Discussion Chairman Paine; This is a mighty im conclusion has been reached in two sep portant subject, and 1 know there are many arate investigations. who would like to discuss phases of it. Let us make our questions dear and concise. The collection of iron oxide was made by the electrostatic precipitation method. A. G. Speer (Western Electric Co., Haw thorne): Are you familiar with the fumes Mr. Speer: We had occasion to make connected with arc welding, .like iron'oxide and ozone, and means'of detecting them? -such a determination but we used the impinger method, and we did not find toxic Mr. Cook: A study has been made of qualities or properties. We could not find any available data on that particular subject, iron oxide concentrations in connection with arc welding, with the thought that a large Mr. Cook: A paper was published by amount of iron oxide being breathed by the Drinker, together with a number of other arc welder might injure his health. X-ray investigators, in the Journal of Industrial determinations have been made, and al Hygiene, and the conclusion was that in though the lungs looked very' much as if jury to health was caused by nitrogen ox they were severely fibrosed, it has been ides, with a possibility of ozone entering pretty conclusively shown that iron oxide into the picture. __ ______..____________ does not cause injury to the lungs. This R. C. Meldrjm (Glens Falls Indemnity mm. 52 Silver Jubilee Safely Congress Co., Glens Falls, X. Y.): Mr. Cook, do you may have been around 2 of a milligram believe that an arsine determination should whereas 1.5 milligrams per ten cubic meters be made in a metal pickling operation? Is definitely safe. Suppose instead of 2 o{ Mr. Cook: Generally, no. I have seen no a milligram per ten cubic meters, there are actual arsine poisoning from metal pickling, two or three times as much present in the even though the literature includes such form of a fume as found by the electro cases. As far as cases in this country are static precipitator. Even if .6 or .8 miilj. concerned, it has seemed to me to be largely a literature condition. In talking with Dr. Cunningham, of the Ontario Department of gram were present we would be within safe limits. This is further shown by the fact that physical examinations of workers in Health, Division of Industrial Hygiene re rooms where lead melting pots are present cently, he mentioned a considerable number have demonstrated that Jhtre is no great of arsine poisoning cases and I suggest you . lead absorption.-- write him for further details. I have not So my conclusion is that the collection of seen any thorough investigation of the sub samples by means of the electrostatic pre ject, and that has been one of the things cipitator is not going to confuse the issue that lead me to believe that the condition at all. It is going to give us more accurate isn't sufficiently severe to cause us great data on some of these exposures where lead apprehension. The experience in this coun is present in the form of fume. try* has hardly indicated the necessity of making such determinations. I have not made any myself. However I should like to see somebody make a series of them at a half-dozen locations where metal pickling is done. F. L. Warner (U.S.S. Lead Refinery, Inc, East Chicago): Do you feel that fur ther investigation with the precipitator will G. W. Daubexspech (Illinois Department of Labor, Chicago): How would you de termine arsine in air around pickling tanks? Mr. Cook: It would be necessary to re sort to a chemical method, and l think that I had better not use the time for a discus sion of chemical methods. J. W, Fehnel (Metropolitan Life Insur change the present permissible limit of lead exposure that has been determined by the impinger method? Mr. Cook: The answer to that question is "No," but I feel that this iurther thought can be added: We have had many opera ance Co., New York City): You mentioned the use of the electrostatic precipitator in lead sampling. I have been doing that work myself along with the impinger samples, at various times, to correlate results on lead, both dust and fumes, since 1926. tions where lead dust was the prime ex Here is an interesting thing. I know that posure. Where the lead is in dust form, the Bloomfield a few years ago made some tests impinger will get essentially the total in a large baking plant and found lead. He amount of the lead; consequently where we came up to consult with Dr. Wright about have made physical examinations of large it, and it was concluded that the source of numbers of workers in such exposures, the lead was the paint they used. That correlation of the results of physical ex sampling was done with the impinger. aminations of workers and of incidence of About two years ago I made an extensive cases of actual lead poisoning with concen survey in one of the General Motors plants trations of lead in air have fixed fairly where there were extensive soldering opera definitely, within workable limits, just about tions. I took impinger samples, and I got how much lead can be considered to be safe. a series of factors that I presented in the The threshold limit based on such ex report, and a short time later I was called posure to lead dust would be . the jsame_ .pjuthe carpet .and told that my figures did whether the samples were collected with not agree with their plant chemist's. So I impinger or electrostatic precipitator. consulted with the chemist. When he On the other hand in rooms where lead sampled with the electrostatic precipitator casting is done, where there are lead melt and I with the impinger, and we took them ing pots, the impinger probably gives low on identical reading levels, we got the same results. Tiie chances are that the concen results. He had consistently gotten lower tration of lead in those rooms is greater results--and we proved this later by checked than found by the impinger. But those im samples--because he had his electrostatic pinger results, those that we have made, precipitator mounted on a little truck that he pushed thro-, working on a pi. 18 Inches higher meant that ins breathing zone sampling at abc Robert Wjnt Co., Carteret, M one point, Mr. metallurgical cc the kettles. If hand, or if yot heat your kettle heit, if you can Fahrenheit, wlr heit, because t: more liberation duced the bazar Mr. Cook sta Men Who C Vice Presiden The title of Down to Their taken extreme:; know, there ar (of which we ? lation in our a. truck tanks and both of which . city streets we for utilities, poage that are als as we call then excavations, sh: factories, you i: ment rooms, Even open pits board ships you enclosed space: Even when you try, as we her dangerous enclc the bottom of many varieties are pickles, an-. Will you pier, demonstration ten;ial conditio: there may be c: need a very g- SpSTiC Dusts, Fumes, Gases and Vapors 53 He pushed through the aisles, and the men y/orking on a platform that was about 12 to 18 inches higher than his main aisle, which meant that instead of' sampling at the breathing zone of the workmen, he was sampling at about his waist level. Robert Winters (U. S. Metals Refining Co., Carteret, N. J.): We have overlooked one point, Mr. Chairman, and that is the metallurgical control, the heat control of the kettles. If you have a problem on hand, or if you are pouring lead and you heat your kettle up to 1,000 degrees Fahren heit, if you can pour that same lead at 750 Fahrenheit, why pour it at 1,000 Fahren heit, because the more heat you have, the more liberation of oxide? So we-have re duced the hazard to a large extent now. Mr. Cook stated that the impinger system is a little too cumbersome. I would say that where you have a definite hazard in the lead industry, have your impinger sys tem a permanent system of the organization of your department and keep it there as a permanent fixture. The question came up too, as to the merits of the electrostatic precipitator against the impinger, and I cannot agree with that statement at all because the fumes are made up of minute particles of dust--a fraction of a micron in size--and we found that the impinger system gener ally is just as efficient as the electrostatic precipitator, with the exception that we do have at least six impinger bottles in series, because you cannot get efficient sampling with one or two or three bottles. You must take enough bottles to get a reliable result. :s ? Men Who Go Down to Their Death in Tanks--A Demonstration By S. E. WHITING Vice President and Chief Engineer, Liberty Mutual Insurance Company, Boston The title of this feature, "Men Who Go Down to Their Death in Tanks," should be taken extremely broadly because, as you know, there are not only stationary tanks (of which we give you a very crude simu lation in our demonstrations) but there are truck tanks and there are railroad car tanks, both of which are enclosed spaces. In our city streets we have thousands of manholes for utilities, power and telephone and sew age that are also enclosed spaces, or "tanks" as we call them here. You have trenches, excavations, shafts, tunnels, mines. In your factories, you have tanks again, small base ment rooms, vaults, cisterns _and sumps. Even open pits may prove hazardous. On board ships you have a very complete set of enclosed spaces, compartments and holds. Even when you go out into the open coun try, as we here look at it, you may find dangerous enclosures--grain bins, wells and the bottom of silos. "So there are just as many varieties oi enclosed spaces as there are pickles, and perhaps more. Will you please remember that from this demonstration you are to visualize the po tential conditions in your own plant where there may be enclosed spaces--and you will feed a very great power of imagination to do so with our necessarily crude demon stration apparatus. There are two hazards in enclosed spaces that we shall not dwell upon at length. In any enclosed space that has not much venti lation, that collects moisture and is dark, you will have a severe slipping hazard and an accentuated electrocution hazard--but we shall here consider only the typical asphyx iation and explosion hazards. Most of those enclosed spaces are nor mally just as good to work in as outside spaces__and that is part of the danger. Men have worked in tanks year after year with no trouble, only to have something ex traordinary come up to contaminate the tank, something that they have not antici pated, to make that enclosure a hell hole, as we shall demonstrate in merely reproducing not an exaggerated situation but only what has actually taken piace. How do these spaces get into that condi tion? Merely because there is no free cir culation. oi norm.2l_atnvcc-5.hsrc.