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FILE NAME: National Safety Council (NSC) DATE: 1937 Oct DOC#: NSC241 DOCUMENT DESCRIPTION: Transactions of the NSC - 26th National Safety Congress 2 6 th National Safety Congress N A T IO N A L SAFETY COUNC IL, Uc. K A N S A S CITY, M ISSOURI O C TO B ER 11 t O C T O B ER IS , 1937 ^LOLMiovPMMpmHSvl #AawJ Ho Mm el gwa m t. it upon nqmt. Mane member* hav found It worth whil# lo diatriba* II), 7# cl# w i t . T M K Tram a citana a r t publiahed a condenwd w o rd of ihr at tha National T m papara o f etch *e talon n r d lv itk m o f th r l '<mfraa Hava town dilati earefwlly to liminai ttirutanua m a llfr and to W rviai Um tent *M *m l l im riiom I m t t m o f apaiw Um llailm t, T h u Hr material h *rin prew nted I n<{ a verbatim report o f all Um h wache* prtantivd at ih r I'o ttfrtaa , toil rather an U a h r h ljM verrion m ad a t compact aa puaalble, y i w lihoui injury to m technical aipaci* o f any a d d r*. T h oriKimil oMiiMMrijti are on die In the I n u m tl't Bureau o f In fo rm lion, where they ara available for additional reference by Council, W here liutiraiiont were ten the (leaker* to the Utete aito are on die. dThimeit\ataettofrnoaml dSiaafetutymoCriomunacliul m1wiht*ich<iamreprnraoetepaertteinde*nt t<> tl<hnelnaut-m oIft tchaenntoont nam***|*i<orfcwt|Hinmd**ibaUreilycofonrtratrhye tovim( o*meint i pItaretetalirditjtinilioilo Intath|wett|Nt|icrt prr tcotrd or (II the ilucumoo* N A T I O N A L S A FE T Y C O U N C IL , Inc tO Naartia Wackar Drive CM HONORARY M BM BBRS AMO0AHON m lMN AMO SWB. fcWOT-- ROMO* W. CAtmKLL Lw K. Falmm OPPICBr if D. o . Fw m u eidit C W. Dw iw y. * * ; l i n w n r Hambv G tn u ir Ip Fran* H. Hak< .. 4 Im atrial Solely Host. KaooloG. t. " i . * tor P*Mk Safety Waltm 8. Fains, Viet-P tor Enfineerin* A. V, RoMWioa, Vkt*Frwi4ml lor Local Softly Council* A. W. Wfonmy, Vice-President for Education W, H. Camwom, Secretary end Managing Director EXECUTIVE COMMITTEE <1937- 1938) K. W, Anosmon, GomtsI Motors Corporation J, I. Banaml F m I President C W. Bmoquist, Post President Hsmrv W, Boaouaa, Petroleum Section C, B. Bouucr, ASSE-Enginacting Section H. W. Boulton, Automotive and Machine Shop Section Harold S. Buttwoohu, The American City Magesine W. H. Camsron, National Safety Council, Inc. Komcht W. Campvkm., Past President Rowrt I. Catmn, Aetna Casualty & Surety Company R. A. CHArrtN, Metal* Section Ikwi* A, DcBmiia, Fm I President C. W. D totrav, The Liquid Carbonic Corporation Marcus A. Dow, P art President D, D. Fkmnki.i., Consulting Erglneer John B. Gtbiion, Western Electric Company Habrv Guiubkht, The Pullmnn Company Pbank H. H aknison, International Harvester Company P. L, G, H abskami., Lehigh Valley Safety Council Hon. Habouj G. Hostuan, Governor, State of New Jersey S, B. Hoaaau., Pood Sectio n W ai.trs G, Kino, Past Pre .ident 1 'CX o 'I fe vi .. .striai Safety u* tarpatile Sale*? !Safety Council tkn fing Director UTTEE (1937-1938) icMm Shop Section a City Msgasine amidi, Ine. t [ Surety Company tic Corporati ir Company mpany H am ster Company Safety Council or, State of New Jersey t tu y i t y u i a u Q m m Cmaaamr Ha m m I Mora* E. I. * F e da Nanioar e Co. ' 1 .....1 . laNMM, Street feltidhway TMk -Sectioa S. J. CPSiriNk Ja* LoaieviSe Safety Cmmcll Wau a Paw* Adua Ute * AflBatad Coe. Vme^ummr<fRlu IlCf'AAwP:^spBMBMBm*ll^mM C1-Wmm cmSaJHHPMMHnf^lmWaMPwBif BmoaAl IwHWH A u w S. te w a , M hntrial Relation Counselors, Ine. Lt. Cot. Hamv A. S i w m Past Preildent A. V. Rdawam* Duteth, Mlsiahe Iron Range Railway Co. Qaoaoa IE. ItettTdti^t fletterai SUactriii Co. ftuM M a. Buon. Past Prsident Gm, Jom H. Sn m oana, Uaseaehasetts Safety Council Juooa L n K. Swa t, Cleveland Safety Council C. W. Surra, Standard Oil Company (Ind.) Wauus Dm Swra, Delaware Safety Council R. T, SoumtCN, EWott Service Company C P, Tolmax, Past President Gaoaet G. TtAVta, Graatar Chicago Safety Council. Inc. Da. C. H. Watson, Past Presldsnt A. W. Wttmtev, National Conservation Bureau T. A. Wilson, Taxte Section W, E. WoaTN, International H am ster Co, Arthur H, Youmo, Past Prsident DIRECTORS (1937-1938) (iKotoK J. Adams, Paper and Pulp Section H. W. Anmumon, General Motor Corp. A. L. Armstrong, Eastman Kodak Company H. H. Bailxy, Chattanooga Safety Council J. I. Bamasn, Consulting Engineer Carl Baskbr, St, Louis Safety Council G. J. Babbstt, Mining Section E arner W. Bkck, United States Rubber Product, Ine. C. W. Bkroquist, Wettern Electric Co. E. F. Blank, Jones & l.nughlm Steel Corp. Hknry W. Bocci*, Petroleum Section H. E. Bolt, South Bend Civic Safety Council OFFICERS A N D DIRECTORS, Cm iImwJ C. B. Boulet, ASSE-Engineering Section H. W. Boulton, Automotive & Machine Shop Section F. S. Brown, Standard Accident Insurance Co. W, A. Brown, Safety Department, Nashville Chamber of Commerce W. T. Buckeridge, Employees' Publication Secticn S. W. Bukchiel, Safety Department, Automobile Q ub of Rhode Island H arold S. Buttenheul The American City Magazine B. J . Callaghan, Contra Costa County Safety Council W. H. C ameron, National Safety Council, Inc. Ray Carney, Kenosha Safety Council Robert I. Catun, Aetna Casualty & Surety Co. R. A. Chaffin, Metals Section K enneth B. Coluan, Seattle Traffic & Safety Council J. E. Culuney, Bethlehem Steel Co. L ewis A. D eBlois, Consulting Engineer . J ay E. D ecker, Mason City Safety Council C. W. Dempesy, The Liquid Carbonic Corp. J ames B. D ouglas, The Philadelphia Gas Works Co. D r. Louis I. D ublin, Metropolitan Life Insurance Co. O. M. E dwards, J r., Safety Div., Syracuse Chamber of Commerce W . P. E lstun, Public Utilities Section D. D. F ennell, Consulting Engineer D. L. F ennell, Kansas City Safety Council Donald A. F inkbeiner, Toledo Safety Council D r. H art E. F isher, Chicago Rapid Transit Co. Chester C. F isk, Berkeley Traffic Safety Commission H oward B. F onda, Burroughs Wellcome & Co. (U.S.A.) Inc. A lexander F oster, J r., Quarry Section J ohn B. Gibson, Western Electric Co. H oward F. Gilbert, Elizabeth Safety Council Otho M. Graves, The General Crushed Stone Co. W . A. Griffin, American Telephone & Telegraph Co. H arry Guilbert, The Pullman Co. I saiah H ale, The Atchison, Topeka & Santa Fe Ry. Co. C. H. H arper, Refrigeration Section D. T. H arrington, U. S. Bureau of Mines F rank H. H arrison, International Harvester Co. P. L. G. H asskari., Lehigh Valley Safety Council R. C. H aven, Commercial Vehicle Section G. T. H ei.lmuth, Chicago, North Shore & Milwaukee KR Co. Chas. E. H im , New York Central Lines H on. H arold G. H offman, Governor, State o f New Jersey E. C. H olden, J k., Marin' Section 6 OFFICERS A N D DIRECTORS, Caatoiml E verett H ord, Madison County Safety Council S. B. H oireix, Food Section H. C. H owsam, Power Press Section Fred B. H unt, Cement Section M ajor N orman A. Imrie, Columbus Safety Council R. D. J ewett, Sjningfield Safety Council T homas P. K earns, Industrial Commission of Ohio Taos. L. K elley, Paterson Safety Council J . M. K errigan, Rubber Section Wm. C. K noelk, Milwaukee Safety Commission W u . S. K nudsen, Detroit Industrial Safety Council C L. L aF ountaine, Great Northern Railway Co. Millard C. Letter, Child Education Section Barney L evy, J r., Rochester Safety Council A. A ugustus L ow, Brooklyn Safety Council T hos. H. M acDonald, U. S. Department of Agriculture W alter B. M artin, Peoria Association of Commerce Safety Council F. W . M atson, Minnesota Safety Council R. A. McA rthur, Transit Section M iller M cCuntock, H arvard U niversity I. W . M illard, Industrial Gloves Co. J ames K. Miller, Grand Rapids Safety Council H arold L. M iner, E. I. du Pont de Nemours & Co. R. B. Morley, Industrial Accident Prevention Assns. P rof. Roger L. Morrison, Street & Highway Traffic Section E rnest M urphy, Albany Safety Council E. J. O 'Brien, J r., Louisville Safety Council George C. A. O pp, The Detroit Edison Co. W alter S. P aine, Aetna Life & Affiliated Cos. L ew R. P almer, The Equitable Life Assurance Society of the U. S. D avid A. P atton, Newark Safety Council M rs. G. M. P elton, Evanston Safety Council Charles W. P endock, Safety Div. Milwaukee Association of Com meree C. F.. P ettibonk., American Mutual Liability Insurance Co. Gen. George B. P illsbury, United States Engineer Office A rthur P otterton, Hudson County Safety Council A lbert S. Regula, Industrial Relations Counselors, Inc. Lt Col. H enry A. Reningek, Lehigh Portland Cement Co. Bistor R obinson, Eastbay Safety Council A V. Rohweder, Duluth, Missabe & Iron Range Ry. Co. W alter Rosenbaum, Western.Pennsylvania Safety Council G. E. S anford, General Electric Co. 7 OFFICERS A N D DIRECTORS, CM ftnnd H enry G. S a u m n a t E rie Safety Council K a il G. Schootucr, Rahway Safety Council H arry A . Schultz, United State* Steel Corp. H. E. Seely, Wood Products Section Earl S. Sh a k .i i , Utica Safety Council Gen. J ohn H. S herburne, Massachusetts Safety Council Da. L. A. Shoudy, Bethlehem Steel Co. E rnest L. S imonos, New Haven Safety Council A. E. Sinclair, Meat Packing, Tanning & Leather Industries Section J udge L ee E . S keel, Cleveland Safety Council C. W. S mith, Standard Oil Company (Ind.) E dwin C. S mith, Bladutone Valley Safety Council W alter D ent S mith, Delaware Safety Council W. A. Snow, Construction Section R. T. Solensten, Elliott Service Co. E C. S pring, Lansdaie, Pa. George R. Stephens, Safety Bureau, Buffalo Chamber o f Commerce J ohn Stilwell, Greater New York Safety Council A rthur M. T ook, Consulting Marine Engineer George G. T raver. Greater Chicago Safety Council, Inc. Major R. D. T rimble, Richmond Safety Council F rank E. V itz, Superior Safety Council Dr. C. H. W atson, American Telephone & Telegraph Co. H arry M. W ebber, Wilmette, III. D r. Davio E. W eglein, Baltimore Safety Council S. E. W hiting, Liberty Mutual Insurance Co. A. W. W hitney, National Conservation Bureau H oward R. W hitney, Worcester Safety Council T. A. W ilson, Textile Section W. H. W inans, Union Carbide & Carbon Corp. F. B. W inslow, Safety Div., Birmingham Chamber of Commerce \V. E. W orth, International Harvester Co. E. J. Zaupt, Safety Bureau, Duluth Chamber of Commerce G. L. Z wick, S t Joseph Safety Council G The com purpose oi The G through a prevention plies to all directly or lation. Recognizi conditions a diseases in accident prt tive in these The Nat profit, non tion. It has app senting evei of the Cana 100 foreign bership arc individuals bers of con tions. Aboi cems, indv the oil coir the United and others The hist the first c< under the Iron and S waukee in Congress t organized members, bership inc These s gram on t unnecessar develop th make acci< The cow expansion ness o f the a coordina L Industrial Dusts W ED N ESD A Y M O K N IN G SE S S IO N 0**K 12, 1117 Thi m S lttc wftt to iMnitf hv Chatr* Yedt City, Mid Viea-Prsslfim t for EagineerA lWi*lHVTJHlSHTte BSBI^WllwYWSNVpSWwSy^mVnAW* taft K otionriSofaty Coondl, who intro duitrial R i t f m Counsalors, Inc, Nw duced tho ipeatera. W h x t In d u stria l D ust A m H arm ftil? W h y ? 1 SAMOA IUXOBOK X. X. IAYXXI Chiaf, DM aioa of I if w M r i KygfgM, If. A Public Hoolth Service Wv--hilTMe dusts axial uepyvserssr^yw lw hi^awtouh^^ow uaetw*^ NagWMpMMp^^iWMMfwig, 0k%VSM*INaP Sff^sgMmPwi w^^UM^pggPffMWwIVOmrOp iw a heUifg^laMio Aww^gilw w^WnU^iwfga^i^grwxto hgoi f*fgg!oM' SXMspsgWfel^vF occupation ara lata healthy than thoaa not M ^MapeUoAamoeMuS TaXImAa mawoaneawnluMr oasB'ymaurmaahousi amni*. P---O--^MJSi H3^I WAiO&tu/ OAOWOiHplkWaMHABMIa OAOu M^ upJnattUB SAMM*< o-w^ls tks sh^^wmaoa^i^ato tadaMsa^ipspI h^vw^maa^^moe. uHpnamei sisi national lOaasaaa s i wanMia In dttstv aft mw^wosaupowhawarawasr htaaamvo bupsawapvsw (wwausawamdua Iwsw he^av dpwnpao taow sntrines of 4w t fade the an te te Intel tioct by hiHoatkML by fia t abaofptlon through the skin, by irritation of the tUa, or by combination of the foregoing. The suspenatom of partioutatc matter in Ir have Men broadly termed dusts, fumes, a*n.da avnwmwkpavai. Su^^u^cmhve aa ewwlavmsmapMuu^awawfsitwlwownu k na^a^wa^aPaw* iarUy arbitrary, since the line of demareation between them is not very sharp, and the chief differentiation is based on the sisa of the particle. Investigations by the Pub lic Health Sendee in dusty Industries* re vealed that about 70 per cent of the dust particle examined were between I and 3 micron in else, only about X per cent were less than 1 micron, and the median sise was 1.3 microns. Industrial dusts are mainly less than 10 microns in sin. However, fibrous dusts in die air, such as asbestos, have been found to contain particles as large as 200400 mlrcons in the greatest diameter. While, generally speaking, according to Collii, dusts are more injurious as their chemical composition differs from that of the human body, or from the elements of which the body is normally composed,' it is difficult to establish a comprehenaive definition for Untie Ante. Soltmann,' after o.eoowluu#.nio.v aeont vvmaurniuowwuesw desawdimoekeetownpws towr -- HI mMU Upi .f*ip VUI Ila# "u 1u1u/ alf XRLmu |n|t W| n adW|Mf O1 Xj|mPX|LM||#IlXtfMXIt mVanXKJm.AA, W--tialtl M___al Ml u MMMM*UfMfHMiOAttaaa HlaaI WUw jC^MaeHa i LNmXA LD*UtlmH^ mNA VsLM*Ss BLWa SAOWhHaO^MWaUlaaHMI awVktMWMrl omaa#oalifti f tha points which must be considered in classing a substance aa such: "A poison is.any substance which, act ing directly through its inherent chetnic properties, and by its ordinary action, is capable of destroying Ufa, or of seriously endangering health, when it is applied to tha body, externally, or in moderate doses (to SOGm.) internally.'' Some dpsts are known to be poisonous, while others, in the concentrations usually encountered, are comparatively harmless. However, it may be stated that brrathmg dust in high concentration is not desirable. Accotdlng to Fairhall, the damage arising from the inhalation of toxic dust may be either local or remote, id depends upon whether the material U a protoplasmic poi son, whether !t is caustic in reaction, or whether it is absorbed into the blood stream and carried to other centers which are in turn affected.* It is now well established that exposure to certain kinds of dusts, such as those con taining considerable quantities of free silica, has increased the morbidity and mortality rate from respiratory diseases; white me tallic dusts, such as lead and it, compounds, 85 86 Twenty-sixth National Safety Congress have bean antedated with general systemic poisoning.' Dusts may be swallowed with sauva, water, or food, and direct poisoning has been traced to absorption by this method; other dusts may act as irritants and produce affections ol the skin, irritate mu* qom membranes of nose, eyes and throat, often causing inflammatory diseases of these organs.* Some inorganic dusts are able to pene trate the deep lung tissues and are sufficiently insoluble to be retained there. Some of these may be active in the human tissues, causing definite and permanent in jury. while others are inert and may be retained for years, apparently without seri ous damage; some are gradually absorbed without causing pathological changes.' All inhaled particles are soluble, at least to a small extent If harmless, cell activity is stimulated so that phagocytes remove the dust. If the solute is toxic, the viability of the phagocyte is affected and an ineffective accumulation results. At the same time, further !ute may diffuse into neighboring tissues, setting up an irritation and subse quent fibrosis. The nature as well as the solubility of the solute is an important fac tor, but of two substances of approximately equal toxicity, the more soluble form causes the greater damage. However, sub stances of such low solubility as silica may ultimately produce extensive injury.' Kettle has stated that harmful dusts, if inhaled into the lungs, may activate a latent tuberculous infection; they may exaggerate an active tuberculous lesion or a coincident infection. If sufficient quantities of a harm less dust are inhaled, some of it remains in the lungs and causes a mild degree of fibro sis merely through mechanical irritation, hut such fibrosis is never sufficient to inter fere with the function of the lung.' Some writers state that while the influ ence of nonpoisonous dusts on health is a debatable subject, abnormally high death rates from bronchitis and pneumonia are sometimes attributed to chronic exposure to nontoxic dusts. Large amounts of dust are occasionally found in supposedly normal lungs, at autopsy* According to Drinker, there arc four dif ferent types of reaction produced in man by the inhalation of dust. The first and most important are the pneumoconioses, such as silicosis and asbestosis, which cause specific lung pathology and often are followed by pnlmmmry tabermilosi. Tbe second type of reaction is caused by toxic dusts like lead, cadmium, and radium, Athird type of mal ady follows tbe inhalation o f finely divided metallic fume particles sock as tine oxide, and is known as metal fame fever. Tbe fourth reaction, allergic in character, is caused by breathing organic dusts such as pollen and certain types of pulverised wood and flour. In all four eases the sole cause of the disability may be dust inhalation, but the reactions from toxic dusts result from swallowing as writ as from inhalation." For various reasons it is difficult to set up an absolute classification for dusts. Opinion is rapidly changing regarding socalled inert or harmless dents and further investigation may prove some of them to be injurious. Some dusts may have both a toxic and an irritant action; while on the other hand, the poisoning resulting from ex posure to a dust may be the combined effect of more than one mode of entrance into the body. However, the following classification of dusts, according to physical character istics and physiological effect, is used for convenience. 