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afid Chief^Surgeon, Chicago Rapid Transit Co., Chicago, who presided, introducing the speakers.^ The Lesser Known Fapts About Conjmon Occupational Diseases B By DR. ROBERT jB. HUNT ! . Medical Advisor, American Mutuadlaability Insurance Co., Probably the leader in the." parade bf .All cases of dermatitis cannot be cured industrial diseases is an acute or chronic by eliminating;: offending - foods; but fur- inflammation of the skin which we .call tiger investigation along these lines, may '"dermatitis! "This' disease may- present it- give us a- clue with which to.lessen the ^seKs.in any type oPshop, factory br foun- loss oP-time from work and the disCbm- Any paste,_powd;er, gas. or liquid fort now produced, by industrial derma - which comes in ^contact with' 'the em titis. c ployee's skin,, even the water supplied by,, the town in which he lives dr works, may1 t.' be the potential cause of such a* skin Lead' Metals J disturbance; * !s. The distribution of : lead. poisoning is >. The^widet diversity bf .causes together quite extensive. o with the varying susceptibility of differ The skin of the body is a protective ent individuals makes the problem `of covering, and as long as it remains in control difficult.. tact it does a good job .except in the case Much investigation is under way to of tetraethyl lead, which is used in blend-., determine wity one person may be sus ing gasoline and which is readily absorbed ceptible to a certain.substance whije an through the 'skin, having a tendency to ' other is not- It bias been proved many create changes in the nervous system. times that a poisonous substance formed^ The effect of. other fdrm.s-of lead, through, within the body'has been able ten prolong that avenue of entrance, is practically the action started by some external influ nil, which explains the extremely low . ence. A printer developed saJmarked^ poisoning rate in typesetters, rpainters and dermatitis from "ink which persisted for others' who continually come in contact two years. Filially fo9d tests were made, with metallic lead. ^ and showed that he was susceptible to . Lead in any form;' introduced through - lettuce, which, when removed .from his .. the mouth, acts rather slowly when com 'diet cleared tHetSkin., He returned-to his; pared with the inhalation of lead dust or' . usual' occupation! without a return Of fumes.- .However, no matter what the symptoms. . * portal of entry may be, lead is. acted ^ -/The bbisp^^ptef allergic substances jjs upon ;by the body fluids and so conyerted ' usually airaij$Mitive process. It-takes that it may eventually be. deposited^ with time to pto&as&ji manifestation of dis in the bones. v ease, but let any other substance cause Those bony safe "'deposit, vaults may. the disease, and the irritating" food may retain their lead contents for days or for be of sufficient strength ^.to magnify its . years, and if the exposure is removed, action. may also free the employee of all signs 117 118 Twenty-fifth National Safety Congress and symptoms of lead poisoning. -But cnose and mouth.. The smaller the dust imagine the surprise of that "supposedly (the size of smoke particles for example) cured person when years later, perhaps the greater the . speed of absorption by following some type of infectious disease rthe blood. Fumes from hot metals carry . or the excessive use of alcoholic bever - not only poisons but numerous minute ages, he awakes to find that he suffers dust particles. This explains the inca the aches and pains and paralyses of an pacities occurring among those engaged acute lead poisoning. As the body fluids - in . acetylene and electric cutting and alter lead that it may be deposited, so - welding. When men are so employed may those fluids attempt to .de-lead the , over a prolonged- period. .of time, the body, and too rapid absorption may pro constant inhalation of . fumes and dust duce the original disease with all its dis might produce symptoms of the metal comforts. upon which they work. In the ship One can readily see, then, that in some, building trade, particularly: in the con- cases investigation of previous occupa struction of metal ships, we find occa tions is quite necessary to . determine the. sional cases, of metal-fume fever. original contact with.lead. "Brass chills" and "spelter shakes'' from Heating of molten'lead causes, a black zinc are names applied by the lay people scum of lead suboxide to form on. its sur to'such diseases. The terrific heat ap face, and the heat from the metal7-'dis plied to some of our common metals and burses the fine powder into, the air. alloys by acetylene torches produces suf Hence, in the process of smelting ores ficient fumes to cause a temporary, inca such as zinc, copper, and silver; mixed pacity in 24 hours. Permanent disability with lead, we find a rather high lead from such causes is- rare, however. poisoning rate. Those engaged in the manufacture of Diseases Due to Dust lead wire and cables, batteries, glass, pottery and rubber industries, plumbers users of dry colors'offer their share (of lejid poisoning. "-^Probably the greatest source of lead poisoning may be found among . those who sandpaper, scrape, chip or burn lead paint, for