- T-hat- is of fundamental importance because all animal life, especially higher animal life, must have a constant supply of normal atmosphere to sustain life. The normal atmosphere is re- vs have to be*; : agencies and-/ ing opportunities!' or the physical^ st be summed Tufi 'o equal quantiUejl applicant's ability^ ' add an unlii* perseverance, int vork and success Occupational Disease THURSDAY MORNING SESSION ttzr- October 13, 1938 'session for the discussion of out* jjng problems in the field of occupa- j disease was called to order by the loo. P. ] Angsten, Chairman, the Illinois industrial Commission, Chicago, who pre sided. The Chairman emphasized the im portance of the selected subjects to be pre sented by eminent speakers, and promptly introduced the first scheduled speaker. The Trend of Occupational Disease Legislation & By HENRY D. SAYER vManager of the Casualty Department, Association of Casualty and Surety Executives J&dt us consider the differences between But some will say, truly, not all accidents he 'accidental injury and the occupational happen in the manner described; that not ^disease. For these distinctions are important always are they held to occur only at a ' ad must constantly be borne in mind when specific moment or under circumstances re consider either legislation on the sub- where they can be visualized and described. set of disease, or engineering methods of By administrative and court decisions, it is arevention or control. true in some jurisdictions that the definition (Generally speaking, accidents occur at a fic moment in point of time, and, from he standpoint of fixing liability under any olicy of insurance, it is in the future; that to say, at the moment of the acceptance :of liability under any insurance contract 'the accident for which liability may be as- has not yet happened. That fre- of "accident" has been greatlj' broadened. We find the entrance of disease germs into the human system without visible trauma, with resulting sickness or death, and even the specific time and place not definitely known, except that it is shown to have probably occurred in the employment, being held to be an accident. is not so with the occupational dis- (Hiers vs. Hull, 178 App. Div. 3S0, 164 X.Y. Insurance by its very nature can \vonly assume liabilities that have yet to v;.-arise--not.those that have already accrued. -.Tt*/-- Again, speaking generally, the industrial accident is something Jhat.can--be--seen-- s' fe yv^.even though unforeseen. It may be visualand described in words, setting forth ;-:-*specificalIy the time, place and manner of 7' happening. It can then be determined, after ' the happening of the event, whether it was :? Prevemab]e or inevitable; blame, if any, can v be assessed; the worker involved, or his 767. an anthrax case: Vennen vs. New Dell Lum ber Co.. 161 Wis. 370, a typhoid ease; and others.) Poisoning of the body through the effects of a deleterious or toxic substance used in the empioymenOhe dangers of which were unknown to the worker, the employer hav ing been negligent in safeguarding properly the use of such substance, has been held to be the result of an industrial accident. (Victory Sparkler & Specialty Co. vs. Francks. 147 Maryland, 368; and the very recent case of Black vs. Creston Auto Co., Iowa Supreme Court, August 5, 1938, 281, N.W. 139.) foreman or superintendent, can be shown And where negligence of the employer the fault, and effective measures can be has been shown, an injury to health, even taken to guard against a like future hap- though not occurring through a happening penlng. _ ____ -zt rugiuea-timj. and place, but by repeated 211 '..i > 212 Silver Jubilee Safety Congress exposures over months of time, has been held to be an accident. (McXeely vs. Carolina Asbestos Co., 205, North Carolina 568, an asbestosis case.) These and other cases I might cite are the exceptions and not the general rule as to what constitutes an accidental injury. I think we may fairly assume that the efforts of administrators of the law and the courts have been directly inspired by their belief in the necessity of finding a remedy for an industrial ill for which no - clear remedy had been provided by specific language of the statute. May we consider them as straws-in' the wind, showing a trend toward industrial disease liability? It may observed that the tendency of the courts is to construe the term "accident" in a more limited manner in those states where there is specific provision in the law covering occupational diseases. Thus, we have clear instances of what has been termed "judicial legislation," that is, the courts broadening the meaning of the law to cover situations not clearly included within the terms of the law by the duly con stituted legislative authorities. Let us now consider what we mean or in tend by the term "occupational disease." Here we find a more difficult field--difficult from the standpoint of administration and judicial interpretation; and difficult from the standpoint of the doctor and the en gineer. What is disease? We think we know, and at least to laymen the term conjures up in our minds something of a rather defi nite nature. When we pause to consider it, of course, infinite qualifications of the term occur to us, and we are confronted with many conditions that fall into the zone of doubt--such as, for example, whether her nia is a disease. At any rate, we say it is an abnormal condition, and let it go at that. But when we come to add to the doubt ful term "disease" the even more indefinite term "occupational" or "industrial," we find ourselves--in ' m area ~o*' highlight- sur rounded by a vast and increasing zone of twilight shading off into Erebian night. Just how then shall we define the term "occupational disease"? Some diseases stand out in our minds as clearly and definitely occupational. As to them we have no great difficulty, either leg-. islatively or administratively. These indnA? the well-known metallic and chemical eon l*w* the sons that are so definite and characterful and vague.*0 a part of some industrial processes. \VJ all occupation the diseases arising from the use of the*** the definition substances the only occupational diseased phrase "and ? with which we need concern ourselves, thej eases," is to legislative difficulty would be largely rcJf one that ma> moved, and we could safely entrust tb<r disappointing problem to the doctor and the engineer, s . 0f the law i But we have seen that the legislating problem is not so simple. . Nor is it simple!! administratively.--We" find ourselves flouo. dering in a veritable morass, either because* of the inherent difficulties of the situation,-^ or because we have not or cannot agree* on our objective. If all parties would ree*j ognize the difficulties and the limitations on what industry can do, or can fairly be pected to do, we could much more coo?3r fidently face the future. If we could agreejj| that provision for "occupational diseases" i$fg. not synonymous with general health and lift insurance tor industrial workers at indus |'certainly be ' employers. An excelle statutory dm nite, certain used in theithan to rest meaningless ' . of which ma; the objective is bred by t controversy . litigation is ;* causes delay; disappointmer try's expense, then I am sure we could ge V.tvea breed d somewhere very definitely. ^'orderly proce. But has there not been too much loos? Why then thinking on the subject? We are met with* demand for : a curious situation. We find the advocates' '< it-with the of so-caiied "all-inclusive" statutory cover* may* result in age deliberately seeking indefiniteness. This workers who is unlike them, for when they know what? besets us all their objective is, and are willing to dis ' .in our play, i close it, they have not refrained from press*-? our sleep, as ing their advantage with definite and speri, II.Perhaps notcific purpose, and with, exact language to-^ a more simaccomplish that purpose. That, at any rate,:g -..could not otr. is correct legislative procedure. Are we to But in this field, even where the liability^ of the employer is made inescapable, the constant suggestion is put forth that it B futile for the legislature to attempt a defir nition or delimitation of occupational dii-^ eases, and, therefore, words of the mostjS general character should be employed, leav-^,, ing to the courts the interpretation of th*;^ law as they see fit. I submit that it is the function of the courts to make up the|| legislative mind; that is the function and the right and the duty of the legislature^ Nor should the legislature seek to.avoi.jS and evade responsibility by transferring^0,^; the most cc ..life' may beet Jts source or an incider, dition there that a pre-e Pavated by We order. ' *uld becorr. * case of life, K **th a show f. Audition or ^Qch disease Numerate. courts and commissions the determinaU0^. '.But we km of questions of liability which the IS,s. , for tubercul' ture finds too difficult for it to deternun*^ V. numen for itself. deaths 1* Occupational Disease 213 ^'effect coverage under the compensa- Add to these pneumonia, asthma, arthritis, crmca! ?j . therefore, by any such general iaracterij{j.'r ss. W^' _ vague language as the term "any and ^occupational diseases," or by adding to s f thtsr: disease Tsehe* largely ^ ^definition of "accidental injury" the ,*^e and shall include occupational dis?vf.. js to create an uncertain liability-- that may require endless and perhaps entrust " IlSSLpointing litigation--before the meaning >gineer, ^Irthe la'v 1S established; and will most H&iUainly be a disservice to workers and "rheumatism, and a host of others; and we discern in this the beginning of a system of health insurance of the most costly type-- a system moreover that would discrim inate bitterly against the many millions who contract such diseases in perhaps ac tually the same way, but who have no em ployment at all against which to assess lia bility. Should not the man who falls vic tim to a disease of ordinary life while . legislative v employers. is it simple- An excellent rule--a cardinal rule--in elves floi. . itutory drafting, is to use words of defl her because' ' ate' certain and understandable meaning, e situation in their common acceptance, rather innot agr^'-5 fftai.'to resort to vague, uncertain and would `neaningless words, or words the meaning citations oTT jfwhich may have the effect of distorting lirly be e*;* objective that is sought. Controversy more cot _Hbred by uncertainty of language, and tould agree 'controversy leads to litigation in courts, diseases" 1$ ; 'litigation is-expensive for all parties; it 1th and life hSicaases delay; and it frequently causes bitter s at indus'. ^disappointment. It breeds rancor. It may ; could get ' ieven breed disrespect for the law and for derly process of government. nuch loose'^ siWhy then should there be this continuing e met with?' ^demand for the all-inclusive coverage? Is e. advocates sggitjVith the vague hope that satisfaction itory cover-^ ^fiuy result in some cases of misfortune to .eness. This 'S^rorkers who fall victims of the disease that know what ^besets us all and lurks in waiting for us ling to dis- sSia our play, in our homes, yes, and even in from press- ;bur sleep, as well as in our employment? searching for a job be just as much the con cern of the state as the man who becomes disabled from the same disease and who is so fortunate as to have a job ? Let us be realistic about this thing called health! Ill health is a deviation from the normal. But what is "normal ?" How great a devia tion is abnormal? Disease is of many and varying degrees. To what extent does the mind affect the working status? Or what part in the situation is played by "will power"? These are not fanciful questions, they are encountered and will obtrude themselves continually in determination of compensation for disease where we depart from the known and characteristic occupa tional diseases. From these remarks perhaps some will say we are opposed to coverage of occupa tional diseases under compensation laws. Mot so! The stock casualty companies represented in the Association have not op *e and spe- ^Perhaps not--yet if that were the design, posed and do not oppose the principle of mguage to ;/'* more simple way of succeeding in it compensation for occupational diseases, if .t any rate, 7could not otherwise be contrived. thereby is meant compensation for those he liability ipable, the that it i< npt a defitional dis- the most oyed, leav- ion of the it it is not ike up the iction and legislature : to avoid terringto ermination w-\ Are we to understand that any disease of diseases that arise from a "trade risk," or vthe most common and ordinary risk of from conditions that are normally and usu ";|He may become an occupational disease if ally present in the particular employment, ^}ts source or supposed source had its origin as distinguished from those ordinary hu ^ m an incident of the employment or a con man ills that beset all of us. Our view of dition there present, or if claim was made it is that the policy of coverage under the ^that a pre-existing disease had been ag-- . law-is a matter of local concern, to be de ?vgravated by such condition? That is a termined by local legislatures in the light j-arge order. It would mean that industry of local demand and with due regard to .would become liable for any ordinary dis- local opinion Of both labor and industry. 