1. Organic Dusts Organic dusts are those which contain carbon, and were originally supposed to come from organised substances derived from animal or plant life. Living dusts come under this classification, and are thought to be of the same order otf size as industrial dusts, with which they are fre quently associated. Bacteria are usually be tween 0.5 and 3 microns, except in a few cases, such as the anthrax bacillus, which ranges from 1 to 1.25 micron in breadth and 4.5 to 10 microns in length and 10 or 12 microns in diameter. However, it is possi ble that the larger and heavier varieties, like the larger and heavier dust particles, settle due to gravity, and do not remain suspended in the air. Many thousands of organic substances, carbon-containing, are made synthetically by chemical processes, such as dyestuffs, explosives, etc. 1, NONLIVING ORGANIC DUSTS. As the name implies, these are comprised of nonviable particles, which may or may not lie inherently toxic or irritant, but which nevertheless produce untoward effects in the human organism. "Allergic" dusts, or those to which only certain persons arc or may become asthma, i included a. To* dusts an untowart local. T1 usually <! ing gen termed b irritant. In rep lowing it pounds, paranitn dinitrob* naphtha! tion of workers dust fro is parti causing titis wh the skin tion of respirat generate lives an particul where ] rections suiisicn. Cases frotn dust.'* bacco < organis produce tobacco Seve1 worker which Picric rose, n ha-, he Picric game handle Sails among dust Africa Per urnim skin p part < tnav ! ! ttiy t a p p i li, m w lip M M 'Vili m Dll m u W U l iiS ilfi V Ini f t m IMM i H l l m m II w m M will 1 f t t n M Hm HM r - if, i ill rmI&m iIm mu fwlM*Wi irt ftfliw #W MMIMI | f ImNH I f M m lit HIM* ffl H iw iw i.iiiP tMm wwaiiHiim ftHw IN N . M M M M N 1 MUfllMl IiI F M U f N I P M N M f P t V w li ll H IM in flW Miff l> O i h i Mc 8 i m i i Vm U (Ih i i w tlim i wMii umiisim P i M i WW HPllHttlll 1* ! |H *M tMfttUtl IMNiftHWI H*flVll m Im h I w nlni \\fa M v l * fimi II HHNIP liti HlUllfMMlWHHi H I I I m N | (H M HI (III MHM fnlr III 11 I tm iw l HtifUi with wiiivn li ir Ir M U m m m M II u ri ir litjiMlly It 0 0.1 ftllw I MIHWH, ll |H ft I m, p h ili m Mi i m Nm II.Iu! wIi|)i f t m I , )I Mf l mMlim a ut W 4;li to In m Iw m ii m Iwtftilt iih I Hi Hr l i >m r in dlMir Hw vri il U mnmi Im Mm m m m m Mm vi i v m Im I^ Mm liPRir inti livlr timi Mtriii Mi Mm in It'iv iiv , m w tlti mil imln In lit it MftftV llHtHMlll Hi HfftMll SHllllMMif 'Nm 'Mm u Ih Iiin. i t h i m niliilvllv h fw i*l |trn(iiH( ih i id d vitiik ftlRtMV*. It i, N t m i v m o i H M W i ' m m a * H IWIH l*H|tll, III! if UilH|lfll! 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T h r u i m U m w m MiirlaH durlui i h i Mu m iIm h i m w iM tl* ftp ill HNilMMftiy W fM f HfHlNliHH. |tftili)ilftrly iha lMrH' ftlrftwr nr*|il ttlur M fll) r d i i i p j M U H In nil iwiltm ," fH l u r hh Ii m i m *>1lyi < Mliinwafti h w ii (rHMMftfy h u m , l ' h I iHiblynpIft liftvft ltn f|ih iIiI n iitmi *m i*Mf Ih jiiltftlftliHHl Hf' I.H`lHIWt tliMi " li Im ltn inumi timIiI linlllmll lti m limtM dun M i ninnimi limi mi ili niftHlM 0i ii lim i ir i f iliftii limi in mimmi Im ili m iii mmnllu ni nmtktl iiittmt-H will) ) turni nltmiH witHi " Hvra ilriim|iiii I *|tFl|fl Itv iimiiy tt(tfltif IihhhI h| Hwdr lift nini T N T , tvlmli 1 H( in nmkliii M ill nlm iv* IN* t li WHltl, w ilflt I Un niiT lui Ini imi m w , iHiutti ilirln i, mi In ini* !!fi k*i Imi. Iman litnml li* irniln iltttmiiii l'It i li {H!I U j}|H III li|lll Hillmlit tu umili *lvMiH ' |irm iiil m in ti imiim li!tmlliMIi' nIti Dilk willi Dm vini iii|m ;v Pilliti itllifMttlilnllimi limi IliWmilil mminititi mmiim wmimi In ilk rliitrr w* tilt in iIih I (limi *llk ruminili iimtii|miinillmil fumi i ! l l i * i* I'm uiiih m im I in III ttmiMllillill ni itiiiMiii mi MMiniM |omiHitn * mH i turni ilt* (ilimiiiMi wliltii Mftni Im tli mnt H i I no Hlimoni |iK Mi III Iti'.lt, orni imn li ><*iiail M liiit'-illmt nr lo Mimm IWrMftilli d i i Ut M w p u k U dwN limi m w M ik M wrd In ilfii) w w iM u m , au.) m m m i i i n m m r M I Im Nn Mi f M w p i k m i l titilli m M M rCMNftd ftIMHI W RfMU M IH M ' jm ilnRlvHI M M id m ftMftr dnil 1 Tii SnIM TIh mmw Minawn M .m imP ImwcHiih, wi4l l*m**i rftttnr w b i h i , ind nwnu m j iu (*|sftlftlly r i ili Im ) w *r li IM k wntkri, lrm)tnflri ni wti wurlmri Ih i Iii iitd M u r ihIIIi . i M u d in timi WHtlnft iM Ir work Mn* U h m NtrM li omv nnuin mtny ititrmiiii* tritivii m w NMft n Irrllftlini w iiw j mi " tiilr*lm v p i p . wli lnflntiti Inn nr lit Mn. H Iiim iv * tliiitilmnu dmlftl dlii h Im Iim ih h III (ll (li. Mwjwwlmljji Imy (twit h!u i vil imi M llliffi im i imv mkm iiirlIfHUtl m Mm tin ih wltftMi iu(i wHfMfo m " . tilkwlt M h w wm NttiU innimm lUHM my |MHd* r*ft(i` tn* ni jt h h i iti wHMlljif Hfitimi mi|tHliiliiv I IMHI "ftlftw^ il H?H Ih Hit liti K tllllnn ni nvHr<Htiillvnit .tt nmi<niMi mi lliil |tlinnmmm tm**t lit|iti .ii5olf*l ilmmlvi iti klo ttiim t* II* r, tlt;v nm n fin fiitm 1 wlmi in ili li.mv W itfo ili * ^ui<*u lff| i IhvmIv W lii** mil Il m tjiii Imv fvi ni "tinti l li til nmv h vI|i * * tmiit >.t ti( tfiiiHv*n iti mii nliilim m |tt<n titilli (.tiH, limmimii, ililiif' Iim , (Hifi#, lf JH llllm , (OH IVI D. Hfltfltt Ih * lt.ll ImlHDin lift * u tnttl Ml whmI ( 1 , omv *nflf*t lumi Imt inno m rnlm Il U mm uttiMit Im llttt ntlHtitlH ilo umi li Ih t((tlliD ni ili Inni tm (mi Ito llt|ti I U-!-'tl(tl| (M |IU|||1M~ | mito! ni Imi Imitti irtiiifit In im him h< lit ditti i |inDimMD iiltmiiit m li mi >ifltii nitlm ti mitt` ummi il ...ttl.i u tlm Ifimlt mi * ivMtlt i.u.imi.lv (l|lViHHll llt|lMU uniti ll m*Hitrt( III #i!U't ni t |ifmn I im i*tl m UfiI, ummi, ini im diM , n h (lidi U |ii inl "I III wt M|iwiimirti ilt lliu {Imi 4M'> Hh Ih In (mi mimii t il li.*rtim iinlintM.dm iii< mnl tmmM( t niiirtiiit.il in ili timo Ih ttilili ti Hi mie r. i t> iln|ni'M-li " im uli ili Muh |hm>i 88 Twenty-sixth National Safety Congress of cotton spinning, cotton-strippers are ex posed to dost arising from cotton husks and dbris, which produces a typical form of asthma.* Ordinary wood dust has been of interest due to its purely mechanical action, but still greater care is required in handling certain kinds, especially woods coming from abroad, because o f the essential oils impreg nating them, which when freed in the dust may affect the health of the workers con cerned. Some of the woods capable of causing skin lesions are Brazil wood, satinwood, teakwood, cutnaru or tonka wood, black ebony wood. West Indian mahogany, Japanese tagayasan, coccoloba, chestnutwood, oiivewood, California sequoia, etc. All per sons who handle these woods are not in jured, only those particularly susceptible to the substances they contain becoming affected." Z . U V i . G ORGANIC DUSTS. These contain particles capable of exhibiting the phenomena of life* (especially the property of reproduction or multiplication), such as bacteria and fungi. They are usually found in low concentrations and are associated with nonliving dusts in the air. a. Bacteria. One of the most important among these is the anthrax bacillus, which is contained in the dust from skins, furs, wool, and animal hair, horns, hoofs, bones, etc. This disease may occur in two forms: cutaneous (in which the organism affects the skin), and pulmonary (when it is inhaled, as in the form of anthrax known as woolMirter-' disease).1' Cases of tetanus, reported in connection sith jute manufacture, were traced to the raw material, the bacillus having been found in the factory dust." Diphtheria, tubercu losis, smallpox, typhoid, or other bacillusproduced diseases, may result from exposure to infected dusts. Bacterial sensitization can be the cause of any of the allergic diseases, namely, asthma, perennial, hay fever, urticaria, angioneurotic edema, eczema, or migraine headaches." b. Fungi. Dusts containing the mycelia and spores of parasitic fungi give rise to annoyance and discomfort. "Maltster's" itch from the dust alone has been reported. In Provence, reeds used for ceilings are stacked while still wet and undergo fermentation: they become covered with a white powder (a dry fungus of the Mticor family: Sporo- trichum dennatodes), which is scattered when the bark is stripped off. This powder is irritating to the skin and mucous mem branes. Mycelia and spores of moulds are commonly found to cause rashes: for in stance, the blade powder craning from macerated sugarcane stalks. Among basketmakers, the mycelium and spores, in the form of a white mould (hyphranycete) from the rhattan canes used, get shaken out when the canes are split, hammered, and cut, causing painful fissures to develop on the skin where they alight" A form of asthma or spasmodic cough, suffered by cotton weavers and known as aspergillosis, has been considered due to in halation of spores of a mildew which some times occurs on the threads." In a study of silicosis among miners, made by the Public Health Service, a number of cases of typical miliary calcification were en countered. Unstained smears of those cases examined were positive for fungus, two types of Aspergillus fungi being identified. All of the subjects but one were farmers, teamsters, feedmill workers, or residents of small agricultural towns where grain is marketed. Fanners are exposed to fungi in threshing wheat, baling hay, or handling various small grains." Some other fungus diseases such as actino mycosis and blastomycosis are associated with occupational exposure to dust. The former occurs among workers handling straw, hay, grass, vegetable debris contami nated with mould, etc. Actinomycosis is likely to affect people engaged in commercial handling, storing, and cleansing of grain (grain distilleries, flour mills, grain crush ing, breweries, and malting houses, etc.)." II. Inorganic Dusts Inorganic compounds are ot mineral origin, not requiring a living organism to produce them.'' A number of dusts not usually classed as toxic may, under some conditions, produce untoward effects on the human organism. Classified under inorganic are toxic and/or irritant, fibrosis-produc ing, and nonfibrosis-producing dusts. a. Toxic and/or Irritant. Toxic dusts are those which are inherently toxic when in haled, ingested, or otherwise absorbed. AmonT those which produce systemic poi soning, some of which are also irritant, are the dusts from heavy metals and their salts, such as lead, mercury, arsenic, cadmium, Industrial Dusts 89 zine, etc. Irritant dust re injurious by reason of their strong irritative or corro sive properties. As rule, inhaled irritant substances im mediately cause a reaction in the upper respiratory tract of such severity that they are prevented from reaching the lungs, al though they may cause lung damage by extension of inflammation if the mucous membrane is corroded.' Lime, calcium oxide, and the di-chromates are examples of irri tant dusts. An inorganic dust may possess both toxic and irritant properties, and the poisoning produced may be the combined effect of more than one mode of entrance into the body. O f the directly poisonous dusts, the most widely prevalent are those of certain lead compounds, particularly the oxide, carbon ate and the chromate. The dust is readily absorbed by the mucous membrane; some dust passes into the stomach and is dissolved by the gastric juice* According to Fairhall, perforated nasal septum is a common occurrence among workers with bi-chromate dusts.* In a study made by the U. S. Public Health Service it was found that continuous daily exposure to concentrations of chromic add mist greater than 1 milligram in 10 cubic meters is likely to cause definite injury to the nasal tissues." It is believed that a similar concentration of the dust would be equally toxic. In the case of poisoning from some heavy metals, exposure may be to both dust and vapor. For instance, investigations have shown the safe, limit of total exposure to lead oxide dust and fumes to be less than 1.5 mg. per 10 cubic meters of air, except for prolonged exposure." In exposure to mercury dust and vapor, it was shown that the incidence of chronic mercurialism in creases rapidly with increasing mercury concentration, after such concentration ex ceeds 2.0 mg. per 10 cubic meters." Alkalis and metallic oxides are common causes of dermatoses. Lye, potash and lime are known to cause irritation to plas terers, cement-makers, bricklayers, masons, stonecutters, modellers, and metal platers." Ulceration and perforation of the nasal sep tum occur among workers exposed to the dust of soda ash; systemic poisoning also occurs from inhalation of calcium cyanimide dust." Cases of dermatitis, scleroderma and can cer are reported to have been caused by exposure to dust of arsenic compounds. Certain aluminum salts are skin irritants and aluminum dusts may contribute to the infection of skin and mucous membranes, through mechanical action." b. Fibrosis-Producing Dusts. The most important of these are the inorganic, slightly soluble dusts which cause fibrous changes in the lung tissues, some of which are seri ous, and some of which cause little or no disability,' So far as is known, no inorganic substances other than silicon derivatives cause more than a very moderate -degree of fibrosis of the lung. Moreover, there seems to be no evidence that any other constituent of ordinary dusts can influence so unfavora bly a pulmonary infection.' Although other dusts, when inhaled in sufficient concentrations over a long period of time, have been shown capable of pro ducing a pulmonary fibrosis, nevertheless, the pneumoconiosis characterized by nodu lar fibrosis has to date been shown clini cally and experimentally to be associated only with the inhalation of dusts containing free silica. Since this dust, to exert its harmful action, must enter the finer divisions of the lung, the particle size of the atmospheric dust may bear a definite relationship to the in jurious effect produced. The silica musi !