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FILE NAME: Oil Industry and American Petroleum Institute (API) DATE: 1939 July DOC#: API156 DOCUMENT DESCRIPTION: The Medical Bulletin Article - Standard Oil Co. of Louisiana Manufacturing Dept Summary of Medical Activities 1938 4 e3 | MEDICAL BULLETIN : JULY, 1939 No. 2 CONTENTS . ... ... . IVUl' /' /; fe - - Ifcprial , , .L.J. Ferenczi, M.D. fe ORIGINAL ARTICLES tel Statistics for 1938................................ ^8 A. W, Schoenleber, M.D. L i g h t i n g ............................................ 75 JameB M. Adams, M.D. ' pia - Always a TropicalP r o b l e m ....................... 87 P. Tekelenburg, M.D. food Handler aB a Transmitter of A m e b i a B i B ............ 92 A. . Schoenleber, M.D. ANNUAL MEDICAL REPORTS r*d Oil Company of Louisiana, Manufacturing Department 98 Summary of Medical Activities 1938 . !i" I. L. George, M.D. and C. M. Allen, M.D. ational Petroleum Company Limited, Medical Report for 1 9 3 8 ................................ LewiB H. FraBer, M.D. .no CASE REPORTS gtinal Infestation with Taenia S a g i n a t u m ............. 116 B. B. R, Burns, M.D. it Year Old Mother ................................. 120 F. Ovalle, M.D., et al. I,Gonorrheal Endocarditis ............................ 12l ft K. R. Fourcher, M.D. re of Ileum Due to Direct Violence. . ............. 127 B. B. R. B u m s , M.D. 131 riers it seemed logi| tting the disease J ol measures, such.I nndlers and servant .c instructions, 0i Lea Infections l Aruba Frequency Bau Amebic Coliti 36.81* 1*.88 1.58 .61 mum. ice for the years 1933 referred to were publ w e been continued si je it seems safe to a cn amebic infection! all other known met because measures for| a marked reductic i e elsewhere, we shall! handlers in our cang| the contrary th MEDICAL BULLETIN' 98 STANDARD OIL COMPANY OF LOUISIANA MANUFACTURING DEPARTMENT SUMMARY OF MEDICAL ACTIVITIES 1938 I.L. George, M.D. and C. M. Allen, M.D. Baton Rouge, La. Organization itofedical Department is organized for the purposes of frfog periodic examinations of all Refinery employees; pfirployment and lay-off examinations} conducting special |jtions for retirement 'or retention in service, special felons for illness that might be created by industrial and foreign service examinations;, treating of all |pd major injuries that occur on the job; supervising, feasible, giving advice to our employees who are on report; attempting to build up a better and more ef~ ^personnel in the future by means of various psycho latests; treating at the Refinery Hospital conditions jpinature received off the job that will aid the em- stay at work; supervising the sanitation of the R e id the placement of men in positions which they can ptly fill because of various physical or mental dis tes; conducting immunization against colds, boils and ^ a n d frequently giving vaccines recommended by out- ?s in order to keep the men on the job (many paSpjnging their own vaccine prescribed by physiciEins to |gping to town for treatment), and in general serving advisors to the employees.and the Management in they may present. Personnel aonnel of the Medical Department consists of four- Wlduals; two full-time physicians, who do exiimina- > supervise in general the entire work of the Medical 5J two nurses, one who spends practically her entire road visiting sick employees and giving them what- jjoe she can to aid in their early recovery, and the |oe duties consist of general supervision of the hos- "T>ing up supplies and giving intelligence tests-; one |f takes care of all laboratory examinations as 99 MEDICAL BULLETIN well as the x-ray department, and is the official photograph for the Refinery; one secretary to the doctors, who handle' all the records going into the New York office, has charge o; the writing up of all sick cases and register cards, and in charge of all general correspondence for the department* one chief clerk, who handles all routine records in the partment, notifies all employees when to report for their e aminations (periodic and special), takes care of posting transfers, has charge of keeping time records and making the schedule hy which the first-aid m en work, and is ava able for first-aid work when necessary; six first-aid men, f5 of whom are on shift duty, one, who assists in posting treatments on the MD-5's, has charge of preliminary handl`d of all examinations for the doctors, such as testing eye hearing and doing urinalyses, while another, is assigned the physiotherapy department and is kept busy all day givi diathermy and Infra red