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from tho th'sk of-- II. II. UWJS o /f L- 0 C. \ V -,OK / i. y \ ' r , i ) iteiatuie Gbsfaacts MEDICAL ENGINEERING LEGAL - decisions and trends ifttdusfaial Health Tlews lu--d Mo~tkly By INDUSTRIAL HYGIENE FOUNDATION 4400 FIFTH AVENUE PITTSBURGH, PA. 0042,-4 j r.ic's 1 ,c--:.r5 i | ;? - J r: K ,r-a rsrv of v/.-rV.cr ar.u r.uj. i ..'CwU.j cun .i.'-IL'I'j'/ , 'cvnaaticr-'s 2 card o vo no-: thu'ul conditions in var plants, -0 /V,'0 ito. i u; O' > rrui tnc roam cn it.us col condition. rractic iVX1k1L v w ^--5- -O'. r.-eotins m a help in 'n no int on durum apcv;c-r. i~ r.c'.oc irons i2 lOGt >usti to-ilur C .T i> >0 fore*' mat .p error r.u v>-- ; out': maintenance oi August, 1943 Vol. VII. Ho. 8. Industrial Hygiene Foundation, 4400 Fifth Avenue, Pittsburgh, Pa. INDUSTRIAL HYGIENE DIGEST Literature and News News Items 733 Occupational Disease Cases. Connecticut's occupational disease report for June, 1943 lists a total of 208 cases. Dermatitis from oils show 141, while acids, alkalis, chlorine, metal dusts, organic dusts, dyes and inks, poisonous plants, soaps and glues, and synthetic resins raise the total number of skin disoases to 179. Pneumoconiosis, including silicosis and tuberculosis, accounted for 14 cases. Poisoning from carbon tetrachloride, 1; abnoimal pressure, lj inorganic dust, 1; fumigants, in secticides and disinfectants, 1; lead, 1; solvents (N.O.C.), 2; and sulfur di oxide, 1. 734 Be Prepared for Here Absenteeism. Vie may anticipate that "absenteeism" will get worse before it gets better. For the simple reason that, as more and moro "marginal" workers -- 'teen age youths, women, older persons and those with physical handicaps -- come into the field of industrial production, they may be expected to aggravate a situation which al ready is regarded in many quarters as critical. These classes of workers ''.nil bring with them their own peculiar sets of absenteeism-causing conditions, among them lower stamina, family difficulties and greater accident proneness. Wo can count on mandays boing lost, too, by these groups for the same capricious causes which are estimated to have cost the war effort 55,000,000 man-hours last year, through "willful." or "voluntary" absenteeism. Unquestionably the biggest opportunity confronting industrial management is to reduce both voluntary and involuntary absenteeism by adopting and instituting simple, inexpensive health and safety measures in industrial plants and by educating both regular and "marginal" workers in proper health and accident-prevention practices for their off-the-job hours. -- American Mutual Magazine, May, 1943. 735 V.'atch For Malarial Returning servicemen and our native anopheles mosquitos may together give us cause for concern over the possibility of the spread of malaria in our civilian population. Since many men are serving in the tropics and sub-tropics, "malig nant" malaria may become an acute problem. Laboratory workers should prepare themselves for this possibility by brushing up on the technics of examination and on the distinguishing features of the three malarial parasites. Remember Industrial Hygiene Digest - 2 that malaria is a group of three diseases, not one. A fourth parasite, Plasmo dium ovale, .not hitherto found in the United States, may put in its appearance. For adequate-laboratory service, the thick blood film is perhaps more important than the thin, film although both are needed in many cases. Laboratory workers should become familiar with- the manner of making and staining both types of blood smears. A concise guide is National Institute of Health Bulletin No. 180, "Manual for the Microscopical Diagnosis of Malaria in Man," purchasable through the Superintendent of Documents, Washington, D.C., price 30 cents. -- Connecti cut Health Bulletin, July, 1943. 736 Trigger Finger. Two ailments are peculiar to women engaged in chipping or riveting with air guns. The first, chipper's palsy, is rare. It consists of weakness or atrophy of some muscles, and is probably caused by improper handling of the tool or a too vulnerable position of the nerve at the base of the thumb* The other, call ed "trigger finger" or "woman welder's hand," is the result of injury to the ten dons of one or more fingers at the level of the knuckles. Bruising the tendon causes swelling which may become so great that the tendon does not pass easily through the opening in the ligament, and external force must be applied. Treat ment involves splinting the fingers for a number of weeks. The tools should be redesigned to conform to a woman*s hand, well-fitting gloves should be used, and easy-relaxed operation of the tools should be taught. -- Safety Eng., 8, 41-44 (July, 1943). 737 Tennessee Industrial Hygiene News. Vol. 1, No. 1 of this periodical appeared March 1, in mimeographed form. It is issued quarterly by the Industrial Hygiene Service of the Tennessee Department of Public Health. A prominent item is "News About Industrial Nursing in Tenne ssee", containing excerpts from a paper presented by T.J. Bulger before a Tennessee State Nurses Association meeting. The desirable qualifications of an industrial nurse are given as personality, educational background, initiative and interest in the work, and ability to keep records. The number of industrial nurses in Tennessee on March 1, 1943 was 226. Other timely items are also re ported. 738 Carbon Canisters Remove Gas From Biological Laboratory. A large processing organization sought economical, efficient means of removing gaseous odors that were nauseous at a concentration of but 1/10 part per million parts of air. Several hundred perforated activated carbon filled canisters were arranged so that 13,000 cubic feet of recirculated air, to be decontaminated, flows through the multiple carbon bods every minute with an air resistance of only 2/10 inch of water. By the use of this method excessive equipment and fuel costs are'avoided and the air conditioning plant is reduced to modest proportions. Reactivation of the saturated carbon made it possible to measure the amount of gaseous impurities extracted during the first 18 months of service. It canc to 150 pounds, estimated at being sufficient to blanket half the city of Chicago to a depth of 10 feet. -- Chem. Equipment Rev., 9 (March-April, 1943). 739 National Safety Congress. The Transactions of the 31st National Safety Congress, held in Chicago October 27-29, 1942, have been issued in two volumes. Volume 1, 720 pages, includes the General Subject and Industrial Sections and Volume 2, 279 pages, the Street and Highway Traffic, Commercial Vehicle, Transit, Child Education, Homo and Farm Safety Sections. Of especial interest in Vcl. 1 are papers given in the sessions on dust, fumes, gases and vapors, pp. 55-75; gas and electric welding, pp.95-102; industrial health, pp. 137-149; industrial nursing, pp. 151-166; occupational Industrial Hygiene Digest - 3, diseases in munitions manufacture* pp. 167-178. Some cf tlie papers on theso subjects, or other papers by the same authors covering the same ground, have been presented in the Digest, and the others appear in this issue. 740 Paint Your Factory Floors for More Light. The painting of walls and ceilings has been found to be an adequate means of improving lighting conditions without changing existing lighting equipment. Nov;, the painting of floors for greater light reflection offers interesting money sav ing possibilities. A survey was conducted by ''Paint Progress," using small models to determine the efficiency cf various paint colors for floors. White has the highest reflecting value. Values of other industrial interior colors are tabulated. -- Paint Progress (New Jersey Zinc Company). Legal Developments 741 Federal Employers' Liability Act.__ Death Due to Excessive Heat in Power Plant of Railway Company. Safe Place to Work. Employer Not Negligent. Assumption of Risk. Beamer employed by the Virginian Railway Company at its power plant, died a short time after having worked in intense heat in the plant for about two and one-half hours. His administratrix instituted an action for his death against the railway company under the Federal Employers' Liability Act, and recovered a verdict fer $10,000. The verdict was set aside and judgment was entered for the railway com pany on the ground that Beamer had assumed the risk of his employment which barred any recovery for his death. Bcsner was originally employed by the firm v/hich built the plant as a steam fitter in the construction of this power plant. He v/as taken over by the railway company when the plant was completed and he had worked in the same capacity for the latter company at this power plant continu ously until his death. He was more familiar with the system of pipes in the plant than any other employee. Beamer had to repair a steam pipe near the ceil ing in the basement. The air circulation around the pipes near the basement ceiling was poor and it was very hot. One hour after Boomer's death the temper ature was 132 deg. F. Physicians testified that the heat v/as most likely the cause of his death. The defense of assumption of risk v/as the principal one. The jury v/as instructed and the case was tried upon this defense just as though Congress had not enacted the 1939 Amendment (53 Stat. 1404, c685, 45 U.S.C. par. 54) to tho Federal Employers' Liability Act. The amendment obliterates from the lav/ the doctrine of assumption of risk in any case where injury or death results in whole or in part from the negligence of the carrier. In tins respect the case was tried upon a false theory. The fact that the court sot aside tho verdict upon an erroneous ground will not compel a reversal of the judgment if a correct result has been attained. If the railway company v/as not remiss in its duty to 3ecmer, no judgment against it should oe allowed to stand. There remains the question whether or not death resulted from the negligence of the railway ccmprry. The railway company v/as not negligent in sending Beamer to work on the heat lir.c under the turbine when it v/as very hot. This was a reasonably safe place for him to work under existing circumstances. The railway company'was only requirec to exercise ordinary care in furnishins a safe place for Beamer to work. It v..v.s not hotter where Beamer v/as v/orking than is required by standards of good prac tice for such plants. Judgment affirmed, 3eamcr v. Virginian Railway Va. Supreme Ct. Decided June 14, 1943. (CCK). Industrial Hygiene Digest - 4. 742 Occupational Disease* Computation of Compensation Payable* Appeal by claimant from that portion of a decision and award made by the Board which modified an award by the referee. Claimant, prior to the date of dis ablement, received as wages $30.00 per week. He suffered an occupational disease and after a partial recovery was able to, and actually did, earn $6.48 per week as a janitor. The Workmen's Compensation Lav; provides that if it shall be deter mined that an employee is able to earn wages at any other occupation and such wages do not equal his full wages prior to the date of disablement, the compen sation payable shall be a percentage of full compensation proportionate to the reduction in his earning capacity. The referee computed the reduced earnings rate by awarding to the claimant two-thirds of the difference between his aver age weekly wages prior to the date of disablement and his actual earnings for the period covered by theaward. The Industrial Board disregarded claimant's actual earnings and arbitrarily fixed his earning capacity at fifty per cent. The Board in reversing the referee sought to apply this statute. It did so, not upon evidence as to v/hat the claimant was able to earn in any other occupation which should be neither unhealthful nor injurious, but upon medical evidence that the physician believed that he could go back to work,' or if his general con dition was built up a little, it might be possible for him to return to work. There was insufficient basis for the application by the Board of this statute. Award reversed and the matter remitted. Lapp v. Owl Laundry Service, Inc., ot al. N.Y. Supreme Ct. App, Div., 3rd Jud. Dept. Decided May 5, 1943. (CCH). 