>* present in the air in particles small enough to enter the finer air spaces and of such dimensions that the phagocytic cells may engulf them. The greater majority of par ticles found upon microscopic examination of the lung fall within the limits of from 1 to 3 microns." Examples of siliceous dusts are granite, quartz, sand, pumice, slate, etc. In a recent study among anthracite miners, the correlations between exposure to dust (which contained silica) and the evidence of constitutional changes left little doubt as to the etiological significance of the dust in the air breathed. Like correlations were found between the silica exposure and the extent of pulmonary changes." When the inhaled dust consists of silica combined with bases, silicates, some degree of change in the pulmonary tissue may result. In this respect asbestos dust seems to be unique among silicates in the prevalence and se verity of the disease it causes." The chief distinction between silicosis and conditions due to simple reactions caused by other dusts is the active proliferative 90 Twenty-sixth National Safety Congress reaction in the tissue* which results in progressive nodulation. Silicosis, when once established, strongly predisposes the lungs to infection, especially with the tubercle bacillus. Chronic interstitial pneumonia, chronic bronchitis, and emphysema are fre quent complications of advanced degrees of silicosis. The relation of the acute respiratory in fections to the reaction due to dusts other than free silica has never been established, though a heightened incidence has often been shown statistically in workers in dusty trades. It is fairly certain that a dust dam aged lung, whatever the cause, fares much worse if an acute infection does supervene upon it.f In a study conducted by the U. S. Public Health Service among marble finishers in Vermont, it was found that marble dust when inhaled in the concentrations found in the examined plants produced a mild, bi lateral, lir r fibrosis in some cases, but no serious lui. ' changes were noted and there was no disability due to the dust, even after years of exposure." c. Nonfibrosis-Producing Dusts. These are inert, that is, they do not cause fibrous tissue to be produced, but may become encapsulated or lie free in the tissues; or they are absorbed without production of fibrous tissue. Included among them are alundum, coal, corundum, emery, limestone, magnesite, marble, plaster of paris (gyp sum), and polisher's rouge. Dust Control Engineering and medical control arc the two most important factors in combating the industrial dust hazard, and arc to a large extent complementary. Engineering Control. As I.anzaB has stated in a recent paper, ``It is a basic principle in dealing with a dust hazard that the dust should be attacked at its point of origin and thus prevented front being dis seminated into the atmosphere." After the dust has been spread throughout the air it is difficult to deal with it, and reliance must le placed on individual protection, which is never wholly satisfactory. Lanza further cites various methods used in controlling dust. These will lie reviewed but briefly, since a paper dealing with the subject of dust control in detail, will follow on this program. Dust may be entrapped at its source by suction devices and thus removed and col lected. Familiar examides, are exhaust hoods in grinding operations, and the devices used in rock drilling. Generally speaking, the exhaust ventila tion method, where applicable, is to be pre ferred in controlling a dust hazard. W ater may be used to entrap dust and prevent its dispersal, and under certain circumstances it may be of advantage to combine the use of water and the use of suction. Sometimes a dusty process can be completely enclosed in a sealed room or compartment. It must be remembered, however, that any mechani cal device of this land offers adequate pro tection only if it is properly designed, installed, and maintained. A great deal of attention has been given the subject of individual protection from dust, and there are many types of respira tory protective devices now available. These are generally of two types: those which provide fresh air from an uncontaminated source and those which rely upon a filtering medium for removing dust from the air breathed. Where the use of such a device is indicated, only one of the types approved by the U. S. Bureau of Mines should be used. As a rule, it may be said that masks, respirators, o r other such protective device should be used only where exposure to the dust is intermittent and brief, or where some unusual condition makes a more ade quate dust control impracticable." Where bacteria or other living dusts in the air are associated with a process, steri lization methods such as increased tempera ture, ultraviolet radiation, and chemicals like chlorine or other bactericidal substances, may be of use. Pasteurization temperature (about 140 F.) will kill most organisms except those bearing spores. Steam disin fection is used for horsehair, and proves to be practicable if the temperature does not exceed 230" F. Wool fibres, however, lose their elasticity by steam disinfection, and the "Duckering" process now used in Eng land includes soaking of the wool in a form aldehyde solution, and drying in a current of air at a temperature of 160 F." There are few occupations in which there would be a sufficient concentration of dead bac teria to cause untoward effects in man. In the case of dusts producing external irritation, auxiliary protective measures may include the use of protective clothing, t Us source by ins removed col lides are exhaust hoods *i ehd the devices used U the exhaust ventilaipplicable, is to be pre* dust hazard. Water ip dust and prevent its certBin circumstances to combine the use o f suction. Sometimes be completely enclosed compartment. It must ever, that any mechanitd offers adequate prois properly designed, ined. ttention has been given ridttal protection from many types of r e s p it es now available. These ro types: those which t m an uncontaminated ich rely upon a filtering ing dust from the air e use of such a device : of the types approved .u of Mines should be nay be said that masks, such protective device where exposure to the : and brief, or where ion makes a more adeipracticable* r other living dusts in d with a process, sterih as increased tempera diation, and chemicals ' bactericidal substances, teurization temperature 11 kill most organisms g spores. Steam disinlorsehair, and proves to temperature does not o! fibres, however, lose steam disinfection, and cess now used in Eng- of the wool in a formd drying in a current lure of 160* F." There in which there would entration of dead bacvard effects in man. m b producing e x te rn a l protective measures may >f protective clothing, Industrial Dusts 91 gloves, goggles and aprons; as well as pro tective salves, ointments, or other com pounds to delay or diminish the irritant action. General rales for hygiene and good housekeeping should also be observed. Medical Control. Equally important, and closely interrelated with the engineering phase, is medical control of occupational hazards. In addition to directing the proper placement of new workers, and guarding the health of all employees, medical control is a check on the efficacy of the engineering control methods already instituted, or a measure of the need for new protective devices. It has been stated that "Industry has found that the best way to treat industrial injuries and illness is to prevent them,''" and medical control, through preemploy ment and periodic physical examinations, is one of the most important factors in such prevention. The preemployment examination is made to determine the employee's physical and mental fitness for work. It serves to dis close the presence of any contagious dis ease, reveals any minor physical defects which might later become serious, or whether the examinee's condition precludes his em ployment in certain or in all types of work. It should be remembered that such preem ployment examinations are not to be made for the purpose of eliminating an employee, but rather for allocating him to the type of work for which he is physically suited. A worker should be given employment unless totally unfit, or unless his disability, even though slight, would cause him to be a haz ard to himself or his associates. Further more, the practice of preemployment examinations should be extended to include executives and officials of industrial organi zations. "The purpose of periodic physical examinations is to secure and maintain physical fitness and thereby lengthen work spans."" Reexamination of employees some times results in the discovery of defects and disabilities which were not observed at the time of employment. In such cases, an oc cupational adjustment should be made to provide continued employment, but remove the risk of permanent injury. Reexamination of employees is required by law in certain occupations in which the handling of poisonous or otherwise deleteri ous substances may result in the contraction of disease." Since some occupational dis eases tend to clear up and recur, records of previous occupations should be included in the physical examinations. The frequency of examinations should be determined by the medical director, unless otherwise speci fied by law. Those exposed to known occu pational disease hazards may have weekly or monthly examinations." "It should always be kept in mind that the basic principle of physical examinations in industry is to keep men on the job and not allow the physical examination to be merely a weeding out process."" References *Bloomfield, J. J. and DallaValle, J. M. "The Determination and Control o{ Industrial Dust." U. S. Public Health Bulletin Ho. 217, April, 1935. *00112, Edgar L. " Industrial Pneumoconioses, with special reference to Dust Phthisis.*' Milroy Lectures, 1915. H. M.S.O., London. *So!!niann, Torald. "A Manus! of Pharma- colon'." W. B. Saunders ft Co., Philadelphia, 1932. 4 Fairhall, Lawrence T. " Toxic Dusts and Fumes." Journal of Industrial Hygiene and Toxi cology, November, 1936. * Bloomfield, J. J. "The Sampling and Analysis of Industrial Dusts." American Public Health Asso ciation, Yearbook, 1935-36. * Gibbs, W. E. " Dust Hazard in Industry." Ernest Benn, Ltd. London, 1925. * Air Hygiene Foundation of America, Inc. "Sili cosis and Allied Disorders." Medical Series, Bulle tin No. 1. Pittsburgh, P*. April 15,1936. 'K e ttle , E. H. " l i e Action of Harmful Dusts." Inst, of Mining and Metallurgy, London, June 14, 1934. * "Dusts, Fumes, and Smokes." Occupai.tn and Health Series, International Labour Office, Gene.? 1930. I D rin k e r, Philip. "Causation of Pneumoconi osis." Journal of Industrial Hygiene and Toxi cology, October, 1936. `'Dyeing." Occupation and Health Series, International Labour Office, Geneva, 1930. " Legge, Sir Thomas. "Industrial Maladies." Oxford University Press, London, 1934. 11Burstein, A. " Nicotine Action from Inhaled Tobacco Dust." Journal of Industrial Hygiene, De cember, 1927. 14White, R. Prosser. "The Dermatergoses, or Occupational Affections of the Skin." H. K. Lewis & Co. Ltd., London, 1934. * Schwartz, Louis. " Skin Hazards in American Industry." U. S. Public Health Bulletin No. 215, October, 1934. " Downing, J. G. "Industrial Dermatoses: Treat ment and Legal Aspects: Review of Recent Litera ture." Journal of Industrial Hygiene ami Toxicology, July, 1935. 11 "Occupational Lesions in Workers in Sugar." Belgium Letter, Journal of American Medical Asso ciation, Sept. 10, 1927. Abst. Journal of Industrial Hygiene, February, 1928. " "Flour Mills." Occupation and Health Series, International Labour Office, Geneva, 1930. " Mayers, May R. " Susceptibility to Dermatitis." The Industrial Bulletin, Albany, V Y. IV i 1937, vol. 16, no. 2. " Drinker, Philip, and Hatch, Theodore. " L.dus- trial Dust." McGraw-Hill Book Company, Inc., New York, 1936. ** Schwartz, Louis. " Skin Ha-ards in American Industry. P u t II." U. S. Public Health Bulletin No. 220, Sep. 1936. " "Poisonous Woods." Occupation and Health Series, International Labour Office. Geneva, 1930. The Engineer's P art in Elim inating D ust H azards By ARTHUR 8. JOHNSON Assistant to Manager, Engineering Department, American Mutual Liability Insurance Co., Boston, Maas. When one realizes that control of the dust hazard depends upon the combined contribu tions of the physician and the engineer, he ap preciates that the solution requires scientific treatment By scientific treatment I mean the technical analysis of the hazard to discover the causes which contribute to injury or ill health, and the development of control meth ods which obey physical law and physiology, and which will be directed at causes that admit of most immediate and economical treatment. That goes for handling the dust hazard in a given plant It goes double for acquiring knowledge to the end that the whole problem may reach ultimate solution. Right now our knowledge of the problem is in big chunks, loosely put together and largely empirical. There are estimates only to judge the mag nitude of the dust health problem, and it is so dosely associated with other health problems that a clean-cut estimate of it alone is imiwssiblc. We do know that it is great in the aggregate, and for the individual plant it may be very bothersome and expensive. What, actually makes quartz dust cause silicosis is not known. It does, so the air breathed by workmen must not contain harm ful quantities of respirable quartz dust. Inex pensive methods for making the air clean are still in the realm of dreams. Much work must be done to know more about silicosis and more how to make atmospheres safe inexpenttvely. As an accident prevention job, dust control lies almost entirely within the admin istrative responsibility. The control measures are capital expenditures of considerable size. A plant with a dust hazard is sick, it needs an expert diagnosis and scientific treatment, which may include expensive major opera tions. Home remedies are seldom much good, and supervision and employee safety con sciousness alone cannot accomplish anything. There may be observed in countless shops installations for exhausting dust which are derisively called "tin knocker" jobs in which the horsepower dissipated is out of all pro portion to the air-borne dust moved. Tonnage efficiency of material moved may be the proper yardstick for pneumatic conveyors but if the material to be moved is air, contaminated with nearly weightless particles of dust, the entire health hazard can lie in the half of one per cent of material not moved. I do not mean that unless a dust supression job was engineered it can be no good. There are many good installations that were never figured at all but grew like Topsy. The re Industriai Dusts 93 suiting freedom from dustiness was so satis* factory thatefficiency held little interest to the owner. This is exceptional, however, and I oner the opinion that dust suppression jobs should be engineered. A dust-suppression installation is a safety device, designed and operated to provide pro tection against possible disease and provide a sense of security which must be absolute. Its safety is not rushing air and rattling chips but a minimal residual dustiness. There is no more pathetic defeat for a dust control jpk than to find faith in its effectiveness so low that workers must wear respirators to find the reasonable safety that was expected from the hoods, ducts and fans. Diagnosis and Control Let us examine some of the features by which we recognize this dust hazard problem, leaving out the sodo-legal aspects. In order to develop more fully the engi neer's place in this dust control program, it seems desirable to separate as sharply as we can the diagnostic considerations from those which deal with control. In the first com partment we can place all the analytical com ponents which describe the hazard and its exposure, the probability of its producing ill health and all the rest of the medical and industrial hygiene facts which make out a case against the existing dust. In the second compartment place the knowledge of physics and engineering necessary to plan the dust control program and so design it that when installed its performance follows prediction that the probability of industrial disease is reduced to insignificance. The Industrial Hygienist Our first feature of interest would naturally be the specific and relative toxicity of silica, silica-bearing and other dusts which make up the dust health hazard. Much might be said to advantage about the quality and quantity of hazard in many dusts. The acquiring of this knowledge has been, and must remain a medical problem. It involves gross and micro scopic pathology and x-rays, and experimental animals. Engineers do not talk that language. Industrial hygienists do; they are a happy combination, half doctor and half engineer. Many of them are quite capable of handling the dust health hazard in all its phases of investigation and control. For the purpose of this discussio j I throw their interest in with the doctors. I want to go so far in my opinion as to state that the engineer should not attempt to define the quality of health hazard-in a given plant or industry, nor should he establish threshold limits of safe or permissible dusti ness. This may be debatable, but I shall con tend that the engineer who writes the speci fications of hazard and dust tolerance is really an industrial hygienist, and is using a very much broader knowledge than engineering alone. In the first case the quality of the health hazard is an opinion arrived at after studying