Document rbdrXoMmKBxJ0qyE6waeJyRe

FILE NAME Pullman PULL DATE 0000 DOC PULL004 DOCUMENT DESCRIPTION Pullman Documents from The Newberry Library Part 2 THE NEWBERRY RIGHT PHOTOCOP ORDER FORM Please allow 2 hours for orders to be processed 1 e For conservation purposes orders are limited to 50 pages per volume ' Copies are 0.25 per page with an additional 1.00 up fee Orders may be picked up in the bookstore on the first floor or they can be mailed to you for an additional 2.00 The Newberry Library Bookstore's hours are Thursday am-6pm Saturday am-5pm e For conservation purposes some materials can only be reproduced in the following forms microfilm photographs slides or copyflo Please consult the desk attendant for further information Name Andrew Andrew AndrewAndrew Wainwright Wainwright Wainwright Wainwright Time needed allow at least 2 hours Address Thernfo Thernfo Thernfo Thernfo Nammes 100 Summer St. Telephone 617 326-1333 326-1333 326-1333 Call Number 06/05/01 Bex4 Bex4 Volume _ Englexet Title Pullman Co. Co. Englexet Labo Rulators Rulators MedicinMeedicine MedicineMedicine | Author Occupatic Occupat2ic Disease Supe Pages please be specific NO MORE THAN 50 PER VOLUME Fill 96 Medicalogal Medicalogal Medicalogal Medicalogal Trands in Oc upational Occupational Disease Comp16 Comp16 Industry a as Dis ofo Diu sos us Courte Courte back NOTICE , WARNING CONCERNING COPYRIGHT RESTRICTIONS The copyright law of the United States Title 17 United States | governs the making of photocopies or other reproductions of copyrighted material copyrighted material Under certain conditions specified in the law libraries and archives are authorized to furnish a photocopy or other reproduction One of these specific conditions is that the photocopy or reproduction is not to be used for any purpose other private study scholarship or research If a user makes a request for or later uses a photocopy or reproduction for purposes in excess of fair use that user may be liable for copyright infringement ; This institution reserves the right to refuse to accept a copying order if in its judgment fulfillment of the order would involve violation of copyright law Reason for not completing this order STAFF USE MP Order taken by MP Date TimTe ime _ . . Order completed by . --...----...-- --...-- Date No. exp 82 20.80 82% .25 20.80 20.80 Set 1.00 + 1,0 1,00 1,00 TOTAL DUE 22502250 te , Medicolegal Trends in Occupational Diseases | -A Statistical and Legal Analysis of Medicolegal Experience- Experience- C. O. SAPPINGTON M.D. DR P.H. 14.7 14.7 Consulting Industrial Hygienist Chicago Illinois 14.7 14.7 Newberry Library For Study Use Only Unauthorized Reproduction Strictly Forbidden Medicolegal Trends in Occupational Diseases -A Statistical and Legal Analysis of Medicolegal Experience ONTEST is as old as C Greek mythology C. O. SAPPINGTON M.D. DR P.H. Consulting Industrial Hygienist larly to certain definitions which are In a land succes- commonly used sively beset with midget Chicago Illinois also to describe a few in- golf courses jigsaw puzzles stances of misuse of terms knock conundrums and the handies fu- Taken partly from the rore it is not unexpected that the diverse factors recommendations of the American Standards Association,, which may affect the medicolegal trends in occu- and also from certain state codesthe following definitions pational diseases should assume all the permuta- portant words are suggested for these im- tions and combinations possible on a Chinese lottery ticket DUSTS particles produced by fragmenta- Any analysis of the medicolegal trends of occu- tbauttisoenttolredbinyargirlayvditoynot flocculate nor diffuse pational diseases involves a consideration of all of the FUMES particles produced by condensa- aspects of occupational disease problems including the measurement and evaluation of indus- tion or volatilization often with chemical re- ~~ trial exposures interpretation and application of information relating to physical examinations ~ action flocculation or coalescence may occur gsoa lidseous forms of substances normally or liquid vapors diffuse diagnoses clinical laboratory work and ray find- formless fluids which diffuse ings the correlation of the industrial and medical occupy the space of enclosures easily and information in terms of effect relation- Anyone who indulges in the mental ships occupational disease legislation case decisions of damage suits commission hearings and of creating definitions realizes how diffigcyulmtnaitstisictso make an adequate definition for review decisions and insurance coverage No attempt has been made in this to be occupational disease into the expression Most such definitions take paper consideration the occupation or the environ- exhaustive the problem of analysis is complicat- ed mental factors without attempting to make limited enough in the attempt to present the proper ma- comments on the effects of such industrial environ- terial and reach some sound conclusions One ment I have finds that he is limited to a great extent by the previously defined occupational dis- ease elsewhere as follows lack of the availability of information as well as An the heterogeneity of the material which is avail- occupational disease is one which occurs with definite able frequency and regularity in occupa- It is desirable in this discussion tions where there is a specific exposure as the to consider defi- nitions and terminology experiences with occu- cause which operates to produce effects in the hu- man body recognized clinically by the medical pational disease claims and reporting an analysis of profession as pathological changes and effects existing compensation laws typical court de- duced by the specific pro- cisions complaints and allegations the activities pational of bureaus of industrial hygiene examples of exposure involved As has been indicated the terminology of occu- disease has been much pending legislation and the suggestions of the American Bar Association very abused from tofime to time The laws and people generally speak compensation for occupational disease It is Definitions and Terminology the intent of the laws to compensate for disability I should T IS NOT feasible or possible to attempt to set resulting from occupational disease the employer not be required to pay compensation for a down in this paper an exhaustive group of defi- It is or diagnosis nitions to comment on all the misuses of terms suggested therefore that the ex- in regard to occupational disease problems How- parteisosniobneoccupational disease disability compens- ever it is well to indicate that these are phases which are important and to call attention The generally used because it is explicit terms exposure and hazard are fre- particu- quently used interchangeably by many persons- Mic* hPirgeapnarMedayfor3-t7he19M3i7d-west Conference on Occupational Diseases Detroit tihnevsoelvteesramns are not the same Although a hazard exposure the latter is not a hazard un- on Se SSE til so proved by adequate methods of measure- ment and rating Disease Claims and Reporting Experiences PROBABLY the best material of its kind re- garding occupational disease claim experience has recently come out of the State of New published in the Industrial York as 1937.5 The original data have Bbueelnletin January the basis of frequency and in certraeianrriannsgteadnco en s where expedient percentage figures have been added ber awards and denials by percentage Observe that of the 684 dermatitis claims closed during 1936 299 or 22.9 received awards and 385 or 77.1 were denied The original data disclosed the fact that the chief causes of dermatitis claims were soap and water and that dyes of various kinds occupied the next place in point of frequency The percentage distribution of the claims therefore by industry or trade as noted in TABLE II results on the whole from exposure to these substances Table I. DISEASE CLAIMS CLOSED METROPOLITAN NEW YORK - 1936 Number % Awards % Denied % ALL CASES 1036 Dermatitis ........ 684 Poisons 2... 76 Synovitis 000... 30 Lead poisoning 41 Tuberculosis = 100.0 ( 66.0 ( 7.3 ( 2.9 ( 3.9 25 39.3 629 22.9 385 55.2 34 63.3 11 61.0 60.7 77.1 44.8 36.7 39.0 pulmonary .... 19 Carbon mon- ( 1.8 2 10.5 89.5 oxide .. Silicosis .. 16 1.5 6 37.5 62.5 3 ( 0.3 0 0.0 3 100.0 TABLE I shows the disease claims closed for Metropolitan New York during the period of 1936 Note that there was a total of 1036 cases of which 407 or 39.3 received awards and 629 or 60.7 were denied Dermatitis was the chief cause of claim there being 684 cases or 66 of the totalof which 299 or 22.9 received awards and 385 or 77.1 were denied Poisons were the next most frequent cause of claim and constituted 7.3 of the total number of cases Of the general classifi- cations synovitis was fourth with 30 or 2.9 of the total number of cases Referring now to the more specific causes of claim we find the following in order of greatest frequency lead poisoning tuberculosis pulmonary carbon monoxide and silicosis Observe that the majority of the pul- monary tuberculosis and carbon monoxide claims were denied although there were only three claims for silicosis a number much too small for any sound conclusion these were all denied Table II DERMATITIS CLAIMS CLOSED METROPOLITAN NEW YORK - 1936 By Industry or Trade Number ALL CASES Restaurant Service Fur Garment Food ow. Manufacturing Printing 002... - Cosmetics ......... Construction ... Mercantile 0... Cleaners __.......... Machinery Paint oo. Automobile ..... 40 36 35 31 26 21 19 15 12 %% Awards 100.0 ( 15.3 ( 8.8 ( 7.6 < 7.3 ( 6.0 ( 5.8 22 ( 5.3 ( 5.1 ( 4.5 21 ( 3.8 8 ( 3.1 14 ( 2.8 2 ( 2.2 6 ( 1.7 2 % Denied % 22.9 51.4 51 36.6 38 63.5 36.0 39.1 55.1 50.0 45.7 67.7 30.7 18 66.7 7 10.5 17 40.0 9 16.7 77.1 48.6 63.4 36.5 64.0 60.9 44.9 50.0 54.3 32.3 69.3 33.3 89.5 60.0 83.3 Because dermatitis greatly outnumbered all causes of claims TABLE II shows the dermatitis claims closed in Metropolitan New York during 1936 by industry or trade showing the total num- Table III DURATION OF DISABILITY OCCUPATIONAL SKIN DISEASE NEW YORK CITY 390 cases 1928 2 weeks to 1 month 3 to 6 months 1 to 3 months More than 6 months Percent 38 16 21 24 BY Ordinarily it is not assumed that dermatitis cases or cases of occupational skin disease create any extended disability The available informa- tion on this subject is not very recent but in TABLE III is shown the duration of disability of tional skin diseases for New York City occupa- about 1928 involving 390 cases It will be seen that there is more of an even spread than one would only 38 of the cases involving expect disability lasting from two weeks to one month Table IV DISEASE CLAIMS CLOSED REASONS FOR DENIAL METROPOLITAN NEW YORK - 1936 Dermatitis Other Claims Number % Number % Number % ALL CASES .......... No lost time No medical evi- 629 195 100.0 ( 30.9 61.2.244 44.2 38.8 10.2 dence ..0000 ww. Not covered by law Failure to prove Not occupational 122 99 67 ( 19.4 16.0 43 ( .... 14.0 68 11.2 56 12.7 18 30.7 22.9 7.4 disease ..00000s 00 e. e. s. Not over 7 days 51 ( 0.8 6 0.3 45 18.4 disability 2... 50 ( 0.8 32 8.3 18 7.4 appearance 23 ( 0.3 223 5.7 1 No casual rela- tion 11 5 Unspecified ........ No lost earnings 21 Notice over limit 21 Case withdrawn 1 Without preju- ( 0.2 ee 62 0.2 62 cette ee eee 00 77 Qo. settee keene re dice Po. - Federal jur- . 532 0.2 532 532 eee ) isdiction 1 typographical TABLE IV shows reasons for denial of claim- separating the figures for dermatitis and for other claims Note that there were three chief causes of denial of claim in the following order no lost time 30.9 no medical evidence and not covered by law 16.0 data included the 19.4 The original expression casual which is here reproduced because the same error has been made twice in other states word causal is intended here The A classification of disease awards according to provisions of the compensation law schedule is shown in TABLE V. Again dermatitis leads although somewhat masked by inclusion under other headings while anilin and any and all occupa- tional diseases follow in order Attention is called Table V. DISEASE AWARDS ACCORDING TO COMPENSATION LAW SCHEDULE METROPOLITAN NEW YORK 1936 Paragraph of Schedule Number Percent ALL CASES eee 100.0 Lead and sequelae 27 Mercury and sequelae 6. Arsenic and sequelae 8 Benzol sequelae eee 3 Anilin others sequelae 65 9 Carbon bisulphide and sequelae Sulphides poisoning 12. Dope poisoning ......... 6.6 0.2 15.92.2 .2 0.5 Carbon tetrachloride 13 Formaldehyde 14 Chrome ulceration sequelae 22 23. Chromic acid 200. Bichromates .... Carbon monoxide | Acids sulphuric ...... hydrochloric .... hydrofluoric 213964 0.7 24. Petroleum products gastro- intestinal 25. Blisters 0.2... Abrasions 19176 26. 27. Bursitis ....... Synovitis Dermatitis acids . Alkalies 2.000000... wee 112112 Oils Oils all 28. Any and all occupational diseases 54 0.20.2 27.527.5 10.610.610.6 No awards for 1 Anthrax 3 Zine 5 Phosphorus 7 Wood alcohol 10 Nitrous fumes 11 Nickel car- bonyl 15 Skin cancer 16 Glanders 17 Compressed air 18 Miners diseases 19 Cataract in glass workers 20 Radium 21 Methyl chloride during 1936 7,760 69.4 tenosynovitis 1,297 11.6 and lead poisoning was third with 1,269 cases 11.3 It seems significant that no compensable cases anthrax were reported during this period due to glanders mercury poisoning manganese dioxide poisoning or radium poisoning It must be pointed out however that this is significant only for the State of Ohio and that we may not conclude that it is of real significance for other states Table VII PROPORTIONATE INCIDENCE OF O. D. COMPENSATED BY CASES DURING 1920 - 1929 INCLUSIVE STATE OF WISCONSIN Number ALL CASES fluids Toxic fluids cecce cet cee eee cecceeenceeceseeneeeeee _ Irritant dusts and fibers.. Toxic vapors gases and fumes ~ Miscellaneous irritants cece 00. ccccosesee 3,019 840 396 353 320 Percent 100.0 27.8 13.1 11.7 10.6 A different picture is revealed by the experience of the State of Wisconsin8 during the year period 1920-29 inclusive in TABLE VII showing the proportionate incidence of occupational diseases compensated by causes Of the 3,019 cases during this year period the data are here limited to those occurring as causes to the extent of 10 or more upon this basis toxic fluids accounted for 27.8 irritant dusts and fibers 13.1 toxic vapors gases and fumes 11.7 and miscellaneous irritants 10.6 Interesting always to industrial executives and economists and of necessity of importance to the industrial physician and surgeon is the cost of oc- cupational disease disability compensation Such figures are relatively rare TABLE VIII shows the to the fact that there were no awards for the various diseases or substances as shown in the note at the bottom of the table Turning now to the State of Ohio there are available data for compensable occupational diseases reported during the year period 19281936 inclusive as exhibited in TABLE VI Of the total of 11,172 cases of compensable occupational diseases dermatitis again took first place with Table VI SUMMARY OF COMPENSABLE OCCUPATIONAL DISEASES REPORTED DURING 1928 - 1936 INCLUSIVE STATE OF OHIO Number ALL CASES ooo... ... Dermatitis ...., . Tenosynovitis poisoning Lead poisoning - a Chrome ulceration nasal and skin Prepatellar bursitis illness air 11,172 7,760 1,287 1,269 322 186 _ Percent 100.0 69.4 11.6 11.3 2.9 1.7 ae 170 1.5 63 0.6 51 0.5 49 Carbon bisulphide poisoning 30 Sulphur dioxide poisoning ...... 23 Potassium cyanide poisoning 17 Arsenic poisoning .0 ee. 15 Wood alcohol poisoning ................ 3 0.4 0.3 0.2 0.1 0.1 . Carbon dioxide .. Phosphorus ce ee eee. 2.0 eeeeene. teeeeen 3 1 No cases of Anthrax Glanders Mercury poisoning Manganese dioxide poisoning or Radium poisoning reported 1928-1936 inclusive Table VIII COMPENSATION PAID ON O. D. DURING 1920-1929 INCLUSIVE STATE OF WISCONSIN _ ALL CASES gases cece Toxic vapors vapors and seevetteeecees ... Irritant dusts and fibers . Germs dusts and fibers fibers testes Cost 575,052 575,052 146,063 117,885 64,980 Percent 100.0 25.4 20.5 11.3 compensation paid on occupational diseases during the year period 1920-1929 inclusive Of the total cost of 575,052 toxic vapors and gases accounted for 25.4 irritant dusts and fibers 20.5 and germs 11.3 Here again we have limited the statistical display to those causes ac- Table IX AVERAGE INDEMNITY PAID ON O. D. DURING 1920-1929 INCLUSIVE STATE OF WISCONSIN ALL CASES sectteet este etectee tenes cee Toxic Vapors and fumes Germs dusts Irritant dusts and fibers Toxic fluids Miscellaneous irritants Average Per seneeeateracnsensteauceseeee ce. 191 191 322 298 52 47 Case counting for 10 or more percent of the total amount paid out Based upon the same experience the average indemnity paid per case is also of interest TABLE IX shows that the case for all cases was 19a1ve.ra0ge0intdoexmincity per vapors and fumes 414.00 germs 322.00 -and ir- ritant dusts and fibers 298.00 were above the average toxic fluids 52.00 and miscellaneous irritants 47.00 were considerably below the average Returning to the important problem of skin diseases in industry the experience of Massachusetts for the year period 1925-1935 inclusive as exhibited in TABLE X confirms experiences Table X. SUMMARY OF REPORTED COMPENSABLE CASES OCCUPATIONAL SKIN DISEASES MASSACHUSETTS 1925 - 1935 INCLUSIVE All Cases of Occupational Diseases.3,215 Total Skin Cases 1,973 or 61.3 Number All cases of skin disease Dermatitis ow. Chrome ulceration ...... - 1,973 1,792 . 93 Anthrax ool cece. sees 78 Potassium cyanide poisoning 0... 10 Percent 100.0 90.5 4.9 4.0 0.6 in other states and gives some additional informa- tion Observe that of all the cases of occupational diseases reported during the year period 3,215 those due to occupational skin diseases numbered 1,973 comprising 61.3 of the total number of reported cases The connotation dermatitis was responsible for 90.5 or 1,792 cases chrome ulceration anthrax and potassium cyanide poisoning figured but a small percentage in the total group but were present in sufficient numbers to be reg- istered In Connecticut it has been possible within re- under two types cent years to show the relationship between the cases of occupational diseases as reported by phys- icians and those cases which have been compen- sated but not reported by physicians The signifi- cant differences occurring these of classification are shown in TABLE XI where it is Table XI RELATION OF CASES REPORTED TO CASES COMPENSATED OCCUPATIONAL DISEASES STATE OF CONNECTICUT - JULY 1935 - JUNE 1936 Reported by Physician ALL CASES oo... ccccsescceecece. Dermatitis Dermatitis Asbestosis alkalies 0... cutting oils ...... 00 Silicosis ceeecee frostbite Arthritis frostbite exposure .. Lead poisoning ... Mercury poisoning 142 10 17 2 10 13 13 including dermatitis ...... 