Document nNa2zz0RQoYMEpXRJzkO1XmVz

: v;~ `?`:N^V';.L'.'L.-l v.vTVrO HOME OFFICE . - - *935 L/P'"~' For OHtdal Use If PHiBrrS f : :v. MEMORANDUM ON THE . INDUSTRIAL' DISEASES OF ' - . . SILICOSIS AND ASBESTOSIS Crvan Copyright Reserved ;; ~pg#,... tj' *' **' ;''*": >' Fj-v ; "*;v ': - . LONDON. '. PRINTTO AND PUBLISHED SY JIT5 MAJESTY'S STATIONERY OFFICE To be pvefaswd Erectly inm H.M. STATIONERY OFFICE at the /oJtowwf iddrams Auttni Hetrie, Kinjewey, Lnadoa, YF.Ci? tzo Georgs S3t, Etlisbut^ xj ' York Street, Maacbetter t; i St. Andrew'* Crastai, Cardiff j I Caiefaater Street, Bctfaat; ' - or through lay BoolucUer . ^iU.j 34-223 ` .-1935 '. Pricr Sfi. Net : '*. '' i `*r"T . jl*. ' a r'r- * -r V`T'. * - K j\* *! ; ?rA.*IS*Arf. V **-.; * k --------- - -, - -Tl Tr i tur `r.- hM ':'C-TEi"w " \*i3S - . i \K CONTENTS ;V 1. luLKMluotma _ m. 2. Xh* origin and development of silicosis 3. Tmlflilfice processes in which ... .. ,, '.**' Pans --3 3--' . _-- 5 4. Mesas of prersatietL;*-- : . .. (!) dost suppression; (E) exhaust rentilitioa; (iu) other methods; (It) iMtiat sad periodic mnnBint>im ltt Ma ^ 6 5. &orisia& for compensation . ,M M& 6 Medics! for a&d of <-- _9 ' 7. Note oa asbestosis "... ^ .............. w ... -- 12 APPENDICES L Bibliography ... -- -- ... . ... . XL list of Comptaiation Schemes and processes to which they apply IS. list of Panels of SSicosis sad -Asbestosis Medical Board ... 17. Pees payable for examination* and certificates by Medical Board, _ 14 15 M 16 -- 1? y Thfi-I in5', ibis. 60 'tfcLasc-'tt ; ..'masons * _ v^ipoeare i j*. Hv/ called J .-gold-aii ; :''.jH2dicate li : " *;\`v-tnberca : .process* X-ipj^Ese; .* r'.*T^rrryfcr ,Z` '^certsTL*r : * :j-Van&^sil : r-.Vrv.-prem^ ..-' zneat-.a ablsmei . :-~v'ioeni ' " ; death.."t ; - Ashe; ` ;-in man: . . ` . asbes . '/.vprocesse *.*?.. a coc ! . . ^.years'l- 1 ';t:>and'5 c . ..;5:Th<T * ' c'disaasfts ' - 'jean be ; :jaA- iht ... .{JttaaxLQL. "' * * 'Clvv-Eese: ;:A'rC/i:pbInd '`-''-'..`the-knt .-.'W.-'tdisease; .f.C-.SBict ,dnst- tv '?`3.j! particle where: i-i -process :i2i * r. fj *. kv ? fA'V . -- - K* * . * ' iifi:: i. 1^- . ,JT. . "'.irj : mm^:re:`;'-^;'.- >' I<. .::-Y' v %vjiV-.`- `I fcs2xa,,tr*v---; j - 3- ..,i }." "Cl !` "I"-, ."it.'*': w}. ." re'. .' - . - ' . reD--XatlOdUcaOTU. ... r pn; ; :*.; { ; *; The-disease" of the' longs now known, -as'aiLLcosii was recognised in 'ibis: country - in very -early times as* a '-trade- disease Meeting those-who worked on certain kinds of stone. It occurred amongst masons working with sandstone, and was called "`'Stone 'masons'* phthisis ; in late; times it was found iur those employed ixt grinding metals.oh''sandstone wheels, and'was.called "grinders' rot'''/it appeared too in potters who worked with ground'dint, and' was called "potters' asthma/*'and amongst miners in lead, tin.and gold-mines-,'it was known as " miners' phthisis.'' ' All there terms indicate the:same disease,-alicosis, which may he accompanied' ,by tuberculosis. ' It has been, found tp-'occur in . many industries and processes, all 'of which have one characteristic in common--exposure of'the'workers, to the inhalation of silica dust. . ' [ The incidence of silicosis continues to be serious and widespread. During the throe .years,' 1932-4 the Silicosis Medical Board have certified 52 cases of disablement and 17 deaths from ganister mines 'and 'silica ,brick works; 252..cases of disablement and 79 deaths from.'the getting.and manipulation of sandstone at quarries or premises'.worked in' conjunction therewith; 289. cases*of disable ment land. 92 deaths mom the* pottery industry -'53-2 cases of dis ablement ."andlOo deaths.from. coal mines; 319 eases of disable^ ment and 142 deaths, from other-industries/ In some cases of death,'the workmen hag ..previously. been.ceriified as disabled. Asbestoais is a* disease of the lungs which resembles'alicosis in many ways. It is produced as a result of tbe inhalation of dust of asbestos, and the-increased use of this mineral'in manufacturing processes during recent years has been followed by the occurrence of a.considerable number.of cases of tbe disease. .During.'the three years 1932-4 the Medical Board certified 60 cases of disablement and 5 deaths,among workers in the, asbestos industry. . - ' ., The object of this Memorandum is to set out briefly what these diseases are, how and where they are. produced, the measures which can be taken to prevent them, the provision made for compensation-, and: the arrangements lor the medical examination and certifica tion of workmen. ' . -. . Desearch is going on, under the direction of a Committee ap pointed by the Medical Besearch Council, with a view to. extending the knowledge and understanding of silicosis and other pulmonary diseases due to the inhalation of dusts. '/ ' 2.--Ths origin and development of Silicosis. " 7. Silicosis is produced by tbe action of minute particles of silica .dust which have been inhaled in the act of breathing. These particles make their way into the deepest recesses 'of. the lungs where some- of them remain - and produce-a* flow, inflammatory process which'eventually destroys the lungs. . : -I : . . .^ 23128 xi /.re/., l _..r-' m. ?--. - i .. *: * : . * * * # .** . . * ' -. r-'*4* . . < m - i- *. !*:; m if re-* t ' Y*.rvri l'. (% v #s; * ..5 *V*/."u*./.rf*e' *V*<**. vm M: - % - * >- r? ^Va ; .. . *. v:. .V. j -. - < . 'M- l i rev i 7re' >1 .. g>V^: i \ - .'.d ' 1* :-vWF' *. ..** . .* ^re.-re.-re- gu; v .................................................... .... . -' ersaasaya>w<^r- .1* W*.* IV >' r 2^^ ElS^,- i?--. *i*i ;-..- 4 Silica is almost the sole constituent of rocks such as quartz, flint and chert, and forms a considerable proportion of others such os sandstones and granite. In'order to produce silicosis the dust most be in the form of minute particles, so small as to be invisible to the eye, except that in a beam of sunlight they may appear as a cloud, like smoke. This dust is produced when any of these - rocks arc broken, crashed, ground, or cut with a chisel or drill, ; or when any ground silica is manipulated is the. dry state, unless .! special means are taken to suppress the dust. ; .... - V . ; ' These minute particles of silica dust float in the air,, and.when ..y/f./inhaled pass through the nose and threat and along the .bronchial .. ... - .'.-tubes to the smallest branches .which end in the expanded balloon .