CORNELL UNIVERSITY LIBRARY 3 1924 092 432 966 Cornell ilr LIBRARY Martin P. Catherwood Library School of Industrial and Labor Relations LIBRARY CLASS )-(Ti BOOK T£GC( '"'"" ^ 8G8 XI Cornell University Library The original of this book is in the Cornell University Library. There are no known copyright restrictions in the United States on the use of the text. http://www.archive.org/details/cu31924092432966 MINISTRY OF MimiTIONS. HEALTH OF MUNITION WORKERS COMMITTEE. FINAL EEPOET. INDUSTRIAL HEALTH AND EPEICIENCY. Presenied to ;]?afliamenthy Command of His Majesty. LON,I>ON: , . , ; . PUBLISHED BY HIS MAJESTY'S ' STATIONERY OFEICE. ' ■ |i To b'ei purchased .ttrou^li any Bookseller or directly from .;U i^gMM' STATIONERY' OFFICE at the following addresses : iMPERiAL jim^iiimQiSWAY, LoNHON, W.G. 2, and 2$, Abingdon Street, .London, S.W. 1 . 37, Petee Stejiet, Manchester; 1, St. Andrew's Crescent, Cardiff; ■ 23, FoRtH Street, JSjinburgh ; or from E. PONSONBt', Ltd., 116, Grafton Street, DtBUN. [Ci:- 9065] 1918. Price 2». Net. GOVERNMENT, PUBLICATIONS ■ ; (witii the undeil^iiflitp^l, exceptiquB) / ctm be piiTc^sed u| tkemavifp indicatct «nithe fir»t pvge of VU» irr^ifffiefe. Hyd|Ographical Publicatiora; of the Admiralty are sold by J. D. Potter; 145, Minorifls, London, K. 1. Palf nt Office Fulllicatidttg are sold at the Patent Office, 25, Southampton Bvdldings, (Chancery Lane„Lond6n; W.C. 2, ,. ; 0#*M8!»e Survey and GedO^bal Survey Publications can be purotiase'd from The Director-General of the Ordnrace_ Surve*' .1 * SouthttBipton J f rom the Birectdv, Ordnance Survey, Dublin^, or from Agents in m06t. of the chief towns jn the United Kmjdofflui; I They can also be ordered through any Bookseller. 'Small Scale Maps are on sale at all Rafl.fll'ay Bookstalls. TOie journal of the. Board of A^Cldture and fisheries is 'ijablished monthly by the Board, and is obtainable from 3, St. Jamei^it, p: Square, Iiondan,S.\S . 1, Price 4ii., post free. . .'-':■ .t The following is a list of some recent ParliameQ<&,ry and OfiScial Publications (Prices in parentheses 'kdudei postme) : — «::v MINISTRY OF MUNITIONS. , of Munition Workers' Goimnjttee Memoranda, : 1. Sunday Labour. **' '• [Cd. 8132] of Session 1914-16. Id. (l\ol.). 2. Welfare SopebviSion; [Gd. 815,11 of Session 1914-16. Id. (lid.). 3. Industrial Canteens. [Cd. 8133] of Session 1914-16. Id. {lid.). 4. Employment of Women. [Cd. 8185] of Session 1916, lld:{%d). : .*>; HotfES of Work. , • [Cd. 8186] of Session 1916. 1J< ,(2,a!.). 6. Canteen CoNSTKUOTioN and EQUiPMteT. [Cd. 8199] of Session 1916., U. {U.). 7. Industrial Fatigue and its Causes. [Cd. 8213] of Session 1916. 1J(^, (M). 8. Special IndUsteul 'Diseases: ■ [Cd. 8214] of Sessioii 1916. ld:{iy>:), 9. ■YENTILA.TION ■ Af'D lilGHTiNG 0$ MUNITStON ' - Factories and Workshops. [Ca. 8215] of Session 1916. IJd (2d). 10. Sickness and Injury. , [Cd. 8216] of Session 1916. ild.'iM.). 11. Workers' Food, and Suggestions as to Dietary. [Cd. 8370] of Session, 1916. l|d (2(^.). 12. Output in Eblation to Hours of Work. &c. :— 18. tTuTENiLB Employment. [Gd. 8362] of Session 1916. Id. {l^d.). 14. Washing' Facilities AND Baths. [Cd. 8387] of Session 1916. Id. (1 Jc?.). 15. BjESIGHT. IjFFEQT'' OF INDUSTRIAL CONDITIOlTSf:;! Upon. ■ , ■ tP^-. 8409] of Session 1916. ; Id. (1|^.). Industrial- Efficiency and Fatigue. Interim , Eegort'(iira^)^ 6'Aarts).. ; ihi: 85ilf of Session 1917 -18. Is. M. (Is. Id.). : 16. Medical Certificates for Munition Wobkebs.' ^[dd. 8S22]'of^ikffi,jl917-18. ld.{U.). ^.(MtpubtUMd,) "" ' --^i 18. Output in • Eblation to Hours of. Work,- ; Influence of Sunday Labour. Further ' information. -^ [Gd. 8628] of Session 1917-18. 3d. md.). <: 19. Worker^' Food, and SuggbstIons as to Dibtary;'| 2nd eidition. ? [Gd. '8^||of Session 19l7vl«. 2d. (3d.). 20. Weekly Hours 01' EkpltioYMENT. \ [Cd. 8801] of Session 1917-18. Id. (2d.), ,,| 21. FACTOifs in *se Causation of Industrial Aotiiyl dents. (With Dioigrams.) . '^ IqA,, 9046] of Session 1918. 6a!. (Bd.). Health of the Munition Worker. Handbook. [Cd. 8344] of Session 1916. lid: (2d.). IlltistratAd. (WIB). Is. 6d. (is. 9^d,). G-eneral Ordering of the Work in a Controlled Establishment. Eegulations made in. pursuance of sec. 4 (5Jof the Munitions of W3,r,Aet, 1915.; ' England and Ireland. Provisional. H.G. 847 of Session 1914-16. . ||^.,(14;). Scotland. ,- \ ; H.a 300 ^f Session 191f-16,:|£p:U^^^^ Trinitrotoluene. ; Eules for the use of Trinitfotoluene. Definitions ; Duties of Emplojrers; Duties of Persons Employed. ' [Cd. 8494] of Session 1917-18. ld.(i^d.). The Nitrogen Problem and the Work of the .Nitrogen Products Committee. ^, ^ ,| J The Nificogen , Problem ; Formation of the Gomxnifctee ; Mtrpgeh Fixation Eesearch : Interim 'i^,|p6jt;*'TIie«| Aster's Dfecisidn and the Action taken. there'on^;.jritrogen in, Sulphiiric Add Manufacture; Further^^S^aiid^'J Minister's Dfecisidn and the Action taken. there'dn^;.Jfitrogen in, Sulphiiric Add Manufacture; Furtherip&ieaiid^;^^ Importance of Cheap Electric Power; Costs of Operating Nitrog&ii Fixation Processes : Co-operation withotherl . ;G-6Yel'nment Departments ; Mterogen Fixation in th§ British Empire and in Allied Countries; Final Keporfcl] (1917.) 2d.Cdd.). - ' I The Boy iri Industry. - Three articles- of interest and value to employers, the Minister of Munitions. (1917.) 3d, (Aid). 'B.e-pnp.t$^ iiota Fhe Daily Telegraph. With a Foreword by | Output of Munitions in France. Eeport by Mission appointed by the Director-General of Eecruiting for Munitions Work. [Cd. 8187] of Session 1916. IJ^. (^d} INDUSTRIAL FATIGUE. Reports on an investigation of Industrial Fatigue by Physiological Methods. ]By A.,F|S*aiiley Kent, M.A,, D.Sc. (Oxon), Henry Overton Wills Professor of Physiology in the University of BristSf^ Lnteeim Eepobt.— Examination of some Physiological Methods for Investigating Industrial Fatigue ; Eesultsi of Eesults. .Power of Eeeovery— Laboratory Workers ; Eesults of Tests — Faetpry Workers ••. [obtained by the Method of Simple Eespoiise and Dileinma; Gritioism of the; Eesults'' With Charts. of Session; 1914-16. 4ld. (6d.). MINISTET OF MIHSTITIONS. HEALTH OP MUNITION WORKERS COMMITTEE. FINAL REPORT. INDUSTRIAL HEALTH AND EPFIOIENCT. Presented to Parliament hy Command of His Majesty. LONDON: PUBLISHED BY HIS MAJESTY'S STATIONEEY OFFICE. To be purchased througli any Bookseller or directly from H.M. STATIONEEY OFFICE at tte following addresses: Imperial House, Kingsway, London, W.G. 2, and 28, Abingdon Street, London, S.W. I , 37, Petee Street, Manchester; 1, St. Andrew's Crescent, Cardiff; 23, Forth Street, Edinburgh; or from E. PONSONBY, Ltd., 116, Geaiton Street, Dublin. [Cd. 9065.;| 1918. Price 2s. Net. PINAL REPORT OP THE HEALTH OP MUNITION WORKERS COMMITTEE. CONTENTS. Seotions. Page. I. — ^Introductory 4 n. — Erelimmary and Historical Survey ' ni. — Relation of Fatigue and Hi-health to Industrial Efficiency 15 IV. — ^The Industrial Emplojrment of Women 20 V. — Hours of Labour... ■•■ ••■ ••• 2Q VI. — Shifts, Breaks, SpeUs, Pauses and Holidays 40 VII. — Sunday Labour and Night Work 44 Vlil. — ^Lost Time and Incentive 48 IX. — ^Pood and Canteens 61 X. — Sickness and lU-health 61 XI. — ^Injuries and Accidents .-. ■•• ■■• 65 XII.— Bye Injuries 71 XIII. — Special Industrial Diseases ... •■• 75 XIV. — Cleanliness, VentUation, Heating and Lighting 83 XV. — Sanitary Accommodation, Washing Facilities and Cloakrooms 89 XVI. — Seats, Weights, Clothing and Drinking Water 95 XVII. — ^Welfare Supervision for Women and Girls 99 XV ill. — ^Welfare Supervision for Boys and Men 108 XIX.— Welfare Outside the Factory 112 XX. — Summary of Conclusions 120 Appendices. A. — ^List of persons who gave evidence or otherwise assisted the Committee 130 B (I) — ^Dr. Janet Campbell's Eeport on " A further Inquiry into the Health of Women Munition Workers "... 132 B (II) — Dr. Janet Campball's " General Findings of Inquiries into the Health of Women Munition Workers " ... 145 C. — Dr. Vernon's Memorandum on " A Comparison of the Systems employed for dividing up Working Hours into SpeUs and Breaks " 153 D. — Summary of Captain Greenwood's Memorandum on " The Causes of Wastage of Labour in Munition Factories emplo3Tng Women " 163 E. — Canteen Planning and Equipment 165 F. — Hostel Planning and Equipment ... ' 166 G. — ^Medical Certificate of Incapacity for Work 175 H. — Police, Factories, &c. (Miscellaneous Provisions) Act, 1916, Section 7 176 I. — Home Office Order in regard to First- Aid Appliances 176 J. — ^Ministry of Munitions Memorandum on " The Duties of WeUare Supervisors for Women " 177 K. — Concessions in regard to Expenditure on Provision of Welfare Facilities, Canteens, Recreation, &c. ... 179 Index 181 (B 12023) Wt. X8484— 6190 5m 6/18 H & S HEALTH OP MUNITION WORKERS' COMMITTEE. TEEMS OF REPEKENCE. The Committee were appointed in September, 1915, by the Right Hon. David Lloyd George, M.P., with the concurrence of the Home Secretary. The Committee were -invited "To consider and advise on questions of industrial fatigue, hours of labour, and other matters affecting the personal health and physical efficiency of workers in munitions factories and workshops." The reference and appointment were subsequently approved by the succeeding Ministers of Muni- tions, the Right Hon. E. S. Montagu, M.P., the Right Hon. C. Addison, M.P., M.D., and the present Minister, the Right Hon. Winston S. Churchill. CONSTITUTION OP COMMITTEE. Sir George Newman, K.C.B., M.D., F.E.C.P. {Chairman) ; Chief Medical Officer, Board of Education ; Member of the Central Control Board (Liquor Traffic) ; Emeritus Lecturer in Preventive Medicine at St. Bartholomew's Hospital. Sir Thomas Barlow, Bart., K.C.V.O., M.D., LL.D., F.R.S., Physician-Estraordinary to H.M. the Bang ; late President of the Royal College of Physicians. Gerald Bellhousb, Esq., C.B.E., H.M. Deputy Chief Inspector of Factories, Home Office. Professor A. E. Boycott, M.D., F.E.S., Director of Pathological Department, University College, London. J. R. Clxnes, Esq., M.P., Parliamentary Secretary to the Ministry of Food. E. L. CoLLis, Esq., M.B., H.M. Medical Inspector of Factories, Home Office ; Director of Health and Welfare, Ministry of Munitions. Sir Walter M. Fletcher, K.B.E., M.D., Sc.D., F.R.S., F.R.C.P., Secretary to the Medical Research Committee ; Fellow of Trinity College, Cambridge. Leonard E. Hill, Esq., M.B., F.R.S., Director, Department of Applied Physiology and Hygiene, Medical Research Committee ; Professor of Physiology, London Hospital Medical School. Samuel Osborn, Esq., J.P., Managing Director Clyde Steel Works, Sheffield. Miss R. E. Squire, O.B.E., H.M. Deputy Principal Lady Inspector of Factories, Home Office. Mrs. H. J. Tennant, C.H. E. H- Pelham, Esq. {Secretary) ; Assistant Secretary, Board of Education. (B 12023) A 2 HEALTH OF MUNITION WORKERS COMMITTEE. FINAL REPORT. To THE Eight Hon. Winston S. Chubchill, M.P., Ministee of Munitions. Sib. 1. Tke Comimttee now beg to submit the following final Report. 2. Since their appointment the Committee have held thirty-nine meetings, and in addition sub-committees have met on numerous occasions. 3. Immediately on their appointment the Committee arranged to sit and take evidence not only in London but also in Birmingham, Sheffield, Newcastle, Glasgow, Manchester and Coventry. Special arrangements were also made for taking evidence at Woolwich. Witnesses were heard representative of employers, workers, factory inspectors and other interested persons. From time to time special witnesses have also been heard on particular questions. In addition, a number of other persons have —by the submission of memoranda or by other means — placed their special knowledge at the disposal of the Committee. The Committee have decided to content themselves with quoting extracts from the evidence, and not to publish it in full. In arriving at this decision they have been influenced not only by the urgent need for economy in paper, but also by the fact that much of the evidence was either not intended for publication or had special reference to particular conditions then existing, but now largely modified. Some persons, while allowing their statements to be made use of, have desired that their names should not be published. 4. Throughout their inquiries the Committee have found it desirable to rely for much of their information on visits paid to factories. Such visits, which were generally paid by two or three members of the Committee together, enabled them not only to interview a nimiber of employers, foremen and workers whose evidence would hardly otherwise have been available, but also to ascertain at first hand the conditions under which munition work was being carried out. In addition individual members of the Committee, whilst discharging other duties, have collected a considerable body of information bearing on questions under consideration. 5. From the first the Committee have been strongly impressed with the importance of obtaining exact and scientific data. The Medical Research Committee not only gave permission for Dr. Leonard HiU, F.R.S., head of their Applied Physiology Department, to serve upon the Committee, but placed the experimental resources of his laboratories at the disposal of the Committee, and ofiered to render any other assistance in their power. The assistance thus offered has proved of the highest value. In addition to other work Dr. Leonard Hill has conducted a number of detailed inquiries in regard to the dietaries of munition workers, and also in regard to ventilation. Dr. Benjamin Moore, F.R.S., and his staff have carried out a long series of experiments and inquiries in regard to the effects of T.N.T. upon the health of workers (separately published). In conjunction with that Com- mittee arrangements were made for Mr. P. Sargant Florence, Mr. H. M. Vernon, M.D., FeUow of Magdalen College, Oxford (with whom has been associated Mr. W. Neilson Jones), Professor Thomas Loveday, Armstrong College, University of Durham, and Captain M. Greenwood, R.A.M.C. (with whom has been associated Mr. S. H. Burchell), to collect data bearing on the relationship of output to hours of work and other industrial problems. Captain T. H. Agnew, R.A.M.C, conducted, on behalf of the Committee, a medical inspection of about 3,000 male workers. Two series of medical inspections covering together about 2,500 women and girls were organised under the supervision of Dr. Janet Campbell (a Senior Medical Officer of the Board of Education). 6. In Appendix A are set out the names of — (a) the Witnesses, other than those who desired that their names should not be published ; (&) the Medical Officers, inspectors and others who assisted in the medical inspections ; and (c) certain other persons who, by the submission of memoranda or by other means, placed their special knowledge at the disposal of the Committee. The Committee desire to place on record their cordial appreciation of the assistance rendered, often at much personal incon- venience, by all those who have thus enabled the Committee to collect a body of reliable information, without which it would have been impossible for them adequately to perform the duties with which they were charged. The Committee are also under a great obligation to the many munition firms and their staffs for the facilities so readily accorded for the pursuit of inquiries. Finally, the Committee desire to express their thanks to the Home Office (Factory Department), the Ministry of Munitions, the Board of Education and the National Insurance Commissioners, for the assistance afforded the Oommittee by the loan of their officers and %^ supply of information. No. 1.- No. 2.- No. 3. No. 4. No. 5. No. 6.- No. 7.- No. 8.- No. 9.- No. 10. No. 11. No. 12. No. 13. No. 14. No. 15. No. 16. No. 17. No. 18. 7. In view of the urgency of many of the problems involved by their tenuB of reference the Com- mittee decided that it was desirable that they should submit their views and recommendations in regard to particular matters in separate Memoranda rather than that they should defer making any report until their investigations were completed. In accordance with this decision the Committee have submitted to the Ministry the following twenty-one Memoranda : — -Sunday Labour (Cd. 8132). -Welfare Supervision (Cd. 8151). -Industrial Canteens (Cd. 8133). -Employment of Women (Cd. 8185). -Hours of Work. (Cd. 8186.) -Canteen Construction and Equipment. (Appendix to No. 3.) (Cd. 8199.) -Industrial Eatigue and its Causes. (Cd. 8213.) -Special Industrial Diseases. (Cd. 8214.) -Ventilation and Lighting of Munition Eactories and Workshops. (Cd. 8215.) -Sickness and Injury. (Cd. 8216.) -Investigation of Workers' Eood and Suggestions as to Dietary. (Second Appendix to No. 3.) (Cd. 8370.) -Statistical Information concerning Output in relation to Hours of Work. (Cd. 8344.) -Juvenile Employment. (Cd. 8362.) -Washing Eacilities and Baths. (Cd. 8387.) -The EfEect of Industrial Conditions upon Eyesight. (Cd. 8409.) -Medical Certificates for Munition Workers. (Cd. 8522.) -Health and Welfare of Munition Workers outside the Factory. {Not published.) -Further Statistical Information concerning Output in Eelation to Hours of Work, with special reference to the influence of Sunday Labour. (Cd. 8628.) No. 19.^Investigations of Workers' Food and Suggestions as to Dietary. (Second Appendix to No. 3. ) Revised edition. (Cd. 8798.) No. 20. — Weekly Hours of Employment (Supplementary to Memorandum No. 5.) (Cd. 8801.) No. 21. — Investigation of the Factors concerned in the Causation of Industrial Accidents. (Cd. 9046.) All of these Memoranda with the exception of No. 17 (Health and welfare of munition workers outside the factory) have been published and placed on sale. An Interim Report, entitled " Industrial Efficiency and Fatigue," was also published (Cd. 8511) in February, 1917, in which was set out the results of a number of investigations which had been made for the Committee. The studies included were : — (a) Industrial Fatigue and its Causes (reprint of Memorandum No. 7). (b) Output in relation to Hours of Work (reprint of Memorandum No. 12). (c) The Comparative Efficiencies of Day Work and Night Work. (d) The Causes and Conditions of Lost Time. (e) Incentives to Work, with special reference to Wages. (/) Report on the Health and Physical Condition of Male Munition Workers. {g) Inquiry into the Health of Women engaged in Munition Factories. Finally, in December, 1917, the Coromittee, acting on your instructions, issued a handbook on the " Health of the Munition Worker," summarising shortly and concisely the principal suggestions con- tained in their earlier publications. 8. The Conunittee are satisfied that the procedure thus adopted has been justified by the results attained. The publication of separate Memoranda has undoubtedly rendered the Committee's recom- mendations more readily accessible. The demand for the Memoranda has been large and continuous • upwards of 210,000 of the Committee's Memoranda and Reports have been sold or distributed and the recommendations contained in them have received a wide measure of acceptance both officially and unofficially. 9. The Committee consider that they have now reached a definite stage in their work. Though doubtless fresh matters for inquiry may arise from time to time, there can be no doubt that the position is now substantially difEerent from what it was when the Committee were first appointed in September (B 12023) A 3 1915. There is apparently an increased appreciation of the importance of the whole question of industrial hygiene, and there can be no doubt that the environment and conditions of employment of munition workers throughout the country are now vastly better than they were two and a-half years ago, though there is still much room and much need for improvement. The developments which have occurred may be roughly grouped under the following heads : — (a) The various Memoranda and Reports already prepared by the Committee may be broadly regarded as containing recommendations in regard to all the principal questions which fall within their Terms of Reference. All these recommendations have been generally accepted as reasonable, and have been widely adopted. (b) In January, 1916, the Ministry of Munitions established a Welfare Section under the direction of Mr. B. S. Rowntree, for the purpose of the executive work arising out of the Committee's recommendations and other necessary undertakings for promoting the health of the large body of workers for which the Ministry was responsible. The activities' of the Department were at first concentrated on securing improved conditions of health and welfare within " controlled " factories by encouraging factory managers to appoint some person or persons to maintain a close personal relationship with the workers, and also to make the requisite structural provision.* Early in 1917, the pressure of other duties prevented Mr. Rowntree from continuing to direct the Department, which was about the same time entirely re- organised under the direction of Dr. E. L. CoUis, a member of the Committee. The new department was made responsible for all matters concerned with the health and welfare of munition workers in national as well as in " controlled " factories, including the medical problems involved in the. prevention of T.N.T. poisoning and the maintenance of the health of those employed in the manufacture of lethal gas. The sphere of the Department was at the same time extended to cover the conditions of life of munition workers outside the factory, together with the inspection of the large number of temporary hostels for munition workers that were being provided. In addition, special provision was made for research and the collection of accurate knowledge upon which administrative action could be based. More recently the Department has been taking steps to deal with the various maternity problems which arise in munition areas. The staff, in addition to the central administrative officers, includes men and women welfare officersf charged with the inspection of conditions inside the factories, the supervision of conditions outside the factories and the inspection of hostels, medical officers charged with the supervision of the Doctors appointed to individual factories and also with advising on all health questions and special research investigators. (c) Under Section 7 of the Police, Factories, &c. (Miscellaneous Provisions), Act, 1916, the Home Office were given power to make Orders requiring special provision to be made at a factory or workshop for securing the welfare of the workers. The matters to which the section applies include : Arrangements for preparing or heating and taking meals ; the supply of drinking-water ; the supply of protective clothing ; ambulance and first-aid arrangements ; the supply and use of seats in workrooms ; facilities for washing ; accommodation for clothing ; arrangements for supervision of workers. As the result of these developments the questions now at issue are concerned not so much with the determination of general policy as with the application of agreed principles to particular cases. They are, in fact, administrative rather than advisory in character. In saying this the Committee must not be regarded as in any sense under-rating the urgent necessity for the continuance and development of the various scientific inquiries which they have initiated. .Other means can, however, be found for attaining this end, and the Comnaittee concur in the propriety of the decision of the Ministry to dis- charge their reference and to establish in their place an Office Committee in association with the Executive. 10. It has only remained accordingly for the Committee to prepare a Final Report of their pro- ceedings. In this report, which they now submit, they have endeavoured to survey concisely (even at the risk of some repetition), the nature and development of aU the various problems covered by their Memoranda. Many of the Memoranda would, in any case, have required substantial modification in view of developments which have occurred since their publication, but what is more important, the bringing together of the various matters which have been dealt with in their various Memoranda serves to emphasise in a manner otherwise impossible the close relationship and inter-dependence which exists between the problems involved. Though it is too early yet to draw any final conclusions as to the per- manent effect on the health and physical efficiency of the munition work of the abnormal conditions which have existed during the War ; it is at any rate possible to set out the extent to which normal restrictions, have been abandoned, to suggest some conclusions as to the results which have followed, and, finally, to indicate certain conclusions as to the steps which should be taken to maintain and promote permanently the health of industrial workers when more normal conditions are restored. * The conditions under which such expenditure may be met out of excess profits are given in Appendix K. t There are now probably about 800 Welfare Supervisors employed in munition factories ; of these approximately 80 per cent, are for women and girls and 20 per cent, for boys. Section II. PRELIMINARY AND HISTORICAL SURVEY. 11. At the outset of their investigation andinquiry the Committee were confronted with the width and complexity of the reference with which they were charged. It had to do with the environment of the worker and the worker himself ; it was concerned with immediate as well as remote problems ; its issues had to he viewed in relation to present exceptional and ephemeral conditions and circumBtances, and also in relation to what would be practicable and permanent after the War ; it involved the con- sideration of the health, not only of the munition worker in the narrow sense, but of all industrial labour —for all branches of labour are inter-dependent upon each other— and of many health questions, such as housing and maternity provision, which lie outside the walls of the factory or workplace ; and lastly, it raised far-reaching social and even moral questions which are not commonly thought of as apper- taining to health. The fact is that this Report of the Committee's work, though concerned primarily with the munition worker, deals also with vital principles and practical methods affecting all forms of industry. ^ Moreover, the health of the industrial worker— man and woman— is but part, essential, plastic, living, of the health of the people as a whole, which in its turn raises manifold problems of administration, economics, social relationships and even ethics, which though apparently remote from questions of medicine, are in truth, intimately associated. The nation a century ago was wise in its generation in recognising the relation obtaining between " the health and morals of apprentices," and, a hundred years later, it is found that some of the most intricate problems of health and physical efficiency are inseparable from large issues of physiology, of social relationship or morals, and of human conduct. It is sufficient to name two examples. First, there is the advent of the woman worker — an advent which brings with it new issues of physique, of physiological function, of staying power, of nutrition, of maternity. The entrance into the ranks of labour of the " young person " of either sex raises many questions concerning the development of the adolescent and the effects of labour conditions upon such growth and the national results which are likely to follow. All such questions are doubly difficult in the case of the woman worker. There has been witnessed what cannot be described otherwise than as a mighty revolution in industry, and the Committee have been deputed to study some of the physiological concomitants or efEects of this revolution. They do not profess to solve the problems thus presented. They are under no delusion in the matter. They can but open the door and invite other students to enter this unexplored region of science and labour. They are convinced that it offers a wide field for research, for careful experiment, for firm, frank and bold statecraft, for a large and sympathetic tmder- standing, which shall secure the inestimable advantages of woman's skill and energy without those irremediable and far-reaching evils which will inevitably arise if her contribution^ be not wisely and effectually safeguarded. Secondly, there is the old problem of the relation of the man to the machine. During the industrial revolution in England there was a tendency, to put it no higher, for the man to be made subservient to the machine. But physically, socially and even morally, this seems to reverse the proper order. Their investigations have convinced the Committee that to secure harmony and smooth working, to secure efficiency and maximum output, the machine must be subservient to the man ; it is his individual health, mental development and moral well-being which is the guarantee of effective labour. The reference here is not to the social relationships between master and man, or between man and man, though the proposition may be true in that regard also. It is only in respect of the physiological basis of labour and of all endeavour of whatever kind. In short, physical health is the fundamental basis. There must be a proper distribution of function of labour, a correct under- standing of the part played by nutrition, by rest, by fatigue, by health conditions, if waste is to be avoided and maximum energy attained. The human being is a finely-adjusted physiological instru- ment, which must no longer be wasted, much less destroyed, by ignorant or wilful misuse. A working man's capital is, as a rule, his health and his capacity to perform a full day's work. Once that is impaired or damaged beyond recuperation, two things happen. First, his whole industrial outlook is jeopardised and he becomes by rapid stages a liability and even a charge on the State. Secondly, if the bodily defence is undermined by stress and strain the man falls a ready prey to disease, such as tuberculosis. Therefore, as the problems to which reference is made in this report concern the future as well as the present, so also they are concerned with the new preventive Medicine which has as its object the removal of the occasion of disease and physical inefficiency combined with the husbanding of the physical resources of the worker in such a way and to such a degree that he can exert his full powers unhampered, and with benefit to himself and all concerned. 