10 Dermatitis plating solution 19 Dermatitis poisonous plants 4 Dermatitis solvents 8 CompensatedNot Reported 265 8 331 331 331 21 11 32 32 21 7 noted for instance that all cases reported by the physicians amounted to 142 whereas those cases which were compensated but not reported by physicians numbered 265. These figures clearly show what happens when the reporting system is not coordinated with compensation activities which be it said to the credit of Connecticut is in the process of being remedied by appropriate leg- islation Analysis of Existing Compensation Laws I MAKING disability analysis of existing occupational disease disability compensation laws it is to be kept in mind that the situation is continually changing one is also reminded that the interpretation of the legal requirements is also subject to changing opinions and judgment It is believed however that the material here presents the gen- eral consensus which in itself may not be as clear as one would like in some instances It is natural to assume that we are first inter- ested in knowing what states have declared dis- ability through occupational diseases compens able Because of a court decision in the State of Maryland defining the term occupational disease Maryland is interpreted as being in a class by itself Assuming this occupational disease disabil- ity is compensable in 18 states and the District of Columbia as follows California Connecticut Illinois Indiana Kentucky Massachusetts Min- nesota Missouri Nebraska New JerseyJersey New York North Carolina North Dakota Ohio Rhode Island Washington West Virginia and Wisconsin In five Minnesota Nebraska New JerseyJersey Ohio and Rhode silicosis is not included among occupational diseases Bill re silicosis now pending in Ohio In West Virginia silicosis is the only occupational disease compensable Our next point of interest lies in determining the type or method of coverage of these laws There are three usual methods of covering occupational diseases in these acts 12 1 by naming the specific occupational diseases for which disability is com- pensable the called schedule system 2 by the inclusion of all occupational diseases by blanket provisions the called blanket cover- age and 3 by using the word injury instead of the word accident in the law and including occupational disease as injuries The following states as designated fall under these three types of cover- age -Kentucky Minnesota Nebraska New Jersey North Carolina Ohio Rhode Island West Virginia and Washington BLANKET - Connecticut Illinois Massachusetts Missouri New York and Indiana California District of Columbia North Dakota and Wisconsin Especially difficult to interpret and somewhat doubtful as to existence in certain instances are the provisions or interpretation of provisions re- garding common law rights of recovery in the various states Common law right of recovery seems well settled in 12 states California Kansas Kentucky Louisiana Minnesota Mississippi Mis- souri Nebraska New Hampshire New Jersey New York and West Virginia However occupational disease is compensable to some extent in all of this group except four states Kansas Louisiana Mississippi and New Hampshire Hence common law right to recovery is very much limited in eight of the 12 states No court decisions on common law right of recovery exist in 17 states and District of Columbia Alabama Arkansas Arizona Colorado Idaho Indiana Montana Nevada New North Carolina South Carolina South Utah Vermont Wisconsin and Wyoming Florida Mexico Dakota Occupa- tional disease is compensable in the District of Columbia and in North Carolina and Wisconsin Courts have held no common law right of re- covery in three states Illinois Michigan and Ohio North Dakota falls into this group probably not because the common law right never existed there but because if it ever existed it has been com- SILICOSIS OF OCCUPATIONAL DIS- EASE NOT COVERED BY ACT New York The Ap- Does pellate Division certified the question the complaint state facts sufficient to constitute a cause for action Complaint alleged that plaintiff through defendant's failure to comply with statutes contracted an occupational disease for pletely superseded by the Workmen's Compensa- tion Act In that respect the law of North Dakota is rather unique which compensation was not payable under the Act Defendant's motion to dismisss the complaint was denied In three states Connecticut Georgia and Texas common law right of recovery is extremely doubt- ful The common law right to recover for occupational disease caused by the negligence of the em- oc upational Court held that this was an occupational dis- ease the natural and unavoidable result of the em- ployment but not an accidental personal injury as limited by the statute The Court cannot dis- regard the express limitation There is still a ployer probably exists although there is some doubt in Delaware Iowa Maine Maryland Massa- field in which the statute fails to impose liability on the employer to provide compensation for in- chusets Oklahoma Oregon Pennsylvania Rhode Island Tennessee Virginia and Washington Increasing interest has been manifested in provisions for medical boards and regarding physical examinations Five states Kentucky Massachu- setts New York North Carolina and West Virginia have what may be called medical boards New Jersey Rhode Island and Ohio provide for better than ordinary type of physical examination but do not have provisions for medical boards.11 jury or death regardless of fault and in which an injured person may seek damages by legal ac- tion where there has been fault Whether the legislature should provide a more effective and comprehensive remedy in such cases or whether the employer should in such cases be relieved of liability even in case of fault is a matter which concerns the legislature and not the courts Order of court below denying dismissal of complaint affirmed and certified question answered in the Court Decisions Barrencotto v Cocker Saw Co. Inc. decisions form a very valuable back- N. Y. Ct of Appeals Decided December 31 1934 Co ground of opinion regarding important points SILICOSIS - SAFE PLACE TO WORK - FAILURE of controversy and also demonstrate the legal TO PROVE SILICOSIS RESULTED DURING PERIOD COM- trends PLAINED OF New -Plaintiff sued for in- One must not forget that these court opin- juries resulting in silicosis Decedent died from ions involve consideration of medical evidence and cancer Respirators were provided but not during - . therefore they are really medicolegal opinions the year period of which plaintiff complained was Sometimes the decisions are rendered on appeals It for the jury to determine whether dece- from lower courts and sometimes on appealed com- dent inhaled dust during the period mentioned mission cases sent up for review whether respirators should have been furnished- With the exception of the first two cases ab- and question of adequacy of the ventilating system stracted the decisions given here were rendered Proof was lacking that the dust contained during 1936.13 The selection of these abstracts for any silica that it was 10 microns or less in size that it this paper was based upon three points 1 medi- exsited in such concentrated amounts and that colegal principles involved 2 type of disease decedent was exposed for a sufficient length of alleged and 2 geographical distribution It was time to cause silicosis thought that by such a selection one might be able to get a sectional view of the decisions during 1936 Because there has been a greater opportunity to review cases of silicosis probably because a greater number of these have been appealed it will be found that this type of alleged disease occurs with greatest frequency in these decisions The cases have been arranged chronologically based upon the date of the decisions The rule has not been adopted that an industry carried on in a lawful manner though its operation produces dust in small or large quantities is per se negligent To hold that the existence of dust is prima facie evidence of negligence would violate the rights of operators and also the presumption against negligence Motion for nonsuit granted.Cichocki Executrix v Geigy Co. Inc. 183 Atl 463 N. N. Hudson County Circuit Ct Decided JanuaryJanuary OCCUPATIONAL DISEASE DEFINED Maryland In this case the Court defined an occupational disease as follows An occupation or industry dis- ease is one which arises from causes incident to the profession or labor of the party's occupation or calling It has its origin in the inherent nature or mode of work of the profession or industry and is the usual result or concomitant If therefore the disease is not a customary or natural result of the profession or industry per se but is the conse- quence of some external condition or independent agency the disease or injury can not be imputed to the occupation or industry and is in no accurate sense an occupation or industry disease Victory Sparkler & Spec Co. v Francks 147 Md 368 128 A 635 SILICOSIS - COMPENSATION DENIED No WAGE LoSS PRIOR TO TERMINATION OF EMPLOYMENT - Wisconsin - Until there is actual wage loss caused by occupational disease there can exist no compensable disability under the Workmen's Com- pensation Act Applicant did not become disabled because of his silicosis until after termination of his employment Judgment reversed be- low instructed to set aside award of Commission and dismiss application Chain Belt Co. et al v Ind Com et al 264 N. W. 502 Wisconsin Supreme Ct Decided JanuaryJanuary 7 1936 LEAD POISONING - QUESTION OFINJURYOCCUPATIONAL DISEASE OR ILLNESS FROM SUDDEN INJURY DUE TO FUMES Tennessee Trial court sustained de- murrer of defendant because occupational disease shown was not compensable under the statute- petition dismissed and petitioner appealed Facts presented tended to indicate a sudden and unforeseen result unlike the gradual development of lead poisoning How this is proof will have to show Reversed case remanded for a hearing on the Johnson v Globe Union Mfg Co. Tennessee Supreme Ct Decided January 25 1936 EMPLOYERS LIABILITY WHETHER RA- DIUM POISONING COVERED New Appeal from judgment for defendants Question was whether contracts of insurance covered loss for which action was brought the plaintiff Finding was adverse to Conceded that radium poisoning is an occupa- tional disease and not compensable at the time these policies were in force The facts furnish no more basis for saying that the effect of the occu- paitonal disease was spread evenly over the whole period of employment than for saying employee was affected only during the first week or year of employment or the last week or year thereof Judgment of no cause of action S. Radium Corp. v Globe Indemnity Co. et al 2 N.E. 2d 640 N. J. Ct of Errors and Appeals Decided January 31 1936 MANGANESE POISONING TO WARN EM- PLOYEE OR ELIMINATE DUST New Jersey Plaintiff alleged illness due to inhaling manganese dust claiming manganese poisoning Jury awarded plaintiff 25,000 Defendant appealed Ample proof of manganese dust in employment Plaintiff changed from a robust individual to a helpless and permanent invalid in five years Shown that defendant was neglectful in not warn- ing plaintiff in not making reasonable provision to protect plaintiff and by failure to eliminate dust as far as reasonably practicable A fact question which only the jury could determine was thus presented Judgment affirmed v New Jersey Zinc Co. 182 Atl 850 N. J. Ct of Errors and Appeals Decided January 31 1936 SILICOSIS DATE OF DISABILITY - WAGE LOSS Wisconsin - Disability as used in the 1933 amendment must be defined as an injury which causes wage loss The question is what is meant by wage loss Considering that claimant is incapable of more than slight physical exertion that by reason of his physical incapacity due to silicosis he can be employed only in occupations which involve called light work there is evidence which sustains the finding of the Commission that he has sustained a wage loss which measured by the rate of compensation he had theretofore re- ceived amounts to 50 Judgment affirmed.- Schaefer & Co. et al v Ind Com et al 265 N. W. 390 Wisconsin Supreme Ct Decided February 4 1936 DEATH CAUSED BY PNEUMONIA - EVIDENCE OF LEAD POISONING AND LYMPHATIC LEUKEMIA Illin- pneumonia ois Immediate cause of death was Plaintiff claimed decedent contracted lead poisoning which with another disease predisposed him to pneumonia Defendant claimed decedent did not have lead poisoning predisposing cause was lymphatic leukemia a fatal disease - that plaintiff failed to establish which of these two caused death Testimony showed that decedent suffered from both disorders each of them tended to lower his resistance to disease The cause of death was a scientific question Testimony of witnesses for both parties was sufficient to justify the Commis- sion's finding that lead poisoning was the predis- posing cause of Lewin Metals Corp. v Ind Com et al 1 N. E. 217 Illinois Supreme Ct Decided February 14 1936 PNEUMOCONIOSIS - INHALATION OF DUST - VIO- LATION OF LABOR LAW STATUTES OF LIMITATIONS New York Plaintiff alleged inhalation of dust and contraction of pneumoconiosis the em- ployer was thereby negligent Plaintiff's employ- ment ceased more than three years before action was commenced Injury to plaintiff was complete when alleged negligence of defendant caused plaintiff to inhale deleterious dust For that injury including all resulting damages the defendant was then liable The statute provides in unambiguous language that the period of limitation begins to run at the nioment when right to begin an action accrues This court concurred in the opinion that the causes of action were all subject to the three period of limitation Regarding the charge that the defendant failed to provide the safeguards required by the Labor Law the court ruled that liability for disregard of statutory duty was really created by statute Judgments modified in accordance with this opinion and as so modified affirmed v Merchants Despatch Transp Co. 200 N. E. 824 N. Ct of Appeals Decided March 3 1936 SILICOSIS AS RESULT OF EMPLOYER'S NEGLIGENCERIGHT TO COMMON LAW ACTION - No RECOVERY Compensa- UNDER ACT Georgia .- Workmen's tion Act cannot be applied except in case of injury by accident The remedy provided by this statute is exclusive within the field of its operation but does exclude redress in cases to which is it not applicable If the act does not apply to an occupational disease caused by injuries which were not the re- sult of an accident and were not compensable under the provisions of the act the employee may maintain an ordinary or common action for dam- ages against his employer provided a cause of action exists in his favor under the law relating to the liability of a master independently of the Workmen's Compensation Act The right to bring an ordinary action for damages is not excluded by this statute as to injuries which do not fall within its Covington v Berkeley Granite Corp. 184 S. E. 871 Georgia Supreme Ct Decided March 24 1936 SILICOSIS WHEN RIGHT TO COMPENSATION AC- CRUES No WAGE DEDUCTION FOR TIME LOST Wisconsin -Commission appealed judgment va- cating an award holding that insurer was liable being on risk at time of first lost time period ascribed by Commission to silicosis although disease was not discovered until six months later Because employer made a gift to employee of wages legally lost did not obviate effects of such loss as far as compensation for permanent dis- ability through silicosis is concerned Recovery cannot be had for amount of wages paid by employ- er for lost time but recovery herein was limited to compensation for the permanent disability found Reversed with directions to enter judgment confirming General Acc Fire & Life Assur Corp. v Ind Com et al 266 N. W. 226 Wisconsin Supreme Ct Decided March 31 1936 INHALATION OF CHLORINE - CLAIM DENIED - No APPEAL - COMMON LAW REMEDY Michigan .Plaintiff appealed from a dismissed declaration al- leging permanent injuries from inhalation of chlorine lack of warning and provision of protective devices Defendant's answer showed that both parties were under the Workmen's Compensation that compensation was denied plaintiff because he had not suffered from an accident arising out of and in course of employment Plaintiff denied that departmental proceedings constituted an election of remedies Plaintiff's remedy was to seek an appeal to the full board and then review by certiorari if necessary as the act provides Plaintiff released all claims or demands at law when he submitted question of injury to arbitration Such exclusive jurisdiction arose not by consent of the parties but by provision of the statutory enactments Plaintiff's declaration definitely localized the alleged injury as to time and place hardly fitting the definition of an occupational disease Order afTwork v Munising Paper Co. 266 W. 311 Michigan Supreme Ct Decided April 6 1936 BENZOL POISONING WHETHER ONE NO LONGER AN EMPLOYEE ENTITLED TO RECOVERY New York _Employee contracted benzol poisoning in em- ployment September 1931 became disabled in June 1932 but meanwhile had ceased to be an em- ployee in November 1931 becoming a partner in a company where he performed the same kind of work He died in January 1933. On dates of disablement and death he was not employed but was a member of a partnership The Industrial Board made an award against the employer and insurance carrier The Appellate Division reversed the award and dismissed the claim The Court adopted the principle that a person who has been employed in an occupation in which he was subject to contraction of a disease described in the statute and who while so employed has con- tracted the disease but does not become disabled until a time when he is no longer an employee is entitled to recover compensation from the employ- er who last employed that person in the employ- ment to the nature of which the disease was due This interpretation applies to the time of con- tracting disease as an employee rather than the time of disablement Order of Appellate Division reversed and award of Industrial Board reinstated -Matter of Comm's of Taxation & Finance et al v Art Advt N. E. 2d 280 of Appeals Decided May 19 1936 N. Ct PULMONARY ASBESTOSIS - No DUST REMOVAL SYSTEM - WHETHER ACCIDENT North Carolina - Claimant denied compensation by Commission because he did not sustain an injury by accident Had been employed for six or seven years and at discharge on October 25 1934 was suffering from pulmonary asbestosis Prior to December 19 1933 defendant had failed to install dust removal system such as those in similar general use Claimant appealed to Superior Court which ruled that plaintiff had sustained an injury arising out of and in course of employment as the direct and proximate result of employer's negligence denying compensation Award of Commission denying compensation should have been affirmed The Commission found that plaintiff was not injured by the negligence of the defendant but that his injury was caused by a disease which he contracted while working in defendant's plant as its employee All of the evidence showed that plaintiff's injury was the result of an occupational disease and for that reason was not compensable under the Act Judgment re- versed and remanded v Carolina Asbes- tos Co. et al 186 S. E. 258 North Carolina Supreme Ct Decided June 15 1936 TUBERCULOSIS - WHETHER DISEASE OCCUPATIONAL TO THE FLOUR MILLING INDUSTRY Minnesota .Plaintiff sought damages for pulmonary tuber- culosis alleged to have been contracted while in defendant's employ basis of claim being violation by defendant of statutory requirements respecting heating and ventilating places of employment Plaintiff recovered a verdict of 18,000 which the trial court set aside holding cause of condition was wholly within the field of speculation and con- jecture The trial court said There was much flour dust in the room where the plaintiff did her work It was not always heated or ventilated to her satisfaction The experts all classified flour dust as one of the harmless dusts The available lists of this locality show that the incidence of tuberculosis is general less among flour mill workers than in the public There is no record of any other workers in the place contracting the disease The evidence fails utterly to indicate that tuberculosis is a dis- ease occupational to the flour milling industry It may be possible that conditions existing in the place where she worked did cause a development of the disease with which she was afflicted But what shall we say of her sister who worked beside her and twice as long who slept with her and yet who did not contract the disease What shall we say of the other workers her companions who worked in the same environment some of them many times as long as she did and who did not contract the disease Upon plaintiff rested the duty of furnishing proof affirmative of the issue The cause of her condition was left in the realm of conjecture and as such her cause fails Judgment O'Connor v Pillsbury Flour Mills Co. 267 507 Minnesota Supreme Ct Decided June 19 1936 TUBERCULOSIS - WHETHER DISEASE OCCUPATIONAL TO THE DRESS MANUFACTURING BUSINESS ConnectiThe Commission awarded compensation to claimant suffering disability due to tuberculosis contracted in the course of employment factory room was badly crowded hours of employment were long conditions were very unsanitary and claimant had been exposed to disease because of the fact that other employees were suffering from it Defendants appealed to court below which found that ordinary tuberculosis from which plaintiff was suffering was a occupational disease not peculiar to the occupation in which plaintiff was engaged Both the doctor called by plaintiff and the one called by the defendants so testified The trial court sustained defendants appeal and remanded the case to the Commission with direction to dismiss the claim From that judgment plaintiff has appealed In 1927 the Workmen's Compensation Act was amended to define a personal injury as including only an accidental injury which may be definitely located as to the time when and the place where the accident occurred and occupational disease as herein defined An occupational disease was defined as a disease peculiar to the occupation in which the employee was engaged and due to causes in excess of the ordinary hazards of employment as such Held that to award compensation to plaintiff in this case would be to go against the legislative intent embodied in the amendment of 1927. There was no Madeo v I. Dibner and Bros. Inc. et al 186 Atl 616 Connecticut Supreme Ct of Errors Decided July 30 1936 BRONCHITIS INHALING ORGANIC DUST No REASON TO ANTICIPATE HARMFUL RESULTS Missis-Plaintiff employed 1921 to 1931 in mixing oats corn alfalfa meal and molasses After quit- ting he developed chronic bronchitis for which he sued four and a half years after leaving employment claiming ailment was caused by breathing dust generated in place of employment It was agreed among the expert witnesses that the breath- ing of mineral dust is harmful and may cause res- piratory diseases controversy is as to whether the breathing of organic dust is harmful Granting that the medical testimony on behalf of plaintiff is true that organic dust is capable of producing chronic bronchitis other words that defendant failed to furnish plaintiff a reasonably safe place to work this alone did not make out a case of liability Plaintiff was required to go further and show that the unsafe place was the result of defendant's failure to exercise reasonable care There was no evidence whatever tending to show that defendant should have reasonably anticipated the harmful effects of the dust Defendant had the right to stand on the history of the business which showed the dust generated by such plants to be harmless It was not required to consult medical experts about a matter unquestioned in the busi- ness There being no evidence that defendant should have reasonably anticipated the harmful jury effects of the dust there was no case for the Defendant was entitled to its requested directed verdict Judgment for plaintiff reversed and judg- ment here for the defendant Grain & Elevator Co. v Jones 169 So. 771 Mississippi Supreme Ct Decided October 5 1936 SILICOSIS - SUFFICIENCY OF THE DECLARATION West Virginia This writ of error involves the sufficiency of the declaration in a silicosis case the demurrer to the declaration having been sustained by the court below Defendant contends that the declaration shows no causal connection between plaintiff's alleged silicosis and his employment and no failure of defendant's duty but does show that plaintiff failed to use ordinary care and that his alleged action is barred by the statute of limita- tions Scott v Rinehart & Dennis Co. 116 W. Va 319 180 S. E. 276 silicosis case relied on by defendants clearly different from this case There the action was not brought until nearly two years after cessation of employment ; here plaintiff's action was brought in the fall of 1934 and within a from the alleged contraction of the disease