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52 FRANK A. PATTY D. THE COMBINED INDUSTRIAL HYGIENE AND MEDICAL SURVEY The combined industrial hygiene and medical survey is the most compre hensive of all industrial hygiene surveys and, depending upon the extent of the study, it usually requires from a few days to a few weeks or even months to complete. In addition to studies of environment and cursory observations of workmen as mentioned previously, this kind of investigation includes studies of individual workmen by medical technicians and physicians; it may include hematological, bacteriological, and parasitological studies as well as physical, x-ray, and other special medical examinations. The interpretation and evaluation of medical information belong in the field of medicine and require the services of physicians qualified by training in each of the above respective fields, or a physician who is closely associated with qualified men in each field upon whose knowledge he can draw. Likewise, engineering findings and recommendations should be handled by someone thoroughly familiar with the principles involved. The purpose of this combined survey may be to determine the exposure to atmospheric contaminants and any detectably adverse effects upon any of the exposed workmen that such contaminants may have caused; its major goal may be either evaluation or control. The scope may range from a single contaminant in a single plant up to a combination of contaminants throughout an industry. The study may evolve from the discovery of unexplained illness among workmen or from the known presence of contaminants in a workroom atmosphere that have, or are suspected of having, little-known or ill-defined, adverse effects. Accepted maximum safe limits for atmospheric contaminants, notably those for benzene, carbon monoxide, lead, mercury, and silica-bearing dusts, have been set by comprehensive studies of this nature. Needless to say, any such standard "safe limit" is no more accurate than the method employed for air analysis and the concentration data recorded, regardless of how many qualified specialists evaluated the pathology found among workmen. For that reason, in all reports proposing safe working standards the methods of analysis should be explained and substantiated. Later and more dependable, or more sensitive, methods of analysis may throw more light upon the picture and show an accepted figure to be erroneous.______ __ ' : Goffibiaifl^^^lja^hygiehe and "medical - surveys - offer - excellent-oppor~ tuniti'Csiof '^puBIil-S;eaith-research regarding adult health, at'ieas?:i'the : health of employed adults; and statistics for special groups are often more readily obtainedin industry than from other sources. All special conditions obtaining in the"intlust1^studird"ffiltrhr^'be`iost'sight'0f7-BS-they~might=have"a-%earing upon any general conclusions drawn from the statistics. III. The Industrial Hygiene Unit The industrial hygiene unit may vary from the simplest and least pretentious one-man unit to the most elaborate and inclusi)Je unit, represented by the United t THE INDUSTRIAL HYGIENE SURVEY AND PERSONNEL 53 . es Public Health Service, which in its Division of Industrial Hygiene at the . lonal Institutes of Health3 has included a staff of over 200 persons (see also ages 7-8). It is obvious that the small unit is limited in Its scope and, therefore, is going to accomplish much toward the preservation of health in industry, it -t necessarily exert its efforts mainly in preliminary and investigational eys,.with almost no time for pure research. , The National Institutes of Health, however, in 1943 had a Research Section nit,, conducted laboratory research into numerous industrial hygiene problems, . ermatoses Investigations Section to study- the occurrence and prevention of vupational skin diseases, and a States Relations Section. Medical, engineering, v!}[|tatistical units served as a source of supply of personnel to.the sections: ^recruited, trained, and assigned persons to sections for duty. Certain in indent studies in the nature of services and research investigations also were i' r fed on. As evidenced by the scope of the publications of this organization, idu|trial hygiene can be extended to influence practically all branches of com ' J % * ' ity, adult health. All hygiene divisions are in a position to distribute educa'l'1' 5n|l|information of great benefit in the promotion of industrial health. State and city industrial hygiene units vary in the number of their personnel jjji^|yer a score down to one or two men. They conduct research to a much ajlgp. extent than the United States Public Health Service, and more recently >i^i^JM2p943, and 1944 with the influx into many fields of relatively inexperienced as well as workmen, created an unprecedented demand for insurveys in order to minimize losses in manrhours due to ill health imgifrom exposure to harmful materials. we several types of consultants and severakorganizations engaged in of industrial hygiene practice, ranging from, those of an essentially and educational nature to those devoted almost entirely to investiga- l?veys- The Industrial Hygiene Foundation -may. be mentioned as an m having a general, educational, and investigational interest; whereas SgS-.f^e'^l^^U'^sfyeiaa-l-lh-hveyigeineen-eu-nuintsit-so-fo~fi-ninsusurfrlnacnec-ec-ncmomnapnaienaie-8-a-arpr-e--n-VDirTin1nc;lnptta1l1lvv pennog-oacgTeodfl iinn fijlffijapybnal surveys and individual control programs. While all industrial |gjg|||:tihits in private industry have environmental evaluation and control as ^mm|ry objective, their activities vary considerably withnft&Hypg and size mi-jg-|l^|Q|.iiulupr.y^and=theatiewpoint of management. In the largef-arid more -proWei dustries there is opportunity for a well-balanced and well-staffed f'lllifP?cialist'S in the different sciences represented, each having a chance Sir1 research within his particular field. ` t' iwdalpHWtfiS. In W. N. Gafafer, ed., Manual oj Industrial Hygiene. Saunders: Ehila- lifer