'easc of life, provided that disease could be, >Co employer in this age can reasonably '1lh a show of plausibility, related to a object to fair compensation for disease ' ndition or incident of the employment, buch diseases are almost too numerous to ' Numerate. arising from such occupational risks, any more than he can object to reasonable com pensation for disabilities due to accidental : But we know that claims have been made injuries. he legisla- " _or tuberculosis and heart disease, the two _This, conception.of industry's obligation determine mst numerous diseases and (Tie cause"of is7 however, quite different from the con . ore deaths than any two other diseases. ception of a public obligation to care for i;-j i;!i Mn Mi H 214 Silver Jubilee Safety Congress and compensate for all sickness and death under a form of health and life insurance. The latter obligation, if it be a valid one, is the obligation of the state and the nation --not the obligation of industry alone. The reasonable, the intelligent, the sane way for industry to discharge its obligation to its workers for conditions of health is to provide for the greatest reasonable re* quirements for industrial hygiene, and to provide compensation only for those con ditions that, arise from specific named dis eases that are truly occupational, charac-' teristic of, and peculiar to the processes in acteristically the obligation of industry -r why continually insist upon the use of lao^i; guage which is susceptible of misinterpTt.~ tation? Be well assured, if legislatures <j0- not perform their duty and lay down clear* definitions of liability, industrial boards af^T commissions cannot in the presence of theu widows, orphans, and industrial cripple^, be expected to exercise greater courage^ than the legislatures. The law in the handt of such an administrative body will be scanned, and I fear scanned in vain, for* limiting--words"*or" language to stay the 5 hand of industry's self-constituted almoner.'i? ^ work is performed a: disease, and which can followed as a natural in w a result of the expo he nature of the empl gji be fairly traced to jbe proximate cause, ar jome from a hazard t would have been equali 0f the employment TT. incidental to the charact not independent of pjoyer and employee. T. to have been foreseen or its contraction it must : which the worker is engaged. The legislative trend, I am happy to re- * its origin in a risk corn: Industry will, I am sure, meet the chal port, in recent years has been toward the^ ployment and to have lenge of the occupational disease problem, definite, rather than the indefinite. Despite*.? source as a rational cons if it is presented under a law that pre scribes the liability of industry in under standable terms. In the early days, the general rule was to include occupational diseases in the compensation law by specify ing the particular diseases or the particu lar conditions leading to diseases that are deemed to be occupational and compensable. This we call a "schedule" law. It is the form in which compensation for occupa tional diseases is covered in all of the countries of Europe and of South Amer ica. It is so simple; it is so sensible; it is so easily administered, that the wonder is that the acceptance of the principle is not tremendous pressure, no legislature has, in the past three years, adopted a blind, "all-in-i* elusive" occupational disease law, except^. New York, of which I shall speak more inj| Under this definition ager can, with any assu what his obligation is tc detail presently. Michigan, Rhode Island,^ 'assuredly no workman Pennsylvania, Delaware, North Carolina,' ease can surely know and Washington, among the states most 'titled to compensation t recently enacting occupational diseases lawsjjg '.'nurse,, as is to be expe have adopted the "schedule" or specified the interpretation of t!. method of coverage. Two years ago, Ohio-g ready in progress in b< amended its scheduled occupational disease law by adding dust diseases to its existing And situations will ari.future where the facts schedule. In two other states, namely, 111k,. nois and Indiana, occupational disease law^g have been enacted in general terms. How-te v'ohly litigation in the cc the..liability of industr the worker to be compc: universal. ever, in identical language, these two states^ ,-;The claims actually If we will keep ever before us the prin ciple that a disease, to be deemed occupa have undertaken to limit and define occupa-"* . dustrial Commission tional diseases and have attempted therein' \ include undulant fever to safeguard industry against liability for^.; ... be commonly commun; tional, must be "characteristic of and pe culiar to" the occupation, there should be no great difficulty in arriving at a proper statutory setup for the coverage of all true occupational diseases. Metallic poisonings are characteristic of occupations in which such metals are used. The diseases charac the diseases of ordinal^ life. Although doubtless familiar to many, the i definition in the laws of those two states* will bear repetition, as indicating the ex^ treme of difficulty in attempting to exactly; define an occupational disease. v meat products), tularcnarthritis, rheumatic h< amebic dysentery', varic athlete's foot, cerebral to due to overwork, nerve' disorder. I have claims for characterist: teristic of chemicals, of acids, of alkalies, "Sec. 6. In this. Act the term `Occupav.^ gases and fumes, are characteristic of and tional Disease' means a disease arising out;jg peculiar to those occupations in which the of and in the course of the employment.-^ such as silicosiPoisoning, and the varic ditions which clearly cc employees are so exposed. The diseases of Ordinary diseases of life to which the the respiratory system, due to the inhala era! public is exposed outside of the env^v; I have referred to tion o-f-dussCr'are tlfe-nsruTi'l aCtonTpani-' ployment shall not be compensable, except..^ ^ork, alone, has in rec ment and the characteristic effect of work where the said diseases follow as an kw covering occupatic in such dusts. cident of an occupational disease as ^ terms. New York When such clear and specific language is available, why should we be asked to use vague, broad terms, the use of which may constitute the giving of a blank check by industry? If the purpose is not to charge industry with diseases which are not char in this section. ';*& ^believe, to enact an o- "A disease shall be deemed to arise oUj>* for occupational d of the employment, only if there is apPafen,J^ to the rational mind upon consideration o all the circumstances, a direct causal con*- nection between the conditions under \vhicj It* The law was a sc - ^ happens that I had t l of those who colta' of that law.) We Occupational Disease 215 .."oil ^ork perfrme^ and occupational new subject. We examined the existing Kriase, and which can be seen to have laws in other countries and adopted the smterp^H atures >wn ^ardsjuT ce of crippj^ couraft?1 the fa*,' will beVvain,!^ stay; alm< py t<T$ ward Des^' e has,:,Q v i, "all-m^r > t more nj 5e Islu^ Carols tes ises la specL__ rdtowed as a natural incident of the work i' result of the exposure occasioned by be nature of the employment and which in be fairly traced to the employment as /proximate cause, and which does not ' rora a hazard to which workmen aid have been equally exposed outside fjfthe employment The disease must be icidenul to the character of the business idiiot independent of the relation of em,Yer and employee. The disease 'need not i^Jiaye been foreseen or expected but after its contraction it must appear to have had Its origin in a risk connected with the em.oyment and to have flowed from that SJonree as a rational consequence." ' ..Under this definition no industrial man ger can, with any assurance, be informed jrhat his obligation is to his workman, and Suredly no workman suffering from dis- e can surely know whether he is en,'tled to compensation under that law. Of otirse, as is to be expected, litigation over ,Je "interpretation of this definition is al form that seemed best adapted to our con ditions, namely, the English law on occupa tional diseases. The schedule was, from time to time, enlarged as new industrial processes developed new diseases. By 1929, the schedule had been enlarged to include every disease that was a potential hazard to the workers in New York State, with the single exception of the dust diseases of the lungs. In order surely and certainly to bring such conditions within the pur view of the law, there was enacted an ad ditional item in the schedule, reading "any and all occupational diseases." The sched ule was not repealed, and the administrative provisions in the law with respect to the schedule were continued. One of the first questions that arose under this new law was whether the new classification super seded the schedule and the limitations set forth therein, or whether it was an addi tion to the schedule and applied only to those conditions not previously included therein. go, Oluo^ ready in progress in both of these states. The legislature, having evaded the duty l disease^? existing/ \nd situations will arise constantly in the of defining the term "occupational disease." future where the facts will be such that the Industrial Board, which administers the :ely, M-/v [y litigation in the courts will determine law, adopted a definition. That definition ase laws*-? Ihe liability of industry, or the right of is well worth repeating: that the Board s. How- the worker to be compensated. deems a disease to be occupational only - o states occupa* therein `lity for any, the o states the exexactly Occupa-ing out }ymenL ne gen- ^JT.The claims actually filed with the In- when it is "characteristic of and peculiar ^-dtistrial Commission oi Illinois already to the trade, employment, or occupation" ^ include undulant fever (a disease said to in which a worker was engaged. This defi ^.be commonly communicated by milk and nition was adopted almost verbatim in the fr. meat products), tularemia, rheumatic fever, Rhode Island and Michigan Laws. The ^arthritis, rheumatic heart, heart disease, Appellate Division of the Supreme Court, y*?.aniebic dysentery, varicose veins, flat feet, however, declined to follow it, and by a .y['; atbjcte's foot, cerebral hemorrhage alleged vote of three to two, held that any disease oc due to overwork, syringomyelia, and that arises out of a condition incidental to ^in,C,7e disorder. I have not mentioned the" the `employment must be deemed to be an ,ms fr characteristic occupational dis- occupational disease. |i,Ca^cs' ,such as silicosis, carbon monoxide (Bishop vs. Comer & Pollock, 251 Appellate '<?' Pp'sonmg, and the various other toxic conaitions which clearly come under the Act. Division. 