year It was held that defendant's strictures on the declaration are not well taken and that demurrer should have been overruled Where an employee without fault himself contracts an occupational disease because of negligence of his employer the latter must respond in damages Judgment reversed v United Zinc Smelting Corp. et al West Virginia Supreme Ct of Appeals Decided October 6 1936 RASH FROM PEELING FRUIT OCCUPATIONAL DIS- plaintiff EASE - NOT COMPENSABLE Oregon -Plaintiff pealed from a judgment for defendant State apIn- dustrial Commission in an action started by plain- tiff to receive compensation for an injury sustained during employment Defendant's order denying compensation was sustained by the Circuit Court Employment was seasonable and extended over a period annually of six to seven months from 1929 to 1934. During the years 1930-1934 inclusive plaintiff suffered from rash as did other em- fruit ployees The evidence indicates that a residue of the arsenic spray used on the remained many of the apples and pears which plaiunptiofnf peeled Plaintiff does not contend that her hands were cut or bruised and does not contend that anything untoward occurred in the performance of her duties except that somehow a poisonous sub- stance entered her system affirmed Held that condition for which plaintiff sought compensation was an occupational disease The ailment for which compensation is sought must be traumatic as distinguished from idiopathic Com- mission did not err when it denied compensation to plaintiff If workmen suffering from occupa- tional diseases in this state are to have relief the authority must come from the legislature and not from this court Judgment Ryan v State Ind Acc Com 61 P. 2d 426 Oregon Supreme Ct Decided October 23 1936 SILICOSIS - THIRD STAGE WHEN DISCOVERED DEFENDANT'S NEGLIGENCE AS CAUSE INSUFFICIENT EVIDENCE Missouri action resulted in a verdict for 27,000 against the defendant upon which the defendant appealed Plaintiff was ex- posed to dust created by operations and the petition alleged several grounds of negligence especially failure to provide protective devices and to provide examinations as well as notice of danger of which were charged as violations of statutes The question is whether injury resulted from dust inhaled by plaintiff while an employee of defendant although evidence amply sustains charge that defendant failed to perform some and possibly all of the statutory obligations which constitutes negligence per se Evidence shows that plaintiff worked from 1921 to 1929 for defendant quitting during the latter year because he felt that his health was being impaired The disease was said to be in its third stage at the time of the first examination in October 1932. There was no port for a finding by the jury that the sup- plaintiff's employment by defendant in 1929 caused him to contract silicosis The evidence sufficiently establishes the fact that the employment by defen- dant from 1921 to 1925 was of sufficient duration to have caused the injury but there is no evidence upon which a conclusion can be based that the disease of silicosis could be follows 1 Is silica dust a noxious poisonous or producing dust 2 Is there a disease of remain dormant and contracted and then silicosis which is peculiar to or the natural unnoticed from 1925 until some time in 1929. The plaintiff to recover must make a complete case result of exposure to continuous breathing of silica dust 3 Was silica present in the dust produced gence as the pointing to defendant's negli- cause of the injury Defendant's de- fendant's grinders in such form and by de- quantity as to murrer to the evidence should have been sustained Judgment reversed Admnstrx produce the disease of silicosis 4 Could exposure to the dust produced by defendant's grind- 100 S. W. 2d 897 Missouri v Goran ers during the time when and in the manner which cided November 12 1936 Supreme Ct De- plaintiff was working about them or any of them produce the disease of silicosis 5 Did the hood SILICOSIS - STATUTE OF LIMITATIONS - WHEN and suction fan of the new Bridgeport grinder ef- STATUTE BEGINS TO RUN Pennsylvania Defen- fectively prevent the production of dust in such dant appeals from the orders of the Court of Com- form and quantity as would produce the disease of mon Pleas granting a new trial Plaintiff silicosis 6 Did the plaintiff have the disease of that he suffered an occupational disease alleged silicosis 7 Did plaintiff contract the disease of from defendant's violation of the statute resulting silicosis from being caused to breathe dust employment in industrial regulating duced by reason of defendant's failure to pro- ing that defendant did neosttablishments contend- with any of the statutory provisions comply Since the safe place to work measured supply a reasonably standard here fixed by statute is no more quirement by the statutory reDefense maintained that than the common law standard it requirededfinite barred by the statute of action is struction in order to determine what con- years In the opinion limitation which was two meant to set up for employers standard it trial granting the new trial the judge stated that the finding that plaintiff Defendant's contention that the certificates of approval of condition in its plant after ltahset wweoirgkhetd owfitthhien etvhiedeyncee ar period is against by the Commissioner of Labor constituitnesdpection on that issue Since the verdict is necessarily premised upon that find- fense is without merit both the a de- The duty to comply with ing the verdict cannot stand and the entire specific requirements and general stand- must be retried case Plaintiff contended that for oc- cupational disease the time should not begin to run ards of these statutes is an absolute and mandatory duty directly placed upon the employer by the until plaintiff knew or should have known that he legislature which does not depend upon any ap- had the disease either during the period of employment or at any time after the proval or disapproval of the Commissioner of Labor Judgment reversed and the cause remanded ended employment -Smith Executrix v Harbison The court held that the limitation period begins tories Co. 100 S. W. 2d 909 Ct Decided December 14 1936 RefracMissouri Supreme swahfee n the breach of duty to provide a reasonably to working place occurs The master's failure Complaints and Allegations perform his duty is regarded as a single wrong IS continuing IT and such so long as the employment continues wrong must be redressed by action thought valuable to consider briefly the kinds of complaints which are registered in brought within two years and not thereafter from commission cases As a rule the complaint is the time when the employment terminates It is filled in on a printed form opposite a heading immaterial that the first symptoms of the disease which calls for the kind of disease claimed It is were misunderstood to indicate pleurisy it now a appears that as a result of the work the believed taken that the following list of complaints from series of recently filed cases shows suffering from incipient silicosis and man was to some extent the character of the it began prior to the termination even of though and the types of disease claimed wording used and matured afterward he is employment entitled to to occupational disease Disability pulmonary due tuberculosis all the resulting damages of which he carnecoofvfeerr steel lung dust in disease lungs from grinding lung abscess proof down to the time of the trial as in other caused by inhalation of dust and affirmed cases Judgment Plazak v Allegheny Steel Co. Pennsylvania Supreme Ct Western Dist sand occupational disease due to collected in lungs chronic asbestos dust dust affected bronchitis asbestos Decided November 23 1936 lungs pains in pneumonia fatal pulmonary flat feet chronic laryngitis SILICOSIS - GRINDER AT TILE PLANT - CONSTRUC- stomach and back affected by dust and fumes pulmonary TION OF SAFETY STATUTES - REQUISITES TO RE- occupational disease from poisonous COVERY Missouri Plaintiff obtained a verdict for substances lead poisoning cement poisoning sili- 11,041.66 claiming contraction of silicosis because of defendant's alleged failure to comply with statu- cosis tetraethyl poisoning lead poisoning from lungs pneumonitis ing surfaces removing mechanic paint and repaint- tory requirements Defendant appealed Plaintiff disease was permitted to file a fatal working in a factory under pulmonary which second amended petition heating changed the allegation of working during 1931-32-33 to 1928-29-30 oil caused by fumes of burning culosis in a grinder andmetal tuberculosis tuber- Defendant claimed that this added a new cause of action lungs tuberculosis and scilhiicpopsiesr dust collected in Court held that both the original and amended petitions adhere to the injury originally declared upon and it was proper for the court to allow this amendment The fact issues upon which the plaintiff had the burden of proof and which instructions authorizing a verdict shouldplhaaivnteifrfe'-s quired the jury to find in plaintiff's favor were as 10 similarity similarity court damage suits there is in the allegations Usually ctohnesicdaeursaebloef substances other deleterious deleterious were dangerous and , gases and knowing that such excessive comply with certain statutory regulations regardingregarding such pro- tection to warn employees of such dangers It is alleged that because of such negligence on the part of the employer the employee became sick sore and disabled the disease may or may not be named -incapable of working at his obliged to pay out certain for medical advice and moneys treatment from the scene as breadwinner at head of his family -death resulted because of illness sustained- survivors obliged to pay out certain moneys for funeral and burial expenses Wherefore the plaintiff prays for certain designated damages to be paid by the defendant There are certain variations in these allegations but the above re- cital covers generally speaking the pattern used Bureaus of Industrial Hygiene I CONNECTION with the medicolegal trends of occupational diseases the activities of the bureaus of industrial hygiene or bureaus of oc- cupational diseases usually connected with the various state departments of health have become an important consideration.14 This phase of the work has become possible through the allocation of funds set aside for this specific purpose by the provisions of the Social Security Act The fol- lowing states have Bureaus of Industrial Hygiene in the State Departments of Health New Hampshire Vermont Connecticut Maryland Rhode Island Pennsylvania West Virginia Virginia North Carolina South Carolina Tennessee Mississippi Ohio Michigan Illinois Wisconsin Minnesota Iowa Missouri Kansas Texas and Cal- ifornia two states New York and Massachusetts have such bureaus in the Department of Labor The principal activities center around industrial hygiene surveys of operating conditions and advice regarding control of these conditions offered to various employers As examples of these activities reference is made to TABLES XII and XIII the former showing the activities of the Bureau of Occupational Dis- eases of the State Department of Health of Connecticut during the year 1935 and the latter showing similar but briefer data regarding the experience in Massachusetts during 1935 It is believed that such information will be of Connecticut considerable value to the employer for purposes of prevention and control when carefully con- sidered and judiciously applied however has seen the wisdom of limiting the uses of this information as expressed in the Public Health Statutes of the State Section 2423 and briefed as follows . .. Said department is also authorized to study and provide advice in regard to conditions that may be suspected of causing occupational diseases provided information cb- tained in accordance with the provisions of this section shall not be admissible as evidence in action at law or in any action under the any Work- men's Compensation Act Pending Legislation THE evaluation of the significance of pending legislation with regard to occupational disease disability compensation is an extremely dif- ficult task In some states there are several bills pending while in others there is only one regulatory scheme proposed for consideration Here again it is only possible to call attention to a limited number of bills and let these serve as examples CONNECTICUT Bill H -Proposes to require every physician having knowledge of any persons suffering from poisoning from lead phosphorus arsenic brass wood alcohol or mercury or from anthrax or compressed air illness or any other disease contracted as a result of employment to report the facts within 48 hours after obtaining such knowledge to the State Department of Health The bill proposes also that physician making such a report shall receive a fee of 50 cents from the State Department of Health Table XII BUREAU OF INDUSTRIAL HYGIENE ACTIVITIES CONNECTICUT A. PLANT SURVEYS Total 145 1935 Foundries 2... 39 Lead ee 27 Chlorinated naphalene 10 Solvents misc ........ 8 Rock drilling 22000. 6 Dust organic oo... 55443 Mercury oc 55443 Electroplating cone 55443 monoxide Carbon monoxide ..... 55443 General ow 13 B. TECHNICAL STUDIES CALIFORNIA Bill A -To amend the workmen's compensation act proposes to make silicosis asbestosis and pneumoconiosis compensable under certain conditions DELAWARE Bill H -To amend the workmen's compensation act proposes to make compensable such disease or infection as naturally results directly from employment monoxide cc cee cacassecon stessssntaenget stars Dust Dust Lead ce eae sevenaeensaneesensesenes Carbon monoxide 2333111 2333111 2333111 Chlorinated naphthalene - 2333111 Nitrogen oxide 20.0000... - 23 31 1 Solvent vapors oo cesses 2333111 Total so ootreceentenncnscccnneerctererneseneetnmccenstrttntrcee 34 _ NEW YORK Bills A 1179 and S -To amend the workmen's compensation law propose to define an occupational disease as a disease which is the natural and unavoidable result arising from conditions that are characteristic of and peculiar to a particular trade process occupation or employment in which the employee was employed or engaged Table XIII BUREAU OF INDUSTRIAL HYGIENE ACTIVITIES Total MASSACHUSETTS 1935 visits to industrial establishments comes _ Fumes Dusts Field determinations 000. 72 Laboratory determinations ................ 476 74 174 Total ooo occ ceeccseceesesteseeseeseeee 548 248 .105 Total 146 650 796 OHIO Bill H -To amend the workmen's com- pensation act proposes to add silicosis to the list of compensable occupational diseases The bill proposes however that a workman shall not be entitled to benefits for the contraction of silicosis unless he has actually been exposed to silica dust in his employment in the state for periods amounting in all to at least five years preceding his disable- ment 11 ' MICHIGAN Bill C 106 -To amend the work- men's compensation act proposes to make com- pensable occupational disease arising out of and in the course of an employment The bill define an occupational disease proposes to is due to as a disease which causes and conditions which are charac- teristic of and peculiar to a particular trade occu- pation process or employment MICHIGAN Bill H 192 -To amend the work- men's compensation act proposes to make com- pensable some 14 stated ocupational occupational diseases and poisoning from some 13 statedstated substances MASSACHUSETTS Bill H 1200 Appendix LVI Proposes to establish a commissioncommission of five mem- bers to be appointedappointed by the governor to investi- gate and study allall aspects of occupational diseases athnedhaanzyamrdetohrolidkelihsoodliokrelwihaooydsofof reducing or controlling disease contracting occupational MINNESOTA Bill H 611 -To supplement the workmen's compensation act proposes to make pneumoconiosis a compensable compensable occupational dis- ease and to define pneumoconiosis pneumoconiosis as a disease due to breathing air containingcontaining dust either inorganic organic or PENNSYLVANIA Bill S 7 -To supplement the workmen's compensation actact proposes to make disabilities resulting from a number of stated occu- pational disease compensablecompensable among which are substances radium poisoning or injury by rays blisters due to use of tools or appliances in the employment bursitis of the knee or elbow due to intermittent pressure in the employment miners nystagmus bone felon due to constant or inter- mittent pressure in the employment synovitis and tenosynovitis caused by repetitive or intermittent traumas in the employment carbon monoxide poisoning poisoning by sulphuric hydrochlorie or hasybdersotfolsuiosric acid tularemia glanders silicosis tuberculosis 2. Special provisions relating to particular dis- eases . 3. Medical Board members one a roent- genologist of six years 4. Bureau of Industrial Hygiene in the State De- partment of Health General Discussion IT SEEMS desirable at this point to digress some what from desirable consideration of digress material which has been heretofore set down in this This is done because there are certain paper principles which have a definite corollary medicolegal problems with regard troeloactciuopnasthiiopnatlo diseases and which should receive some considera- tion Under the heading of general discussion therefore I want to point out rather briefly certain principles involved especially regarding the responsibility of the physician the responsibility of the employer the problem of disability and present methods of adjudication of claims , dusts brass zinc bheyndzroolcarbbeonnzsenmeangaanndesneitrdoi-oxaindde derivatives of benzol compressed air ill- ness destruction of tissue by radium or chrome ulcerations epitheliomatous rays cancer or ul- ceration of the skin or of the corneal surface of the eye resulting from the handling or use of tar pitch bitumen mineral oil or paraffin infection or in- flammation of the skin resulting from the handling or contact with oils cutting compounds lubricants liquid fumes gases or vapors anthrax silic- osis and chronic incapacitating miners asthma Suggestions of the American Bar Association IT IS significant that the American Bar Associa- tion significant critically studied American question Associa- legislation for occupational disease disability and has made certain pertinent suggestions as published in the Report of the Section of Insurance Law dated February 16 1937.18 to Although it is only possible summarize the excellent treatment of this sub- ject some of the more important suggestions are as follows 1. Schedule system including anthrax brass or zinc poisoning lead poisoning manganese poison- ing mercury poisoning phosphorus poisoning poisoning by carbon bisulphide methanol petrol- eum or petroleum products or volatile halogenated hydrocarbons poisoning by benzol or any deriva- tive of benzol chrome ulceration compressed air illness dermatitis that is infection or inflamma- tion of the skin on contact surfaces due to oils cut- ting compounds or lubricants dust liquids fumes gases or vapors epitheliomatous cancer or ulcera- tion of the skin or of the corneal surface of the eye due to tar pitch bitumen mineral oil or ffin or any compound product or residue of parathese 12 bacteriology RESPONSIBILITY OF PHYSICIAN Industry and the legal profession cian to quite naturally look to the physi- work out the etiology diagnosis and differ- ential diagnosis in occupational disease problems Etiology has been a most neglected factor as evidenced by the repeated review of the medical records cians of hospitals dispensaries and plant physi- It is not expected that the physician be- come an engineer but it is respectfully recom- mended that he take enough interest and inform himself sufficiently so that he will learn to estab- lish etiology in occupational disease problems just as scientific a basis as has been upon in regard to similar situations in previously used communicable dis- eases where plays so prominent a part and also in surgical diseases or injuries in which the mechanism surgical the provocative agent has been thoroughly studied and demonstrated Further it is my contention that the etiology of occupational diseases is just as much a part of the doctor's responsibility in working out these problems as the etiology of occupational or industrial diseases non- It is also rather difficult to understand how the physician may come to a correct diagnosis and also give differential diagnosis the tion if he does not work out proper considera- logical factors thoroughly the etio- It can therefore be concluded in logy that it is because of regard to etio- that a great many of our mendeigcloelcetgaolf csouncthrosvteurdsiieess arise In the diagnosis the physician is confronted with a similar problem In the ence the physician so average medical experioften disease instead of sees established or normals oTbhseerlvaittnegr ctyaplels eofdinndoirvimdauallss are very commonly seen in industry in routine surveys and it is in this work that it has apparently been so easy to misinterpret the findings Furthermore such misinterpretations are again misinterpreted by industrial laymen too often resulting in the discharge of bodied employees It is evident then that in evaluating industrial exposures the physical examination clinical laboratory and ray findings one must know and be able to interpret the slight deviations from the normal and also to recognize when changes occur within the normal range of variation evidence of gross pathology or gross changes can even be observed by those not medically trained although not properly interpreted real expertness lies in judgment experience and discrimination applied to insignificant changes This is in truth the real basis for much of our present difficulty in diagnosis especially as applied to medicolegal cases Differential diagnosis has been and will continue to