all the environmental conditions including the general sanitation, occupational analysis and a scientific analysis of the- dust exposures. In the exploration of dust exposures, the nature of dusty operations must be viewed from physical, chemical and mechanical aspects, the determinations of dustiness must be not only counted and classified by particu late sizes, but chemically and tnineralogically analyzed. The plant layout must be studied with respect to dust production and distribu tion, and the housekeeping and existing dust control equipment evaluated. The presence of specific hazards, such as toxic gases, abnor mal temperature and humidity conditions, etc., must be explored for their complicating effect upon the whole picture. This is distinctly an industrial hygiene job, and some of the most critical data requires only medical viewpoint. This is absolute in the case of tuberculosis study and the qualifying of men for employ ment. So far, not one atom of engineering to suppress dust is involved. It is entirely anal ysis of hazard. The diagnosis must be that the dustiness is hazardous to health or that it is safe. If it is hazardous, it must be brought down to a specified residue. If it isn't, leave it alone. On the second point, if the hygienists can not specify threshold limits graduated upward for relatively less hazardous dusts, let the engineer not worry about it. The diagnosis is dust which is harmful and too much of it. The remedy is control of the dust. The engineer designs controls which will produce the lowest practical residual dusti ness. He should not attempt to write his own specifications of threshold limits or permis sible dustiness. This may be an imp' 'ant goal in the study of dust health hazards. Safe Limits At the present time the medical men and hygienists believe that quartz dust is safe 94 Twenty-sixth National Safety Congress bdow five million particle. They mem will ing to tn d u a te upward to 20 million for medium silica and 50 million for low silica percentages. Five million particles is virtually dust free, and is very difficult and expensive to achieve and maintain. The declaration of safety of the installations must remain in the hands of the medical and hygiene groups in whose hands now lies the responsibility for determining the hazard. We now enter the chapter of our discussion intended to demonstrate Oat dust control is an engineering job, that it must be given scentific treatment, not guess work, applying engineering methods which are based upon a knowledge of physical law, the behavior of dust, the performance of air-moving machin ery, etc. Prerequisite Knowledge Let me recite briefly, a few of the things which, in my opinion, the engineer should know to ciu this job correctly. He must know ltow to make a survey. Surveys depend upon sampling, and sampling is not a catch-ascatch-can proposition. It involves the place, the time, the frequency, the amount in a sam ple. and the number of samples so that maxi mum, minimum and average data mean some thing, so that credibility can be given them. For the type of sample involved he must know how to weigh or count respirable dust, as distinguished from large masses of nonrespirable dust which complicate the picture. He must know how to observe the sources of dust floods as distinguished from conditions of normal dustiness. He must know the sources of dust and the principles involved in the dispersion of dust. He must determine how much dust enters the problem because it is part of the material, and what dust is created in the pntcess by the fracturing of the material. Any less survey cannot tell the engineer wliat his task of dust control is,. To visualize that task intelligently he should know the physics of Brownian motion, laws of resist ance to the motion of particles moving in air, Ixith when the air is in turbulence and for stream-line motion. He should know terminal velocities, movements due to centrifugal mo. tion; flocculation and the effects of air motion and the effects of humidification oti it. He must know all about the difficulties of w etting and what is known about overcoming these difficulties. He should know the several elec trical phenomena which bear upon dust be havior. Those are all principles of physics which explain the behavior of dust and upon which ttg in w riig practice must be based. They must be understood and be taken into account. Dust control is not a matter only of general ventilation; the engineer most study the pro duction as well as the dispersion. The problem should be analyzed to determine die applica bility of segregation, enclosure, wetting, local exhaust and general ventilation. In some instances, substitution of non-hazardous material, or non-dust-producing oper ations may have specific application, and they should be explored first. This implies plant engineering. I am convinced that many bad installations are bod because plant engineering was not used. In the designing of exhaust systems installed to capture the dust at the points of generation, the physical behavior of air (noving toward hoods and in ducts must be known, and that knowledge used. Each system must consist of collection hoods, pip ing, air-cleaning plant and a source of suction. Before selecting a hood for a job the engineer must know dust dispersion by dynamic pro jection as well as dust dispersion by air cur rents, and design the hood accordingly. Knowledge Needed The aero-dynamic characteristics of suction hoods appear to be little known because little thought was given to them in designing thousands of hoods which can be found every where in industry. All the possibility for entrapping dust and much of the efficiency of the system lies in this factor. Air velocity, static suction, and rate of air flow are all related, and they must be known. It is essen tial to use high velocity of air in certain types of exhaust systems to entrap dust projected at high velocities as in the case of a granite surfacing machine, and low velocities must be used in others, as in the case of cleaning asbestos fibre of dust to prevent wasting material. Quantity of air and its velocity must be determined, then the piping should be de signed to take into account the behavior of air-flow through pipes at low and high veloc ities. Where the problem is complicated by the large sized particles which go along with the fine dust, how these behave must be taken into account. Pressure losses are very impor tant elements in the design of an exhaust system. L and loss i Pipe desij of the m pressures The sek is a matt Power co ble, fans 1 must kno peller tyi other fan More i goes intc selection' method <1 calculatio edge of < mination behavior a filter, : perform, resistanci say not! relation I items for Appan Consi< past as tion in I just wh vious u two sei their eff The f must be are dan know h the mar must b< sons w dust, ar disease dust di; first si] expose L mgress mi Mtndi bear upon dust be- all principle* of physics which tfcnvior of (but and upon which ffaettee most be baaed. They reloadand be taken kilo account, is not a n atter only of general be engineer m w t tody tbo proB nslkediapenkn. The problem ilyaed to determine die applicafigation, endosure, wetting, local general ventilation, stances, substitution of non-hazial, o r aon-dwt-prodneing oper ate specific application, and they placed first This im plies plant I am convinced that many bad ire bad because plant engineering 1 In die designing of exhaust tiled to capture die dint a t die eratioti, die physical behavior of oward hoods and in ducts must n d that knowledge used. Each a s i i t of collection hoods, pip ing plant and a source of suction, ing a hood for a job die engineer lost dispersion try dynamic pro sit as dust dispersion by air curssign the hood accordingly. Cnowledge Needed lymumc characteristics of suction r to be little known because little s given to them in designing hoods which can be found everyidtistry. All the possibility for met and much of the efficiency of lies in this factor. Air velocity, n, and rate of air flow are all they must be known. It is essengh velocity of air in certain types tystems to entrap dust projected cities as in the case of a granite chine, and low velocities must be ers, as in the case of cleaning re of dust to prevent wasting of air and its velocity must be then the piping should be deike into account the behavior of Mtgh pipes at low and high veloce the problem is complicated by ted panicles which go along with t, how these behave must be taken - Pressure losses are very impor ts in die design of an exhaust Industrial Dusts 95 system. Lots at the hoods, loss at die bends, and loss in the ducts most not be guessed a t Pipe design must take into account the gage of the metal and reinforcing to withstand pressures and erosion. The selection of a b n and its motive power is a matter of calculation, not guess work. Power consumption in the system is calcula ble, fans follow certain laws, so the engineer must know die behavior of a n a l flow, pro peller type, radial flow, paddle wheel and other fan performance. More physics and engineering calculation goes into the air-cleaning apparatus. The selection 'of gravitation, inertial or filtration method depends upon what the dust is, die calculation for any methods requires knowl edge of discharge through stacks, the deter mination of sizes of settling chambers; the behavior of cyclones. The use or non-use of a filter, and if so, what type, how it should perform, how big it should be, what land of resistance and how much each kind offers, to say nothing of their proper location with relation to cleaning, accessibility, etc* are all items for accurate engineering determination. Apparatus to check the behavior of installa tions must be known and used. Performance cannot be left to guess work. Supplying suffi cient air to be exhausted is part of the prob lem. The same may be said of heating. Do I give the problem too severe a build up ? I think not. Remember these two things: 1. You are dealing with hazardous mate rial so small in size and so little of it by weight that it is as invisible as the air that bears it. 2. Physical laws involved in the behavior of dust and air do not permit inexpensive methods of control. I am acquainted with budgets set up for this purpose which amount to more than a quarter of a million dollars, and I know of many where 60 to 80 thousand dollars is involved. The need for this much engineering is rec ognized by men who know. Already much has been done toward getting the knowledge into handbook shape. Perhaps the best job of this sort to date is "Fundamentals Relating to the Design and Operation of Exhaust Systems" developed under American Stand ards Association procedure. The Doctor's P art in Controlling D ust Hazards By A. D. LAZBNBY, M.D., F.A.C.S. Chief Surgeon, M aryland Casualty Co., Baltim ore, M aryland Considerable confusion has existed in the past as to just what is the physician's func tion in the prevention of dust diseases, and just wh^t is the engineer's. It is very ob vious upon even casual thought that the two sciences must work hand in hand in their efforts to solve the problem. The physician through his special training must be able to tell the engineer what dusts are dangerous and what are not. He must know how those dusts enter the body and the manner in which they do their harm. He must be trained in the examination of per sons who are to be employed to work in dust, and to discover those who are already diseased, or are peculiarly susceptible to dust disease. He must be able to detect the first signs of disease in workers who arc exposed to dust, and must be prepared to recognize the disease when it is fully de veloped. It is not necessarily the physician's func tion to analyze dust. That is a task for the chemist and the petrographer. It is not the physician's function to ccunt the particles of dust in a given industrial atmosphere. That, in reality, is the function of the engineer. It is not the physician's function to devise ventilating equipment for the removal of dust, nor even, to be more than an adviser as to the means that must be adopted to render the atmosphere safe. The physician nevertheless must correlate with his medical knowledge am with his studies of the industrial worker the findings of the engineer. A diagnosis of silicosis, for example, requires not merely characteristic occupational history and characteristic physi- J 96 Twenty-sixth National Safety Congress cat finding, but the knowledge as well that the patient has been exposed to hazardous dusts in dangerous concentrations. We have no real knowledge as to true figures, but as a simple rule, we can adopt for practical purposes, die thought that the worker himsel: and the public ing susceptibili AH dusts when inhaled in excessive human body can withstand successfully a Compli quantities may be considered as harmful, but concentration of dust containing 100 per cent only a few can be regarded as dangerous. silica dioxide in a particulate size less than Silicosis per From the standpoint o f their dangerous 10 microns, in a concentration not in excess as a complica properties, they may be divided into three of 5,000,000 particles per cubic fo o t If we recovers desp general groups. decrease the percentage of silica dioxide vidua] so affl present in the dust, we can correspondingly abled himself, 1. Those which are dangerous because of increase the concentration with comparative with whom he their poisonous action, such as lead, arsenic, safety. We m ust of course, take into ac the fellow w< It f mercury, and similar substances. count the portion o f the worker's time spent So perhaps t 2. Those which cause only irritation in the in the dusty atmosphere. which the sen respiratory tract, resulting in such condi To arrive at a rough conception of a safe tions as bronchitis or to o l inflammation; atmosphere, we multiply the percentage of trade are nect discovering a such substances as vegetable fibre, cork dust, flour, starch, and other relatively innocuous organic or inorganic materials. free silica in a given dust by the total num ber of particles per cubic fo o t If the result is under 5,000,000 the condition may be con a silicious du ready have a ondly, discov< 3. Those which tend to produce fibrosis of the lungs, thereby predisposing to respira tory infections, especially tuberculosis, such sidered relatively safe. If the result is over 5,000,000 the condition must be regarded as unsafe. posed to dus whom tuberc veloped. dusts as asbestos, silica dioxide or mag nesium silicate. I shall confine my remarks chiefly to dusts occurring in the latter category. It has been generally believed that the harmful effects of dusts inhaled into the lungs depended more upon their physical structure than upon their chemical. It was believed, for example, that silica dioxide, or quartz, was particularly harmful because of its crystalline structure, and the hardness and sharpness of its particles. This concep tion is now known to be faulty. The dusts which cause their damage by mechanical in terference with function are the dusts which are relatively innocuous, whose symptoms are transitory, and which subside upon re moval from exposure to the dust. Chemical Effect la Harmful The disease of particular interest to us today, silicosis, owes its harmful effects very largely to a harmful chemical reaction oc curring between silica dioxide and the body tissues. It so happens that silica dioxide is decidedly a tissue irritant to the body, re gardless of the part of the body it invades, it causes local irritation, local destruction of tissue, and the replacement of that tissue by scars. Thus, given a dust containing silica diox ide in sufficient concentration, in sizes small enough to perm it its entrance to the ultim ate air spaces in the lungs, we have a situation which offers danger to th e worker. 