12. Any account of steps which have been taken to promote the health of workers in the engineering and other trades' with which this report is immediately concerned, must inevitably deal in a large measure with the efforts that have been made generally to promote the health of aU industrial workers during the century and a quarter which has elapsed since public opinion first became aroused on the subject. At first the health of children in cotton factories was the primary matter for concern. The evils of long hours of work and insanitary surroundings, though they had existed previously, had become accen- tuated by the aggregation of large numbers of workers in factories and by a marked increase in the demand for child labour. The children were helpless to protect themselves against the demands of the (b 12023) A 4 employer for clieap labour and against the cupidity of the parents. That any action was taken waS due partly, nio doubt, to a fear that the conditions of employment might react, not only on the health of those immediately concerned, but on that of the nation as a whole. Action was, however, mainly due to the gradual awakening of the political and social conscience which occurred during this period It was a time, not only of factory legislation, but of educational advancement and of prison reform. The awakening was religious as well as social, and the first Factory Act was concerned, not only with the health of apprentices, but with their " morals." It dealt with their education and religious traimng as well as with their physical welfare. The modem Factory Acts were only gradually evolved ; legis- lation was directed to removing particular evils as they became recognised, rather than to the realisation of definite principles, based on a critical examination of the causes of the evils. That progress was slow was due in the main to the strength and character of the individualistic views then held and to the widespread belief that any curtailment of the liberty of action of the manufacturer must be prejudicial to the national prosperity. More than half a century passed before there was any general acceptance of the principle that the State has both a right and a duty to concern itself with the physical and moral welfare of its people. 13. The movement of reform expressed itself in two ways. First, there was the individual effort of the more enlightened pioneering employers, and secondly, there was the intervention of the State through its central Board of Health and, subsequently, the factory department of the Home Office. From the days of Robert Owen, and before his days, down to the present time, there has been a succession of benevolent employers who have made it their business to provide for the well-being of their workers, and have thus set a standard and an example to the State. Wood and Walker of Bradford, who inspired Oastler, John Fielden, who, in 1836, felt he was " the trustee of the interests " of those he employed, Robert Gardner, of Preston, and others were fore-runners in a long line of famous employers who have taken upon themselves the responsibility of the care of their workers. " We manufacturers," wrote Robert Owen, " are always perfecting our dead machinery, but of our living machinery we are taking no care." The movement began with the reduction of hours of labour, but it now comprehends the whole wide compass of " welfare." The medical examination of applicants, the provision of surgeries, convalescent homes and dental climes ; a nursing staff, prevention of accidents, supervision of sick slow or backward workers ; canteen accommodation, recreation agencies, clubs, swimming baths and playing fields, libraries, allotments, educational classes ; welfare supervisors ; improved wage systems savings clubs, profit-sharing — make a formidable array of agencies for the benefit of the worker. " It is taken for granted," writes an employer, " that before any so-caUed scheme of welfare work can be of lasting good a living wage must be paid, and hours of labour and hygienic conditions must not involve the deterioration of the workers. It must be quite evident that clubs and classes, savings funds and libraries are qxdte thrown away upon workers who are overworked and underfed."* 14. It is important to observe that, with few exceptions, tlie pioneer reforms of employers were inspired by social and "moral motives rather than by scientific or economic evidence. There was, indeed, all through this long period of tardy reform, little or no appeal to the actual facts of the relation between the hours and conditions of labour on the one hand and the energy and output of the workman on the other. It seems now, on looking back, an extraordinary thing that there should have been little or no scrutiny or inquiry, no experiment, no research, no investigation into the real state of the case. Men guessed, or assumed, or were guided by their own prejudice, or at best, were compelled by humane or religious ideals. One of the first control experiments on this subject made in the workshop was that initiated in 1892 by the Right Hon. Sir William Mather in the Engineering works of Messrs. Mather & Piatt at Salford. As a result of negotiation between employer and employed it was arranged to make a year's trial (1st March, 1893-28th February, 1894) of a 48 hours' system, excluding the two hours of work before breakfast (7.45 to 12 noon and 1 to 5.30). The reStilts showed — (a) that there was an increase of .4 per cent, in the ratio of the wages cost to the turnover ; (&) that there was a saving in gas, electricity, fuel, wear and tear, &c., amounting, by coincidence, to .4 per cent. ; (c) that there was a fall in the amount of lost time from 2.4p per cent, in the 53-hour period to .46 per cent, in the 48-hour period ; {d) that though piece workers lost 1 . 76 per cent, at the beginning of the trial year, this fell to . 78 per cent, at the end ; and (e) that there was " increased cheerfulness and brightness" on the part of the workpeople. " We seem," wrote Sir William Mather in 1894, " to have been working in harmony with a natural law, instead of against it, as in the unnatural conditions of men beginning the work of the day without provision required by nature for the proper exercise of their mental faculties and physical powers. ... Of this I am assured, that the most economical 'production is obtained by employing men only so long as they are at their best — when this stage is passed there is no true economy in their continued work." The Committee have had the advantage of discussing this admirable experiment with Sir William Mather, and they are satisfied that his experience and those of other employers who followed his enlightened example of inquiry and of reform demonstrates the value to the workman, the employer and the commumty as a whole, of applying to industry the scientific method and the scientific spirit. 15. Secondly, alongside the ameliorative efforts of individual employers, sometimes guiding them sometimes guided by them, there has been the ever increasing intervention of the State. For a hundred years the movement has been slowly, with tardy steps, gaining ground. To-day, in the presence of a wide interest in "welfare," it is important to remember tbat the foundations have been laid for many * " Experiments in Industrial Organisation." By Edward Cadbury, 1912. years It is no new discovery either as need or remedy. For a proper understanding of the present situation it is necessary to take cognisance of the past. For convenience the matter may be considered under four subheadings : (i) the hours of employment ; (2) factory environment ; (3) personal well- being ; and (4) the effect of occupation on health. (i) Limitation of Hours of Employment. 16. When at the beginning of the last century public opinion first became seriously concerned mth conditions of industrial employment interest was mainly concentrated on the excessive hours of employ- ment of children and adolescents, and somewhat later of women. Though the hours of employment of men were the subject of continual agitation amongst the workers, legislation on the subject was never seriously contemplated, the action of the legislature being confined to limiting the hours of women, young persons and children, and to the provisions necessary to secure the effective enforcement of the hmiis decided upon. The earlier Factory Acts applied only to the textile industries, mainly because they were more highly developed, and regulations were consequently easier to enforce. It was not until limitations of hours, substantially as they exist to-day, had been established, that their extension to other industries was seriously considered. 17. The " Health and Morals of Apprentices Act," passed in 1802, was concerned solely with appren- tices. Their working hours were limited to 12 a day, and their employment was forbidden between the hours of 9 p.m. and 6 a.m. Except as a statement of principle this Act was of but little effect. It did not apply to the large and increasing number of children who were employed otherwise 1 ban as apprentices, and even as regards apprentices its administration was lax. It was not, indeed, until 1819 that the agita- tions headed by Eobert Owen,* himself a cotton manufacturer, led to the passing of a fresh Act under which the employment of all children under 9 years of age was prohibited, and the employment of young persons between 9 and 16 years of age was limited to 12 hours. No further development of importance occurred until the agitation led by Richard Oastler and Michael Sadler commenced about 1830. These agitations were in a large measure concerned with the establishment of a 10 hours day for juvenile workers, though it was anticipated that any limitation of the hours of children would result in a similar limitation in the hours of employment of all workers. The opposition during this period was primarily based on the view that any restriction of the hours of employment must seriously prejudice the prosperity of the country. Even as late as 1844 the view that " the longer the hours, the greater the profit," was stiU being expressed in its crudest form. 18. In 1833 Commissioners were appointed to inquire into the existing conditions and to consider the need for further legislation. They reported that children employed in the principal branches of manu- facture throughout the country worked during the same hours as adults ; that the effect of labour during such hours was, in a number of cases, permanent deterioration of the physical condition and the production of diseases whoUy irremediable, and that at the age when children suffered injuries from the labour they underwent they were not free agents. The Commissioners were accordingly of opinion that a case was made out for the interference of the Legislature on behalf of children employed in factories.f The Factory Act, 1833, which resulted from the report of the Committee, distinguished for the first time between " children " and " young persons." Children between the ages of 9 and 13 were only to be employed for 9 hours a day and 48 hours a week, while young persons between the ages of 13 and 18 might be employed for 12 hours a day. No person under 18 years of age was to be allowed to work at night, that is to say, between 8.30 p.m. and 5.30 a.m. Owing to frequent abuses a medical certificate was required that a child was of " the ordinary strength and appearance " of a child of 9 years of age. Finally, the ineffectiveness (complained of by employers and workers alike) of earlier attempts to enforce the law through persons appointed by the local justices led to the appointment of Factory Inspectors. 19. The demand for factory reform and for a 10 hours day continued, and was gradually enforced by the reports of the Factory Inspectors as to the difficulties experienced in administering the Act of 1833. The Factory Act, 1844, which was largely supported by the employers as weU as by the workers, contained numerous provisions for the better enforcement of the limitations already imposed and for preventing encroachment on meal times, but the most important innovation was the limitation of the hours of employment of all women to those permitted for young persons.| The struggle for a 10 hours day was practically ended by Factory Acts passed in 1847 and 1850, under which the hours of employment of women and yoimg persons were limited to lOJ hours (with 1 J hours for meals) a day and 60 hours a * Robert Owen stated in evidence that the reduction of hours in his own factory had not appreciably affected the output. He explained that " a larger quantity may be produced by a greater attention of the hands while the machinery is at work, in preventing breakages, and by not losing time in commencing in the morning, at meals, or when stopping at night." t While they rejected the proposal of 10 hours a day they pointed out the fallacy underlying the arguments of the opposition. " It appears in evidence that the practice of working more than the ordinary hours a day in each branch cannot be turned to account to any such extent . . . When work is protracted beyond these hours the workmen become inefficient, the quality of the work is injured, the amoimt of waste augmented and moreover, additional expense for light is incurred." Reports of " Conunissioners on employment of children in Factories," H.C., 1833, XX, XXI and H.C., 1834, XIX, XX. J As one inspector pointed out, " 12 hours daily work is more than enough for anyone ; but however desirable it might be that excessive working should be prevented, there are great difificulties in the way of legislative interference with the labour of adult men. The case, however, is very different as respects women ; for not only are they less free agents, but they are physically incapable of bearing a continuance of work for the same length of time as men, and deterioration of their health is attended with far more serious consequences to society." 10 week.while to prevent evasions of the law it was prescribed that the legal working day was to te from 6 a.m. to 6 p.m., thus coinciding in length with the legal period of employment. 20. The Children's Employment Commission, the first commission of inquiry into the general conditions of industries other than textile, was appointed in 1840 as a result of representations, made by Lord Ashley. The Commission in their first report dealt with the mining industiy ; their second report,* which was published in 1843, showed that in the metal ware and other industries children were generally employed for as long as adults, sometimes for as much as 16 or 18 hours without intermission. Night work was also common. Though the reports of the Commission resulted in legislation in regard to coal mines and the extension of the Factory Acts to certain textile industries not hitherto included, no action was taken to remedy the abuses shown to be existing in the metal ware and other non-textile trades. 21. It was not until 1862 that the second Children's Employment Commission was appointed. The inquiries of this Commission were conducted under circumstances widely different from those which had existed 20 years earlier. The extent of the restrictions on hours of employment to be imposed by the Factory Acts was no longer a matter of dispute. It was, moreover, generally recognised that the industries affected had benefited by the imposition of these restrictions. The old opposition to the Factory . Acts had largely disappeared. It is evident from the repprtsf that the character of the metal industries had widely changed during the 20 years which had elapsed since the previous inquiry. The increased use of machinery and the regulation of hours in other trades had tended to secure to a far larger degree regular hours of work. The phrase " overtime " is now used in something approaching the modern sense of hours of work in excess of the normal day. In continuous processes regular day and night shifts, and occasionally the three-shift system, are found estabUshed. The Commission quoted with approval the evidence of a number of witnesses who were opposed to overtime. The following, amongst others, were quoted : — " If over-work lasts only for a short time 20 per cent, increase of hours' labour gives only about 10 per cent, increase of result in production. If overtime is continued for any length it gives no increase of result at all. " We find that those on piece work make as much in lOJ hours as they do when they know that they have 2 hours longer. If they have been working their full time well they have not the- energy left to get through much more at the end of it. " Bad management and carelessness is the source of aU overtime. When they work on tiU 8 p.m. they get wearied — men and boys. There is quite time enough from 6 a.m. to 6 p.m. for a man to do aU he can do satisfactorily." 22. The Commission recommended the inclusion of the metal trades within the provisions of the Factory Acts, and legislation followed in 1867. Simday work was forbidden, and also night work except to a limited extent permitted for male young persons employed in iron mills and blasting furnaces. Overtime was not allowed in the metal industries. 23. The reporfcj published in 1876 of the Commissioners appointed to inquire into the working of the Factory and Workshop Acts, with a view to their consolidation and amendment, did not recommend any change in the limitation of hours of employment then imposed, and no material change has since been made. The Commission also considered in this relation the desirability of placing special restric- tions upon the occupation of married women in the interests of themselves as well as of their offspring. They, however, regarded it as impracticable to place any prohibition on the employment of women immediately before or after child-birth, and confined themselves in condemning their employment and to recommending the provision of public nurseries in factory towns. And it was not until the Factory and Workshop Act, 1891, that it was provided that an occupier of a factory or workshop shall not know- ingly allow a woman to be employed therein within four weeks after she has given birth to a child. 24. The Factory and Workshop Act, 1901, so far as the limitation of hours of employment was con- cerned, was mainly important as consolidating the law on the subject and as setting out the law as it at present exists. A summary of the principal provisions is given in Section V. 25. In 1911 a Departmental Committee was appointed on " The Night Employment of Male Young Persons in Factories and Workshops." In their report (published in 1912)§they stated that they were strongly of opinion that the employment of boys under 18 years of age at night in factories was un- desirable and ought not to be allowed to any greater extent or at an earlier age than was absolutely necessary. They considered that this applied especially to boys between 14 and 16 years of age, " when the rate of growth is most rapid and when the conditions of life ought to be rendered as favour- able as possible for mental and physical development." This Committee reluctantly came to the con- clusion that the adoption of a system of three eight-hour shifts was not generally practicable. They recommended the prohibition of all night employment of boys under 18 years of age in blast furnaces, and of boys under 16 years of age in iron mills. They considered it important that provision should be made for the periodical medical examination of boys employed at night until they are 18 years of age, at least once in six months. They added that records should be kept at the works of any physical defects or oth6r matters calling for watchfulness on the part of the occupier, the examining doctor or the inspector of factories. * House of Commons Iteport, 1843. XIH-XV. t H.C., 1864, XXII ; H.C., 1865, XX. i H.O., 1876, XXIX and XXX. § Cd. 6603, 1912. 11 26. Such, briefly, are the outlines of the story of the struggle for a standard of working hours which should not overstrain the workman. For upwards of a century the State has accumulated indisputable evidence that it is the conditions of employment rather than its character which undermine the physical strength and endurance of the worker. Apart from exceptional occupations which are in themselves injurious, the principal of the undesirable conditions, the most radical and persistent, the commonest, is that of long hours. It is a significant fact that all through the history of the industrial system of this country the dominant evil is not accidents or poisoning or specific disease, but the stress and fatigue due to long and unsuitable hours of labour, entailing inadequate opportunities for rest, recreation and nourishment. In a word, it is not the work but the continuity of the work which kills. (ii) Factory Environment. P " 27. Though in the earlier controversies of the last century public attention was primarily concerned with the limitation of hours of employment, the necessity was also recognised of attention to the environment of the worker in the factory. The Health and Morals of Apprentices Act, 1802, required that in all cotton factories in which more than 20 persons were employed (whether as apprentices or not), provision should be made for limewashing and " for a sufficient number of windows and openings in such rooms or apartments to ensure a proper supply of fresh air in and through the same." Prom the first, therefore, the importance of ventilation and cleanliness were recognised (unlike the limitation of hours of employment) as necessary for men as well as for women and young persons. 28. Various Conmiissions called attention to the matter. The Children's Employment Commission in their report, published in 1843, on the metal ware and other industries stated that— " In the great majority of instances the places of work are very defective in drainage, ventilation and in due regard of temperature, while little or no attention is paid to cleanliness." 29. The reports of the Children's Employment Commission (1862) show that, notwithstanding the great developments which had taken place during the previous 20 years in the organisation of industry, conditions in these respects remained much as before. The Factory Acts (Extension) Acts, 1864 and 1867, contained provisions in regard to cleanliness and ventilation. As a direct result of the inqiuries of Dr. Greenhow provisions for the first time appear dealing with overcrowding and with the provision of fans or other mechanical means for the prevention of the inhalation of dust. The development of opinion in regard to public health matters led to the Factory and Workshop Act, 1878, incorporating certain provisions of the Public Health Act, 1875, and requiring that the factory should be kept free from effluvia and other nuisances. 30. With the development of machinery the prevention of accidents became a question of increasing importance. The Factory Act, 1844, first provided for the fencing of machinery, though its provisions were largely confined to machinery " near to which children and young persons are liable to pass," and it was only by the Factory and Workshop Act, 1878, that requirements as to the fencing of machinery were extended to all workers. The same Act introduced for the first time restrictions as to the cleaning of machinery by women, young persons and children. Notification of accidents to the certifying surgeon, first introduced in 1 844, was now extended to cover notification also to the factory inspector. The Factory Act of 1901 consolidated the measures for the improvement of the environment, and included requirements regarding cleanliness, ventilation, lighting and sanitary accomjnodation. 31. The enforcement of legislative requirements in regard to the environment of the worker has inevitably been a gradual process. The difficulties were greater than in the case of limitation of hours, since in the main the requirements were couched in general terms, words such as " adequate " left many loopholes for evasion, and the raising of the standard was and is largely dependent upon the exertions of the workers, the employers and the factory inspectors. Nor must it be forgotten that pari passu with improvement in factory environment there has been an immense advance in general sanitation outside the factory. (iii) Personal Well-being of the Worker. 32. Since the earliest developments of the factory system there have always been employers who have not felt their social and moral obligations satisfied by fulfilment of the minimum requirements of the law, but have actively concerned themselves in promoting the health and welfare of their workers, not only by providing clean and well ventilated work places and moderate hours of employment, but by providing facilities for obtaining food and by other means outside the ordinary range of factory manage- ment. Thus one of the special commissioners appointed to make inquiries for the Commissioners on the Employment of Children in 1833 reported that— " The greatest mills I have always found to be the cleanest, the machinery most securely fenced off, and the hands of the neatest and most respectable appearance ... In Messrs. Strutt's miU at Belper each hand is allowed a pint of good tea or cofEee, with sugar and milk, for Jd., and medicpl assistance gratis. A dancing room is also found for them in this establishment." 33. In one of the earliest reports of the factory inspectors it is stated — " In some cases an active and anxious interest in the welfare of those employed has been evinced by the establishment of institutions and difierent regulations for the improvement of their moral and social condition which have been productive of great advantage. Some of these institutions have in view the providing of medical advice and medicines when ill, and occasionally pecuniary assistance during sickness." 12 Such cases were, however, exceptional, and there is no douM that it was not usually considered a part of the duty of the employer to make any special provision in these respects. 34. The Children's Employment Commission reported in 1843 that — " Even in those trades and manufactures in whioh deleterious substances are used there is in general no accommodation for the workpeople to change their clothes on leaving the place of work, or to wash themselves if they remain at meal times ; and it is very uncommon for any means to be provided for workpeople to dress and warm their food." 35. In the report of the Eoyal Commission on Labour,* there is considerable evidence as to the need for increased interest being taken in these matters, especially as regards women — " In ordinary employments the lady Assistant Commissioners call attention to various common causes of unhealthiness such as the absence of places for drying outer clothes when wet, absence of dining rooms and provision of hot water, or means of cooking or obtaining proper food in or near works." 