743 Asthma Contracted by Employee in Soap Factory. Trial Court1s Authority to Sub stitute Own Findings for Jury* s Findings. Construction of Findings to Uphold Verdict. This was an action for damages for personal injuries in which plc-.intiff alleged that while in defendant's employ he contracted asthma, an occupational disease, as a result of negligence of defendant. The jury answered special questions and returned a verdict for plaintiff for $3,000. Defendant moved to set aside most of the special questions. This motion was sustained in part and overruled in part. Defendant also moved for judgment in its favor on the answers t the spe cial questions notwithstanding the general verdict. This motion was sustained. Plaintiff has appealed from the adverse rulings on both motions. Plaintiff worked in several departments of defendant's plant. There were large quantities of soap dust in all those departments every time he worked there. The floor of one department was covered with soap dust. His lungs got tight and his breath ing became difficult while working in tho dusty departments. He coughed contin uously during tho last months of his employment. The jury returned its gen eral verdict for plaintiff and answered special questions. The jury found, in answer to some of the special questions, that plaintiff's disease is an occupa tional disease incident to working in and about defendant's soap manufacturing plant, that the average employee working about a soap manufacturing plant suffers similar ailments, and that defendant knew of such a disease being contracted by other employees working in said plant, naming two such employees who had con tracted asthma. The trial court set these findings aside. The trial court's powers extend no further than to approve or disapprove the verdict, or the answers to special questions. It has no authority to render a judgment contrary to the verdict nor to find an answer to a special question opposed to that re turned by the jury. The court may not substitute its judgment for that of the jury. The trial court had no 'authority to make findings, which amounted to answers to.the questions, contrary to those made by the jury, as the trial court's written rulings indicate was done. The limit of the court's authority was to approve or disapprove the findings. The .question as to what other employees had contracted asthma should not have been submitted, for'the reason it was imposs ible for tho jury to have answered it from the evidence. The answers to the Industrial Hygiene Digest - 5. special questions approved by the court are not so inconsistent with the general verdict that the latter cannot 'stand* The trial court erred in sustaining defendant*a motion for judgment upon the answers to the special questions* The pleaded defenses of assumption of risk and contributory negligence were found against defendant, and rightly so, by the general vordict of the jury. Appellant asks that judgnent be entered for plaintiff upon the general verdict. This may not be done for the reason the trial court has not approved the general verdict, and no judgment should be entered upon a verdict which has not been approved by the trial court. There is no specific order of the court in the record cither approving or disapproving the general verdict* If the court approves the ver dict, judgment should be rendered thereon for plaintiffs; otherwise, the court should grant a new trial. Judgment reversed with .directions. Walker v. Colgate-Palmolive-Peet Co. Kan. Supreme Ct. Decided June 14, 1943^ (CCHf. 744 Occupational Disease. Compressed Air Tunnel Worker Disabled as P>esult of Com pressed Air Illness. Section 40 of Workmen's Compensation Act Construed. Claimant was employed as a compressed air tunnel worker. Claimant became dis abled as a result of compressed air illness or its sequelae. The Workmen* s Com pensation Law expressly provides coverage of this occupational disease. The sole issue raised by appellants concerns the question whether this occupational disease was contracted within the terms and conditions of Section 40 of the Workmen* s Compensation Lav;. The Board found that claimant became disabled as the result of an occupational disease due to the nature of his employment, which was contracted by him while employed by the employer-appellant within twelve months previous to the date of disablement. Award affirmed. Connell v. Walsh Construction Company, ct al. U. Y. Supremo Ct., App. Div., 3rd Jud. Dept. Decided January 13, 1943. (CCH). 745 Factory Employee Exposed to Gases and Dust. Resulting in Tuberculosis. Cross motions, by defendant for judgment on the pleadings pursuant to Rule 12(c) of the Rules and by plaintiff for leave to file and serve an amended complaint. Briefs have been presented on behalf of both parties and the matter submitted to the court for decision. Plaintiff was employed in a factory operated by the defendant. During such period of employment, the defendant violated certain pro visions of the Labor Law as a result of which plaintiff was exposed to various gases and dust from which he contracted tuberculosis, silicosis, heart injuries and various aggravations thereof. Such diseases and injuries were not, at the time of the contracting thereof, within the purview of the Yforkmcn* s Compensation Law. Plaintiff*3 proposed amended complaint presents two causes of action. The first cause presents a claim for the disease of tuberculosis arising from the various gases to which the plaintiff alleges he was exposed, and the second cause alleges general'injuries from the various dusts to which he alleges expo sure, Under the complaint proposed to be amended, when considered in connection with the Bill of Particulars, proof can bo made of tuberculosis, silicosis, or general injuries, and therefore the motion to amend should be denied. Defen dant* s motion for judgment on the pleadings is on three grounds: (1) that the action is barred by section 48(2} of the Now York Civil Practico Act requiring actions on statutory liability to be commenced within six years from the accrual of the cause cf action; {2} that the action is barred by Section 66, Article 4A Worimen* s Compensation Act requiring frdust disease" actions to be begun within 90 days after April 16, 1940; (3) that this court has no jurisdiction ever the subject matter of the action. With respect to tho first ground, it is the court's opinion that in viev; of tho wide latitude of evidence admissible under the complaint that decisions of this nature arc more properly reserved until tho evidence is presented. YJith respect to the second ground the complaint is sufficiently broad of scope to permit proox" of gaseous inhalations and non-aust Industrial Hygiene Digest - 6. diseases, and the plaintiff is entitled to presdnt his proof at the trial and defendant's motion to the complaint is not well taken. Defendant contends that since plaintiff's employment extended from September 1, 1935, the Depart ment of Labor has exclusive jurisdiction, as provided by the Act, where the last exposure to dust occurred after September 1, 1935. The common lav/ right of ac tion is preserved even though the employee continued to be exposed after Septem ber, 1935. The motion to amend the complaint is denied. The motion, for judgment on the pleadings is denied. Conner v. S.I. duPont deNemours &. Co. Inc. U. S. Dist. Ct., Western Dist. of N. Y. Decided March 10, 1943. ICCH). 746 Wrongful Death. Inhalation of Sulfur Dioxide Gas as Cause of Death. Former Workmen* s Compensation Case. In an action for v/rongful death the testimony of a physician as to the possibility of a causal relation betv/een the inhalation by decedent of sulfur dioxide gas and subsequent death is not sufficient, standing alone, to establish such relation. Prior to the institution of this action decedent's wife prosecuted a claim as surviving widow before the Workmen's Compensation Commissioner, which claim was denied on the ground that decedent's death did not occur as the result of his employment. It is now contended that because in that proceeding asserted that her husband's death was the result of a single exposure, plaintiff may not now bo permitted to contend that decedent died from a disease incurred by being gas sed over a long period of time* There is no merit in such position. Mrs* Ihyztatt in her claim before the commissioner appeared as an individual, while in the instant case she sues as administratrix of decedent's estate. Moreover, the bases for recovery are entirely dissimilar in the two proceedings. The court reverses the judgment in remanding this case to the court of common pleas for further development, and enters judgment on the jury verdict, Havzlett, Adnx. v. V/estvaco Chlorine Products Corporation. W. Va. Supreme Ct. of App. Decided May 11, 1943. (CCKT 747 Compensation Agreement. Discontinuing Compensation Payments Upon Employer's Filing of Petition for Review* This cause is before the court for determination upon two questions certified by the superior court. The proceeding was begun by the employer's filing with the director of labor, a petition to review a certain preliminary compensation agree ment, upon the ground that respondent's incapacity had subsequently ended or diminished. The questions certified to this court for determination are: Where an employee receiving compensation under the Act voluntarily returns to work with the employer from whom ho has been receiving compensation, and earns wages equal to or greater than Ms average weekly wages at the time of the injury, but where no final agreement has been filed, is the employer obliged to continue mak ing the payments of compensation while the employee is so employed or until a final agreement is filed; where the employee voluntarily returns to Ms work under the above stated conditions, but no final agreement has been filed, must the employer, before being permitted to proceed with a petition for review of tho preliminary agreement, pay to the employee the. compensation fixed in the preliminary agreement for the period during which the employee has been so em ployed? It was held that the first of these questions did not so affect the merits of the controversy as to justify certification, and consideration there fore will be confined to the second question. It is the court's finding that the legislature required that all compensation agreements must be approved by the director of labor in order to have the status of effective compensation agreements under tho act. An agreement entered into by employer and employee and approved by the director of labor under the act has the force and effect cf a decree of court; that until it is modified or terminated in accordance with the provisions of the act, it must be complied with and is enforceable as a Industrial Hygiene Digest - 7. decree. The second certified question must be answered in the affirmative. A further confimotion of this conclusion is found in the statute which permits an employer, upon the filing of a petition for review, to cease, for a reason able time, payments of compensation. The papers in the.cause, with this courtfs decision certified'thereon, arc ordered to be sent bach to the superior court for further proceedings. Brown fc Sharpe Manufacturing Co. v. Giacop-na. R.I. Supreme Ct. Decided July 23, 1943. (CCH). Book Reviews 748 Exploring the Dangerous Trades. By Alice Hamilton. Littlo, Brown and Co., Boston, Hass. Index, illustrated, 433 pp. (1943). Price *3.00. Industrial hygiene has been granted a great service in this book, which is a biographical account of the last thirty years by an authority with a gift for interesting writing. Dr. Hamilton tolls at first hand of the period from 1910 to 1920 when industrial medicine was frowned upon by the