treatments, massages, whirl pi baths, and ultra violet and galvanic treatments; and a hi pital porter. Reports During the latter part of the year three papers were vr ten on work done in the Medical Department of Baton Rouged finery. The first was a paper entitled "PRELIMINARY ON SICKNESS AT TEE BATON ROUGE REFINERY, "* in which it pointed out that the sick report had been materially lesse by the use of a fulltime visiting nurse and close supervi: of the sickness records.The next paper was a report on " STOOL EXAMINATIONS AT BATON ROUGE REFINERY," in which if shown that 5-55 per cent of the employees were infested intestinal parasites. The actual treatment for the firs, cases amounted to $5 1 -50, which was paid for by the Camp- The stool examinations completed on December 51, 1958, 1559, with 86 positive stools. This work is to be conti until the entire Refinery has been checked; and the Department suggests that this procedure be included in preemployment examination as well as, where indicated, employees. The third paper is on "THE USE OF EUCUPIN, analgesic) IN THE TREATMENT OF CERTAIN TYPES OF LCWt PAIN." It is extremely interesting to note that with treatment the Medical Department has been able to estima^ seventy-eight per cent reduction in disability resulting! this type of condition, and since the institution of -treatment there has been very little loss of time due t back pain. SUMMARY OF MEDICAL ACTIVITIES 1938 100 Dfficial photograph ectors, who hanfl Dffice, has chargoj later cards, a n d For the deps records in the report for their 1 care of posting lords and making 9 rork, and is aya Lx first-aid men,fj its in posting ` ireliminary ha-nflij 1 as testing ey ler, is assigned | busy all day giv usages, whirl po -tments; and a ho ee papers were writ -,.t of Baton Rouge R| "RRELBUIIARY * in which it materially lessen n d close supervisicj a a report on "12 Y, " in which it were infested wit ent for the first' for b y the Campa ber 31) 1938, W0^ is to be continu d; and the Medioa e included in tlj re indicated, in ol USE OF EUCUPIN (a IE TYPES OF LOW BAG te that with th able to estimate ility resulting fro nstitution of tb of time due to 10! Intelligence Tests Within the next few months the Medical Department expects resent to the Management the results of their experimentiil ^iyith intelligence tests. It is hoped that this research i?`help establish standards that will aid in building a type of personnel in the future. Syphilis . he Medical Department is also preparing a paper on the lienee of syphilis among the colored employees and will pt to correlate the accident and sickness rates in those afflicted with this disease and those who are not. there is no Public Health unit in Baton Rouge, Doctor Snleber suggested that the Medical Department make an ef;:to obtain medicine for the treatment of syphilis from p-State Board of Health free of charge; and should this be plished, employees would then be able to obtain treatment "Syphilis at the Refinery Hospital without cost to them. Boils and Carbuncles . Reoently the Medical Department has been using Allantojn ent (2%) in which is incorporated Chlorobutanol 0.5 per Nnt in the treatment of chronic ulcers, and during the prop W M was rather surprised that it has an excellent effect in ^'treatment of boils and carbuncles; in fact, one patient having so much trouble from a large carbuncle on hie leg ||#fto prevent sleep. On the first day of application of Al>in the pain was immediately relieved and the sloughing a began to heal. The Medical Department is quite impress|with the use of this ointment and at some future date may je a report on its use in various conditions. Alcoholics fpiiHecently the Management came to the conclusion that many '.MPonic alcoholics in the employ of the Company would be worth Salvaging, if possible to do so. In accordance with this -thought they have set up a program whereby any employee who .fes not as yet "gotten his business in a jam," so to speak, iftttt who feels that alcohol has gotten such a hold on him that Will not be able to break it, may go to an institution for of alcoholism and during his stay there the Company 101 MEDICAL BULLETIN SUMMARY III; m will pay him his regular sickness benefits. At the presejj time five out of nine have accepted this offer from the Co pany. Heat Exhaustion About July 1, 1938, the Medical Department was being quired to treat quite a few heat exhaustion oases. It noted that by far the larger percentage of these came from ooke stills. Upon investigation it was found that the color workmen on these stills were apparently