36. In this gradual development of opinion as to what is needful to secure the well-being and efficiency of the worker, the factory inspectors have played animportant part ; though primarily concerned with the enforcement of the law, they have inevitably developed a wide^r view of their responsibilities. Since the first appointment of women inspectors, in itself a significant fact, this movement has been increasingly valuable, and the Annual Eeports of the Chief Inspector contain constant evidence of the interest shown in such matters as the provision of washing facilities, baths, cloakrooms, overaUe, canteens and messrooms. The influence of these wider views has, moreover, not been limited to individual employers and factories, but has led to the insertion, with the concurrence of the employers concerned, in Orders governing employment in certain " dangerous " trades of elaborate requirements binding upon the whole trade. (iv) Effect of Occupation on Health. 37. Though individual writers had already drawn attention to the effect of difEerent occupations upon health, it was in the beginning of the nineteenth century the common view that all occupations were equally healthy, provided that the hours of employment were not excessive and the conditions of ventilation and cleanliness were reasonable. It was only gradually that the influence of occupation upon health became more fully appreciated. The Commissioners on the Employment of Children in 1833 reported as follows : — " That this excessive fatigue, prevention of sleep, pains in various parts of the body and swelling of feet experienced by young workers, coupled with constant standing, the peculiar attitudes of the body and the peculiar motions of the limbs required in the labour of the factory, coupled with . . . the impure atmosphere did sometimes terminate in the production of serious permanent and incurable disease." 38. About the same time Dr. Turner Thackrahf drew attention to the effects of the principal trades and professions on health and longevity. He pointed out that mortality was greater in the manufacturing districts, and called attention to the effect on health, not only of atmospheric impurities and excess of labour, but also of dust and gaseous impxirities, postuie, muscular effort and other conditions of employ- ment. He pointed out that in many occupations injurious conditions existed which might be imme- diately removed or diminished. 39. The Children's Employment Commission (1840) which was the first Commission to make investigations into the conditions outside the textile trades, reported that — " The work in which children and young persons are employed is seldom in itself oppressive, or even laborious ; and very few iudeed of the processes in the care and management of which children take any part are in their own nature injurious ; but to this there are some lamentable exceptions in certain processes con- nected with the manufacture of metal wares, earthenware and of gkss." 40. In 1853 and 1854 were published two reports by Mr. A. G. Finlaison, the Actuary of the National Debt, on the subject of sickness and mortality among members of friendly societies. He showed that the demand for sickness allowances depended, not so much on difference of locality or on the density of the aggregation of the population, as upon the amount of the expenditure of physical force.J 41. In 1857 Dr. H. Greenhow, Lecturer on Public Health at St. Thomas's Hospital, made an elaborate investigation into the incidence of mortality from lung disease and other causes. He found that there existed no fixed relation between the prevalence of pulmonary affections and the size of towns. He suggested that various disturbing causes seemed capable of displacing the normal proportion and, of these, probably occupations and modes of life were the most influential. "It is well ascertained that the great mortality among grinders and cutlers arises from the irritation, caused by the mechanical particles produced during the process of manufacture and received into the lungs with the air in respiration." 42. This report was published by the Board of Health, with an introduction by their Medical Officer Sir John Simon. The Public Health Act passed in that year led to the transfer of powers of the Board to the Privy Coimcil, and one of the earliest acts of Sir John Simon as the Medical Officer of the new * H.C., 1893, XXXII— XXXIX. t " The Effect of Arts, Trades and Professions on Health," by C. Turner Thaokrah, 1832. J " The only practical difference in the distribution Of sickness that can be discovered was seen to turn on the amount of physical force called out by the occupation of the contributors ; other features of the employment, the circumstances of the place, or of shelter or exposure under which that occupation was carried on, seeming to have but very minor influence on the question." 13 Central Authority was to instruct Dr. Greenliow to in-vestigate on the spot the conditions in certain areas where lung diseases were specially prevalent.* Dr. Greenhow included amongst the conditions which his inquiry had shown to be direct causes of pulmonary disease, the inhaling of fine dust of metal and the breathing of air polluted by fumes or overheated: Other causes included habitual exposure to hot and exceedingly moist atmosphere, working in ill-ventilated and overheated factory rooms vicissitudes of temperature and strained posture. 43. The inquiries of the Children's Employment Commission (1862) showed that, in spite of the general development of industry, many of the evils revealed by the Children's Employment Commission, appointed in 1840 still existed and called for redress.f Though primarily concerned with the conditions of employment of children and young persons, the Commission necessarily dealt with many conditions, which affected all workers. The conclusions of Dr. Greenhow, which were fully confirmed by their own inquiries, were freely quoted. The Factory Acts (Extension) Acts, 1864 and 1867, which followed, marked the end of a stage. Parliament had intervened to remove certain general conditions of employ- ment obviously prejudicial to health. Though the reports of the Eegistrar-General have constantly drawn attention to the influence of occupation upon mortality, public interest and scientific inquiry have since been largely diverted to questions affecting the health and welfare of the worker outside the walls of the factory. 44. The Education Acts, 1870 and 1876, placed education within the reach of every child, and estab- lished compulsory attendance. The Sanitary Act of 1866 was foUowed by the Public Health Act, 1875, which is still the principal measure dealing with aU questions of public health. That any further general intervention by Parliament was imnecessary in the trades already under the Factory Acts was the considered opinion of the Commission on the consolidation and amendment of those Acts, which reported in 1876. For the future legislation was to be largely confined to dealing with the special conditions of particular industries. It took two forms. First, Acts were passed dealing with single industries, such as laundries ; and secondly, the State was given power to confirm, or later themselves to make, codes of regulations specially designed to protect the worker against the effects upon health of " dangerous " trades or processes. 45. Under the influence of Dr. Greeniow's reports the Factory Acts (Extension) Acts, 1864, and 1867, conferred upon employers the power, with the approval of the Secretary of State, to make special rules to secure the requisite conditions of cleanliness and health. Further, where any process was carried on by which dust was generated and inhaled by the workman to an injurious extent the Inspector was given power to require the provision of a fan or other mechanical means for the prevention of inhalation. Under Section 8 of the Factory and Workshop Act, 1891, if the Secjetary of State certified any machinery or process as dangerous or injurious to health, the Chief Ins^ctor might, subject to certain safeguards, niake proposals and require the adoption of special methods. These rules, like those made under the Act of 1864, only referred to single factories. Section 28 of the Factory and Workshop Act, 1895, strengthened these powers and extended them to cover rules prohibiting employ- ment, or modifying, or limiting the period of employment for all or any class of persons. 46. Finally, the Factory and Workshop Act, 1901, consolidated previous legislation which had for its object the protection of the health of the worker. It conferred powers upon the Secretary of State to make regulations applying to all factories where particular processes injurious to health were in operation. The regulations are normally divided into two parts — the duties of the employer and the duties of persons employed. They deal with such matters as the removal of dust or fumes, method of manufacture, certificates of fitness before employment, periodic medical inspection, suspension of affected persons, costume (overalls, respirators, clogs, gloves, &c.), provision of messrooms and cloakroom, provision for the partaking of food in workplaces, and washing and bath accommodation. The Act also continued the power given by previous Acts to the inspector to require the provision of a fan or other means for preventing inhalation. A provision first included in the Factory and Workshop Act, 1895, is also continued, imder which the Secretary of State may require the notification of certain diseases contracted in the factory or workshop, including those arising from lead, phosphorus, arsenic, mercury or anthrax. By special Order of 1916 this provision was extended to toxic jaundice. J 47. In addition to dealing, as has been seen, with the hours of labour and factory sanitation, the Act of 1901 carried further previous enactments for the safeguarding of personal health. Home work was brought rmder special control ; notification of the occurrence of industrial poisoning was extended ; dangerous machinery had to be more strictly fenced, and certain dangerous employments were for- bidden to young persons ; and lastly, the provision of the Act. of 1891 that a woman might not be employed within four weeks of giving birth to a child, received under the new Act increased administra- tive attention. * Reports by Dr. Greenhow are included in the third and fourth reports of the Medical Officer of the Privy Cotmoil which were laid before Parliament in 1860 and 1861. t Thus of one centre of the metal industry they report that — " Considering, therefore, the early age at which the children go to work, the injurious state of their places of work, the lowering and exhausting modes of their emplojrment, the unreasonable and excessive hours of work, irregular and undefined hours for meals, late work on Saturdays, or extra work in the earlier part of the week to make up the time granted for relaxation on Saturday afternoon, and exposure to frequent accidents of all kinds from machinery, it will be acknowledged that on physical grounds legislative interference is required as a protection to the young in this large and ianportant department of manufacture." J Under Section 8 of the Workmen's Compensation Act, 1906, the Secretary of State has power to make Orders extending the provisions of the Act to diseases contracted in the course of employment. 14 48. In submitting tlieirlleporttlie Committee desire to make certain quaUficatioDB and reservations for the consideration of those who study its pages. Krst, they wish to express the view that a true understanding of the questions dealt with in the report is only practicable if the facts and findings set out in these pages are considered in relation to the history of industrial hygiene in England. There is no greater mistake than to suppose that care for the health of the worker and the introduction of welfare supervision are new and untried ideas invented, or at least patented, by the Committee. In this matter, the Committee enter into other men's labours ; but to them has been given the opportunity of urging the application of previous knowledge in a great national emergency, rapidly and on a con- siderable scale. During the last 20 years immense progress has been made under the Factory Depart- ment of the Home Office in many of the essentials of health in the workshop. The reports of the Chief Inspector of Factories have set out year by year the milestones of this advance. For several years before the European War there were not wanting signs that employers were beginning to recognise the importance of humanising the life of industrial workers and providing for them better conditions, and the Police, Factories, &c. (Miscellaneous Provisions), Act of 1916, promoted by Mr. Herbert Samuel when Home Secretary (which passed Parliament subsequent to the issue of the Committee's first reports), is evidence of the desire .of the central authority in the same behalf. Secondly, the Committee wish to point out that in spite of the great progress which had been made it remains true that up to 1914 relatively little attention had been paid by employers and others responsible to the steadily accumulating evidence of the influence of occupation upon health, and but little effort had been made scientifically to investigate its causes. Efforts to protect the health of industrial workers had been mainly based on the need of mitigating or removing admitted evils as they arose, rather than on the actual results of scientific inquiry and research. No doubt, partly as a result of the appointment of medical inspectors by the Home Office, increasing attention had in recent years been devoted to the critical examination of certain " dangerous " trades ; but most trades are not " dangerous," and the vast bulb of industrial disease did^not find its origin in dangerous trades. Yet there is the strongest evidence that rates of sickness and mortality amongst males had been materially affected by occupation. In spite of this well known fact much remained to be learned as to what are its causes, whether they are peculiar to individual occupations or are common to many, whether they are the same for sickness as for mortality, to what extent they depend upon variable factors, and to what extent they are removable. Then as to the injurious effects of industry upon women and young persons, reliable date may be said to have been almost wholly lacking, as they are equally lacMng in respect of the relation of fatigue to disease. Again, the proper length and distribution of hours of labour — spells, pauses, overtime — ^in relation to output is another problem which has never yet been scientifically explored. The Committee here also found themselves without data. Once more^ though attention is now being given to so-called " scientific management," evidence is still wanting to show how far the speed of working can be increased or the method modified without involving an undue physical or mental strain on the worker, which counterbalances or even destroys the advantages claimed. In the absence of reliable data on these and other problems of industrial organisation, the difficulties in the way of a wise handling of the special problems arising out of the War have been greatly increased. The Committee mention these points with a view to laying emphasis upon the imperative need of a more accurate understanding and a firmer and more comprehensive grasp of the whole problem of health and physique in relation to industry. In the Committee's view it is necessary to make arrange- ments, without delay, for a national sc^heme of industrial medical research, and to accord fuller recognition to the importance of industrial hygiene. 49. Thirdly, it is important to remember that the work of the Committee has been concerned with an emergency. The situation to be explored was continually changing and expanding. It would have been improper and impracticable to undertake any investigation which delayed output or interrupted the arrangements of the factory. Consequently the Committee have been debarred from making various experiments and inquiries which had suggested themselves as likely to contribute to the elucida- tion of the matters referred to them. Notwithstanding these limitations, there has been, during the period of the Committee's labours and owing to the public spirit and foresight of the Ministry and of directors, proprietors, managers, foremen and workpeople, a very remarkable advance in all that makes for industrial betterment. The munition worker is a type of all workers, and the principles of the present Report concern, in fact, all forms of industrial labour. The^ Committee earnestly hope that every effort will be made to secure this progress as a permanent gain to the whole nation. 50. Lastly, the Committee recognise that the various questions raised in the present report are intimately related to larger social and industrial problems, which lie outside their reference, but as to which they are deeply concerned. First and foremost there is the fundamental question of sjiorter hours of labour from a political and economic point of view (as well as from a health point of view) ; the Committee are convinced that this question lies near th^oot of the whole labour problem. Secondly, there is the far-reaching issue of the social and economic conditions of women's labour (over and above the issues of health with which the present Report deals), a matter of vital importance to the future of the British race, for the health jconditions of women are even more inseparable from the social condition than in the case of men. Thirdly, there is the question of the solidarity of industrial society, the inter- dependence between employer and workman, which is closely related to the whole issue of the status, health and physical equipment of the worker. And fourthly, there is the title of the worker to an effec- tive voice in regard to the conditions under which he works. If industry be indeed a national service, the object of those engaged in it is the good of the community as a whole, and the worker should have a fair and legitimate share in the responsibility of the transaction. The Committee are convinced that these four problems must be faced and solved if ever the State is to lay sound foundations for the health and physical efficiency of the industrial worker. 15 Section HI. RELATION OF FATIGUE AM) ILL-HEALTH TO INDUSTRIAL EFFICIENCY. Introduction. 51. The personal health and physical efficiency of the munition worker, as of all industrial workers, are measurable by two standards — first, that of fatigue, weariness and exhaustion of the healthy physical faculties and functions of the individual ; and secondly, that of disease. _ It is not possible always to difierentiate these two departures from the normal, or to say when fatigue passes beyond the confines of what is physiological to that which is pathological. It is obvious there comes a stage in the processes of fatigue where recovery in any individual falls short of the diurnal rhythm of rest and work, and its degree or character is so severe as to be, in fact, a form of disease. Indeed, the truth of this proposition is one which is necessary to a sound understanding of the problem which presents itself. It is necessary to widen the whole view and apprehension of the subject of health and disease in relation both to industry and to the personal welfare and capacity for work of each workman. The science and art of Medicine is not restricted to the diagnosis and cure of disease in its gross forms ; it includes also a knowledge of how disease comes to be, of its earliest beginnings, and of its prevention. It is, in fact, the science and art of Health, of how man can learn to live a healthy life at the top of his capacity of body and mind, avoiding or removing external or internal conditions unfavourable to such a standard, able to work to the highest power, able to rest to the fullest, growing in strength and in the joie de vivre. The new Preventive Medicine must not be understood to consist only of sanitation, of the isolation from the commimity of cases of infectious disease, of disinfection and outward cleanliness, and of the registration of births, deaths and other vital statistics. These are, of course, matters of the first importance. But much more is required. The individual man as an animal — the body in all its parts, the senses and their functioning, the nutrition of the body, its growth and development, its capacity for work, its powers of resistance — must receive practical consideration. The fight against disease is something more than the closing of its channels of communication, something more than an avoidance of the ways and means of its infection and invasion, certainly much more than a registration of its effects, a record of the morbidity and mortality which foUow in its train. The turning point of the battle is elsewhere. The first line of defence is a healthy, well-nourished and resistant human body. And to this end the whole man must be dealt with, for he is something more than animal. His body is in greater or less degree the instrument and expression of emotion, intellect and will. There is thus a psychological aspect of preventive medicine hitherto greatly neglected. Nor is the individual, taken at any one moment, the whole of the issue. There is his life history, his heredity, his family, his domestic life, has personal habits and customs, his home as well as his workshop. In short, preventive medicine to be effective must deal with the man, the whole man, as an individual as well as a member of the community. Whilst this is true of preventive medicine geneiraUy it is particularly true in regard to that portion of it which has been referred to the Committee for examination. The subject of industrial efficiency in relation to health and fatigue is thus in large degree one of preventive medicine, a question of physiology and psychology, of sociology and industrial administration. Before dealing with many of the practical questions involved the Committee think it desirable to refer briefly to some of the principles underlying present knowledge of fatigue and personal health, for upon a right understanding of fatigue, its causes and its relation to efficiency, the practical solution of the problems raised seems to depend. : Definition and Causation of Fatigue. 52. Fatigue is the sum of the results of activity which show themselves in a diminished capacity for work. — ^In ordinary experience fatigue is generally associated with familiar bodily sensations and these sensations are often taken to be its measure. It is of vital importance for the proper study, of industrial fatigue, however, to recognise not only that bodily sensations are a fallacious guide to the true state of fatigue which may be present, and a wholly inadequate measure of it, but also that fatigue in its true meaning advances progressively, and must be measurable at any stage by a diminished capacity for work, before its signs appear plainly, or at aU, in sensation. 53. In the animal body the performance of work depends on the activities of parts which are best considered under three groups : — First, the complex nervous mechanisms of the brain and spinal cord, which are concerned in the initiation and distribution of impulses to action. Second, the nerves, which conduct the impulses to muscles ; and Third, the muscles themselves, which by contracting finally perform external work. Fatigue has been separately studied in aU these parts. In its essential features the fatigue of aU alike has been found, when it occurs, to depend not upon the simple Tising up — " exhaustion " — of the sub- stances supplying the chemical energy which is liberated during work, but upon the accumulation within the living elements of the products of the chemical changes involved. Fatigue of the animal machine, that is to say, is not to be compared with the failure of fuel as in a steam engine, or with the running-down of a clock weight, but rather with the clogging of the wheels in some mechanism by dirt. 54. The chemical products of activity in the nervous and muscular elements are removed by the blood, in part directly by irrigation and in part indirectly through chemical changes in the tissue itself produced by constituents of the blood. Rest after activity is not a passive state, therefore, but is itself 16 an active process, or a series of active processes, leading to a restoration of the normal capacity for work. Time is required for these, and the time taken will be in proportion to the amount of restoration needed. There will be a definite relation accordingly between the degree of any given activity and the time necessary for the completion of the subsequent restoration process. If the activity is repeated too quickly to give time enough for restoration after each action, fatigue wiU become progressively more intense as the debit balance accumulates, and each repeated act in consequence will be more and more impeded, and will become smaller, until further action is impossible. 55. Of the three groups of organs just mentioned, the nervous system, the nerves, and the muscles, particular chemical and structural characters wiU decide in each case what time-relation must exist between action and the rest needed for complete repair. In the tired man the symptoms of fatigue are referred to the muscles ; they ache, or they may appear to " give way tmder him," but in reality the most severe bodily activity fails to produce any close approach to complete fatigue of the muscles. The fatigue is fatigue of the nervous system, though in sensation its effects may be referred to the muscles themselves. A hunted animal may be driven to intense muscTilar fatigue, but in this extreme case the blood becomes charged with chemical products of activity, for the elimination of which no opportunity is given, and the muscles, with every other organ of the body, become poisoned. Even in laborioii work it is doubtful whether a man by voluntary effort can cause his muscles to approach advanced fati^e. It is well known that a man apparently " run to a standstill " in a race may upon some new excitement run freshly again, under augmented stimulus from the nervous system, initiated there perhaps in part along new paths. The problems then of industrial fatigue are primarily and almost wholly problems of fatigue in the nervous system and of its direct and indirect efEects. The Ehythm of Action and Eest. 56. The necessary time-relation between an action and the recovery from it in rest has been men- tioned already. For every acting element a given rhythm of activity will allow exact recovery after each act, and wiU maintain the balance between action and repair throughout a long series. The heart, for instance, in alternating contraction and relaxation, may continue to beat incessantly through the life of a man without any accumulated fatigue for 70 years or more. Among the great variety of nerve centres there wiU be found a great variety in these time-relations. Some may allow a relatively raoid rhythm, as in the act of breathing, where the rhythm, which is a nervous rhythm, may be almost incessant for years, while at the other end of the scale there are sloWfer rhythms like those shown in the need for diurnal sleep. 57. In connection with this natural pace of the animal machine, to and fro, from action to rest, refer- ence must be made to the wide adaptability of the animal mechanisms, and especially to that of the nervous system, in response to training, use and habit. Complicated co-ordinations in the nervous system, at first easily fatigued, may by training, and, as it seems, by some improvement in the routes of connection due to the increase of traffic itself, become capable of maximum efficiency at a more rapid rhythm. A man will swing each leg, weighted with a heavy boot, as in walking, for 10,000 times in an unbroken march without notable fatigue, but he cannot as an impromptu exercise raise his lightly weighted finger for more than a few score times at no faster rate before the movement comes to complete standstill. 