be one of the most important problems in the discussion of medicolegal claims Here it is vital that the physician depend upon special tests and diagnostic criteria which are characteristic Such methods are really available although not used to anywhere near the extent that they should behence the real source of difficulty in differential diagnoses The principle of proper and adequate interpretation of technical reports and data is also very im- portant I have previously said in another paper 1 It means practically nothing to the manufacturer to tell him that he has dust in his plant containing 50 million particles per cubic foot of air that the free silica content of this dust amounts to 35 and that a particle size distribution study shows that the majority of the particles are below three microns in greatest diameter Nor does it do him much good to find out that he has in certain processes a lead content of 10 milligrams of lead per 10 cubic meters of air or a concentration of 1500 parts of carbon monoxide per million parts of air What the manufacturer desires to know is what the significance of these measurements is and what they mean in terms of possible occurrence of disability among his employees Someone must therefore explain these things to him promptly and understandingly Similarly insur- ance company representatives including engineers claims men and underwriters also ask the same questions The engineers want to know just what exposure would be safe and if it isn't safe what to do about it The underwriting group wants to know whether plant A as surveyed is a good risk to put upon the books judging from present and previous industrial conditions and also the present and past physical conditions of employees Attorneys and members of industrial commissions and their associates desire to know whether a given set of industrial conditions is an actual occupa- tional disease whether the employee ac- tually has the occupational disease in questionwhether such disease was contracted in the plant where the employee worked It is therefore evident that there must be some- one who can integrate information relative to the industrial exposure and in regard to the effects of such exposure so that the final expression will occur in terms of cause relationships I cannot see any other way than that the physician should become the real interpreter of the etiologic data diagnostic and differential diagnostic medi- Assuming this the challenge to organized medi- Preventive and cine is much greater than most people people realize As I told the Section on Industrial Medicine and Public Health at the 81st Annual Session of the American Medical Association here in Detroit seven years ago The answer is largely one of standards of excellence One must go back to the student in the medical school Curriculums should be so constructed and arranged that the medical student will be exposed to the fundamen- tals of industrial medicine Not only must the undergraduate be provided for but the postgradu- ate courses should be so correlated and so ized that greater opportunity will be organpresented for the promulgation of the basic fundamentals of industrial hygiene among the established practitioners ... The physician is and always will be the leading figure in the field of industrial health as a professional technician he has gained recognition but as an administrator it must be said that he has not clearly seen his responsibilities or his opportunities . Industry will not brook dictator- ship but medicine must officially present a united front if it would continue to assume responsibility and leadership in industrial medicine RESPONSIBILITY OF EMPLOYER In discussing the responsibility of the employer I am again obliged to quote from a previous paper21 The wise employer has no intention of evading compensation for actual and typical occupational disease but should not be compelled to pay for occupation diseases which have no definite relationship to employment The greater use of industrial hygiene surveys routine and special physical examinations with proper interpretations will put the manufacturer in a position to know what he has in his plant which may ultimately lead to the contraction of occupational disease All of this ma- terial needs proper and adequate interpretation however for its efficient use Mention should be key- made of the fact that prevention is the real note and the hub of the wheel for the proper functioning of a manufacturing plant with regard to occupational diseases of all kinds In regard to the cost of acquiring proper information I have also previously said The employer is sometimes rather concerned about the cost of industrial hygiene surveys and physical and laboratory examinations Enough of this work has now been done in this country in various types of industries to say that whereas the cost of these procedures will run into hundreds of dollars the cost of defending one case at common law and paying a judgment or the cost of one claim will run into thousands of dollars This then is truly a problem of industrial economy and becomes one which should be handled with the same amount of intelligence as a production problem Will the intelligent industrial executive adopt a laissez faire attitude and merely let things go or will he find out what he has in his plant in the way of possible potential occupational hazards and also what the condition of his men is Or will he wait until he is forced to pay damage claims It would seem that the ingenuity the resourceful- ness the courage of the American industrial execu- tive could be used in this problem as in other in- dustrial problems avoiding greater expense in the future to say nothing of the suffering disability and unemployment on the part of his employees Continuing with the responsibility of the employer and also from the same source I have pre- 13 viously said No momentous court decision no be controlled amount of political political adventure not even the most Clearly those who oppose such a responsibility intelligently framedframed and administered state laws will solve these problems Such program are shouldering greater than they realize problems as these are now and the being solved in plants in the laboratory examination room by accepted and to- METHODS OF ADJUDICATION OF CASES parent that the ideal method of It is ap- date scientific methods The responsibility be- cases is not in existence at adjudicationadjudication of longs to the employer for the securing of informa been discovered present or has not yet tion as to exactly how he stands so that he Three know what methods to adopt in the future may The general methods of adjudication are in responsibility belongs to no one else use hearings before industrial commissions not to the city not to the state nor to primarily the It is up to the employer to select the nation damage suits before courts of law and by the use of medical boards gent professional and most intelli- In the commission hearing the arbitrator or professional advisers that he can obtain and referee rules on the admission of evidence He is no amount of money or time spent judiciously will be thus vested with a great deal of power in this re- wise investment for the future anything but a gard The evidence so admitted is recorded and sent to the commissioners who make the final de- THE PROBLEM OF DISABILITY It has been cision Here we have then a body of medical in- creasingly evident in estimating the disability due men who are hearing evidence and also ruling it to occupational disease that there is upon sity for the use of objective great necesevidence rather In damage suits in courts of law we have the than depending upon symptomatology and physical j of ury system Here again we have a group findings which are commonly not characteristic medical persons who are likely to be very much The essential basis for the scientific less informed than are arbitrators ref- disability is dependent therefore estimation of erees and commissioners However particularly criteria rather than subjective findiunpgosn objective As stated by Dr. May Mayers22 of the New York in Federal courts the judge can exercise a great deal of choice in commenting on the evidence as State Department of Labor Industrial well as asking questions to bring out important Bureau At the present time we are freHqyugeinetnley points In cases on review it will be found as before stated that the opinion of the court represents unable to diagnose these early cases solely on the basis of very consideration intelligent physical examination thorough this may be We require laboratory tests to assist In using a medical board we are giving an example of the only kind of adjudication us because with their aid we are able to detect medical adjudication where characteristic or diagnostic chemical reactions men are used officially in a specific capa- taking place in the body under specific conditions city Here again however we are somewhat lim- And we can in many instances relate those ited in achieving competent adjudicatoryadjudicatory results changes specifically to those conditions Thus usually because of the lack of money to pay prop- we make examinations of the blood the urine the feces the spinal fluid etc. Dr. Mayers well erly and adequately informed informed medical men for such positions In also have applied this same may a situation where there appears to be so much principle to cases which are not really early cases but which difference of opinion and lack of general informa- established cases of are tion it seems advisable to make a suggestion for a occupational disease Dr. Mayers has also made the practical plan of adjudicationadjudication of cases Might it following comments in the same article in speaking about the of such tests Nevertheless the not be feasible in each each case for the commission the court to appointappoint one several recognized speo-r expense tion of such scientific data is of the essenaccequisIits- cialists with proper background and training to act in an officialofficial capacity in each instance contributions are fold It provides 1 data as to clinical manifestations of disease with- Conclusions a out which truly effective preventive program in RETURNING RETURNING industry cannot be developed preventive program program in material presented presented the statistical and legal means of which greater accuracy in the differen- presented in this paper and and legal sume that these tial diagnosis of compensation cases can be at- experiences can be accepted as typical we may conclude that tained making possible the expression of more positive medical opinion as to causal relation 1. Prevention is the most important considera- tion Because silicosis is such an important occupa- 2. There is tional disease and has been written about so much choice of wordsgrienat necessity for the meticulous in the literature it may be advisable to say a few terminology words about disability in silicosis The disabling making adequate definitions and adopting standard The majority of factor in silicosis is infection the majority of commission claims have been denied in one state in instances tuberculosis It would therefore ap- York chief causes of one year's experience New pear that any program calculated to promote the no medical denial being no lost time early discovery of tuberculosis in industrial work- evidence law in order of not covered by frequency ers would eventually reduce the occurrence of 4. disability consequent upon the contraction of sili- Occupational skin affections were by far the cosis It is an accepted fact that early lesions of most frequent conditions encountered 69.4 in tuberculosis can be recognized in films Ohio in New York in Massachu- ray months before causing characteristic setts the chief assignable causes being exposure and signs The need for a properly conduscytmepdtoms to soap and water and various dyes or dye prod- gram of periodic examinations of industrial permo- - uskcitns The disability period in these occupational ployees is thus established if huge monetary losses cases than has been shown to be a great deal longer needless litigation disability and suffering are to lem mLoasntepehoapsle realize In discussing this prob- stated As one of the medical 14 contributions to the solution of the problem of occupational skin diseases it will be necessary to provide adequate training in this field in medical schools and in institutions with large skin clinics Not only should there be courses provided for public health workers but industrial physicians should have a proper opportunity of reviewing the knowledge of skin affections occurring in industry A wider dissemination of the facts about these con- ditions is urgently needed It might well be said that these same principles enunciated by Lane also apply to all other occupational diseases shown toxic 5. Certain experiences have fluids irritating dusts and fibers toxic vapors gases and fumes as important frequent causes of occu- pational diseases Wisconsin As examples of specific conditions tenosynovitis and lead poisoning may be added Ohio portant phase of investigation of the industrial en- vironment Judicious and limited use of resulting information however is an essential in avoiding embarrassing delicate and strained relationships 14. The trend of pending legislation is toward legal provisions for the reporting of occupational diseases more accurate statutory definition of occupational disease the adoption of the schedule system of compensation for disability and the ap- pointment of special commissions for the investi- gation and study of occupational diseases especially relating to methods of reducing or controlling hazards 15. The suggestions of the American Bar Asso- ciation as already reflected in the legislation of a sizeable number of states are significant in indicating the general trend in future legislative enact- ments 6. The cost of occupational diseases generally estimated as approximately % of the cost of all compensation has nevertheless never been ade- quately studied and computed Although toxic 16. Finally and to prevention is by far the most important phase of this whole subject Bibliography vapors and fumes - germs - and irritating dusts and fibers cost above the average per case for indemnity in one state Wisconsin we must remember that there are hidden costs of occupa- 1. Fundamentals Relating to the Design and Operation of Exhaust Systems Preliminary Edition 1936 American Standards Assn New York City 2. Dusts Fumes Vapors and Gases Safety Orders Is- sued by the Ind Acc Comm of State of Calif 1936 tional diseases vitally affecting all the financial outlay must be included before we have the real facts 7. The fact that no cases of occupational diseases SAPPINGTON C. .: What Price Occupational Diseases Pit & Quarry September 1936 4. SAPPINGTON C. O Occupational Diseases The Situation in Illinois Indust Med 5 71-73 February 1936 5. Occupational Diseases Studied in Claims Industrial have been reported corresponding to certain Bulletin Vol 16. January 1937. Pub by Indust Commis- schedule provisions even for a considerable period of time Ohio is significant for that state only sioner Albany N. Y. 6. SWARTZ NELLE Occupational Dermatitis dustrial Bulletin 2. 454-456 November 1928 The In- The factors influencing such data are highly vari- able in the different states and must be considered 7. Occupational Diseases Cases in 1936 Second Highest on Record Ohio Health News Vol 13 April 1 1937 ay each instance 8. Some Aspects of Blanket Coverage of Occupational Diseases in the United States U.S.P.H.S. Pub Health Re- 8. As revealed by experience in one state Con- ports 52 329-334 March 19 1937 necticut there is considerable discrepancy between the cases reported by physicians and the cases compensated but not reported Statutory 9. LANE C. Guy Occupational Skin Disease Pre- ventable Disease and a Challenge to Modern Preventive Medicine New England J. Med 215 859-865 November 5 . provisions are anticipated in Connecticut to cope with this situation 9. At present occupational disease disability is compensable by law in the District of Columbia and 18 states as previously named The called schedule plan is most frequent 9 with blan- ket coverage next 6 and the use of the word injury including occupational disease third 3 Common law right of recovery is an exceedingly variable factor perhaps impossible of definite in- terpretation in some states requiring special study and critical analysis inter- 10. Court decisions are essentially legal inter- pretations of the statutory provisions and in some states include opinions regarding factual evidence reflect Generally speaking such decisions intelli- gent and mature consideration Of obvious neces- sity the character of recorded decisions is wholly dependent upon the occurrence of appeal from lower bodies physical 11. The questions of medical boards and physical examinations are still in infancy states as mentioned have provisions for boards states have provided for better than the usual type of examinations 12. Complaints in commission cases show great variety and are liable to be indefinitely worded Allegations in damage suits conform fairly well to type following certain traditional points 13. The work of Bureaus of Industrial Hygiene in State Health Departments is an exceedingly im- 10. Personal Communication ALBERT S. GRAY Director Bureau of Occupational Diseases State Dept. of Health Hartford Conn 11. A Survey of the Statutes and Court Decisions Re- specting Occupational Disease from Air Pollution Air Hygiene Foundation of America Inc. Legal Series Bull No. 1 Part VII Pittsburgh September 30 1936 12. Occupational Disease Legislation in the U. S 1936 Bull No. 625 U. S. Dept. of Labor of Labor Statistics Washington D. C. 1937 13. Abstracts of Decisions Occupational Disease Cases Workmen's Compensation Law Service Commerce Clearing House Inc. Chicago 1936 14. SAYERS R. R. and BLOOMFIELD J. Industrial Hygiene Activities in the United States Am J. Pub HealthHealth 26 1087-1096 November 1936. Also Personal Com- munication J. J. BLOOMFIELD 15. Report of Bureau of Occupational Diseases State D1e9p3t5. of Health Connecticut fiscal year ending June 30 16. Report of the Division of Occupational Hygiene Annual Report of the Dept. of Labor and Industries chusetts year ending November 30 1935 17. Public Health Statutes Connecticut Act Concerning Occupational Diseases 2423 18. Occupational Suggestions for Legislation Committee on Workmen's Compensation Section of Insurance Law American Bar Assn February 16 1937 19. SAPPINGTON C. O The Etiologic Diagnostic and Mediocolegal Problems of Occupational Diseases Illinois M. J. February 1937 20. SAPPINGTON C. O. and MARBAKER N. D dustrial Physician and the General Practitioner 95. 1955-1957 December 27. 