the dust and fumes caused by those activities) are rather rapid in their action. Such workers- may become in-., capacitated in a few days because the inhalation of lead dust causes the maxi mum amount of absorption into the blood stream in the minimum space of time. Twenty-five per cent of all workers exposed to high concentrations of inor ganic dust are expected to develop changes within their lungs due to . that agency. We are at a loss to explain why the other seventy-five per cent are not: so affected. Mining,_ ^quarrying, foundry work, grinding, Sandblasting, abrasive. - soap manufacturing, asbestos work, the mak ing of emery and carborundum products, and many other occupations offer op-, portunities for employees to inhale mic roscopic dust particles and create a foun Chromium dation for possible future incapacity. ' " We are interested particularly in those' Chromium is a, metal widely used as .a men who Work with sandstone,- quartz, foundation for colors, and dusts from its flint, granite, and sand,-because they ex various salts may produce lesions elf the pose themselves to silica, and the chem skin and mucous membranes of the nose. ical ^changes between that.' dust and the Chromium plating by electrolysis may body'fluids, in the presence of tubercu cause fumes which are similarly irritat- losis, may and usually do lead to a fatal iqgT^Although chromium poishning^does ending. nf>t usually cause death, the number of c It'is safe to say, in light of our present days /of absence from work on account knowledge, that the action of other- in of incapacity which it causes is gradu organic dusts is much less virulent and. ally increasing. incapacitating. That, however, does not Other iletala allow us to lower the vigilant methods to improve dust control and protect em The most efficient portals of entry of. ployees, because all dusty occupations ; foreign substances into the body'are the are potential trouble. makers, / . * >) 0ccupationalxDisedses -119 Although the actions df)various''dusts hemorrhages are common; it may cause differ- within the body,' the exposure to death., "1 asbestos, fibres,, present in tfye weaving The fumes from benzol ate heavier than and grinding of dry asbestos material, air and lie near the floor, which is an,ijn- offers another; type of. dust which may pprtant point in the engineering prob cause fatalities among workers... . lem ofj ventilation. - The organic dusts from- cotton,silk, The members of the .benzene group wool, tobacco, -flour and. similar sub? are absorbed through the skin, and more stances are practically harmless. Sucb cases., of-poisoning, are found when men dusts rarely reach the lungs. but may perspire' than , when -their bodies are. cool. cause irritation, of the windpipe and-larg Probably the answer, to ..that,is that the er air tubes and result at the most in'a fumes may-solidify as they,coot and the mild bronchitis.. - .'- * , , powder may, settle -on the skin. ' The The factor which should be borne-in' mind, particularly when dealing with silicosis and ' asbestdsis'T' relates to the. progression, of such disease.^ When 'sweat on the body may dissolve this dust so that'it is more readily 'absorbed through the increased -surface blood, supply. c ! "'<> changes. occur within the lungs' as a re sult ofcthe presence of such* dusts, -nature Chlorinated Hydrocarbons forms scar tissue to heal such lesions but This group of petroleum derivatives may fail to stop when the job is finished. has been known to science for years but As a result,- the continuation of that heat during ttie past dCcade its advance into' ing process may lead to such structural the industrial 'field has been widely dis- changes within the lungs that partial or tributedf-and most important.^ Led by total incapacity may follow months or carpon tetrachloncle and its chemically years after the employee has been re Associated members, it has. furnished in moved from his' dusty occupation. dustry with refrigerants for ice chests, excellent, solvents for. rubber, wax, oil . Benzole-Benzene and grease, thinner*. fpr lacquets and a ' very fine household necessity for the re- . Benzol is a distillate of coal, tar used . moval of spots, from clothes. .Hospitals extensively-.in industry. It is an 'essen have been using it-morie and more for tial ingredient in the manufacture of ex the removal of adhesive plaster. plosives. It is an excellent solvent for Due to -the non-flammability,.of car- grease, oils and cements, and because of ., bon tetrachloride^ it Is used in fire ex that* property it .is important jn many tinguishers. The rapid- evaporation' pro- phases of-the rubber and cleaning indus - duces fumes which -may smother- a 'small tries. In the manufacture'of shoes ben blaze; but we mustP not forget that 'ex zol may be ah ingredient of the dressing cessive heat of the actual fire may bring applied'to the leather and of-the. cement about combustion sufficient to produce which fastens the heels and' soles. Not such 'biproducts as hydrochloric acid and only in- ..the shoe trade but- `in other phosgene gas. Like its associated mem branches" of industry where employees ber,chloroform,' it may''produce sleep work .