-. -. ' like air-sacs of which the respiratory tissue of the lungs is com " v..posed. The nasal passages have an important function in helping : to cleanse the. air from dust before is reaches the lungs, and : - although the value of this function varies very widely in different -V .individuals and'under different conditions,' it is always better to , .take advantage'of the protection afforded by breathing through the . . -.nose. Many of the dust particles do not come into contact, with. ; - : / /-the walls of the bronchial tubes or air-sacs,-bat are breathed oat - . / . ` again in the returning air stream. Some of the particles are ... / caught on the moist lining of the bronchial tubes and are readily 'removed with the mucous secretion. A certain proportion of the :. particles which And their way to the air-sacs come to rest on the . walls, and these an attacked by living cells from the lung tissues . ' v and are conveyed'either outward to the bronchial tubes or towards the drainage chancels and spaces of the lung. If the quantity of : dust is small the cells will be able to deal with it successfully, but - if it be excessive they will be unable to remove it and the dust laden cells will accumulate and give rise to an inflammatory process. ' Once this process has commenced it continaes more or less slowly to produce a kind of scar tissue (fibrosis) which ultimately replaces the lung substance, at first in small spots or nodules which may become joined up to form larger areas. The extent of lung tissue . involved will depend on the concentration of silica dust in the atmosphere and the period of time over which the worker has been - exposed to it. . . When silica dost is inhaled, even in injurious amount, it pro ; duces no immediate effects, because it does not irritate the nose or / . throat. Sooner or later, however, the effects begin to be felt. . ; .When the fibrosis of the long has advanced to a certain extent ' shortness of breath appears and increases, it may be to such a -.- . . degree as to render the worker incapable of continuing at work. 'Moreover, chest trouble arising from infections such as tuberculosis, influenza and common colds, is liable to be much more serious ' in persons affected with silicosis than in those with healthy lungs, - .V- -/and at any time in the course of its development silicosis may be came compile: organs. It is posstbL in the atmasp several kinds, particles count examinations.. .dusfeaafprwMl dost .vases* ;wi .than.'10*Q0G;p remembered ytl 500 cnhicrcsnti a suns^By it/w ' reach the.lung: , ' It has* not Jimit within w! Attempt, have dustnes.carriei - States granite. in' tunnellingdardsymayoe methods used.i be . wrong * to**: safety .under Before standar be obtained of the lungs,.and the concentrate Much t progress co-ordinated re. being carried o .; - * ***r * t.'. Silica is-wide -stituena of'ma stone, sandston it is present-in chiel areas'-wh shire; .-.Iibncasl Cheshire and.,2% shire, and-part shire,. Piieshix Cranite' aad-.ot and .Devon,: p: .District^nnd ir ssiss /' 4 Pi w > * >> ** * -V. \ *4 : is sack as quartz, rtion of others such ce silicosis the dust ill is to be invisible t.;they mf..r r.rpenr when any of these h -a'- chisel or drill, he dry. state, unless 'the'air; and when along the bronchial expanded balloon* i-.the. lungs is com* function in helping es the-,'lnngs, and widely,-m-different .>;* is; always-better to ' nothing.through the : Ji-into contact, with, tt" are tbreathed out ; rthe particles are -' ;es and are'readily :- ^proportion of the oaie to* rest .on the `' the lnng tissues . __ cubes or towards.-*.^ ' of the-quantity of it successfully, bet and the dust laden ammatory process. V*. nbre. or less slowly ultimately replaces 'V iodides which may* :tent of lung tissue . 'silica dust in the is worker has been js'amount, it pro* irritate -the nose or . vb'egin-.'to be felt. >"_ o, a.-certain, esten; may-be^. tcrSuch a '?>-* in turning at wort. :ch as tuberculosis, ouch more serious .vith healthy lungs, it silicosis may be* i 4 l V 5C^srrraV,' r~V l'.. 5 come complicated by these or other infections of the respiratory organs* It is possible to determine the concentration of particles of dust in the atmosphere of any workplace by menus of instruments of several lands. Semples of the dust can be collected and the particles counted and measured by microscopic examination. Such examinations of the atmosphere -have been made in many- in dustrial processes, and it has been found that the concentration of dust varies within wide limits of less than 100 particles to more than 10,000 particles in a cubic centimetre of sir. When hfc is remembered that a man during ordinary quiet breathing inhales 500 cubic centimetres of air with each breath and breathes 16 times a minute, it will be seen that the number of particles which, can reach the lungs during a working day is enormous. -- It has not yet been possible to determine for all industries the limit within which a concentration of dust may he considered safe. Attempts hare been made to determine the limit for. special is* dustries carried on under uniform conditions, as in the 'United States granite industry, the South Africa gold mining industry, and in tunnelling in sandstone at Sydney, Australia. Such stan dards may be of value in estimating the relative efficiency of the methods used for suppressing dust in a single industry, but it would be wrong -to adopt any of these standards as the measure of safety under different conditions and in. other industries. Before standards of safety can be set up, more knowledge must be obtained of the factors which iuftueuce Ihe action of dusts on the lungs, and methods of precision must be devised for measuring the concentration and character of dust clouds which cause disease. Much progress has Imcn made in these directions as a result of co-ordinated research, and more is hoped for from work at present being carried on. . . 3.--Industries and processes in which silicosis occurs. ` Silica is widely distributed in nature and occszs as the chief con stituent of many rocks feuch as quartz, quartzite, gnnister, grit stone, sandstone, chert, dint and in the natural qnarizose sands, and it is present in many of the igneous rocks, including granite. The chief areas where sedimentary silica rocks arc found are in York shire, Lancashire, Northumberland and Durham, Derbyshire, Cheshire and North Wales, South Wales, Somerset and Gloucester shire, and parts of Scotland, including Angus, Ayrshire, Dumfries shire, Fifeshire, Lanark, Midlothian, Morayshire and Stirling. Granite and other igneous rocks are found principally in Cornwall and Devon, parts of Leicestershire and North Wales, the Lake District, and in the West and North of Scotland. ssm as Certain natural deposits of silica occur os the remaihs'of -animal and vegetable life, the best known of these deposits being perhaps kiesclguhr. All processes which involve the manipulation of any of those materials in the dry state in sack a way that the silica is broken up .into minute particles; and inhaled; are -liable to give rise' tb silicosis. Chief5among these are :-- ' *J . " ; , or quarrying of quartz, quartzite, genista,'.