not taking their as tablets. Hollowing the work done by the Harvard Fatigue Qq mission at the Youngstown Sheet and Tube mills and Boulfl Dam, the Medical Department requested that a level teaspoo^ ful of table salt be placed in each gallon of drinking wate this being a .1 of one per cent solution of salt water whiU when taken internally would replace the amount of salt lcj in sweat. Following this there were no further complain| from heat exhaustion and the foreman stated he was able get much more work out of his men without their becoming nes ly so exhausted. During the latter part of the year thirtjj six portable sanitary pressure drinking fountains have bq distributed to the various gangs and it is contemplated no summer using sixteen thin salt wafers of 15|- grains to a fq gallon sanitary pressure drinking fountain instead of measij ing the salt by teaspoon. Periodic Examinations There were 2,b52 periodic examinations made during year, 1 ,9U of which were done within the last six months | an effort to bring the schedule up to date. During July 1938 the records of the entire personnel checked and dates for periodic examinations set up method developed by Dr. Jas. M. Adams, which is as folloy Employees between the ages of twenty to 'thirty are to be e| amined every three years; employees between thirty and fo would be due an examination every two years; employees bet forty and fifty would be due every eighteen months; employ^ between fifty and sixty every year, and from sixty to si five every six months. According to this schedule the deps ment is due to complete 1 ,9^-5 periodic examinations duri the year 1939- This does not include special examination These examinations are so arranged that five men report the hospital at 7*'30 in the morning, five at 8 o'clock, |830 o'clock and i t of periodic exe ItorB to direct moi y and industrial i Imployme ring the year IS K: made and in the CB were given to 1 the month of 1 |itude test, using By the end oi be had been given 568 tests given Blligence examinat All men leaving tl son were examined Sir leaving. When jury that had not 1 `not laid off but was reached, at loal Department fc loal Department tl materially curtE B_B. There were api the year. L oe Lvery detailed re years was just 1 SBted. The last 1kere not include ttber 25th, it he 52 employees in tl , Vas a total of I' a total of 30, J+ ^industrial accide total for 0icier S cases losing a SUMMARY CEP MEDICAL ACTIVITIES 1958 102 J 5O o'clock ana usually b y 9:30 or 10 o'clock the day's 'L of periodic examinations is completed, allowing the 9>rS to direct more time to sickness cases, first-aid -'and industrial research. j Employment and Lay-off Examinations ring the year 1938 a total of 663 employment examinations |jaade and in the early part of the year no intelligence were given to those new employees; however, starting the month of August each n e w applicant was given an itude test, using the Otis General Intelligence ExaminaBy the end of the year approximately 125 of these bs had "been given to new employees. This, in conjunction ^568 tests given to old employees, makes a total of 693 diligence examinations given during the year 1938. men leaving the service of the Company in 1938 for any on were examined by the Medical Department at the time f leaving. When the examination showed a major or minor Jiry that had not reached maximum improvement the employee ynot laid off but kept on the rolls until maximum improve- was reached, at which time he was then approved by the Jloal Department for lay-off. It is the feeling of the ioal Department that the handling of cases in this manner materially curtail the number of industrial controver- There were approximately 912 such examinations made the year. Lost Time Sickness Cases Yery detailed report on sickness statistics for the past ?f years was just recently compiled and forwarded to those rested. The last two months - November and December -- of Were not included. Briefly reviewing the report made fiber 25th, it has been found that there was an average of 2 employees in the Manufacturing Department during 1938. was a total of 2,0^ sick cases during the year who Jra total of 30,1+86 days. In addition, there were 101 ^industrial accidents who lost a total of 1,920 days, the A total for sickness and non-industrial accidents being S cases losing a total of 32,*K)6 days. 103 MEDICAL BULLETIN Dally Ineffective Rate Per 1000 Employees from Sickness 1 9 3 3 ..................... 1^.9 193^.......................... 13.2 1 9 3 5 ......................... 16.5 1936 ......................... 