Document ejMREB70qd1o6VEoR3R6Kq4M

i M k t aJrn-*- ZtoJieu? 44> (Fd-jU$) Safety and Health *** LEAD POISONING IN 1936 AND EARLIER YEARS By F rederick L. H offman, LL. D .1 | STATISTICS for this and other countries are consistently indicative of a marked decline in the occurrence of fatal lead poisoning. Tlu< t decline is one of the most encouraging signs of progress in the sanitan I administration of modern industry and in public health generally For foreign countries the returns are not always precise, because oi ' their varying practices of including or excluding deaths front nonir.- ' dustrial sources. It would be' highly desirable to have uniformity o! , procedure in recording occupational deaths from lead poisoning , separately, as is the practice in Great Britain. For the United States f the returns include both occupational and nonoccupational deaths from lead poisoning; in other words, they include deaths from nonin- ;< dustrial causes, such as contaminated water supplies, the poisoning of children by lead-painted toys, and other sources. The incidence of the fatal form of lead poisoning in this country declined from 2.5 deaths per million of population in 1900-1904 to 1.0 death per million in 1936, or 60 percent. In England and Wales the occupational death rate from lead poisoning declined from 2.5 per million in 1911-15 to 0.6 in 1936, or 76.0 percent. In Scotland the f rate declined from 0.6 in 1911-15 to 0.2 in 1936, or 66.7 percent. I Similar downward trends are shown for most of the other countries included in the present review. During 1935 there were 130 deaths from lead poisoning in the United States, 36 of which were of painters, the remainder being scattered 1 among a wide range of occupations, as well as among women ant among boys and girls under 18 years of age. The decline in industria load poisoning is largely the result of sanitary improvements in factory conditions, which during the last 20 years have continued on a pro gressive scale from year to year. Another factor is the improved economic condition of the workmen, who receive higher wage--, w.-rk shorter hours, and represent a decidedly better type of physique than during earlier years. Chronic intoxication, which was once common 1 Dr. stitute, TJofTman is consultuig ?t.uj-:tici>in for the Biochemical Kestuireh Foundation Philadelphia! Pa. Burlier publications by him on Pad poisoning include U. of S. B[Iuf.reFaju<dc'! In i.f.I.-r Statistics Bulletin No. 427: Health Survey of the Printing Trades, tistics Bulletin No. 4SS: Deaths from Lead Poisoning, 192.5-27; and 1922 to 1925; 11. S. papers delivered aBt uHreeaaulthof CLouwbcrusstaof Koval Institute of Public Health, Ghent, Belgium, and at National Convent I'm of American Public H Association, 1932. 420 %m0,,g lead workers, has disappearea. Another iactor of importance ,0 (lie introduction of workmen's compensation, which places the r, ^cial responsibility for the occurrence of lead poisoning on the employers in the lead-using industries. Unfortunately, no uniform rt*tistics of workmen's compensation for lead poisoning are available. The physical and clinical statistics of lead workers are indicative of thoroughly healthy and physically sound bodies of the workers, whose tondition has been materially improved by more widespread practices .-.f personal hygiene and bodily cleanliness, and the use of improved -aspirators in dust-exposing occupations. The increasing practice of gifdical supervision of employees and their periodical examination is proving its value in other directions, as the early recognition of lead absorption prevents the development of toxic conditions and avoids the risk of death or permanent disabilitjx It is regrettable that there are no statistics of lead absorption on a Urge scale showing the number of nonfatal cases of lead poisoning in industry, corresponding to the returns of the factory inspector of (Iroat Britain. In that country, during the 5 years 1931-35 there were SS4 cases reported under the Factory Acts, of which 105, or 11.9 per cent, terminated fatally. It would be mere blind conjecture to apply this ratio to our American deaths from lead poisoning, in the absence of any useful data on the probable number of cases in American industry at the present time. Finally, it may be pointed out that there has been considerable progress in the diagnosis of lead poisoning in both industrial and non industrial cases, and that treatment is making considerable progress, with the result that the incidence of fatal forms of lead poisoning is now decidedly less common than in former years. Fatal lead