^dsfcqne, V .gritstone or chert;' . . r . .. . . ' 5r i;drilling.and blasting-in these rooks ^breaking, crushing and grinding'.of* such rocks, or.ofdried . ~ quartzose sand or dry deposits or dry residuesof- silica,, and'the . ^manipulation of the-ernshedor ground material in. the dry state/; . mason's-work on sandstone or granite'; ' ' ' ** . . : manufacture of- ginister or silica bricks and other refractory * ..materials;. : * *.. ' .--^v >., /> breaking, crushing or grinding* or iint,ahd processes in'the * '* -"pottery industry involving the use of powdered flint.'or materials . c f* . ' grinding of metals'by means of grindstones composed of ~ ^staxal or artificial.sandstone; * < .. -.fettling of steel castings; and. . . -:* * x . sandblasting done' by means of compressed air with use of quartzose sand or crushed silica rock or dint. ' . - . ' . ; * f 4.--Means of Prevention. ' * . The most important means for prevention include (i) suppression of dust; (n) ventilation; fiii) other methods of preventing the in halation of dust; (iv) medical examinations. . Q) Suppression of dust includes all measures which prevent . the dust from being produced. It is sometimes successfully accomplished by the use of water, but to be effective .the supply of water must be' sufficient to keep all surfaces of the material . vret.during.the .whole.process. .In some cases, as in grinding _ of -metals, effectual dust suppression, is only attained by the ; ' ' complete immersion of the metal being ground., - . -. ' .. . .(11) Exhaust .Ventilation.--One of: the .most Widely applied 'means of prevention, is by localised exhaust ventilation which to be .effective- should ;be applied at or-as sear as possible to .. . ... the point of origin of the dust and so arranged with reference -- ' to the .-air- inlets and* general ventilation of the rooia -as'-Qj .v .. . prevent; the. dust .from, entering the atmosphere ofthe work* j - place-1 Where the dust is. produced over i large surface;' as in. <m:ahing .'.machinery;-;conveyors,. or' -mechanical' sieves,; it;=k ' usually necessary.' ;to.''enclose the* machine-1'as -completely-as ' . - '. *r - .... possibl ,. in", su vent es . where 1 x**. assu rec ^ventsrin . .vo/yeafc2a ;-;:jargeiy* y^.tfea-qff :giW>fc Ijkafr'thjfcs. y^;axms^. :-'-diessmj %fth^Ho: i?.`ir-.rgapbsT'H.nhd-:rei ^'`quired; '"^''tent'df ' Hy'-gthphs thes consist! .r^..an air j .protect! -- > dust ar .: occasiot '.'r;`..:'Sespi . Tiaust v* .--of'such tors as . ---tissue a .vestigai -``aad'-Inc `factory, hbped:.i ; -prODert1 ,The '< .rf.ir'isrori:ais y'esposur ;is.requi .' ing-oi C '* At 97 7 10 m. to 4 p. ^ssizcsi jerhaps 4 0^'these IWt- scristonev riots drieS.- 'and'iHe ct state", vj ** . .* . rpsrtetbry .`.S` . .-.*y . . ssirrtbe; ceased -of 3'NQ- ;r;r.*"y .:?*?^T*. imise^pf { nssiQa^.... -'.* h prevent.-.'. ttcsssfnUy.V xs supply j material i grinding . fcy: the .; . # 7'sppjied im'which cssibis- io reference in -&S;'b is work- ' - :ce7 astin-. ^s, it is petaly' as '. V ... . possible and to apply exhaust draught to the inside of the boos? . ing, sufficient to maintain a slight negative pressure arid prs* . vent escape of dust horn apertures. In the case of silica diet; where the particles are minute, considerable care and experience - . an required in designing the plant` for the removal of dost.' It >i& also necessary to prevent the dust from the exhaust plant : entering &e atmosphere of any room or place where persons an weriring, and for this reason systems of localised exhaust ventilation must be provided with dust collecting appliances. * . - The percussive drills worked by oompressed air, which arc ' largely used at mines and quarries and produce large quanti- . ties of fine dust, can now be provided with a44 dust trap '* which , . gives the workman efficient protection. .A considerable number of those dust traps an now in use.' The principle in these drills has been adapted to pneumatic tools for stone ' dressing by a device the worldng of which is demonstrated at . the Home Office Industrial Kuseum. * - . In this Museum then an also exhibited a series of pboto- ' graphs of the chief processes in the pottery, metal grinding, and refractories industries, and the protective measures re* quired, as well as specimens of the materials giving, rise' to silica dust, microphotographs and dust counts of the dust con*.' ' "tent of the atmosphere of the workplaces, and X-ray photo graphs of the lungs of workers affected by silicosis due to work in these industries. . ' ' (Hi) Other primitive measures.--A breathing apparatus .. consisting of a helmet or closely fitting facepiece provided with. an air supply drawn through a tube from a pun source affords . protection for workmen' employed in processes giving rise' to . dost and is most useful in industries.--which are carried on ..occasionally only or for short periods.. ..Respirators can never be regarded as. a substitute for ex-, haust ventilation, but for processes which are outside the range of such ventilation an offices t respirator is desirable. Respira tors at present available with a filtering medium of fibre or . tissue afford insufficient protection against fine dusts,* but. in* . yestigatioas are being made by the Department of Scientific, and Industrial Research with a view to the provision of a sni& . ; factory type. Considerable progress has been made and it is hoped that before long a respirator, possessing the necessary properties will be produced. ' *' ; . The effectual segregation of dusty processes, so as to protect workers employed in non-dnsty' processes from unnecessary 'exposure to dust, should be adopted wherever.practicable. .It .. *is. required, for example, in racing grindstones:.by the Grind ing of Cutlery.and Edge Tools Regulations. ` - * At 97 Horseferry Bend, Westminster, S.W.l. Open an every wcofe-day 10 aja. to 4 pA Admission freo. The success of preventive measures depends not only on the satis factory design and installation of the exhaust ventilation system, but to an eves greater extent on the proper maintenance of the apparatus or plant provided. In this connection there is a respon sibility on the workman as well as on the management, and the undermentioned codes of Regulations make it obligatory on the workmen employed to make lull and proper use of the appliances provided and to report forthwith to the management any defect in the same. .. - :" ' Regulations to safeguard the workman aguiost the inhalation of silica dust are now in force for the grinding of metals and cleaning of castings,* the- manufacture of cutlery and edge tools,i hand ling; moving, breaking, crushing, grinding or sieving of refractory material, and the manufacture of silica bricks^ and certain pro cesses in the manufacture of pottery. * . " Rot the detailed requirements regarding each industry reference . should, be made to