492; Goldberg vs. 954 Marcy Corpora tion, 251 Appellate Division, 904.) The Goldberg case was appealed to the he eos- J*aVe Teferred to the fact that New Court of Appeals--the court of last resort except ; orlq alor.e, has in recent years enacted a in New York. So completely do the facts an ia- ' -Jft covering occupational diseases in gen- in the Goldberg case bear out what I have iefinf^ t , terms- ^tVf York was the first state, said about indefinite liabilities under an all- ^ la r VC' to enact an outright compensation inclusive law, that they will bear repetition. se oot occupationaLdiseases. It-did-so in^- Shirley Goldberg was employed to sell parent ^ t* t.' T"e ^aw was a schedule type law. (It tickets in a moving picture theater. Her ion of ^ appens that I had the privilege of being booth was on the sidewalk. It was kept I con- V" * ) those who collaborated in the draft- heated, in cold weather, by a small electric which t S of that law.) We were dealing with a heater, operated from a switch in the .?: \ I' \ I! Occupational Disease 217 in whjd^v of their etiology and pathology industry who may have in the past in s aud^ ^still going forward. curred some degree of fibrosis of the lungs. 2 nle k ** ot ' it has'.,: 3 wgard-' acddtnt" ^&Oue fact stands out clearly, and that tfiat these diseases do not progress to l*te point of disability until after many *ars of exposure to dust. The length of S=5*!nt varying from five to twenty-five or h Court'''.' 3r hernia ~'l the In. that no';' ase pre- SW>ort yearSf is dependent in large measure the concentration of dust, the com- ^oosition of the dust, the time actually exgv*^j during working hours, and the in^Sual susceptibility or resistance of the in the ', frequent ^Imi-ker. Another fact that stands out is ^ fibrosis of the lungs, once ac- the hips, ,emfed, is permanent and incurable, and, factory. : Uncomplicated cases is not susceptible to : end o| --* jeal treatment. ig about jrifany thousands of workers .today, under was not no law but the common law, have been } a few ^employed in employments exposing them to te Court `l^mort or less heavy concentrations of dust '"%'for many years. In the event of the enact ience,' is ment of an occupational disease law in- ifting of - loding those diseases, industry will find But if industry cannot assume these liabil ities. how much less justification is there to call upon insurance, out of the premiums of next year, to pay for disablements ac quired over the past fifteen years, and for which it received no premium ? In this difficult situation, it has been found necessary in many states, if em ployment is to be continuous and uninter rupted, and if men are eventually to be compensated for the fibrosis acquired due to future exposures, to absolve, to a great extent, industry from the obligation of com pensation for past exposures, and to base compensation upon the extent of exposure after the enactment of an occupational disease law. Thus, there has come into acceptance in several states the principle of graduated compensation benefits for dust diseases, limited to future exposures, and eliminating in large measure the ex posures of the past. constant' itself, at the stroke of a pen, liable for Under this system compensation for dis iy. This i-* ^conditions already acquired through long ability or death occurring during the first resulte4 iyears of employment, and which may be- month under the new law would be only latter ofv* icome disabling at any moment. In this sit- a nominal amount (it has been set as low ..) There;' -- S-tiation, the best guaranty against disable- as $500 to start with). A person disabled t's occu'*' T^s-ment is continuous and steady employment. during the second or third month after :nd there f^Uanj* a man, actually able to work and the enactment of an occupational disease isdictions ^.earn good wages, while he has a job, will law will have been exposed, to a small anal da 2g;be able to demonstrate by x-ray and clin- extent at least, under that law. The ex ys. Ini _; ical examination the presence of a marked posure is perhaps in itself insufficient to Ins. Cor degree of silicosis, when his job stops actually result in any harm. But the max because of depression or otherwise. imum benefits will be increased, month by ;s x. y. Hence arises the question of the so-called month by small increments, until in the question ;islation lust disjf cases icddents id occuIn this nthracon forms diseases ang the een ree ls been .usation, amplicafund of n gathntensive "accrued liabilities." This term which has course of two or three years the full limit come into common use is perhaps not an chargeable to industry in the particular exact term, in that "liability" does not state will have been reached. This system occur until disablement, and the liability is not so complicated as it might seem. is only "accrued" at that time. What we The effect of it is rather to postpone the have in mind when we discuss accrued going into effect of a dust disease law for labilities is the condition of. fibrosis "of" a matter of two or three years, and experi the lungs which has accrued and has been ence under this law has demonstrated that acquired over a period of years. This few claims arise where the compensation condition, being permanent, remains with benefits are so limited, the workers pre the worker, whatever and wherever may be ferring to stay at work as long as they hts employment. Perhaps a more exact can. It may be said that it works harshly expression would be "potential liabilities," in the case of the person who becomes ^ yet they are more than potential; the really totally disabled in the early months condition giving rise to them is actuallv existent. ot law. When measured by the liability with which the employer may fairly be ` ja<fustry te(fs_u&. quite^l.ruIy.-Lhat.it--caoi--.. charged, it does not, in fact, work a hard ot now pay full compensation out of cur- ship, and when compared with the exist ent income to all of the men employed in ing system in states not now under occu- ' i':! If i 1 ; rf! Silver Jubilee Safety Congress tates toward an inferior physician, less con of the chest of this workman may stro work Placcs cerned with the lack of qualifications. The `suggest the possibility of silicosis, nowh! ' an? ut a!I mar extent to which lack of qualifications in oc on the work record may it be shown ' These physicians cupational disease work may go is reflected for a period of seven years at some n ' stared miners; d in the fact that recently a duly licensed earlier time this workman was employed physician in the State of Michigan reported a laborer in a pottery. "intestinal peristalsis" as a diagnosis of an In this same connection it should be occupational disease. phasized that one of the many handicai While the unwillingness of a physician to to the physician in making an accu accept responsibility for pathologic states diagnosis is to be found in the widesp . with which he is not conversant is com practice_of..hospitals,`of clinics, insurance mendable, there still.remains a duty to di-" " records, etc^ in merely naming the trade rect his patient into channels wherein ade a workman rather than describing his quate sendees may be procured. occupation. It is quite insufficient for mi Industrial Terminology One of the most annoying handicaps in ical purposes for a record merely to sho for example, that the patient was employ as an "automobile worker." Under miners' wives; m for measles and tempted to meet t detached commur jpmeS contributec ? physicians and jingle man was ta couth in order j)l?ry- Thus a: physician." This represent the be. ill instances wer {the highest ty: establishing the exact etiology of a possible heading, there are perhaps not less occupational disease resides in the wide 200 different and dissimilar types of IW| Later some of larger towns, o: spread practice of industry in using code ployment leading to different exposure* sought to symbols in the designation of its substances. such for example as to silica in the foundrjjj find that the cor On inquiry, the patient may state to his cyanide in the heat treating room, chro saddle. This Sz physician that his work consists of filling in the plating department, lead in body ^ oofof this "Pa* containers with "B-72" But, inquires the ishing, and on and on. physician, "What is B-72?" The patient continues, "B-72 is a mixture of M-20 with Lack of Library Facilities fnumerable evils the highest ^piper-vision unc H-40 and L-97." Completely the physician With some temerity the statement ^commendable c is left in the dark, but if the truth were made that regardless of many book p: Become' a traditic known it might be shown that this patient cations in the field of industrial hygi |jrthe medical pro was engaged in the filling of cans with a and occupational diseases, special mag* manner of the: varnish remover, which consists of a mix zines, and articles appearing in gen t industrial physi ture of wood alcohol, benzol and a syn medical magazine publications, there is,.'? 'affection that thetic wax. this time, no condensed, informative ^ groups have sc Such situations may become so confus . terial on occupational diseases well sui ing that it may be almost impossible for to the needs of the family`practitioner. the physician to obtain proper information It is of course impossible and undesi as to work exposures. Medical, safety, so that any attempt should be made to red# cial service or insurance departments all all of the lore of occupational diseases S may have difficulty in obtaining full in some thin book to which the practitif fe;, most any form i&' dee and in so- J&j bership in me ` physicans. As jf daas in some fe'^itK a scarlet '. formation as to actual chemicals and mix tures of chemicals designated in production operations only by code numbers. The Absence of Records The majority of industrial plants fail may refer and with certainty obtain all guidance needed in the treatment and n _ agement of occupational diseases. Grandaf all this, there still is occasion to assert that a real need now exists for a book public*tion on occupational diseases designed f xThis queer jb-Nay serve as 4 of occupation:. physician 4j timid ones; fe |;` smitched by to maintain sufficient medical and work services to the neighborhood physician w records to serve the physician properly in in the aggregate sees far more occupabo* I', aedical endea |i. any dose affili connection with occupational disease work. In a given instance an afflicted workman may give as his occupation some innocu ous job as "elevator operator." He may re disease cases than the small number specialists in this field. Attitude Toward Industrial Medicine throw's by |j|: the profes >.