poisoning occurs not only in the lead-using industries but also in the general population, though only to a negligible degree in the latter case. The situation is somewhat confused by the vary ing practices of local authorities in reporting the occurrence of fatal lead poisoning in conformity to the international classification of causes of death, which, if strictly* complied with, records only deaths from occupational lead poisoning while disregarding deaths occurring in the population at large from nonoceupationnl sources. The prac tice varies for different countries, although general statistics, as a rule, include both types of the disease, ancl in most of (lie discussion following it is assumed that the term includes all cases of lead poison ing, whether of industrial or nonindustrial origin. In a special and cTondrd inquiry for different countries and localities no other pro cedure is feasible at the present time. The following discussion is divided into four separate sections: (1) Statistics of occupational and nonoccupational load poisoning in the United Stati-s, as derived from the general mortality returns; 39S7:+--3S----- 9 422 >. M o n th ly L a b o r R e v ie iv -- F e b r u a r y 1 9 3 8 (2 ) statistics of cases of lead poisoning and deaths resulting from the disease, according to workmen's compensation practices and other sources of information utilized for the present purpose; (3) statistics for foreign countries, limited to those countries for which the returns are conveniently available; and (4) physical and clinical statistics of lead workers. Lead Poisoning in the United States CASES AMONG GENERAL POPULATION Statistics for the United States registration area are available since 1900, when the area comprehended 40.5 percent of the total popula tion. Since 1933 the registration area has included the entire popu lation. During the 37 years 19,00 to 1936, the rate per million for lead-poisoning deaths has varied from a maximum of 3.1 in 1903 to a minimum of 0.6 in 1932. By quinquennial periods the fluctua tion in the rate has been as follows: T able 1.-- D eaths F rom L e a d P o is o n in g i n U n ited States R eg istra tio n A re a , 1000 to 1936, by 5-Y ea r Periods Period Registration area Aggregate population included Total lead-poisoning deaths Number Percent of total popu Number lation Rate per million Estimated number of lead-poison* ing deaths in United States 1900*1904............................................... ...... 160.212,631 40.4 407 2.5 992 1905-9........................................................... 216,713,041 50.2 457 2.1 913 1910-14......................................................... 302,3SS; 727 64.2 740 2.4 1,141 1915-19.......................................................... 379,929,059 74.8 763 2.0 1,022 1920-24......................................................... 468,499,432 86.0 682 1.5 S24 1925-29.......................................................... 546, 643, 899 93.2 688 1.3 76S 1930-34............................................:........... 610,422, 900 97.8 525 .9 562 1935.............................................................. 127, 521, 000 100.0 130 1.0 130 1936 >............................................................ 12S. 420.000 100.0 131 1.0 131 *According to preliminary statistics received from the Bureau of Census, the number of deaths from lead poisoning in Continental United States in 1936 was 131. For certain States the deaths were as follows: California, 9; Florida, 4; Illinois, 9; Indiana, 4; Maryland, 11; Massachusetts, 7; Michigan, 0; Missouri, 4; New Jersey, 8; New York, 19; Ohio, 6; and Pennsylvania, 11. There were no deaths reported in Arizona, Arkansas, Colorado, Delaware, District of Columbia, Idaho, Louisiana, Montana, Nevada, New Mexico, North Carolina, North Dakota, Oregon, South Carolina, South Dakota, Vermont, and Wyoming. In the remainder of the States; the number of lead-poisoning deaths was from 1 to 3 in oach State. The preceding table shows that the death rate from lead poisouing iu the United States has declined from 2.5 per million in 1900-190-1 to .0.9 in 1930-34 and 1.0 in 1936. Statistics of lead poisoning for (he United States include both occupational and nonoccupational deaths from the disease. There were 130 deaths from lead poisoning in the United States in 1935; these included 36 painters, 6 paint workers, 10 laborers, 7 persons in lead-using industries, S farmers, 5 miners, 3 metal workers, 4 printers, 2 electric-sforage-battery workers, 1 rubber worker, 1 worker in the automobile industry, and 13 whose occupations were unknown or