-with gummy, sticky material, - the when, inhaled by, an individual, and only workers soon learn of the ..solvent. and 1?3S0 of aii ounce. in a quart pf air/is cleansing ..action of thisc.liquid and use it .necessary to produce-such action. ''That freely for that purpose , upon, themselves. thought, must be remembered when a The subsequent outbreak ofo skin-, af large quantity of those; liquid-.products is flictions may -be .the first indication. of '-''spilled..on the'floor, perhaps accidentally. such unauthorized use;' Action should be started at once before . Benzol' is extremely poisonous, enter the-liquid gasifies, and employees should ing either through the nose-.or mouth or *be notified to keep their ^heads up to absorbed thrpugh the skin. Its actioii ' avoid the low ceiling of, gaS.^v - O Within the body, unvaried.and-,may pro Chemists have) developed .'and intro- duce multitude of. signs .and symptoms. t duced toeindustry many! new products, The bone marrow becomes affected' which .thl? basis of which is the chlorinated ..hy in turn alters the character of the blobd; drocarbons.: These derivatives of petro< - . .. 120 Twenty-fifth National Safety Congress learn distillation are frequently combined others of the danger. Even if removed with those from coal 'tar to form valna- from the' poisonous gas at that period, ble chemical combinations. They have * the .damage actually done, by the gas may been placed on: the market so rapidly :result in permanent physical damage, that medical science has been" unable to ^ - determine their physiological effect upon Infection the health of man. We haveknpwn that some of these chemicals are capable of -The skin is a protective covering of creating changes in the liver, and only the body against infection and is ex recently in a city in Massachusetts one tremely efficient as long as it remains in of these newer products caused the death tact, but allow it to be broken or punc of two employees arid a battle to retain tured, introduce bacteria, and a battle life among two. others. ensues 'between the offensive agencies of Carbon Monoxide ' ip ^infection and the-defensive powers of the dJbdy. The winning of such a struggle vraaiy determine the presence or absence of You remember the adage, "Where incapacity. 3 Infections are common there is smoke,' there is fire." We might throughout industry, but two types are add to that, "Where there is fire there is particularly prominent--infection result carbon monoxide." - , ing from anthrax atid infection among !}: H. --7 This odorlessHbut poisonous gas-may occur in any industry or in any home, but . the poorer the ventilation the better the - chance of producing physicat incapacity. . Since the advent of the. motor car, whose exhaust pipe may pour, forth as high as 6% of carbon monoxide, we are all exposed to that gas, particularly in crowded cities. The' ordinary passenger car liberates about two cubic feet per minute, and one can readily estimate, the physical damage that, may be~ done .if such a motor is allowed to run within the doors of a poorly ventilated garage or shop. Fortunately, serious cases of such poisoning are not .common among those employed in public garages, but many of those employees are likely to complain of headache and faintness at the.end.of a day's work, especially in colder weather when doors and windows remain dosed. meat packers; and fishermen. Many of our fur, hair; or wool-covered animals may contract anthrax. The germs of that diseasp defy the ordinary methods of sterilization and may linger, on hides, bristles or hairs for .long periods of time. Tanners, wool sorters, and hair'or bristle workers may introduce the anthrax spore beneath, their, skin, and undergo much physical suffering and sometimes death. .Infections are frequently found among -meat and fish packers and., those engaged in deep sea fishing. Although death rarely occurs, the loss of fingers, hands .and nasty septic wounds are the result Punctured wounds, cuts,. abrasions, burns and scratches are potential avenues of entrance for bacteria which wpuld seem to be waiting everywhere at all times for such a break in the skin. Early medical treatment might often save later surgical interference, not to mention the rM In the steel industry, where. gas is used "accompanying discomfort, incapacity and . as the heating agency in- the blast fur perhaps the loss of an essential body naces, care must be used to provide part. proper ventilation. Within the' mines, workers are warned to allow .enough time . Summary following blasts for the escape of this, I feel that the time -has come when an gas. employer must demand of a manufacturer Being a colorless, odorless and taste the answers to two questions: less gas, quick' of action within the. hu 1. How will your product affect my man body, the manifestation of the very - business? first symptom may be too late, to save a 2. How will your product affect the workman from partial or total incapacity health of my employees? or perhaps death. That employer is entitled to honest Because the exposed person suffers answers based upon sufficient chemical first from motor paralysis, he . may be and physiological examinations of the unable to help himself.pr even to warn questionable producjt. That manufacturer - s. - . *i . *> Occupational Diseases .121 shoul^h, be held responsible for , the; ill?