medical profession. Prom 1920 on it gathered impetus, while in the last 10 years the preventive as pects have assumed a permanent place in American industry. The humanitarian and social aspects of industrial health matters occupy a large part of the book. Dr. Hamilton has seen our nation emerge from a position of disgraceful backwardness in the control of industrial health to the present time, when wo can take our place as a world pioneer. It is doubtful if there is any other person qualified by personal experience to write such a book. Few, if any, who could do it in so charming and interesting a manner, *9 Air-Borne Infection. Some Observations on its Decline. Dwight 0fHara. The Commonwealth Fund. New York. (1945), 114 pp. Price 1.50. The book is a study of air-borne diseases, mainly from the standpoint of preven tive medicine. The most coinmon ones arc given detailed consideration, usually a chapter to each, including smallpox, diphtheria, pneumonia, streptococcus infec tions, rheumatic fever, tuberculosis, the common cold, whooping cough, measles and influenza. In the discussion of the first two the author traces the evolu tion of cur knowledge of immunity and the development of vaccination and of anti toxin administration. From the other diseases we have as yet no such means of protection, and the author presents various facts and theories about the dis eases and speculates on the possibility of their successful treatment. In the laal chapters the general amelioration cf health that has boon progressing for number of years is discussed* The dependence of one disease on another is isidercd, but the decrease in some diseases in the absence cf any preventive vpaign, is credited to a better standard of living, including better medical i, rather than to unknown factors in immunity. Finally health is depicted resultant of biologic constitution, emotionalconstitution and living stan, each appropriately subdivided. The final chapter deals with age and disand their relations. The book is well worth reading for the viewpoints ited. However, the reader who is acquainted with industrial or general a v.ili be disappointed in the brief treatment accorded actual air transfer case. In the chapter with that heading, the author describes the transfer roorganisms in droplets set in motion by coughing, sneezing or talking, droplets and the gems they cany are always in the air when people gather, n makes the point that it is of r.c use to purify the- sir when it is im_..c7 to bo polluted. The actual disease reservoir for respiratory infection 004222 Industrial Hygiene Digest - 3. is not in the exhaled vapors, but in our nasopharyngeal membranes, and the atmos phere is merely the vehicle by which the microorganisms nove about. Moreover, the remedies that have been successful against these diseases have no relation to their transmission by air. These statements are largely true; yet the indus trial hygienist reading the book would wish that the v/ork of Wells and others in proving that disease-producing organisms are 'transmitted by air, shoving how they are transmitted, and how they depend on moisture for their life; also that the use of ultraviolet light as a bactericide had been at least mentioned. In his foreword the author admits that his pages record speculation; so why not speculate also on the possibility of the elimination of disease transmission by air through developments along the lines that have been begun? 750 Creatine and Creatinine Metabolism, H.II, Beard. Chem. Publishing Co., Inc., .Brooklyn, N. Y. 576pp. cloth v4.00. (1943). This monograph is a well written and inclusive summation of the biochemical liter ature on creatine, creatinine, and muscle metabolism in general. It is a necess ary revision of Hunter's monograph which has been a classic for sixteen years. In addition to biochemists and students of muscle metabolism, this book should be of considerable interest to the clinician interested in myopathies. It should also be of interest to the industrial hygienist and physician, because it gives one a better understanding of muscle metabolism and shows the importance of ade quate and proper nutrition for the production of a maximum amount of muscular work. 751 Medical Jurisprudence and Toxicology. J. Glaister. Williams & Wilkins Co., Baltimore, Md., 7th Ed. 671 pp. (1942). $8.00. There aro few changes made since the 6th edition was published in 1938, when the work was extensively revised. The book has been primarily written for use in England and Scotland and the legal chapters vail be of limited value to American readers. However, most of the book is medical, including 12 chapters on medical investigation of deaths and 8 on toxicology. A now appendix is devoted to medico legal procedures in relation to deaths following air raids. Industrial Health Hazards and Their Effects 752 Byssinosis - Report of Two Cases and_Rcvicw_ of the Litoraturo. H.L. Bolen. J. Ind. Hyg*. & Tox. ,"25, 215-223""(June"''19437*."* The term Byssinosis, derived from a Greek word meaning fine linen, identifies a form of respiratory disease affecting workers in cotton mills. Considerable dust, is released in the processes which prepare the cotton for spinning and weaving. Follcvang a description of the symptoms and progress of the disease, two case reports and a review of the literature arc given, as indicated in the title. Ho specific treatment for the disease is known, but sensitization injec tions have been administered with seme success. A special dust respirator has been devised in London and many plants aro taking steps to control cord-room dust. 753 The Physiologic Properties of Indium and Its Compounds II. G.C. Harrold, S.E. Meek, K. Whitman and C.P. McCord. J.Ind.Kyg. & Tox., 25, 233-237 (Juno, 1943). Continuation of an investigation cf the toxicity of indium leads to the following supplemental statements: Indium treated silver discs implanted in rabbits /-'l /*> /*. CO u. C~ J Industrial Hygiene Digest - 9. (subcutaneously, intramuscularly, and intraperitoneally), induce only foreign body reactions in periods up to 156 days. The prolonged daily feeding of indium sulfate to rats produces no demonstrable changes at the 53 mg./kg. level. High er amounts (116 mg./kg.) may produce poorly defined subnormal states after more than 40 feeding days. The equivalent daily dosage in man would be near 123 grains. Indium absorption after feeding is proved by the presence of indium in the urine and its rclativo absence in the urine of control animals. Diverse foods in contact vath indium treated metal, remotely simulating indium treated metal food containers, present amounts of indium, which in the case of weak acotic acid dilutions, thus akin to pickled foods, are important and noteworthy. A chemical method for the analysis of indium in the presence of both organic and inorganic mixtures is described. No industrial applications of indium are now known to introduce serious exposures for workers. 754 The Effect of Arsenates on the Storage of Lead. L.T. Fairhall and others, rub. Health Hepts., 58_, 955-959 (June 18, 1943). A soluble arsenate, such as sodium arsenate, when fed to rats receiving lead carbonate, was shown to produce effects similar to those produced by lead arsen ate alone. The administration of sodium arsenate with lead carbonate diminished the concentration of lead in the kidneys, whilo the concentration of arsenic amounted to only half that of the sodium arsenate group. More significant is the fact that arsenates in general definitely diminish the storage of lead in bene tissue. The amount of pathologic damage follows that observed in experi ments previously described in which lead arsenate and lead carbonate were fed to animals for comparison of the relative toxicity of molecular components. In this study the spleen showed the most narked changes vath sodium arsenate and the least with lead carbonate. Conversely, the kidney showed more marked changes with lead carbonate. The tissues from the animals receiving both sodium arsenate and lead carbonate showed changes of an intermediate degree. No pathologic changes of any significance were observed in the liver. 755 Effect of Lead Absorption on Blood Calcium. V/.V. Jenretto ana L.T. Fairhall. Pud. Health Hepts., 53, 1001-1005 (July 2, 1943), Investigation cf the serum calcium content of animals ingesting large amounts of lead as well as animals receiving smaller doses over a longer period of tin at different levels of calcium intake indicates that lead absorption docs not appre ciably affect the blood calcium level. -- Authors' summary. 756 Magnesium in Industry - Magnesium Burns. F.J. Jarzynka. Ind. Med,, 12, 427-431 (July, 1943). The rise in prominence of magnesium in industry has awakened much interest in the occupational hazards incurred in its fabrication. Burns arc the most common injuries encountered and are usually severe and deep, as magnesium fires produce high temperatures. The fires arise from molten nctal, or from the igniting of the metallic dust or swarf. The author gives a short history of the experience of his company with magnesium firss. A number of case histories are related. Treatment, v.hich differs in no way from that of other thermal burns, is discuss ed bricily. Protective measures against magnesium burns arc good housekeeping, instruction cf employees in precautions to bo observed, and '/rearing of protective clothing and plastic face shields or goggles. 757 The Physieloeic Properties of Palladium. S.F. Meek and G.C. Harrcld. Ind. Med., 12, 447-443 (July, XS45). Palladium is one of the metals now enjoying wider industrial application in varicus fields. The sources, physical properties, some common coupcunds and zheir specific uses arc givon. These substances are not known to constitute a hazard Industrial Hygiene Digest - 10 to exposed workers, but they have been found, from animal experiments, to cause damage, when injected intravenously in small amounts. The chief sites of damage appear to be the heart, kidneys, liver, bone marrow, and blood cells. Indica tions are that palladium is eliminated from the body chiefly through tho kidneys. 758 The Threshold Toxicity of Gasoline Vapor. Philip Drinker, C.P. Yaglou and U.P. V/arren. J. Ind. Hyg. &Tox., 25, 225-232 (June, 1943). In 1921 and 1927 the Bureau of Mines published reports on the threshold toxicity of gasoline vapors, using human subjects. The authors conducted experiments with the same general methods, but v/ith larger groups of subjects, varying from 8 to 13. The gasoline concentration ranged from 0.015 per cont upward. The re sults on toxicity agree sufficiently with those obtained in the earlier work; real toxic symptoms dovelcped when the gasoline concentration was 0.1%. Trial of gasoline fractions cut at 110 C gave substantially tho seme results. The threshold of detection of gasoline by odcr was found to vary among individuals, but by many the odor was noticed at 0.015%. This figure is lower than those found by the Bureau of Mines. Such low concentrations produced slight degrees of gastro-intcstinal disturbance in one or tv persons out of 10. While gasoline may be detected at vory low concentrations, it is very difficult to judge its concentration even roughly by the odor. This fact makes it possible to consider that serious complaints of gasoline odor may bo referable to very low concentra tions of gasoline in the air. 759 The Physiological Response of Rabbits to Cyclohexane. Methylcvclohexane, and Certain Derivatives of These Compounds. I. Oral Administration and Cutaneous Application. J.F. Treon, VI.2. Crutchfield and K.V. Kitzmiller. J. Ind. Hyg.& Tox., 25, 199-213 (June, 1943). 1. The minimum lethal doses of cyclohexane, cyclohoxanol, and cyclohexanone, and their methyl derivatives, administered to rabbits in single doses by moans of a stomach tube range from 1.1 to 5.8 g./kg. 2. The minimum lethal doses of the oxygenated compounds applied to the skin of rabbits range from 6 to 17.6 g/kg. Single and repeated application of tho hydrocarbons failed to induce fatal poisoning in rabbits. 