the particular code of Regulations, but broadly they consist of the elective enclosure of the apparatus with pro- - vision of efficient localised exhaust ventilation, and an approved system of mechanical general ventilation, the provision of a steam or water spray, the segregation of the dusty processes; and general measures for securing greater cleanliness of the premises and appliances. : - In factories and workshops to which special Regulations do not apply, the powers given in. section 74 of the Factory and Work- . shop Act to require the provision of localised exhaust ventilation . or other mechanical" means for removing dust for any process in which dust is generated to an injurious extent are exercised to prevent exposure to silica dust. ' Section 78 of the.Coal Mines Act, 1911, requires generally that mechanical drills used for drilling in highly siliceous rocks gkaH be provided and'used with an efficient means to prevent the escape of dust into the air. . . ' .. Under the same Act general Regulations!! have been made for ganister mines, and under the Metalliferous Mines and Quarries Acts, special rules have been established in tin mines and in many . quarries where ganister, sandstone and other sSlta. rocks are worked. (iv) InUSaL and periodic medical sxaminctio?is.--Workers in , certain processes are required to be examined medically when -* * * * Tfc* Grinding of Metals (Miscellaneous Industries) Regulations, 1325 : SJL tc 0.1925, No. 904). - -t The Grinding of Cutlery and Edge Tools Regulations, 1925 (3JL & 0. 1925, No. 10S9X ; X The Refractory Materials Regulations; 1951 (S.IL & 0. 1931, No. 350J . ' The Potterr (Silicosis) Regulations, 1932, (S-R. & 0.1932, No. 393). ' D S.R.&0.1920, No. 873. . c t 'c `C -c -`i .../ 3 s , - Cot . - . : silicos 1 temple ; . / risk c . ...... specie vision '.; ; Sped; ' * under which .given . applic -. actual ** Ilariy * . Schec 6.-- i ^ ' t - . V*' 'An: f *' V ;haTe * - * Sr ' paragr :: . *ppir ' : - . which : .. ' yv. tTfc .* ; Coorai - be mac publish y en-tbo-sads- * lation system, -ice of the v - a- responnent, and the 'atory on the :he appliances a: any defect * / ** inhalation of Vend cleaning tools,'I '.hand.-of refractory I certain -pro- _ . "' . ' . srrj reference ^'but broadly ;as with .proin. approved ncf.x,steam Sand: general demises.; and- . . _ ittpoB'd&'not " : .v'and Work-. '` if 'ventilation .; v* process ini- exercised; .to , / / raiy.'thkfc shall be.,' he' escape' of :: ^ ' en made'for. , . usd 'Qusmas ; - ' ind in many ' ' . ` -ore worked. -- . -Workers in Iically when ' " olatioes, 1925 25 (S^ * 0. . . \;e:r.^-3o3:3:3U5w^- 9. J .first employed, knd .also.at intervals during-their .employ* meat.* The object of the initial examination is to prevent . workmen .whose respiratory physique is defective and who, if ' . not more liable to contract silicosis, ran much greater danger . if silicosis develops, from entering tho industry. The periodic medical examinations which are carried out at the works should be of great value as a preventive measure. They enable cases j of silicosis to be detected at an early stage, and if the work .' man is then excluded from,, or voluntarily gives up, further . employment in the dusty processes, the development of the disease may he arrested. They-also enable persons found to be i ` ' suffering from pulmonary tuberculosis, who not only expose ^ themselves to additional risk by remaining in the dusty in- ' dustries hut are also a possible source of infection to their fellow , ; workers, to be eliminated; and they provide cumulative evi- . dence as to the changes in the workman's condiMon which is ' of the greatest assistance in diagnosis when the question arises of certification for purposes of compensation. Further, they \ indicate where the conditions are still giving rise to the disease,- and may thus be of material assistance in enabling the neces* / -. . sary precautions to be taken. .. 'v'"-'.." . " 5.r-Provision lor compensation. ' . : Compensation in . cases where death or disablement is caused by . .silicosis or silicosis accompanied by tuberculosis contracted during 'employment is now payable in all the industries where a serious risk of the disease exists. Owing to the nature of the disease a special compensation procedure different from the ordinary pro visions of the Workmen's Compensation Acts has had to be devised. . Special Compensation Schemes have bees made by the Home Office under the powers given by Parliament for the purpose, a list of which, and an indication of the processes to which they apply, is given in Appendix H. Before making claims to -compensation or applications to the Medical Board for Certificates (see below) the actual Compensation Schemes should be carefully studied, particu larly the definitions of the processes given in paragraph 2 of the Schemes. /\ .. . 6.--Medical Arrangements for examination and certificaiicn of . cases.t . * ' Any workman desiring to make a claim to compensation must have a certificate horn the Medical Board appointed by the Home * S** tho Silicosis and Ashestosis (Medical Arrangements) Scheme, 1931. paragraph* 12 and 15 as amended by the Scheao of 1934. The requirements apply to tho processes in the Refractories, Sandstone and Pottery Industries which ora sot out in tho Schedule to tho Schema of 13J t These arrangements aro based on the recommendations of a Departmental Committee appointed to advise as to the medical arrangements which could bo mode for die diagnosis of silicosis. . The Report of tho Committee was published by HAL Stationery Office in 192i>. Price Gd... " . : Y ; r--f- t Zr^T-TT si- " " "* 10 Office unless his employer agrees that he is liable to pay compen sation without such certificate.' * ' This Medical Board, consisting of a Chief Medical Officer and eight Medical Officers, is divided up into four " panels '* of two Medical Officers each, with centres at Bristol, Mandiester, Sheffield and Stoke-ou-Trent; The-Chief Medical Officer'is stationed at. `Sheffield. A list of'the panels and the area'assigned to each is given in Appendix HL.* ; . :.:v`v- - - - > . ` . The remuneration and expenses'of the Medical Baird are paid ont of a general. Medical Expenses. Bund, which is 'maintained -out of fees payable by the' employers and .Workers or then dependants.' These fees, and the. directions' as.to when and how they are to be paid, are set ont in Appendix 17. ~ # . . -. The Medical Expenses Band is-administered by five Trustees,' consisting of two' employers' and two workers' representa- ;tives and one official representative. The present address of the Secretary of the Bund is the Home Office, TFhitehall, London, .S.WJL - - - . -> \ .. ' Certificates of disablement or suspension.