-. dustry -has been made fool-proof by the produced by.the use bf his productTarnr substitution of non-toxic preparations for - unlegs he can guarantee its safety, it has, those now found, to be harmful, and when no place in industry.? Too many-Jives ea,ch employee is imbued-, with the idea' have been lost or' jeopardized by tpo that constant thoughtfulness and care are little knowledge-,of. a produces action most necessary forv the maintenance'of upon those who handle it. ^ health and happiness,'then, and not un- The incidence-of lost time due to ill- til that idealistic-stage has been reached ness and-HbjmrjK in industry`"has-been may vigilance and perseverance to main- greatly lessene4j)by the many agencies tain and preserve health,' limb and Jife working along line$ of safety. When in- be1 lessened. '. i b ^- Industrial Diseases ' By dr! W. C. TEMPLER . ftedlda.l wDi.rect.or, CornVi`ng GJtl.ass .W..orks, Com*.i"ng, tN. Y. We may well' ask whether or not physjeal examination ia'of' any value to the world at large, rather than limit' the,disr cushion to the control, of industrial' diseases. In the coirservation of life and health much progress lias been made in j the eradication or control, of such diseases 'as. occur in epidemic form, as well as that .type of disease .which is not truly Jepidemic-but Occurs in. such frequency that general health programs are necessary. Much has been done to control such disabling illnesses as heart disease,' -death .rate due to tuberculosis,. In fact. in the treatment of all epidemic-type, diseases that have so far been eradicated,"' the examination of patients to .determine the severity of .symptoms and''the im- proyement has. been of foremost yalue.' '' Knowing that the average span of life,, has been increased eight-years in the last quartern-century- and assuming that the above mentioned factors'have had some bearing on it, could" we decry the value of physical examinations for the general population? *, ., / arterio-sclerosisj- kidney disease and dia- If we know that, examinations made by betes; and something has been accom- .' insurance companies and their associating tihed in the control of morbidity, which examining institutions.--the clinics run by ids to, at least, make people happier the United States Public Health Service, rough good health,.even thougban in-, and the.great mass of physicians, who*-all creased span of life is not gained. carefully examine their clientele; have Physical examination has played-a large-2' been-of value in the control of disease, role in accomplishing these' things, be- may we not assume that examinations tn cause it was through physical.examination industry, will help control the incidence and'physical observations that investiga- 'and. extent of industrial disease, particutors were led to';exert themselves to'find larly. when the life .expectancy of ma* remedy 'for the cause of such coh'di- dustrial, workers is less than that of the tions. Small-pox is no longer prevalent, geheral population? due to* such observations, which l.ed to In.; fact oh April 14, 1936, at the NaitS' control by vaccination, Malaria and tional Conference on Silicosis and Similar yellow fever have "been brought largely Dust Diseases, called by the Secretary of under? control, and knowledge,, is -now Labor, Dr. R. R. Sayers , of the Unitedavailable, in the.-control of venereal di- States Public. Health Service said; "Preseases, if the proper physical examination ~ liminary and periodic physical and rbent- and laboratory methods' are used to arrive Cgenological examination should b.e made at a diagnosis. We are all familiar^ with of all employees engaged in" industrial the- results obtained in decreasing the processes where there is a1'potential if 122 Twenty-fifth National Safety Congress not aictual exposure to excessive concen must be correlated as' to time spent m trations of silica in the atmosphere." the hazard, although a period of one year Naturally in the early work of industry, only basic materials were used, ingredients, had not arrived at a sfete of development and complexity, whennntricate chemical compounds and other toxic materials were even known of, much less used. At the is, perhaps, proper for persons who feel in good health and have no-.complaints, or who are - not working in `toxic sub stances or with other, materials which Would under some"conditions impair, their health and usefulness. , present time over 500 materials are listed The objectives of pre-employment and which can, .under certain conditions, cause post-employment examinations: are the industrial disease and the' list is by no same, that 'is: the establishment of a means complete, inasmuch as experifnental physical standard in which the employee ''--.work is being done by the personnel of can pursue his trade or labor, having no 'practically) every plant oriindustry'\o im discomfort; or ill effect due to industrial prove or enlarge its manufactured products exposure to harmful products. Such by taking advantage of the great amount products and-, materials are, as we have. of knowledge science has given us. mentioned, of great-number and variety. Industrial , examinations are . of two. Attempts