58. The problem of scientific industrial management, dealing as it must with the hmnan machine, is fundamentally a problem in individual capacity, physical and mental, and in industrial fatigue. The rhythms of industrial conditions required by the hours of labour, the pace of machinery or that of feUow-workers, or otherwise, are imposed upon the acting bodily mechanism from outside. If these industrial rhythms are faster than the natural rhythms of the body they must produce accumulated fatigue, and cause an increasing debit, shown in a diminished capacity for work. It is therefore the problem of scientific management to discover in the interests of output and of the maintained health of the workers what are the " maximal efficiency rhythms " for the various parts and faculties of the human machine. These must be determined by the organised collection of experience or by direct experiment. They must be separately determined, moreover, not only for the performance of relatively simple muscular movements, all of which depend on the action of " lower " nervous centres, but also for the manifold faculties of the various systems of the body, and for the " higher " co-ordinating centres, and for aU of these the natural rhythms must be studied for the best arrangement of industry, the hours, shifts, spells, pauses, the periods of sleep and holiday on the one hand, and the conditions of factory environment on the other. Signs and Symptoms of Fatigue. 59. It must be repeated that the bodily sensations of fatigue are not a measure, or even an eariy sign, of it. Eeal or objective fatigue is shown, and is measurable by the diminished capacity for per- forming the act that caused it. Bodily Fatigue. 60. Fatigue following muscular employment is primarily nervous fatigue, as explained already, and it has been seen that no advanced degree of muscular fatigue as such can be obtained by voluntary action, for fatigue in the nervous system outstrips in its onset fatigue in the muscles. In accustomed 17 actions, however, as in walking or digging, where there has been habituation, the activity may be so prolonged without great nervous fatigue as to give approaching " exhauption " — that is, notable loss of chemical substance — ^in the muscles. Industrial work is habitual work, but the case in which muscular labour is so intense and prolonged as to give exhaustion in this sense need not be considered here, nor the causation of the special symptoms which arise. It must be noted, however, that prac- tically the whole of the mechanical energy and heat yielded by the body during work com§8 from the chemical energy stored in the muscles. In proportion as this store is called upon, and quite apart from the question of fatigue, it must be made good by supplies from the blood, and ultimately from the food. Practically the whole of the energy transformed in the muscles is derived from carbohydrate material, and the importance of this in relation to the diet of workers is well known. 61. Whilst referring to this point of muscular fatigue, the Committee wish to record the view that for work in which severe muscular effort is required it seems probable that the maximum output over the day's work and the best conditions for the workers' comfort and maintained health, will be secured by giving shcyrt spells of strenuous activity broken by longer spells of rest, the time ratio of rest to action being here, for maximal efiEiciency, greater than that for the employments in which nervous activity is more prominent or more complicated than in the processes involved during familiar muscular work. Nervous and Mental Fatigue: 62. It is under this head, as has been seen, that the special problems of industrial fatigue arise. The signs and symptoms of the fatigue will depend upon the nature of the particular work done, whether it be general bodily work of this or that kind, carried out in fixed routine, or whether it involve mental activity of a simple or of a more complicated kind. The fatigue may spring — (a) from the maintained use of intelligence and observation with varying degrees of the muscular effort necessary in every kind of work ; or (6) from the maintenance of steady concentration upon one skilled task ; or (c) of dis- tributed attention, as when several machines are to be tended or other manipulations performed ; or {d) it may depend upon the continued use of special senses and sense-organs in discrimination, whether by touch or sight ; or (e) upon other parts of the body acting upon the nervous system. It will be affected greatly according to whether the worker has opportunity for obeying his natural rhythms, or whether unnatural rhythm is imposed upon him by the pace of the machine with which he works or by that of his fellow-workmen. Considerations so inexplicable at present in terms of physiology as to be called " psychological " will also arise ; if the work is of a " worrying " or " fussy " kind, with a multiplicity, that is to say, of imposed and irregular rhythms, fatigue will be more rapid, perhaps on account of the more numerous, and " higher," nervous centres which become implicated. 63. Monotonous work — and much industrial work is monotonous — ^presents some special problems. It has been seen that uniformly repeated acts tend to become in a sense " automatic," and that the nerve centres concerned become less liable to fatigue — the time ratio of necessary rest to action is diminished. But when monotonous series are repeated fatigue may appear in what may be called the psychical field, and a sense of " monotony "may diminish the capacity for work. This is analogous to, if it does not represent, a fatigue process in unrecognised nervous centres. Conversely, "interest" may improve the working capacity even for a uniform monotonous activity, and the interest may spring from monetary incentives, emotional states, or, as some think, from states of anticipatory pleasure before meal-time and rest (" end-spurt "), or, again, from a sense of patriotism eager to forward the munitions output. 64. For practical purposes in industrial management two chief characteristics of nervous fatigue must be observed. First, during the continued performance of work the objective results of nervous fatigue precede in their onset the subjective symptoms • of fatigue. Without obvious sign and without his knowing it himself, a man's capacity for work may diminish owing to his unrecognised fatigue. His time beyond a certain point then begins to be uneconomically spent, and it is for scientific management to determine this point, and to determine further the arrangement of periods of rest in relation to spells of work or other body or environmental conditions that will give the best development over the day and the year of the worker's capacity. Second, the results of fatigue which advances beyond physio- logical limits (" over-strain ") not only reduce capacity at the moment, but do physical or mental damage of a more permanent kind which will affect capacity for periods far beyond the next normal period of rest. It will plainly be uneconomical to allow this damage to be done. 65. For these reasons, chief among others, it is important to detect latent fatigue at the earliest opportunity, and since sensations of fatigue are unpunctual and untrustworthy, means must be sought of observing the onset of fatigue objectively. Tests of Industrial Fatigue. Output. 66. The true sign of fatigue is diminished capacity, of which measurement of output in work will give the most direct test. The output must be measured under the ordinary conditions of the work, and, in cases where from the nature of the work the output cannot be automatically measured, it must be tested by methods which do not allow the workers to be conscious at particular times of the test being made. In this way the errors due to special effort from interest or emulation will be eliminated. The results of work expressed in output must be corrected by allowance for all variable factors save that (b 12023) B 18 of the worker's changing capacity ; changes in supply of steam or electric power and of raw materiali for instance, must be determined, for correction and interpretation of the actual output returns. The output must be estimated for successive short periods (e.g., each hour) of the day's work, so thp.t the phenomena of " beginning-spurt " and " end-spurt," and other variations complicating the course of fatigue as such, may be traced and taken into account. Isolated tests of output taken sporadically will be misleading. The records must also extend over longer periods to show the onsel; of fatigue over the whole day and over the whole week, and under particular seasonal or other conditions, in order to detect and measure the results of accumulating fatigue. 67. Measurements of output must obviously be recorded at so much for each individual or for each unit group. The size of total output will be meahingless of course without reference to the numbers engaged . But it will also be important for proper management to take account of the output of particular individuals. This in many factory processes is easily possible, and when it has been done the results have shown surprising variations of individual output which are independent of personal willingness and industry, and have generally been quite unsuspected by the workers and their supervisors before the test was made. Information so gained is valuable in two respects'. Good individual output is often the result of escape f ];om fatigue by.conscious or unconscious adoption of particular habits of manipulation or of rhythm. Its discovery allows the propagation of good method among the other workers. In the second place, these tests of individual capacity (or its loss by fatigue) give an opportunity for a rearrange- ment of workers and their assignment to particula;r and appropriate processes of work. Astonishing r^ults, bringing^ advantage both to employer and employed, have been gained in this and other countries by the careful selection of individuals for particular tasks^ based not upon the impressions of foremen but upon the results of experiment. .6^. In passing it may be said that if the proper adaptation to particular kinds of labour of the relations of spells or shifts of work to rest intervals and to holidays is to be determined, as it can alone be, by appeal to experiment, it will of course be an essential condition for success that' the workets should co-opetate with the employing manageinent and give their highest voluntary efforts towards the maximum output during the spells of work. It is not surprising that where employers, following tradition rather than experiment, have disobeyed physiological law in the supposed interests of gain— and for a century this has been almost universal— the workers have themselves fallen very conimonly into a tradition of working below their best during their spells of labour. In so far as hoixirs of work in excess of those suitable for maximal efficiency havie been imposed, during the last two or three genera- tions of modern industry, upon the wofkers a tradition of slowed labour must necessarily have arisefi, probably in large part automatically, as a kind of physiological self -protection. Without solne conscious or unconscious slackening of efiort ihdeed during working hours of improper length in the past, tW output Height have been even more unfavourable than it is known to have been for the hours of work consumed. Accidents and Spoiled Work. 69. An important and early sign of fatigile in the nervous centres is a want of co-ordination and failure in the power of concentration. This may not be subjectively realised, but may be shown objectively in an increased frequency of trifling accidents, due to motoaentary loss of attention. Such accidents may result in personal damage to the worker, trifling or serious, breakages of tools or materials, or the spoiling of work. In well-managed factories the incidence of accidents of this kind is recorded for unit periods throughout the day, and these records may provide a good secondary index to fatigue; but only in so far as they are corrected by reference to the rate of work being done and other variables. The subject of Accidents will be considered subsequently. Associated Fatigue and Laboratory Tests. 70. The primary sign of fatigue in a given fxmction is diminished capacity. But there is evidence to show that accumulated fatigue in connection with a given act may afiect adversely the condition of other parts of the nervous system not immediately employed. There is little experimental knowledge, however, as to whether this effect, shown in " associated fatigue," is more direct and definite in kind than the effect upon general health to be mentioned below. The appearance of associated fatigue will need for its detection and study the application of special tests, involving the use of suitable apparatus and laboratory accommodation. 71. It should be remembered, however, that experiments of this kind will have no validity unless the fallacies due to einotions and ideas, such as a sense of novelty, iniierest in the desired result, anticipation of release from experiment, unconscious suggestion by the observer, and so on, are eliminated by the most rigid attention to experimental conditions and by long series of control observations. The objects of experimentation must be trained for the purpose, and it is unlikely that tests of this kind will offer results of sufficient value to justify the special education of teams of selected workers for the prolonged studies which the method demands. 72. In view of the fact that the Committee's sphere of experiment and observation comprised actual factories and workshops in all parts of the country, they have not engaged in any laboratory tests of fatigue, mechanical methods, experiments with the ergograph, etc. They haye preferred to make their investigations of fatigue under conditions actually obtaining in the industrial world and comprising many individuals instead of few, 19 Lost Time wnd " Stateness " 73. The accumulated results of fatigue, are damaging to general health, and they will be reflected in the sickness returns and in the returns. of lost time. Many problems arise here which cannot now be discussed in detail,* and they are complicated by the influence of other factors. 74. Reference must be made here, however, to a pronounced andcommonsymptomof industrial fatigue, which appears to be the reflection in the workman of the results of accumulated nervous fatigue rather than a direct and measurable sign of it. In many munition factories the complaint has been made by workers, and not least by the most intelligent and willing of them, that they are feeling " done up " or " fair whacked," to use local phrases, and the evidence shows that this state of " staleness " has been corhmon and obvious. By experienced managers and medical officers this condition of staleness is attributed almost wholly to persistent long hours and the deprivation of weekly rest. It has grave accompaniments, which paradoxically appear not only in a state of lethargy and indifference, but also in a craving for change and excitement. No doubt the restlessness of the condition must often pre- dispose also to indulgence in the apparent alleviations given by alcohol. At all points the state is apt to set up a vicious circle in which the very need for change and rest prevents the proper use of such chances of rest as are given. 75. The Committee hold the view that proper attention early in the War to the need for a weekly rest would have prevented a large part of the diminished capacity of this kind that was allowed to appear, and would have averted much costly and wasteful expenditure upon imperfect work. But stress must be laid here on a further point. For the avoidance of staleness in conditions of strenuous labour it is not enough to treat workmen in the bulk and to regidate daily and weekly rests upon a physiological basis devised for the average. Good management will conBider always the individual workman as well. The Committee have no doubt that in many cases, in which staleness is well marked or has even advanced to definite sickness, a single "day off," given occasionally at the right .time, would have avoided much wasteful reduction of capacity and in the worst cases the total loss of many days of work. The Study of Industrial Fatigue and Ill-health. 76. By studies of industrial fatigue measured by tests of individual output a large body of valuable information has already been gained in various countries, and its application wherever management is scientific has become a commonplace of administration. f It must be admitted, however, that in England, and no doubt to the detriment of both health and wealth, management based upon the experi- mental science of industrial fatigue is far less common than in the factories and business concerns of America and of Germany. Hitherto there has been a surprising uncertainty commonly found in this country, even where professional knowledge is to be expected, with regard to the proper solution of some of the most elementary practical problems of labour management. 77. There is the most urgent need for the application of the results of experience scientifically acquired. Upon a sudden national emergency the accumulation of fatigue and its results in workers may well be temporarily disregarded, but when the race is to be a long one, a failure to conserve the maximum efficiency of the workers must be disadvantageous. Misguided efforts to stimulate workers to feverish activity in the supposed interests of industry or national welfare are likely to be as damaging to the desired result as the cheers of partisans would be if they encouraged a long-distance runner to a futile sprint early in his race. Even during the urgent claims of a war the problem must always be to obtain the maximum output from the individual worker which is compatible with the maintenance of his health, strength and capacity. Life itself must not be sacrificed to output. In war time the workmen will be willing, as they have shown in so many directio&s, to forego comfort and to work nearer the margin of accumulating fatigue than in time of peace, but the country cannot afford the extravagance of paying for work done during incapacity from fatigue just because so many hours are spent upon it,t or the further extravagance of urging armies of workmen towards relative incapacity by neglect of physiological law. , , 78. The Committee have found an increasing number of instances in which the onset of industrial fatigup has been avoided — (i) by intelligent observation of the output ; (ii) by regular study of the returns of sickness and of lost time ; (iii) by prompt initiative in adapting the hours and conditions of work to physiological need ; (iv) by providing proper facilities for the feeding, resting and recreation of the worker. These cases are, however, still far from universal. Taking the country as a whole, the Committee are bound to record their conviction that conditions of reduced efficiency and lowered health have often been allowed to arise which nnght have been avoided without reduction of output by attention to the details * Further reference is made to this subject below and in the chapter on Sickness and Injury. t References to published work may be found conveniently in " Fatigue and Efficiency," by Josephine Goldmark, New York, 1913 (3rd edit.), and in the Interim Report to the British Association (Manchester, 1915) by the Committee upon the Question of Fatigue from the Economic Standpoint. I'On the question of Sunday work by exhausted men, one foreman said he did not believe in " a holiday on double pay." Another remarked that Sunday work gave " six days' output for seven days' work on eight days' pay." (B 12023) B 2 20 of daily and weekly rests and other similar means of welfare and favouring conditions. The signs of fatigue are even more noticeable in the case of the managers and foremen, and their practical results are probably more serious than in the case of the workmen. • 80. Finally, it must be remembered that when fatigue passes beyond physiological limits (" over strain") it becomes ill-health, which leads not only to reduced output but to more or less serious damage of body or mind. There is also, of course, much industrial sickness and disease which bears no exact relation to fatigue, though it may follow or precede it. Subsequent sections of the present Eeport are concerned with general and special diseases associated with factory life and an account of means for their amelioration. Here it is only necessary to draw attention to the primary and fundamental importance of maintaining a high standard of health in the industrial worker. For without health there is no energy, and without energy there is no output. The actual conduct of business is thus primmrily dependent upon physical health. Moreover, health bears a direct relation to contentment, alertness, and the absence cf lassitude and boredom, conditions bearing directly upon industrial efficiency. In this matter the interests of the employer and the workmen are identical. Nor are their respective responsibilities separable. The employer must provide a sanitary factory and suitable conditions of labour. The workplace must be clean and wholesome, properly heated and ventilated ; there must be suitable and sufficient sanitary accommodation ; dangerous machinery and injurious processes must be safeguarded ; circumstances necessitate in many factories the establishment of industrial canteens, the provision of seats, suitable overalls, lavatories and baths, rest-rooms, and first aid appliances. Owing to the factory employment cf many workers for the first time, and of increased numbers of women, often at a distance from home, arrangements must be made for individual supervision and the maintenance of their health. The employment of boys also calls for special vigilance and attention. Further, it has been recognised for many years that the wise employer considers the personal well-being of his workpeople. He cannot be only satisfied with external betterment. He will have regard to the individual worker. Their nutrition, their rest and recreation, their habits of life, are all of interest and importance in relation to their health and efficiency. 81. The problems of industrial fatigue and ill-health, already soluble in part by reference to an available body of knowledge well known and used in other countries, have become acute during the great recent development of the munitions industries of Great Britain. It is not too much perhaps to hope that the study of industrial fatigue and the science of management based upon it, which is now being forced into notice by immediate need, may leave lasting results to benefit the industries of the country during succeeding years of peace. 82. The national experience in modern industry is longer than that of any other people. It has shown clearly enough that false ideas of economic gain, blind to physiological law, must lead, as they led through the nineteenth century, to vast national loss and suffering. It is certain that unless industrial life is to be guided in the future- — ^(i) by the application of physiological science to the details of its management, and (ii) by a proper and practical regard for the health and well-being of our work- people in the form both of humanising industry and improving the environjnent, the nation cannot hope to maintain its position hereafter among some of its foreign rivals, who already in that respect have gained a present advantage. Section IV. THE INDUSTRIAL EMPLOYMENT OF WOMEN. 83. In considering the conditions of employment of women workers as compared with those of men, the Committee have recognised that account must be taken not only of physiological difEerences but also of those contributions which women alone can make to the welfare of the community. Upon the womanhood of the country most largely rests the privilege first of creating a id maintaining a whole- some family life, and secondly, of developing the higher influences of social life — both matters of primary and vital importance to the future of the nation. In modern times, hqwever, many of the ideals of womanhood must find outward expression in industry, and in recent years hundreds and thousands of women have secured employment within the factory system. The problems thus raised are numerous, but broadly they may be considered as chiefly concerned with the wise and effective organisation of women's industry, in such a way as to protect and safeguard their unique contribution to the State. The engagement of women in the manufacture of munitions in the present war presents many features of interest. Probably the most striking is the universal character of their response to the country's call for their help. Of equal social and industrial significance is the extension of the employment of married women, the increased occupation of young girls, and the revival of the employment of women at night. The munition workers of to-day include dressmakers, laundry workers, textile workers, domestic servants, clerical workers, shop assistants, university and art students, women and girls of every social grade and of no previous wage-earning experience ; also, in large numbers, wives and widows of soldiers, many married women who had retired altogether from industrial life, and many again who had never entered it. In the character of the response lies largely the secret of its industrial success, which is remarkable. The fact that women and girls of all types and ages pressed into industry, on account of the war, showed a spirit of patriotism which was as finely maintained as it was quickly shown. Conditions of work have been accepted without question and without complaint which, immediately detrimental to output, would, if continued, be ultimately disastrous to health. It is for the State to safeguard the devotion of its workers by its foresight and watchfulness lest irreparable harm to be done to body and mind both in this generation and the next. More than ever in the past 21 should consideration now be given to the well-being of young girls fresh from school, of the proripectiv6 mother, and of the working mother whose care is especially claimed by her infant during the first months of its life ; for more than ever is their welfare of importance to the nation, and much more than ordinarily is it threatened by conditions of employment. 84. Speaking generally, there are five principal matters which, apart from the question of wages, concern the health and industrial output of the woman worker, and which demand the careful and continuous attention of employers in regard to the employment of women in factories on any large scale, viz. : (a) the physical condition and capacity of the woman worker, including the far-reaching issue of maternity ; (6) the period of employment (including night work, length of hours, overtime, &c.), and its relation to home duties ; (c) the necessity of rest-pauses and the convenient provision of meals ; {d) the sanitary condition of the factory and the hygiene of the worker ; (e) questions of management and supervision. The Committee recognise that certain collateral issues, such as housing, transit and the means of recreation, are also intimately concerned in the welfare of women workers, although they may be somewhat outside the immediate sphere of the employer. The Committee have given careful consideration to the subjects enumerated above, and they desire to ofier some observations under each heading. They appreciate the exceptional importance of women's labour in the present emergency, and in the future, and they do not desire to suggest the imposition of conditions which are likely to embarrass employers or restrict the usefulness of women. They confine themselves, therefore, to matters which in their view are both necessary and urgent in the interest of the women themselves, and the industrial output of which they are capable. The Physical Condition of Women Workers. 