17.7 1937 ......................... 13.6 1938 ......................... ll*.l* Frequency Rate The'frequency rate (number of employees off sick per for the year 1938 Is l*6l per 1000 employees, the rate 1937 being 536 per 1000. Days Lost Per Employee 193^............................ if-.8 1935 ........................... 6.0 1936 ........................... 6.5 1937............................ 7 A 1938 ...........................7.0 ' Days Lost Per Case 19 3 ^.............. 12.9 1935 ........ "................ lit-.8 1936 ..........................12.5 1937 .... 1 9 3 8 . .......... .....13.7 15.1 j The days lost per case increase in proportion to the caseprolonged illness. A Comparison of the Last Six Years of the Amount Paid in Sickness Benefits to Salaried. Employees and Wage Earners Year 193^ 1935 1936 1937 1938 Total Benefits $ 37^60.89 38,101-0.28 1*7,8*1-5.11 76,312.1*6 113,7lt-7.50 Av. Per Month $ 3,121.7i* 3.203.36 3,987.10 6.359.37 9,1*78.95 4 Employees ) ..14.9 1 ..13.2 ..16.5 1 ..17.7 1 ,.13.6 .14.4 off sick per , the rate a to the easel the Amount l Employees bnth SUMMARY OP MEDICAL ACTIVITIES 1938 log gull-time benefits went into effect in August, 1937. For Ifirst Beven monthB of 1938, $74,305.90 were paid out and fijfaring the institution of a full-time visiting nurse i|l,,60 were paid out the last five monthB of the year, ^average for the first Beven months waB $10,615.13 and 'average for the laBt five months was $7,888.32. The above indicate how important it iB that the Medical DepartIjnaintain a full-time viBiting nurse. This nurBe urgeB l|mbiilator.v caseB to report to the Company doctors1 office Iodically until they are able to return to work. SickneBB Cases Not Losing Time Hiring the year 9,718 Bick and non-industrial accident |s were seen a total of 23,426 timeB for advice and treat- The Medical-Department made no attempt to treat cases than those who were ambulatory or who had been pre|bed some type of treatment by the Stanocola Medical and ptal Association or their family physician which could be at the Refinery Hospital while they remained on the Plant Sanitation ae Banitary squad organized in 1937 continues to function baking care of the bathrooms and toiletB in the Refinery, ire still remain a number of old bathrooms under the con ger boxes which are gradually being eliminated by the jement,, by bto program of the being continued 6 prevention the ub of of athlete's Penchlor, foot infection stated previously, thirty-Bix portable Banitary preB- Ke''drinking fountains have partially replaced the water Pels and buckets. If these prove BucceBBful, no doubt, e will be used. J|At the present lous points in time it is a practice the Refinery and thiB to deliver iB handled by ice to employ- fij'in being placed in the portable Banitary drinking fount- ThiB seemB to partially defeat the idea the Medical partment had in mind in recommending the fountains. In 0r to prevent handling of ice and placing the ice directly |the water, the Medical Department intendB recommending a at the ice houBe where the water will be kept at the per temperature and it will not be necessary to place the fin it. In view of the Bize of the Refinery there will 105 MEDICAL BULLETIN probably be some objections; however, it is hoped that tH can be overcome and at no place will there be ice in drinking water. A n attempt will be made by the Medical Department to 1, the 'malaria rate this summer and to eliminate mosquito br ing areas. It also hopes to reduce the rat population at'' Refinery by cleanliness and the installation of covered bage cans in areas where employees eat their lunch. Occupational Disease Hazards Solvent Dewaxing Plant From time to time there is an occasional complaint1 nausea by an employee working at the Solvent Dewaxing pi" however, the Medical Department has actually seen no evid* of illness caused bythe fumes at this plant. It was usv found that the men who complained either had not been foi ing the safety regulations or they were using those complai in order to be transferred to some other department. Whe^ man complains of his work around the Dewaxing plant,if Medical Department has made every effort to have him tr_ ferred to some other part of the Refinery. The plant is i ning at reduced capacity and permits a better control fr: medical standpoint. Phenol Plants . There have been no serious injuries to men working a these plants; however, the hospital has treated quite a superficial b u m s which seem to happen more at the time.