have been niade to classify kinds. First, the pre-employment ex workmen as to age, sex, color and na amination,^which consists of a very ire tionality. Whether or not any of these ful history', not oily of the family, but classifications are of-value, it still, remains also of the previous occupations with that -the. primary effort is to have healthy length of service in' each,' previous health workmen and the benefit is of as great and illnesses, and present habits. Naturally value to the workman, as to the industry. such a history is of no value unless truth The benefits .of individual and community fully given and a reasonable amount of good health are numerous and obvious;, time must be taken to acquire details, and the benefits of good health to industry which are oftenjvague' in a .workman's are equally important. The employee will mind or considered by him to be unim-' be more productive, receive higher wages . portant. The physical ^examination, of and beitappier. The labor turn-over(rate course^ varies with the type of industry, - because of poor health will be lowered as and should be, given with the knowledge will the costs of insurance. . The working . of what the man's exact occupation is to personnel will be more-efficient and con be, -and by a physician familiar with the tented, and will dislike 16 be exposed to industrial processes in which he is to be the overt acts of people who are epileptic, > employed.- In this way selected employ insane, or who disregard communicable' ment can be obtained for men Who have disease,. and will use their endeavors to some basic disqualification for one job, " but w^ich does not impair their ability work sktely among hazards they have been ^taught * to respect. for useful employment and the conserving The.harmful exposure, to each hazard is, of health in another. , of. course, different, ranging from a few days as, for example, an acute poisoning The physical, examination must be thorough. It should , include all methods ' from toxic' gases, years in. some of to that of 15 the less, toxic or 20 dusts;' of -determining a latent disability, dt one therefore the period before re-examination that is already present. . Many- examina tion forms are available from' insurance for each class of' employee will be dif ferent. However, individuals differ.also companies or other health services, which and it is hard to state a definite period have been designed entirely for industrial which may be satisfactory for each em work. It has been the experience of men interested iti this work, that-all the special ployee in a single class of hazard. Super visors can often be of great;value in send ^senses of the body .must be teste(i as well <' "as the measurement of motion in1all joints. ing employees but for physical examina tion whenever-there is a change in ap-.. The cardio-vascular system is of great pearance or work ability, or when they" importance as 1 is < the - respiratory and gastro-intestinal tract .. J haye been off on account of some illness; such -as, those self-diagnosed .as common Re-examination and periodical^ checks, cold, lagrippe, cough, sore throat or skin' because of particular industrial hazards, irritation. Such observations should be *Occupational Diseases :- 123 considered, ^where there is not. a full-time . properly place' employees, such a small physician, and they are of the greatest percentage is. finally rejected, and that. value'in'the early determination' ll a sj percentage is so obviously unfitto work?^ susceptibility to or the beginning of . an that no fair-minded person cin fail to^. industrial .disease. * " see the justice of it - We are fortunate in having had a large These objections, however,' are being amount of research work done on in noticed by legislative bodies, and in one dustrial .diseases, until-at the present" time, State a law is in force which says: "It materials from acetaldehyde to .zinc are J is hereby declared to. be the policy of listed, together with -the processes .in the legislature of this State,'in. enacting which, they are used and ,th'e symptoms " this article,.to prohibit through every law-' ; which they cause,'3 and .an estimate of the ful means available, any requirement'as a amount .of exposure in nearly' every case pre-requisite to employment which com necessary to. produce .symptoms. It is: pels an applicant for employment in any really nipt too much of,a problem for an occupation coming within the purview of interested' physician to accumulate a sup-. this article to undergo a medical examina- . . p|y of such knowledge, particularly when . tion..1' This statement is in a paragraph - he knows the processes involved during labeled,' "Prevention of Silicosis and Other the manufacturing procedure.' of. his-' in ' Dust Diseases,'* and the! logic of .it is dustry. It thus become^ relatively, a entirely non-understandable, even. though . routine matter of observation, together at the''present time there is no lawful with examination for. specific signs or' means available to enforce the stated symptoms at the time of the periodical policy., . re-examination, to obtain some degree of ^physical examinations are of benefit control of the hazard. tovKe population at large; they certainly' JWe