85. In considering the physical ability of a woman successfully to withstand the fatigue consequent upon continued heavy work in a factory it should be remembered that her body is physiologically difierent from, and less strongly built than, that of a man ; that her muscular system is less developed ; and that she may have lived a sedentary or domestic life without contracting the habit of taking active and regular exercise. The nature of her work should therefore be determined with due regard to its efiect on her immediate and future health. Certain ailments and forms of physical disability to which women are liable are readily caused, or at least accentuated, by inattention to these matters. Among such conditions are : (a) disturbances of digestion, due to unsuitable food, irregular and hurried meals or fatigue ; (6) anaemia, with possibly associated disease of the heart and circulatory system ; (c) head- ache ; {d) nervous exhaustion ; (e) muscular pain and weakness, flat-foot, &c. ; and (/) derangement of special physiological functions. Though these conditions may not in all cases be immediately in- capacitating, they frequently have a tendency to become chronic in nature and far-reaching in effect ; they lead directly to mal-nutrition and a reduction of body energy ; if allowed to persist they inevitably lay the foundations of ill-health and disease in later years ; and in some cases they may exert an injurious effect on maternal functions. With a view to the adequate consideration of this subject the Committee made arrangements in 1915-16 and in 1917 for two medical inquiries to be carried out in various factories where women were employed. The Committee were fortunate in securing the services of Miss Janet M. Campbell, M.D., M.S. (one of the senior medical officers of the Board of Education), in this behalf, and they have received from her most valuable assistance not only in the clear and compre- hensive reports of these particular inquiries but in all their consideration of health questions in relation to the employment of women. The report of the first medical inquiry, in which 1,326 women and girls were exanuned, will be found in the Interim Report (published 1917), pp. 110-121 ; the second inquiry, in which 1,183 women were examined, is reported in Appendix B to the present volume. The medical examination of these women workers could not be made as complete or exhaustive as might well have been wished, partly because suitable accommodation for the examination was not always available, partly because the time at disposal was limited (women being summoned from their work), but chiefly because presumably healthy women are naturally shy and hesitant of all medical examination. In estimating the physical condition and the amount of fatigue, reliance had to be placed to a large extent by the doctor on statements and descriptions of symptoms given by the women. The heart, lungs and abdomen could not be fully examined as a routine in all cases. (For particulars of medical inquiry, see AppendixB.) As in the previousinquiry the workers were classified into three groups : (A) normal and apparently free from fatigue ; (B) suffering from some fatigue ; and (C) suffering from well-marked fatigue. The results in regard to fatigue in the second inquiry were as follows : — Number of workers examined. A (healthy). B (slight fatigue). C (marked fatigue). England. Number. Percentage. Number. Percentage. Number. Percentage. Facto ry No. 1 2 3 4 5 6 8 193 264 116 157 199 73 67 114 110 199 63 112 77 45 35 51 56-9 75-3 54-3 71-3 38-6 61-6 52-2 44-7 70 53 46 41 114 19 30 52 36-2 20-07 39-6 26-1 57-2 26-02 44-7 45-6 13 12 7 4 8 9 2 11 6-7 4-5 6-03 2-5 4-02 12-3 2-9 9-6 Total 1,183 692 58-4 425 35-8 66 5-5 (B 12023) B 3 22 86. It is inteiesting to observe in the following table the results of the two inquiries whiph, in spite of different conditions of the examination, are surprisingly similar :— Inquiry No. 1 2 .. Number of workers examined. 1,326 1,183 Class A (healthy). 763 = 57 • 5 per cent. 692 = 58-5 Class B (some fatigue) or ill-health). 461 = 34'0 per cent. 425 = 35-8 Class C (marked fe.tigue or ill-health). , 112 = 8-5 per cen^. 66 = 5-7 87. These tables indicate generally the amount and degree of fatigue observed among typical women workers chosen at random. The following points clearly emerge : — (a) The proportion of serious fatigue amounting to marked ill-health and incapacity for work is relatively small, approximately 5 per cent, to 6 per cent, of the cases examined ; (h) There is a considerable amount of slight fatigue which varies from 20 to 57 per cent. (c) The total proportion of women exhibiting definite signs of fatigue is about 40 per cent, of all cases. But this percentage does not represent the full burden of fatigue, for the fojlowing reasons : (a) much early fatigue is latent and objectively unrecognisable ; (6) the women most seriously affected tend to drop out of factory life before they have served for any long period, and therefore are not included ; ^(c) women knowing themselves to be fatigued were not willing in all cases to subject themselves to examination ; and (d) the examination was necessarily superficial and incomplete, and only such as could detect definite and obvious fatigue, amounting almost to sickness. 88. It might have been anticipated that the findings of the second series of examinations would indicate an increase of fatigue, over-strain or sickness owing to the longer period of work undertaken (nine months or more). On the other hand, the hours of work had been shoirtened, there had been less overtime and no Sunday labour, and there had been an immense improvement in the conditions of factory life. Dr. Janet Campbell discusses in her report the relation to the health of the woman worker of: (a) the character of the work ; (i) the length of hours of work ; (c) .her nutrition and physical health ; (d). the tax imposed upon her by bad housing conditions and inconvenient means of transit ; and (e) the " welfare " conditions surrounding her at the factory. The Committee concur in Miss Campbell's view of the relative importance of these matters. In spite of long hours and arduous labour there is no doubt that much fatigue is reduced or removed by active incentives to labour, such as interest, a sense of patriotism, higher wages, and a great improvement in the conditions of labour. 89. It is evident that whilst, physiologically, fatigue may be measured by a diminution in the capacity for doing work, it may easily increase to such a degree that it affects the health of the worker. And to this point Dr. Janet Campbell and her colleagues turned their attention. The ailments most frequently observed were indigestion, serious dental decay, nervous irritabiUty, headache, anaemia, and disorders of menstruation. Something like a quarter of the women workers examined failed in one respect or another ; 7 per cent, had throat trouble ; 8 per cent, suffered from eye-strain ; and 9 per cent, from swollen feet (see Appendix B). The report states that : — The commonest causes of indigestion among women are dietetic, e.g., unsuitable or improperly prepared food, the persistent use of certain unwholesome articles of diet, such as unduly rich substances or food con- taining excess of carbohydrates. Alcohol may be a cause, especially in older women, but this was not obEerved in the present examination. Headache was fairly common. It could often be attributed to one or more causes, such as fatigue in transit, noise in the factory, eye-strain, general tiredness, and was often associated with anaemia, indigestion or carious teeth. " Neuralgia " was complained of by a number of workers evidently sufiering from nervous fatigue. Sleeplessness, especially among women on night shift, was frequently accompanied by headache. Anosmia is most common among ill-fed, overworked girls in industrial districts, who have to work in badly ventilated- and badly lighted rooms, under conditions which prevent proper exercise, especially in the open air and sunshine. A large number of the workers classed C showed signs of more or less severe ansemia, frequently accompanied by hsemic murmurs. A higher percentage was noted in one or two factories where it was mainly due to pre-war rather than post-war conditions, such as chronic malnutrition or work in artificial light. The improved diet and the usually healthy factory environment have no doubt acted as preventives of anaemia, and as far as can be judged on general grounds, munition workers compare favourably in this respect with young women workers in other trades and industries. Indigestion, constipation, anaemia and headache are so closely associated that it is often difficult to say which is primary and which secondary. That all depend in considerable degree upon environment and habits of life, and they are remedied less by drugs or direct medical treatment than by improved hygiene and nutrition. Sunshine, fresh air, exercise, good food and suifioient sleep are the most potent factors in the restoration to health'. Muscular pains, including aching or stiffness of the neck or limbs, are naturally common during the early weeks at the factory until the workers become habituated to unaccustomed muscular exercise. Among more experienced workers muscular pains may be complained of towards the end of a shift or attributed to a particular operation. They may indicate the commencement of fatigue in the worker or that the work is unduly heavy or otherwise unsuitable. Nervous symptoms, such as neuralgia, irritability, nervousness, sleeplessness, or an undue tendency to woiTy were complained of by many women who were beginning to feel tired and worn. The symptoms were dependent on the general state of health rather than upon any organic defect. 23 90. The Committee are relieved to find that the results of these inquiries indicate that, although for the reasons given in paragraph 87 (c) above, the amount of existing fatigue and sickness probably exceeds in considerable degree that discovered by the investigators, the women and girls employed at these factories are as a whole bearing the strain of their munition work remarkably well. The Committee concur in the conclusions stated by Dr. Janet Campbell, viz. : — (1) That there is a definite burden of fatigue, which though relatively small in amount aa regards severe fatigue is considerable as regards that of a less severe character ; (2) That the fatigue and ill- health are less than might have been anticipated ha,ving regard to the hours of work and the nature of the employment, and that this is due, broadly speaking, to the greatly improved a'ttention to the health and welfare of the workers ; (3) That fatigue and sickness are greatest where heavy work is combined with long hours at the factory and associated with onerous domestic duties after factory hours ; (4) That unless brought under control, the considerable amount of moderate weariness and ill-health now present is likely to reduce immediate efiiciency and also exercise in many cases an injurious effect on subsequent health and on "capacity for maternity ; ^ (5) That although there has been substantial improvement in the conditions and circumstances of women's work in factories further action is necessary if the amount of fatigue is to be diminished rather than increased- In particular the findings of this inquiry seem to indicate the necessity — .. , , (a), for further shortening of thei hours of labour for women ; (6) for restricting women's work in. the heavier branches of industry to those who are young, physically fit and capable and who have not arduous home duties to perform ; (c) for the continuation and development, wherever wom-en are employed in factories, of hygienic conditions and especially " welfare " arrangements (including industrial canteens) ; and {d) for making appropriate provision for efEective medical supervision, both on entrance to the factory (in heavy and exceptional occupations) and subsequently, by means of the services of medical officers (women preferred) and nurses, and in the form of suitable accommodation as to rest rooms, first-aid appliances and well-equipped surgeries. 91. Maternity. — The employment of large numbers of women of child-bearing age has also raised the problem of m!at6rnity and owing to causes associated directly with the making of munitions it is apt to becoiiae acute and iirgent in an unusual degree. The overcrowded condition of inany munition areas and the abnormal influx of women into these areas naturally strain to the breaking point the always inadequate provision for maternity which exists locally. The impression the Committee 'have gained from inquiries at numerous factories and among many of those responsible for the supervision and welfare of the workers is that though the problem in an aoiite form is limited to a relatively small proportion of women workers, there is somewhat urgent need for immediate action in regard to the care of those expectant mothers, married and single, who are unable to make suitable arrangements for themselves. 92. The care of the mother naturally falls into three stages — ^pre-natal, natal, and post-natal. Pre- natal. — ^The married woman with a home of her own usually leaves the factory in the early months of pregnancy, or at least as soon as her condition becomes obvious. No specialprovisionis required for her apart from the provision for women as a whole. A certain number of women, however, are obliged to work almost until their confinement as they have no other means of livelihood. In Filling Factories it is usual, on account of the danger due to explosion or the handling of poisonous materials, to discharge a woman as soon as she is known to be pregnant. In engineering factories the practice varies. Where the work is heavy and it is not possible to transfer women to lighter processes they may be discharged as soon as their condition is recognised. Where lighter work is available and the general environment suitable they may be retained until, say, the 7th or 8th month. There is the further difiiculty of suitable accommodation for the pregnant woman awaiting confinement. Natal.-^Ag&m, the number of lying-in hoifies and hospitals is notoriously inadequate to the needs of the country as a whole. In many over- crowded munition areas the workhouse is the only institution to which women can go for their confine- ments, an arrangement naturally repugnant to most women. Nor is there always available sufficient or skilled midwifery and nursing attendance. Post-Natal. — Thirdly, the post-natal care of the mother's own health is complicated by the need for suitable arrangements for her child. Practical questions, as Dr. Campbell points out, soon present themselves : " Wher« is she to live ? How is she to support heiself until fit to resume factory work ? What is to become of the child whilst she is absent night or day. The only statutory provision which relates to the employment of pregnant women or nursing mothers is Section 61 of the Factory and Workshops Act, which states that a woman must not be employed within four weeks of giving birth to a child. It is obvious that the mother's first duty is to her young infant and that in the interests of its health she should not return to the factory until the expiration of a much longer period than four weeks. But she may have to choose between remaining with her baby without adequate means of support or returning to well-paid work as soon as possible, even though this entails virtual separation from the child. A breast-fed infant is more likely to thrive than one which is brought up by hand, but an ill-nourished mother is either unable to nurse her baby or continues to do so only at undue cost to herself. Until the State is prejjared to recognise the claims of nursing mothers to assistance and financial aid the lesser of the two evils may be for the mother to go back to work as soon as she is physically fit to do so, provided that she can ensure the care of the baby during her absence . 93. It appears that the practice in regard to the employment of mothers with young infants varies in different factories. In some, with a view to encouraging breast feeding, no woman is supposed to be (B 12023) B i 24 employed who has a child under 9 to 12 months of age. In others, no general rule exists and cases are judged on their merits. In some, no attention is paid to the age of the child. It is of course impossible to investigate all cases fully, and a woman who is badly in need of employment has often little difficulty in evading inquiries. Children are thus commonly left with relatives or " minders," or sent to a day nursery when therel is one. 94. Dr. Janet Campbell has' submitted for our consideration the following Maternity Scheme for the assistance of munition workers : — " (a) Skilled supervision of pregnant women is necessary, both factory and domiciliary, by a qualified and competent officer, in order to ensure that suitable arrangements are made for the confinement at home or in lodgings (engagement of the midwife or doctor, ante-natal care, post-natal care, &c.) and for the care of the infant after birth. Such an officer would be able to bring the woman into touch with local agencies for assistance. She would also encourage thrift and proper preparation for the confinement. This supervision might be arranged by the welfare staff of the factory, though in large factories an extra officer with midwifery qualifications might be desirable for home visitation, &c. " (6) The provision of light employment may be made available inside or outside the factory during the later months of pregnancy, say from the 4th or 5th to the 8th or 9th month, and also after the birth of the child. In some factories this might be arranged as part of the general organisation, in other factories all the work is too heavy or the general conditions too unsatisfactory to admit of pregnant women being employed at least after the early months. In such cases separate workrooms would be necessary, which might serve more than one factory, where lighter work such as sewing and mending might be undertaken {e.g., the sewing of exploder bags, the making of light boxes, the manufacture of overalls, &c.). Such small separate departments might also be used by other women temporarily ailing from one cause or another. " (c) Favourable welfare conditions are essential for all pregnant women, including the aboUtion of night work and where possible, reduction in the length of the day shift. Arrangements for an adequate supply of suitable food, including milk, through the canteen or otherwise, is also advisable. " {d) Maternity Homes should be established for women who cannot be confined at home or in their lodgings. These institutions should also provide, where necessary, for pre-conflnement residence and lying-in accom- modation. Maternity homes might be organised — (i) As a branch of an existing lying-in hospital available for normal and abnormal cases ; or (ii) as an ad hoc maternity home of six or a dozen beds in charge of a competent midwife. " In connection with these Homes, but not necessarily under the same roof, there should be accom- modation for women before and, if necessary, after confinement. Arrangements should be availa,ble for married or unmarried women, and as far as possible the schemes should be self-supporting. Exchequer grants would be necessary for the establishment of such Homes and also to make good deficits in the cost of working and maintenance, but the greater part of the maintenance expenses should be met by payments from the women themselves. " (e) Lastly, in many districts a creche or day nursery is necessary for the children where they may be cared for during absence of the mother. The number of available ' minders ' to whom children would ordinarily have been sent has steadily diminished, largely because these women have themselves sought regular employ- ment. Mothers working long shifts are physically unable to devote as much attention as they would wish to the care of their homes and children. There is thus a substantial case for an increased provision of mu:series which would take charge of children under school age by day and, if necessary, by night." 95. Sympathetic administration is essential to the success of such a scheme, the aim and intention of which is to encourage the women to report their condition at an early stage and to afford them such advice and assistance as are needed without exercising a burdensome or inquisitorial supervision. 96. The Committee consider this scheme valuable and suggestive. They are glad to know that in many munition works successful efEort has been made on these lines, and they are satisfied that a similar scheme is feasible for industrial women workers generally.* * A woman Welfare Supervisor in a National Ordnance Factory has written to the Committee as follows :—" A pregnant woman in this factory is expected and encouraged to see me that I may assure myself that her work is not harmful to her in any way. She is questioned as to her home circumstances, and permission to put her in touch with the Medical Officer of Health is asked. This, if granted, ensures her a visit from the Inspector of Midwives Staff, who sees that a suitable Midwife is, or will be, engaged. Provided that the work on which the woman is engaged is not injurious to her, she is retained as long as possible. In many cases a woman has worked on her lathe until the eighth month of pregnancy. Others require to be transferred quite early to lighter employment such as disc oiling and cleaning, hammer- head crane driving, or in the Overall Department. " During enforced absence before confinement, if the worker's income is insufficient, her case is brought before a small sub-committee of the Hospital and Benevolent Fund, and a grant made to her of Is. 6d. or 10s. weekly. After the birth of the child in the case of a married woman, in consideration of the Health Insurance benefit of 60s., the aEowance from the fund stops for four weeks and is resumed until the child is three "months old, when the mother is reinstated at her old work. I have fixed that period of absence as I find that once nursing is estabMshed during those months, it is possible it may be partially continued with good results to both mother and chUd. If not continued, the three months' nursing is of inestimable value to the child. Another reason I advocate these three months' absence is, that the work is heavy for a recently confined woman. " The case of the unmarried mother presents greater difficulties, and more individual study and care is required. It is a great anxiety to me. to obtain the necessary knowledge early enough to be able to assure the girl that care will be taken of her during her pregnancy and help given her in her trouble. My experience convinces me that serious con- sequences to the health of many girls have arisen from their fear of facing the situation. I have found that once her confidence is gained and the girl understands that for her child's sake she is entitled to every care, a much happier and healthier state of mind and body exists. Should there be no home care available for the girl during her confinement, the only place for her in this town is the Workhouse Infirmary. Under these circumstance we generally manage to keep her at quiet work until very close to her confinement, and she is admitted to the Infirmary immediately on application. " I have never deviated from my rule regarding the three months' absence from the factory after confinement, even in the case of the homeless girl, but some arrangement has always been made for her care and well-being. Friends have bsen found for her and she has had a weekly grant from the Hospital and Benevolent Fund, also advice and help given her as to putting her in the way of receiving maintenance from the father of her child. I have, at different times, brought in a girl, whose case has been difficult to deal with, to work as cleaner in the Canteen on days only. The baby comes with its mother and lies (in summer) in a cot on the verandah. This works very well. The baby thrives and is a source of interest and joy to the factory girls. I have always found that the help given to a girl in her trouble has a wonderful result in improving her character and deepening her sense of maternal responsibility. " The problems in work such as this are many and aU different and have each to be considered under no very bard and fast lines, but I hope 1 have outlined the main points sufficiently clearly to show oiur aims and ideals," 97. The Ministry pf Munitions decided, in 1916, to make special grants in aid of the establishment and maintenance of nurseries for the children of munition workers as follows : — {a) A grant of 75 per cent, of the approved expenditure on the initial provision and equipment of the nursery. (6) A grant of Id. for each day or night attendance made by the child of a munition worker. It has been arranged that the Board of Education, as the Department charged with the administration of grantsin aid of ordinary day nurseries, should be responsible for the inspection of munition nurseries and for advising the Ministry in regard to the provision of schemes and payment of grant. The number of munition nurseries wholly or partly occupied by the childien of munition workers is now 31. In most cases the nurseries are open by night as well as by day for the benefit of women working on night shifts. 98. It is sometimes suggested that the nurseries should be in or close to the factory, so that a mother may be able to nurse her baby during the dinner interval. On the whole the Committee think that it is not usually desirable to have the nursery in close association with the factory, however, partly because this entails bringing babies and little children night or morning in trains or trams which are often already overcrowded. Further, the usual interval of an hour is scarcely sufficient for the mother to get her own meal and feed her baby unless a dinner can be provided for her at the nursery. Though arrangements have been made for a few individual cases nothing has been attempted in a general way. Probably in certain exceptional cases some provision is also needed for the younger children who are able to attend school but are too young to look after themselves during school hours while the mother is at work. A few children's " hostels " have been established through voluntary enterprise, to which such children may go for all meals and for play and recreation, small payments being made by the mothers to cover the cost of the food. 99. In this connection the Committee consider it is desirable that the lifting and carrying of heavy weights* and a}l sudden, violent, or physically unsuitable movements in the operating of machines should, as far as practicable, be avoided. Often a simple appliance, or the alteration of a movement, modifies an objectionable feature when it does not altogether remove it. By similar thought and care much may be done to mitigate the strain of prolonged standing, which should be restricted to work from which it is inseparable. f Prolonged standing has been found a highly provocative cause of trouble to women and girls. When standing is absolutely unavoidable, the hours and spells of employment should be proportionately short, and seats should be available for use during the brief pauses which occasionally occur while waiting for material, or for the adjustment of a tool. Where so much depends upon the character of a movement, upon the angle and position at which a weight is lifted or carried, it is not advisable to lay down a standard of prohibited weights. But serious accidents and injuries to health have been caused in factories in the past by the excessive carrying of weights, and it is trusted that employers will give this matter their earnest consideration, especially in view of the heavy work which now devolves upon women in factories. J Periods of Employment and Hmne Duties. 100. Night Work. — The imperative necessity of war has revived, after almost a century of disuse, the night employment of women in factories, with its associated economic, physical and moral dis- abilities. In a working-class home, however, the difficulty in obtaining rest by day is great ; quiet cannot be easily secured ; and the mother of a family cannot sleep while the claims of children and home are pressing upon her ; the younger unmarried women are tempted to take the daylight hours for amusement or shopping ; moreover, sleep is often interrupted in order that the mid-day meal may be shared. The employment of women at night is, without question, undesirable, yet now it is for a time inevitable ; and the Committee have, therefore, directed their efforts to the consideration of those safe- guards which would reduce its risks to a minimum. 101. In practically all factories where night shifts are worked it is customary to change the shifts weekly or fortnightly. The frequent change of shift has proved more convenient and acceptable to the women than more prolonged periods of night or day duty. The importance of adequate pauses for rest and meals during the night is now fully realised ; arrangements for the comfort of the women have steadily improved and most women have learned the advantage of suitable and substantial food when on night work. 102. While the urgent necessity for women's work remains, and while the mother's time, and the time of the elder girls, is largely given to the making of munitions, the home and the younger children must inevitably suffer. Where home conditions are bad, as they are frequently, where a long working day is aggravated by long hours of travelling, and where, in addition, housing accommodation is in- adequate, family life is defaced beyond recognition. If the home is to be preserved from such processes of destruction reasonably satisfactory conditions of transit and housing must be secured, as well as the best possible hours of work by night and day. It has been far from uncom_mon to find some two or three * For further observation on weights, see paragraphs 418-424. t See medical evidence on the grave eiiects of long hours of standing on the health of women given before the Select Committee on Shops, 1895 (page 219, answers 5401 to 5406), and the effects of industrial strain on the working woman (Trans. Fifteenth International Congress on Hygiene and Demography, Washington, 1912, vol. iii., part 2, page 933). r 1- 6 'J Report of Departmental Committee on Accidents, 1911 (Cd. 5535). 