'Bear in mind too that silicosis is essentially a disease of great chronicity. Except in a few exceptional instances it will require from seven to thirty years for a worker to develop advanced silicosis. It is evident too that coincident dusts may either retard the development of silicosis or hasten it. Recent research seems to indicate that the admix ture of aluminum dust to a silicious dust will greatly inhibit the reaction of the latter; whereas a silicious dust combined with some alkaline coincident dusts may hasten the de velopment of silicosis. Much research is now under way in prob lems such as this. We have never learned how to cure silicosis, but we are learning rapidly how to prevent it. Our knowledge in this respect seems to be limited to the removal of dust from the breathing zone of the worker. Later discoveries may show us how to modify existing dusts with contaminant dusts that will render silica dioxide innocu ous. Owing to its very great chronicity, it is only the rare case who actually develops disabling silicosis during his industrial life time. It is realized, of course, that excep tional instances take place, but the coincident ravages of age usually keep pace with the effects of dust, so that much nt the dis ability usually attributed to silicosis is often, in fact, actually attributable to other dis eases or incapacities which advancing years bring in their wake. To me the great peril of silicosis, the peril not only to the industrial It is well should be ex dioxide until physical exa made and ii chest. It is miliar w ith i exposed to < the privilege tions and xto discover tl but to disco such exists. A man so himself and in contact, l me emphasi: examination properly tal of gross tub It s tlie I fore, to coni gent manne tion of ail in a dusty animation discover an any person culosis in ; rested state A possib individuals prim ary co fection. It X ss a! knowledge u to true taple rule, we can adopt oace. the thought that the withstand successfully a ast cowtaining 100 per cent pt rtim lttt else less than racw rtritk not in excess ks per cubic foot If we xntage of silica dioxide t, we can correspondingly ntratioo with comparative of course, take into acof the worker's time spent phere. ough conception of a safe mltipty the percentage -of im dust by the total num* cubic foot If the result die condition may be eonn f e If the result is over itioa must be regarded as >that silicosis is essentially t chronitity. Except in a in^ ances it will require irty years for a worker to sihoosis. It is evident too ists may either retard the licosis or hasten i t Recent > indicate that the admixa dust to a silicious dust t the reaction of the latter; s dust combined with some t dusts may hasten the dex>tis. is now under way in probWc have never learned how Mt we are learning rapidly i t Our knowledge in this ie limited to the removal of thing zone of the worker, s may show us how to dusts with contaminant mder silica dioxide iimocu- reiy great chronirity, it is sse who actually develops i during his industrial lifesed, of course, that excepake place, but the coincident usually keep pace with the so that much nt the dis tributed to silicosis is often, attributable to other disties which advancing years Im. To me the great peril of il not only to the industrial Industrial Dusts 97 worker himself, but his family, co-workers and the public generally, is the accompany ing susceptibility to tuberculosis. Complicated by Tuberculosis Silicosis per se does not kill. Tuberculosis as a complicating factor o f silicosis rarely recovers despite treatment, and the indi vidual so afflicted is not only totally dis abled himself, but a definite menace to all with whom he comes in contact, particularly the fellow worker who may have silicosis. So perhaps the most important places in which the services of the physician in a dusty trade are necessary are--first, along lines of discovering and barring from exposure to a silicious dust those persons who may al ready have arrested tuberculosis; and sec ondly, discovering those persons already ex posed to dust, possibly already silicotic, in whom tuberculous infections may have de veloped. It is well recognized that no individual should be exposed to dust containing silica dioxide until he has undergone a thorough physical examination, including carefully made and interpreted x-ray films of his chest. It is likewise obvious to anyone fa miliar with silicosis that no person who is exposed to silicious dust should be denied the privilege of frequent physical examina tions and x-rays of the diest, not entirely to discover the existence of possible silicosis, but to discover a coincident tuberculosis if such exists. A man so diseased should, in protection to himself and to all with whom he comes in contact, be removed from industry. Let me emphasize the uselessness of a physical examination, unless it be accompanied by properly taken x-ray films, except in cases of gross tuberculosis. It is the function of the physician, there fore, to conduct in a thorough and an intelli gent manner the pre-employment examina tion of all persons who are to be engaged in a dusty trade. The purpose of this ex amination should be threefold. First, to discover and bar from employment in dust, any person who is suffering from tuber culosis in an active, a quiescent or an ar rested state. A possible exception might be made in individuals suffering from a so called healed primary complex, or a healed childhood in fection. It :s well known that exposure to silica dioxide is very likely to excite into activity a turbcrculous lesion which may be quiescent or arrested, and once such a lesion is reactivated, the chances of recovery are remote. The second problem which confronts the physician at the pre-employment physical ex amination is whether a given individual is, by reason of secondary physical defects, more susceptible to the development of sili cosis than a normal. Is he suffering from diseases of the nose or upper respiratory tract, such as chronic sinusitis, disease of the lungs or air passages, or obstructions which produce mouth breathing? We must remember that silica dioxide is not dangerous until it reaches the lungs, and that the normal individual retains in the nose and the upper air passages a large quantity of the dust inhaled from the atmos phere. In instances where this nasal reten tion is disturbed, exposure to silica dioxide dust may be dangerous to that individual, where it would not be to another. It is believed that certain diseases of the heart and circulation, of the kidneys, possi bly syphilis, chronic coincident diseases of the lungs, all may render a man more sus ceptible to silicosis than normal. The physi cian at his pre-employment examination must follow certain established criteria in this respect, and bar from expo ,ure to dangerous dusts those persons who through existing disease may be more ready prey to silicosis or tuberculosis. Re-Examination Needed After the applicant for employment has successfully passed his physical examination and is engaged in a dusty trade, the duty of the physician is not yet ended. This work man must be periodically re-examined, first to discover the early appearances of pul monary fibrosis, but what is even more im portant, to detect the early evidences of complicating tuberculous infection. A man should not be dismissed from em ployment in a dusty trade merely because he has evidences of non-disabling silicosis. Workers in dusty trades, especially stone cutters, moulders, pottery workers, and similar craftsmen, are usually highly skilled, and it seems unfortunate from a social and economic point of view to deny the. em ployment so long as they are physically able to carry on, especially since the actual dis abling qualities of silicosis are in doubt. Twenty-sixth National Safety Congress They should be denied employment in a dusty trade if that condition is found at pre-employment examination, but they should not be barred from continuing an employment in which they are already en gaged. O f course, in such instances you, as engineers, must realise that yoa have failed, because if you had kept the breathing zone of the worker free from dangerous dusts, silicosis would not be present on physical examination. In this work of preventing dust diseases in industry, it should be evident that the closest and most intelligent cooperation between the physician and the engineer is necessary. The physician must, through his knowledge and research, tell the engineer what dusts, or, for that matter, what other substances used in industry are harmful. He must tell the engineer how such dusts or other materials enter the body, how they leave the body and what they do in their passages through or their resid e in the body. M ust Make Analyses The engineer must in turn tell the physi cian of the harmful dusts and other sub stances surrounding his .workers. He must make chemical and petrographic analyses of the dusts, and other indicated analyses of the atmosphere in the workshop. He must make dust counts and check his counts at regular intervals, conferring with the physician m an effort to discover whether, in the light of their joint knowledge, working conditions are dangerous. He must develop and install carefully designed ventilating equipment He must arrange for modification of chemical and other industrial processes, where such modification is oossibie, and must bend his efforts toward removing from the danger zone of the worker the offending substance, whatever it may be. Too many engineers construe this function loosely. They pass on to die physician as his responsibility certain functions which es sentially are theirs; such functions as dust analyses, dust counts, and similar technical duties. All too often it is considered ade quate merely to install a fan. Ventilating devices in dusty work rooms must be constructed only after careful en gineering study has given a knowledge of the physical properties of the air and of substances polluting it. It is possible to calculate to a very fine point the volume of air that must be removed from a given spot to remove the dust originating at that place, and the engineer must approach his task from just as scientific an angle as the physi cian approaches his. There is no room in industry for hap hazard methods on the part of either the physician or the engineer. ADJOURNM ENT Steam Railroad Meeting WEDNESDAY AFTERNOON SESSION October 13, 1937 The session was called to order by W. W. more, Md., who presided, introducing the Wood, Baltimore and Ohio Railroad, Balti speakers and directing the discussion. The Past, Present and Future of Railroad Safety By J. M. SYMES Vice President, Operations and Maintenance Department, Association of American Railroads, W ashington, D. C. No industry in the world requires more diversified study and more exacting applica tion of safety principles than the steam rail road industry. Picture a quarter of a million miles of railroad line covering in a virtual network the vast expanse of the United States. Over this network are operated a billion train miles annually. Vast yard and terminal operations are necessary to make up the beginning of the journey of passengers and goods, and to break up at the end of that journey the 12 piillion trains that accumulate that billion miles. These trains carry 500 million passengers and one billion tons of freight annually. It requires more than one million railroad employees to run the trains, make them ready for road movement, su pervise and safeguard their movement and maintain the equipment and roadbed, as well as perform the many other duties incidental to the production of railroad transportation. Safety has in the past, is today, and always will be the first principle in railroad opera tions. But it is within the past fifteen years that greatest advances have been made in railroad safety. During that period we have seen a complete remodeling and moderniza tion of railroad physical properties. Road beds have been strengthened; bridges, trestles and culverts rebuilt; tracks have been laid with heaviir rail and with treated ties of greater service life and de pendability; grades and curves have been eliminated or reduced; signal systems have been modernized and extended; other safety devices have been installed; new and more powerful locomotives, embracing all modern safety devices, have been purchased; new cars, both freight and passenger, have been installed. This capital improvement program has cost the railroads about eight billion dol lars since 1923, and a large part, if not all, of that huge sum had a beneficial effect, di rectly or indirectly, on the safety of opera tions. But the engineer's job is never done. As soon as new equipment, new rail, or other devices are installed the engineers go to work to develop more efficient and safer units. The railroads spend millions of dollars annually in research and laboratory work experimenting with engineering improve ments. In all this work safety is of primary importance. An invention which might mean great economies to the railroads would not find its way to a single locomotive or car if its use in any way lessened the opportunity for safe operation. Conversely, any improve ment, mechanical or otherwise, promoting safety of operation immediately commends itself to railroad officers and employees. The search for greater safety will continue so long as railroad transportation is used. About a quarter of a century ago, the 587 S IliV E It (ju b ile e SBFETV CONGRESS NATIONAL SAFETY ' ayrffhl, 19St, Ndtaaal Maty CmMN>h e Mated la * U. S. A COUNCIL, in c. Foreword THE Transactions of the Silver Jubilee Congress and E x position of the National Safety Council, October 10-14, 1938, are published in two volumes. Volume I contains the general and subject sessions and the sessions of the various Industrial Sections. Volume II contains the Street and Highway Traffic, the Commercial Vehicle, the Transit, the Child Education, and the Home Safety sessions. Volume I is distributed automatically to all industrial mem bers of the Council. Volume II is sent to members who are believed to be interested chiefly in the sessions it contains. However, other Council members may obtain Volume II upon request. Many members have found it of benefit to distribute copies of the Transactions volumes to both executives, foremen and supervisors, who have used th practical information they contain in safety programs and for general reference pur poses. Extra copies of the Transactions may be obtained as follows: One to 10 copies of Vol. I, at $2 each ; II or more copies, $1.75 each. Extra copies of Vol. II cost 75 cents each. THE Transactions are a condensed record of the pro ceedings of the Silver Jubilee Congress. The papers and addresses have been edited to delete extraneous matter, ab breviate the less important portions, and emphasize what may be of particular usefulness and value in promoting ef fective safety organization and other accident prevention measures. These volumes, therefore, are a somewhat abridged version, compact, practical and of particular value to the student and executive interested in achieving more thorough accident prevention success. The original manu scripts are available for additional reference, if desired, in the files of the National Safety Council. THE National Safety Council, at its Congresses, seeks to eliminate from discussion matters which are not pertinent to the aims of the Congress or which may be contrary to the Council's policies. It cannot accept responsibility, however, for all views expressed either in the papers which have been delivered or in the discussions based upon these papers. NATIONAL SAFETY COUNCIL,!. 20 North W acker Drive Chicago N atio n al Safety Council, Inc H O N O R AR Y MEMBERS A ssociation of I ron and S teel E ngineers Robert W . C ampbell L ew R. P almer OFFICERS (1938-1939) I). I). F ennell, President C. W . Dempesy, Vice-President for Finance and Treasurer F rank H. H arrison, Vice-President for Industrial Safety Dr. M iller McCmntock, Vice-President for Public Safety W alter S. P aine, Vice-President for Engineering A. V. Rohweder, Vice-President for Safety Councils R. T. Solensten, Vice-President for Membership A. W . W hitney, Vice-President for Education W. H. Cameron, Secretary and Managing Director EXECUTIVE COMMITTEE (1938-1939) H. J. A ldrich, Spencer Kellogg & Sons, Inc. J. I. Banash, Past President C. W. Bergquist, Past President H. W. Bogoess, Sinclair Prairie Oil Company C. B. Boui.et, W isconsin Public Service Corporation Robert W. Campbell, Past President W. H. Cameron, National Safety Council, Inc. L. C. Campbell, Mining Section Robert I. Catun, Aetna Casualty & Surety Company L ewis A. D eBlois, P ast P resident C. \ \ . 