5. The compounds range themselves in decreasing order of toxicity as ketone, alcohol, and hydrocarbon, in both the methylated and non-mcthylated series and for both methods of administration. In all in stances the methylated compounds are more toxic than tho non-mcthylated. 4. Physiological effects, upon the animals, of tho oral and cutaneous admin istration of these compounds, are given. 5. The pathologic findings in fatally poisoned animals were those of an acute toxic process lacking in specific characteristics, the damage having wide distribution by virtue of general vascu lar injury. 760 Carbon Tetrachloride. M. Bowditch. Ind. Med., 12_, 440 (July, 1943). Tho "code for safe concentrations" to toxic exposures in Massachusetts plants gives the allowable maximum for carbon tetrachloride as 100 parts per million. The author believes that this figure is too high by 100%, and gives in support of his assertion, tho evidence published by Elkins in 1942, which was deduced from a study of 11 separate plants. Elkins concluded that tho correct value is not above 50 p.p.m. and probably not below 25 p.p.m. Atmospheric determinations for carbon tetrachloride made in 2 factories by the Massachusetts Division of Occupational Hygiene gave findings which warranted discarding the figure of 100. They ask cooperation in Their quest for a standard which will insure tho worker*s well being without imposing undue burden- on tho employer. GO o/ o r* Industrial Hygiene Digest - 11. 7GI Chlorinated Solvents - In Common Wartime Use. D.H. Byers. Ind. Med., (July, 1943}. The most important of the chlorinated hydrocarbons, from the viewpoint of indus trial health are carbon tetrachloride, ethylene dichloride(1,2 uichlorethane) and trichlorcthylcne. The toxicity of these compounds follows the order in which they are named, in descending order. The author discusses each solvent, giving chemical and physical properties, applications in industry, principal dangers of industrial poisoning, the effects of the compounds upon the body and safe atmospheric concentrations. Some precautions to be observed in the use of trichlorcthylene as a degreasing solvent are given. The importance of institut ing proper measures to prevent hazards in the use of hydrocarbons from reaching serious proportions is stressed. The use of air tests to determine the concen tration of the solvents is recommended. 762 Hazards of Common Organic Solvents. H.P. Giuadland. Occup. Haz., , 9, 27-23 (July, 1943). Hazards in the use of organic solvents arc: (l) Fire and Explosion; (2) Toxi city; (3) Bodily Contact. Financial losses from fires due to flammable liquids have increased from more than 7 million dollars in 1936 to 9 million dollars in 1941. Lists of common organic solvents which offer the hazards of fire and ex plosion and of those which are non-flammable and non-explosive are given. The "Table of Common Hazardous Chemicals," published by the National Fire Protection Association gives detailed information on proper safeguards against fire. F. Flury in "Toxicology and Hygiene of Industrial Solvents" makes a three-fold classification of the toxicity of.common solvents: . (1) Those which are harmless under ordinary conditions of industrial use, but dangerous if their vapors are breathed in high concentrations; (2) Those which cause secondary reactions in the body, from ?;hich a quick recovery is possible if the damage is not severe; (3) Solvents which may cause secondary effect which, when not fatal, may bo irreparable. The last group must be handled with the greatest of care under the proper controls. The common organic solvents, in prolonged contact with the human skin will absorb the natural oils, leaving it dry and open to infection or they may bo absorbed into the body through the skin. Personal cleanliness and the use of protective creams and solvent-resistant gloves are enjoined. In structions of the manufacturers concerning the safe use of their products should be heeded. 763 Some Toxic PLeactions of Common Explosives. J.H.Eddy, Jr. Ind. Med., 12_, 433486 (July, 1943). The paper is intended particularly for private practitioners who are, in gener al, not familiar with the material treated. During this war there have boon fatal cases of poisoning, due to T.N.T., both in this country, and in Europe. Evidences and results of exposure to T.N.T. are given, with methods of treatment and measures for prevention. The effects from tctryl while less serious than those associated with T.N.T., nevertheless call for similar preventive measures. 764 Industrial Sanitation. Anonymous. Industry, 25-26, 50-51 (July, 1943). The progress in the science of industrial hygiene and sanitation is noted. New exigencies induced by employment increases, multiple shifts, longer hours, and loss recreation are being met by health authorities. Pules for sanitation and hygiene are fairly uniform throughout the country. An American Standard Code, sponsored by the U. S. Public Health Service is a minimum code, offered as a guide to States and to individual industrial plants. Some of the previsions of the Code arc discussed. Of Ot Industrial Hygiene Digest - 12 765 Industrial ..Hygiene - In Synthetic Rubber Manufacture, F.S. Hallette. Ind. Med,, 12, 495-499 (July, 1943). '"The vital.importance and rapid expansion of the synthetic rubber industry pro vides an excellent opportunity for industrial hygiene activities. Of the four different types of synthetic rubber called for in the government program, 3una S is the most important and will be produced in the largest quantity. The almost complete enclosure of this process prevents exposure to all but low concentra tions of vapor." Safe concentrations for butadiene, styrene, and acrylonitrile, ingredients of Buna S and Buna N rubber are given, with methods of determination of low concentrations. "In a series of several hundred blood examinations, no effect traceable to butadiene, styrene, or acrylonitrile could be found. The points of potential exposure in these processes are in tho handling of raw mater ials, coagulation, centrifugation and drying." Means for avoiding or preventing these exposures are given. -- Condensed from the Author* s summary. 766 Drinking V'ator on Construction Jobs. Industrial Data Sheet No. D.-Con.3. National Safety News, 47, 57, 99-101 (June, 1943). Hazards in supplying drinking water on construction jobs are due cither to use of polluted water or to contamination during handling. A thorough discussion of Sources of Water Supply, Testing and Treatment, and Dispensing is provided. 767 Bubbling Drinking Fountains. A.P. Hitchens and O.A. Boss. J. An. Water Works Asscc., 3j3, 165-167 (February, 1943). Studies of drinking fountains actually in use emphasize the need for serious attention on the part of health officers to fountains so constructed and used that they actually concontrat and distribute agents of disease. Large numbers of bacteria, smong them, pathogens, wore found in drain pipes. These are trans mitted to users by splashing up of water in the bowl, which results from air bubbles caused by partial clogging of the drain. These findings are supported by bacteriological examination of material in the drain and by animal experiments. 768 Save Your Skin. L. Tulipan. Safety Eng*, 85., 45-48 (June, 1943). In normal times there are, on the average, about 250,000 cases of industrial diseases cf the skin occurring annually in the United States. It is probable that the war has produced an appreciable increase in the number of cases. The prevention of dermatoses in the following industries are summarized: Explosives, electroplating, acids, cement, cyanamide, chromium, coal tar, petroleum, synthe tic dyes, artificial silk, organic solvents, resins and waxes and rubber. A description cf the general principles of treatment is also provided. The need for the study of skin disease by research dermatologists and the employment of specialists by industry are stressed. 769 Hypersensitivity to Adhesive Tape. Report of Four Cases Shoving Its Variable Etiology. 51. Kcil. J. Ind. Jt/g. <x lox., 25., 23S-242 (June, 1943). The protocols of 4 cases of hypersensitivity to adhesive tape are recorded. The results of patch tests with the various ingredients of adhesive tape are discuss ed, with particular reference to Beni Para rubber and so-called "pitch subccnpound." Tho first example of hypersensitivity to commercial dehydrogenated rosin is recorded. The fundamental question of hypersensitivity to oxidized fractions in abiotic acid is discussed. Preliminary data are furnished to show that a positive patch test to abietic acid may not be duo to the acid itself, but rather to oxidized fractions, phenolic bodies ana so^forfch. The etiology of hypersensi tivity to adhesive tape is variable and each/h c`5Sires study to determine the pre cise cause or causes. G04227 Industrial Hygiene Digest - 13. 770 Bronchial Asthma Due to Sensitivity to Gum Acacia. P.H. Sprague. Canadian M, A. J., 47, 253 (September, 1942). ' The case is reported of a printer who experienced asthmatic attacks while at work. He was exposed to dust arising from an "offset" spray which contained gum acacia; this spray v;as a fine powder used to prevent the colored material from one sheet from being smeared on to the sheet below it. Masks were worn by the workers, but in one man the mask was not sufficient protection. He found his breathing becoming difficult, so that he had to leave his work in the early after noons; shortly after leaving, his breathing improved. Investigation showed that it has taken almost four years for him to become thus sensitized to this sub stance, which is no longer being used. Others have found that acacia is a highly specific allergen which constitutes a definite industrial hazard. The affected man had an allergic rhinitis, his father had asthma, and a brother had eczema. With him, a simple scratch test with the powder gave a definite weal and an ex tensive flare. v 771 Physiological Reactions Applicable to Workers in Hot Industries. F.C.Houghten, C. Gutberlot and M.B. Ferderber. Heat., Pip., & Air Cond., 15, 205-208 (April, 1943). 1. A study of the rise in body temperature and increase in pulse rate of workers at relative humidities of 30 per cent and lower shows the same reaction at a given effective temperature as previously found for higher relative humidities. 2. The body temperature rise correlates well with effective temperatures, indi cating a possible maximum, plus or minus, departure of less than one degree in effective temperature at 30 per cent relative humidity on a given effective tem perature line in the neighborhood of 95 deg. FT. 3. Rather conclusive evidence is reported to substantiate the earlier findings of the Laboratory, that a person is comfortable at a slightly higher effective temperature when standing and moving about at work than when seated at rest. -- Authors' summary. 772 Do Women Create More Problems in Industry than Hen? C. Hash. Ind. Med., 12, 450-451 (July, 1943). The closing paragraph summarizes the author's answer to the question, as follows: "In fairness to my sex, I would say women do not present any unusual difficulties but rather that the biggest and important problems lie in industry itself. After all, industry was not prepared for women workers on a large scale - machinery was set up at working heights for men, for one thing; washrooms were just washrooms, not rest rooms, and so on. It will take a little tine and patience to make the necessary adjustments, but women have shown they 'have what it takes' and every thing will cone out all right." 773 Women's Wartime Occupational Hazards. Women's Bureau, U. S. Department of Labor. Ind. Med., 12, 436-487 (July, 1943). Figures arc given, shoving increases from 65# to 90# in injuries to women in America and Great Britain. Need for more complete statistics on which to base prevention programs is indicated. Special accident problems of women war work ers are listed. Industrial health problems, due to war conditions and the inci dent expansion of women's employment in certain jobs require the full use of medical and engineering control to prevent occupational diseases as well as the use of protective devices for the avoidance of accidents. 