1930 The InJ.A.M.A. J.A.M.A. 21. SAPPINGTON C. O The National Occupational Disease Situation The Kiwanis Magazine May 1936 22. MAYERS MAY R The Application of chemis- try in Industrial Disease Prevention 34 July 1933 Indust MedMed 2 32- 15 Reprinted from May 1937 MediIcnidnkusMteridaliIncduistrniakl 844 Rush Street Chicago 16 Industry as a Source of Disease -The Character of the Various Industrial Hazards and Their Relative Importance- i EMERY R. HAYHURST M.D. Consulting Industrial Hygienist Columbus Ohio Newberry Library For Study Use Only Unauthorized Reproduction Strictly Forbidden Industry as a Source of Disease -The Character of the Various Industrial Hazards and Their Relative Importance- NDUSTRY means a I place of business also being busy That industry should be a source of EMERY R. HAYHURST M.D. Consulting Industrial Hygienist Columbus Ohio Our subject industrial health is but a phase of the general topic Hygiology Usually it is classed as an disease either in regard to place of business or the nature of one's application is truly an anomaly or an artifact and not some- environmental phase whereas health also covers personal hygiene the physical status quo and even eugenics or the source of thing in the natural course of events as I shall well being attempt to point out below i The source of disease in industry is covered by Historical Background the term industrial health hazard The word : on occupational disease danger- TEXTBOOKS j disease itself I am going to use in rather a broad ous trades vocational hygiene and industrial | sense to include not only pathological states but health cover this subject The recent series of also disturbed functions and conformities in : articles in INDUSTRIAL MEDICINE by Robert T. anatomical and functional status Outside of this Legge have encompassed the subject in both a there is an industrial or occupational disease rate broad and a particular way from the earliest Bib- for certain common afflictions which statisticians lical times to the present For America in 1902 show is in excess of the standardized rate for all C. F. L. Doehring a student of George M. Kober's gainful workers combined.,,Space forbids my dis- at Washington made the first official survey of cussing this here except for an occasional brief industrial hygiene This was done under the Hon reference Carroll D. Wright Commissioner of the Depart- Health is a good old Saxon word mean- ment of Labor and the survey was made in the ing Hale sound and whole in body mind and government shops in Washington In 1905 Massa- soul Hence it is the state of being or the chusetts was investigating its factories under Dr. quality of life The threshold of being varies William C. Hanson In February 1908 Dr. George rather remarkably between individuals and in the M. Kober while Secretary of Theodore Roose- same individual from time to time Life is a broad velt's Homes Commission published a volume up- a highway A marker down the center and soft on the subject INDUSTRIAL AND PERSONAL HYGIENE shoulder with a ditch alongside are the lateral In the same year valuable articles by Dr. George limits for safe going Drivers swerve from M. Price Dr. C. T. Graham Dr. Frederick shoulder to center and even beyond these limits L. Hoffman and Dr. W. Gilman Thompson began much too often and this is when mishaps if not to appear disasters occur Usually however they swerve In 1910 the Illinois Commission on Occupational back successfully This variation in thresholds Cannon calls homeostasis Freely translated Diseases finished its survey under the direction of this means the ability of man to stay put de- Dr. Alice Hamilton and the guidance of Prof. Charles R. Henderson Dr. Ludvig Hektoen and spite thresholds of anatomical and physiological others and in June of the same year the First Na- limits varying from the average or swervings tional Conference on Industrial Diseases met in from side to side In short the called threshold limit for a given hazard is no more fixed than bi- ology itself and the great field of study for the future is why some are more susceptible and others more tolerant Why in the most striking disasters do 70 to 80 of those exposed nevertheless escape In fact only the more susceptible ever suffer from occupational diseases Precision methods are of course preferable but it must not be forgotten that they have only a relative Chicago at the call of the American Association for Labor Legislation under the guidance of Dr. John B. Andrews Prof. E. R. Commons Prof. Henry W. Farnam and Dr. Henry B. Favill Also in New York City in 1910 Dr. Thompson started the first clinic on occupational diseases This was followed in 1911 by the establishment of another at Rush Medical College Chicago by the writer who had been with the Illinois Commission above men- tioned value due to homeostasis in the individual Following these activities came those of the U. * Presented at the Midwest Conference on Occupational Diseases Detroit Michigan May 3 1937 S. Bureau of Labor Statistics the U. S. Bureau of Mines the New York State Factory Investigation 4 Commission under Price in 1912-1914 and others also the impetus given by the XV International Congress on Hygiene and Demography held at Washington in 1912. For a summary of more recent events one should consult the special report of the Harvard Tercentenary Celebration on En- vironment and Man.5 The Industrial Health Hazards N INDUSTRIAL HEALTH HAZARD is any condition or manner of work which is adjustment the threshold of physiological adjustment of the hu- man being so engaged It is to be noted that this physiology is adaptable by gradual tolerance to wide variations in environment and experiences but subjection to conditions which are unnatural or beyond the threshold of physiological adjustment including adaptability results in pathology or disease industrial or occupational disease These industrial hazards group themselves un- der 10 convenient headings 1. The poisons systemic and constitu- tional 2. Mechanical irritants such as mineral or metallic dusts producing dermatitis often secondarily infected or when inhaled and especially if there is an irritative solution in the pulmonary lymphatics pneumoconiosis of various forms 3. Friction and pressure producing blisters calloused places worn teeth bursitis etc. 4. Fatigue producing nervous breakdown or when localized synovitis myositis and other forms of strain subluxations avulsion etc. 5. Infections of which there are not many peculiar to industry itself but examples are anthrax glanders tetanus actinomycosis and the very common machinist's boils associated with oils greases and cutting compounds even such infections as typhoid fever undulant fever and tularemia where such occur from exposure on the jojb ob 6. Diseases following accidental injury at work such as secondary infections deformities and fi- broses 7. Abnormal spectral conditions from the infrared through the brilliant or overly subdued light waves to and through the violet to rays and radium radiations producing afflictions all the way from scorching blistering conjunctivitis retinitis ophthalmia and nystagmus to bronzing light burns and epithelioma 8. Temperature extremes producing on the one hand thermic fever heat retention cramps stroke and collapse and on the other chilling followed by pneumonia Bright's disease etc. also local afflic- tions like frost 9. Noise especially reverberating noises which in time produce called maker's deaf- ness and 10. Abnormal atmospheric pressures producing on the one hand compressed air illness of several types including local effects such as ruptured eardrums and on the other rarefaction disease as in aviation mountain climbing and we might include here asphyxial states due to decreased percentages of oxygen in the air so that mechanical and chemical factors combine While custom has classified these abnormal atmospheric pressures and asphyxial states as diseases they usually partake more of the nature of acute or accidental mishaps To summarize a rapid method for spotting all - usual health hazards in any industrial exposure is to memorize 12 words or terms and apply them in the survey Dust Dirt Dampness Darkness De- vitalizing Air Conditions Temperature Fatigue Infections Poisons Compressed Air Stimulant- ism and Susceptibility In some cases these terms also conjure up their opposites This opionative method was used I beopposites opposites This success method method was used of Industrial Health Hazards and Occupational Diseases 1913-1915 where a large number of indus- tries had to be covered rapidly and with a small budget McCord has competently discussed industrial hazards in his book Industrial Hygiene for Engineers and Managers and more recently in his paper on the Industrial Hygiene Survey The Occupational Diseases TT IS with the greatest difficulty that hoc procter hoc reasoning can be kept out of the present discussion That is we are so very apt to look at the mishaps and wreckage along the highway in the nature of morbidity and mortality statistics and assume forthwith that they are results of haz- ards upon the highway when too often as we well know the hazards lie with the drivers and very often were there before they left home for the trip Nevertheless I feel at least obligated to classify some of the obvious results of these exposures to industrial health hazards which are known as oc- cupational diseases When the condition of homeostasis is passed that is the threshold of natural adjustment is over- stepped any of these mentioned hazards may produce functional disturbances actual impair- ment or death Thus an occupational disease which is the result of exposure health hazard.10 is any affliction to an industrial A ready classification of occupational diseases which correlates them with industrial health haz- ards is the following four groupings 11 1. The called specific or characteristic occu- pational disease such as lead poisoning silicosis prepatellar bursitis tenosynovitis machinist's boils tar cancer etc. In short one or more quite characteristic occupational diseases can be named for each of the 10 hazards above enumerated 2. Diseases partly occupational These are afflic- tions where the hazards may exist elsewhere than in connection with the work such as hereditary or congenital predisposition pathological states or faulty personal hygiene bad living living conditions etc. For example allergic asthma and dermatitis tuberculosis etc. can at most be no more than partly occupational in nature Many diseases of the human body are occupational only to the extent that work may aggravate or activate the condi- tion present For example the effects of heat cramp upon a duodenal ulcer chronic pyorrhea as a se- quella to benzol or lead poisoning etc. Still the elimination of common known health hazards would mitigate if not forestall the onward march of such afflictions 3. Occupational health complaints These are disease conditions such as headache sleeplessness dyspepsia pain numbness stiffness cough etc. Being only symptoms and in themselves not true diseases they are nevertheless the earmarks which should guide the industrial physi- 5 cian engineer chemist and all health guardians to the elimination of possible industrial health haz- ards 4. Conditions which are neither diseases nor complaints but which may be advanced by one's occupation Examples are postural defects such as flat feet and round shoulders or faulty work habits such as constant nodding of the head in rhythm with motions of the hands etc. Some Statistical Evidences CCORDING to the U. S. Census for 1930 there 4 United were, of 48,829,920 occupied workers in the United States 48,829,920 of whom 38,077,804 were males and 10,752,116 were females.12 While a great depression slump has taken place in the intervening years possibly amounting to 10 million who were thrown out of employment I have seen some recent figures which place the present total employment at approximately 45 million were dislodged from their homes and often assembled in large numbers in many places but with no increase whatever in communicable diseases of any nature This is the more remarkable when we consider that this was in the midst of the win- ter season when the respiratory diseases are at their zenith and it contrasts especially with the war period of 1917-19 when the respiratory diseases ran rampant The situation is not so favorable however in working groups as will be shown below In the British Journal of State Medicine for October 1936 Dr. A. Massey commenting on health and safety in the factory found that time lost through sickness was much greater among works employees than among office staffs For example FIRM A had respective percentage losses per week as follows Works employees 2.82 office staff 0.82 FIRM B 3 vs. 0.4 and FIRM C 2.25 vs. TABLE I SUMMARY OF COMPENSABLE OCCUPATIONAL DISEASES REPORTED 1928-1936 INCLUSIVE OHIO DEPARTMENT OF HEALTH BUREAU OF OCCUPATIONAL DISEASES No. Name of Affliction 1928 1929 1. Anthrax 2... eee 2. Glanders 0.0.0. 000.00.0..0..0.. 3. Lead Poisoning . 180 183 4. Mercury poisoning _ 5. Phosphorus poisoning .........0.... 6. Arsenic poisoning 2 7. Benzol poisoning and nitro- or amido- lerivatives 11 11 8. Volatile petroleum products poisoning gasoline benzine naphtha etc. 3 4 9. Carbon bisulphide poisoning . 1 1 10. Wood alcohol poisoning ... 1 _ 11. Dermatitis infection or inflammation of the skin on contact surfaces due to oils cutting compounds or lubricants dusts liquids fumes gases or vapors 22.2020... 12. Epithelioma skin or eyes due to car- bon pitch taror compounds 13. Compressed air illness 14. Carbon dioxide poisoning . 15. Brass or zinc poisoning . 16. Manganese dioxide poisoning 1 17. Radium poisoning 1 18. a Tenosynovitis hand 1 b Prepatellar bursitis 1 . 19. Chrome ulceration nasal and skin 2 20. Potassium cyanide poisoning 2 21. Sulphur dioxide poisoning 2 2... . 894 985 3 2 16 62 7 5 _ _ -* 37 -__* 13 6 10 3 2 2 1930 134 _ 1 3 2 884 1 59 2 _ 130 23 20 _ _ 1931 1932 ._ 114 148 21 3 6 6 851 1223 18 1223 851 _ 1933 134 1 1 w 16 16 _ 833 621 726 53 -22 53 20 -22 10 -22 -. 1312 1312 1312 1312 _ 166 29 16 1 5 149 1303 1303 1303 4 191 19 20 5 2 193-1 _ 162 3 10 10 ] ee 913 218 218 218 228 27 43 oe 7 1935 oe 102 3 3 7 7 1 1 875 1 1 1 3 218 25 49 1 1 1936 ee = Total _ 112 1269 _ 1 - 15 3 63 36 51 36 30 _ 3 930 _ 2 _ 7660 13 170 3 49 178 27 79 2 2 1297 186 322 17 23 Total 1127 1317 1259 1217 1069 1129 * Statistics not kept on Tenosynovitis and Bursitis in 1928. Both of these afflictions had injuries previous to July 1 1929 1 Added to compensable list July 31 1929 by Legislative Act 89th General Assembly 2 Added to compensable list July 9 1931 by Legislative Act 90th General Assembly 1415 1294 been compensatedcompensated 1346 11172 as accidental A decade or two ago mid was the safest age 1.5 These were large engineering firms in Coven- while death rates were high for the child and youth try employing from 2066 to 2391 in the works and as well as for the aged However things have shifted remarkably and the safest age is now in the per- 368 to 500 in the office The author in searching for an explanation observed that office workers iod of youth and the safest year that of age 11.1 were often drawn from more educated groups Even here accidents cause 36.8 of the deaths of than manual workers and accordingly were bet- boys and 11.4 of the deaths of girls The Census ter versed in the practice of personal hygiene covers gainful workers from 10 years of age on- They also enjoyed in the main better home en- Fets ward en vironment Again initial selection as to suita- ee Man's recent and rapid control of the commun- bility for their jobs was more systematic in the ntti icable diseases in civilized countries is no doubt case of the office staff and they had more perma- the chief cause of this shift This control is no bet- nent terms of employment Furthermore the aimcoverusnthf ter illustrated than in the situation created by the great Ohio River flood of January and early February this year when possibly 1,500,000 persons larger number of works employees increased the chances of both importation and spread of infections while the hazards appertaining strictly to .5 occupation were of course greater among works employees Ohio Occupational Disease Statistics THE PERIOD 1913-1936 According to the official statistics compiled in Ohio over the period from May 15 1913 to the end of 1936 a total of 20,296 occupational diseases was reported.1 Of these 2,575 occurred in the eight years prior to the time compensation for occupational diseases began August 4 1921 or an average of 322 cases a year since compensation began 15.4 years 17,624 cases were reported or a yearly average of 1,144 cases Acute mishaps even though due to poisons corrosives asphyxiants etc. and incomplete reports are not included in any of these figures In Ohio occupational diseases are divided for convenience into the compensable group and the noncompensable group There are 21 causative agents listed in the schedule of compensable diseases These are shown in the accompanying Table I. The first 15 of these were scheduled for compensation August 4 1921 the next three July 31 1929 and the last three July 9 1931 THE PERIOD 1928-1936 ANALYZED A glance at TABLE I which covers the year period from 1928 to 1936 inclusive shows a total of 11,172 compensable cases17 reported and that 7,660 or 68.6 of these were due to dermatitis caused by infection or inflammation of the skin on contact surfaces due to oils cutting compounds or lubricants dusts liquids fumes gases or vapors Broad as this cover- age appears it nevertheless omits industrial skin afflictions due to physical agents viz friction heat cold light and radiant energy of any form It also omits perspiration The second leading cause comes under strain or fatigue viz 1,297 cases or 11.6 of tenosynovitis involving the flexor or extensor muscles of the hand only and 186 cases or 1.7 of prepatellar bursitis both of which afflictions were added to the schedule in 1929 The third group of significance is lead poisoning with 1,269 cases in the nine year period or 11.4 of the entire group The fourth group is chrome ulceration involv- ing either the nose or the skin with 322 or 2.9 of the cases Chrome skin ulcers it will be ob- served are scheduled separately from dermatitis in Ohio The fifth group is compressed air illness with 170 or 1.5 of the total cases and occurring practically altogether in the first five of the nine years Thereafter follows benzol poisoning including its nitro- or derivatives with a total of 63 or 0.6 of the cases or exactly seven per year This is followed by volatile petroleum products with a total of 51 or 0.5 The less significant causes of compensable oc- cupational diseases were in descending order Poisoning by brass or zinc 49 carbon bisulphide 30 sulphur dioxide 23 potassium cyanide 17 and arsenic 15 then follows tar cancer 13 and finally three charged to poisoning by carbon dioxide three to wood alcohol and one to phosphorus It is notable that during this year period there were no cases reported of anthrax glanders or poisoning by mercury manganese dioxide or radium An analysis of the reported compensable cases is given below The Industry as a Hazard I HAVE been greatly assisted by Dr. W. E. Masters former Chief Medical Supervisor and Dr. K. D. Smith now Chief Medical Supervisor of the Bureau of Occupational Diseases of the State Health Department in compiling the following data for Ohio for the year 1936 The industries in which occupational diseases occurred are represented by the 1,453 cases reported for that year We can give but the bare figures and not the rates since the number em- ployed in each industry is not known nor can it be closely estimated You all know that Ohio is a state with extensive manufacturing transportation trade mining and agriculture also with extensive institutions and utilities Steel automo- bile food electrical goods rubber clothing publishing are all paramount industries See TABLE II It has not been possible to observe a standard terminology in our use of the terms industry and occupation because we have had to rely upon the reports of physicians very few of whom have any knowledge of a standardized terminology in this field and especially that recommended by the U. Bureau of Census.19 OCCUPATIONS OR TRADE PROCESSES AS A HAZARD The Ohio occupational disease reports for the year 1936 were listed as shown in TABLE III for oc- cupations or trade processes AGENTS PRODUCING OCCUPATIONAL DISEASES An Ohio law of 1913 Section 1243-1 to 5 G.C. Ohio makes all occupational diseases reportable by the attending physicians to the State Director of Health The agents producing them are best classified by noting the types of diseases produced Sexes also the number of reporting physicians and employers can be stated Of the 1,453 cases reported in 1936 249 or 16.3 were females 1,248 or 83.7 were males The percentage of females the preceding year was 20.3 and in 1934 it was 18.6 This total of 1,453 cases was reported by 664 physicians or approximately 7.3 of the 9,000 practicing physicians in Ohio They were em- ployed by approximately 833 different employers 1. The compensable cases Section 1465-68a G. C. Ohio are delineated in Table I. There were 1,346 cases in this group 92.6 of the total ; 1,112 82.6 were males and 234 17.4 were females For the year period ending with 1936 the total compensable cases numbered 11,172( See Table ) In 1936 dermatitis with 930 cases constituted 64 of the total reported cases and 68.4 of the compensable cases The chief greases and causes of dermatitis were Oils cutting compounds 211 specified chemicals 97 chemicals not specified 78 clean- ing compounds 65 plating and cyanide solutions 59 paints lacquers enamels varnishes thinners and turpentine 59 plants flowers vines vegetables grains and fruits 52 petroleum and its products 48 stains dyes and dyed goods 44 bake- lite and other synthetic resins 37 inks blue prints etc. 25 dusts variously specified 23 rub- ber 21 lime and cement 19 bakery and confec- tionary goods 18 wool fur glue hair feathers 17 irritants not otherwise specified 15 brass and zinc 15 adhesive cement 6 abrasives polishing rouge 6 leather hides and shoes 5 infestations 4 fish and meats 4 paste not otherwise speci- 7 fied and garbage and rubbish only one each Lead poisoning comprised 112 cases 10 more than in 1935. The occupations of the workers were as follows Painters general painting 14 spray painting 12 others 4 30 compared with 15 in 1935 and 26 in 1934 foundrymen moulders etc. of ferrous metals 23 storage battery workers 18 enamelers of sanitary ware 12 white lead TABLE II I; NDUSTRIES ASSOCIATED WITH OCCUPATIONAL DISEASES IN OHIO YEAR 1936 Number of Cases Reported in Each workers manufacturing white lead 8 printers electrotypers lithographers etc. 5 automobile manufacturing and repairing 5 manufacturing steel and its products 4 glass workers 3 clay products workers 2 window puttier and junk worker 1 each Three women incurred lead poisoning two in decorating glassware one employed making bolts and nuts In the eight years 1928-1935 inclusive 71 deaths were associated with lead poisoning 10 occurring in 1935 figures for 1936 not yet available There were also reported 79 cases of chrome Industry Total Male Female mad 1. Iron and steel products mfg 2.2... .176 .... 14 2. Foods and confectioneries mfg and 1 handling ...000 0220.00.00 .131 .... 29 3. Electrical products mfg Electroplating 66 64 2003 Storage batteries . 23 23 2003 ulcers 24 occurring in women The nasal mucosa was affected in 44 and the skin in 35 Other compensable poisonings totaled 18 carbon bisulfied 1 and its derivatives carbon tetrachloride 4 butyl acetate ) two females 5 petroleum products 5 benzol 3 potassium cyanide 2 sulfur dioxide 2 Appliances 41. 35 2003 4. Automobile and parts mfg124.... 2003 Tenosynovitis of the hand wrist registered 178 cases of which 57 were females prepatellar bur- 5. Tools metal stampings machine products mfg . ... .... 25 6. Rubber products mfg .... 65 17 7. Institutions public and public 60 49 11 8. Machinery mfg n.o.s. 49 45 4 9. Construction buildings roads etc. 48 ... 0 10. Cloth clothing dyed goods mfg . 44 30 14 11. Printing and publishing . 40 35 5 12. Synthetic resins mfg 37 ... 7 13. Glass mfg .... 36 33 3 14. Foundry products ferrous mfg 31 ... 1 15. Wood products mfg 30 24 6 16. Unclassifiable 20.00 000000000.00.... 29 24 5 17. Retail merchandising 2. ......000..... 27 11 16 18. Chemicals mfg n.o.s. 27 ... 2 19. Window shades mfg 21 .. 21 20. Leather shoes and leather goods mfg .... .... 6 21. Sanitary ware bath tubs sinks etc. mfg . sinks etc. .... 303 22. Paints lacquers varnishes etc. mfg 20 20 0 23. Clay products mfg 17 ... 