--A workman desiring ' to apply to the Medical Board for a certificate is advised in his own interests to consult, in the first instance, his Approved Society, who will arranged for him to be examined by tlie Regional Medical Officer appointed under the National Health Insurance Acts. This ' examination will he free of cost to the workman. If the Regional Medical Officer is satisfied that there is reasonable cause for sus pecting the existence of silicosis he will certify accordingly'.. On production of this certificate the workman will be entitled .to examination, by the Medical Board at a reduced fee. He should send the certificate, together with the prescribed fee, either to the chief officer of the Medical Board, or to the senior member of the panel for his area (see Appendix III) stating the. Compensation Scheme under which the claim is made, the uaiue and address of the works of the employer who last employed him in a process in- eluded in the Scheme, the nature and diuut.ion of the employment and the dato when he left the employment. The Medical Board will then fix a time and place for the examination and will notify the workman accordingly. -.r There is no appeal from the Medical Board's decision, and hence . 'it is important.that all material information and especially- the employment history should be given to the Board. - *. If the workman foils to obtain the certificate from the Regional Medical Officer he may still decide to proceed with his application for examination by the Medical Board, but in that case he will be required to deposit a fee based on the full cost of the fcion, part of which will, however, be. refunded to him if the Medical Board issue a certificate and the liability of .the employer has been established. . .. . . Before I l to the emx 1 lished nnds I made or s: Ipioy*or..; .rMuired-tc I- suifezing.-t such a.'deg ;. / the` Indust " examntatic ;* :.r. a wor inatlon.is, aieni oh as ' y- - the- Board `Wy--. this'the;w;: .' * `provisions < 7 \Ccrtificz. . \.yy tiom.can 'o . '! SBoaad.11 Sa .-/O' entitled to life and the ` - tion is. uni ' mortem ex desired.to < . tion. shouh' . arrange fo Coroner or: . . pariiedbyt and inform man's'- enr 1 Coroners' h to the acre 1 the Board j at`the* era 5 ' -..Disposal : Industries ! i* workers b :* Medical 3 ' ' iippsopriat ` man' a:' hi I " y la case: ' . ' to'`the w: - claim, to c ! ; for these ; -/ . employer to pay compen- .-Officer and panels " oi two hester, Sheffield is stationed at {ned to each is aid are paid out mtained -out of iir dependents, ithey. are to be five Trustees, s'.--representant address of ehall,' Loudon, kman desiring '.'' ssd in his own roved Society, . gional Medical ce'Acts. This (the Regional . cause for sus- ' .. ordihgly..- On &_ entitled- .to .-. He. should ; Neither to the { hber'of .the , ', npensarioo. . ad address of ja process in i'employment fedical Board id will notify ' ;**a :] n, and hence specially the the Regional s application case- he will ;he examina`/the.Medical mployer has 3ar. . Before' issuing-any certificate: the. Medical Board send. notice, to the employer, or,.where a Compensation Fund has been estab lished under the Scheme, to the Fund, and consider any statement- made or submitted to them in tenting by or on behalf of the em ployer or the Fund. ' .-. . . h- * Except in cases of death--see below--the Medical Board are hot required to issue a certificate -unless the workman is .found to be' suffering from silicosis- or silicosis accompanied by tubercxriosis'to such .a degree os to make it dangerous for him to continue .work in the industry or- process, but an intimation of the result- of tier examination is sent to the workman in every case. ' * ry ' If a workman who is subject to initial or periodic medical exam ination is, as the result of such examination,'excluded from employ ment on account of silicosis or silicosis accompanied by tuberculosis,, the Board issue a certificate (for which no fee is payable), and on this the workman can base a claim to compensation subject to the provisions of the appropriate Compensation Scheme. ' ** ' Certificates of death.--In cases of death from silicosis, compensa tion .can only' be! claimed on a certificate given by the Medical Board. Save in exceptional cases where the deceased workman was entitled to weekly payments under a Compensation. Scheme during life and the Medical Board ore satisfied that a post mnr*rn examina tion Is unnecessary, this certificate will only be given after a post mortem examination. .It is important, therefore, that when it'is desired to claim compensation for the death of a workman, applica tion should be made without delay to the Medical Beard, who will arrange for the post mortem examination except where EM. Coroner orders one. to be made./ Tho application ri20uld_.be *ccom>. ponied'by the fee prescribed by.the Regulations (see Apperi5xJ7), and information as"to the nature and duration of the .deceased work man's employment. ' .In cases where inquests .ore held,' ILM. Coroners'have been-invited to. consult with the Medical Ttn^ as to-the anabgements. for the post mortem examination,' and to give the Board an opportunity' either of making or of being represented at the .` * ....Disposal of certificate-.--II, as in-the Refractories and Sandstone Industries, Joint Committees representing both employers and workers have been appointed' for the settlement of claims, the Medical Board will forward the certificate to the Secretary of the appropriate Joint Committee, who will communicate with the work man or his .dependants, as tho case may be, in regard .to the claim. In .cases arising,. in other industries the certificate .will be sent to the workman .or his dependants who should then notify the claim to compensation direct to the employer, tinder the Schemes for these other industries, compensation .is recoverable from the employer who last employed the workman in-one or more of the j .. - -- * ' - V;J,-* y.' W , .;v ^ /.; > k r tf: - IV*.'. i* h-. .. >t V ' .. . i ' 12 proeesses> and the procedure for recovering compensation is sub stantially the same as that laid down in the Act for recovering' compensation for accidents or scheduled diseases.* . J. 7.--Asbwtosis. Asbestosis is a disease of the lungs produced as a result of the inhalation of asbestos dust usually over a period of several years and occurs, in workers in occupations associated with production ; of asbestos dust in a due state of division. 'It is characterised, by-/; a special type of fibrosis of the lung tissue .which resembles silicosis ..' ; in its general features of causation and development} hot differs'; ' from it in some of its clinical and pathological manifestations. 