774 Fatigue - A Misnomer. K. Bartle. Ind. Med., 12, 436-438 (July, 1943). The author points out that fatigue is a very general and indefinite term, and that its definition needs to be clarified- in terms of modern concepts. Ho sug gests the use of the words abnormal and normal as amplifiers and recommends studies to increase our knowledge of the; mca-cal aspects of fatigue. GO if n c. o c. r, - Industrial Hygiene Digest - 14. 775 Studies on the Duration of Disabling Sickness. IV. Duration of Disability from the Non-Rospfratory - Non-Digestive Diseases Among Male Employees with Particu lar Reference to the Older Worker. Y/.LI. Gafafer. Pub. Health Repts., 58, 9 699 79 (Juno 25, 1943). This, the fourth of a scries of papers on the duration of disabling sickness, is based on absences lasting 8 calendar days or longer, and presents principally an age comparison for males of certain pertinent indexes determined by specific nonrespiratory - non-digestive diseases. Four specific causes are presented. These causes, which were the principal time losers among males 50 years of age and over, are diseases of the heart and arteries, the rheumatic diseases, diseases of the nervous system, and cancer, all sites. Thus the frequency of 8-day or longer ab sences on account of diseases of the heart and arteries among this older group of males was approximately 6.5 times the corresponding frequency for men under 50, the number of days lost per man from this cause being 8.5 times that for the younger group. 776 The 1942 Fire Record for Chemical Plants. L.F. Maar. Chem. and Eng. News, 21, 484-85, 520 (April 1C, 1943). In chemical plants large losses from fire marked the first year under war condi tions. A list of special hazards that most often cause fires is given, with ex plosions at the top. Admonitions offered by the U. S. Office of Civilian Defense include: (l) Value of early discovery of afire; (2) Proper maintenance and use of alarm ecniipment; (3) provision for suitable public and intraplant fire alarm services; (4) Knowledge of materials used and stored, with observance of safe guards for hazardous materials and general cleanliness; (5) Inspection of all fire appliances, including any private hydrants; (6) Weekly inspection of the entire plant, in cooperation with executives, safety director, medical officer, air-raid warden and other interested persons; (7) Cooperation in inspections by public fire and police departments, and fire protection engineers of the insur ance interests. Occupational Disease Considerations. E.R. Kayhurst. (July, 1943). See our Abstract No. 673, July, 1943 Digest. Ind. Med., !, 443-446 Methods of Detection and Determination 777 Determination of Small Amounts of Carbon Monoxide in Air and Blood. H. F. Holden. Australian J. Exptl. Biol. Mod. Sci., 21, pt. 1, S-12 (1943). A description is given of two types of apparatus for detcimining carbon monoxide in small air samples (less than 25 cubic centimeters). A sensitivity of 1 part per 100,000 is claimed for the methods which employ a combination of carbon mon oxide with hemoglobin. One apparatus may be employed for the determination of carbon monoxide in blood. It is said to oc accurate for cases of slight poison ing. 778 Estimation of Roducod Degradation Products ir. Experimental Trinitrotoluene Do: sonlng. B.B. Westfall and M.I. Smith. Proc. Soc. Exptl. Biol. Mod., 51_, 122124 (1942). The Industrial Hygiene Digest - 15, 779 Determination of Volatile Halogenated Hydrocarbons in Blocd. H.E. Moran. J.Ind. Hyg. & Tox.-, 25, 243-248 (June, 1943). A method apparatus for the determination of dichlomethsne in blood arc des cribed. The method consists of aerating the blood, passing the air containing the halide over heated platinum, and absorbing the resultant halide in alkaline sulfite solution. The halides arc then determined by standard procedures. Anal ysis of prepared samples containing known amounts of dichlormethane indicate an error of less than 1/10 mg. of the material determined. It also was demonstrated that the same method can be applied to the analysis of less volatile halides, such as carbon tetrachloride and dichlorethane. The apparatus is modified so that the aspiration can be carried out at reduced pressure. Accuracy and preci sion of analysis are comparable to that of analyses of the more volatile dichicr- methane. 780 Determination of Nitrous Gases. Karl Beyer. Z. Anorg. Allgem. Chem., 250. 32130 (1943). Nitrogen dioxide is absorbed in alkaline iodide solution and the nitrate and nitrite formed are reduced to ammonia* The method is suitable for high concen trations of air-borne nitrogen dioxide and control analyses indicate results within one per cent of the known value. A second more sensitive method employs absorption in alkaline iodide with the colorimetric analysis of nitrogen dioxide by means of Ilosvay reagent. The second method requires less time for analysis and is also suitable for high concentrations. Control analyses gave results within one per cent of the known value, 781 Determination of Phosnhine. Karl Beyer. Z. Anorg. Allgam. Chem., 250, 312-20 (1943). Air containing phosphine is passed through a 10 per cent solution of mercuric chlorido. The precipitate of PCHgC^)^,formed in the sample bottle, is treated with excess standard iodine solution, one phosphine molecule being equivalent to 8 iodine. The excess iodine is determined with standard thiosulfate. The method is sensitive for air concentration as low as one mg. of phosphine per liter of air at a sampling rate of 600 liters per hour. Two auxiliary methods are described, both based on the oxidation of phosphine to ortho phosphoric acid by bromine or by a brcmatc-bromide mixture. The bromine oxidation is followed by determination of the phosphoric acid photometrically. 7/hen bromate-bromido is used, the excess is back titrated icdcmetrically. Control Methods 782 Prevention of Butadiene-Air Explosions by Addition of Nitrogen and Carbon Dicxiqo. G.V/. Jones and R.E. Kennedy. U.S. Bur. of Mines, Hept. of Invest., No. 3691, 11 pp. (March, 1943). Knowledge of the explosion hazards cf combustible gases and liquids used in the manufacture of synthetic rubber is especially important at present. This report gives in tabular and graphical forms tho results of numerous experiments estab lishing the limits of inflammability of mixtures of air and butadiene to whicn various proportions of nitrogen and carbon dioxide were added. Tho graphs ana tables indicate tho limits of inflammability of complex gases containing buta diene and tho percentages of oxygon that must not be exceeded to prevent mix- ^ turcs containing butadiene from becoming inflammable. Pull experimental dotnii-* arc given. 0 0 2 .` Industrial Hygiene Digest - 16. 783 X-Ray Protection. M.B. Evans, Jr. Ind. Med., 11_, {June, 1942). Tne penetration of x-rays and ether radiations is discussed briefly. Excessive radiation is injurious to the systen. Local symptoms on the hands may or may not indicate" excessive general exposure. The best test of exposure is the use of small photographic film carried on different parts of the body. Protective measures include confining within a suitable lead-lined room, absorbing screens, and making exposures in the absence of worlauen. A table gives the required thick ness of lead for various peak voltages. Other materials than lead, for instance concrete, are usable if loaded with barium sand, iron filings or iron ore. Other wise the thickness must bo very much greater than that of lead. Suggested safety precautions include regular examination of the installation, use of the test films as indicated, examination of circuit-breakers, and physical examinations of those who may be exposed. Industrial Medical Practice 784 Medical Planning Research. Interim General Report - A Distinguished Report on a Proposed Reorganization of Medical Practice in Great Britain. Published in the U. S. by Medical Administration Service, Inc., New York. Pamphlet 32 pp. The report, originally published in The Lancet of London is reprinted in pamphlet form for American readers. Only a few changes have been made, such as the omis sion of some sections applicable only to British problems, and minor condensa tions. Tables and charts have boon converted into our monetary units. The repre sentatives of the American publishers express the hope that the pamphlet will interest American physicians, members of the allied professions, sociologists, economists, hospital administrators, social workers and public officials. They are cognizant of tho fact that such a report, prepared in and for another country can make no more than a general contribution to American medical planning; yet they believe that it warrants study and that it should point tho way to a more forthright and non-controversial health planning than has been customary in the United States. The report was prepared by Medical Planning Research, an organ ization of 400 anonymous British physicians in widely divergent fields of prac tice, most of whom were under 45 years of age. Because many of the members were in the "Forces," only about 200 wore able to make contributions, which have been used in preparing the report. The aim of the editorial group was to select the more constructive proposals and those most calculated to attract constructive criticism. It is in fact designed to test public opinion. Men in the "Forces" arc urged to contribute to the discussion. The publishers in the United States would welcome American comment on the report. 785 How to Plan an Industrial Hospital. Anonymous. Occup. Haz., _5, 9,22 (May,1943). In 1903 the Manhattan Rubber Manufacturing Division of Raybestos-Manhattan, Inc. was tho first industrial plant in the busy Passaic, New Jersey, area to set up its own first-aid hospital. It is staffed by a physician, 5 nurses, a secretary* and a clerk. Equipment is of the latest type and includes examining, treating, operating and recovery facilities. The first American Red Cross First Aid De tachment to be organized in an industrial plant under the auspices of the Passaic chapter was recently formed at the Manhattan plant. Tho detachment is designed to function in disasters of any nature, including bombing, sabotage, explosions, fires, ana floods and would assist the plant doctor and hospital staff. Ordin arily it would not leave the plant, but in event of an air raid causing many casualties in. other localities it would be available for emergency calls. Employ ees forming the detachment are ail Advanced First Aiders or Instructors and hold practice and drill sessions once each month. Industrial Hygiene Digest - 17. 