303 24. Alcoholic beverages mfg 12 4 25. Public Utilities sitis or housemaid's knee 27 cases only two occurring in females Compressed air illness caisson disease ac- counted for two cases in sewer construction work The following compensable diseases reported no cases Anthrax glanders epithelioma or skin cancer and poisoning by mercury phosphorus arsenic wood alcohol carbon dioxide brass and zinc manganese dioxide radium 2. The 107 compensable occupational dis- eases reported including 15 females 6 with constitutional symptoms are of considerable in- terest Dusts were responsible for 40 variously specified fumes and chemicals 25 tenosynovitis other than wrist from repetitive motion 8 infections 10 undulant fever 2 tularemia 4 tuberculosis 3 Vincent's type organisms 1 pressure 3 lifting 2 acids 2 chrome constitutional 2 cyanide poisoning other than the compensable potassium cyanide 2 heat thermal dermatitis 2 chronic carbon monoxide poisoning 2 the rest scattered causes Gas and Electrical .. .. .. 00 Common carriers railways buses etc. 8 8 00 pneumo- Analysis of the 40 dust cases reveals coniosis in some form was the cause in 30 cases 26. Stoves mfg . eee cee cee 15 15 0 27. Farming horticulture gardening .... .... .... 2 28. Laundry and dry cleaning 14 4 29. Roofing and roofing materials mfg 12 .... 0 30. Auto sales and service .. 11 0 31. Paper and products mfg .... .... 5 only a few checked by the Department Silicosis 14 silicosis with siderosis 4 silicosis with tuberculosis 1 silicatosis 1 pneumoconiosis not otherwise specified six In the remaining 10 cases inorganic and organic dusts caused upper respiratory and conjunctival irritation The dusts caus- 32. Beautic. ia cen ces ee ... . 6 33. Bicycles . 7 .... 1 34. Caskets and vaults mfg 7 .... 0 35. Plumbing supplies and plumbing mfg 7 .... 0 36. Coal mining and dealing .. .... 0 37. Mfg of petroleum products and dealing 5 5 0 ing the pneumoconioses arose chiefly in foundries mines sandblasting and clay industries At the end of the year an inquiry was made of the 21 tuberculosis institutions in the State Of these six reported upon pneumoconiosis in general They specified 11 cases of silicosis exclusive of 38. Dental supplies mfg ... ... 3 those enumerated above and one sanatorium re- 39. Saw mill and planing products mfg 4 4 40. Carbon coke products mfg .. .... .. 0 ported 35 additional pneumoconiosis cases exclu1 sive of silicosis Among the tuberculosis institu- 41. Musical instruments infg 0.2.02... 3. 3 42. Banking . 0000.0. cece cee .... .. 43. Vegetable oils mfg 3 .. 44. Cigars tobacco mfg 3 .... 0 tions Hamilton County Cincinnati the largest 1 635 beds also Franklin County Columbus 0 210 beds reported no case of any form of pneu- 3 moconiosis 45. 46. 47. Matches mfg 00. 00000000000.00.... Raincoats mfg Grass mats mfg 3 .... .. 1 .... 0 2 Undulant fever showed two cases and tularemia 1 four cases considered as industrial in origin 2 There was one case of each in 1935 48. Soap mfg 0.0 cece eee eee .... 49. Junk dealing . 00000c 000. 50. Warehousing 2 2 One case was reported in each of 20 other industries 2 1 2 0 During the year period 822 compens- 1 able cases were reported of which 596 were has In 0 the diagnosis of silicosis and other pneumoconioses this Department has followed the recommendations of the Committee on Pneumoconiosis of American Public Health Association as rendered in the Year Books the p 131 1932-33 p 100 and 1935-36 p 65 1931-32 8 agent cases and 226 were afflictions agent not specified Of the 822 approximately 274 were due to inhaling dusts 11 were asthma 70 were tuberculosis alleged industrial and the balance scat- tered Summarizing the 1,453 cases reported in 1936 969 occurred by way of the skin 251 chiefly by in- TABLE III OCCUPATIONS OR TRADE PROCESSES ASSOCIATED WITH OCCUPATIONAL DISEASES IN OHIO haling substances 188 through strain 30 by pres- friction by sure or and 15 other means poisons Acute mishaps 31 even though due to poisons corrosives asphyxiants etc. occupational dis- eases 7 and incomplete reports 9 are not in- cluded in any of these figures In 1936 one plant physician reported 79 cases 4 industrial physicians reported between 31 and 40 cases each and three reported between 21 and 30 cases each It can readily be seen that private physicians reporting but one or two cases made up the vast majority Year Number of Cases Reported in Each Occupation Total Male Female 1. Machinists ics machine operators me- .... 2. Electroplate 00.r 00 s eee 145. 3. Painters enamelers ... 4. Food handlers bakers and confec- tioners 22. eae nd confec- confec- .... .... 5. Rubber workers 76. .... 6. Cleaners janitors etc 65 7. Iron and steel workers n.o.s. 64 8. Laborers n.o. ans d cloth- ... 9. Dyers handlers of dyed cloth and cloth- 47 63 62 and and cloth- ing ... ... 10. Glass workers ......:................ 36 .... 31 11. Synthetic resins bakelite etc. 12. Printers book binders publishers lithog- raphers typers 34.27 .... ... .... 13. Foundry men ferrous 25 25 14. Chemists and chemical workers 23 20 15. Foundry and machine shop workers 22 16. Storage battery workers 21 17. Clerks retail merchandising 21 18. Window shade workers ieee2 . 0 19 21 8 .... 19. Grinders sanders and treaters iron and steel cece eee cee cece ces eenees 19 .... 20. Photographers and printers ....... 21. Leather and shoe workers ............ 19 19 19 12 22. 23. 24. 25. Carpenters and wood workers . Construction workers buildings roads bee etc eeeeee Laundry and dry cleaning workers .. Paper workers 02... 0.00. ceceess 19 ... 18 15 17 18 13 5 26. Clay products workers 13 13 27. Electricians workers in mfg electrical equipment .. orchard. ists gardeners 28. Farmers florists orchardists gardeners etcChrom orchardists a orchardists t gardeners gardene ers gardeners 29. Chromate workers mfg 30. White lead workers 13. 11 10 9 .... 0 .. 10 9 31. Beauty parlor operators 9 2 32. Miners coal .. 0.00 eee ee eee 8 8 33. Polishers and buffers 7 7 34. Institutions public and public 7 6 35. Oilers oil and petrol workers 6 6 36. blasters 5 5 37. Professional persons doctors dentists musicians etc. 5 3 38. Truck drivers 39. Unknown 5 05 54 40. Plumbers 5 0.0.00... 0.c0 ce cee .. 41. Welders beverage ce cc eee eee 42. Alcoholic beverage workers 43. Galvanizers and tinners 5 5 4 5 4 4 44. Auto workers auto parts repairs serv- ice 4 .. 45. Fire0m 0.0000e c een e eee 46. Roofers cece cee ee ere eee eee eeee 4 3 4 3 47. Mineral wool workers 3 3 48. Dental supply workers 49. Mill hands not otherwise specified ... 50. Grass mat workers 3 2 2 1 2 0 51. Refrigerator workers and service men 52. 53. elect . and service eee eaeae Bank clerk 0000s 0 eee Glazers .... ee ee cee e nee eee wees .. .. .. .. 1 2 54. Fertilizer worker 1 1... 55. Window puttier 56. Solderer 000000000 ee .. 1 1 2.2... 57. Motorm00a 0 ce cn ece 1 1 26 29 10 28 16 18 1 0 14 5 7 4 1033032 1033032 1033032 1033032 1033032 20 1072 1072 1072 1072 0500 0500 10 0500 2 20 0 0 0 20 0 0 0 20 0 0 0 20 0 0 0 20 0 0 0 20 0 0 0 20 0 0 0 20 0 0 0 20 0 0 0 20 20 1 0 0 1 0 10 0202 1000202 1000202 1000202 1000202 1000202 1000202 0 I 0 0 0 0 0 PNEUMOCONIOSIS REPORTS ANALYZED BY INDUSTRY In Ohio 284 cases of pneumoconiosis were officially reported in the year period 1927-1936 In 1931 Dr. Byron E. Neiswander20 of the Ohio Health De- partment analyzed 59 cases of pneumoconiosis from 26 localities giving the industries and occupations involved These cases occurred between 1927 and 1930 inclusive To these I have added 54 more Ohio cases occurring between 1931 and 1936 inclusive TABLE IV shows the sources of these 113 cases by industries and TABLE V by occupations The manufacture of iron and steel and of pottery and refractories products lead the industries while sandblasters and pottery workers lead the occupations The numbers of course are small and merely suggestive of the chief sources of pneu- monoconiosis SILICOSIS In 1926 Kindel and Hayhurst made a study covering job race exposure symptoms and stereoscopic ray examinations of 912 sandstone workers in a year old industry at South Amherst Ohio This was accompanied by a chemical minerologic petrographic and comparative tuberculosis study.22 Of these 912 men pulmonary pathology was found 55.1 including 28.5 with silicosis in various stages The total tuberculosis however was but 1.9 Likewise general disability was low The tuberculosis findings checked relatively closely with the tuberculosis statistics of the community A check in 1932 of the County tuberculosis records revealed that only five deaths had occurred from tuberculosis among those workers still resident in the intervening six years and but five active cases were or record In the next five years only some 12 to 15 additional cases of tuberculosis have been re- ported among these workers Silicosis with low incidence of tuberculosis is reported in case reports in both of the last triennial summaries from South Africa 2 out of 20,000 men etc. and relatively low in mortem findings 20-30 etc.24 The same is true in reports from other parts of the world Theoretically the two diseases should be antagonistic but the mass of older evidence ir particular is all to the contrary Evidently the matter needs more investigation The average period for developing silicosis was 16.24 years ir our sandstone inquiry The rock had an average content of 92.15 to 97 crystalline silica SiO2 Of the total number 409 were essentially nega tive 238 had increased fibrosis 180 beginning silicosis 45 moderate silicosis 22 far advanced silicosis 13 silicosis with tuberculosis and five were tuberculosis alone While the men in our study ranged from 1 to 73 years of age few under 25 had silicosis bu at 34 years of age and after 44 years of age there were usually as many and sometimes more sili cotics than silicotics at each year of life Year 9 of exposure and certain jobs grindstone and curbstone workers saw setters hookers rockmen etc. were directly related to the incidence of silicosis but race and work outside or within en- closures appeared to be of little significance Acute silicosis or that occurring with a few weeks to a year or two's exposure was reported as early as 1713 while an unusual outbreak was reported by W. W. Betts in Nevada in 1899,26 involving hundreds of cases and another at Gauley Bridge West Virginia in 1932-33.27 Here a large amount of fine siliceous dust was involved while pneumonia and possibly acute tuberculosis occurred in many cases The situation seems sim- ilar to the scourge to American soldiers while pa- trolling the Mexican border in 1915-16 and to the trolling the Mexican Mexican border border 1915-16 the When it is recalled that there are three isotopes of silicon and some eight stabilities as regards temperature ranges in the natural formation of silica the possible range in biologic effects of this TABLE IV AND SILICOSIS SILICATOSIS ASBESTOSIS BY INDUSTRIES IN OHIO 1927-1936 Special Cases Investigated Ohio Department of Health Bureau of Occupational Diseases Industry Number 1. Iron and steel products mfg 0.0.00... 00000. 820980422 2. Pottery refractories ( brick 1 cement 820980422 3. Monuments granite stone n.o.s. 820980422 dealer 4. Coal mining ( 0.0.0... ccc eee 82098042 5. Brass other soft metals mfg oe... es seee 82098042 Sanitary Ware eee eee 6. ..... 0c. eee Lecce 82098042 7. Sandstone 82098042 oc... cece cee eee c sence ceases ennee 8. Auto accessories n.o.c. . cece ee ceeee 82098042 9. Storage battery containce e cer ce es eae 82098042 10. Asbestos 00. cee ccc e cc cnceneeses 11. 1 chemicals I furniture 1 glass 1 live stock 1 matches oc cece cc ee vec e ce cnseseenes 5 Total ccc cece cece cece eee ecenecraes 113 inspiried air There seems no doubt however of the association so far as arsenic ores are concerned in Schneeburg Germany.32 Arkin and Wagner33 found 72 of 135 cases of primary can- cer of the lung to have occurred in men between 41 and 60 years of age and only 10 to have oc- that curred in women Dr. George M. Curtis says at the present time the incidence of cancer originating within the lung is considered approximately % of all malignancies of the body He is inclined to favor extraneous irritating substances as significant including tobacco smoke and industrial dusts andirritants Lack of Interest on the Part of Labor IN AMERICA a truly anomalous condition preIN vails AMERICA AMERICA organized labor itself leaves the health question pretty largely to the individual worker It does little in the way of educational TABLE V . SILICOSIS SILICATOSIS AND ASBESTOSIS BY OCCUPATIONS IN OHIO 1927-1936 Special Cases Investigated Ohio Department of Health Bureau of Occupational Diseases Occupation Number cece eee ee 1. Sandblasters porcelain 31 2. Pottery and porcelain workers 18 3. Grinders and polishers ve. 11 000 4. Molders foundry men ek e eee e enue 11 5. Coal miners 4853222 6. Monument makers 4853222 7. Quarrymen n.o. 00 ceecs ee cece. cele. 4853222 - 8. Stonecutters n.o.s. 4853222 9. Clay mixer me . cece cn ence eee eee, 4853222 10. Furnace builders repairers 4853222 machinistmachinst assembler assembler assembler eee cece 11. Fire pit workers wee cept eens 4853222 12. Asbestos workers mfg 4853222 13. One each of gas mfg assembler auto parts welder glassworker cement worker hog sorter furniture sander chemicals mixer complex element and compound becomes appar- ent The literature is annotated in the recent three volumes of Davis Salmonsen and Earlywine also by Harrington and Davenport of the U. S. Bureau of Mines Changes in the Nature of Hazards ERTAIN poisons such as benzol aniline carbon bisulphide and carbon monoxide which were prominent 20 years ago have largely disappeared as industrial hazards no doubt chiefly be- cause attention has been focused upon them while others especially new toxic agents have taken their places We see daily the paradox of a new method engineered to the last detail for production or perfection with no thought given to a preliminary investigation of possible health hazards with the result that employees become human guinea pigs far too often in establishing the hazards which arise Of this there have been several outstanding examples such as distilled turpentines and tetraethyl lead in their early manufacture radium in watch dials and the using or producing industries lungs Whether or not primary cancer of the lungs is increasing because of the inhalation of irritating substances is a very controversial question at the present time A suspicion has been cast toward silica dust as well as to irritating factors in the or investigative work in the matter of occupational diseases as may be seen by a scrutiny of its various publications Accidents Versus Diseases in Ohio I N TABLE VI is shown the average number employed per annum the number of accident claims with fatalities and the number of oc- cupational disease claims with fatalities over the year period 1927-1936 The estimated aver- age annual number of employers or establish- ments not shown in the Table was 40.772 during this period with extremes ranging from low of 37,578 in 1933 to a high of 45,203 estimated in 1936 . The average number employed per annum was 1,058,040 with extremes ranging from 817,862 in 1932 to 1,278,992 in 1929 The average annual number of accidents was 187,268 of which 1,037 were fatal Accidents ranged from 129,101 in 1933 of which 883 were fatal to 260,485 in 1929 of which 1,258 were fatal The average annual number of occupational diseases was 1,258 of which 27 were fatal with I am indebted to Mr. Evan I. Evans Actuary Mr. C. C. Beasor Statistician and Mr. W. R. Scofield Division of Labor Statistics of the Industrial Commission of Ohio and Professor Lester S. Kellogg of the Department of Business Organization Ohio State University for the funda- mental figures under this heading  10 a range from 1,051 including 22 fatalities in 1927 to 1,445 including 33 fatalities in 1930 Incidentally in 1936 the average accident claim covered by the State Fund cost 66.14 and the average occupational disease 114.35 Of course the very insignificant number of oc- cupational diseases as compared to accidents is outstanding and is clearly out of step with insurance data and employment sickness data as compiled by many observers A partial explanation lies in the greatly restricted schedule set up by law in Ohio for compensating occupational TABLE VI EMPLOYMENT AND DISABLEMENT OHIO 1927-36 Year Average Number Employed Number of Accident Claims Number of Occupational Disease Claims 1,171,267 1,197,885 1,278,992 1,133,846 963,791 817,862 854,991 980,594 . eee 1,068,456 1936 1,112,720 218,946 228,020 260,485 211,305 170,528 130,379 129,101 158,022 163,316 202,580 Total 10,580,404 1,872,682 Fatal 953 1078 1258 1225 1094 954 993355 942 1048 10370 Average per Year 1,058,040 187,268 1037 1051 1213 1416 1445 1240 1140 1215 1226 1256 1376 Fatal 22 3377 33 40 29 23 21 1188 12,578 273 1258 27 disease claims while no doubt the vast amount of sickness occurring among industrial employees which was found by Sappington some years ago to amount to 20 times the number of cases of accidents and to cause seven times as much absen- teeism is very largely attributable to community factors and the mode of living Industrial Mortality Statistics I Lectures Sir Thos Arlidge in one of his Milroy Lectures That lidhe vital statistics of oc- cupations can only be general and approximative Mortality returns of themselves are insufficient to show to what extent the deaths in an occupa- tion are due to its pursuit They represent the number following that occupation who have died and so afford a crude idea of the relative fre- quency therein of certain fatal forms of disease Those who are interested in this phase of the subject would do well to consult the RegistrarGeneral's Decennial Supplement for England and Wales Part II Occupational Mortality 36 and the more recently compiled statistics of Dean K. Brundage Rollo H. Britten and William M. Gafafer of the U. S. Public Health Service and the reports of Louis I. Dublin and his associates Jessimine S. Whitney statistician of the National Tuberculosis Association showed that when deaths from all causes were arranged according to economic class in 10 selected states in 1930 the standardized death rate for all gainfully occupied males per thousand was 8.70 For agri- cultural workers it was only 6.21 professional men 7.00 proprietors managers and officials 7.38 clerks and kindred workers 7.40 and skilled workers and foremen 8.12 but for skilled workers it was 9.86 and for unskilled workers 13.10 Between 1910 and 1930 tuberculosis the great criterion disease of environmental health conditions receded from first to seventh place as a cause of death in the general population but still stood in second place in 1930 for gainfully occupied males Rollo H. Britten statistician for the U. S. Pub- lic Health Service showed the major causes of excess mortality among unskilled workers as compared to all gainfully employed taken as 100 was as follows Tuberculosis 211 pneumonia 196 industrial accidents 175 cirrhosis of liver 159 nephritis 144 heart diseases 139 cerebral hemorrhage and softening 139 cancer 130 In 1936 the Metropolitan Life Insurance Company found that the chief cause of all deaths between 20 and 44 years of age was tuberculosis A study of Ohio vital statistics showed that in mechanical and manufacturing industries in 1929 the tuberculosis death rate for females was 118.1 versus 96.6 for males and that in 1930 the tuberculosis death rate of female workers was nearly six times that of males Brundage points cut that clerks have a lower rate of mortality than the proprietors managers and officials who employ them Both in England and the United States the death rate of ministers and preachers is almost as low as that of agri- cultural workers Again economic status is really a minor factor since for example the concept of affluence is not associated with the status of the average farmer who of all persons has the extraordinarily longest life In Scotland fishermen shepherds gardeners and foresters are free from disease and especially when compared with the morbidity experience of miners of Scot- land It appears also that in the United States good health and long life are not dependent to any very important extent upon climate but from mortality data upon conditions of life such as celibacy mode of living and occupational ex- posures incident to our industrial civilization The question is Do agricultural pastoral and even clerical and mental pursuits provide biological necessities for health longevity and accom- plishment At least it appears that health and longevity are only indirectly if at all dependent upon affluence station education or work except where work involves an artificial mode of living or hazardous working conditions or both In closing I am much inclined to the idea that in general a low state of health of the industrial population is closely associated with prolonged states of industrial unrest and that if it is hazard- ous to human lives to produce an article of human usefulness then the cost of production must include the cost of health protection Industry should not be a source of disease but a source of health and happiness References 1. BRUNDAGE DEAN K Sickness among Male Industrial Employees During the Final Quarter of 1936 and the Year as a Whole U. Pub Health Service 1393 a 3 pp mimeo April 1 1937 2. CANNON WALTER B Stresses and Strains of Homeostasis Am J. M. Sc 189 1 1-14 January 1935 3. LEGGE ROBERT T The History of Industrial Medi- cine and Occupational Diseases Indust Med began June issue Vol 5,1936 5,1936 continued monthly through the February issue Vol 6 1937 . 4. HAYHURST EMERY R The Industrial Hygiene Sec- tion 1914-1934 Am J. Pub Health 24 1039 1044 October 1934 ee Symposium 5. Harvard School of Public Health the Environment and Its Effects upon 1936. Also see the various upon Man August 24-29 published in J. Indust Hyg p&apTeorxsiocfolth1is93s6ym1p9o3s7ium as 6. HAYHURST EMERY R Health Hazards Some Common Industrial U. B^...rof Labor Statistics Bull 577 April 1933 190-205 Ohio State pp 7. HAYHURST EMERY R Hazards Survey of Industrial Health and Occupational Diseases in Ohio special re- port Board of Health February 1915 438 see pp 10-12 8. MCCORD and CAREY P Industrial Hygiene forEngineers Managers Harper & Brothers 1931 336 pp In9d.usMtCM COeRdD 4CA1R0EY5P 29-53T3heOcItnodubsetrri1a9l3H5ygiene Survey 10. See Reference 6 Ti1m1e.lyHATYiHdUinRgSsT onEMTuEbReYrcuR losis OLcicmuapatDiisotnrailct DHoisspeiatsaels Lima Ohio September 1935 2 pp 12. GAFAFER WILLIAM M Age of Gainful Workers of the United States 1920 and 1930. 