'The characteristics of the dust which gives rise to the disease differ in.some ways from the silica particles which cause silicosis. -. Is the case of asbestos, owing to the fibrous character of the ;! mineral,'- many of the free particles are elongated and extremely, thin. ` - ' . . ' - . ' ' The change produced in the lungs is a gradually' developing fibrosis in the form of a network throughout the lungs. The'nodular - distribution of the fibrosis, so characteristic c silicosis, is not seen. Tuberculosis may co-exist but apparently does not supervene--so' frequently as in silicosis. " * ... **-.. Once the fibrous tissue change is established in the lungs; the disease becomes progressive. The first prominent symptom. isV usually shortness of breath and it remains the most prominent**, one throughout. Bronchitis, bronchiectasis and broncho-pneumonia '' are complications frequently met with. Industries cud processes in which asbestosis ocears.--Processes involving exposure to asbestos dust which ere known to give rise to asbestosis or in which the conditions are such as to be liable to produce the disease, are the breaking, cradling, disintegrating, : - opening and grinding of asbestos and the mixing or sieving of asbestos or any admixture of asbestos, the manufacture of asbestos textiles, the making of insulating slabs or sections and the or repairing of insulating mattresses composed wholly or partly of asbestos, and the sawing, grinding and turning in the dry state of articles composed wholly or partly of asbestos such os motor cur broke and dutch linings, jointings, eiectric insplating materials and some types of electrodes. Means of prevention.---As in the case of silicosis, suppression dr control of the dust is the chief means of preventing the disease. The Asbestos Industry Regulations! require the adoption of tret* ' .methods, effective enclosure of dust-producing machines, adoption * 8m Bom* Office Memorandum os the Workmen's Compensation Acts. 192A-1931. B.M. Stationery Office, pries Cd. . . t SJL ft 0.1881. Ke. 1140. . : . l l * i W. , - x -orapoaiaiion is sub* Acs for recovering' 5&ses.* . luced 25 2 result of the .period.of ..several years related with production frit is characterised by vhich resembles silicosis ierslopmeut, but differs gical manifestations. - .Tvea rise to the disease es. which cause silicosis, ibrons: character of the Fongated and extremely. X' gradually developing ;vthe lungs. The nodular. ibf. silicosis, is not seen, r.-does-not supervene1 so lishe'd in* the lungs; the prominent 'symptom is ins the most * prominent .-and broncho-pneumonia )F' w- occur*.--Processes ^ j'.iawwn to give ;rsse :;Sccii.as to be liable to crushing, disintegrating, ithe ..mining or sieving e manufacture of asbestos /sections.and the making nposed wholly or partly turning in the dry state resbestps such as motor ^Ctric insulating mnfri'giq >! silicosis, suppression or Cpreventing the disease, oire . the .adoption of wet ijring 'machines, adoption jrkmcn'j Compensation Acts, xa * of enclosed mechanical methods instead of hand conveyance and dnsty hand work generally, and application of exhaust draught at dust-producing points. - As in the silica industries, initial and periodic medical examine* toons may be of great value as a means of preventing or arresting the development of asbestosis; and these are obligatory* for vrork- . men employed in the processes of breaking, crushing, disintegrat ing, opening or grinding of asbestos, and the miving or sieving of asbestos or any admixture of asbestos, and in the making of asbestos 11 textiles and insulating mattresses. * ": ' .. ... . Provision for Compensation.--Compensation is provided for under a special Scheme in cases of death or disablement caused by asbestosis or asbestosis accompanied by tuberculosis. This Scheme' applies to workmen employed in the processes, a list of which is given in Appendix H, at any time on or after 1st May, 1231. The. compensation is recoverable from the last employer who employed the workman in the processes and the procedure for recovering compensation is substantially the same as that laid down in the Act for recovering compensation for accidents or scheduled diseases. : . ' Medical arrangements for examination and certification: of cases.--The medical arrangements for the examination and certification of cases are similar to those described in the earlier pages of this Memorandum for silicosis. * Silicosis and Asbestosis (Medical Arrangements) Scheme, 2932, pars. 1C and 1.1 (SJL fc 0. 1931, No. 341), as amended by the Scheme of 1934 (SJL 0.1934, tfo. 3S9X f 4 :i. tt . t *4. ' lz > J>. #r"->: <%. >". :-- & L e: Tsr - v , i 1 5a i i 4 S 1 '* ` 'i *r ?* . _ i } APPENDIX-L--BmioomraT. {X) " Industrial Pnetmtoaocoaioscs with Special Reference to Dust Phthisis.1* By Dr. EL L. Couas. 1LAL Stationary Office, 19X9. 1 (2) 11A Stud; of..Pulmonary Silicons." By Dr. E. li. 3msu70X. Journal o/ladnatriai '.2wt#*e, March, 132L ... . ^--- <31 ** hTaanfactamoT Silica Brides ;aad-'Other :~Dgfractoi^Materials used* in .Ruraaces, with special reference 4o--t2ae effects-ol 'Dost Iakalstica 'upon. \ the , Workers.'*-:.. By- W. `.row*T. Saars. .ad*.: Dr..-:S. T- ... H.AC'Stationery Office, 1917. ,v-.- (4) - ** Beport on the Grinding of Metals sad Cleaning of` Carting, withi .. special reference-to,-the edeets of Dust Inhalation . opoa the Workers." . fir S. L lIsasrBr-'aad Dr. S. L. :-MmnLWOm SJX. Stationary:'-- Mi- (Q "Report on the Oeenrtesee of Silica* among Worker*.". By Dw. C. L - Sotmun aad S., Barsov. gJI. . Stationary Offiee, 1329. - - i' '. ./. V' . (6) **Bepcri an the Incidence of Silicosis in the Pottery Industry.**'; ' By: Die. CL L. 3vm*ausn aad S. Bxnox. ILA1. Stationerr Office.'-' 1928. - **.: . /* ' ; ` ............. .:-* *'(7)' ** Baporfe on the- Occurrence of. SSimVie among Granif* Workers.'*: By Dn. C. L. Sorsmiss, S. Besson and H. Sxxbxf. BJL :- -. Stationery Office,' 193ft..', " /, * (8) w Pint Ilepart of the Departmental 'Committee on Compensation*..' for Silicons dealing with the Refractories Industries (StUceea) 'nrheme.' ". ISIS." MIL Stationary Office, 198*. '* ' * (9) " Deport of the Departmental Committee on Compensation for , SiUcom dealing with the Pottery Industry." g.hl. Stationery Office, .. 292S. - . (IQ) "Deport of. the Deportments! Committee ss to the- Medical . Arrangements which could he made for the Diagnosis of Silicons." ZLM. '. Stationery Office, 1329. .' . (XI) '* SiUuasU Records of the International Conference held at Johan* neeburg in August, 1930." International Labour Offico, Gaoera, 1930. , (12) 11 Beport on the International Conference on StBcoeie held at Johannesburg in August, 1930." By Dr. E. L. Mzss&smec. JSJX. Stationery Offico, 1931. . (12) " Physical Methods for the Estimation of the Dust Hazard in . ' Industry, vrith special reference to the Occupation of the Stonemason." By H. L. Gnsst and H. H. Watsox. Special Report No. 199 of the Modfcsi Deseareh Council of the Privy Council. K.M. Stationery Office, X33S. ' . -- (it) u Deport on ESeets of Asbestos Dust on the Lungs, and Dust V Suppression in the Asbestos Industry." By Dr. . XL A. Usarnsn . And Mr. C. W. Pkxc*. H.M. Stationery Office, 1930. (IS) 11 The Occurrence of Pulmonary Pibrasis and Other Pulmonary Affec- ' tioo in Asbestos Workers." By Dr. X X. 1 hfsncuxaccu - Jouraai of -. Industrial -Hyyscne, 3Iay and June 1930. . . .... (18) u A Xtenoraadun on Aebestoszs." By Dr. E. B. A. w*wi*wr . ^ Tubercle, November and December, 1933 and January, 1934. . ... .