1)empesy, The Liquid Carbonic Corporation R. E. Donovan, A S S E -Engineering Section Marcus A. Dow, Past President W ai ter A. E verson, Lehigh Valley Safety Council E arl E. Grover, Safety Council o f the Columbus Chamber o f Com merce I). I). Fennell, Consulting Engineer H arry Gitlhekt, The Pullman Company F rank H. H arrison, International Harvester Company H arold G. H offman, Unemployment Compensation Commission, New Jersey S. B. H orkei.l, Food Section H. H. K elly, Interstate Commerce Commission O FFICERS A N D DIRECTO RS, Continued W alter G. K ing, Past President Wm. C. K noelk, Milwaukee Safety Commission J ohn . Long, Past President T hos. H . MacDonald, U. S. Department of Agriculture A rthur W. M agee, Commissioner of Motor Vehicles, New Jersey Dr. M iller M cClintock, Y a k University R. S. M etzger, Public Utilities Section I. W. Millard, Industrial Gloves Company H arold L. Miner, E. I. du Pont de Nemours & Company E liot N ess, Director of Public Safety, Cleveland E. J. O 'Brien, J r., Louisville Safety Council W alter S. P aine, Aetna Life & Affiliated Companies L ew R. P almer, Past President C. E. P ettibone. Past President B. O. P ickard, Marine Section A lbert S. Recula, Industrial Relations Counselors, Inc. Lt. Col. H enry A. R eminder, Past President E. A. Roberts, Textile Section A. V. Rohweder, Duluth, Missabe & Iron Range Railway Company George E. Sanford, General Electric Company Charles B. Scott, Past President P rank T. S heets, Portland Cement Association Gen. J ohn H . S herburne, Massachusetts Safety Council C. W. S mith, Standard Oil Company (Indiana) W aiter D ent S mith, Delaware Safety Council W. A. S now, Construction Section R. T. Solensten, Elliott Service Company L eslie J. Sorenson, City Traffic Engineer, Chicago Col. J ohn Stilwell, Consolidated Edison Company o f N. Y., Inc. C. P. T olman, Past President George G. T raver, Greater Chicago Safety Council, Inc. I >r. B. L. Vosbuhch, General Electric Company D r. C. H. W atson, Past President A. W . W hitney, National Conservation Bureau D. A. Barret, Carnegie-Illinois Steel Company A rthur H. Young, Past President DIRECTORS (1938-1939) H. J. A ijqrich, Spencer Kellogg & Sons, Inc. A. L. A rmstrong, Eastman Kodak Company J. I. Banash, Past President C ari. Barker, St. Louis Safety Council L eo H. Bkaulac, Blackstone Valley Safety Council W. A. Bechill, Automotive & Machine Shop Section E rnest W. Beck, United States Rubber Products, Inc. O FFICERS A N D D IRECTO RS, Continued C. W. Bergquist, Past President . F. Blank, Jones & Laughlin Steel Corporation H. W. Bogcess, Sinclair Prairie Oil Company H. E. Bolt, South Bend Civic Safety Council C. B. Boulkt, Wisconsin Public Service Corporation F. S. Brown, Standard Accident Insurance Company J. H. Bkown, Petroleum Section W. A. Brown, Safety Dept., Nashville Chamber of Commerce R. A. B ullock, Rubber Section W. H. Cameron, National Safety Council, Inc. L. C. Campbell, Mining Section Robert W. Campbell, Past President R aymond A. Casey, Evanston Safety Council Ray Carney, Kenosha Safety Council Robert I. Catlin, Aetna Casualty & Surety Company M aurice Chaillet, Rahway Safety Council L. O. Cheever, Employees' Publication Section W m. M. Clark, St. Joseph (Mo.) Safety Council K enneth B. Colman, Seattle Traffic & Safety Council J. E. Culuney, Bethlehem Steel Company F rank J. D ean, Kansas City Safety Council L ewis A. D eBlois, Past President C. W. D empesy, The Liquid Carbonic Corporation R. E. Donovan, ASSE-Engineering Section J ames B. Douglas, The Philadelphia Gas Works Company Marcus A. Dow, Past President D r. Louis I. D ublin, Metropolitan Life Insurance Company O. M. E dwards, J r., Safety Div., Syracuse Chamber of Commerce W. A. E verson, Lehigh Valley Safety Council D. D. F ennell, Consulting Engineer Donald A. F inkbeiner, Toledo Safety Council Dr. H art E. F isher, Chicago Rapid Transit Company Chester C. F isk, Berkeley Traffic Safety Commission H oward B. F onda, Burroughs Wellcome & Co. (U S A.) Inc. A rthur C. F rey, Worcester Safety Council J ohn B. Gibson, Western Electric Company L yle H. Gift, Peoria Association of Commerce Safety Council H oward F. Gilbert, Elizabeth Safety Council E dgar H. Gorsuch, Grand Rapids Safety Council W. A. G riffin, American Telephone & Telegraph Company E arl E. G rover, Safety Council of the Columbus Chamber of Com merce H arry Guilbert, T h e Pullman Company C. H . H arper, Refrigeration Section D. T. H arrington, United States Bureau of Mines F rank H. H arrison, Internationa! Harvester Company Corporation ompony Council ce Corporation ance Company ; Chamber of Commerce ncil, In c y Council :tl Surety Company Council on Section ety Council Sc Safety Council npany i Council : Corporation Section . Gas Works Company J f e Insurance Company racuse Chamber of Commerce ty Council ety Council Transit Company lafety Commission lcome & Co. (U.S.A.) Inc. ' Council Company f Commerce Safety Council ety Council Safety Council e & Telegraph Company the Columbus Chamber of Com * tmpany ion lureau o f M ines Harvester Company -J Chas. E. H ill, New York Central Lines H ahold G. H offman, Unemployment Compensation Commission, New Jersey E verett H ord, Madison County Safety Council S. B. H orrell, Food Section F red B. H unt, Cement & Quarry Section W m. F. J ames, Philadelphia Safety Council T . B. J ohnson, Commercial Vehicle Section T homas P. K earns, Industrial Commission of Ohio H. H. K elly, Interstate Commerce Commission W alter G. King, Past President W m. C. K noelk, Milwaukee Safety Commission W m. S. K nudsen, Detroit Industrial Safety Council O tto C. K uhrt, Greater Springfield Safety Council C. L. L aF ountaine, Great Northern Railway Company J. H. L ee, Wood Products Section M illard C. L efler, Child Education Section J ohn E. L ong, Past President T hos. H. M acDonald, United S tates Department o f Agriculture R obert A . M cA rthur, T ra n s it Section D r. M iller M cC untock, Yale University A rthur W. M agee, Commissioner of M otor Vehicles, New Jersey F. W. M atson, Minnesota Safety Council R. S. M etzger, Public Utilities Section I. W. M illard, Industrial Gloves Company H arold L. M iner, E. I. du Pont de Nemours & Company R. B. M orley, Industrial Accident Prevention Associations P rof. Roger L. Morrison, Street & Highway Traffic Section E rnest M urphy, Albany Safety Council C. L. M urray, Mason City-Cerro Gordo County Safety Council E liot N ess, Director of Public Safety, Cleveland E. J. O 'Brien, J r., Louisville Safety Council George C. A. O pp, The Detroit Edison Company W alter S. P aine, Aetna Life & Affiliated Companies L ew R. P almer, Past President David A. P atton, Newark Safety Council C. K. P eacock, Chattanooga Safety Council Charles W. P endock, Safety Division, Milwaukee Association of Commerce C. E. P ettibone, Past President B. O. P ickard, Marine Section A lbert S. R egula, Industrial Relations Counselors, Inc. D r. A. R. R einke, Contra Costa County Safety Council L t. Col. H enry A. R eninger, Past President P hillip C. R hoads, M eat Packing, T anning & L eather Industries Section L O FFICERS A N D DIRECTO RS, Continu'd A. C. Rissrercer, Rochester Safety Council M arines Riter, Paterson Safety Council E. A. Roberts, Textile Section Bestor Robinson, Eastbay Safety Council F. A. Robinson, Paper & Pulp Section H. E . Rockhoff, Power Press Section R alph L. Rogers, J r., Chemical Section A. V. Rohwedek, Duluth, Missabe & Iron Range Railway Company W alter Rosenbaum, Western Pennsylvania Safety Council G. E. S anford, General Electric Company H enry G. S chaffner, Erie Safety Council H arry A. Schultz, United States Steel Corporation of Delaware Charles B. Scott, Past President E arl S. S hartzer, Utica Safety Council F rank T. Sheets, Portland Cement Association Gen. J ohn H . S herburne, Massachusetts Safety Council D r. L. A. Shoudy, Bethlehem Steel Company E rnest L. Simonds, New Haven Safety Council J udge L ee E. S keel, Cleveland Safety Council C. W. S mith, Standard Oil Company (Indiana) W alter D ent S mith, Delaware Safety Council W. A. S now, Construction Section R. T. Solensten, Elliott Service Company L eslie J. Sorenson, City Traffic Engineer, Chicago E. C. S pring, Philadelphia, Pa. Georce R. Stephens, Safety Bureau, Buffalo Chamber of Com merce Col. J ohn Stilwell, Consolidated Edison Company o f N. Y. Inc. A kthur M. T ode, Consulting Marine E ngineer C. P. T olman, Past President M ei.l E. T rammell, Metals Section G eorge G. T raver, Greater Chicago Safety Council, Inc. Major R. D. T rimble, Richmond Safety Council F rank E. V itz, Superior and Douglas County Safety Council Dr. B. L. V osburch, General Electric Company D r. David E. W eclfjn, Baltimore Safety Council Dr. C. H. W atson, Past President G. W ise W escott, Safety Dept., Auto Club of Rhode Island S. E. W hiting, Liberty Mutual Insurance Company A. W. W hitney, National Conservation Bureau Charles E. W ilson, General Motors Corporation F. B. W inslow, Safety Div., Birmingham Chamber of Commerce W . E. W orth, International Harvester Company A rthur H. Young, Past President E. J. Z auft, Safety Bureau, Duluth Chamber of Commerce 8 Occupational Disease THURSDAY MORNING SESSION October 13, 1938 The session for the discussion of out standing problems in the field of occupa tional disease was called to order by the Hon. P. J. ngsten, 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. 8AYER Manager of the Casualty Department, Association of Casualty and Surety Executives Let us consider the differences between the accidental injury and the occupational disease. For these distinctions are important and must constantly be borne in mind when we consider either legislation on the sub ject of disease, or engineering methods of prevention or control. Generally speaking, accidents occur at a specific moment in point of time, and, from the standpoint of fixing liability under any policy of insurance, it is in the future; that is to say, at the moment of the acceptance of liability under any insurance contract the accident for which liability may be as sumed has not yet happened. That fre quently is not so with the occupational dis ease. Insurance by its very nature can only assume liabilities that have yet to arise--not those that have already accrued. Again, speaking generally, the industrial accident is something that can be seen-- even though unforeseen. It may be visual ized and described in words, setting forth specifically the time, place and manner of happening. It can then be determined, after the happening of the event, whether it was preventable or inevitable; blame, if any, can be assessed; the worker involved, or his foreman or superintendent, can be shown the fault, and effective measures can be taken to guard against a like future hap pening. But some will say, truly, not all accidents happen in the manner described; that not always are they held to occur only at a specific moment or under circumstances where they can be visualired and described. By administrative and court decisions, it is true in some jurisdictions that the definition of "accident" has been greatly 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. (Hiera v s.'H ull, 178 App. Div. 350, 164 N.Y. 767, an anthrax case; Vennen vs. New Dell Dum ber Co., 161 Wia. 370, a typhoid case; and others.) Poisoning of the body through the effects of a deleterious or toxic substance used in the employment, the 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. Franck*, 147 Maryland, 568; and the very recent cac of Black ra. Crtaton Auto Co., Iowa Supreme Court, August 5. 1938, 281, N.W. 189.) And where negligence of the employer has been shown, an injury to health, even though not occurring through a happening at a given time and place, but by repeated 211 2U Silver Jubilee Safety Congress exposures over months of time, has been held to be an accident. (McNeely vi. Carolina Asbestos Co., 206, 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 cove ing 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 (he 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 arc 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. Hut when we come to add to the doubt ful term "disease" the even more indefinite term "occupational" or "industrial," we find ourselves in an area of highlight sur rounded by a vast and increasing zone of twilight shading off into Erebian night. Ju st 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 include the well-known metallic and chemical poi sons that are so definite and characteristic a part of some industrial processes. Were the diseases arising from the use of these substances the only occupational diseases with which we need concern ourselves, the legislative difficulty would be largely re moved, and we could safely entrust the problem to the doctor and the engineer. But we have seen that the legislative problem is not so simple. Nor is it simple administratively. We find ourselves floun 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 rec ognize the difficulties and the limitations on what industry can do, or can fairly be ex pected to do, we could much more con fidently face the future. If we could agree that provision for "occupational diseases" is not synonymous with general health and life insurance for industrial workers at indus try's expense, then I am sure we could get somewhere very definitely. But has there not been too much loose thinking on the subject? We are met with a curious situation. We find the advocates of so-called "all-inclusive" statutory cover age deliberately seeking indefiniteness. This is unlike them, for when they know what their objective is, and are willing to dis close it, they have not refrained from press ing their advantage with definite and spe cific purpose, and with exact language to accomplish that purpose. That, at any rate, is correct legislative procedure. But in this field, even where the liability of the employer is made inescapable, the constant suggestion is put forth that it is futile for the legislature to attempt a defi nition or delimitation of occupational dis eases, and, therefore, words of the most general character should be employed, leav ing to the courts the interpretation of the law as they see fit. I submit that it is not 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 avoid and evade responsibility by transferring to courts and commissions the determination of questions of liability which the legisla ture finds too difficult for it to determine for itself. press r administratively. These include town metallic and chemical poiire so definite and characteristic some industrial processes. Were :s arising from the use of these the only occupational diseases i we need concern ourselves, the difficulty would be largely re el we could safely entrust the the doctor and the engineer. have seen that the legislative not so simple. N or is it simple tively. W e find ourselves fiount veritable morass, either because erent difficulties of the situation, : we have not or cannot agree iective. If all parties would recdifficulties and the limitations on itry can do, or can fairly be exdo, we could much more con:e ti e future. If we could agree ion for "occupational diseases" is mous with general health and life for industrial workers at indusise, then I am sure we could get ; very definitely. there not been too much loose i the subject? We are met with situation. We find the advocates d "all-inclusive" statutory coverately seeking indefiniteness. This hem, for when they know what :tive is, and are willing to disey have not refrained from pressidvantage with definite and spe>se, and with exact language to that purpose. That, at any rate, egislative procedure. his field, even where the liability iployer is made inescapable, the uggestion is put forth that it is the legislature to attempt a defidelimitation of occupational dis, therefore, words of the most sracter should be employed, leav- courts the interpretation of the y see fit. I submit that it is not >n of the courts to make up the mind; that is the function and and the duty of the legislature, d the legislature seek to avoid responsibility by transferring to t commissions the determination ns of liability which the legislatoo difficult for it to determine Occupational Disease 213 To effect coverage under the compensa tion law, therefore, by any such general and vague language as the term "any and all occupational diseases," or by adding to the definition of "accidental injury" the phrase "and shall include occupational dis eases," is to create an uncertain liability-- one that may require endless and perhaps disappointing litigation-before the meaning of the law is established; and will most certainly be a disservice to workers and employers. An excellent rule--a cardinal