26 hours Spent on the journey each way, generally under the fatiguing conditions of an overcrowded train or tram,, often with long waits, and a severe straggle before even standing room, could be obtained; Often far from offering a rest from, the fatigue of the day, the home conditions have pfEered but fresh aggravation. A day begun at i or even 3.30 a.m., for work at 6 a.m., followed by 14 hours in the factory, and another two or two and a half hours on the journey back, may end at 10 or 10.30 p.m., in a home or lodging where the prevailing degree of overcrowding precludes all possibility of coinfortable rest, Beds are never empty and rooms are never aired, for in a badly crowded district, the beds, like the occupants, are organised in day and night shifts. In such conditions of confusion, pressure and pyercrowding, home has had no existence. 103. Though much has been now done to remedy these conditions, there is still great need for improvement in means of transit, and this alone would help to relieve the unsatisfactory conditions of housing ; but, however great the increased facilities of service, the journey between home and factory must still add, in many cases, a couple of hours to the working day. When considering hours in relation to efficiency and fatigue this influence upon the total length of day should be remembered ; the factory day cannot always stand by itself as the only contribution towards fatigue. 104. Happily there should be in the matter of hours of labour for women little conflict between the interests of the home and the interests of munitions, for the hours which conduce most to a satisfactory home life and to health conduce most to output. Long hours, particularly when they are worked during the night, are among the chief factors in fatigue, and the Committee are of opinion that in the interest of output and health alike they should be restricted within proper limits ; that there should' be suitable pauses for rest during the working period ; and that there should be adequate cessation from work at each week-end in addition to periodic holidays. It may be stated broadly that conditions which press hardly upon the average man press, because of her different constitutional development, with greater severity upon the average wom,an ; while similarly, though conditions of mental fatigue are piobably equally injurious to boys and girls, conditions of muscular strain well borne' by the ordinary boy may be highly detrimental to the girl of corresponding vigour and physique. It is therefore especially important that women and young girls should be relieved from those conditions of overstrain to which they have been so widely exposed. 105. Since the early days of the war the tendency has been towards the reduction of the weekly total of hours worked and the length of the shifts. The overtime system which was then common has now been practically abolished and the weekly hours for women limited to 60 or less. In order to avoid undue fatigue an increasing number of firms have three eight-hour shifts in the place of two of twelve hours. Though not always easy to organise from the factory point of view, when accompanied by an adequate minimum wage the system of eight-hour shifts appears to yield the best results in the long run. On the one hand the machinery is used for the maximum part of the 24 hours and effort is better sustained throughout the shift. On the other hand less strain is put upon the worker, with, a resulting reduction in the amount of ill health, disability and lost time. The special strain of night woik is imposed less frequently, and, partly for this reason, a class of labour is attracted which would other- wise be unrecruited. It has been suggested that in certain districts, and for certain industrial processes, it may be possible, during the stress of the war, to employ married women on half time, in two or more shifts daily of four or five hours each. The Committee recognise that such a system possesses its own inherent difficulties, which may, however, not prove insurmountable. Arrangements for Rest and Meals. 106. Pauses, well distributed and adapted in length to the needs of women workers, are of the highest value in averting breakdown and in giving an impetus to output. The Factory Acts permit in textile factories a maximum of four and a-half hours continuous work ; in non-textile the limit is five, but many managers believe that four hours is the longest period during which a woman can maintain continuous work at full vigour. "Within this period a pause of ten minutes has been found to give excellent results, and where the spell is continued for five hours some such pa.use should certainly be made for a cup of tea or cocoa. It is particularly valuable in the morning spell in those numerous cases where breakfast has been hurried or omitted altogether. The proper arrangement of intervals for food needs special consideration in Filling Factories, where work on some of the high explosives seems to create a special feeling of hunger. Here there is the added reason that a well-fed persoii is the bettef'able to resist the influence of poisonous materials. Facilities should be provided, especially during the night shift, for rest in cases of fainting or other temporary illness. Kest-rooms are now frequently found in well-equipped works ; they usually consist of a few comfortable chairs and a camp bed for the more serious cases, placed in the surgery or rest-room now being provided by many employers. A nurse is generally in attendance, whose assistance may be claimed by men and women alike. 107. The week-end rest has been found to be a factor of such importance in maintaining health and vigour that it has been reinstated by employers who had taken it for work at the beginning of the war. The Committee are strongly of opinion that for women and girls a portion of Saturday and the whole of Sunday should be available for rest, and that the periodic factory holidays should not, on any account, be omitted. Where women are employed on eight-hour shifts an interval o^ half an hour for a meal may be regarded as normally sufficient, but where longer hours are worked, it is important that they 27 should be allowed an tour for dinner and for the principal meal during the night. Indigestion cannot easily be avoided if a substantial meal is followed immediately by work without an intervening period for rest. Half an hour, especially in large factories, and in Filling Factories where the actual consumption of food in the danger area is prohibited, provides but scant time even for the eating of the meal. Ten minutes are easily spent in reaching the mess room and returning to work, certainly another five are occupied in washing the hands and the service of the dinner ; and so but fifteen remain for the meal. The provision of well-managed and suitably equipped canteens in convenient proximity to the workrooms has now been made in a large number of factories and the mess-room accommodation and arrangements for heating the workers' own food have been much improved. These are available both night and day at suitable hours. The Committee desire once more to emphasise the importance of providing seats with backs and similar amenities with a view to securing the comfort and relaxation of the workers. The Sanitary Condition of the Factory. 108." The effect upon the health and energy of women and girls which results from clean, bright, and airy workrooms, well warmed in winter, can hardly be exaggerated. The Factory Act secures a mini- mum of these essential things, but the highest standard attained in the best factories is not too high. Women desire these things in their -ft-orking hours, and appreciate and respond to a good environment. Cleanliness and good order contribute to increased output as well as to the discipline and morale of the factory. The provision of washing accommodatic n has become increasingly important. The refreshing effect of washing and its influence on self-respect, especially where women are heated by their work, have been dwelt upon by many witnesses who have given their evidence before the Committee. For those processes in which poisonous substances are used, such for example, as the filling of shells and fuses with high explosives, special regulations for washing have been framed.* It is a great convenience when the lavatories and cloakrooms can be grouped with the canteens. The lavatories should be of sufficient size to accommodate all those workers from a room or department who cease work at the same time, and must be properly equipped and maintained. If suitable facilities are easily accessible and are sufficient to enable the workers to wash without undue encroachment upon their meal times, experience shows that they are much appreciated and fully used. 109. Cloakrooms should also be provided, and wherever possible should be near the canteens and lavatories. It is of importance that they should afford facilities for changing clothes and boots, and for drying clothes. The cloakrooms should be kept scrupulously clean.f 110. The provision of adequate and suitable sanitary accommodation is a matter of special impor- tance. The necessity for proper equipment and maintenance of cleanliness, privacy and convenience of access should be borne in m.ind. It is the more necessary to call attention to this matter since in many instances women are now employed in factories where, until recently, there have been male workers only. The conveniences for women should be so situated as to be readily accessible at all times, with due regard to the privacy of the approach ; they should be adequate in number, suitably p'lanned, and of sound sanitary construction. A high standard of cleanliness must be maintained, and it is desirable that an attendant shall be in charge of the conveniences throughout the period of employment. J Management and Supervision. 111. The Committee have received abundant evidence of the necessity of wise and suitable arrange- ments for the management and supervision of women's labour. Their personal visits to large and small works where women and girls are employed, as well as the evidence placed before them, have led them to the opinion that there is hardly any condition of greater importance than this, in respect both of smooth working and of maximum output. The modern development of commercial undertakings, not to speak of the vast size of many factories, precludes the personal oversight and interest of the responsible employer and makes it all the more necessary to appoint efficient substitutes. This is particularly important in regard to the occupation of women unaccustomed to the organised factory life, business methods, and discipline of large engineering shops (often with unsuitable accommodation for women, difficulties of discipline, and long hours). Briefly the Committee recommend that in all cases where women are employed consideration should be given by the management to the appointment of forewomen, nurses and welfare supervisors, whose position and status should be properly assured and whose duties should be prescribed. In this way provigion is made for each woman worker to have ready access to an officer of her own sex in case of difficulties occurring in regard to her work, her health or the conditions of her eniploynient. Surgeries for the treatment of minor as well as serious accidents, rest-rooms for workers temporarily incapacitated, are of special importance where women are employed. " Welfaie supervision," in its broadest sense, which has abundantly proved its value to both management and workers, is essential for women workers if their well-being is to be fully safeguarded. 112. The ultimate purpose of wise supervision is twofold. First, there is the purpose of securing sound and helpful conditions of labour, under which the employer obtains diligence and skill from those in his employ, and the worker is occupied, healthily and not unreasonably, to his own satisfaction and to the best of his capacity. Here, without doubt, the highest interest of employer and worker is one and the same. There is, or should be, satisfaction and advantage on both sides. A second purpose of supervision is economical management and the accurate adjustment of energy applied to the end in view. The Committee have been interested to observe the diverse operation of these purposes in * For further consideration of the provision of washing facilities see paragraphs 392-404. t I"or further suggestions as to cloakroom accommodation see paragraphs 411-412. % For further suggestions as to sanitary accommodation see paragraphs 388-391, 28 connection with the health of women workers, and have decided that it was desirable to investigate further a point which had much impressed them, namely, the apparently large amount of " wastage " of women workers in munition factories. It was reported to them that large numbers of women were drifting in and out of factories without sufficient reason, and they sought the aid of Captain M. Greenwood, the statistician, in endeavouring to find an explanation of this phenomenon. Accordiiigly he made invest- gations* in 16 factories, or parts of factories, employing altogether some 40,000 women workers. An abstract of his report will be found in Appendix D. Briefly his conclusions are : (a) that of 37,000 women workers, under observation for at least a month, illness or physical unfit- ness or incapacity was given as a cause of leaving work in 1,651 cases, the lost workers owing to ill- health being practically the same at all ages in " light " factories, but increasing at the age of 22 years in " heavy " factories. In other words girls over 23 years of age have fewer sickness losses in " heavy " than in " light " factories ; (b) that in sum total the " wastage " is substantial and such discontinuance of employment appreciably reduces output ; (c) that much of this " wastage " is inexplicable ; of 11,000 women who left work as many as 6,700 gave no adequate reason for so doing; {d) that, whilst prevention appears obscure, the remedy is organised welfare work including intelli- gent and sympathetic following up of absentees. The Committee concur with Captain Greenwood's recommendations that wherever any factory loses more than 20 per cent, of its entrants within three months a special inquiry should be instituted, and that older women (who more usually have home duties) should be put on lighter work in order to reduce the double demand made upon them. 113. Clearly, everything possible should be done to reconcile the woman's confiict of interests between her duties to her home or children and her work in the factory. Wherever other labour is available, the employment of mothers with infants is to be deprecated, as is also that of the mother of any young family, for it must be remembered that the mother's work is certainly not ended with her factory day. Her children make many claims upon her time and energy, more especially, of course, at the period of the mid-day meal and at bed-time. In some factories the majority of the women employed at night are married, and many of them express a preference for their work, because it leaves them free for domestic work during the day. In thus undertaking double duties their zeal may easily outrun their strength, and factory and home equally may suffer. Where married women are indispensable, every effort should be made to give them the preferential treatment common, in normal times, in some factory districts, and also in France. It is the experience of managers that concessions such as half an hour's grace on leaving and arriving, or occasional " time off," is not injurious to output, as the lost time is made good by increased activity, and under the system of eight- hour shifts it might be arranged without industrial di^ocation of any kind that married women are employed only in that shift which would cause least dislocation in their home. For organisation of this kind, as well as for the care of young girls, individually during the first few months of their employment, the Welfare Supervisor has proved herself to be invaluable ; she can secure short periods of rest, or such interchange of occupation as tends to lessen either the spell of muscular fatigue or the continued exposure to an injurious process. Her supervision possesses particular value during night shifts when ordinary supervision tends to become relaxed. Conclusion. 114. Finally, the Committee desire to state their considered opinion that, if the maximum dutput of which women are undoubtedly capable is to be secured and maintained for an extended period, the following essentials must be provided f o"r : — ■ (a) Short hours of work with suitable shifts, pauses and intervals ; (b) Adequate and suitable medical supervision, including the provision of rest-room-s, surgeries and first aid appliances, properly staffed ; (c) The careful selection of women for work within their capacity, the heavier work being allocated to the younger women ; {d) Good and sufficient food obtainable at convenient times : women appear to require food and refreshment more frequently than men and always before commencing work in the morning. (e) A suitable factory environment : women are probably more susceptible than men to the benefits of effective ventilation (including ample fresh moving air), sanitary accommodation and convenient washing facilities. (/) Sympathetic management and tactful supervision. 115. The Comrnittee recognise that emergency conditions must obtain in many cases, but they are satisfied that ev6ry effort should be made to organise women's labour effectively and promptly. The Committee take the view that to use up or damage its women by over-strain in factory work is one of the most serious and far-reaching forms of human waste which a nation can practise or permit. It * Dr. Greenwood's Memorandum on " The Causes of Wastage of Labour in Munition Factories employing Women " is being publishgd, as a Special Report, by the Medical Research Committee. 29 may be that in the entanglement of problems new and old the coming of the new and their imperative clai m for solution will help the solving of the old. There is impulse now as there was impulse long ago when the cause of the children in the cotton mills of Lancashire won the early Factory Acts for the generations that followed. There is need now as there was need then. There is need for the work of women in industry ; there is need also for safeguarding that service. Happily there is manifest a public spirit and a devotion able to overcome difficulties and solve problems. There is also a fuller recognition of the claims of women and of their children and of their vital importance to the State, which is reward for the sacrifice and courage of those women now working steadfastly in the ranks of labour. Section V. HOURS OF LABOUR. Legal Restrictions on Hoxtes of Labour. 116. The Factory and Workshop Act, 1901, imposes certain restrictions on the hours of employment of protected persons, that is of women and young persons (i.e., boys and girls between 13 and 18 years of age who are legally exempt from attendance at school). The following are the principal provisions bearing on employment in non-textile factories : — (a) The hours of employment of protected persons on the first five days of the week are not to exceed a fixed daily period of 12 (including 1 J hours for meals), and on Saturday 8 hours (including J hour for meals). The period of work may commence at 6 a.m., 7 a.m. or 8 a.m. That is to say, the maximum weekly hours of employment, exclusive of meal times, are 60. (Section 26 (i), (ii), (iii).) (6) Sunday labour is forbidden. (Section 34.) (c) Protected persons may not be employed continuously for more than 5 hours without an interval of at least J hour for a meal. (Section 26 (iv).) (d) Women may be employed in certain industries for two hours overtime in addition to the ordinary hours on any day except Saturday, provided that an additional J hour is allowed for meals after 5 p.m. ; that no woman is so employed for more than three days in any one week, and that the number of days in the year on which any woman is employed on overtime shall not exceed 30. (Section 49.) No similar exception is allowed for young persons. (e) Night work is not allowed for women and girls, but is allowed for boys over 14 if employed in certain specified trades, e.g., blast furnaces and iron miUs. (Section 54.) No restrictions are placed upon the hours of employment of men. 117. Section 150 of the Act provides that :— " In cases of any public emergency the Secretary of State may, by Order to the extent and during the period named by him, exempt from this Act any factory or workshop belonging to the Grown, or any factory or workshop in respect of work which is being done on behalf of the Crown under a contract specified in the Order."* 118. Under this provision Orders have been made by the Home Office allowing relaxations of the limitations set out above. These Orders are of two kinds^ — (a) General Orders setting out the conditions under which women and young persons may ordinarily be employed in munition works (the last General Order was issued in September, 1916) ; (6) Special Orders authorising variations of the General Order in particular cases. ' 119. Under Section 6 (i) of the Munitions of War (Amendment) Act, 1916 :— "The Minister of Munitions shall have power by Order to give directions . . . (subject, so far as the matter is one which is dealt with by the Factory and Workshops Acts 1901 to 1911, to the concurrence of the Secretary of State) as to hours of labour or conditions of employment of the female workers so employed." 120. No Order has as yet been issued under this section, hours of employment continuing to be dealt with under the Factory Acts. A committee, including representatives of the Ministry of Munitions, of the Home Office, and of other Departments concerned, has been established at the Ministry to consider special applications for permission to work on Sundays or for exceptional hours. Weekly Hours of Employment. 121. Prior to the war the weekly hours of employment of women and young persons were as a rule substantially below the limits imposed by the Factory and Workshop Act. This was due, partly to the action of employers who believed that shorter hours were desirable from the point of view of health and output, and partly to the action of the Trades Unions in regard to the hours of adult male workers. In the Engineering Trades the normal weekly hours of adult male workers were, as a rule, about 52-54 though in a few instances they were as low as 48. These normal hours were generally liable to extension * By Begulations made under the Defence of the Realm Act, and dated June 10th, 1915, and October 3rd, 1916, the power of the Secretary of State is extended to any factory or workshop in which he is satisfied that by reason of the loss of men through enhstment or transference to Government Service, or of any other circumstances arising out of the present war, exemption is necessary to secure the carrying on of work and that it can be granted without detriment to the national interests. 30 (" Overtime ") to meet special emergencies. Since if overtime were to become a regular practice the value of the normal day would largely be lost, it was usual to restrict overtime by requiring wages at a higher rate for the additional hours, and by limiting the additional hours which might be worked in a given period. Thus the agreement existing at the outbreak of war between the Engineering Employers' Federation and the Engineering Trades Unions concerned provided that overtime should not exceed 30 hours a month. The establishment of the normal working day for Engineering Trades is not entirely a modem develop- ment. As early as 1836 the London Engineers secured the normal 60-hour week w.th additional wages for overtime, and more than 50 years ago the principle of a normal day and overtime was already widely recognised. ' 122. At a very early stage of the war the ordinary restrictions on hours of employment were widely relaxed. Sunday labour, previously forbidden for women and young persons, and practically unknown for men except in a few continuous processes, became common. Night employment, which for 50 years had been abolished entirely for women and in the main for boys, became regular. The strain of these hours, in itself severe, was increased through large numbers of men and women taken into employment being unaccustomed to such labour, or being physically less able to bear the strain than the selected body of workers previously employed. The difficulties of housing and transit became accentuated and the conditions of employment were frequently makeshift and inconvenient. The employment.of jnen for 70 to 90 hours a week was common, for over 90 hours was not infrequent, and there were even cases of hours in excess of 100. The highly skilled workers (tool and gauge-makers, tool-setters, &c.) were gener&Uy the most difficult to obtain and were thus most frequently employed for long hours. These hours were defended on the ground that : — (a) the dearth of workers and other causes prevented any general adoption of the shift system ; (6) the demand for output was urgent and immediate, and had to be met even at some risk of future • breakdown ; (c) patriotism introduced a new incentive which rendered unreliable all previous experience as to the number of hours which could be successfully worked ; , .. ^{d) even though the rate of output might be reduced, and the cost of working increased, these long hours did result in a larger output than short hours would have done. 123. The evidence, however, showed that the long hours are open to certain serious objections : — (a) they are liable to impose too severe a strain on the workers ; (5) at any rate, after a period, the rate of production tends to decrease, and the extra hours produce proportionately little or no additional output ; moreover, the quality of the output may be adversely affected during the whole period of work, and not only during the hours of overtime ; (c) a large proportion of the hours gained may be lost through broken time ; the workers become exhausted, and take a rest ; sickness tends to increase, at any rate among the older men and those of weak constitution ; (d) they lead to an undue curtailment of the periods of rest and sleep available for those who have to travel long distances to and from their work ; (e) the fatigue entailed increases the temptation of men to indulge in the consumption of alcohol ; they are too tired to eat, and therefore seek a " stimulant." (/) a very serious strain was imposed upon the management, the executive staff, and the foremen, both on account of the actual length of the hours worked, and of the increased anxiety over the maintenance of the output and quality of the work; the staff cannot take days off like ordinary workers. 124. Whatever may have been the justification for the long hours worked, they undoubtedly imposed a severe strain on the workers, as evidenced by the following statements made by Trades Union Representatives : — " Some of his men had been working from 6 a.m. to 9 p.m. These hours were undoubtedly a severe strain, and some men were just at the limit of their powers. They stayed away for a day or two to rest, but did not see a doctor, if they could help it." " The men were reaching the ' fed-up ' stage. They were getting nervous and irritattd, through working long hours. They could not keep up their physical efficiency, he pould see it in their faces. Men on overtime were more tired. They were liable to have time for only about five hours' sleep." " The excessive hours now being worked were too much for the men. They led to a diminished output per hour. Men were continually having to stop working ; they were obliged to rest, it was not a question of slackness. For fear of being called slackers, they hesitated to get a doctor's certificate." 