miscellaneous. Among the nonoccupational deaths there were 0 women, and 14 girls arid 14 boys under 18 years of nrre, a total Safely and Health i_j 0( 24, leaving 96 deaths from lead poisoning strictly chargeable to industry. -'The average age at death in the lead-poisoning cases in .1935 was 42.5 years, the ages ranging from 1 to 90. The average age for paintsV as 58.9 years and for lead workers, 61.8 years. During the 11 years 1925-35, there were 1,343 deaths from lead poisoning in the United States registration area, at an average age of 48.5 years. The average age of 584 painters who died from this cause during this period was 53.9 years, and for 51 lead workers, 51.8 years. The number of deaths clearly nonoccupational during this period was 195, leaving 1,14S in the strictly occupational group, or 85.5 percent of the total. During this period there were 47 deaths of women from lead poisoning, at an average age of 49.7 years. These deaths in most cases were due to contaminated water supplies and in a few other cases, In all probability, to painting at home. There were 36 deaths of farmers, at an average age of 55.5 years, most of which were probably caused by painting at home, but some also by contaminated water "supplies. There were 56 deaths of boys under 18 years of age, 22 of whom were 1 year of age, 24 were 2 years, 6 were 3 years, 1 was 5 .years, 1 was 6 years, and 2 were 17 years of age; the average age for the group was 2.4 years. There were also 56 deaths of girls under 18, 17 of whom were 1 year of age, 22 were 2 years, 7 were 3 years, 3 'were 4 j7ears, 1 was 5 years, 4 were 6 years, 1 was 10 years, and 1 was 16 years; the average age for the group was 2.7 years. Most of the deaths of the little children were due to sucking paint on lead-painted toys, furniture, walls, or banisters. .? The number and rate of deaths from lead poisoning in four leading industrial States, by 5-year periods, are shown in table 2 . 'f . T able 2.--Fatal Cases o f L e a d P o is o n in g in S p e c ifie d S ta tes, b y 5 -Y e a r P eriods * Period Total deaths Aggregate population Num ber Rato per mil lion Period Total deaths Aggregate population Num ber Rate per mil lion New York Stalo: Pennsylvania: 1921-25................. 5-1.153,217 71 1.3 1925-29............. 46,934, 224 61 1.3 1920-30................. 58.7GG. 391 72 1.2 1930-34................. 49.179.000 42 .9 . 1931-35................. 65, S94.610 55 .8 1935-36................. 20.187.000 22 1.1 1936...................... 13,345.22G 15 1.1 Massachusetts: New Jersey: 1901-5................... 14, G51.094 30 2.0 , 1915-20____ ____ 18, 007,290 4S 2.7 1906-10................. 16,175,209 30 1.9 1921-25................. 17,107, 615 36 2.1 1911-15................. 17, 873,1S4 3S 2.1 1926-30................. 19.321,224 31 1.6 1916-20................. 19,212,911 43 2.2 1931-35................. 20,90S. 4S5 28 1.3 1921-25................. 19, 93S, 619 46 2.3 1930...................... 4, 328,000 7 l.C 1926-30................. 21, 437, 990 44 2.1 1931-35................. 21,581,290 29 1.3 1936...................... 4,425,000 7 1.6 A tabulation of deaths from lead poisoning in 18 American cities in which the lead-using industries are more or less concentrated gives the following results: In the aggregate there were 179 deaths during X tke period 1929-36, of which 30 occurred in New York City 29 j Baltimore, 28 in Philadelphia, 22 in Boston, 16 in Chicago,' 15 x Cleveland, and 10 in Providence. By single years the number of lead poisoning deaths in these cities has been as follows: 1929, IS' 1930 '1n1931, 24; 1932, 17; 1933, 17; 1934, 24; 1935, 26; 1936, 33. The Metropolitan Life Insurance Co. has furnished returns of deaths from lead poisoning in the experience of the industrial department of that company for the period 1914-36. According to these returns the death rate from lead poisoning of these policy holders declined from 3.0 per million in 1914-18 to 2.3 in 1919-23, 1.6 in 1924-28, and 1.1 jn 1929-33. It was 1.0 in 1934, 1.4 in 1935, and 1.7 in 1936. For the entne period the rate was 1.8 per million exposed to risk, ages 1 year and over, the highest rate, or 4.2, having been reached in 1914, and the lowest, or 0.7, in 1930. In the aggregate there were 605 deaths m the experience of the company_during the period under review. Of interest in connection with the foregoing are the statistics of the Massachusetts General Hospital for the period 1918-36, differentiatim; acute and chronic cases. By 5-year periods the figures are as follows: T able 3. L e a d P o is o n in g a t M a ssa ch u setts G eneral H o s p ita l, 1918 to 1936, b y 5-Year P erio d s 1918-22.......... 