786 V.'ar Medicine and Surgery. Chemical V/arfare. Compiled under the direction of the Committee on the Survey of Y!ar Medicine of the National Health and Medical Research Council. Supplement to the Med. Jour, of Australia, no. 8, 29-32 (February, 1943). The article is an outline of the now recognized war gases. The properties, methods of dispersal, toxic actions, pathological lesions,clinical picture, prophylaxis, decontamination, treatment and prognosis are given in detail for mustard gas and phosgene, and in outline for lewisite, arseniuretted hydrogen, hydrocyanic acid, hydrogen sulphide, lachrymators and stornutators. A gas decon tamination center is thoroughly described. In brief, mustard gas is a "persis tent" vesicant, with an insidious onset, affecting mainly the eyes, skin and res piratory tract. The effect upon the eyes is seldom permanent; the effect upon the skin is essentially a burn and should be treated as such; and the effect upon, the respiratory tract is irritation of the mucous membranes with common develop ment of septic bronchial pneumonia. Lev.lsite is similar in most respects, ex cept that its action is swifter. Phosgene is essentially a "non-persistent" pul monary irritant. The pathological and clinical effects are all the result of pulmonary edema. The other gases discussed are not so dangerous. Arseniuretted hydrogen is an hemolysin, and hydrocyanic acid and hydrogen sulphide affect tis sue oxidation. Gas masks provide complete protection for all the gases mention ed except hydrocyanic acid. 787 Industrial Medical Service. H.J. V/hitacre. Ind. Med., 12^ 480, 482-3 (July,1943) The program instituted by the state of Y/ashington for promoting industrial health is discussed. A coordination committee, with two representatives each from the Department of Health, the Department of Labor and Industries, the medical pro fession, management and labor, v?as created to study the problem. The tentative program of this committee includes (1) industrial hygiene and safety engineering, (2) improved professional care of the sick and injured, (3) rehabilitation, (4) research. Considerable progress is reported in each of these fields. Subversive influences are management indifference, personal indifference, incompetence, sel fishness and carelessness, but the medical profession continues to progress, des pite these handicaps. 788 Stream-lined Pro-Placement Physical Examinations During Wartime. J.J. Prendergast Ind. Med. 12, 423-426"(July, 1943). The author believes that less of the industrial physician's tine should be spent in following the cut and dried procedure of pre-employment examinations and raoro in the medical department. Nurses should replace doctors in conducting the ex amination under fixed standards and the careful supervision of the physician. Stream-lining the examination would omit certain procedures, which though desir able in peacetime are expendable in time of emergency. Other basic indispensable . procedures must be retained and even more rigidly inspected. A number of condi tions discovered by the nurse performing the physical examination, in -which the doctor should be called, are enumerated. A test devised by the A.M.A. committee on Cpthalmology in 1925 has proved helpful in determining central visual acuity. Criteria for accepting arrested tuberculosis cases arc given. The use of "Nur ses' Aides" to replace the nurses who arc fulfilling the duties of examiners is suggested. The chango in the significance of the pre-employment physical examin ation is pointed out -- examination is no longer for the purpose of rejecting the handicapped or sub-marginal worker, but rather for fitting these groups into the united effort of war production. The experience gained will be valuable in solving the post-war problem of placing soldiers and sailors when they return from overseas. The cooperation of the foreman is important in the employment of handicapped persons. A point emphasized in the discussion which follows the paper is that the nurse conducting the pre-employment examination assumes nc res ponsibility for diagnosis. She acts as a screening agent for the physician and calls certain things to the attention of the physician, who makes the diagnosis. / ' ^/ o* 1 'Industrial Hygiene Digest - IS* 739 Physically Handicapped Applicants Registered for Employment with the U. S. Employ ment Service in Ohio* Ldimeographcd 17 pp. Vf. Hammond, Director Office for Zmergency idanageaaent, war Manpov.*er Commission, U. S. Employment Service in Ohio. Reports and Analysis Section, Columbus, Ohio (January 16, 1943). A report is made of a special inventory of physically handicapped persons regis tered for employment in the active file of the U. S. Employment Service offices in Ohio, made on January 16, 1943. The classification of handicaps presented a major problem, because of the lack of a generally-accepted classification of physical handicaps and of a satisfactory nomenclature of defects. The system followed represents a modification of existing classifications. Several limita tions to the data reported arc noted as follows: (1) Handicaps arc those readily discernible or reported by the applicant (the handicap may or may not be based on medical diagnosis); (2) A subjective element is involved; (3) The severity of the defect is unknown; (4) There is little information as to the prospect of re storing the applicant to usefulness. In spite of these limitations, the findings give a significant perspective in a field, heretofore little explored. A larger proportion of men than women applicants were liandicapped. The percentage of negro applicants with handicaps was somewhat lower than that of white applicants. Nearly one-fifth of the applicants who were war veterans had some physical defect. Other data presented were the percentages of skilled and unskilled laborers among handicapped applicants, the nature of defects, factors of age and education. The opinions of the local U.S. Employment Service managers as to prospects of employ ment for the handicapped applicants is given. The tightness of the labor market is one of the most important factors in determining those prospects. Eleven tables from which these and many other findings are deduced form part of the re port. 790 Problems in Employing the Physically Handicapped. F.H. Albee. Illinois M. J., 83, 251-237 (April, 1945). This forceful article should convince any doubting employer that the physically handicapped may, indeed must, he safely and profitably employed in industry. The greatest handicap faced by the cripple who desires to work is the illogical pre judice egainst him held by employers. Dr. Albee repeatedly cites instances where the average cripple (not just the unusual one) exceeds his fellow "normal worker" in excellency of work# Indeed the remarkable experiment by the Western Electric Co. (which relaxed for one year all restrictions against employing cripples) so convinced the company that the cripple employed in a job to which he is fitted could and did exceed the safety, attendance, production, wage increase and stabil ity records of the "normal" worker, that they abolished those former restrictions and kept the cripples (300 of them) at their jobs. The cripple does not want sympathy, rather only a chance to prove his loyalty, so that he can earn a place in society. Humanity, national security and the industrialist's own prosperity demand that we scrap our prejudices and give the cripple this chance. 791 Employment of Physically Disabled "Workers. Anonymous. Labor Information Bull., 10, 4-5 (June, 1943). The article presents a new aspect of the matter of employment of handicapped per sons in calling attention to the rapid growth in the disabled population due to the increase in industrial accidents and to war casualties. The large number cf war jobs filled successfully by disabled workers gives assurance that men and vromen in the armed forces who return with handicaps, will be able to earn a good living. 792 The Physically Handicapped - Their Rehabilitation and Employment in Connecticut. J.H. Biram. Ind. idea., 12_, 448-450 (July, 1943). Connecticut is one of four states that have "waiver" clauses in their compensa tion act. This clause makes possible the employment of handicapped workers p H TO" Industrial Hygiene Digest - 19. without unjust penalty to the employer. The employee is protected against all occupational hazards except those pertaining to his specific disabilities. The author believes this is why Connecticut has been able to obtain cooperation of both labor and management in carrying out its rehabilitation program. This pro gram includes a Vocational Rehabilitation Service, clinics to evaluate handicapp ed workers, a training program in connection with the State Trade School, a pro gram for tubercular coses, a plan to provide assistance for needed surgical pro cedures. The program has been successfully administered through offices sot up in the various manufacturing centers. 793 Employing the Physically Handicapped from the Employees Viewpoint. NG.P. Y/ardly. Illinois S3, 257-258" (April, 1943). Three classes of physically handicapped persons are described: (1) Employees found handicapped by the company's medical examinations. These examinations of ten inform employees of latent or incipient ailments, leading to timely preven tion of disability. Practical tests often 'show that these disabilities often need not exclude a man from his job. (2) Employees injured in plant acci dents. This type of employee, formerly relegated to an unskilled job after an accident is now trained by the industry to do a job rating a wage rate as nearly equal as possible to his previous rate. One plant established a Plant Employees Rehabilitation Committee; five members and the Chief Surgeon of the plant decide whether the employer is physically fit for rehabilitation in his own division if possible, if not in another division of the plant. (3) Physically handicapped seeking initial employment. These people are tho greatest problem since the plant has no direct responsibility for employing them. 794 Policies Regarding Youth Employment in Wartime. K.F. Lenroot. The Child. 7, 127-129 (March, 1943)." The article is a review of the policy of the Y/ar Manpower Commission concerning child labor. This policy sots an ago limit of 16 years for factory and mining employment, and of 14 years for part-time work outside of school hours. Stand ards of maximum hours and conditions of labor recommended are a 48-hour six-day work week; no night work; adequate conditions of work; and adequate transporta tion of workers. The policy states that the activities of the school and tho health and education of the student must not be placed under too great a strain if part-time employment is necessary. Finally the policy sots certain restric tions in regard to tho recruitment of youth to work away from home. 795 Psychiatrist Looks at Industrial Truancy. L.S. Selling. Ind. Med., 12, 189-231 {April, 1943). This articlo treats the problem of v.forker absenteeism - it discusses and lists tho psychological reasons for absenteeism, and suggest ways for factory physi cians and personnel officers to meet the problem. The author emphasizes tho key role of the plant physician, for many of the new workers are mentally and physi cally second caliber, and it is impossible to hire competent full-time industrial psychiatrists. 79 6 The Role that Industry Can Play ir. the Elimination of Tuberculosis. Y.'.A. Sawyer. II. Y.~ Ststeliod. J., 43, 143-151 (January, 1943). Although silicosis is the only industrial condition predisposing to tuberculosis, industry can help much in the control of this disease. The ideal procedure in cludes chest roantgencgrams of all present employees and future applicants and periodic fcllow-up roentgenograms. Rocntgcnogrnphic techniques in order of effi ciency are 14" x 5.7" films, 4" x 5" films, 35 rum films and tho fluorcscope. Younger employees must be fcllcwcd-up more- frequently than those over thirty. Accurate bookkeeping is also necessary, especially in seeing that employees keep appointments for ro-exaninations. The best way for small plants to handle this G A U * -r A h A O * Industrial Hygiene Digest - 20, problem is for a group of plants to set up their own medical service, although arrangements may also be made through local physicians or hospitals. In a dis cussion following the article, Dr. Bridge points cut that the cooperation of the employee is necessary and that this can be attained only through sympathetic treatment of the worker and his family, and, above all, by saving a job for him. 797 Tuberculosis in Industry. H.R. Edwards. Am. J. M. Sc., 205. 