125. Though as stated the long hours thus undoubtedly placed severe strain upon the workers, the Committee did not find that they had caused any serious breakdown among workers. This was in some measure due to the tendency, after a time, to reduce hours. Further, there was goodreason for believing that the increased pay and better food which workers w6re able to enjoy, helped to counteract the strain of long hours. There is little doubt, too, that workers were stimulated to make special effort by an appreciation of the national importance of their work. These influences have been thus summarised by a Trades Union Official : — "(1) Will power. Men have continued at work in a condition that under ordinary circumstances would have put them off for a week or two. Even when a man comes off for a time he is anxious to get back 31 again as quickly as possible. I have had one or two oases of serious breakdown. The main factor is that practically all the men want to do their best ; " (2) Better wages mean better food for a large number of men with families, and they mean a little better provision for those families, which again reacts upon the man's health and his work. In these cases it is not so much the saving or possibility of saving money, but the satisfactory spending of it which is the factor of importance ; " (3) The possibility of getting more money has also its effect. You read much about the slacker. There is quite a large proportion of workmen really too anxious for overtime — employers will corroborate — even under normal conditions." 126. It would, however, have been a mistake to depend too largely on the operation of influences of these kinds, or to hope that they could continue indefinitely to be effective against fatigue. The Committee wer6 satisfied that if workers were to be asked to work for anything approaching 15 hours a day for weeks and months on end, one of two results must follow, either the health of the worker would break down, or they would not work at full pressure. 127. While the Committee, at an early stage of their inquiries, were convinced as to the urgency of lecommending some limitation of hours, it was a matter of serious difftculty to determine what limitations to recommend. Not only was there an almost complete absence of any scientific data as to the relation of hours of employment to output, but the evidence of witnesses differed widely as to the limits which might properly be imposed. 128. Mew.— :This conflict of opinion was specially marked as regards hours of adult male workers. On the one hand, those who had been employing their workers for 15 hours a day, sometimes with Sunday work in addition, stated with confidence that such hours were not excessive, that they had been worked in times of peace, and that they could not be reduced without loss of output. Amongst those who favoured the longer hours were to be found some of the largest employers of labour, and whatever their views might be as to the ultimate gain from the reduction of hours, they hesitated to incur the responsibility for any reduction of output, since such reduction, even though temporary in character, might, owing to the large number of workers involved, prove serious in bulk while it lasted. As a representative of one of the largest firms in the country said :■ — " Once a reduction was made it was impossible to go back to the previous position. In consequence one must be sure of the ground before making experiments. Previous experience is not a complete guide on this occasion, because patriotism is a new and important factor." 129. On the other hand witnesses, many of whom had devoted a close study to questions of industrial fatigue and scientific management, were emphatically opposed to overtime, except for quite short periods. " As regards overtime, he did not consider it efficient, nor was it profitable if paid for at 1 J rates. It did-not induce any increased output, except when working for a short speU to attain a definite object. If continued for a long period, the tendency of overtime is to reduce rather than to increase output. The strain caused by the work is a mental rather than a physical one. The monotony of always being at one job was also productive of fatigue." " In his opinion, the greatest economical efficiency of engineering labour is obtained with a week of 48 to 55 hours. Longer hours, in the long fun, meant a diminished output, inferior quality of work, and much greater cost of production. Though attending to heavy machinery might involve periods of rest from physical strain, it involved mental strain, owing to the amount of damage caused if anything went wrong." 130. Between these two extreme views a middle course was also advocated. It allowed a maxi- mum of 10 to 12 hours of overtime a week. Thus a large employer of labour, who was also engaged in organising National Factories, expressed the view : — " Definite restrictions should be placed on overtime. No workman ought to work for more than 80 hours in any one week, or to maintain an average of more than 65 hours a week." 131. Similar views were expressed by Trades Union Representatives : — " Where there is overtime beyond two hours daily there is evidence of fatigue and men cannot be employed economically, from health and production point of view, on continuous overtime of three and four hours daily. Fatigue is rarely reaching the point of breakdown, but does affect health and production, and in my opinion wiU manifest itself later. In some cases where such overtime is worked, apart from night shifts, men are allowed one early night per week, and I think this is wise and economically sound." " The witnesses were inclined to think that, to meet the present abnormal circumstances, men should be able to work as much as 60 to 65 hours a week over a long period. The exact length of hours would necessarily depend on the character of the work. Thus 65 would certainly be too high for gauge makers. The hours at night involve greater strain and should not exceed 60. Even these hours were justified only by the present crisis, and were no criterion of what was reasonable and proper in ordinary times." 132. In the agreement between the Engineering Employers' Federation and the Engineering Trtdes Unions already referred to a similarlimit was adopted. 133. Boys. — In the case of boys the evidence showed that the hours of employment were largely determined by the fact that they frequently worked with men. The Home Oflice had fcr:ndit neceeeaiy to sanction the employment of boys for 671 hours a w'feek, and for even longer periods in special cases, the period of the working day being extended to 14 or even 15 hours as compared with the 12 hours allowed by the. Factory and Workshop Act. Though as in the case of men no substantial breakdown occurred there was no doubt that the hours worked in m-any cases involved a serious strain. Dr. Agnew as a result of a medical examination of 1,500 boys employed in all parts of the country and under varying conditions of employment reported as follows : — " My general impression is that hours tend to be too long for the proper preservation of health and efficiency. I^rge numbers of boys are working a net average of 68J hours per week. Under certain conditions the effect 32 upon their health is not so deleterious as in others), but, whatever the conditions, where more than one hour has to be spent in going to and from the factories, in my opinion, 68J hours are too many. Many of these boys are just over 14 years old, and they spend considerably more than two hours per day in travelling, thus having very little time for recreation or for rest. The natural bent of most of us is to revolt against a yoke of any kind in modern times. This is just what happens. The boys have found from experience that they cannot comfortably work over 60 hours per week, and as evidence of this — in one shop where 600 boys worked, 500 of them on a Saturday afternoon did not return to work. " The same state of afEairs, with a few exceptions, is found up and down the country. On the night shifts, boys do not tolerate well long hours, and in one factory a very large percentage of the boys complained of sleepiness and disinclination for work. It has to be borne in mind that the average age of the boys examined would certainly not exceed 15 years, and it makes one consider very seriously the future of the rising generation." 134. A social worker with considerable experience of boy labour in munition works informed the Committee that : — • So far as he knew, there had been no general breakdown, but then he did not expect to see immediate effects, notwithstanding the long distances that some boys had to travel. He suggested, however, that the boys are drawing on their strength, and pointed to the fact that the boys fall asleep in the trains and trams, and often travel on beyond their stations. They have no leisure, no recreation, and no classes, and he was very anxious as to what would become of the boys after the war. He suggested tbat too big a price was being paid for output. Even the hours allowed under the Factory Acts were very lenient. The granting of relief at the week-end was a great boon. 135. In considering what hours of employment are reasonable for boys, it is necessary to distinguish between boys under 16 years of age and those over. A witness with wide 'experience expressed the view that : — " Boys between 16 and 18 were quite different from boys under 16, they were much stronger. Boys under 16, on the other hand, were probably more delicate than girls of the same age, and more likely to break themselves up. The essential safeguards were the reduction of hours and welfare work. Apart from the strain on the health involved, long hours had disastrous effects upon the characters of boys. They also might make an adequate amount of sleep difficult and, perhaps most important, they prevented adequate facUities for recreation. Such facilities were of primary importance both for the physical and the moral welfare of the boys. This latter danger was accentuated by the monotonous character of their work, which afforded no intellectual interest. In the absence of healthy recreation the boys' minds and conversation were likely to become unhealthy and to lead to a general deterioration in character. Bight hours of sleep at least were essential, nine hours would be better. Unfortunately many boys got only six or seven hours." 136. Women. — Important as it is that the hours of work for men should be kept within reasonable limits, it is essential that hours of work for women and girls shoilld be even more closely safeguarded. Adnoittedly women and girls are unable to bear the strain of long hours as well as men. Conditions which press hardly on the average man, press, because of difference in constitutional development, with greater severity upon the average woman. Under the General Order issued by the Home Office in September, 1915, women and girls over 16 years of age were allowed to be employed up to 67| hours a week. While this Order applied to the great majority of munition works, permission was granted in special cases for between 70 and 80 hours a week. The maximum hours of daily employment was extended to 14 hours as compared with 12 hours allowed under the Factory Acts. 137. Though, as in the case of men and boys, no serious breakdown of health can be pointed to, the Committee were left in no doubt as to the strain involved. A medical examination* which was conducted of over 1,300 women selected from varying types of work in different parts of the country showed that though for various reasons no general breakdown had then occurred, there undoubtedly existed a serious amount of strain. Only 57 per cent, were classified as healthy as compared with 78 per cent, in the case of a similar examination of men ; even if full allowance is made for variations in the standard adopted by different medical officers, the difference between these two percentages is still significant. In one factory where the women were employed for 77 hours weekly, 15.5 per cent. of the workers showed evidence of marked fatigue and it was reported that the workers were practically unanimous that the hours should be shortened. 138. Many witnesses expressed the opinion that the hard work was telling on the women though they were keen to work, feeling that they were performing a patriotic duty. Though some employers sought for permission and used to the full power to employ women for more than 65 hours a week, the majority limited their application to that figure. Moreover inquiries showed that in many factories the maximum hours were not worked continuously. Employers sought permission for a wider limit of hours than was ordinarily necessary or desirable in order that they might have latitude for dealing with special emergencies. 139. The nature of the evidence available made it clear to the Committee that any recommendations they put forward in regard to the limitation of weekly hours of employment must necessarily be tentative and provisional in character. Moreover, if the recommendations were to be of practical value, and secure any wide measure of acceptance, it was necessary that they should satisfy two essential conditions. First, they had to be such as would be regarded as reasonable and moderite by the great mass of employers and workers, and secondly, while taking account of the probable duration of the war they had to have regard to the immediate urgency of output at that time. Any recommendations which might involve even a temporary diminution of output would have been doomed' to failure. It was evident in fact that any reduction of hours proposed must be gradual, and the Committee accordingly based their recommendations on what appeared to be immediately practicable, rather than on what was ultimately desirable, or might be defensible on a physiological basis. Further, they found it necessary * See Committee's Interim Report (Cd. 8511), pages 110-121. 33 to confine themselves to suggestions as to the maximum limits within which weekly hours of employment should be restricted, and they did not endeavour to set out the extent to which, in their opinion, it was necessary or desirable to reduce these limits to meet varying industrial conditions. 140. The limits of the weekly hours of employment provisionally suggested in their memorandum No. 5 (" Hours of Work "), which was prepared in January, 1916, were :— (a) For men, that the average weekly hours of employment should not exceed 65-67 (exclusive of meal times), i.e., a 13-14 hours working day. (b) That boys under 18 should be allowed to work the same hours as men, provided that : — (i) The hours of boys under 16 should be limited to 60 so far as possible ; (ii) Substantial relief at the week ends should be insisted on ; (iii) Night work should be limited as far as possible to boys over 16. (c) That for women and girls employment should be restricted within the normal legal limit of 60, i.e., a 12-hour working day, though within these limits moderate daily overtime might be allowed, and that the employment of girls under 18 at night should be limited as far as possible. 141. These recommendations were generally accepted as fair and reasonable and were widely adopted. In September, 1916, the Home Office, after consultation with the Ministry of Munitions, issued a new General Order reducing the maximum hours of work for women and young persons which had been allowed in the previous General Order. Under this Order which was based Upon the recommendations of the Committee — (a) The employment of women was limited to the 60 hours a week permitted under the Factory and Workshop Act, though within this limit night work was allowed and work for not more than 14 hours (including meal times) instead of 12 on any one day. The employment at night of girls between 16 and 18 was only allowed in special circumstances where the Superintending Inspector of Factories was satisfied that the work was suitable and of a specially urgent character. The employment of girls under 16 at night was not permitted at all. (6) The hours of employment of boys over 16 were limited to 65 by day (excluding meal times) and 63 by night. Night work for boys under 16 and their employment for 65 hours by day was only permitted where the Superintending Inspector of Factories was satisfied that the urgency of the work and other circumstances made it imperative that they should do so. 142. The Order made the relaxation of the requirements of the Factory Act subject to the fulfilment of the following general conditions : — {a) Employment on night shifts shall be subject to the provision, to the satisfaction of the Factory Inspector, of proper facilities for taking and cooking meals, and in the case of female workers, for their supervision by a welfare worker or a responsible forewoman. ' (6) No woman or young person shall be employed continuously at any time for more than five hours without an interval of at least halt an hour, except that where not less than one hour is allowed for dirmer, an afternoon spell of six hours may be worked, with an interval of quarter of an hour only for tea, if the Factory Inspector is satisfied that adequate provision is made for the workers to obtain tea in the works and for tea to be actually ready for them as soon as they stop work. (c) If work commences before 8 a.m. and no interval is allowed for breakfast, an opportunity shall be given to take refreshment during the morning. (d) A woman or young person shall not be allowed to lift, carry or move anything so heavy as to be likely to cause injury to the woman or young person. (e) Different schemes of employment may be adopted and different intervals for meals fixed for different sets of workers. 143. In a covering Circular the Home Office stated that : — " The Order which fixes maximum limits of hours, does not discriminate between the various forms of work carried on in munition factories, and subject to these limits it is for the occupier to decide, having regard to the nature of the work, the time taken by the workers in getting to and from the factory, and other circumstances, what are the best hours to be adopted at his particular works in order to secure the maximum efficiency and output over a long period ; and he is ettipowered by the Order to fix different schemes of hours for different sets of workers. Further, it wiU be necessary for occupiers to instruct managers and foremen to watch closely how each scheme works in practice. Experience shows that some slight alteration or adjust- ment in the hours of work, such as, for example, the rearrangement or extension of the meal intervals or, in cases where overtime is worked, a short cessation occasionally from overtime, may be sufficient to check staleness or fatigue and cause a marked improvement in the workers' efficiency." 144. Since the issue of the Order the Home Office and the Ministry have taken other gteps to reduce hours. Special concessions have been withdrawn notably as regards the employment of women for more than 60 hours a week and the employment at night of girls between 14 and 16. In addition action is being taken which is resulting in the steady abolition of the employment at night of girls between 16 and 18. Special concessions as to the employment at night of boys between 14 and 16 are also being reduced. 145. As already stated the recommendations originally put forward were only provisional and the evidence which has since accumulated has shown the necessity for their revision. From the commence- ment of their work the Committee have attached the highest importance to the collection of exact data afEecting the problems at issue. The field to be covered is a very wide one, while the process of collection has been slow and laborious. The Committee, however, consider that the data which have already been collected on their behalf by Dr. Vernon and others are of great practical value and demand the most serious attention. The results of these investigations are the more valuable in that they have been undertaken in the workshop and not in the laboratory, solely in a spirit of scientific investigation and with (b 12023) C 34 no preconceived opinions. The selection of factories for enquiry was based entirely on the likelihood of reliable data being forthcoming. Further, in none of the operations studied was there any change in the nature of the operation or the type of machinery during the period under review. The data were so chosen as to eliminate any possible disturbnace due to increasing skill. There is no reason to suppose that the data were vitiated by any artificial restriction of output. On this last point Dr. Vernon reports : — " When the hourly outputs of individuals are plotted on a diagram, the distribution in the majority of operations is roughly symmetrical, persons who exceed the value reached by the largest group being about as numerous as those who fall short of it. In certain operations ("drawing" and "rect.fying" cartridge cases) where the machine itself places an upper limit upon the, possible speed of production, the shape of the diagram was different, the number that exceeded the output most frequently attained — ^what may be termed the fashionable or " modal " value — being much smaller than that which fell short of it. A corresponding result was obtained for women sorting cartridge cases, when paid at time rates, but fot similar operatives when paid at piece rates the symmetrical distribution was once more observed. It is accordingly contended that the form of distribution, whether approximately symmetrical or asymmetrical, may be a ustful test as to the existence of limitation of output, and that in the majority of the operations here studied no such limitation occurred." The following diagram was prepared by Dr. Vernon to show the variation in Output of Women Turning Fuze Bodies :— 40 30 Q, o Cj 20 .10 ■ Nov.-Dec. 1915 Mar. -Apr; 1915 Nov.-Dec. 1916 , , I , ss 75 9S lis 13S relative: iss us HOURLY OUTPUT 19S ZIS US 146. The result of Dr. Vernon's investigations, which covered a period of over a year, are set out in Memoranda Nos. 12 and 18,* but it appears desirable shortly to set out again the principal results of his investigations in so far as they concern the relation of weekly hours of employment to output. The following are the four sets of data which bear on this subject : — * Cd. 8344 and Cd. 8628. 35 \y 13 o pq o X H o ■S -S 00 fS •| I o 00 u o in H S 53 o e* . I— i ^) 0) ts o S' ^"3 fL( :\. o E-i ^1 f5- =3 „-« fl 92 fH M jH ^ £ (D (D O :— . O 05 fi OS O 00 SO >o to to 10 o O M O (M OOONtOC-N'MCOtO tH'IO 00 CO CO e^ Td CO i> c5 CO c "^ 1,^ iOr-ii-HOeOr- CO in 10 i> CO CO 00 ifi CD CO ■^■^"oOCOCOCOOOOOOOOONINi-lCoeioJcJ ooooooco t^CClU5COCOC010lOiO»OC010W5COCC)i^i!t1. »o»o»oo lOW»0»ClO»OlO»OOiCiA»CiO (b 12023) 05 : ^ :::::::::;:: ; : : : • : :;::::::::::: 1—1 Is :::::::::::::: : : : : : : ::::::::::::: > o sj 10 cfl CD n fl 5^ O O r^ S 0^ ° -, fl ac o "^ ^1 10 02 &c o '3 1^ "~^ CO &> • fH _S CO o "73 CO o g ^^ 02 .9 OS rQ OJ 1> 6D C3 &D aj fl rJ:^ fl c3 1 cu o a O) bD c3 fl OJ 10 o 10 J -a M ^^ > o n ha- '^ > •in 0) O ^ I ^ rfl rt o 1 ^ fl o ,-5.10 CO *> 10 =* ^ fl CO "^ g S a> « ^ S 9 >>— ' & ° fl O g OJ CO fl ^ ^ C 2 36 t S I- O X M !3 a, ID s OQ 60 "1-1 l=i •rl o 1^ ■ 5 ^ . cS O g 3 ^ ^ O H-l ■< o -M o PlH cc C M a!^ & ¥ ^ bD T3 .2 h i i O O 03 +=> S O Ph &^ £^ ce -p o S -p ■'3 S S ft S g o to ce ^ 53 ■P u u p CD >* "I m -P O •a f^ JS ■5 S «D O 001OCOTt © m -H 1-1 -<11 CO 10 a: 05 a> 05 IN OOOJK5>00010>0<2>>0>0'0^ ©©U3W3lCW5U5lO»OmOlO 1>F- l-5jl00O5-^T^00»O000000 -82 :::::::::: : ::::::::::::::: CD __ CD i! Q ^ ll' :::::••:•: : : : • : : : ^1 ..:..:::::: :::eqo2iocoo- ..rii^oo (M , t* Til I-H 00 S >> l-H I-H (N S S gl^§ . . ..i^ I -^ -— I 1 -" =^ --i " " o 2 H eS to ■a q o OQ o fH a lU ft O ■— ■ §• IC nt«f o u I-H 'I-H O 'a •3 &l-t^ OQ -t:> fl «i ft >.s -<-] !^ pi , , +3 m ra H fl -M 3 ft-a ^+-1 +3 -4-> ao a) d a t3 ca r£5 p. -> '^ a t 60 a> a ft ■^ ii> s -t^ rd u T3 iKi -M >, -s Oj ■Ti ffi ^^ a > 3 ^ m 8 fl ^ ft tu g^ § l» (H -iJ -1^ rd -l-> Tl E3 ^3 ^ OS S a ID cd m ^ 1- 1 T! Si 1 IV 1 0) 1 rd iT" g S o ^ :^ a e^;: o o B "^ S 2 S " 60 ca o 3^ Pa .0 rj3 -W 37 Table III.— 56 Men Sizing Fuze Bodies. n \ Nominal Per cen< . of time lost per week as — hours of work Actual hours of work per Relative output per Hours of work Week ending 1 X per Broken Short Absent week. working hour. relative output. week. time. weeks. weeks. Total. • Nov. 14— Dso. 19 66.7 4.4 5.6 2.8 12.8 58.2 100 5,820 ( = 100) Feb. 27— Apr. 16 62.8 5.2 8.6 5.8 19.6 50.5 122 6,161 ( = 106) May 28 66.5 -v 54.91 ' 117^ June 4. . . 63.5 55.8 122 „ 11... . 58.5 . 49.9 118 „ 18... 53.5 . 5.2 8.3 0.9 14.4 46.0 .52.1 119 >119 6,200 ( = 107J „ 25... 58.5 51.2 122 July 2... 58.5 f 48.3 118 „ 9... 61.0 \ 51.7 112 „ 16... 66.5 59. Ij ' 120. „ 22... . 55.5 1 47.61 119-1 „ 29... . .. 58.5 I 5.2 9.0 2.7 16.9 45.9 Ue.s 124 1 123 Aug. 5... 53.2 J 45. 3j 126 J „ 12... 31.0 27.8 130 „ 19... 39.5 33.0 136 „ 26... Sept. 2... 58.5 - 51. 6-] 131 T „ 9... „ 16... 58.5 44.5 - 5.6 4.8 1.1 11.5 49-2 L.- t, 40.1 r^-6 I33 h^ 6,426 ( = 110) „ 23... 53.5 . 49. 4J I39J „ 30... 29.5 28.2 135 Oct. 7... 54.5 ~i 51. 3> 133^1 „ 14... 54.5 51.4 142 „ 21... . „ 28... . 55.3 51.8 ' 4.1 1.6 0.9 6.6 50.2 47.7 ^51.3 138 13S *-137 7,028 ( = 121) Nov. 4... 58.5 55.7 138 „ 11... 58.5 53.3 = 138' „ 18... 56.0 50.6 136 „ 25... Deo. 2... 55.2 54.5 . 4.2 5.0 0.7 9,9 50.7 49.1 ^51.2 135 ■ 140 ^139 7,117 { = 122) „ 9 58.5 50.6 1 — ^141 „ 16... 58.5 53. OJ 146 J „ 23... 29.5 ' 27.1 13,6 / 149. During the period ending December 16, the nominal weekly hours were substantially less than during the period ending April 16, but owing to the cessation of Sunday labour the time-keeping was so much improved that the actual hours of work were greatter than during the earlier period. » Table IV.— 15 Youths Boring Top Caps. ^ ' / Weeks in Nominal Per cent, of time lost as — Statistical which Sunday hours of work ' Actual hours of work per Relative output per Hours of work. period. X labour was per Broken Short Absent week. working hour. relative output. performed. week. time. weeks. weeks. Total. ' Nov. 15-Dec. 19 5 out of 5 78.5 3.6 0.0 4.0 7.6 72.5 100 7,250 ( = 100) Jan. 3-Peb. 13... 4 „ 6 75.5 - 5.8 1.7 1.0 8.5 69.1 106 7,325 ( = 101) Feb. 21-Apr. 16 6 „ 8 63.4 5.4 5.8 2.3 13.5 54.8 108 May 1-May 28 2 „ 4 61.5 5.8 2.3 3.0 11.1 54.7 117 6,400 ( = 88) May 29-July 2... „ 5 51.1 1.9 5.3 0.0 7.2 47.4 124 July 3-Sept. 23 2 „ 6 59.7 5.5 3.9 2.2 11.6 52.81 1291 (day shift). ^54.5 k29 7,030 ( = 97) July 2-Sept. 23 „ 6 61.6 2.6 4.8 1.4 8.8 56. 2j 128 J (night shift). Sept. 25-Dec. 16 „ 6 54.8 3.7 7.3 0.0 11.0 48.71 1261 (day shift). ^51.7 k26 6,514 ( = 90) Sept. 24-Dec. 16 „ 6 58.2 2.7 0.0 3.3 6.0 54.7 J - 126 J (night shift). ► 150. This process is largely automatic ; increase of output could only be attained by a more continuous feeding of the machines throughout working hours. (c 12023) C 3 38 151 A Speaking generally, the above data show that a reduction in the weekly hours of actual work, varying from 7 to 20 hours per week, in no case resulted in niore than an insignificant dinunution of total output, while on the average it produced a substantial increas^;>As Dr. Vernon points out, the classi- fication of the operations according to the possibility they ofEet'lor speeding-up production demonstrates anew the self-evident fact that the alterations of hours may have very different effects in different operations. The exact measure of such alterations cannot be predicted : it can only be ascertained by observation and experiment. It appears evident, however, that for processes similar to those examined by Dr. Vernon the weekly hours can advantageously be reduced to a total of from SO to 55 hours, and he suggests that even lower limits might give an equally good output. 