* a turn-around. Lead Special examinations continue to be made on men ha lead, on painters, litharge handlers, laboratory wor- handling tetra-ethyl lead, colored employees cleaning tanks, and also lead burners. These are made twice each year and there has been no assigneii examinati_ evidencS'i any toxic symptoms. Benzol Benzol examinations have been continued but no evidencS, toxic absorption found. " loped that he ice Dartment to ? mosquito hr copulation atj of covered lunch. il complaint Dewaxing seen no evid It was uai not heen fo] those cample irtment. Whe ixing plant -lave him ti he plant is control fr . working at) ed quite a'^f .t the timej n men hand oratory work es assigned^ se examinatig no evidence'; t no evidence* SUMMARY OF MEDICAL ACTIVITIES 1938 106 Welders (Eye Examinations) jl;examinations of all welders have revealed nothing abHowever, after conversation with the Mechanical Su- tendent, it appears that the Medical Department should these welders at reading distances as well as distant One or two cases have shown up in which vision was with work, yet when checked for distance their Inormal. Placing of glasses on these employees cor- i^their visual difficulties. The Safety Department fur ' electric welders prescription goggles whenever recomjtyby an oculist. (i ' Dust Hazards He vacuum cleaning system in the Lubricating Filter is now in operation. It appears, however, at this that adjustments will be necessary in order to properly ol the dust cleaning up operations. The dust collection is in process of installation and will not be completg&r about sixty days; therefore, no comments can be made Lb time on the unit. ipoviBionB are being made in the crusher unit where cork sbestos are handled to control the dust by means of a sr and duct which are connected to the feed hopper and rged to a point outside the door. Istudy is being made of sand blasting operations at Baton Refinery with the view of locating a sand blasting shop point remote from where men gather, with facilities for oiling the dust and preventing it from being liberated he atmosphere. p tors and blowers have been installed in connection with bool grinders and abrasive brushes in the Salvage and ReBhtion shop. Similar units are on hand and will be in|p.ed in the near future in connection with the Yankee ^grinder and Universal tool grinder in the Machine shop. has been indicated by various authorities that it would iteresting to see x-ray pictures of men that had been em5d for many years as electric welders and we plan at the 6 examination of welders to take x-rays of their chests. estimation has been prepared and forwarded to the local jement covering the installation of a fume removal system |he building where acetylene brazing and welding opera- ere carried out. fetailed examinations with x-ray of the lungs of all men 107 MEDICAL BULLETIN working in dust hazards, including Filter building sand blasters and asbestos workers, are made each yo some of these individuals there does seem to be some ii ed markings in the lungs, but it has not been found ne'! to make any recommendations for removal of any of the from their occupations. Chemical Plant The Chemical Plant has been out of service for bc until recently; therefore, at present it is manufe Bmall batches of catalyst for experimental purposes an are no particular hazards involved. Laboratories Examinations are conducted on men in the laboratorie handle lead, Benzol and other toxic materials. To da one has been found to show toxic symptoms. Catalytic Polymerization Plant The screening of the catalyst prior to charging the .< at this plant presents a dust problem and adequate prot? is provided in the open by the use of proven dust respii When handling the catalyst in an enclosed area, such asjS in the towers, fresh air masks and rubber gioves are ! This catalyst when subjected to moisture will burn the 1 and rubber gloves and rubber goggles are used in additi^ a respirator whenever handling the material in a moia state. . Proper Placement Of Disabled Employees II The Medical Department continues to have its proamong employees who suffer disabilities of varying deg The Management gives their full cooperation in securing -; that is suitable to these disabled men. Equipment During 1938 three infra red lights were added to the s ment of the Medical Department. Also six tablet-chairs been added for the use of men taking intelligence tests.h is anticipated and hoped that the Medical Department will ing employe ach year. 1 some inci ound neoeaH of these; 'or some manufactu loses and ti Doratori es To date ging the to uate protect| st respirato , such as yes are wq h u m the in addition! _n a moistt fees 5 its probi arying degre| 1 securing ed to the e<lu let-chairs :ence tests. Vf artment willlj SUMMARY OF MEDICAL ACTIVITIES 1938 108 P|lo purchase a needed x-ray during the year 1939. The Cat machine has teen in use for almost twenty years and ibsolete and inadequate. 