cannot discuss .the benefits of pre- must be to'fthe industrial.workers, who employment examination and 'periodic re may be exited to special* hazards; examination without mentioning some of periodical cKeck-up examinations are - the objections to it. If a man has a dis necessary in any. hazardous work or.tradeHk ability, he naturally is anxious to keep it. in order to prdtect.the workers as well/as\jr- to himself and in some cases we , find .' the industry; arid the. benefits to thtO' . that .the workman Is disinterested to. a workers of proper*, and fair-minded ex point that he'would father not .know of aminations, in all ordinary cases, outweigh a' disability' even though he has it. Cer the objections. - y tain social groups, regard, each mail as entitipd to employment whether he is physically, fit of not, on the. assumption that industry hires labor, ndt health,, and that . rejection:--because.~of3physicaf dis ability causes a class, of artisans to/D&bme prejudiced against^'and become \<ihayity cases.* It..is also alleged that the quality of medical service .in industry is1 such that the results of .examinations are mis leading: and of no value. Another objec tion isvoiced by. labor unions, it being, claimed that pre-employment examinations are used to-discriminate against labor union workers or members. Many labor leaders realize; however, that preemploymeqt examination and periodical check-ups are the only' ipeafts of prevent -1 have purposely omitted- any reference to the economics of pre-employment and periodic re-examination, '. which:' apply either to 'the. individual or. the industry. / . However, one of the great public health' problems of-today is. the question of. t,he cost of medical care. If industry .assumes some of this cost by periodical examina- ,, tion in connection with. the prevention of industrial disease,'it relieves'the. individual. ^of .this responsibility,and allows- more, ' room in his Bridget for the care of his" family. The benefits toiindustry, of course, ate those > of,,,a better, personnel and a . , lower rate of'insutance. This rate, due to industrial. disease hazards, is in many' States;--very high and theological conclu ing disability from- certain ..industrial sion is that the real, remedy lies in the hazards. Competent, aridf honest medical "prevention of industrial disease by any' service renders all ,these objections quite method,1^orie of"which, I believe, is pre- impotent; for if an endeavor is made to . employmnet and periodical examinations; i .is I: l.* x. ` ii* \ /V v r* " 124 * Twenty-fifth National Safety Congress c What Can, the Engineer Do to Eliminate the Hazards of Occupational Diseases? * By REUEL C. STRATTON Supervising Chemical Engineer, The Travelers Insurance Co., Hartford, Conn. If I were asked, "Can the engineer pre While the problem confronting indi vent the majority of occupational -disease vidual safety engineers varies according cases" my answer would be, "yes" Ob to the industry, there are -certain funda-c. viously, with the exception, of those mentals common to all- such problems diseases brought about through a sudden which provide a workable basis ..upon or accidental contact with a poisonous? which an occupational disease prevention material `or a virulent disease-producing. program may be developed. Once these organism, if the exposure were controlled fundamentals are set in. motion tpward a by engineering technique, then** there safe working environment, continuance is wotild be no occupational' disease.. much the same whether the engineer .is The engineer must rely upon the engaged with a large organization or with medical director to place individuals a small one. The fundamentals follow this capable ,of working in hazardous occupa sequence: tions and to assist .him in controlling (1) An' occupational disease inventory these individuals through periodfifphysical ifrrequired. examinations when the men are-exposed (2) A plan for correction of the. ex to occupational disease^ hazards; but the posures shown by the inventory requires engineer alone is responsible for reducing development. generation of harmful substances and for (3) A concentrated1 attack upon the the control of employees' contact with major exposures first, following through . processes' using harmful materials.. until all are corrected or. eliminated. The ascribing of many and'new occupa An inventory of all materials used in a tional diseases' to industrial, environment plant will astound the average engineer. has produced a problem for him. The He will find , many items about which he engineer" generally works with materials may have little or no knowledge. He which he can see, but the 'study of in may be confronted with items he had not dustrial disease control- may require the recognized previously, even though he has handling of invisible materials. It isra been associated' with the plant perhaps common fault to focus attention upon one .many years. When this inventory is com- . object to such an extentQthat others of - plete, he should card index it, placing equal .importance may thereby be rele against the name of. the material the health, gated to obscurity. Today Safety en hazard associated with it both from a gineers and industrial hygienists are. con ntaterial and a process viewpoint; Such centrating their attention upon diseases card index should contain the com caused by the inhalation of dust, but X ponent parts or constituency of com do not believe the safety engineer is war pounds. . '( 1 ranted in confining himself to the preven Process exposures should be studied in tion-of diseases caused.by dust alone. * His conjunction with ' hazardous materials. consideration should extend to include all Assistance in compiling such data may be materials produced in any-manner that, obtained in the ' bulletin .'