-rNow that -.cation is sor member that the job before that was as a "truck driver." There his memory may fail. His work record may show no items In times long ago, when mine wor sawmills, and railroad construction < were established in remote sections of has orga inclc industrial mec as to transfer within the factory of his country, far removed from the usual sou ^ last employment and no record of any pre of medical services, it became nec^ that : fcSS.0** hec vious employments. Although the x-ray that the management bring into these Occupational Disease 223 orkman may strqS^ of silicosis, nowlS? .iay it be shown years at some ajman was employed*-1. work places a physician who might `-out alt manner of medical services. MS2* physicians set the broken arms of SSed miners; delivered the babies o the K? . wjves; treated the miners children r^measles and mumps and otherwise at- .tion it should be*.the many handicap making an accurij- rnd in the widespf*d* of clinics, inswap y naming the traded* in describing &$* e insufficient form'-''' eeord merely to sh ; patient was empFoyjJ worker." Under - tlo* oerhaps not less th^" ssimilar types of eo^-' different exposure*'1 :o silica in the foundry,'"' eating room, cbromina ment, lead in body ited to meet the medical needs of these idled communities. Usually the cont cs contributed to the income of these ysdans and every family and every ie man was taxed a stipulated sum each tfa In order to cover the physician's ry. Thus arose the term "Contract Jysician." ' This perhaps did not always `iftsent the best of medicine and not in ^instances were these contract physicians Ohe highest type. ' ater some of these communities became towns, or cities, and other physi- ___sought to gain a livelihood, only to 24 that the contract physician was in the jddle. This gave rise to complaint and ^Sjof this "Pandora's box'' have come in1 erable evils that even to this day at- rary Facilities 'the highest type of industrial medical sion under the most ethical and rity the statement!*^ endable circumstances. It has be s of many book pubSv ta? a tradition on the part of many of of industrial hygiene*'- 5?medical profession to blame almost any iseases, special mag*'- fanner of their economic difficulties upon appearing in general-' fc&ostrial physicians. So real is this dis sblications, there is/M:. section that some organized medical nsed, informative"mK` oops have sought to legislate against al- \\ diseases well suited Jteost any form of industrial medical prac- imily practitioner. H&iet and in some instances to deny mem* ossible and undesirable *3iership in medical societies to industrial uld be made to reduce TMH?Shysicans. As a result, industrial physi- tcupational diseases to Mw in some respects have been branded vhich the practitioner plinth a scarlet letter. :ertainty obtain all the JsjjhciTbis queer situation, strange to say, :e treatment and man- serve as a handicap in the diagnosis nal diseases. Grantin? ^occupational diseases, since some_of .the occasion to assert that, 3gp**t physicians, and particularly the more ;$ for a book public**. ones, fear lest they may become be- diseases designed fa - jjjpwbed by cooperating in this type of .orhood physician who jiedical endeavor and to some extent shun far more occupational close affiliation that might lead to lifted the small number w. c-.^e*ehrOWS by those regarded as the leaders i. industrial Medicine when mine working .d construction, emote sections from the usual of soouurrecdtf it became neeootssssawtf._ bring into these .... ^ow that the American Medical Asso- is somewhat alert to this situation - | forgoaun,|*iz4*evud oa wCouuiinvcuil voun <In<dtuuuositJriiaail deluding some members with ing|?wt*trial medical experience, it is to be that after all uthe industrial physi* *respcctable' New Chemicals A further deterrent to accurate diag nosis of occupational diseases is linked up with an almost endless flow of new chem icals into industry's processes. Year by year, a far greater number of new chem icals are introduced than the number of investigations referable to their toxicity. It is often true that nowhere in the entire literature concerned with industrial tox icology may any word be found aiding the physician in determining if a given chemical might be responsible for a series of objec tive and subjective symptoms in any patient. One of the most desirable changes needed in connection with worker health protec tion is the requirement that no new sub stance be introduced into industry on a production basis until it shall have been established to the extent possible, through animal experimentation, that such a sub stance is without dangerous potentialities. Significance of Handicaps in Diagnosis A recital of the type just presented might be continued almost indefinitely, but perhaps without profit. The entire situa tion may be summarized by stating that whereas occupational diseases themselves are probably as diagnosable as any other difficult class of diseases, just about every stumbling block that may be produced is laid at the door of the physician sincerely seeking to acquire sufficient evidence upon which to make exact diagnostic decision. The greater number of these stumbling blocks represent no willful desire to hamper the physician, but instead arise from the results of peculiar circumstances that in some measure separate industrial diseases from the general run of afflictions. --As'a'consequence, large numbers of un warranted diagnoses of occupational dis eases have been made and are being made. Scores of suits have been instituted and some have been won by claimants whose claims possess no whit of merit, chiefly be cause well meaning physicians unhappily implanted the seed of possibility that his disease might have been caused by work and that the responsibility might be laid at the door of the employer. While the re sults may have appeared to work* an in justice and monetary loss upon the em ployer, in the long run the interests of the worker himself are not served by these {t^?- fej-" W: Hi % Is \\$m v; rq Hm 1 Occupational Disease 227 problems. Perhaps in some cases up and maintaining records of sickness in > *ndustrial establishment may find it dif- their particular plants.. An analysis and *4 SJA t0 undertake a complete record system evaluation of these reports and records is Prabsenteeism. I do urge you. though, to another service offered by them to manage H&. a start somewhere. It need not be ment. elaborate. Before showing you a form on which to >r 'have heard it said that the best way i detect illnesses which are causative of * jnteeism from work is by periodic phys- examinations. I am not fully in accord 5th this type of prevention. It may be SSfcJpfu! where the illness lasts longer titan g^reek or ten days, but something should collect your absenteeism data, and which can be termed the "master sheet," I should like to acquaint you with several important items that must be had for your records before they can lend themselves to analysis and evaluation. The form is self explana tory except for a few general remarks. tv done about the frequent one, two or A card should be made out for each and fe day absences, and l fear that periodic every employee on the payroll, regardless JEysical examinations will not help tre- of whether he or she gets sick or not. This &&dously. This, of course, does not mean is necessary in order to ascertain the ratio tot industrial medical services should aban- of those sick to the number on the payroll. Joa or minimize that phase of health serv- The workers' age, sex, color and occupation are important to record since they will have ^The industrial hygiene divisions of State jlealth Departments and that of the United State Public Health Service: arc urging the to be related to the specific exposed popu lation. Under "occupation" state the work in mployment and use of a uniform code for which the employee was engaged when his scording and reporting absenteeism of the sickness began. The "date disability began" worker due to sickness. Forms and meth should only be recorded for one full day ods have been developed after a study of or longer. In the column "work days lost" ?sotne twenty years by the Public Health we refer to calendar days and this is neces rvice and also as a result of the recent sary to put lost time on a comparable basis ational Health Inventory of chronic dis* for all employees. For "diagnosis" one eise affecting workers. The aforementioned should list the sickness or injury when defi Shealth agencies will gladly assist and co- nitely known; if there is any doubt about -v|j&bperate with industries desirous of settingthe correctness of the diagnosis, a statement .dally blems : and .lealth I and order thods must laced, : dis able. .0 ac- Sickness Record Form Name or Cloth No. i Dept. Oecu potion Age Sex Color i Dole Dis ability Began Date Dis ability Ended | * *"i i1 War* Days Lost (Cal endar days) Diag nosis By Wham Diag nosed Termination of Cast rfn != U.i !'i!!1 }!) ! 'J :!r!i, u Iff! if Mil! 1r Cement and Quarry Section 323 wr 2eir representative v r^|imany natural hazards foorr even the olems surroundio,.- S&'.^rcful and skillful driv,'cr, and i y are discussed ^ .p^c*^J^rare to be reduced, wc must stress [ ^ dig^ . ' building out accidents by .na the results of mV i^lans" ol,ilsp- roper atte__n_ .t_i_o__n_ to th_igih__w___a__y_ ___e__n_ - 1 both to the sdS tvjsjon. Plays arTteT -s given at eachscW ^v&SIbbo[aajejuejiaarainrrrddgu,sssi1aam*n--pdrom vainkge, widening, elimination the higv hways conform b'the ssppeeeed and traffic to which they ited with a travS, s^^'sj^uTbubjejeectttedd.. school maintainingel &$The Iowa State Safety Council is deff- ver a 30 days* ptsv* -:ar the trophy ^ ooJ which had it ^ :mes during theyea?.- ^g^Vfy' on record against diversion of motor jSfwhtcle license fees for any purpose.other fet'S&j highwav construction, maintenance and safety, and we believe there is no tendency on the part of the great majority of our legislators to even consider such a plan at this time; at least up to the present time there has never been any diversion in Iowa and wc have been very vigorously opposed to any program of this nature. "Save 100 lives during 193S and 1939 in Iowa" was announced early this year as the goal of the Iowa State Safety Coun cil's program; and if there is no upturn in killings late this year, the 1938 part of the goal is assured. r Safety Council r$-uc Court. This rj m-.c students. They. *-4 , Prosecuting and D*. THURSDAY AFTERNOON SESSION and their own Jury, kig*y is found guilty el 1 October 13, 1938 ;1 be given the right ic or other means c* : City jail lor a* What About the Health of Quarry Workers? fit. . By W. C. JAMES 11 has been operating of ,\300 per year financed Safety Engineer, Portland Cement Association, Chicago strics of Mason Gtyj; 3||3n'spite of the widely recognized need for attribute his condition to his employment. ading our program ts ^'^totective measures in certain types of On the other hand, if a quarry worker is .uiity, we have had ai> RjrSaes, relatively little attention 1)3S been part time office fcof kSjpYen to the related occupation, quarrying, ndividual memberships ^'it is apparent, though, that quarry work- ->,)<] non* have aboi-i jf~;iwh were pretty much alert to what might dtips. |-r be expected from their employment. discovered to have tuberculosis, which is also contagious, there is a general disposi tion to assume that his occupation is re sponsible. Sometimes this assumption is carried to ridiculous lengths. For example, 'erro Gordo Couaty L-i'Ia 1913, the English factory inspector. >r 63 County or Cat* . 