1923-27... 1928-32.......... 1933-36.......... Period Total cases Acute cases Chronic cases ............................ V"........................ 11 54 ............................................................ 14 lt/J ................................................ ......... 19 10 5 It The statistics for the United States Navy, for the period 1913 -35, differentiating acute and chronic cases, show a remarkable decline for both types of lead poisoning--from 300 cases in 1913-17 to 56 cases in 192S-32 and 35 cases in 1933-35. The details by 5-year periods are given in table 4 . T able 4. L ea d P o iso n in g in the U nited States N a v y , 1913 to 1935, b y 5- Y ea r Periods 1913-17........... 1918-22........... 1923-27........... 192S-32 1933-35......... Period ......... ........... .................... ......... ............................ . ........................... Average strength of Navy 516,015 1,214,326 5S0,303 574,372 328, 283 Acute cases Chronic cases Total Number Total Number number of deaths number of deaths 109 45 85 42 28 -- i 131 33 33 14 7 w o r k m e n 's co m pen sa tio n e x p e r ie n c e . ^ orkmen s compensation statistics for lead poisoning arc especially interesting, in that they afford a view into tlic financial aspects of the problem. ^As a result of new laws passed in 1937, there are now 21 tates which compensate for occupational diseases, as compared with 16 a year ago. These States are. California, Connecticut, Delaware, Illinois, Indiana, Kentucky, Massachusetts, Michigan, Minnesota, kjjftfsouri, Nebraska, New Jersey, New Tork, North Carolina, North nSSta ' Ohio, Pennsylvania, Rhode Island, Washington, West tfoinia, and Wisconsin. Coverage for occupational diseases is also wtended to employees under the workmen's compensation lavs of rfS*District of Columbia, Hawaii, Puerto Rico, and the Philippine Uknds and to employees covered by the Federal Lmployees Com pensation Act and the Longshoremen's and Harbor Workers' Act. A| the 21 States enumerated above, all but Kentucky and est vfenia compensate for lead poisoning. Unfortunately, for only a U * of these States are statistics available which are useful for the Bresent purpose. The most important of these are for the State of jieyr York, 1935-36, yielding the results shown in the following table: tS 'le 5 --W o rk m e n 's C o m p e n sa tio n f o r L e a d P o is o n in g i n N e iv Y o r k S ta te , 193o a n d 1' fSfcv' 1936 1935 1936 Type of disability Total cases "Weeks of compen sation Amount of compensa tion Total cases Weeks of compen sation Amount of com pensation jdJ types of disability.......................... Death or permanent total disability _ Permanent partial disability-- ------Temporary disability-------------------- 99 i3 3 .| 93 8,414 3,000 2,321 3,093 $141,379 a37,517 53,272 50, 590 69 3 3 63 6,390 3,000 1,411 1,979 $73,239 20. SI7 . 21,471 35, 951 '>IIncludes 1 case of permanent total disability. Present value of compensation awarded. ffin the State of Ohio the number of cases reported under the work men's compensation act since 1928 and amount paid as compensation were as follows: 1928. 1929. 1930. Cases 180 1931. 183 1932. 134 1933. Cases . 114 1934. . 148 1935. . 134 1936. Cases . 162 . 102 . 112 "As the above statement shows, the total number of cases of lead poisoning in Ohio during the 9 years, 1928-36, was 1,269. Of the=e, 77 terminated fatally, equivalent to a rate of 1.3 per million of popula tion. The statement below lists the lead-poisoning cases m Ohio in 1935 and 1936, classified according to the principal occupation of the worker: Painters___________________________ Foundry workers------------------------------Storage-battcrv factory workers-----------Sanitary-ware enamclers.......................... . Lead workers----------------- -------------Printers, electrotypers, and lithographers. Potters (clay workers)-----------------------Miscellaneous occupations...... ....... -- -- 1935 19S3 10 30 9 23 23 18 13 12 7S 55 02 23 14 Total............................. - .......... - 102 112 in the State of New Jersey, 1929-35, the number of cases of poisoning and amount paid as compensation were as follows: T able 6.-- Coses o f Lead Poisoning and Compensation P a id in New Jersey, 1929 u> Cases of lead poisoning Compensation paid Year Total Per ma Deaths nent total dis- .ability Per ma nent partial dis ability Tem porary dis ability Total Death or perma nent total dis ability '-cither year. The total number of days lost on account of ^ P o iio m a g during these 2 years was 2,287--1,837 in 1934 and only j M J ^ t S a c t o r y compensation data are available for the State of tfMBachusetts. The number of cases of lead poisomng reported to the -- Department of Labor during the 5 years 1931-35 was 175, deaths, equivalent to a rate of 0.1 per million of population. 