."Occupation. they may cause an effect upon a- worsen Hazards and Diagnostic Signs," prepared The question of whether a material exists by Dublin and Vane of the Metropolitan as a gas, a vappr, or a dust is but one of. Life Insurance Company, and in a publi particle-size-.and chemical make-up. -> cation of the United States Public Health He must not forget that many such Service, Public Health Bulletin No. 216, diseases are produced by exposure,. to "The Potential Problems of Industrial vapors and gasescas well as to dust, -and Hygiene in a Typical Industrial ` Area in that the control of these industrial diseases the Uqjjted States." . may be brought about by the application In addition the engineer should obtain of certain fundamental principles common all available information upon the ma to all. terials he is required to study. New 0 Occupational Diseases 125 : chemicals,: solutions, dusts) degreasing the. open-air does -not /always eliminate agents, condensation products, paints, lac the danger; in fact, .it may .increase the quers, dyes, abrasives, and other products' number of 'workers affected. too numerous to mention are being placed upon the market daily, and `the average engineer's- knowledge of their possible effects.upon health is slight. .Academic research - determining the effect of these Process Revision. To reduce transport tatioh of materials and exposure to harm ful substances it is desirable to have..all processes mechanically continuous'and, if possible,, enclosed. When this cannot J>e new materials'upon huinans is progressing . accdmplished, suitable physical divisions slowly, and .serious injuries may be- sus tained in industrial application long before' the toxicologist is able to determine the properties of the material and the 'maxi mum permissible amount to ,which J a worker may be exposed. ^ In seeking this inforination.it is essential to determine in so" far as possible, the maximum -per missible amount* of contaminants -which may exist in a work place,without causing an occupational disease.,.. should -be provided. ;The engineer should consider the substitution of we.t processes for dry processes, providing at the same "time* for the disposal of the moist col lected material in a safe place. He should consider the substitution of automatic . Operations, for hazardous^hand work* or machine work. A change of abrasive, materia! will, often reduce the quantity of dust produced. - I can cite 'an example of how a- little ' Armed, with this information,. the En thought can cure a hazardous, machine gineer is ip. a position, to.locate properly operation with little or no expense: in his own plant the process -and the A plant producing 2 finely ` pulverized. operation in which ;the exposure, may exist. material created large amounts of dust in The engineer, should study .together with bagging the inaterial,,-using porous sacks.c; the plant physician the length of employ: This high concentration of dust, not'neces ment of* exposed individuals and they sarily toxic, inconvenienced the ^workers. should Jointly determine the normal ex , The., cost of ventilating the department pectancy or averagE length of employment would, have -been prohibitive. By- careful. 'for the specific exposure. From -such '-study the engineer determined that the* data may be developed a factor of safety, fall of the material into the sacks forced and the maximum allowable period-of em- the air out through the interstices lof the ployinent in certain areas may be assigned. material, carrying with it a f,quantity of ( Naturally this study should be -focused the pulverized product. His problem, thus, upon fthe more- h--az--a--rdous location~s first, was itpo proviade a means wnhereoby itnhiiss-aaiir and When Cthese .are corrected, attention . could be harmlessly expelled from the turned toward r.minnopr oconndrfi.ttio.TMns,. sack prior to filling. ' Study Jed him to Housing. One of*the most important, suggest: and. apply the use, of a collapsed. considerations in attempting to control oc . paper bag which contained tittle or.* no cupational disease is housing. Whenever .free air.. The problem was solved.' Dust practical, any hazardous' manufacturing `generation was practically eliminated.by process should be separately housed and this simple change.. Many hazardous. Isolated; every , effort should be made to pro.cesses,in ordinary manufacturing opera arrest harmful substances--4ust, Vapors, tions may be.cured in like manner if the or gases--at their source of generation. engineer'" exercises his ingenuity. Buildings should be' so- constructed that ' Ventilation. Proper ventilation is' of accumulations of dust may be avoided. * , . * paramount -importance in the -control of When ' physical separation- of depart cany occupational exposure.