'Dr; E. L. Collis, reported that masons and M, cot oi 59 * quarrymen ``are said to regard sandstones with the Iowa Sj* . ..as dangerous while limestones they regard a state members.-1: , . a> harmless."1 This interesting tradition of 0 individual ciwf* < the stoneworkers' profession is a quite tncils teel that t*T i accurate summary of the modern scientific rial support tor '"proposition that quartz is the causative 1 highway protect : ' agent in practically all forms of occupa- y. tiorial lung disease. a cement contractor's employee <liscovere<l that he had tuberculosis. He promptly demanded compensation--on the ground that a small amount of the mix from the mechanical mixer had splashed on him. Vet this ciaim was given serious enough con sideration to warrant two trials. George G. Ornstcin, a New York physi cian on the staff of Sea View Hospital, suggests that a possible connection between x been worked c- Since this is true, it will readily be ap- he railroad corni^ : j^'ent that discussion of quarry health Vehicle DepaTM^ : tiazards cannot very well be general. It Council Tor wnt be specific :'cr the type 0: material don :or tr.c -^n3 Quarried. This paper, therefore, pro- $i.3eco;v;:. . f^es to suggest v. hat is known about the . to ucv.- gradt . ---tect of employiv.c'tt in four representative Ming of vPes oi quarries: sandstone, granite, slate xcd out ot 1c' . ml lirtestonc. ieiiways v--`c . .:<! au-.l rr"`,.-. ..city, . ^'rst, tb.ough. how broadly must wc re,i,e acaitii io quarry employment r Jl a i;- a quarry contracted hick.:'. - : v.o-il.l r.vt cV'occur to rnvouc. employment a.cJ tuberculosis can be estab lished only in those occupations where workers arc regularly exposed to lubcrculars (nurses, for example) or in trades --here there is continuous and extensive -xposurc to silica dust/ Sandstone Obvicusiv, -ar.dstcr.e contains quartz. 7: has long been recognized as potentially hazardous. C:li:s reports that dour millers '.'mcriy sttxered from, a v.tvorc lung d;.;. _ v. 1.e:v.::v:v disappeared when metal r*. hers '..ere ubstkutc.i :Mr the ->.:ne Cement and Quarry Section chJ Vlcmy of i ade to separat^J; eIic dressers or 1 ""a" r cent of the to}-A only 1.4 tuberculosis andfcg. '^1 statistics Amherst and SoS.ttheemployee^,;: It-- ite Group K.' <0-60 `-A 60-70 <ii._ 70-80 **; '* _ _ i i i i Age Distribution of Quarry Workers and Drillers Total .Vo, of Quarry Workers di 119 80 52 24 4 J40 % of Quarry Workers 17.94 35.00 23. S3 15.29 7.06 1.18 Total Ho. of Drillers 7 31 22 14 4 79 % of Drillers 5.86 39.24 27.85 17.72 S.06 1.27 . *ab!> all ages) tije county and n Length of Service of Quarry Worker* and Drillers e nearest Industry Employment ;te . Period 0- 5 - information oti the' - granite dust, bo( i# * 5-10 10-15 1S-20 :ais exclusively with.' -an quarriers. There v- 20-25 25-30 " 30-3S ;dy of a group by'^oya, Western Au$.v t . 35-40 40-45 45-50 Twenty-five of these ; mining experience -t previous experience" V-V . 50-55 1 y? total Ho.'of Quarry IVorftcrj 64 113 79 34 23 18 7 -- i 340 % of Quarry Workers 18.82 33.24 23.24 10.00 6.76 5.29 2.06 -- .29 .29 Total Ho. of Drillers 13 26 20 9 3 6 2 -- 79 %0f Drillers 16.46 32.91 25.32 11.39 3.80 7.S9 2.53 ---- -- --_ ry. Three of''those mines showed definite ur.gs but they had'a!! years in mines ar* the quarry. Further- V_;: Incidence ot X-ray - dcnce of Lunz Changes Possibly Attributable to Dust in Quarry Workers by Ago ; 2s tlae rule so there exposure. In view quality of granite led, this report at value of control Bloomfield made an *ry . workers in Ver- t - Age Period ' r Under 30 : 30-40 ** . 40-S0 50-60 60-70 70-80 Total .Vo. of Men 61 119 80 S2 24 4 340 0 Ho. . % 57 93.44 110 92.44 68 85.00 41 78.85 19 79.17 1 25.00 296 87.06 Fx Vo. Ve 3 4.92 7 5.83 8 10.00 JO 19.23 5 20.83 2 50.00 35 10.29 Ft No. % 2 1.68 1 1.25 _ 1 25.00 4 1.18 5) Ho. r: 1 1.64 --- 2 2.50 _-- --- -- 3 CAS Si Ho. % _ _ 1.25 1 1.92 --- --- 2 0.59 :iicrs were exposed the neighborhood per cubic foot.' No ed in men with less In the group ot Incidence o( X-ray Evidence of Lung Conditions Possibly Attributable to Dust in Quarry Workers by Length of Service years' service, one/'.ved definite luff hs of the men with c-rc found to have : men examined i-: e, lut the distint.% in these quart}.rose in Austral ,'.od< were used Empl. Period 0- S 5-10 10-15 15-20 20-25 25-30 30-35 40-4$ 45-50 Total 0 Fx St Ho. of Men So. .Vo. % Xo. % ;V>. Vo So. 7o :64 55 SS.V-I 10.94 1 1.56 l '..56 - --115 11)0 SS.49 $ 7.08 3 2.65 ; ?7 _ -79 7l S9 87 O 7.59 -- 2 2.S3 _ -- _34 ,t: 94. 1 * 5.88 - -- - -- -23 ! 75.26 s; 21.71 _ -- - --IS 14 77.78 4 > >* 7 5 57. 14 5 42.SO - -- -- --- _1 1 100 00 _-r __ _ 1 1 ]00.00 - -- - -- - -- - -- .'40 :r, 87.06 35 10.29 l.U 3 . ss > 0.59 illijili :::}[:;! i I! >j jii i{$'! Ifl! K:!'t jj!' .m Cement and Quarry Section ' 327 cent of these men ros'is, of a type wVii^v' not specifically <fot' > urtcen men, all ol 20 years' experience u,"? PAertitodl jund to have defitnite nudy careful aanna-liy-ses * nnd the atmospheric le the rock contained fo! per cent quartz, the qmn Under 30 30-40 40-50 50-60 60-70 70-80 ..it was between 40 pet ^ TJie authors conchy .vh,en i"t c--o`n"ta"imnss q-uartz v ;S lo"fcr t0 xertjts3*|^;>. would. '0tc -ft**- -- limestone . .;Tr Infections of Qu*fT7 Workers by Age .Vo. of Men 61 119 80 52 24 4 340 PC 4VO. % 9 14.75 18 IS.13 19 23.75 to 19.22 8 33.33 1 25.00 ' 65 19.12 Old TB Vo. % 3 2.S2 4 5.00 3 5.77 2 8.33 1 25.00 13 3.82 Non TB No. % --- 1 1.25 --- -- --* --- 1 0.29 Pleurisy No. % 2 1.68 7 8.75 1 1.92 2 8.33 l 25.00 13 3.82 Infections of Quarry Workers by Length of Service data on the health rs has been available <^0 ^;'E*nf4oymml Total No. of Men PC So. C Old TB So % Non TB No. % Pleurisy No. % probably read otasiaal iicosis, defined as "a In; , stone cutters." Thettm led to the effect of lie*, mgs is definitely a.rak nless fibrosis which we-. . in the films of p?rsdta iliccous dusts is, as'Th.' , . ... ...w.v ia- 0- S \-A 5-10 JO-15 ids-15-20 V' 20-25 ; 25-30 *6;. 30-35 fell 40-4$ fe.45-50 jT'$0-5$ fe A-' 64 13 20.3! 1.56 1 1.56 2 3.13 113 23 20.36 5 4.63 - --- 3 2.65 79 12 15.19 2 2.53 ---- 2 2.53 34 8 23.53 3 8.82 --- 1 2.94 23 S 21.74 8.70 ---- 2 8.70 18 3 16.67 ---- -- 2 IMl - " * - - 1 14.29 t 1 _ 1 100.00 __ --- __ --- __ 340 65 19.12 13 3.82 1 0.29 13 3.82 : callouses on the palms.'of :rc is no increase in tubl chronic lung disability, sb ^'overV 47.9 per cent of the men had had ited chest expansion, dia* "more than ten years* quarry experience and breath or any other of the "ft.? per cent had worked for more than 20 >i the silicotic. Limestotr 'years in quarry operations. general, a quite healthy Lung conditions which arc directly re as the following infomi:l for the first time, w.i \ lated to dust exposure arc of two types: The non-specific pneumoconiosis and the pecific disease, silicosis. Non-specific con sclerosis or other non-occupational troubles as of dust inhalation. Furthermore, it is non-clinical; that is, it gives rise to no symptoms, signs or complaints nor does it have any effect on the individual. Any per son. especially it he has lived in a large city where he inhales considerable quantities of coal smoke, might show this condition, vet r. Leroy Lb Gardner and nac- Laboratory' for tir iosis embarked on an ".c health oi cement r.v.: ditions may be seen on the x-ray as exag geration or the r.crmal lung shadows, these exaggerations being classified according to two degrees or intensity, F, and Fs. The he entirely unaware of it. This fact is worth, remembering, since many physicians un skilled in x-ray interpretive technique are apt to classify these harmless conditions as study included elv<3 first degree is almost imaginary. In fact, "`early silicosis," thus unnecessarily fright sew York, Pctsnsylvar-- one of the leading roentgenologists of the ening both the worker and his employer. -souri. Alabama, Kan.^-1. nia. gantry, Dr. H. L. Sampson of Trudeau If the ``linear exaggeration" as it is often Sanatorium, says that if the interpreter termed is the result of such a variety of and forty of the = during this study rrr "rcdominaiu experit"^ Two hundred and for"' had bc-en employed t'1 :arry. Seventy-nine 1 mimic hammer dni-t'-' *cre iiot specifically looking for a dust condition, he wcul.i ignore first stage linear |*roniinence. He calls' it the stacc of irr.ageutson.14 7},e Second siace is somewhat more pre- but <;y; j< p. healihv conditic::. *_w? impertan: facts about this con<Ji::cr. causes, one might wonder how it can be shown that it is ever due to dust. Gardner's explanation is: If a majority of individual; exposed to a given dust show this condition and the frequency of the condition increase? will) length of service the assumption tha: the dust is the cause is justified." >nccd<: 'i 10 be the dm: :iOSt :: alf of these i:-- r"u^ ** wmlerstcad. First ot all. according The incidence oi this condition by tier y'ding autiv:r:::c?. non-silicouc fibre;:; i; -hown. You will note that only 11.5 per `C. -1) years of age y :uii ait v.ip.e r^siv,'. id advancl::': cent of the 340 limestone quarriers sitoweJ ere 50 years evidence of the condition and in on." Cement and Quarry Section . 329 ' <*a*Ple e{ Chronic Lung Infections in Pneumatic Drifters silicS- ;`stor>- of ^ later. ,,7y 'nd F. it ** '; PrSrejii0o ivancing agt not see, ^ Pfo^yearv 'Ps (20 ye*, ^ers is hardly Under 30 . .. JO-JO - 40-50 KV' s60o--7#0 kvW 7<h*o Total No. of Afen 7 31 22 14 4 1 79 PC No. % S 71.43 6 19.35 S 22.73 2 14.29 - ----- IS 22.78 Old TB No. % --- 1 3.22 ---- 1 7.14 I 25.00 v - 3 3.80 Plturity No. % --- -- 3 13.64 --- " --1 3 3.80 onstratc tha' -* quarries arc Jung: disease, the limestone tendency of :s to devei:* d fibrosis, of increasing ceptibility to rticularlv 'tue Welsh slate; Total' No. of Men 14 26 19 9 J 6 2 -- 79 By .engtb of Service .Vo. % 6 42.86 J 19.2J 15.79 2 22.22 t 33.33 ( 16.67 ---- --- IS 22.78 .Vo. -- 1 2 -- 3 % -- -- 5.26 22.22 --. -- -- j.ao No. /0 _-- t 3.85 - *-- 1 11.11 --- 1 16.67 - -- --- 3 3.80 instates that' ingie case of active tuberculosis was seen infection. Is" J-;the x-rays of 340 employees. 3.8 per quarry dusts? o the men had at one time had tuber- Kvcr. Not one Hilosis, but it had healed or was at least quiescent when the x-ray was taken. is generally assumed that among in* `-k.dustrially employed males about 2 per cent : : will be found to have active tuberculosis st - -Vo. r. and anywhere from 4.5 per cent to 11 per cent would show the scars of healed or quiescent infection. 