* \ ~(17) ''Deport on Confereneos between Employers aad Inspectors comji'u*. '" ihg Methods for Snppmsing Dust in Asbestos Textile Factories." '*' Statianery Office, 1S3L ` ' * ' . ;. *J* t'T^; . V !' :' Lis 1 Bet -silic *ae< *tr-.iale 'C tr.^.vorith ~'.rj: jiyr^'TSeheiminii .ti f `v^tf^miaa I ;.: -;highij -. V'.-V.r-certsi ;`.->yV- -*.C. to the V'/'r^^'yelectr .> eandh .V y-;jwiih . .under ' S. 4 . - ..i'-the to. V" . * inft e . sieria? r . s ' aebestc C ;.;V.compo~ ' on in * . . ,J : .'`.rawtw V ' -*.applies *.'** ..-e^ to ' - - * asbeats . ..-w, iapreg: `r-Iadnstr ,`3.*;73) `raff's '' Scheme V'tS3 Schame-V(SJ&-* >:-:l S3 . SchemeNo. STS 'C No. 109 ;'y.S.'S^ Si-Vt- 15 APPENDIX II. List o Coasrsx&iTXOx Seneares ard the Processes to wiucr wisr ah*,*. L J?e/mefori Industries (Silicosis) Scheme, 1931*.--A Scheme for tbo Refractories Industries, that is,, the setting of ganister aud^ other highly ^'Mcconv* f*^*<w*T?*t*j tnii tho sueik materials' ia -the manu- factsro of silica bricks aad othar artidas for listing faraacst ->' 'i? . 2. Soadrtons Industry (SUieotU) Sckemt, I931t.--This Scheme covers the gofctingvaad manipulation of iaadtoB with a-view -to manufacture, salo or use 'at mines, ari guarries..ot oa., prnmiies vroxhad'in injunction with e mine or qua7.`.7* ' 3. llstai Grinding Industries (Silicosis) Scheme,* 19312.--This. Sdiaaa deals with tits grinding, of metals .on griadrtoata composed of natural or artificial mndrtooe, aad certain, incidental processes. ___ ' . .. ,4. Various '.Industries (Siiisosis) Schemes; 1931, 2934 and 19355.--A general a variety of processes in different- industries, including and quarrying of a****- rock axeepfc in. so far as this is covered by the Refractories Industries and Sandstone Industry Schemes (see shore); drilling.and blasting in rock in or incidental to tbo getting of othar minerals;, say operations underground in coalmines and haematite iron ore :siines; stono mason's work on silica rack or granite or other igneous rock '.(in so far as it is not included in the Sandstone Industry); breaking, crush-, ing, grinding, sieving; wTMHg or packing of silica rock and certain other highly .siliceous materials or dry admixtures containing inch materials; <*>>&* specified processes involving exposure to silica dart in or incidental to the manufacture of ohinA or eartboawaro including sanitary earthenware, electrical earthenware, aad earthenware tiles; fettling of- -rteel catting; candblastiug'of metal or .articles of metal by means of compressed ` air .with tbo uso ofquartxose sand or crushed silica rock.or flint; and all underground and certain surfuco operations at tin mines. . * 5. Asbestos Industry (dsbertests) Scheme, 1031(1.--This Scheme 'covers the following processes in which asbestosis Is UaUo to occur, namely,- break ing,' crushing, disintegrating, opening and griuding of asbestos, mixing, or sieving uf asbestos or any admixture of asbestos; the manufacture of asbestos tustiUs, the making of insulation slabs' or sections or mattresses composed wholly or partly of asbestos, other manufacturing processes carried on iu tbo same room as any of the foregoing processes, tbo cleaning of machinery and plant used in tbo processus and uf chambers, fixtures and appliances for* the collection of asbestos dust, and tho sawing, grinding and turning in tho dry state of articles composed wholly or pertly of asbestos, except articles composed wholly or partly of* woven asbestos impregnated with'bitumen or other bead of on adhesive nature. . ' * S.R. & O. 1931, No. 345. This Scheme superseded the Refractories Industries Schemes, 1929 (SJL & 0. 1919* No. 12) and 1925 (SJL & 0.1925, No. 79). . . +? S.R. & 0.1931, No.34G. This Scheme superseded the Sandstcne'Industiy Scheme, 1929 (SJL & 0. 1929, No. 171). . - . 2 S.2- & 0. 1931, No. 343. Tills Scheme superseded the Metal Grinding Scheme, 1927 (SJ2. & 0. 1927, No. 3S0), as amonded by the Order of 1930 (S.R. & 0. 1S30, No. US). -- - $ SJL & 0. 1931, No. 342, 1931, No. 1135 and 1935, No. 69. The 1931 Sohemo superseded the Various Industries Scheme, 192S (S.R. & 0. 29*23, No. 975), as amended by the Order of 23rd December, 1930 (S.R. & 0. 1930, No. 1095). * i| SJL & 0. 1931, No. 314. . . . \ t t /.t m rrr?3-r> r. ,4 3 itC:>. r.*. tv-41r &*.V {nrfi*e- **>.<*-:", v.i*.-.i4* :t gOr..*wi- v2../: S^** 5^J f* p'*e V>**'' ||I4 SrT r* t'w ;v-.-^*'4 t-?v -s K* >*;; E>- 5 *f- - iw*;?*j f *=:-*' . <*?>- t .i fer $'-' i r? sw-..1 U`* *3 C --J '? HV: i > is* 5 Jt ff. t-?.:&~24 ; 16 APPENDIX IIL Stlicosts itn> Aucroi Bo*an. TheChief Medical Officer itC.1. SutherlsadlhLD., D.P.H., 37'Exchange Street, Sheffield 2. . .: . .. . 13m ccntrerat which panels bar* beta set op, the aanben of the paneh, and the ana* assigned to the panels an as follows*-- - * . Centre, end Member* of Pantl. Area. Sheffield, 37, Exchange Straot ' S. Siysen, 1LB,, Ch3. ' (Senior Member). ; H. Blyth, 3LB., QuB. ` The Counties of Took East and Wot Hidings, Nottingham and Lincoln, part of tbo Cooaty of Derby, ria., tbo.. Borough* .of Buxton, Chostarixold had GIossop; tho Urban Districts of Bolxervwr, Brampton and Walton, C2y Cross, Dronfield, and Nov hSSa; aad tho Dural District* of CSiapol-en-le-Frith, Cbosteraold, down, Cl&nop Dale, Hayfield and Norton. . Manchester, 14a,* Blaekfrioxs Stroat. J. 1L Tyrrell, MJL, ChB. (Senior Member). J. a MeYittie, M3., QuB. The Counties of Nortbumboriaad, Durbom, York North Biding, Cumberland, Westmorland and Lancaster; aad Scotland. . Bristol, Atlas Buddings, Clare Street. - K. Seating, LJLC.?., L.R.C.S. (Senior Member). ` B. W. Thomas, M.D. ' The Counties of CorsvaB, Doran, Dersot, Gloucester, Hereford, Monmouth, Salop, Somerset, Wanrick, Wilts and Worcester; and Wale*. Stoke-on-Trent, Lonsdale House, Lonsdale Street.. A. Maikiejoha, M.P. ' (Senior Member). F. N. B. Price, M3., QuB. The Cooatios of Chester end Stafford aad tho County of Derby egggyt the portion 1 to the laKfr&eld Panel. . For any area not assigned to aay of the ebore-mentioned panels of the Board, arrangements will be made by the Chief Medical Officer as aad vfesa necessary. f* / } ..-A. .* - of , 7m. n 'Ox "-:a . *C` i w*vir- : : v,. * Ca :0b iy.s?*s =**^trbug ..> Aabeatosia ( .aa-aaaaded ;-'.:"mnt Scbac ;.7. ';':.