10 269-281 March 5 1937 Pub Health Rep 52 13. Metropolitan Life Insurance Company Eleven The Safest Age Statistical Bull 17 1-12 . November 1936 11 26. BETTS W. W Interstitial Pneumonia Induced by Stone Dust Denver Medical Times 19 354-366 January 1900. Also M.A. 34 2:70 January 13 1900 J.A. 27. SAMPSON CLAYTON HOMER L. GARDNER LEROY U. SMITH S. and WYCOFF HELEN L Am J. Pub 23 1237 et seq December 1933 Health . 28. HAYHURST EMERY R Silicosis periment Station News Ohio State Engineering Ex- February 1936 University 8 1 10-14 29. DAVIS SALMONSEN and EARLYWINE The Pneumokonioses Silicosis Bibliography and Laws Industrial Maneddicine Inc. Chicago 1934 482 pp Also Volumes II III the latter just published 30. HARRINGTON D. and DAVENPORT SARAH .: of Literature on Effects of Breathing Dust with Special Reference to Silicosis of Information Circulars U. S. Bureau Mines 1935 1936 31. See Reference 4 1936 32. TELEKY .: Occupational Cancer of the J. Indust Hyg & Toxicol 19 73-85 February Lung 1937 33. ARKIN A. and WAGNER D. H Primary Carcinoma Lung 135 Cases J.A.M.A. 106 587 February 22 14. Ohio Department of Health Health News 13,3 April 1 1937 A Real Flood Ohio 580-586 the15F. aMcAtoSrSyEYJ.A StateObM seervdat4io4ns10on Health and Safety in 16. Ohio Department of Health October 1936 Cases in 1936 Second Highest on Occupational Disease Record Ohio News 13 2-3 April 1 1937 Health 17. Ohio Department of Health Compensable Occupational Diseases in Ohio Leaflet 2 pp 1936 edition 18. See Reference 16 19. U. S. Bureau of Census 1. Classified Index of Occupations 15th Census of the U. S. 1930 205 pp 2. Al- phabetical Index of Occupations same 1930 527 pp 20. NEISWANDER BYRON E Silicosis in Ohio Industries T1h9e3s1is94fp orpt3h0e cMhaesstterp'lsateDsegree Ohio State University 21. KINDEL and HAYHURST Stereoscopic Ray Examination of Sandstone Quarry Workers Am J. Pub Health 17 818-822 August 1927 22. HAYHURST E. R. KINDEL D. J. NEISWANDER B. E. and BARRETT C. D Silicosis with Low Incidence of Tuberculosis J. Indust Hyg 11 228-244 September 1929 23. HAYHURST EMERY R Discussion of paper by A. J. Lanza Etiology of Silicosis J.A.M.A. 1018 August 19 1933 24. South Africa Union of Report upon the Miners Phthisis Medical Bureau for the Three Years ended July 31 1935 pp 23 and 45. Same for Three Years to July 31 1932. Also see Annual Report South African Institute for Medical Research December 31 1935 Johannesburg pp 44-47 Same for year 1934 pp 45-49 25. SAYERS R. Silicosis 595-602 May 18 1934 U. Pub Health Rep 49 34. CURTIS G. M. and KNIERIM H. G Cancer of the Lung Timely Tidings on Tuberculosis February 1937 pp 3-6 Lima Ohio District Hospital 35. ARLIDGE J. T Excerpted from The Diseases of Occupations Percival & Co. London 1892 p 52 36. Great Britain General's Decennial plement England and Wales Part II Occupational Sup- Mor- tality Fertility and Infant Mortality 1921. H. M. Sta- tionery Office British Library of Information 270 Madi- son Avenue New York City Published 1927 37. BRUNDAGE DEAN K Some Implications Afforded 2by7 M3o-r2t6a1l-it2y66anMdarMocrhbi1d9i3t7y Statistics Am J. Pub Health 38. BRITTEN ROLLO H Important Causes of Sickness 9a5nd8 DJuelayth17 P1u9b 36 Health Rep 51 947-969 Fig 18 p 39. GAFAFER WILLIAM M Further Study of the Dura- tion and Cost of Federal Compensation Cases with Dis- eases as a Complicating Factor 33-48 January 8 1937 Pub Health Rep 52 40. WHITNEY JESSAMINE S Death Rates by Occupa- tTiuobneBracseAd. oSnpDeacitaalofRethpeorUt. S3.2Cepnp susJuBnuere1a9u31493s0e.e Nalasto same author New and about Tuberculosis Supplementary Facts and Figures Nat Tuberc A. Special Report 46 pp June 1935 41. See Reference 38 42. See Reference 13 43. Ohio Department of Health Solve Worker's Health Problems 19 October 1 1932 Industrial Hygiene to Ohio Health News 8 44. See Reference 37 Reprinted from June 1937 Industrial Industrial Medicink Reg U. S. Pat Off 844 Rush Street Chicago SUBJECT -- Report of Division of Industrial Hygiene State of Illinois MEMORANDUM TO DR T. R. CROWDER With reference to previous correspondence subject matter and Dr. Kronenberg's report dated April 1 1938 recommending the use of Martindale respirators for employes in the sorting room at the Chicago Laundry A test in the in the use of respirators sorting room and washroom was for made at the Chicago Laundry a day period as a further study to determine whether the potential hazards from dusts should be controlled thru the use of respirators While Dr. Kronenberg did not recommend their use for washroom employes it was felt the potential hazard was equally as great in this department as the washroom employes are required to place the linen in the washers from the soiled linen hoppers which extend to the sorting room We are attaching for your information Manager Fitzgerald outlining the test memorandum from Laundry in detail and are also forwarding identified under separate containing the cover a number of filter pads which envelopes properly were removed from the respirators each day during the test Provided the use of respirators was dry we would eventually be obliged our other plants which would result approximately 640.00 per year adopted at our Chicago to extend the practice in a total expense of Launto In view of this tions regarding test we would appreciate the use of respirators in your further recommenda- our own laundries EK CHICAGO ~ April 11 1939 enon! TO ALL REPAIR SHOPS October 31st 1938 3 Dear Sir The Industrial Hygiene survey of Calumet Shops revealed the need for a proper exhaust ventilating hood over picker in Mattress Room to remove dust from the hair as it enters the picker The hond es applied at Calumet Shope is connected to the suction piping of the fan se shown on drawing C..A 2386 copy attached hereto You should make application of this hood es shown and in addition make weekly inspections of the exhaust fen fen drive piping and dust collector to make sure that the fen is operating st the required speed to exhaust the dust from the picker and storage bins these inspections Proper record is to be maintained covering Piping and collector must be maintained in dust tight condition to provide the proper air supply at the picker and bin Please advise when these instructions have been complied with JVL ht Enc COPY NOTICE COPY TH;IS Mr. Harry Guilbert MEMORANDUM to Mr. Champ Carry CHICAGO ~ October 27th 1988 berg's Referring to your memoraofnOdctu obm er 11th in connection with Dr. Kronen- this industrial hygiene our survey of Calumet Shop and report submittetdo you covering survey with memorandum of August 24th and AFE submitted to you with our memorandum of October 1sts for Car to vow. . In referenicteem 1 page 61 The reason PulimWoarkns inability mainatcaonsitan nt oil pressure is on account of the distance oil has to be transported oiroulating system This oil is handled for approximately 4000 ft from the storage point to the outlet During cold weatthheeor il congeals causinga sluggish condition which affects flow and pressure Pullman engineers understand the difficulty involved and have done everything possible to overcome the problem to the extent of purchasing higher grade oils in winter time at an increase in price It an remodeled engineering problem and we do not feel that the present system and oan be to work satisfactorily the only way to overcome the trouble com- plained of is by the installation of an oil storage system at Calumet Shop where the distance the oil has to be transported will be short it can be kept under proper pressure and and think the supply heated when necessartyo permit of the proper flow at outlets , we that this item should considered at this time . . ; In reference to item 5 page 21 is The use of respiratofrosr laborers are sweeping out cars be swept known thenowtetremceotmmheonddetdhaesdwuistthcpornodpietrionsp is rinkolf iflnoorgs which to conditiowne do think that it is necessary to controllaendd with restarn i empcloyte by the such a use of respirator or have the expense furnishing them as we not . consider the a exposure is haza unr derd ouo r mu eths od . ree _ phot ts August The use vos + cy, Item page was started on August lat 1988 , respirators by employes mixing asbestos cement Item ditions ditions 10 page 8 ditions that the combined use It of has been definitely determbiy nacteuadl goggles and approved working con- operator's vision as makea definite safety type respirators reatriots hazard The dust from opera- tion is mostly It does not reach the operator's breathing sons and the . Committee the job is of the opinion that there no hazard and agree that respirashtoulodrnost be worn by the bandsaw operator = ee improved methods - s page 4 We are using and nozzles permit the satipsrfoapcetrorbylomwainnnegrof. uWnederdforanmoetsfaeneld etqhuaitpmceenmtenutndpeirtscaarrse ann ecdesdsoarythneorwodreksi irn able as they are hard to keep clean and offer a very definite hazard as men may fall in them when they are not covereudp by cars and we see no need for them and not recommend their installation because of the additional hazard invol thv eyewid ll not permiotf to the and any better handlinogf the work or give better protection employes the cost PON Re the the - .,.,,. Item 16 page 5 . We have insisted that manufacturers furnish asbestos repair cement to the shops in paper bags and they have agreed do this the Pur- chasing Agent will purchase asbestos cement only in such containers ssystem yssytsteem m in|. cIotnencmon ectie on pcawtigtiheothn1eOsutrreixpppeirnigmoefntsmawtittrhestsheesveetnct.ihlaavteiphrnooogvdeadndtheaxthtahuest _ arrangement as recommendaendd covered by AFE papers will be entirely satisfactory Memo Mr. Champ Carry Oct. 27th 1938 and of devlopments Page 11 = We will keep you informed as to materials will state here that theEngineer developments Testgos ing of leadfree this matter into by Item 2 page 17 Calumet is typical of The installation of thruout spray bootinhts he VarnRoi omsah t installations chook with engineers that of Chrysler General oncerns made plants of Ford Chrysler General Motors the country made the Devilbiss Company oncerns to installations tn by them railroad shops and manufacturing where the same type is that are of equipment as wehave being used shows plants none ofthem equippaetdtwhieth forced venti and it not required Every test made of the air flow this is the face of the booths revealed a greater air supply than required and oonolusion point to be considered was reached after going The changes into the unnecaeresusnnaecresysary and this Devilbiss engineerswas Would also state further that matter very thoroughly with the Devilbiss if we fora c foe rcd ed draft over the work Being handleidn these boothwse would not get satisfactory job periods Items 1 and 2 page 19 Regular cleaning have been set up and a weekly check of the air floiws made to guarantee proper operation of dye booth | Item 1 page 20 in the Machine Department to tAhier movements are necessary on themachines Wood of the removal system remove dust and wood debris away from them would be noticed immediately operator the Any failure by the in to the foreman of thedepartment and the system is maintained of the machine or order have an effi- we cient operating condition Under such conditions do not feel that velocity read- wwouolu d nlotdra emdodveantyhtehidnugsttoatnhdechsiypsstem as what might be considered necessary velocity and chips indicates satisfactory opferormattheimoanchiT ne o and proper removaE l oe f quoh dust sack dg . page which is Item 2 21 The operator on a small spray booth a room in lacquer that designed so the off the operator cannot enter into the booth is to not exposed to spray His work requires him handling trays of trimmings leave the front of the booth frequently in from under these con- ditions with to and thebooth An airline mask hose trailing around out and the give hanging around as to would not work satisfactorily hose freedom of movementmovement to the opinion other employes thru constitute a tripping hazartdo going operator this room and There are no open dipping tanks in this room and to the operator from any solvents in dipping tanks and we feel tmhe atn a tr he eynohtaveexpprosoepdertoprfoutmeecstiorneleanadsed there is no health hazard for this work and These men use a respirator which is of the approved type provides necessary protection | a re the for Item 4 page 22 The inspection and checking of respiratory protection equipment With the is made by the shop safety supervisor reporting direct to Mr. Harry Guilbert installation of a room centrally located for handling and dispensing respira- tory equipment the employes in this department will be under the direct of the Safety Department All equipment is to be changed regularly and supervision record to insure exchange sterilization purposes at proper stated kept ig also in connectiocon enction with item 5 page 22 and items 6 7 and 8 onipnatgeerv2a8ls This type Items 1 2 and 3 page 25 The plating room is not of the latest modern It represents the average type found in in the state use The employes in this department receive majority of plants in the and each employe has many years of service in monthly the examinations by Dr. DeMotte oate any serious illness attributable to work and their records do not indi- the employment With these conditions and Memo Mr. Champ Carry the fact that wwe e have :not hadoccupational |diseases inthis department Ifeel that the alterations can be deferred until nextyear as it would be desirable to make suoh changes during summer season Items 1 and2 page 31 _., The proper ventilation of toilet rooms is possible present with openingwindowsand ventilatorsnow provided |andunder feel that thisissatisfactory meetsallreasonable requirements ventilation be controllable bysupervision asit would be present method if not properly operated wouldnot eliminate eliminate thecause of complaint ventilating system installation of anyforced isnotrecommended recommended - clear until ** ** Item 3 pages 3182and85 The intent of thelaw is not and we know more about what is required to comply withthe law Iam still ofthe opinion developments that we should wait and see what the are when the first firstvisits inspector our ote F Kronenberg shop 7 In reference to the item of Dust page 85 Evidently what Dr. had in mind was the setting up of a permanent industrial hygiene program under the Medical Department in a central laboratory supposedly in the dispensary at Pullman properly equipped and manned by assistants and laboratory techniciansworking in oon- Junction with representatives of the Engineering Safety andChemicalDepartments Departments to make field surveys andstudies of all Pullman properties collecting samples samplesof collecting dust gases and fumes etc. to which employes are exposed , taking of blood disease samples from all men in contact with materials liable to oause occupational making necessary analysis of same and in general their periodical surveys to develop liable the fast as to whether or not any of the materials being are endangering the health of the employes and are used or dust gas or fumes to result in occupational diseases and to advise corrective measures The setting up of such a system would have to take in the repair shop employes and also anyother occupational yards subject disease employes distriota to ** hazards r in the and p 9300.00 recommended preliminary ; Theapprovalofthe AFE in amount of is in and alsothat work in connection with thePlating room the Brass Department Department | be gone ahead with theintention ofmaking thesechangesnextsummer 6 CHIOcC tobeA r 27G th O 1988 BC - Dr.T.R.Crowder Dr.T.R.Crowder Dr.T.R.Crowder r 7M Mr. C. W. Pflager Chicago October 11 1938 Referring to your memorandum of August 24th submitting your analysis of the Kronenberg Industrial Hygiene Survey at Calumet Shops also your memorandum of October 1st submitting A.F.E. covering certain of the for improvements made in the course of the Kronenberg survey recommendations theDealing first with your memorandum and A.F.E. of October 1st I am returning A.F.E. asking that the third item that is Purchase and - install fuel oil storage and pumping system to replace present pipe line to Standard Car Manufacturing plant be deleted It seems to me that before we make any expenditure such as recommend that the unsatisfactory service performed by Pullman Car Works you ing us fuel oil through a pipe line should be brought to their in furnish- with request that they advise what they can do to attention in writing We can give this particular improve this faulty condition from the question further consideration when we have reply Manufacturing people A.F.E. to Mr. CrawWfiotrhd this item omitted I will recommend approval of the revised Dealing with the balance of the Kronenberg report and your analysis and recommendations in connection therewith into effect or there already was in effect a I note that you have put very substantial number of the Kronenberg recommendations and I will therefore make no comment on these I have already signified my willingness to recommend items included in your A.F.E. with the carrying out recommendations exception above noted There are however several features of the report that I wish to comment on as follows 2 - Item 5 Page Your concurrence is not fully stated You apparently reject the recommendation for the use of respirators on the basis wet methods of sweeping are in use The that either respirators or wet recommendation was not on the basis of fuller statement of sweeping methods but contemplated both I would like a your reasons for rejecting this recommendation 7 3 - Ite Pagem but do not indicate whether you would appreciate advice on this You say that you concur in the recommendation have put the recommendation into effect and I point 10 PagPe age 3 - hazard that the report states would saw operators in the Tin Department I wish Mr. Guilbert would study the safety be involved by the use of respirators by band and report on that feature Item 4 and 15 Page - I assume that we are using the improved methods equipment mentioned as eliminating the need for the pits recommended Mr. C. W. Pflager -2- 5 Item 16 Page - It is not quite clear from the wording of your al recommendation whether you propose to carry out the report's recommendation or not | with Item 3 Page 8 - I await with interest the results of your experimentvaenttiilao tin ng hood and exhaust system for use in connection with the stripping of mattresses Comments on use of lead paints ~ Page 11 - I furnished with periodical advice as to to our ability to secure that could be substituted for materials presently in use would like to be lead materials , 17 fresh air sufficient and windows Pag Page e - I am not particularly interested whether is taken into the spray rooms by keeping the doors ventilators open but it is essential and necessary that sufficient fresh air be supplied I am not entirely impressed by your statement of how this air is presently being supplied If some sort of force ventilators are necessary they should be installed and I wish you would consider this item further with advice 2 - Items 1 PagPae ge 19 Your recommendation 19 but also indicathtateast the time ofof the Kronenberg survey duct were not in satisfactory condition condition This indicates the regular checks and reports on this condition seems satisfactory the fan and exhaust absolute necessity of 20 Item 1 Page I feelfeel that the regular velocity readings recommended by Kronenberg would do no harm and might do a lot of good Item 2Page 21 -your concurrence in having the operators on small spray booths M8 wear airline masks based on greater cost hampering men at work or just what is the reason 22 - Item ,Page Who conducts the frequent inspections referred to and to whom are the results of these inspections reported 5 Item Page 22 - This This item is included in the A.F.E. which I have u stated I would approve however I would like to suggest that this central dispensary 1 fi be under the supervision of the Safety Department who would have direct 1 ) q responsibility for proper maintenance and inspection of equipment \ I think that Items 6 7 and 8 on Page 23 all form a part of proper ssuupcehrvaissitohne SoafferteyspDireaptaorrtymeenqtuipment by some central source with full responsibility expenditure was on these items As regards Items 1 2 and 3 not included in your A.F.E. Page What 25- I note that this is your present state 9,500 9,500 of mind Items 1 and 2 Page31. - It seems to me that something more positive than supervision is needed to insure proper ventilation I should think that the installation of some sort of force ventilator would be the solution what made Item 3 Pages 31 32 and33- I concur in your recommendation that we wait and see developments are along this line tn, Referring to your general comments onDust on Page 35 I do not get the full significance oftheKronenberg recommendationand would like a fuller statement on this point oNDOR j Item 1Page36 I would suggest that Dr. Crowder discuss this with the Standard people and see if we cannot work out some sort ; EIDE of a joint arrangement }aepicn Item 2 Page 37 - I concur in your recommendation I also conour in your recommendation under Solvents on Messrs Dr. T. R. Crowder a H. Guilbert Champ Carry Mr. F.S. F.S. Ricks that Referring to your memorandum of June 23rd in connection with part of the Kronenberg Industrial Hygiene Survey as it affected your Departments I note that you reject the suggested use of respirators in the soiled linen room Such use could