1 1.55 i i.s: Such a record would have been impos sible in the presence of a real oust hazard, according to authorities. These cases oi old or healed tuberculosis, in the eider men ' especially, would in all probability have be come active in the presence of a dust with - a-silica hazard. In this connection it is interesting to note Gardner's statement to the American mining and metallurgical ettgbteers last February. He said: `With cal cium compounds, there is a tendency to deposition in the areas of tuberculous de- only as a matter of general interest and have no bearing on the question of occu pational Health. Since a large number of quarry' workers arc not exposed to more dust than the aver age outdoor worker, it seemed desirable to make a special analysis of the pneumatic hammer drillers. If the dust of limestone quarries is at all harmful, one would ex pect to nr.d these men affected. The following charts tell the story even more clearly than words. No case of pronounced linear exaggeration was found among the drillers but there is a higher percentage of Ft in all 3ge groups. The or.e case of Sj was found in a driller in a sandstone quarry being operated in conjunction with a cement plant. He was the only sandstone driller found during the survey ar.J had been working at tins job for a little over tc-n years, in a dust concentra tion in the neighborhood of 12 million par ticles per cubic toot. It should be noted 15 and Hn ac^c*er`lti;d healing of .1? '"faction. ... On the other hand, free S|l>ca, in the body at least, seems to have ^ specific stimulating effect upon the growth (Jt the tubercle bacilli."'5 v Primary cempi-.-s or healed chd-ihood tu- ^rculosjj a::d pleurisy arc -i:n';;- '.videnee.- that this matt was not disabled, even par tially. In the classification by length of service, the sr.tr.: increase m percentage of F:. and :be -ae i.-.ck of uniform increa.-*: in the vendixer. v. ;:h increased length of service J* .,d '"tcciiouN probably :.'.r'd : Ui- - .\10 Silver Jubilee Safe!': Ceuvress dust, ever, though the concentrations be moderate, will increase the incidence of tiiis distinctly harmless departure from normal-- but, the increase is not progressive with increased length of service and as far as is now known, never goes beyond the harm less stage. The incidence of healed lung infection among drillers paralleled closely the inci dence among quarry workers generally. Both were under the average of 4-f-Sfc for adult males.'* Acute Illness Little satisfactory data on the amount of acute illness among quarry workers exclu sively is available. In Gardner's survey of the cement industry, which we have just been discussing, the men were asked to report any disabling attacks of acute res piratory illness they might have had in their working lives. Approximately 17 per cent of the quarry workers reported that they had suffered at least one attack of influ enza. Only a little over 1 per cent had suf fered from pneumonia and V/i per cent had suffered a disabling attack of bronchitis. Among the drillers 9 per cent reported influenza, 1 V per cent, pneumonia, and 2Vi per cent gave a history of bronchitis. Gardner's observation is that these figures do not seem excessive. He could hardly say more without a definite basis of com parison with the general population. During the last two years, the Portland cement industry has made a complete analysis of absenteeism among its employ ees. "'* This has given us valuable informa tion on the exact condition of health of cement industry's workers. No effort was made to secure information on quarry work ers separately but in general it can be stated that cement workers showed no pro nounced difference from other men of ihcir age and economic condition. The upper res piratory illnesses, influenza, rheumatism and heart trouble were the leading illness causes, as would be expected in any group of pre dominantly outdoor workers. Unfortunately, so lew other industries have kept accurate absenteeism records (at least they have not published them) that no general compari sons can be made. An excellent statement of the value of absenteeism -tudies has been made by Dr. U. R. Sayers, Senior Surgeon, United States Public Health Service.1'' "A knowi^J-* ot absenteeism with, respect to trequo^r sir cAis<> duration and cau>c in each numerically kf j2, Crdn< portant occupational group in an indi^T particular r- or in a factory, serves to reveal to responsible tor the - industrial health p^j gram the type of action which should u uew" nitfh* S. ` I' ,a$es of ,',e C*. Ph\,w?e taken to obtain a maximum reduction infy * Lr,kS " amount of time lost from work on accot* of disability, [n the absence of such * formation it is impossible to estimate u, relative importance of sickness probity in need of attention. For example, the*, cidencc of pneumonia may be abnornajj cioe; 6:1' ' \i. Card" the health o: 14. Satnr-1- nosis of Sin ployers M;. Wausau, ." high in some occupational group, but situation may be undiscovered for yesj when the number of eases occurring intk group is not related to the population et- Protec posed. When such sickness rates arc avai able for specific diseases bv occupation, ti* efleet on health of certain environment^ conditions may be measured and evaluated* Bibliography In quar .ical equip t. Cotlis, E. L. Quoted by Cobhet, L.: ards to t causes of tuberculosis, Cambridge University Cambridge 191", p. 9S. year ther plants. T 2. Orstcin,- George (.: Tuberculosis in lad Industrial Medicine, 7:419-429, July, 1938. and the t chine ter 3. Collis, E. L. Quoted by Cobhet, L.: f jv were cle causes of tuberculosis. Cambridge University Prtajj.... Cambridge 1917, j>. 98, and the 4. Wheatley. J.: Report on the prevalence! lung disease among workers at Grinsktll Quarries; "enemy, I age for County Medical Officer for Shropshire, Shtett* per cent bury, 1912. Also abst. in British Medicine Joww Vol. 1, 1912, 694.695, March 23, 1912. * 5. Hayhurst. E. R. Kimlcl, D. P.: Meiswacder. B. E. anti Barrett, C. 1). Silicosis with low it* deuce of tuberculosis in sandstone quarries. > fications Quarr which s ning anc hid. ilyg. 11:223-244. 1929. ' 6. Tvrer, T. L.: Report of an examination ef employees at the State Quarry, Boya, West A traiia. Medical Journal of Australia 1:86W".. 1929. To b practice lion of the bes 7. Bloomfield, J. J.. and Dreesson, W._C.: cosis among granite quarries, U. S. Public Heal reports, 49, 679-'>4, 215 pp. _ -'J 8. Dreessen, V.'. C.: Effects of certain '**? dusts on the litr.vs. J. ltnl. Ilyg., 13:66-73, * ^ , 9. Wade. W. 7.: A report ot an investisP^ into the alleged high mortality rate from losis of the respiratory system atnong slate flul Holstoit quit >vas tie t at a feet o: throug and fc men and slate orkors in the Cwyrfai r trict. Report cr. Med. Subj.. Welsh Boar* Health, Min. of Health. II. M. St.it. Off- l`>nn 1 \ , 1927. , lOl.t. -Ii 10. Collis, E. L.: Milroy Lectures * | considt ebinke the a: shale Quoted in Wade's report, (see 9). 1J 1!,. Sutherland. C. L. and Bryson. S. t ^ t on an inquiry into the occorence of X* ' f the lungs from dust inhalation in the Sw ' <Iustry in the Cwvrfai district, 13 i'J'- ' the re We strips baulin M 686 Silver Jubilee Safety Congress \ tell him, (3) talk it over, and (4) let him 12. Preventive vs. Corrective Supervis(0n : j education in the try the operation by himscit. --Supervision should anticipate possible djS e materials, but ah 9. School vs. On-the-Job.--The decision as to method is a question of economy (not cheapness). For a given situation--consid ering geographical distribution of students, availability of instructors and equipment, faculties or hazards rather titan wait ior these situations to develop and use them ^ "horrible examples" and subjects for dis cipline. An emphasis on safe practices is better than a study of accident reports. .V** t0 -be ?p-r'Z solute ,or eUmu : a man -who is tndivm ta&ct him from cxyo> effect on service, etc.--one method will be found to be most effective at least cost. 10. The Foreman's Kit.--In the old days there was a tendency to create foremen simply by picking a good workman, giving him the title, the "book of rules," and the authority to boss the gang. 11. Trained Foremen Are Good Super 13. The Foreman's Job.--A technically competent workman is not thereby qualified as a foreman, since supervision is a "craft" in itself. 14. Developmental vs. Informational Train, ing.--Since the nature of the supervisor's job is different, it seems evident that the training approach should be different De One ot the most tr the hazard incident ^standing in this gre ?wide which is extr *lToxic, When iulu 5 in space that is , produce unconscm !\ $fltvftnoimprmeemdoiantietodryeastyhr visors.--Just as trained men are good work men, so does it follow with foremen; with the proviso that administration of the or ganization is good. velopmental training cultivates judgment and an understanding of principles, and so is better suited to supervisor}- people than informational training, which imparts facts. ! rt made a study ot 1 xtracliloride and Jour. \JcA in various mamten. nonflammable grease irorite in maintaining Occupational Disease Hazard in Public Utility Industry a a generating station. ^ in cleaning meter By DR. J. J. WITTMER action and repair ot jtjjja had been filed, am; Medical Director, Consolidated Edison Co. of New York, Inc., New York City . j* w-e discourage its the operation per- An occupational disease has been defined dermatitis can vary from a mild irritation, ilotide is not necessa: as: lasting a few hours or days to a chronic I ses in most of the "A disease peculiar to the occupation weeping lesion which may continue for ' Stations where in which the employee is or was engaged weeks or months. Dermatitis may be pro- ' fifijpensible have since and due to "causes" in excess of ordinary duced bv the preservatives and insulating ; abed a clean house a: hazards of employment as such." In 1935 the New York State Industrial Board, before the "all inclusive" amend ment became effective, offered the follow ing definition for the guidance of its refer ees; "TIjc disease must be characteristic and peculiar to the occupation to make it come within the provision of the law." A recent court decision in the Connecti cut Supreme Court of Errors ruled that; "To come within the definition, an oc cupational disease must be a disease which is a natural incident to a particular occupation, and must attach to the occu pation a hazard which distinguishes it from the usual run of occupations, and is in excess of that, attending employment in general." substances incorporated in various kinds of ; Y, using only clean rap equipment. To avoid dermatitis, particular edit free from dirt, g" care is necessary not only in the selection' ; of insulating materials, preservatives, and even transformer oils but also in the way .if - : is handled by the men. : Where carbon tetri'. * the operation of th*. i dosed system, adcqti; &tion or* a fresh air Each summer we have had several com-A an, whichever is the }pensation cases arising in our distribution^ i*dose check is kept thr work where contact with poison ivy washr iepartment of the aoua natural incident in the employees' par* . (Aloride used and thro licular occupation. Certainly education in'-* safety group, as to ' the recognition of the poison ivy plant and . sstd, Another import: immunization of the more susceptible help*....- tJchloride is in the fir to eliminate this hazard. ) i2y. fires do not occ Care must be used in the selection of all-V \ fifcnt exposure is rar*. materials for cleaning purposes. Even orv-* Wee. The use ot a dinary hand soaps for the personal use. * kterethlene lias been of employees must be selected. In consider*.