4 ' International Statistics of Lead Poisoning Total. 3929.. 1930.. 1931.. 1932.. 1933.. 1934.. 1935.. 962 14 124 4 169 2 227 3 ISO l 123 1 70 1 64 2 6 502 440 $677,468 $53,790 $477,449- f lfE a * Stionary *ccorfnO,ddTiittc.iioo"nn ii,nn`>atthhteeoffrrreetqqhuueeennpcceyyrio<df l,e1a9d31p-o3i.5somorneg. Dur`m,j7.g6 _19f36*,, 2 1 1 2 40 61 152 121 67 40 21 78 91.490 105 105,593 71 217.814 56 126, S3S 60 60,121 29 49,358 41 28,254 11,829 16,946 17,223 1,500 1,600 4, 692 74,963 183,900 99,790 51,124 44, 933 17, 739 S ^ J a marked increase in the rate, or from an average of 0.8 per .n.*i * S n to 1.6, based on 18 deaths for the year. The rates per million 9, Off ^population for the 5-year periods are shown m the following table. la f Mg* Canada, 1921 to 1936, by 5-Year Periods In addition to compensation awarded, there were' 242 cases m New Jersey in the period covered by the above table in which medical costs, to the amount of S35,295, were incurred. The maximum Paid m af y f these years on account of medical costs- $15 981-w as reached in 1930. The proportion of compensation to' medical costs recent years. indicates a decided decline in lead poisoning during ______ ___________________ ___________________ m / . M "a Aggregate pop ulation 32, S33,654 49,096,000 ................................................................................................ .. ll) 014,000 Total deaths Number Rate per million 37 .8 44 .8 18 1.6 44299o,'4a3^5,totfralwhLUicThb8oe4i',00f0dwaejSre lf0oSrt p(ewremiahnteendt) tdoutarlindSistaKbiislitpye,ri2o5d0 w04a4s for permanent partial disability, and 23,109 for temporary disability. According to information furnished by the Connecticut Bureau of Occupational Diseases, there were in that State 96 cases of lead poisoning during the 5-year period, 1931-36, as shown in table r T able 7.-- Lead Poisoning in Connecticut, 1931-32 to 1935-36 'Vv'Provinces the deaths from lead poisoning in Canada for 1936 were distributed as follows: Ontario, 11; Quebec 5; Nova.Scotia, 1, British Columbia, 1; and no deaths in Prince Edward Island, New Brunswick, Manitoba, Saskatchewan, and Alberta. . i:i.For England and Wales data are available since 1911, obtained from the reports of the Registrar General. These data, amplified by *statistics on lead poisoning under the Factory Acts, derived from the annual reports of the chief inspector of factories, are shown in table 9. Total...... 1931- 32... 1932-33.... 1933-34.... 1934-35.... 1935-30...... Year Total cases Cases re ported by physicians Compen sated cases 90 42 - T able 9.-- Cases o f Lead Poisoning in England and Wales, by 5-Year Periods Period Fatalities among general population Aggregate pop ulation Occupational Nonoccu pational Number Rate per million Number Rate per million Cases under Fac tory Acts Total Fatalities In Wisconsin the number of lead-poisoning cases for which compen sation is paid is comparatively small. In 1934, the sum of $8,380 was paid in compensation for 13 cases of temporary disability and 1 case of permanent partial disability resulting from this cause. In 1935, ;;1'2 9 TM s paid in compensation for 13 cases of temporary disability. I here were no compensated cases of death or permanent total disk- 1911-15.. 1916-20.. 1921-25.. 1926-30.. 1931-35.. 1939___ 181.257.000 175.637.000 192,03-1,000 197.252.000 201.500.000 40, 600, 000 444 251 241 231 148 23 2.5 1.4 1.3 1.2 .7 .6 1 46 14 13 11 13 0.25 2, G17 .OS 1,259 .07 1,626 .06 1. 424 .06 SS4 .10 1G3 115072 119 169 105 13 The. above statistics do not include cases of lead poisoning m house painters and plumbers not employed under the acts. These have been included in the total number of cases given as 1,990 durmg the first 5-ytar period, 1,595 during the second, and 914 during the third! r` , 1tm 05 based on 5 deaths. However, during the single - The number of deaths in this group was 201 in 1921-25,206 in 1920-30^ ^ 3 6 there we're aleo 5 deaths from this cause, eqmvalent to e and 115 in 1931-35, while the respective fatality percentages wejf 5 * 1.3 per million. 10.1, 12.9, and 12.6 . Of interest in connection with the foregone h the following tabulation of cases of lead poisoning reported in t]* M v j - o * * . ^ m S-Year Periods * Sp* fM _____'__l> United Kingdom, by industrial groups. These statistics have been derived from the annual report of the chief inspector of factories for 1935, amplified by a communication from Dr. Bridges, chief medic*) inspector of. factories, dated February 1, 1937. T able 10.