571-581 (A.pr. ,1943) The results of findings in the roentgenograph!c examination of 15,644 union workers in various industries in New York City are analyzed. There was found to bo a prevalence rate of 0.61# with evidence of clinically significant pulmonary tuberculosis. The prevalence of chronic pulmonary tuberculosis of apparent arres was 2.92#. The prevalence of healed primary lesions for the entire group was 12,43#. Surveys of this type are valuable in revealing the prevalence of chronic pulmonary tuberculosis and should be the basis for a definite program in medical care of the industrial employee. Such a service should provide pre-employment as well as periodic re-examination. The handling of the pulmonary phase of such ser vices requires competent clinicians trained in chest pathology, otherwise over emphasis may be placed on lesions of no importance as well as the reverse. If such v.tirk is properly handled, there is no reason to believe that the worker vail be unjustly discriminated against because he presents a pulmonary lesion. The increased tempo of industrial production, with all the varied social and economic problems attendant in these times, is justification for the establishment of a tuberculosis control program in all industries. Such a program is greater than can be handled by the local Department of Health ana is a responsibility that should be shared jointly by management and organized labor. - Author1 s summary. 798 Shock: The Physiologic and Clinical Aspects. E.B. Mahoney and J.W. Howland. Surgery. 13_, 188-198 (February, 1943). 1. The early recognition of shock and its therapy depend on a knowledge of the physiologic changes occurring in the failing circulation. 2. There is no single diagnostic criterion by which impending circulatory fail ure may be recognized and at the present time the diagnosis depends on a general evaluation of the patient. The inadequacy of single hematocrit and plasma speci fic gravity determinations has been stressed. 3. The plasma specific gravity may decrease rather than increase in the early stages of shock. 4. Adequate fluid therapy depends on the relative amounts of rod cells, fluid, and protein which must be restored to the circulation. 5. Fluid therapy is most efficient when instituted before the patient develops the classical signs of shock. 799 Shock. M.A. Barnard. N.Y. State J. of Med., 43, 228-230 (February^1, 1943}. The report of a committee of medical men from Rochester hospitals, directed by the medical defense committee, is submitted in the form of a sutsmary of the practical aspects of shock treatment at the site of the disaster. The need for such an emphasis of the practical rather than the theoretical aspects of shock treatment has been evidenced by the experience of the English medical personnel in this present war. A great responsibility rests on the casualty station sur geon and his personnel. The discussion of treatment of the patient in shock from severe trauma without hemorrhage considers sedation, fluid therapy, oxyccn treatment, etc. The outline cf treatment of shock in patients suffering from hemorrhage lists the indications and contraindications for morphine sulfate sedation, ana chemotherapy in the foim of adrenal cortex extract, ana lasts ^no composition of several fluids appropriate for fluid administration. The treat ment required in the case of shock cue to burns is presented in a liko nunne-. If the burn exceeds 15# cf body surface, fluid treatment, e.g. full strength plasma injections, should bo begun whether or not the patient shews sign-s Ox shock during the early treatment. Industrial Ifygiene Digest - 21. 800 Koat. Anonymous. Nat. Safety News. 47, 103-166 (March, 1943). The subject pf heat cramps and its prevention by addition of salt to drinking water is discussed briefly. 801 Health of Industrial workers, 1942, Anon. Monthly Labor RlV., 56.734-35 {Apr.1945) Comparative data, as found in the mortality record of the Metropolitan Life In surance Statistical Bulletin for January, 1943 are given for tho year 1942 and the years immediately preceding. Except for the last 3 months of 1942 when the death rates were somewhat in excess of those of the corresponding months of 1941, the mortality rate was slightly less than in 1941. The favorable rate of the first 9 months was due largely to the decline in death rates at the early childhood ages and at ages over 55. Tho excess in rates for tho last 3 months was particularly marked in the age groups of 15 to 19 and 20 to 24. In the latter age group a large percentage of dea?Ss/due to causes charge able to the war; others to occupational accidents due to rapid expansion in in dustries. Rates for the principal causes of death reveal some interesting facts. There was no increase in the communicable diseases of childhood, as compared with extensive epidemics that occurred in the last war, which resulted from the con centration of large numbers of individuals who had not had these diseases in childhood. Influenza, pneumonia and tuberculosis showed declines in 1942. The rate for syphilis in 1942 for industrial policy holders is the lowest on record, which indicates that the organized efforts to control the disease are proving effective. The sharp rise in the birth rate helps to balance the war losses. The puerperal death rate has declined continuously since 1939. There was little change in the rate for the diseases of middle and later life. The rate for mor tality from all foims of accidents was the same as in 1941. The report for 1942 demonstrates, it is stated, the value of the health work of past years as the decline in the mortality from the acute conditions counter-balanced the rise in war deaths and kept down the rate for the year, 802 How Can the Doctor Hein in Occupational Disease Prevention? T.E.P. Gocher. Occup. Kaz., b, 14-16, 30-31 {May, 1943). The use of blood tests supplementing information obtained from dust counts and chemical analysis makes it possible to guard against occupational disease condi tions. Several cases are cited which are striking examples of what can be done whon the hazard is recognized. Good plant hygiene is needed in the control of exposures. Under a discussion of personal hygiene, a technique for washing is detailed and some faulty personal hygiene conditions found in industry are listod. Other factors which should be considered in relation to exposures to toxic or irritating substances are individual susceptibilities due to weaknesses or aller gies. The following general instructions for occupational disease prevention are given: (lj Cooperation of the employer and employee with the medical and engin eering staff; (2) Tho use of simple English in explaining hygienic rules; (3) Blood examinations; (4) Actual demonstration of correct washing. 803 Health Education for Industrial Vfcrkcrs. E.I. Perkins. Industry 8_, 31-34, 36 (June, 1943). Planned health education programs help to reduce absenteciaa, aid in improving employee morale, and contribute, as a whole, to community health. The employment of large numbers of teen-age boys and girls and of women brings into industry new groups which need the advantages of health education. Methods which have al ready proved to be useful in many industries are discussed briefly. A planned health education program, designed to roach all personnel, and described as mass or group health education, supplements individual instruction. Practical suggestions, together with a number of sources of material, for developing such a program are given. 004 23 6 Industrial Hygiene Digest - 22. 804 The Coimaon Cold as an Industrial Problem. E.E. Brewer. Ued. Bull., No.5 363-471 (Ajttil, 1943). The cojEmon^wld (excluding its numerous complications) is the most frequent reason formless of industrial man-hours due to sickness. Bacteria, a filterable virus and allergies have all boon accused of causing colds. The author recom mends the following for treatment: Vaccines are of no use; ephodrine, benzedrine arc useful; and sprays of 30$ argyrol and hot alkaline nasal douches. Prompt application is essential. Also recommended is an active prophylactic campaign including: clinical histories of all v.orkers; education as to prevention of colds, isolation of carriers and spreaders of gems, with early treatment. Inoc ulations are only of a minor psychological value, and are of no prophylactic value. Physiological well-being is all-important in prevention of common colds. 805 V.:hat Can V.'e Do to Keep Employees at Work? C.D. Selby. Illinois M. J., 85, 242-246 (April, 1943). - Industrial physicians, under the impetus of the alarming amount of industrial "sickness absenteeism" have converted their health programs to (1) provide for safe employment of workers and (2) reduce number of lost man-hours due to sickness and injuries arising independent of employment. Intensive surveys of 150,000 employees, (onc-eighth of them women) wore undertaken. These showed an alarming sickness absenteeism in women which was four times the same rate in men. Explan ations for this fact rest in (1) a groat susceptibility of women to respiratory infections, especially tuberculosis. Numerous specific recommendations for pre vention and cure of respiratory diseases are mentioned; (2) Digestive diseases, especially diarrhea and appendicitis, arc very prominent and disabling in women. Education as to early signs and symptoms leading to earlier treatment would nater- . ially reduce hours of labor lost. {3} Chronic and acute diseases of the female sex organs, nervous diseases and breakdowns, and pregnancy all account for a large part of sickness absenteeism of women. It is thought that employment of a female physician or registered nurse would accomplish considerable in these latter fields. 806 The Problem of Absenteeism. K. MacRury. Conference Board Management Record. 4 pp. (April, 1943). This article reports the studios of absenteeism made by the Conference Board. The author states that "original compilations were based upon record patterns and types of information suggested by the U. S. Public Health Service and the Industrial Hygiene Foundation of America, organizations which first promoted the use of absentee statistics." Changing conditions, as they affect absenteeism are discussed and remedial methods arc suggested. The importance of the indus trial hygioae survey is stressed. A 807 Absenteeism in Canadian War Industries -- Data From Canadian Labor Gazette Janu ary, 1943. Monthly Labor Rev., 56, S33-C3S {April, 1945). Figures are given showing percentages of absenteeism in the varied Canadian war industries. Attention is called to monthly variations. Some causes of absence arc discussed. The following recommendations are listed, as important in the control of absenteeism: (1) Improvement cf labor relations between employer and employee in particular plants. (2) Establishment of joint labor-management pro duction committees. (3) Inauguration of a system of recording absences and their causes. (4) Establishment of safety and health programs. (5) Plant cam paigns, intelligently conducted, to publicize the importance of individual res ponsibility in unnecessary absences in terms of lost production vital to the fighting front. C r\ J -r a o J Industrial Hygiene Digest - 23. 808 Observations on Absenteeism. H. Earnheart. Ind. Med., 12, 367 (June, 1943). Various factors which affect absenteeism are considered and some remedies in use arc g42iP&n and others arc proposed. 809 Ryan Hits at Absenteeism Thru House Organ Feature. Anonymous. Western Adver tising, 42, 54 (March, 1945). The use of advertising techniques to reduce absenteeism was demonstrated by the Ryan Aeronautical Company in San Diego. Hardboilod copy, of mail order advertis ing style, was usc-d in the employees* magazine to shock the workers into the seriousness of the situation and make them realize tho cumulative effect of their absence. A sharp decline in the absentee rate was noted in the week following the magazine's first attack. This v/as followed by a continuing decline during the next two months. The curve has now levelled off at an average rate of 23.9 8;? below the former rate* 810 First Aid Treatment. Anonymous. Nat. Safety News. 47, 152-153, 158 (March,1943). Full recommendations for first aid treatment are presented in compact form, in cluding a list of furniture, instrments and supplies, number of rooms and gen eral equipment necessary for various sized plants, emergency kits, departmental kits, portable kits for isolated groups. 