do no harm and good and I would be interested in knowing what might do some estimate of carrying out the Kronenberg suggestion would you be the cost As regards your comments on a scrap shed it would to me that the indicated thing to do regardless of appear would be to prepare recommendation on what work existing should be conditions estimate of the coat done and an It does not seem to me that the picture or the analysis is complete without these figures even though we not be in a position to do anything about it at the may present time You say in your comments on the paint stock room that water brushes and soap are available at all times but warn do say that any effort is made to see that they are used you I not think that that part of the Kronenberg recommendationrecommendation certainly \ washing etc. could and should be carried out requiring hand tne glove I am not entirely impressed by your arguments for the glove as against the rubber glove and think that unless canvas a more them rceoncvoimnmceinndgatairognument can be made we should follow the Kronenberg eres cc - Mr. C. If Pfleger Dr. T. R. Crowder Hr Harry Guilbert dronettedronette ~ dronette drodrnoneetttte e dronet e dronette dronette dronete dronette th th ( Chicago October 10 1958 Referring to your memorandum of June 3rd in connection with that part of the Kronenberg Industrial Hygiene Survey that affected your Departments I note your first recommendation for expenditure of 60.00 to provide exhaust ventilation in the welding booth and I concur in this recommendation I also concur in your second recommendation for application of exhaust system at an expenditure of about 5.00 ventilating My only other comments are in connection with concurrence in the report recommendations for the use of approved respirators and positive pressure helmets You say that these would be impractical for yard use but do not out why and I would be interested in an explanation of that feature point ocDr. R. Crowder a Mr. Harry Guilbert Desk 3 MEMORANDUM to Mr. W. T. Stewart With reference to your memorandum of the 29th ult , file Cont 810 stating that Asbestos Cement can be obtained in 50 dust- proof paper bags at an increase of 1.00 per ton or a net price of 27.00 per tons As the present cloth bags permit the dispersion of asbestos dust during handling which is objectionabfrloem a hygiene standpoint it is desired that in the future all asbestos cement be furnished to the Repair Shops in the 50 dustproof paper bags and would thank you to arrange accordingly CertiflageCnertiflagenCertiflagen Certiflagen CHICAGO ~ October 4th 1938 JWL hr 00- Mr. Mr. C. Gartelman Mr. Mr. Mr. Mr. Mr. Mr. Dr. John Cannon F. H. Geiger J. H. Dietrich J. Darragh Harry Guilbert T. R. Crowder -- COPY -- MR C. W. FFLAGER PULLMAN ~ Aug. 23rd 1938 ddaatitonis ons brock brock nenberg havehave read over over t th he e completed report report wiwtithh recommen- Mr. approve of for I committee yesterday and changes at CaluCamleumtet Shops given me yesterday all recommendations made by Mr. Lim- think both Dr. Kro- the committee have done a very very good piecpe iece of work good sgd R. J. DeMotte Newberry Library For Study Use Only Unauthorized Reproduction Strictly Forbidden ~= COPY =< THE PULLMAN COMPANY BUREAU OF SAFETY AND COMPENSATION Chicago -~ August 22nd 1938 MR C. W. Pflager OCCUPATIONAL DISEASE SURVEY Dear Mr. Pflager | As you know I was not present at the last meeting at which the above report was discussed but I have read the Committee's findings and am in accord with them Mr. Limbrock is to be congratu- lated on a good job particularly in view of its tedious nature This morning I discussed some of the items with Mr. Lim- brock particularly De DeMotte's remarks in regard to an industrial technician It seems to me that before adopting the Doctor's recommen- dations we should give some consideration to the Pullman Car Works report and the situation at the other shops In other words in the final analysis it appears that there will be sufficient work for a technician on Dr. DeMotte's payroll Sincerely sgd Harry Guilbert MEMORANDUM to Mr. Champ Carry CHICAGO ~ August 24th 1958 Deak # With reference to our memorandum of June 28th regarding Cal umet Shops Industrial Hygiene Survey report made by Dr. M. H. Kronenberg and his associates Upon completion of our studies of the report survey of the Shops and several conferences between the Medical Safety and this department department we have been able to prepare a joint report which includes the above three departments conclu- sions and recommendations specifically agreed to at a meeting held in this office on August 15th attended by Drs Crowder and DeMotte Mr. Lewis of the ment Messrs Williams Limbrook Gartelman and me Safety Depart- It is the concensus of opinion that Dr. Kronenberg has done a good job and written a fine report on his survey On the whole it should result in improve- ment of health conditions in the Shop In making his recommendations he has in mind the ideal set for the control of unhealthful conditions and they are un- questionably good a number of which we comour in and have placed into effect at nominal costs and have so stated in our report of In a number of cases where we have found practices which were considered by Dr. Kronenberg to incur potential health hazards although his analyses of the dust fumes etc. according to his survey proved to be well within the safe limits presoribed for health control of employes we were able to make substitutions the materials used or complete elimination so as to remove all question of doubt A number of the recommendations concurred in by all will require purchase and installation of equipment facilities and building changes at an estimated cost of 47,800.00 increasing the net annual operating expense 6655.00 which includes 8500.00 allowance for added personnel in the Pullman Dispensary room attendants for washrooms and the maintenance of personnel respiratory protective equipment balance of which is increased cost of power maintenance outside laboratory fees as listed in the attached summary of investment and annual ment operating expense state- Referring to sheets 39 and 40 of the attached report In regard to item of 9500.00 for Brass Finish Departments ment should be made but considering conditions it is recommended that ferred for the present and until conditions improve The this rearrangebe de- In reference to item of 29,000.00 for of the law calls for such an expenditure in order Section S Illinois Wash House Law reads new Wash Rooms to comply with Our interpretation interpretation same However or It shall be the duty of the State and county mine inspectors factory inspectors and other inspectors required to inspect places and kinds of business required by this act to be provided with washrooms to inspeot such wash rooms and report to the owner or operator the sanitary and physical condition thereof in writing and make recommendations as to such improvements changes as may appear to be necessary for compliance with the provisions of this not Any inspector shall have the authority to look and close any wash room found to be conducted in violation of this Act and may institute proceedings to enforce the penalty provided in Section 4. Memo Mr. Champ Carry action be quest for to comply that It is our recommendation no action be taken at this time and that deferred until we have a visit from factory inspectors and they make a recomplying with the law and definite recommendations as to what must be done with same The other expenditures are recommended : The Medical Department reports that during the 23 years of medical vice at Calumet Shops by Dr. R. J. DeMotte we have had a certain amount of ser- ser- with occupational diseases but during that time we have had no lost time trouble of | employe due to purely occupational disease Years any who were doing lead burning prior to the time ago we transferred a few mon ; stalled We transferred two or three an efficient exhaust system was in- recollection of men from varnish removing jobs There is no of lead transferring poisoning Years anyone in the Paint Department account signs or symptoms | ago we had certain amount of dermatitis due to paint sol- vents chiefly turpentine Improvements in materials and methods of the latter years have eliminated this trouble handling in On the whole working conditions at Calumet Shops are above the for Shops doing this type of work not eliminate claims for The adoption of all of the recommendatioanvserwaiglel occupational diseases We will however be in a better position to make a proper defense of unfair claims before the Industrial Commission if the recommended practices are placed in effect of The expenditures involved cover Calumet Shops and with the Occupational Disease laws spreading to other states in which tendency we contemplate making oooupational disease our plants are located our recommendations for consideration surveys at the other shops submitting CHICAGO ~ August 24th 1938 JWL A Eno cc- Dr. Mr. Dr. Mr. T. R. Crowder Harry Guilbert R. J. DeMotte C. Gartelman be COPY a COPY ThTh  PRUaled Wosy uy , Suyrpaey / STG mOU;esed ede St pwe suoygrpucesawe oe Jo aay ee Ss suoTaezdo *[ zeque bebe stripestrp should operations thethe dailydaily andFurthermoreFurthemore respiratos JoumpsDsdoys dGHS PASEngew "Zt t) 09 TIVES Sd0qRaydse sefag) SU3 =e WO Upp enemy supwc peTsqeo fprek FG stripers ATseda silca64 eyQ silica and asbestos respirators maintedmaintedstripers .maintained LIe *T doug 9uy soT rs eq proelyWeqr oq ay covering and use water starting stripers to remove it *T Hygiene Hygien 5}Ou, OS e288, seq i Shops Gerd Ge#n020O8{S SH) Shops waz *ecusnbe poutyese Juyaso ed^'qgeG] #Fyy 8} $B TOrgUON PUESassy JO ueysZtpuco inclusive wedoad en Atoapquwdmo Teoqusdmy inclusive HERE sdrd uy SHOPUy yenp oq Saydyzage MoU 04 of RECOMNDATIO RECOMNDAT*IOuNozarpe peqtdmo ePpAcad q2ous punoy 4tOa8704 SiG, ceye operations sy RECOMMENDATION pu Jo 6q ETE All stripping cars are now buildings performed performed conditonsbuildings Buzop is the handling operations YoT from weather outside weather handling . required the Build- buildngs far sefsord required S404 to operations conditrieoqnusired conditions theand intermit this plan of Respirators recomndatio2this this operations operationslocalize Thisand operations*@ . short Item . Arep andcfaonnuontd thorughly typetype covered OFpie ay se7ue thitshis few compartcivoelyntrol *S eT waar SuzsesoasnzyeqyR coveringcovering tocovering _ REPORTyrs RECOMNDATIONRECOMENDATION RECOM ENDATION RECOMNDATIONREPORT Item RECOMENDATION 3 Cont'd ay prnog Juyasce4enp peurTgno uoTynTos edtd Se ROPSTNAT Tepgued "P980 e4y . exhaustItem Item inMechanical Mechanical Mechanical Department ROLVUESNIGOH DepartmenDepartment staled .Similar colector Uno to anyextenetxtent (GsZHCO) dOHS Trvas *Pagmog ROULVIGHOR "gE magy 2HOLE CONT D OT) RECOMNDATION OUROUR 0} OF Od45 Onp 308 would insulation TheoperationsRespiratorRespirator adequt page OY)page ET RecomendaRteicoonmendatiRoeconmendation grinder the of - adequate ~~ Uy install is Department intermit ent theyconcedOp ventilated ay mechanical *e ou S@acns eon _ao3etydes*{ require drying drying drying eficency eficiency previousprevious thegrindgonexhaust the grinding andalthoughalthough aplicatonaplicationaplication aplication *saoqez}dserWe recommendation sweping practice pescadiewhile aplies seenregard floors Jo underneath Wesreo sug *g ynofact and Buydeans creating moat creating drafts intermitent duration toFgt changes ventilation OUVCS soqseqs RECOMENDATIONRECOMENDATION Item 09 Item aprovedIatpermoved Item That operationoperation conductedwe |x 290 (Usd8G) GOHS STALL_SHOP CONT) Tees - perpnbesom Sy SF OUR SupAeGA 9003 RECOMENDATION Shy Item O74 *Tejem OUR | conur one SY have cemnt conurwear per theasbestos cement which day eso, hwaatveerwater minialse to the mixing water " 2eqze "g B mixng Wedo Item detrmine it be 3 concur recomendation recomendation ' this concur be imposible advance car outside determine pum outside and while requires removal The We operationsoperations testing the doys operations operations operations Stall TIVES SupXPR Of wet 88400 poem YuRQ , *dous respiatorslabores florfsloors sweepingsweeping HOLVRGAE the*Z Item That Item *g operators uoygesedpysqno aproved the the respirator GUOCaE an ywTr naturalnaatunrald ventilation aproved this respirators oy; su0T2uydeus UT szeqsedo Dupdoeastre 45u3 10 concur in Pay of delicate edhy *OT aes recomendation recomendatiroecnomendation andthe delicatedelicate definte very slight slight mostlmyetal - *; enp oO S} RECOMENDATION RECOMNDATIO *g SHOP STALL SHY Of gO odis, afeg 4500 eo;zurd earpnbes OUR RECOMNDATION RA02GNl RECOMENDATION OnE 1 RECOMNDATIO paerday *a980n Item ou sy saeo eq Jaequwcsy We concur now the Underneath w0aeg boxes "ag We Undernath same 45#o Casings Underath These G40 Uy in recomendation recomendation previously under under being being onSurpaubes the recomndatio pepngs operationsare Therfore conducted aplication to Theseair conditioning conditioning Therefore Therfore peqwure *amegtsese recomende UTJo ayy Item recomnde . recomend YOyR syeu4 Ti . et sp ST of LT Item *] ot 12 graduly and uopguted recomendationrecomendation That men Body uy Department of TecZouslWe respirators operations respirators qrupigeamnod-sb for recomndation recomndatio co*0"Zt {GsE803) BeTEOK upAT Item 15.sre ay We concur in this recomendation and eyz now ef ect. Uy is *qofwoeHg, og ee oP 13SEs ozsyne dOue quemgzc4OU TIVES f*oqe "sexoqfpog Item workingJoiners Joiners working working ROLVGSM0Re theDepartmenJO ef4 That cement Paint the him togetStal LBOCe ofa, QUT suop aq aca aoa UOTIBT *suoTyezdoquempedq HAUT aprovedaproved respiratorsrespiratos .aoj tf}weya jo Uy for in yardthe operations in that respiatorseastthe require O49 any 4HCypeasd wey peande practily lfoengweerr . Stripng coverd which now *aeo 15theirelimnate recomndation in recomendatioen y not methods of this elimnate need use maintenace maintenance go04 yey, weyR pus ayy _ *g CONT qeuntep CONT SURE ecuaRS quedy FIyfi pOoy opAge #509 3%0p ole RECOMENDATION RECOMENDATION Meng omy RECOMMENDATION RECOMNDATIO *peuyqwE Item suy 09, Sirpjanp Itembe ayy Fae Grepro this asbestos to Fo paper UT pumoz bags asbestosdispersionAT during handling recom endation ap roximately aproximatelyacordingly peowyd Treaay pus acordingly : the DEPARTMEN b 203pao os Item eBapTseus {uSserd Page , end exhaustexhaust That the emignarvqputsyoe efctively exhaust polishing scTa0ur Polishng be redesignedredsigned polishng andtreads mene (Ged80) nat delegated the ENG "ft so sqy Jo one polishing polishing that wheewhleel DEPARTMENT yo * Z sur mpay seaZep ySty stu, om, og Trea *T 3} oq from brass Polishing buildings Polishing PolishinPoglishing ax operato dOHS TIVES foreficiency Item fouIndtem SandblaRst oom designed HOLVMNCOSE/ designed itself"ST aq Bal sogeq ey fol *sqons LBOcaE S2eq TIeonpos ut Sandblast pipes ofeficency eficenySt} pipes PeyodeuyT MeTqosc TOeye YoYeS @Q Yad. SUPYSTOC SULySTod oy Jo While system the sytem controlcontrolcontrol Department systemhashas oq ey WOOY was uo UySey Sas 1 be conditions conditions are dificult dificult peustepdproblem ASBTGPUE, resulting Zenyxe maintained s.enqxe rearester screnswhich specy make with This pooy 40u} screns which *T gsnp pus ayy *2 ou make repairs ,resultingresulting resulting meqr eq3 of teqr Uy se the dust service screns aq puE ot O73 o79 times peyFerp the Company sTesua ureague al change sTSTA e@zy QUT soOp Zoey, 120.0 the recomende TRUCK FLACKSMITH petnics type RECOMNDRATEIOCNOMENDATION WEVOL PESTS TRUCK FLACKSMITH OURRECOMENDATION rof RECOMENDATION ayesRECOMENDATION RECOMENDATION RECOMENDATION 00g woead PYnon RECOMENDATION RECOMENDATION RECOMENDATION UE RECOMENDATION & AUSSpy, Epo y Item Item yorua *uedo ventilaors ventilatorsventilators several roof rotary ventilators not type be severalroof of sevral peouszaeds during rofqerqxe UVLIN, surveysurvey Zinsttaled yy yoryA|yyS14Loy, TRUCK and TRUCK Uo edyd OF o Anex ous 8 the Sytoy 20x rotaryrotary su oqy09 uy FLACKSMITH FLACKSMITH wars Ue fqTRE FORI OUR RECOMENDATION RECOMENDATION RECOMENDATION [eoPsST on jo We do in for for Item Item e; 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Safety wearing difcultynot Departmen andthem Safety sz new capity respirators breathing SAF 47 *s2equadsaeuBeToO part 2 O8g DepartmenPeSTRs the weay respiratora respirators typetsypestypestypes was new is comfortable the comfortable lection Department has set investigation investigation rreesuslutlt ccapaapciatcyity them checkings ROGLVEHOZ controTl he jedas0BETI and mainteance frequent as AvadsBrpoduse maintenace maintenance lection comfrtableItem sured *ga8; HHO ARG ety 9 SULoFBy 04 Item 2 PUTITrs SB oxy omy esmersd *sdefsdRatz Te0d 'guped *P, wen zee ROIAVUBEROS pauemcedaOUBOT Wop 20x *T "3 weqy wey Godse *TT 049 8B LEGIGP eBay; uty Aw /Ot petTauce REOCOMEENDATIlON RECOMENDATIONRECOMNDATION Sdoe.x MetaRECOMENDATION whe . 9 ueypy ee RECOMENDATION a ItemItem we enter sandblasting positn respirato regardles of vicnity the regardles spy wer omy zederg vicinity company pesce ocupational 12 Page ME 4gy 3OU *engr ocIutpateiomnal "y eae tog 09 eG RGLIVONSREDY building That sncreeenws erected ptreveontsorap Junethaos weted BBS dust be *ag the regard our (UsdlOS) CEYZ Item built shoveling *zoguadsc*Aedio v f ayy Megr Szp28eRuz "IT esey gnowgyaWopgsod We Wedo stilstill There and imatelyimately asing and and those protection ouy protection developed UT dations es vy atrm Wadsmoty aq 2a; wegSOueZEspRatLteTgencys instal reductionreduction the inasmuch ofersconsideroffoerrs equipment Uy rs 13 Sepqecy e2e~1 Pages Asn#9 o% BY * SE COMENTS LEAD ( piped COMENTS COM ENTS COMMENTS PAINTS HTUQ LEAD appreciateCOMENTS LEADAq PAINTS lead lead essentialesential quality ON apreciate quality that but that quality we moredoubt moremore pigment cent is required in lead hashas load load sine market lithopns sseevvrraallreplaced taken purchasing beenshould , are manufacturers manufctres reputable that has retaining manufctres purchasing experience reputableexprienc Division supposedlysuposedly Divson experience this paints to cent find lead free contain an desirable desirable (@azentouy also desirable industrythat adoptin highlyhighlyplant operations whether compunds plant eliminated desirable for compensation protection not boards more interested in whether not percentage medical poisng canot compensation PeTsrentA5F20 canot lead = *oz * ete 03 perpoisoning lead occur The in remains remains tthhatatVRQ 4nO of poisoning exist knownknown exist setaz) Supem: question ustified HIFOC anotheoarnotfher compensatcioomnpeWnhsaattion been wpoeirnet j stified 03 ecun oF poisnig point juemt: compensation WACKY actualites the compensation poisoning compensation cost managememntaanangeamgenetmentmangemnt 035roo actualites the spre . 04 cost Strep uoyBy loadous Aq STAL CEI emoyy 4eqy oem, STALL eyesq Uy SHOPHOP a en RECOMENDATIONRSECOMNDATIONS compensation *suotRzedo RECOMANDTIS wpszatg *anseo REPORT REPORTRECOMENDATRIEOCNOSMMENDATIONS pusi uNa OUR RECOMANDTIONS Axqenpuy etquryep OUR RECOMENDATIONS REPORT 18 fiFWy Item Item peqwtequySTAL 18 Page Ojaiemeaygoun gueyd cUMASE peel 18 1 uz go OU} UT department The department engin combination engiering exhauster department delgate engineering engineering an delegateexhaustedan engin The ser liberation department Sazuoeyd combinat the engin flexible flexible blow exhaust systemsystemto preventprevent the exhausterstudied in design exhaust outing liberatidoenleterious operations is outting burning burning operations control ed health prevnt operations which liberation fumes operations tip completly health from tip deleteriousdeleterio us health ex. se47 ef por TAD oO: exhaustionexhaustionexhaustion they pegdasye2argne BaGQIN'MiGuw0gedor3d eqy v dous in ay2 paint paipntainit n buildinbguildinpiggmentmsainm-ain- substitut2ed27 tois pigmentsreputable ,testing finishes As reputable reputable by our testing testing of aprovedaproved aproved this / this reportsituation C1 RECOMENDATIONS SItfem"60*0'L 47 Speqmrad^'eBP, FuCD eageTIN *y SHOLYGREAMDS egy eq QuEFeTSH prnoa Soo apps 3800 (rdhos) Cons Tivas That SECILVUNDOSE Any meq er LEGE soe, *2t PaegSTAO a@uy 50Of BS It Of duration side . 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spacein s25o0.z0 Fyouoz,d Trequy TEQSUT LsuTre2Sa0p3rey go PepNTouyoste DUST Geqy , ot t ventilating hood for t t t z T *peaynbes METAL FOMES qetodey~eSec 2 g g 2 fume e st ot St st at suoygwpaemOsMETAL Jo uy queysaryuoTadopezo METAL SEMOI 510.0 50.0 SHI SRig Lremne se e1y METAL 309) qns isn isha mrcses Lincoln fume exhauster TVLER 95.0 95.0 75.0 75.0 IVLE (srud)} IVLSK(Nour)  Sumary and genSumary of oe ~ "OF cotcrey oseg Estimated paqunrgsperseTnrsnauySubjectSubject PcERoSfOoNcALs Page Item Descripton Description OequiOpme"nt on*s6e4$Cost C120o."0 PROTECION PROTECION respiratos 23 'o* co*ast including 4509 008s s eT including set respirators ALKALIES PUS sytem local auypequyn 26 I Rearngemt saypnouy ocd Glas S1OZUTGSe2SANITON sytem *Psdtop Sos SANITATION 31-3231-32 31-32 Glas shower 3 faciltes esudxe yytaSaznsy;SsxeunJO go 36 3 facilties seomyz up 908 up TEOT suTD atories anlyse Hygien quemstwie Permant gase Surlpeqsat atories fuzqesdc HygienPermanetHygiene *uegcds TeyEUrfmeqaks POUL *gernplaboratory EDICAL Tunwe LEAD g 2 =g t other T pre | *peanbes FxypoOr qtodeg Seay = 22 4 2 92 TOTAL TOTAL 3 ventilating ventilating ventilang ventilagventilangwashromwashromuE subtances toxic substances outside outsideoutsidetechnician technican technian technican - of ig yUegsauT SueTIALdo not ~ duringvalue expnse 150 Jo NOTE during Areumng increased operating increasdquarterlyquarterly examintosexaminationsexaminations etc which men includeYel 350.0 2900.0 20 .0 Weu St Uopua800.00 80 .0 Jo op o9e 150.0 1e5l0v.a0es a480e5 sucTotexAo *aek 4807 sed Sut4vsedo 640.07295.0 640.0 640.0 JO 38 A[204.1erb6 5 .0 6655.00 RA pe_umTyE0eu e4342azpanp %SLON