-- Lead Poisoning in. the United Kingdom, 1934 to 1936 Industrial group- All reported cases Deaths 1934 1935 1936 1934 1935 1536 All groups................... ..................................... 7............... 198 168 163 25 17 U 206 17 3 19 3 1 1 1 24 10 11 343 1 1 Other contact with molten lead................ ;.................... 10 11 5 77 Pottery............................................................................... 26 18 18 s 7 i i 81 12 10 15 19 21 19 1 8 5 71 1 1331 12 41 i 11 24 19 1 i Painting of buildings........................................................ 41 32 27 10 7 7 V .;- * > i.. ' * frTiftrr and period Total deaths Aggregate Rate population dum per ber mil lion Country and period Total death3 Aggregate population Rate Num per ber mil lion Mgisnd: .................................. 23.738,306 24.101,793 24, 462, 722 24,411,691 24. 524,490 4,966,300 MA Tree Stato: 9.004,000 1926-30....................... 14.767.000 14.908.000 fwftieriand: 19,943,900 15 5 8 i9 8 23 0.6 Netherlands: 1921-25........................ 1925- 30........... 1931-34........................ 33,732,943 38.427.737 32, 762,152 .2 .3 1.0 .5 1.2 Australia: 1926- 30.......... . 1..9.3.1.-.3.5...................................... Victoria............--- New South IVales Queensland........... South A ustralia- Western Australia 31.408,493 33,13S. 325 6,777,744 1,847,841 2,667,839 987.5S9 587,549 450.036 i6 i3 13 100 82 10 0. .1 .1 3.2 2.5 1. 5 .8 7.2 01.7 20,610,900 ...................... > r, 1^933-35...................... 163,345,671 169,279, S73 125 123 ..87 international classification of the causes of death. Included under No. 77 (mineral poisoning) of the i up* s f L * T intaU e U. The annual report of the chief inspector of factories and workshops of the United Kingdom is an invaluable source of information regard ing lead poisoning in industry, disclosing a wealth of useful informa tion not otherwise obtainable. It is a model of its kind, and the ,h . first. 5 years! 8 5 e= d :L^were 1^ ^ ^ ^ second 5 years, of the S2 d > , ny 0f the deaths are 'The Australian situation is in ere . .fce ^formation is avail- probably of noninclustnal origin, iqqi-3 5 10 were of persons able. Of the 82 deaths during the period. 19W 3o, U U e r e ^ P ^ ^ method adopted should be followed by other countries. The fatalities from lead poisoning, by 5-year periods, are shown for specified countries in tabic 11. Considerable variation in the mor tality rate is evident here, but, as already indicated, the data are not entirely comparable because of the varying practice in the different countries with regard to the inclusion or exclusion of nonoccupational are shown for that State lor the 2 latest 5-ycar periods and for 1936 , in table 12. M **,m 1 " IM fclgrM W M M . fatalities. All of the countries, however, exhibit a marked decline in \ the relative frequency of lead poisoning. i As the table indicates, lead poisoning is comparatively rare in the Irish Free State and the Netherlands. The statistics are not entirely l satisfactory for certain years, since they include all forms of mineral t poison under No. 77 of the international, classification of the causes -------------------- --- ' Period Aggregate popula tion Total deaths Num ber Rale per million Males females Aggregate popula tion Deaths Aggregate Num ber Rate per million popula tion Deaths Num ber Rate per million of death, but deaths from mineral poisoning other than lead are very infrequent. On the whole, the statistics can be relied upon as fairly representative of the whole problem. In Denmark the deaths from 1926-30.................... 1931-35.................... 1935......................... 1 4,420,417 1 4,727,630 978,5S9 40 | 47 7 0.0 2, 323, 413 9.9 2,479.421 612, 652 27 25 3 11.6 2,097,004 10. t 5.9 2, 248, 215 405,937 13 22 4 6.2 9.S *.0 lead poisoning arc also rare, the rate having been 0.3 per million for 3 430 M onthly Labor Review-- February 1938 The situation in Queensland has attracted much attention becauserf] the alleged exceptional frequency of the disease in young children contracted by sucking painted surfaces, toys, etc. It is also allegedthat contaminated water supplies play an important part at th*i present time. For the Dominion of New Zealand lead-poisoning returns are r*J ported under No. 77 of the international classification, for the 7 years, 1929-35. According to these returns there were 9 deaths during this period, all males, equivalent to a rate of 0.9 per million of population. For Germany the only data available are the workmen's compea* sation statistics of lead poisoning for the period 1926-34, based on information derived from the German Statistical Year Book and from correspondence with the German Statistical Office. Table 11 gives the total number of cases -reported and the total cases compen sated, as well as the number of deaths. T able 13.