rule--in statutory drafting, is to use words of defi nite, certain and understandable meaning, used in their common acceptance, rather Add to these pneumonia, asthma, arthritis, 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 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 than to resort to vague, uncertain and health! meaningless words, or words the meaning of which may have the effect of distorting the objective that is sought. Controversy is bred by uncertainty of language, and controversy leads to litigation in courts. Litigation is expensive for alt parties; it causes delay; and it frequently causes bitter disappointment. It breeds rancor. It may even breed disrespect for the law and for 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 orderly process of government. compensation for disease where wc depart Why then should there be this continuing from the known and characteristic occupa demand for the all-inclusive coverage? Is it with the vague hope that satisfaction may result in some cases of misfortune to workers who fall victims of the disease that besets us all and lurks in waiting for us in our play, in our homes, yes, and even in our sleep, as well as in our employment? Perhaps not--yet if that were the design, a more simple way of succeeding in it could not otherwise be contrived. Are we to understand that any disease of the most common and ordinary risk of life may become an occupational disease if its source or supposed source had its origin in an incident of the employment or a con dition there present, or if claim was made that a pre-existing disease had been ag gravated by such condition? That is a large order. It would mean that industry would become liable for any ordinary dis ease of life, provided that disease could be, with a show of plausibility, related to a condition or incident of the employment. Such diseases are almost too numerous to enumerate. But we know that claims have been made for .tuberculosis and heart disease, the two most numerous diseases and the cause of more deaths than any two other diseases. tional diseases. From these remarks perhaps some will say we are --------- ro,pp- ose- d to coverage occupational diseases under compensation !?w$. Not so! The stock casualty companies represented in the Association have not o p posed and do not oppose the principle of compensation for occupational diseases, if thereby is meant compensation for those diseases that arise from a "trade risk," o r from conditions that are normally and usu ally present in the particular employment, as distinguished from those ordinary hu man ills that beset all of us. Our view of it is that the policy of coverage under the law is a matter of local concern, to be d e termined by local legislatures in the light of local demand and with due regard to local opinion of both labor and industry. No employer in this age can reasonably object to fair compensation for disease arising from such occupational risks, any more than he can object to reasonable com pensation for disabilities due to accidental injuries. This conception of industry's obligation is, however, quite different from the con ception of a public obligation to care for 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 which the worker is engaged. Industry will, I am sure, meet the chal lenge of the occupational disease problem, 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 co ditions 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 universal. If we will keep ever before us the prin ciple that a disease, to be deemed occupa 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 teristic of chemicals, of acids, of alkalies, gases and fumes, are characteristic of and peculiar to those occupations in which the employees are so exposed. The diseases of the respiratory system, due to the inhala tion of dusts, are the natural accompani ment and the characteristic effect of work in such dusts. When such clear and specific language i` 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 acteristically the obligation of industry, why continually insist upon the use of lan guage which is susceptible of misinterpre tation? Be well assured, if legislatures do not perform their duty and lay down clear definitions of liability, industrial boards and commissions cannot in the presence of the widows, orphans, and industrial cripples, lie expected to exercise greater courage than the legislatures. The law in the hands of such an administrative body will be scanned, and I fear scanned in vain, for limiting words or language to stay the hand of industry's self-constituted almoner. The legislative trend, I am happy to re port, in recent years has been toward the definite, rather than the indefinite. Despite tremendous pressure, no legislature has, in the past three years, adopted a blind, "all-in clusive" occupational disease law, except New York, of which I shall speak more in detail presently. Michigan, Rhode Island, Pennsylvania, Delaware, North Carolina, and Washington, among the states most recently enacting occupational diseases laws, have adopted the "schedule" or specific method of coverage. Two years ago, Ohio amended its scheduled occupational disease law by adding dust diseases to its existing schedule. In two other states, namely, Illi nois and Indiana, occupational disease laws have been enacted in general terms. How ever, in identical language, these two states have undertaken to limit and define occupa tional diseases and have attempted therein to safeguard industry against liability for the diseases of ordinary life. Although doubtless familiar to many, the 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. "Sec. 6. In this Act the term `Occupa tional Disease' means a disease arising out of and in the course of the employment. Ordinary diseases of life to which the gen eral public is exposed outside of the em ployment shall not be compensable, except where the said diseases follow as an in cident of an occupational disease as defined in this section. "A disease shall be deemed to arise out of the employment, only if there is apparent to the rational mind upon consideration of all the circumstances, a direct causal con nection l>etween the conditions under which ; obligation of industry, w*i*t poo the use o f tenw w p t i Ms o f misinterpret assured, if legislatures do r duty and lay down dear Mhty, industrial boards and not in the presence o f the i and industrial cripples, exercise greater courage ires. The law in the hands nim strative body will be fear scanned in vain, for o r language to stay the 's self-constituted almoner. ! trend, 1 am happy to re rears has been toward the han the indefinite. Despite sure, no legislature has, in ars, adopted a blind, "all-inional disease law, except fhich I shall speak more in Michigan, Rhode Island, lelaware, North Carolina, t, among the states most ocv jpational diseases laws, he "schedule" or specific age. Two years ago, Ohio eduled occupational disease lust diseases to its existing 0 other states, namely, Illii, occupational disease laws ed in general terms. How1 language, these two states to limit and define occupaind have attempted therein dustry against liability for trdinary life. btless familiar to many, the ; laws of those two states tion, as indicating the extty in attempting to exactly tional disease. his Act the term `Occupameans a disease arising out course of the employment, es o f life to which the genxposed outside of the emnot be compensable, except diseases follow as an inmpational disease as defined tall be deemed to arise out ent, only if there is apparent mind upon consideration of tances, a direct causal conthe conditions under which Occupational Disease the work is performed and the occupational disease, and which can be seen to have followed as a natural incident of the work as a result of the exposure occasioned by the nature of the employment and which can be fairly traced to the employment as the proximate cause, and which does not come from a hazard to which workmen would have been equally exposed outside of the employment The disease must be incidental to th character of the business and not independent of the relation of em ployer and employee. The disease need not to have been foreseen or expected but after its contraction it must appear to have had its origin in a risk connected with the em ployment and to have flowed from that source as a rational consequence." Under this definition no industrial man ager can, with any assurance, be informed what his obligation is to his workman, and assuredly no workman suffering from dis ease can surely know whether he is en titled to compensation under that law. Of course, as is to be expected, litigation over the interpretation of this definition is al ready in progress in both of these states. And situations will arise constantly in the future where the facts will be such that only litigation in the courts will determine the liability o f industry, or the right of the worker to be compensated. The claims actually filed with the In dustrial Commission of Illinois already include undulant fever (a disease said to be commonly communicated by milk and meat products), tularemia, rheumatic fever, arthritis, rheumatic heart, heart disease, amebic dysentery, varicose veins, flat feet, athlete's foot, cerebral hemorrhage alleged to be due to overwork, syringomyelia, and nerve disorder. I have not mentioned the claims for characteristic occupational dis eases, such as silicosis, carbon monoxide poisoning, and the various other toxic con ditions which-clearly come under the Act. I have referred to the fact that New York, alone, has in recent years enacted a law covering occupational diseases in gen eral terms. New York was the first state, I believe, to enact an outright compensation law for occupational diseases. It did so in 1920. The law was a schedule type law. (It so happens that I had the privilege of being one of those who collaborated in the draft ing of that law.) We were dealing with a new subject We examined the existing laws in other countries and adopted the 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 dm 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. The legislature, having evaded the duty of defining the term "occupational disease," the Industrial Board, which administers the law, adopted a definition. That definition is well worth repeating: that the Board deems a disease to be occupational only when it is "characteristic of and peculiar to the trade, employment, or occupation" in which a worker was engaged This defi nition was adopted almost verbatim <n the Rhode Island and Michigan Laws, i !.: Appellate Division of the Supreme Court, however, declined to follow it, and by a vote of three to two, held that any disease that arises out of a condition incidental to the employment must be deemed to be an occupational disease. (Bishop v. Corner Sc Pollock, 251 Appellate Division, 492; Goldberg vs. 954 Marcy Corpora tion, 251 Appellate Division, 904.) The Goldberg case was appealed to the Court of Appeals--the court of last resort in New York. So completely do the facts in the Goldberg case bear out what I have said about indefinite liabilities under an allinclusive law, that they will bear repetition. Shirley Goldberg was employed to sell tickets in a moving picture theater. Her booth was on the sidewalk. It was kept heated, in cold weather, by a small electric heater, operated from a switch in the 216 Silver Jubilee Safety Congress booth. She contracted what she described as blotches or a rash on her legs. The blotches or rash she claimed were due to the alternate heating and chilling of her legs when she switched on or off the heater. They did not constitute a disability. How ever, on complaint to her employer, she was told to see her doctor. While on her way to see her doctor, on her own time, she slipped on the sidewalk and fell, fracturing an ankle. Although the day was cold and she testified there was ice and snow on the sidewalk, the claimant alleged that she fell solely due to weakness resulting from these blotches, and the Industrial Board so found; and found that the cause of the fall was an occupational disease, character istic of and peculiar to her employment. The Court of Appeals, in an opinion that bristles with logic and sound sense, struck this free-for-all system from the language of the New York Act. They unanimously refused to concede that this was an occu pational disease. To make every disease that arose out of and in the course of em ployment compensable as an occupational disease, they said, would be to make the compensation law "the equivalent of life and health insurance." The court further said that to be "occupational," the disease must be one which "results from the na ture of the employment" ; and that by na ture of the employment is meant--conditions to which all employees of a class are subject and which attach to the occupation--"a hazard which distinguishes it from the usual run of occupations, and is in excess of the hazard attending employment in general." (Goldberg vs. 954 Marcy Corporation, decided January tl, 19.tS, and reiKjrted in 276, N. Y. 313 12 N.F.. 2nd. 311.) Thus, after more than two years of great uncertainty as to the meaning of the law, the Court of Appeals has eliminated from the New York Statute the diseases of ordinary life which are only incidental or speculatively related to the occupation. Just a wortl altout hernia as an occupa tional disease. Never heretofore regarded as an occupational disease, but quite gen erally recognized under certain circum stances as an accidental injury--the Occu pational Disease Law of Michigan, enacted last year, specifically included hernia in the schedule of diseases. Not all herniae, however, are so included, but only those clearly of recent origin, as to w hich d is ability follows immediately, and in which prompt report to the employer is made. This is not far different from the rule in regard to hernia as an accident. But in New York, during the past year, it has become somewhat the fashion to regard almost every hernia as either an accident or an occupational disease. This followed on a decision of the Court of Appeals, sustaining an award for hernia as an occupational disease wherein the In dustrial Board specifically found that no accident had occurred. In the case pre sented, the worker was required, in the course of his employment, at frequent intervals, to rotate his body on the hips. This man was employed in a glass factory. He gathered molten glass on the end of a punny, which he, in turn, swung about and placed in a mold. The weight was not excessive, being only a matter of a few pounds. In affirming this award, the Court of Appeals said: "The finding, supported by evidence, is that the continuous gathering and lifting of glass from a furnace involved a constant twisting and straining of the body. This process, from gradual stretching, resulted in a hernia which is a disease (Matter of Alpert vs. Powers 223 N. Y. 97, 101.) There is medical testimony that claimant's occu pation would produce this disease and there are judicial decisions in other jurisdictions holding that hernia is an occupational dis ease (Marathon Paper Mills Co. vs. Ind. Comm. 203 Wis. 17; Travelers Ins. Co. vs. Locke 56 Fed. (2nd) 443, 444)." (Foster vs. Gillender Brothers Inc., 278 .V. Y. 348 16 N. E. 2nd 360.) Perhaps the most controversial question involved in occupational disease legislation is the treatment of liabilities for dust dis eases of the lungs. In no class of cases is the marked difference between accidents arising at a given time and place and occu pational diseases more pronounced. In this category of cases, we find silicosis, anthracosilicosis, and asbestosis, all of them forms of pneumonoconiosis. While these diseases in some of their forms are among the most ancient, their ravages having been rec ognized generations ago, little has been known until recent years of their causation, of their pathology, and of their complica tions with other diseases A vast fund of knowledge of these diseases has been gath ered in the past ten years, and intensive immediately, and in which 0 the employer is made, different from th e rule in 1 as an accident. B ut ir ing the past year, it hat it the fashion to regard m ia as either an accident il disease. on a decision of the Court lining an award for hernia al disease wherein the Inspecifically found that no curred. In the case preleer