-;, Vlteve it presents a ing industrial dermatitis we are all . kin carbon tctrachlo of the frequency of individual sensitivity: ,. k* same precaution m It is with this interpretation that we will where the material itself may not be * followed. The ext consider the occupational disease hazard in fault. A substance may be entirely harmless-h;>! ^llt to the use oi the Public Utility Industry. to the vast majority of men but peculiar# .jjfcohol discourages : Consistent with uniform experience, der harmful xo a certain few. Therefore, o. t they present matitis is one of our major problems. A problem is not in the selection of materia . *^rd. rcss Public Utilities Section 6S7 entive vs. Corrective Super*?*'''*' ion should" anticipate ootsiki?*-' r hazards rather than uions to develop and use , *r examples" and subjects foJ,.*1 >n emphasis on safe practicM^* m a study of accident reports***" n in the proper handling of i^tnaterials, hut also in not permitting Employee who is allergic to certain inces to be exposed to them. The solution for elimination of dermatitis Jfman %vho is individually sensitive is to f^ve him from exposure. Foreman's Job.-A technic*!,; : workman is not thereby quaS man, since supervision is' a clopmcntol vs. Informational TraiH ;c the nature of the supervise,/ tterent, it seems evident that t/ approach should be different, tie tal training cultivates ;tidgm ' ndcrstanding of principles, and $<, suited to supervisory- people than ional training, which imparts fats .blic Utility Industry. .EH ^ of the most troublesome problems --a- hazard incident to volatile solvents. EjBjiding in this group is carbon tetrawhich is extremely and danger- toxic. When inhaled m concentrated in space that is poorly ventilated, it 5fproduce unconsciousness with practi- S-oo premonitory" symptoms, followed by Sat immediate death. Several years ago 5^nade a study of the use of carbon trichloride and found a large amount jo various maintenance operations. As I'tmfiannnable grease solvent, it was a l^ente in maintaining good housekeeping j generating station. It was extensively id in cleaning meter parts and in the in action and repair of meters. While no jjjflhad been filed, and no cases of poison- ew York, Inc., New York City j we discourage its use entirely where* j 'fff the operation permits. Carbon tetra- is can vary from a mild irritation Jfcride is not necessary for cleaning pur few hours or days to a chronic ists in most of the places where it is lesion which may continue for jgd.'-Stations where it was considered r months. Dermatitis may be pro. gspensible have since its exclusion main- by tiic preservatives and insulating iced a clean house and efficient operation ccs incorporated in various kinds of posing only clean rags to keep the equip- u-nt. To avoid dermatitis, particular 504 free from dirt, grease, and grime. necessary not only in the selection dating materials, preservatives, and .wsforrocr oils but also in the way it d by the men. ^Vbere carbon tetrachloride is essential the operation of the plant, we insist on idosed system, adequate down draft ven ation or a fresh air mask for the work- -ummer we have had several com- *w, whichever is the more practical. A "i cases arising in our distribution dae check is kept through our purchasing .ere contact with poison ivy was kfartment of the amount of carbon tetra- .1 incident in the employees' par* ceupation. Certainly education in sbride used and through inspectors of the alety group, as to where and how it is .jiition of the poison ivy plant and Another important use of carbon tet- ration of the more susceptible help* ^Moride is in the fire extinguisher. Hap- :atc this hazard. fires do not occur often and the in- v.ust be used in the selection of a- *t exposure is rarely in a small confined - for cleaning purposes. Even or- Jfct The use of a substitute such as tri- .-.and soaps for the personal. use 4rcthiene has been discouraged, since we yecs must be selected. In consider* J*'** it presents a greater health hazard :>trial dermatitis we are all a`*r< 7* carbon tetrachloride. When it is u<ed frequency of individual sensitivity .-<same precaution mentioned above should ::e material itself may not be * followed. Tlte extreme fire hazard inci- . substance may be entirely hanTile.*? 5* to the use of benzene, gasoline, or ast majority of men but peculiar-* -<(phol discourages their use and. accord* to a certain few. Therefore, os- thev present practically no health is not in the selection of mat<na:; t Wherever lead is used in any combina tion, rite possibility of lead poisoning is present. However, in the utility industry the hazard is easily controlled and can be quickly eliminated. The lead covering the transmission cable and the soldering of splices offers no problem of lead poisoning, if the workman follows ordinary rules of personal hygiene so that lie does not ingest the lead. The soldering operations inci dental to meter repair work offer no dif ficulty if hooded ventilation and strict per sonal hygiene are followed. Lead melting operations in the reclaiming of scrap con duit or for surfacing parts is not hazard ous, if the temperature of the lead pot is held to that point where there is no emana tion of extensive fumes, but adequate ex haust ventilation is advisable since one can not always visualize chemical vapors. Acety lene cutting of lead pipes does present a problem of lead poisoning, if the workman is not given adequate protection from lead fumes. The maintenance of equipment and prop erties requires the services of painters who still must use paints containing lead. The degree of hazard and the possibility of con trolling the hazard are the same as with painters in any other industry-, viz., to cat food uncontaminated with paint particles from the hands and to keep the hands out of the mouth. Probably the greatest pos sibility of the workman ingesting or inhal ing lead dust in the utility industry exists in the operation of chipping or blowing off lead paint from old structures preparatory to repainting. Here, respirators and good hygiene are absolutely necessary. The utmost care must be taken in con cluding that an occupational disease really exists. It must not only be clearly demon strated that the individual's complaint or incapacity is due to a toxic material, but very definitely that the particular occupa tion exposes the employee to that toxic ma terial. Three recent cases illustrate this problem. Fir<t, a middle aged employee who had been a painter for fifteen years was con fined to his home suffering with headache, nausea, vomiting, and elevated temperature. The attending physician, informed on hi.first visit that the man was a painter, filed a report with the State Labor Department that the employee was suffering from lead : t X Public Utilities Section 689 one of our construction shops resulted busy metropolitan intersection. ,the eyes of \jn a case cadmium poisoning in one of workn*n most . flour employees. Fortunately, it was a mild ^exposure and the employee was not seri- (lously HI nor did any after-effects result. jt illustrates the care which must be taken Where there vfjj, making sure that no health hazard exists feqmres dril,W ?cks ^ere U, 0f |jtt any new procedure. 1 present ln the 1 the hy^g of underground drilling this work present workman's head street level and s not exposed to !1 as to cause silthat even in some e character of the that unless dust applied, the man U Recent attempts in the literature to confcfuse the results of acute carbon monoxide poisoning with claimed effects from so-called '^chronic carbon monoxide poisoning warSlant some comment There can be no Question but that in -some cases harmful J-after-effects may result from acute carbon 1 monoxide poisoning. It is also generally con ceded that the possibility of after-effects --lis greater where the individual has been vexposed to a low concentration of gas over f'S'a Jong period of time, that is continuous f exposure for several hours or even a day Serous conccntfs- i'.-or two. We also know that in this type Ail jobs must Tf of exposure the probability of fatality is : according to the greater. But these are still cases of acme |S carbon monoxide poisoning and any un- It must not be inferred that just because the material is toxic or capable of produc ing an occupational disease, that the mate rial or process must be discarded. Only re cently two methods of processing the ends of poles to prevent decay and termite de struction were presented to our medical de partment for an opinion as to the health hazard. In each process the chemicals used were poisons. However, in conferring with the engineers, a procedure in the uses of these two processes was devised, i.e, using heavy gloves or long handled brushes; or where the chemical was injected into the pole, unbreakable containers are used, so that there is no health hazard present to the workmen who follow instructions. The public utility industry must constantly keep before them the possibility that an occupational disease hazard may exist in any of their various operations. It is only by a continuing preventive program that the employee will be adequately protected. Need I say that the employer will also thereby ted with the prob- being incapacitated i in the course of :i my opinion, this been at least par. tsicn in Kew York kman is ' not dcn though by x-ray ience of silicosis; employer is pro- u liability, should capacitated. Our se as to relationtuberculosis and a state of contun pulmonary ftr- d problem which -ily solved tvherot excessive dust of this confused tie medical than C'favorable scqucllae which may be attributed "# to the exposure are the result of "acute" '.carbon monoxide poisoning. I have never -seen, nor do I know of any authentic case - where symptoms or pathology were the re; suit of repeated exposure to a low concen tration of the gas for short periods; or where at the time of the exposure the in. dividual had no symptoms. So, while we do recognize the occupational disease consist ing of the scqucllac following acute carbon monoxide poisoning, vet we do not recog nize any problem of so-called "chronic car bon monoxide poisoning." Contrary to popular belief, the incidence of acute carbon monoxide poisoning in the utility industries is comparatively rare. The requirement of efficiency in production and distribution demand a dosed system and a minimum amount of waste due to leaks, ft can safely be said that the workman in a be aided in getting a better job doner There is no need for any hysteria over the occupational disease laws which arc being enacted. A calm, intelligent, and ra tional approach to the problems which they present will eventually result in an improve ment in the health of our workmen and a benefit to the industry- One of the greatest hazards in this in dustry or in any industry is the human re action to existing hazards. Contempt be cause of familiarity or long contact with a procedure or substance is hard to over come. However, constant reiteration of rules and regulations and in special in stances severe disciplinary action do aid in holding down the number of cases. Absentmindedness or periodic lack of concentra tion does increase the exposure hazard. Close observation and an understanding of the character and behavior of each employee W$ manufacturing plant or around a hold by the immediate supervisor is of material the engineer and v processes, ne* ing station is exposed to less carbon mon aid. o-ride than the averaze traffic officer a: a yi old materials s in advance o: ih hazards witri" .v procedure. -*>f cess of rr.etai:*J` ADJOURNMENT faces. This n"' experimentatic-r