-- Lead Poisoning in Germany, 1926 to 1934, by Specified Periods Period Total cases reported Total cases com pensated Number Percent Deaths Percent of Number compen sated case* 1926-30............. ............................................... 1931-34___-........... : ...................................... 16,170 6,630 1,717 787 10.6 14.0 62 11 39 10 Physical and Clinical Statistics of Lead Workers To the foregoing discussion of the vital statistics of lead poisoning, some clinical and physical statistics of employees in lead-using indus tries are added, based on examinations made during the last 2 years. The statistics represent examinations in 9 different plants in Brooklyn, Philadelphia, Chicago, Atlanta, Staten Island, and Oakland, Calif. * In the aggregate there were 1,623 employees, of whom 62.9 percent were born in the United States, S.l percent in Poland, 4.6. percent in | Italy, 3.0 percent in Spain, and the remainder, or 21.4 percent, in 27 , different countries. The average age of 1,621 employees was 3S.6 years, the ages ranging from 16 to 71. The largest group of employees were 24 yrears of age. Of the total, 74.6 percent were married, widowed, or divorced, while 25.4 percent were single. For 1,594 employees the-average duration of employment was 88.2 months, or 7.5 years. The range in duration of employment was from 1 day to 509 months (42.4 years). Table 14 shows the occupational distribution and certain data re garding the workers' previous disease history. The number of work ers for whom data were obtained on each point is shown in parentheses. * - Safety and health . -- Occupational D istribution and Disease and In ju ry Experience o j Workers in W the Lead Ind ustry J H 'v untm tot, occupation, and number reporting Em ployees reporting Department, occupation, and number reporting Em ployees reporting distribution (1,439): Number mill ... 345 54 47 31 19 18 IS 12 12 12 11 11 10 90 233 60 24 * Packers............................... -........ 21 ` Dumping fumes........................... 19 17 17 > laborers--.................................... 16 11 4S OB mill................................................ 217' Pressmen...................................... 108 3S 16 > Coopers....... ........ ........................ 10 "'-Yard ?- Setting-lead workers.................... Shipping -and warehouse depart* Shipping laborers......................... Miscellaneous occupations.......... 198 60 27 25 17 17 52 178 48 41 40 ` 15 13 21 162 44 37 36 28 17 Occupational distribution-continued. Number Laborers........................................ Oil and color department................... Fillers............................................ Miscellaneous occupations.......... Sheet-metal operators.................. Foreman........................................ Metal mixers................................ Exposure to lead dust or fumes (l,60S): 29 23 5 26 8 4 4 3 7 23 14 3 2 2 1 1 Percent Former employment (1,612): Previous history of lead poisoning (1,617): Previous other diseases (1,60G): 42.2 11.4 S3.6 96.5 Numb3e.5r 23 23 19 Tuberculosis........................................ Previous injuries or defects (1,602): Abnormal tonsils................................. 2 2 3 9 83 1,430 113 49 35 18 8 S 7 69 1,295 Certain other clinical data are given in table 15. T a b l e 15.-- C lin ic a l D a ta on L ea d W orkers Item and number reporting Height (1,814)............................. Pulse rate (1,424)...... ................ Systolic blood pressure (1,462).. Hiastolic blood pressure (1,462) Body temperatures (S32).......... SHpeemciofigclogbrianvi(t8y0S(1).,.0.2..7.)........................... Chest Inspiration (f`G)........... Chest expiration (590).............. . Range Average Largest group -- Inches. ..degrees. .percont. ...inches. --- do... 52.5- 7S. 0 40.0- 140.0 8G.O- 234.0 30.0- 145.0 94.0- 101.0 1,002.0-1,010.0 50.0- 140.0 31.0- 55.0 29. 6- 53.3 67.9 7S.G 129.6 S2. 2 9S.4 1,021.0 S3.7 3S.0 36.0 6$. 