*.f'Parap . . as payable :. Cempeaseti ' - :Tnnd^ the provided, b . ie-recoves*; 3. -sc the psotls, - *. East."didinffhaa and . County, of troughs- of vndGI*op; of Bolwrer," dtea,. Car. New 1221a; )i'tricti . of Chssterfiald, .'ilayfiaidaod.. 'lnabariand^ ih .'Rieiag, ^ iriond _Aad'" fli, Dtebn;*': iHsrtfed;': / Soasmt^V rroQBOtMfV*'f'* J 'tT'&ii-t-.: \ 'VAnd--.County of-"; on,assigned'. -' . v'.****:*' . nil*1 of the s M*d.\wtoi' :17 ASPECTS IT. Tats ?ataslk yoa examc&atuns ar crErmcarrs bt Mebxcax Board. Prescribed by the SHicasss end dsbesiorit (Zlcdiecl Test) JUgulaiiant (SJl.O. 1331, .Vo. oad 2SJJ, 2ic. 10CJ). . No. Description of exsaisatiss or eertificais . '* ^ of in respect of which fee is peyaUe7 and Pee. directions as to payment. Amount of Bee. Cases of death (see paragraph 7 of Schema).* a 1 On application for certificate --' ... 2 2s. This fee, less This fee is payable by or am behalf 12*. is returnable to of the applicant tirowyk the iledicai tbo applicant if the Board. Medical Board issue a certificate that the death wea due to the disease and Fee Kb. 2 .. , referred to below bas beep paid over to the i On issue of a certificate that the death Tins Fund. dee to the disease 510 ' This fee it payable by or on behalf of the employer} on demand from the . Secretory to the SiSeosit and Asbestosis Medical Expenses Tund. Cam of Total Disablement or of Suspension (see paragraph t of Setose). 3 Qa application for examination-- 110*. Thee fee, less (i) where there is leortoeed a mrtifieste 10*. U returnable to of tha Begional Medical Officer of tbe applicant if the the Ministry of Health that there Medical Board issue . is reasonable cause for suspecting a certificate of total the disease -. -- ... .. disablement or sns* pension on aecoant of thedssease and foe .No. 4 referod to He* - low has been paid over ta tbe fund. ' ' - * Throughout these Begnlstions u Scheme " mean* the SBkosis and. Asbestosis (Medical Arroagcsents) Schema, 1931 (SJ?. 3s 0. 1231, No. 321), as amended by the Silicons and Asbestosis (llodical Arrangements) Amend* meat Setose, 1934 {SJL & 0.1934, No. 333). f Paragraph 21 (2) of the Sfbprrro prorides that where a fee b jaataihtd ' v - os payable by or on behalf of a employer, and no precision made m the - '"iCompensation Setose for the payment of each /tea from a Compensation Bund, employer liable to pay tbo said feo shall, except as otherwise 'si prended, be the employer from whoa tto compensation due to the workman ' is recorerabie. & i E'r| i t Kl | i'JlT/j. i h,'- v t*s* itiiv\ r j^gvaF* grfcfev; ?#[. #:E *v i ; Ss-R B3$. W$ && fc $*V sse ft* 3 **$*/ V ti--; Vr;r.-1' \ ikTf ". 't o';- /,! K:>- r Cd r: -7 i -. / <V *.' ^ &*>;. ?' t - ; I?T.Jt tf-c:-0. ' ;g*4 vXri*-.* I? ? ". * & t4 <* i- i~ >:' -* j Si ". . -* :j .** ... 3* r\ -4 - No. Dewriptiou of examination or certificate of is reipect of which fee is payable, and F*. direction* as to payment. Amount of Fee. a (a) where no such certificate is produced '$, This fee, less 10s^ This fee is payable m cither ea* by is returnable to the or o behalf of the applicant through applicantifthe hlcd- the Medical Board. . . *- feel. Board; isstite u .certificate of `total disablement* or- sus - V~-- _ -. . ' '. - pension on* account .of the disease sad . ; Fee No. 4 referred t below has been paid r .;. . . ! I .. : . ever to the Fnad. ' 'i .. . . . `/ . Os israe of a certificate of total* disable* most or of saspensxonod account of the disease ... m. ... . * - This'ft* is payable bp or on bthtilf of the employer on demand from the Secretary to the Silicosis and Asbestosis * .Medical Expenses Fund, '* . &. ; t * Re-examinations of workmen (see paragraph , 9 of Sehemt)*. . 1 ' 5 On application for anysuch ,reexamination' ' . i 110a. Aadimxaycase This fee is payable, by of on behalf where a radiographic of the applicant through the Medico1 Board. ` .- exemiaatien : is directed by. the ESadieal Board, 'an additional ' feo of Initial examinations of newly engaged work* 1 11s. G4.. ... men (see paragraph 12 of Scheme). 6 For every such examination ... _ 5*. ' This fee is payable by of on behalf of the employer responsible for arranging for the examination, either through the * - * member of the Board or other medical practitioner making the examination or, ` vhefe not so paid, on demand from the Secretary to the Silicosis and .Isbssfosis Medical Expenses Fund. . \ . .. . Periodic Examinations (see paragraph 13 of . .. Scheme). . . , 7 For every such examination of a workman, ' iaciscUas the issue of any certificate as ' the result of such examination ... M . This ftt is paydbls by of on behalf of. . *5 * the employer by whom the xeerkman is . .. % employed'at the time of the examine* . *. tion, on demand from the Secretary to . : -.. . the Silicosis and Asbesiosis Medical ' ' ' Expenses Fund. : ' . - * .* . ..t.* lQOb had is any ease . where a radiographic -examination is directed by-thb Medieal ~Boerdt'' an : SI Ua. sd:--^* .' c!. ^ ". s--.2-\\vr-"*** >8fo*8S*gv. - - IS y*H 9 Mi# **.'4f,V f? Ka of Foe. Bescriptiua of examination or certificate in respect of which foe is payabio, and directions as to payment. Amount of Foo. Arbitrations or otittr Proceedings in tho County Court. Whore a reference is mode to tho Medical And is any Board for a certificate undar section19 of tho Workmen'* Compensation Act) 1325-- casowhor* . a radio (I) if the workman has previously boos graphicex- examined by the Board 2 10s. caiantioji (2) If tho workman has sot previously ia directed - been ortttmned by tho Medical by tho Board *.. ... M 8 10*. Medical This fee is payable t either eaee by Board, as the applicant far the reference as and additional ' when directed by the County Court Seoistrur. *' foe of . 1 Us.Gd. % Whtro tho Medical Board make a report o& a eaeo under section 23 or paragraph - (21) of tho First Scliedalo of tho Act-- (i) if tho workman has prerioosly boon examined by tho Medical Board (it) if tho workman has not previously been examined by tho Medical Board ~ This fee is payable in either case by the employer or workman as and when directed by the County Court Judge or other arbitrator or the Countv Court Registrar, And ia " aay . , case where "a radio* 2 10s. graphic -ex amination , is directed, 6 10s. by tho Medical - Board, as additional foe of . 1 21s. dd. 10 Where in the case of a workman, desiring to roceiro hi* eompeosatiwu abroad, ia pur- saonee of seetioa 16 of the Act, a refer* taco is tcado to tho Medical Board for a certificate as to the permanent nature of tho incapacity ....................... .. This He is payable by Me workman 1 10*. on application to Me County Court for the re/ereace. Miscellaneous. 11 For a copy of aay certificate issaed by tho Medical Board u&der tho Scheme ... Is. This fee is payable by Me applicant for the certificate at the time of the application. aas-M> wtsm-un vs s/a ?.st o.m V*' >..