'is hoped also that an electrocardiograph will he pur- i>4j which the department feels is very much needed in diagnosis, prognosis and treatment of heart cases. It is that with this machine more defnite and detailed infor- ion can he furnished to the New York Medical Department as pas the local Management in regard to the status of heart land, no doubt,will pay for itself in a very short time, "have teen many requests from employees that this type Equipment he added to the Refinery Hospital. It is anticipated that a new ambulance will be procured as Bjn.as the 1939 budget is approved. SUMMARY OF ROUTINE WORK - 3.938 mtions - Periodic and Special..... ............ lations - Applicants..... ............ side visits by doctor and nurse..... ........... . oved for return to du t y..................... . watory examinations............ ................... examinations.............................. . 2,796 663 3999 2,1I4-I4- l+,9l+l 1,18*+ pelotherapy treatments.......... ...... ............. loidents - No Lost T ime............. ................. Jidents - Redressings................. Cases - No Lost Ti m e......... ................ industrial accident cases - No Lost Time......... 3,1+57 3*267 8,962 8,675 l,0l+3 pit- Office visits................. .20,820 Industrial accidents (Office visits) No Lost Time 2,606 rage number of employees..................... . 4-, 652 .. No, of cases losing time (Sickness)........... 2,0I+I4- |al No. of days lost from sickness................. 30,1+86 Sal No. of cases losing time (Non-industrial acc.) 101 |tal No. of days lost from non-industrial accidents. 1,920 average - number sick - losing time....... . sickness rate per 1000 employees.... .......... No. of accidents - Disabling - NEW............ 88.23 18.8 25 fed No. of days lost from accidents........... 1,188 average - number accidents - losing time....... 3.25 accident rate per 1000 employees............... .7 juency rate per 1000 employees (sickness)......... 1+39 pLUency rate per 1000 employees (Non-industrial a c c .) 22 iilost per case (sickness)............ ll+.9 lili m l 109 MEDICAL BULLETIN JH SUMMAEI OF ROUTINE WORK (Continued) ,i Days lost per case (Non-industrial accidents).... Days lost per employee (sickness)................ . Days lost per employee (Non-industrial accidents).. Total visits to Refinery hospital by employees.... Average number of visits per employee....... ...... Visits to Ref. hospital other than Ref.employees... Total hospital visits-Refinery and others......... Aptitude examinations..................... ......... it 19.0.^i 6,5^1 j^r 39,121: [ 8.4M l,lfflpi hOj22l *See MEDICAL BULLETIN,Vol, kt No.l, pp.7~I3.Apri! 1939. We have frequently called attention to the fact that factors other than actual sickness disability must be 00 sidered when studying disease frequency rates. The folic extract from a monthly report submitted by Dr. Tekelerib of Soengei Gerong, Sumatra, illustrates the fact that religious holidays may have an influence on sickness ratef}| "As far as the Mohammedans are concerned, this month , was their yearly Lent, ending with their New Year,;) a time which a true native does not want to pass ini a hospital, and in order to avoid this "risk" they!; do not report for sickness during the days before. It is a regular event, that during the Lent and; Mohammedan New Year, the hospital is at least hal empty, but after the good time is over, patients will very quickly fill the empty beds. Some of these natives that pass their vacation in their na tive villages will come back with dysentery, ma laria or other diseases which they got there andothers have been ill for a few days, but did no r e p o r t ." E d itor's Note. INTERNAT MEDICAL ] llhe most importair tt''adapt himself to lidity and althoug! ere the heated air and humidity ar sed by the Humbol ntains on the oth ate, with d i u m a sky is often ove or slight showe during the day : et and sand and th 90 from clouds, al at times quite JPChildhood diseas W o k e n pox, and so- phoid fever were m than last. Th children and yo ldren of the fore i'Amebiasis in a Dole, abdominal pa ||Physical examinat Sor discharged, al gjftificates for mar using a gun, et |taie medical cent the company as w " .oil fields. B lo all hospital large store-ho |F tuilt and put 1 "an. All art