0 72.0 120.0 Of 1,494 employees, 221 or 14.8 percent had shown a gain in weight, 143 or 9.6 percent a loss, while in 1,130 or 75.6 percent the weight had remained stationary. The average weight of 1,613 employees was 158 pounds, the weight ranging from 100 pounds in 1 case to 2$4 pounds in another. The maximum group, 43, had a weight of 145 pounds, while the number of persons weighing 200 pounds or more was 46. The condition of the mouth for 1,607 employees was reported clean in 1,054, or 65.6 percent, while for 300 pyorrhea was reported. In 76 the condition of the mouth was poor, 67 fair, 31 septic, 25 abnormal tonsils, 24 bad, 23 shrunken, and 3 cleft palate. Of 1,273 employees, 74 or 5.8 percent showed a lead line on the gums. The condition of the tongue in 1,596 employees was clean in 1,349 or S4.5 percent, and coated, fissured, or beefy in the remaining 247. The condition of the teeth in 1,603 employees was clean in 327 or 20.4 percent, satisfactory . in 324 or 20.2 percent, fair in 372 or 23.2 percent, poor in 90 or 5.G percent, and bad in 249 or 1.5.5 percent. Artificial teeth were used by 148 or 9.3 percent. The condition of the veins in 1,604 employees was indicated ns normal in 1,308 or 81.6 percent and fair in 169 or 10.5 percent. Vari cose veins were reported for 99, enlarged veins for 19, arteriosclerosis for 8 , and relaxed veins for 1, a total of 7.9 percent. The con'dition of the heart in 1,615 employees was reported as normal in 1,457 or 90.2 percent. In the remainder, or 9.8 percent, the condition was reported irregular in 45, murmurs in 90, both irreg ular and murmurs in 8 , cardiodegeneration in 5, cardiovascular dis ease in 2, flabby muscle in 2, poor in 2, and enlarged in 5. The nervous S3'stem in 1,619 employees was reported as normal in 1,55S or 96.2 percent. Neuritis was observed in 24, tremors in 11, poor reflex in 11, a fair condition in 9, paresthesia in 2, nervousness in 2, and headache in 2 . The condition of the digestive system was normal in 1,564 cases, or 96.5 percent of the 1,620 for whom information on this point was obtained. Constipation was observed in 2.2 percent, hemorrhoids in 0.5 percent, a fair condition in 0.4 percent, gall-bladder trouble in 0.1 percent, and miscellaneous conditions in 0.3 percent. Of 1,617 employees, no indication of hernia was observed in 1,384 or 85.Gpercent. Right inguinal hernia was observed in 15 cases, left inguinal in 13, double inguinal in 5, not specified inguinal in 5, bilat eral in 1, and others not specified in 15, a total of 3.3 percent. Vari cocele was observed in 30 cases and hydrocele in 5, impulse in 124, large rings in 11, enlarged testes in 2 , and miscellaneous conditions in 7. The urinary condition of 877 employees was found to be satisfac tory in 781 or S9.0 percent. Nycturia was observed in 92 cases or percent, nephritis in 2 cases, and miscellaneous conditions in 3 `cases: Chemical analysis of the urine of 1,209 employees revealed that sugar was present in 167 or 13.8 percent, while of 1,215 employees jjjbumen was present in 76 or 6.3 percent. '^Anemia was observed in 75, or 9.6 percent of 779 employees, and (Was not present in 704, or 90.4 percent. The condition of the skin in 1,556 employees was reported negative in 1,345 or 86.4 percent. The complexion was ruddy in 118 or 7.6 percent, while miscellaneous conditions of minor importance were observed in the remainder. Of 1,563 employees, SS9 or 56.9 percent used respirators and 674 or 43.1 did not use them. The types of respirators used were Pulmosan 30.4 percent, Cover's 30.2 percent, Dustite 20.3 percent, Willson 15.7 percent, Diamond Disk 3.2 percent, and Approved 0.2 percent. Of 1,538 employees, S8S or 57.7 used gloves and 650 or 42.3 percent did not. . The height, weight, and circulatory conditions of the majority of those examined are shown in table 16, by age groups. ` T able 16.--H eig h t, W eig h t, a n d C irc u la to ry C o n d itio n s o f L e a d W o rk ers, b y A g e G roups Average height Average weight Relative weight Average pulse Systolic blood pressure Diastolic blood pressure w* ` *>r Num Num Num Aver Num Num- berre port- Inches ber re port- Pounds ber report- age pounds ber re* port Beats berreport- ing ing ing per inch ing ing Aver age mm. Num ber report- ing Aver age mm. Total........................ 1.614 Under 30 years......... 30-39 years................ 40-49 years............... 60years and o v er... Not specified........... 445 442 397 32S 2 67.90 1.613 69. 02 67. So 67. 39 67.05 G6. 13 444 440 398 329 2 153.0 1.612 157.2 157. 8 161.1 156. 1 136.0 444 441 397 328 2 2.33 1.424 2.27 406 2. 32 3S5 2. 39 342 2.32 2S9 2. 06 2 7S.6 1.462 80.7 414 79.2 409 76.8 341 77.1 296 80.0 2 129.6 1.462 124.6 125.3 130.5 141.4 124.0 414 409 341 296 2 82.2 78.3 81.1 83.5 87.8 S6.0 ++******<