- Most of the* ments -is required, Such physical divisions^ chief occupational / diseases ..other than should be dust or vapor tight. Floors dermatitis arise , through the inhalation or should .be tight to prevent transfer of the ingestion of foreign material. If ven-. materials to floors or, departments below. , tijating equipment can reduce the concen The engineer should" give study to the tration -of contaminating .materials to a complete enclosure of machinery or, safe limit, the problem is solved. The'en-. process, units as individual .units a'hd, if gineer should study each- process sep so required, yentfteacb. one separately. arately and - ventilate each* separately. It - The transfer of hazardous operations into is Seldom wise to, rely upon .general ven- , Ip:- u!}. * 1! 5 |iSEii.: f!: r`.* \' O' Twenty-fifth National Safety Congress tilation. Instead, high velocity ventilating ever, the. engineer interested in ' ascer apparatus should be installed, functioning taining not only' exposure. but also: effi as closely to the point of generation of ciency of control should realize control the hamtful substance as is possible. cannot be fully .effective nor the effidency .Individual machines should be so of any protective device determined with equipped if possible. Baffles may be in out scientific tests. Assumption, guess troduced to prevent air stream disturb work, unscientific procedure or apparatus ances or to increase the intake efficiency have no place in. an engineering program. at the nozzle. Down-draft systems The engineer must test each step unless it should be preferred .for the collection of has been previously proved, carefully cal dust or gases of high specific gravity. culating in advance to avoid false protec-, Even after the-installation-'of exhaust tion. 'Systems, the*- engineer must study the He must be familiar with dust counting, ^ype of m&hfyenance required' to keep -air sampling, and chemical analysis tech^ them operating at peak efficiency.' Noz nique, having such determinations made^ zles should not be permitted to become .by established and proper methods. If covered nor moved out of proper posi such tests arerbeyond the scope of his. tion. Exhaust, piping must be kept <dust 'ability or equipment and if the engineer tight. Bloweir efficiencies must be con considers such tests absolutely essential, stantly checked to insure that intake, ve then his executives should permit him to locities are proper.- ..The best ventilating obtain experts qualified to make such- sur system is a false protection if -it does not veys as his problem-may require. 'The function properly or if it is so poorly -, need for-an'accurate engineering approach maintained that it falls below its designed to any control measure cannot be over rating. The engineer must exercise ex emphasized. treme care to ^provide a dean source of replacement air for .the work place. He may find it necessary to install filtering and heating devices. ;The engineer, must study the proper disposal of the collected or expelled material to be positive it .will not drift back-into the work place.' c Conclusion. Every engineer realizes control of any industriid disease expo sure is divided, part of such control faU'ing- within the jurisdiction of the. indus trial physician and part within his own .engineering province." Medical knowledge is invaluable in the detection of early Employee Protection. While the pri symptoms and in the administratiqn of mary engineering means of protection suitable preventive treatment The- en against possible occupational diseases gineer should gladly obtain the services should..be mechanical-correction, the en of an industrial physician to make a gineer will find instances where even the study of the plant, to assist in the'classi b'est systems must be supplemented by fication of>the hazardous operations and. individual protection. He must carefully working locations. By such coordination study such exposures to provide the high he will speed control of the exposure. est effidency of protection; yet obtain a device easy for the operator to. wear con tinuously. When the engineer has-been successful in obtaining such a device, he must educate workers to use it * , Each individual occupational disease exposure must be studied, analyzed, and controlled individually. While general data may be available upon common ex posures, the -solution can be found only - - Sanitation. Clean washing facilities and in individual treatment. Such exposures toilets should be provided. Lunch., rooms cannot be compared -to ordinary' safety should be not . only dean but also well engineering efforts. A circular saw is a lighted and attractive and should be un circular saw wherever it may be bperat- der the supervision of the plant physician. ing, but industrial disease exposure, varies Sdentific Testa. Up to this .point the . within plants and certainly varies between engineer has deduced that an "Exposure different manufacturing establishments, exists, and from accumulated data has even though they may produce a' like devised his means of prevention. How product or article. ADJOURNMENT