811 First Aid for Heat Cramps. J.U. Buchanan. Nat. Safety News. 47, 25 (May, 1943). The loos of salt from the body fluids was found from clinical and laboratory study to be the cause of heat cramps and related conditions. A level teaspoon ful cf salt added to a gallon of drinking water is enough to make up the loss. Sait tablets are convenient to use, as they require no elaborate equipment. For the treatment of mild cases of heat exhaustion, a 0.1 per cent solution of salt added to charged water or soda pop is beneficial and more agreeable to'taste. Patients suffering from severe cases of heat exhaustion arc also given intraven ous saline solution. 812 Educational Techniques in Industrial Nutrition. C. Kuh. Ind. Med., 12, 210-211 (April, 1943). A six point program for solving outstanding nutritional problems is presented and the educational techniques in each of the six fields are discussed. 313 Communal Feeding: Preliminary Report. E.B. Gunson. British Med. J., 2_, 753 (December 26, 1942). The communal feeding of some 10,000 Royal Ordnance Factory worke-rs (mostly girls) resident at hostels adjacent to the factories, according to Gunson, seems to im prove notably the health of these residents. This improvement can be attributed in part at-least to the manner and method of tho feeding arrangements. In gen eral the -tKpes of food necessary for health are well appreciated, and these arc supplied -to the limit to which they are procurable. The catering management is in good hands, but more precise direction in the preparation of some particular foodstuffs is desirable and would be welcomed. The communal meal is a practical and economic arrangement so far as Royal Ordnance Factory workers living in hos tels are concerned. 814 Rationing Boosts "In Plant" Feeding. C. Cloves. Domestic Commerce. 4,5,17 (May*, 1945) Industrialists arc supplementing the hone-raticned diet through providing war workers with one v.-ell balanced mod a day. The O.P.A. has made an amendment to its general food rationing order to make provision for plant food needs. The Technical Advisory Service cf the Nutrition in Industry Section gives workable suggestions on how best to provide for in-plant feeding and tho Nutrition in In dustry staff supplies information on proper in-plant feeding. A nows servico P: n 'a o <*' h if : - Industrial Hygiene Digest - 24. is being used by 1600 industrial editors in their company magazines. A folder entitled "0^ 5. Needs Us Strong - Eat tho Basic Seven Every Day" and two book lets, -of Industrial Nutrition and Planning Meals for Industrial Workers arc availatjio on request. Twelve recommendations devised for Amy Ordnance Plants and'"adaptable to industrial use are given. These or similar recommenda tions have been used successfully by many plants. Several examples of in-plant feeding programs are given. Education for home feeding is continuing through material issued by several electrical manufacturing companies and through V.'ar- time Nutrition Schools. 815 Training Safety Leaders. A Report to the Planning Panel on War Safety Training. National Committee for the Conservation of Man Power in War Industries. U. S, Department of Labor, Div. of Labor Standards. A.W, Whitney, Chairman of the Planning Panel on War Safety Training, states tho content of the report thus: "This report indicates in more detail the need for war safety training, the program developed to meet this need, the actual accom plishments already achieved under this program, and the job that lies ahead." Charts are reproduced which present figures on the standard basic course and the full time classes, showing the number of students, the number of classes, the number of colleges offering the courses, the progress of safety engineering train ing in the years 1941 to 1943, and tho number of workers who will be equipped to wage war against industrial accidents as a result of the training received. An appendix gives outlines for tv>o courses: (l) An intensive course offered under the direction of the U. S. Office of Education, in cooperation with, the U. S. Department of Labor for Engineering, Science and Management Defense Training. (2) A course in Industrial Safety Engineering Defense Training. 81$ Goodrich's "Good Housekeeping College" Pays Off. P.B. Plant. Occup. Haz., 5_ 10-13, 35-40 {April, 1943). The 3.F. Goodrich plant, under the direction of a committee of six, headed by the author of the report and including five production superintendents, has been working on the project of overhauling the plant for salvageable material. They found it worth while to institute a thoroughgoing system of factory clean up. The good housekeeping campaign was so successful that it has become a permanent feature. The character and value of the program is expressed in the sentence, "Novel presentation plus intensive promotion established a good housekeeping program that could well serve as a national pattern." Facsimiles of tags and posters used in the campaign are reproduced. 817 No Plant Too Small. F. G. Bennett. Safety Eng., 85, 16-18, 20,21 (April,1943). A safety organization is practicable in plants employing as low as 25 workers. General japinciples of safety organization applicable to any industry are offered. They incJadet (1) The manager or the operating head should be interested in safety. SEsually, not more than 2 or 3 hours per month of a manager's tine is required after a safety program is well started. {2) The job of safety inspector in largo plants is a full time job, but in a small plant some employee with tact and the proper attitude toward safety could make frequent inspections of the premises as to conditions of stairways, elevators, etc. -- also of fire extin guishing equipment, sanitary conditions, and general housekeeping conditions. (3) A Safety Committee of about 5 persons, with the manager acting as chairman should investigate and deliberate upon any accident of consequence that occurs in the plant. (4) The use of bulletins, particularly those pertaining to public safety. Other considerations of importance in carrying out a safety program arc: (1) The interest of the manager and the vigilance of the safety inspector; (2) tho use of safeguards, after installation; (3) observance of the steto's In dustrial Commission code; (4) study of codes and bulletins on sanitation from o O' Industrial Hygiene Digest - 25. the State Department of Labor; (5) an annual dinner meeting of interested persons with an outride speaker, if possible, to talk on accident prevention work; (6} installationof a standard first-aid station; (7) education regarding home acci dents and highway safety. A few figures given relating to accidents in small plants emphasize the need for safety attention, no matter how small the plant. 818 Governments Obligation in Industrial Health. Y/.F. Draper. New England J. lied., 223, 177-179 (February ll' 1943)". Present day obligations of the U. S. Public Health Service include: (l) Assist ing the Y/ar Department. (2) Assisting the Stato and local industrial hygiene units. (3) Recruitment and training of personnel. (4) War research problems. (5) Coordination of the health-conservation activities of industry, labor, medi cine and interested government agencies. The necessity of reaching the home front is emphasized, the local health department being of invaluable aid here. Finally, the author states that if in the future, the community and plant physi cian are the same man, he must have full government support. 819 Physician and Surgeon. Relationship to the Compensation Carrier in Wartime. J.VJ. Vaccaro. lad. Med., 12, 402-412'(June, 1943)7 The relationship of the physician and surgeon to the compensation carrier is primarily legislative, secondly social and finally medical. All three of these relations are discussed at some length. Under the first are considered the legal definitions of injury and of industrial disease and the physician's handling of cases of simulated, exaggerated and protended injuries. In such cases the res ponsibility of recognizing and distinguishing between the various categories of pretense rest upon the physician or surgeon. A third responsibility is that of determining peimanent and temporary, partial and complete disability. In the social relationship, the author discusses especially the duty of urging an in jured employee to undergo an operation when necessary to fit him for reemploy ment rather than accept compensation without employment, in which he is a social loss. In the medical relation, the question discussed is that of expert testi mony. The compensation medical expert should always confibo his testimony strict ly to the realm of the facts which are before him without speculating on possible but improbable facts. The testimony must present a basis which is reasonable in nature and character. 820 Industrial Disease and tho Insurance Carrier. R.N. Gray. Rocky Mt. Med. J., 40, 162-167 (March, 1943). The praoticing physician cannot be expected to be familiar with all the indus trial diseases, but he should never make the mistake of diagnosing a case from a history Of exposure alone. The state loses much money annually in this way, un less tlM^pfay3ician is willing later to change his diagnosis. To aid diagnosis of industrial diseases, the physician should refer to a textbook of industrial diseases and to the recent American Medical Association Journals. Even better than this is the reference of such patients' to specialists. The relative im portance of various industrial diseases is discussed. Skin lesions are very numerous, but the average case is unimportant; other lesions are fewer but moro serious. 821 The Nurse In Industry - Her Functions and Responsibilities. J.M. Johnson. Ind. lied,, 112,~336-390 (Juno, 1943). The author considers the fact that 10,000 registered nurses are employed in in dustry an indication that industry has a sincore interest in the welfare of its workers. She traces the progress of industrial nursing and names several con tributing factors. The nurses part in the physical examination program is con sidered. A differentiation is made in the duties of nurses in small and large plants. Reasons for keeping records arc given. INDEX (August, 1943) Absenteeism 305-80 6-S0 7-806-809 and psychiatry 796 Air analysis carbon nonoxide 777 oxides of nitrogen 780 phosphine 781 Analysis hydrocarbons in blood 779 Asthma from gun acacia 770 Book reviews 748-749-750-751 Burns, magnesium 756 Butadiene explosive mixtures 782 Bvssinosis case review 752 Carbon tetrachloride allowable concentra- tions 760 Cold, common 804 Communal feeding 813 Cyclohexane and derivatives physiological 759 effect Dermatitis adhesive tape 769 prevention and treat- ment 768 Drinking water 766 industrial 767 Dxnlosives. toxicitv 763 Fatigue 774 Fire hazards 1942 record 776 First aid Gasoline, toxicity 810 Palladium physiological properties 758 757 Health industrial and government 818 education 803 workers 801 Heat cramps first aid 811 effect on workers 771 sickness 800 Hydrocarbons chlorinated 761 Indium physiologic properties753 Physical examination pre-placcment 788 Rehabilitation 789-790-791-793 in Connecticut 792 Safety organization 817 Safety training ' 815 Sanitation industrial 764-816 Shock 798-799 Industrial hospitals 785 Industrial disease and insurance carrier 820 Industrial medicine and compensation 819 Lead absorption and blood calcium 755 ' arsenates and storage 754 Medical practice (Great Britain proposed reorganization 784 Medical service plans 787 Morbidity, statistics 775 Nurse in industry 821 Solvents hazards 762 Synthetic rubber industry health hazards 765 TNT poisoning 778 Tuberculosis in industry 79 6-797 War pjases 786 Women in industry 772-773 X-ray protection from 783 Youth employment 794 Nutrition education 812 in industry 814 Occupational disease prevention 602 a ,-\ > n * / t t./ t.