was required, in the employment, at frequent ite his body on the hips.. nptoyed in a glass factory, then glass on the end of he, in turn, swung about mold. The weight was not only a matter of a few ning this award, the Court supported by evidence, is >us gathering and lifting of iraace involved a constant aining of the body. Tbis radual stretching, resulted :h is a disease (Matter of s 223 N. Y. 97, 101.) There nony that claimant's occutduce this disease and there sions in other jurisdictions nia is an occupational disPaper Mills Co. vs. Ind. s. 17; Travelers Ins. Co. d. (2nd) 443, 444)." nder Brothers Inc., 278 N. V. 360.) nost controversial question ipational disease legislation o f liabilities for dust disngs. In no class of cases ifference between accidents n time and place and occu- more pronounced. In this i, we find silicosis, anthracojestosis, all of them forms iosis. While these diseases sir forms are among the :ir ravages having been rec kons ago, little has been nt years of their causation, gy, and of their complica diseases. A vast fund of ese diseases has been gath>t ten years, and intensive Occupational Disease 217 studies of their etiology and pathology are still going forward. One fact stands out dearly, and that is, that these diseases do not progress to the point of disability until after many years of exposure to dust. The length of time, varying from five to twenty-five or more years, is dependent in large measure upon the concentration of dust, the com position of the dust, the time actually ex posed during working hours, and the in dividual susceptibility or resistance of the worker. Another fact that stands out is that the fibrosis of the lungs, once ac quired, is permanent and incurable, and, in uncomplicated cases is not susceptible to medical treatment. Many thousands of workers today, under no law but the common law, have been employed in employments exposing them to more or less heavy concentrations of dust for many years. In the event of the enact ment of an occupational disease law in cluding those diseases, industry will find itself, at the stroke of a pen, liable for conditions already acquired through long years of employment, and which may be come disabling at any moment. In this sit uation, the best guaranty against disable ment is continuous and steady employment. Many a man, actually able to work and earn good wages, while he has a job, will be able to demonstrate by x-ray and clin ical examination the presence of a marked degree of silicosis, when his job stops because of depression or otherwise. Hence arises the question of the so-called "accrued liabilities." This term which has come into common use is perhaps not an exact term, in that "liability" does not occur until disablement, and the liability is only "accrued" at that time. What we have in mind when we discuss accrued liabilities is the condition of fibrosis of the lungs which has accrued and has been acquired over a period of years. This condition, being permanent, remains with the worker, whatever and wherever may be his employment. Perhaps a more exact expression would be "potential liabilities," and yet they are more than potential; the condition giving rise to them is actually existent. Industry tells us quite truly that it can not now pay full compensation out of cur rent income to all of the men employed in industry who may have in the past in curred some degree of fibrosis of the lungs. 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 e x posures of the past. Under this system compensation for dis ability or death occurring during the first month under the new law would be only a nominal amount (it has been set as low as $500 to start with). A person disabled during the second or third month after the enactment of an occupational disease law will have been exposed, to a small extent at least, under that law. The ex posure is perhaps in itself insufficient to actually result in any harm. Hut the m ax imum benefits will be increased, month by month by small increments, until in the course of two or three years the full limit chargeable to industry in the particular state will have been reached. This system is not so complicated as it might seem. The effect of it is rather to postpone the going into effect of a dust disease law for a matter of two or three years, and experi ence under this law has demonstrated that few claims arise where the compensation benefits are so limited, the workers pre ferring to stay at work as long as they can. It may be said that it works harshly in the case of the person who becomes really totally disabled in the early months of law. When measured by the liability with which the employer may fairly be charged, it does not, in fact, work a hard ship, and when compared with the exist ing system in states not now under occu- 218 Silver Jubilee Safety Congress pational disease laws, it not only is not a hardship but is, in 'act, a great boon. The principle of limited and graduated liability of the employer for dust diseases has been recognized by enactments in New York, Michigan, Pennsylvania and Ohio. An unusual provision has been adopted in the state of Washington, providing under their schedule form of law that the cost of compensation for occupational diseases shall be divided equally between the em ployer and his workers, and deductions shall be made from the employees* wages as contributions toward the insurance premiums involved. But what, you may say, has all this to do with the safety engineer? It has much. The safety engineer can no longer regard himself as doing his job if he seeks only ways and means to eliminate the industrial accident. The in dustrial hygienist must become the colleague of the industrial engineer. Medical science must give intensive thought and study to determining the effects upon the human system of various industrial processes, and exposure to various materials therein. All exposures cannot be eliminated and still have industry perform its functions. Most important, therefore, is the medical deter mination of what are safe limits in ex posures--the so-called "threshold limits." The engineer cries aloud today for expert medical guidance on this subject. Armed with such medical opinion and advice, the task of the engineer then is to devise prac tical ways and means for attaining condi tions where such threshold limits apply. Every industry presents a problem or series of problems in itself. No two in dustries arc exactly alike. What is toler able in one may be intolerable in another. What is good practice in one industrymay be totally inapplicable for _practical reasons in another. The task of the en gineer then is to find how right principles may l>e made applicable. Industry today, more than at any time in its history, must bear the burden of responsibility for the health as well as for the safety of the industrial worker, and if his health and his safety are adequatelysafeguarded l)is happiness and the happiness of those about him will be increased. There fore, it is of prime importance in the field of safety that intensive an^ increasing in terest must be given to industrial health. The care for the health of the worker must not be confined to the guarding against those conditions that are mentioned specifically in the law. The engineer** re sponsibility is a broader responsibility than is the legal liability for compensation. There can be no doubt that the enumeration in the law of specific conditions for which liability is absolute will be of great ad vantage to the industrial engineer in seek ing to enforce proper health standards. It is far easier for him to obtain approval of nis recommendations, if he can point out to management that the use of benzol or some benzol derivative is specifically men tioned, and point to the specific paragraph in the law that cites the liability of the employer for that condition. No argument is needed to convince management of its obligation in such a case. The same Is true with regard to all of the metallic poisonings and all of the other wide range of chemical exposures. Psycho logically there is great power in the printed word, and even the most backward manage ment may be made to respond when the clear mandate is set forth in the law. Not so easy will it be, under a general, vague, and all-inclusive occupational disease statute, to convince management that it has specificduties with regard to the elimination of health hazards. Thus, we see there is an other and potent argument for the schedule law, rather than the all-inclusive law. There is perhaps yet another and even more compelling reason for applying the rule of sanity and common justice to leg islative mandate in the complex field of occupational disease. Shall employment be limited to those who are physically per fect? All humans are not examples of physical perfection, nor can we by legisla tive fiat reverse the laws of nature which immutably decree that we shall grow older with the passing years. We have seen and discussed the dangers inherent in the all-inclusive theory of stretching the law to cover every sort and condition of disease, and to try to make them employment-related. When that stretching is complete, when administrators of the law find it easy and possible to burden industry with the responsibility of health insurance under the guise of an occupational disease statute, what of those Occupational Disease 219 who, wanting employment or seeking to re tain it, are not physically perfect yet cer tainly are not disabled? Much is heard today o f he dread fortyyear-line for employment. Whatever the facts may be as to that, is it not possible-- if not probable--that industry, in despera tion and against its desire, will be forced eventually to accept only those among whom the health hazards are least uncer tain--the physically perfect, the young and the strong? We may well pause to con sider tlie devastation such a situation would produce. In the interest of all workers, tlie young and the old, the perfect and the imperfect, let us not embark upon legislative policies that can lead only to enlarging the field of unemployment, and to closing the door of industrial opportunity to those skilled and faithful workers who, having passed the meridian of life, are subject to those natural infirmities and ills of the flesh to which all men, in time, must bow. Handicaps in the Diagnosis of Occupational Diseases By CAREY P. M cCORD, M.D. D etroit, Mich. It is a popular medical belief that occupa tional diseases are far more difficult to rec ognize and precisely to class as such than any other type of disease state. So firmly is this idea rooted in the minds of some physicians that they argue that occupa tional diseases never should be made com pensable because of extraordinary diag nostic difficulties. Lately, Kettering has said, ``The doctors tell us there are certain diseases that are incurable. Do you know what an incurable disease is? It is one that the doctors don't know anything about. The disease has no objection to being cured at all." This may be paraphrased by saying: There are no undiagnosable occupational diseases. The only ones that appear undiagnosabie are the ones the physicians have not learned how to diagnose. No occupa tional disease has ever offered any resis tance of its own to being diagnosed. The disease is perfectly willing to be diagnosed. At least one-half of all occupational di seases are almost self-diagnosing, particu larly when arising in groups; the remaining half present no greater difficulties than attend the diagnosis of some other classes of diseases. To maintain that occupational diseases are beyond the diagnostic skill of the physician is pure defeatism. With equal propriety, it might be suggested that all neurology be abandoned because the ma jority of conditions arising in this field may not be diagnosed with ease. While it may be said that there are no undiagnosable occupational diseases, it must be recognized that many remain undiag nosed, or more often misdiagnosed. The prime reason for this is that the usual physician sees only small numbers of any one type of occupational disease. Taking Ohio as a typical industrial state, the total number of occupational diseases, compens able and otherwise, reported to the State Department of Health during the year 1937 was 1,666. On the other hand, there are in this state 9,200 physicians. Thus, only one occupational disease arose for every 3.3 doctors in the state. Here then is the foremost hanJ'Vap to the recognition and diagnosis of occupa tional diseases and at the same time a back-handed compliment to industry. In dustry, because of its prevention achieve ments, has so limited the number of oc cupational diseases that day by day the physician is ordinarily not spurred to the possibility that any worker who seeks his professional guidance may have a disease of occupational origin. Here, too, is the funda mental reason why more medical schooldo not develop training departments in tlm field or organize special hospital service1 for the care of occupational disease pa tients. While there are reasons for rejoicing tha there are comparatively so few occupations diseases, we should recognize that ther are specific situations which introduce diag nostic difficulties. A number of these ar now presented, as separate entities. Steam Railroad TUESDAY AFTERNOON SESSION October 11, 1938 The first meeting of delegates to the Steam Railroad Sessions was called to order by Mr. W. W. Wood, Superintendent of Safety and Welfare, Baltimore & Ohio Railroad Company, Baltimore, Maryland, who presided. Chairman Wood briefly out lined the significance of the programs of the two sessions planned, and then intro duced the first speaker. ``Hidden Causes" By FRED W. 8AROENT President, Chicago and North Western Railway Company, Chicago We have seen the evolutionary growth of accident prevention work from its in ception, as applied to the American rail roads. Many of us here knew Mr. Ralph C. Richards intimately, and discussed his hopes and ambitions with him frequently. Though he met from time to time with dis couraging results, yet he never surrendered. He laid the foundation for safety work that is vastly enlarged and is rapidly ripening into collateral lines that are of benefit not only to employees and managements but to the entire economic and social structure of the country. In the beginning, and even until rather recent times, the greatest emphasis was laid upon working rules and physical conditions of plant and facilities; in other words, a safe place to work. There was every rea son in the world why the greatest emphasis should be placed upon these factors, and, indeed, we are not yet so far along that wc can afford to lessen our efforts with relation to these matters. In the beginning, the idea of a surgical department was to care for men and women after they were injured. Gradually this conception has been enlarging and changing into a broader field and greater service, if a greater service is possible. This depart ment no longer has as its sole objective the healing of wounds and the saving of human lives after injuries. Gradually, steadily, the whole conception of safety work has progressed and evolved until to day it has become a nationwide activity, drawing to its cause the best minds and the finest characters in our social structure. And with this greater interest in the work it has been but natural that the whoie scope, theory and conception of the under taking should gradually enlarge to embrace the wider field of accident prevention, to which I am about to refer. In recent years many of the railroads have enlarged their conception of this work and have come to the realization that safety work involves not only safe tools, safe way and structures, and safe surroundings, but involves likewise, and with equal impor tance, the very physical and mental condi tion and attitude of the employee or officer himself. With this thought in mind we have changed the title of the head of our surgical organization from that of "Chief Surgeon" to that of "Medical Director," because if men are to avoid accidents we know that they must not only be sur rounded with saL working rules and safe working conditions, but they themselves must be physically and mentally fit ; and that the so-called human element, always and ever present, must constantly be reck oned with if we are to achieve the ultimate beneficial results so earnestly desired. And so it is that in all this work, whether