152. Two further points of importance emerge from consideration of these data, l^n the first place the rate of production changed gradually, and frequently four months elapsed before an equilibrium value was reached. This gradual change appears to nullify the suggestion that the effect upon output of the change of hours was a mere consequence of the desire to "earn the same weekly wages as before the hours were shortened. The explanation is rather to be traced to the worker finding unconsciously and gradually by experience that he can work more strenuously and quickly for a short-hour week than for a long-hour week. In the second place the evidence suggests that a considerable increase in the average hourly output is possible, quite apart from any increased rapidity of working. Thus, as the result of special investigations. Dr. Vernon found that in the case of the first body of workers mentioned above the time lost in commencing and stopping work during the first period^ averaged 37 minutes as compared with only 26| minutes during the third period. (See Cd. 86284^^ 153. Professor Loveday, in his Memorandum on the " Causes and Conditions of Lost Time," which is included in the Committee's Interim Report on "Industrial Efficiency and Fatigue,"* also supplies valuable data, though of a somewhat different character. In the first place, he points out that the pro- portion of lost time that is due to sickness and other unavoidable causes is, as a rule, greatly under- estimated in factory records, and the proportion due to slackness consequently over-estimated. In the second place, he expresses the view that long hours, much overtime, and especially Sunday labour exert a pernicious effect upon health, particularly of persons occupied in heavy trades. In paragraph 33 (5) of that Memorandum he gives two tables, the first dealing with a body of about 180 men, and the second with between three and four hundred men employed on heavy work, their normal hours being from 65 to 70. In both these cases, xhen comparison is made with the figures of lost time for June, 1915, and for a year later, the fact emerges that there was a material increase in the amount of lost time, and that by far the larger portion of the increase was due to recorded sickness. In both cases, through- out, recorded sickness represented a noticeably high proportion of the total amount of time lost. 154. Professor Loveday also devoted considerable study to the examination of figures concerning the amount of time lost before breakfast. He concludes : — ■ (a) That if early hours be worked, the loss is likely to decrease if the start be later than 6 a.m. (6) That when the total hours of the day-shift week are the same, there are likely to be more hours actually worked without than with work before breakfast, other conditions being similar. (c) That a i:eduction of hours may be compensated for or even outweighed by the abolition of early hours, partly owing to reduced absences, partly owing to reduced waste of time, and partly to the greater vigour of work after taking food. 155. He quotes figures for a number of different factories which confirm these conclusions. He strongly presses the view that food should precede work. ,< He points out the imdesirability of hunger work, its bad effect upon health and the temptation to lose time in the short early spells. 156. There can be little doubt that there is an increasing recognition on the part of both employers and workers of the broad fact which emerges from the investigations of Dr. Vernon and Professor Love- day, namely, that suhstantial reduction of hours can he effected without any reduction of output. Whereas at the beginning of the War there was a general belief that longer hours necessarily produced larger out- put, it has now become widely recognised that a 13 or 14 hours' day for men and a 12 hours' day for women, excepting for quite brief periods, are not profitable from any point of view. Few, probably, would disagree with the statement contained in the Smnmary prepared by the Right Hon. G. N. Barnes, M.P., of the recent Reports of the Commissions on Industrial Unrestf that — " There is a general consensus of opinion that Sunday and overtime labour should be reduced to a minimum, that holidays should not be curtailed, and that hours of work should not be such ae to exclude opportunities for recreation and amusement." 157. It must be recognised that the conditions are not the same now as they were in the early days of the War ; not only have large numbers of the youngest and strongest workers been withdrawn for military service, but those who remain have undergone the strain inseparable from a continuous period of long hours of employment. To this must be added the strain caused by family and other anxieties arising out of the War. While much has been done to improve conditions of employment they are still in many cases far from ideal, notably as regards housing and transit. Further, large numbers of women are now employed on heavy work and on skilled operations which were considered two years ago to be quite beyond their capacity. It may be true that no serious breakdown of health has as yet * Cd. 8511. •j- These Reports (eight in number) have been published and can be purchased through the usual channels. 39 been observed among the great mass of the workers, but it cannot be assumed that this condition will continue indefinitely. The effects of the strain may even have been already more serious than appears on the surface, for while it is possible to judge roughly the general condition of those working m the factory to-day, little information is available concerning the large number of workers who, for one reason or another, and often because they find the work too arduous, are continually giving up their employment. This is an important point which is liable to be overlooked, since the supply of labour has hitherto been adequate to fill their places. The irritability and nervousness mentioned by the Commission on Industrial Unrest are moreover well recognised symptoms of fatigue, while it must not be forgotten that the effects of fatigue are accumulative. How great is the burden imposed upon women by a 12 hours' shift is shown by the following extract from a report recently prepared for the Committee upon an enquiry amongst individual women as to the conditions of employment in a factory, where much of the work was heavy in character :— " It appears that out of 140 women 99 were having under eight hours' sleep to fit them for a night of 12 hours shift plus travelling time. Moreover out of 146 women only 16 felt that they were able to go out at all during the week. Where replies were not given it was in general because of the obvious absurdity of asking the women what they did in their spare time, after having heard their account of domestia responsibility. " It may therefore be very strongly urged that these hours of work coupled with the distances to be travelled are such as to preclude the women taking any outside interests if they are to get sufficient rest. It is obvious that the majority of the women recognise this and are content to save themselves only for their work. Such a sacrifice may be with justice demanded for a short period through the exigency of a great and unexpected emergency, but should certainly not be enforced for a longer duration than is absolutely necessary. It may again be noted that already many of these women have worked on these long hours for 16 months." 158. After careful consideration of all the circumstances, the Committee are convinced that the maximum limits of weekly employment provisionally suggested are too high except for quite short periods, or perhaps in cases where the work is light and the conditions of employment exceptionally good. In the great majority of cases, however, the hours of work should now be restricted within limits lower than those quoted in paragraph 140 above. It is impossible to lay down a single rule as to the best hours inaU cases ; the best scheme can only be determined after a careful consideration of a number of different factors, e.g.— (a) The strain involved in the work, its character (heavy or light, continuous or intermittent), the mental demand which it makes upon the worker, and the length of process. (b) The extent to which the pace of the work is governed by the machine. (c) The factory environment — temperature, ventilation, &c. (d) The individual physical capacity of the workers, and their age, sex and experience. (e) The organisation of the factory (including welfare supervision). (/) The sufficiency and suitability of the workers' food, canteen accommodation, &c. (g) The arrangements of the hours of work (spells, breaks and pauses). (h) Conditions outside the factory — e.g., housing and transit. 159. In arranging the hours of work for a factory allowance should be made, as far as discipline and organisation permit, for the fact that the best hours of employment will not be the same for all pro- cesses, even in the same factory. 160. Though no exact statement is possible as to how far the reduction of hours can advantageously be carried out, either now or in the near future, it is not without significance that so experienced an employer as Lord Leverhulme should be now advocating the establishment of a six-hours' day. Though many will not be prepared at the present time to agree as to the feasibility of so radical a proposal the grounds on which the proposal is advocated, as stated in a memorandum submitted to the Committee, appear worthy of quotation : — " But under the present system of hours of work, the thorough education of our children is practically impossible. An absolutely essential step in the direction of a more efficient Educational System is the shortening of the hours of labour and the improving of the conditions of living for the worker " We are only just beginning to make a considered study of the inefficiency and resulting waste that is produced by fatigue. We cannot claim even yet that we have any very profound knowledge on the subject, but the wastefulness of fatigue has been abundantly proved by the researches already made. Therefore it is essential that work in the factory, the workshop, and the office should be so arranged as to avoid fatigue, and by maintaining the general health of the workers, to prolong their activity and increase their skill and efficiency. "Moreover, modem conditions of production requiring costly plant, machinery and factory buildings make it obvious that such division of the 24 hours must be made as wiU (whilst utilising the mechanical utilities to their utmost capacity so as to get as large an output from plant, machinery, and mechanical utilities as possible) tend to relieve the human element from fatigue. Only by so doing can we reduce to a minimum all overhead charges for interest, depreciation, and rent, &c., &c. " It is obvious from the above that when our modem industries are run on a less fatiguing system of say two shifts each of six and a halt hours with half an hour offi for meals (ma,king six working hours in all per day), the efficiency of the worker by thus avoiding fatigue can be increased by at least 33 per cent., and consequently that as much work can readily be done in six working hours as under present conditions is done in eight. But in addition to the ability of the employee to produce as big an output in six hours as is now produced in eight, there would be the added advantage that the plant, machinery, &o., would be running lor 50 per cent, longer time, viz., 12 hours instead of eight, which running of machinery would reduce the overhead charges proportionately and increase the output enormously. " At the close of the war we shall be in a unique position to try this experiment as a nation. We shall want all the output of majinfactured goods we can produce. We shall not have immediately the power largely (B 12023) C 4 40 to increase our plant and machinery. We shall have the return of our heroes from the field of battle ; there- , fore we shall have ample supply of labour to test the experiment. The world's demand for manufactured articles after the war will be overwhelming and unprecedented. " The six-hours working day does not mean some hours gained for loafing. It is not intended to produce a loafer's paradise within the United Kingdom, and I say, without hesitation, that there is not a single man or woman of those who would be benefited by a six-hours working day, who would not feel themselves to be insulted if he or she were thought capable of viewing the proposal in that light." 161. Though the extent to which hours of labour can be advantageously rediiced must necessarily vary, the Committee desire strongly to emphasise their opinion that the time is now ripe for a further sub- stantial reduction in the hours of work. If this be effected with due regard to the varying conditions .prevailing in different branches of industry, they are satisfied that reductions can be made with benefit to health and without injury to output. It is highly significant in this connection that the Government should have recently announced their decision to introduce an experiment in some Government National Factories of a week of 50 hours. It is to be hoped that the experiment will be closely watched and its results accurately recorded. 162. It must be obvious that any reduction of hours which can be accomplished without loss of output is profitable not only to the employer, in that it reduces running expenses, but to the worker since even if his or her daily'measure of work involves the same amount of fatigue a longer period is left for recovery, for the enjoyment of adequate sleep and rest, and for the necessary opportunity for recreation, exercise and the discharge of the ordinary duties of citizenship and domestic life. Section VI. SHIFTS, BEEAKS, SPELLS, PAUSES, AND HOLIDAYS. Shifts and Daily Hours of Employment. 163. If weekly hours of employment are limited, as suggested in the last section, it necessarily foUows that average daily hours of employment will also be confined within moderate limits. The special questions which arise in regard to them can therefore be dealt with briefly. 164. The daily employment of workers is organised in single shifts, in double shifts, or in three shifts. From the point of view of output single shifts are open to objection owing to the large munber of hours out of the 24 during which the machinery lies idle. In the earliest stages of the war, when it was frequently found impossible to organise a second shift owing to the dearth of workers, and especially of skilled operatives, an endeavour was made to secure larger output by prolonging the hours of employment, men, and even women, being employed over long periods for 14 or even 15 .hours a day. For reasons already explained it is now generally recognised that these long hours are unprofitable, and that much shorter hours can be worked without a^ny loss of output. Many munition employers, as a result of recent experience, now take the view that for women and young persons a 12-hour day is too long, and hours are now frequently limited to a 10-hour or even a shorter day, longer hours being only worked occasionally to meet special emergencies. 165. Double shifts are the form of employment now most commonly adopted. Though for reasons to be stated in a later section, night work is in itself open to serious objections as a permanent part of the industrial organisation of the country — at least, so far as women are concerned — it must for the present be regarded as inevitable, at any rate, for adult workers, since it enables the machinery to be employed for the greater part of the 24 hours ; and so long as the hours of work are not unduly long, and due attention is paid to the environment of the worker, it is undoubtedly productive of increased output. 166. For men the two shifts are most commonly each of 12 hours' duration, though occasionally to meet local conditions the night shift is of 13 hours, as compared to 11 hours of the day shift. Such an arrangement can hardly be economical, in view of the greater strain involved by night work, and the arrangement should certainly be avoided wherever possible. Where the nature of the work does not render it essential that the end of one shift should coincide with the commencement of the next, it is unquestion- ably advantageous to leave an interval between the two shifts. The shorter hours thus rendered possible are beneficial from the point of view of both the health of the workers and of output. Apart from this, opportunity is afforded for cleaning and ventilating the shops^ — a matter of much importance. This point was emphasised in the circular issued by the Home Office with their General Order of September, 1916. They stated : — " The Secretary of State desires to emphasise the desirability of allowing an interval of half an hour or more, between the two shifts unless the process is one which must necessarily be carried on continuously, Such an interval is of great value in affording an opportunity for cleaning and ventilating the shops." 167. Men are occasionally employed on a system of three eight-hour shifts. Of the operation of this system in certain steel works a prominent trades unionist spoke as follows : — " While it is too early to make any definite statement as to the effect of the change upon the health of the workers, employers had borne testimony to the great success of the change ; bad men had become good and good men better. Under the old system a worker was completely worn out by his work, under the new system he was able to take up hobbies such as allotments, bowling or fishing which kept him out of the public-house. 41 Thus at one place it was reported that amongst a population of over 30,000 people there had not been during the last year a single conviction for drunkenness, the shorter hours enabled the worker to get home and get dressed and generally encouraged self-respect." 168. If only on account of the dearth of male workers the system, whatever its advantages, is not capable of general adoption at the present time. 169. The three-shift system, especially for women, has much to commend it where it can be ' organised. It imposes little or no strain upon the workers, while the periods for which the machinery stands idle are much reduced. Difficulties, in regard to an alternative supply of labour, do not arise to the same extent as in the case of men, and there is no doubt that the three-shift system yields the best results where it can be arranged for. The strain of night work, indeed, the strain of work generally, is sensibly diminished. Greater vigour of work is maintained throughout the shift ; less time is lost by unpunctuality or illness. In the 8-hour shift each hour has a sustained value in contrast to the diminishing value of the later hours in a longer shift. The night shift, which is the most, trying, recurs every third, instead of every other, week. 170. On the other hand there are certain difficulties of organisation which have to be surmounted : — (a) Male tool-setters have ordinarily to be employed on two 12-hour shifts. Difficulties conse- quently arise in combining the hours of men and women workers, notably as regards meal hours and the supervision of work. (&) The break for meals being limited to half an hour may afford an inadequate time for refreshment, especially at night. (c) Time may be lost at the change of shifts. (d) Workers may object through fear that shorter hours will mean smaller wages.. (e) The benefit of shorter hours of employment in the factory may be lost through misuse of leisure time, or by its devotion to household duties. Difficulties are also sometimes experienced in the home and in lodgings through meals being required at times inconvenient for other workers. 171. Experience shows that these difficulties, though substantial in particular cases, are seldom insurmormtable ; there are numerous instances throughout the country where the three-shift system has been successfully organised. Thus it was reported of one firm : — ■ " The firm believe the three-shift system to be the best for output and health. They are satisfied that the difficulties are not substantial and that they can all be met by re-organisation and shop management. They consider there should never be a shortage of material, loss of time, friction in taking over shifts, or any of the other difficulties alleged against the three-shift system. In their opinion aU the alleged difficulties can be overcome." Breaks. 172. The ordinary daily hours of work are organised under the " two-break " system or the " one- break " system. Under the former work usually commences at 6 a.m., and the ordinary breaks are half- an-hour for breakfast and one hour for dinner. Under the " one-break " system work commences afte breakfast at 7 or 8 a.m., and there is generally only a single break of one hour for dinner though a break for tea is provided where it is necessitated by the hours of working. This break is generally of half-an- hour's duration but is sometimes reduced to 15 or 20 minutes in order to permit the workers to return home earlier. In the case of women and young persons this limitation of the interval for tea is only allowed where adequate provision is made for the workers to obtain tea in the works and for tea to be actually ready for them as soon as they stop work. 173. Professor Loveday has devoted considerable attention to investigating the conditions of the " one-break" system, and the results of his inquiries are set out in his Memorandum on " The Causes and Conditions of Lost Time " which is included in the Committee's Interim Eeport on " Industrial Efficiency and Fatigue." He suggests that the system has the following advantages : — {a) A large number of " quarters " are lost before breakfast. To some extent this loss is no doubt unavoidable and due to the workers being fagged, to minor ailments (colds and rheumatism) or to transit difficulties ; but much of the loss is avoidable. In his opinion the shortness of the spell before breakfast increases the temptation to miss it. He says : — " The regularity with which a greater number of quarters is lost on certain days indicates deliberate choice of those days, and the preference for ' sleeping in ' on Monday even when there has been no Sunday shift disproves any direct connection between overtime and much of the loss of early hours." (b) The amount of time lost before breakfast is often sufficiently large to cause serious disorganisa- tion. (c) It is only a minority of workers who can put in their best work before having a proper meal in the morning. (d) There is less interruption of work. Dr. Vernon in his first Report (see Memorandum No. 12) has called attention to the large amount of time which is lost in starting and finishing work. 174 Professor Loveday, in paragraphs 51-54 of his Report, gives particulars of a number of factories in which work before breakfast has been abandoned with good results. Even where the change has 42 involved a small reduction in the number of weekly hours this reduction has frequently been more than compensated for by the reduction in the amount of time lost. Apart from a conservative feeling against any change objection has been made to the adoption of the " one-break " system on the ground that — (i) where a reduction of hours is involved a logs of wages is feared. (ji) domestic inconvenience may be caused through the worker requiring his breakfast before he leaves home, (iii) a later start may involve a later hour of finishing work, (iv) the workers do not in fact always get a good breakfast before they start. On this point a representative trades unionist stated that :— " In some cases the ' single break ' system is in force mider which work generally starts at 7. This arrangement is based on the assumption that the worker will have had breakfast before he comes. Where, as is frequently the case, workers have to travel aij hour or more to reach the works, this involves a very long period without food, in addition to the fact that an early start frequently involves at any rate a hurried brealdast and, in some cases, none at all. Even the men get a sinking feeling and cannot work properly. It is worse for women." 175. Professor Loveday is doubtful as to the force of the first three of these objections. As regards the last he suggests that, where the workers live far from home, work should commence at 8 a.m. rather than at 7 a.m. Where the earlier hour is adopted it is generally desirable that a short break for refreshment should be provided in the middle of the morning, and the Home Office General Order of September, 1916, requires in the case of women and young persons that — " When work commences before 8 a.m. and no interval is allowed for breakfast an opportunity shall be given to the workers to take refreshment during the morning." 176. Professor Loveday's view that the "one-break" system is preferable to the "two-break" system is confirmed by the evidence of employers who have practical experience of it. Thus Sir William Mather, as a result of his great experience, informed the Committee that — ■ " The two hours before breakfast were practically wasted owing to the long walk to the works, the absence of breakfast or the temptation to get a drink on the way to work in order to keep warm. Both morally and physically the worker was a better man if he had a good breakfast with his family before leaving for work. His firm tried the experiment for a whole year and the results were such as to leave them no hesitation in adopting the system permanently and nothing had since ooomred to modify their views. The change had proved salutary as well as profitable. Thrift and sobriety had been encouraged. The worker was a better individual. Even now that owing to the war they were working two 12-hour shifts they still attached great importance to the day shift only starting work after breakfast." 177. Dr. Vernon, in his Memorandum (see Appendix C) on "A comparison of the systems employed for dividing up working hours into spells and breaks," gives the results of enquiries into the output of workers before breakfast ; he thus summarises his conclusions : — ■ " Day shift workers on the one-break system were found to work up to their maximum output each morning rather more quickly than the night shift worked up to their maximum ; but day shift workers on the two-break system, in which work was begun at 6 a.m., and was followed by a breakfast interval at 9 a.m., had 7 per cent, to 18 per cent, less output in these three pre-breakfast hoiirs than the night shift workers had in their first three working hours. This was presumably due to the night shift having had a good meal before starting work." Spells and Pauses. 178. Attention has already been drawn to the importance of the proper distribution of rest pauses in providing against fatigue. In America, much attention has been devoted to the proper length and distribution of pauses, and this is one of the most important aspects of " scientific management." In this country, as yet, the subject has received but little attention. Experience has indeed proved that under present circumstances many women and young persons cannot profitably be employed for the full spell of five hours on continuous work as allowed by the Factory Act, and even where the spell is somewhat less than five hours, there is a general tendency amongst employers to allow short intervals for refreshment in the afternoon, and frequently in the morning also. These pauses not only provide an opportunity for refreshment, but a period of rest and recovery from fatigue, and a break in the monotony of the work. 179. Dr. Vernon, in paragraph 31 of his Report on "Statistical Information concerning output in relation to hours of work " (Memorandum No. 12), draws attention to the importance of this subject. He " The custom in many munition works is for the operatives to work for a spell of five hours, and then, after an hoiu:'s interval, for another spell of four and a-half to five hours. Such spells are undoubtedly too long in many types of munition work, but if a second break is introduced in the working day much extra time is lost in starting and stopping work. If the operatives are left to themselves, they take rests at irregular and often unsuitable times. Hence it would be njuch better if the rest pauses were chosen for them. For instance, a 10-minute break in the middle of the morning and afternoon spells, during which the operatives remain at their machines, but take tea or other nutriment brought them by boys or by travelling canteens, has been found a valuable aid to output in some munition works. Some types of work need longer and more frequent rest pauses than others, and the best times can be determined only by experiment. After being fixed they should be made compulsory, and rest pauses at other times be checked so far as possible." 43 180. In- his Memorandum on " A comparison of the systems employed for dividing up working hours into spells and breaks," Dr. Vernon records the results of certain inquiries into the output on five hours' spells ; he concludes that : — " Five-hour speUs of work are too long, for it appeared that by cutting up the 10-hour day into three spells of, e.g., 4, 3 and 3 hours, separated by two breaks (the first of which is too late to function as a breakfast break) the output might be increased 5 per cent, to 12 per cent, above that experienced when two 5-hour speUs were worked. What is probably a better system stiU of avoiding 5-hour spells is to stop work tor a quarter of an hour in the middle of each spell, and provide the workers with refreshment by means of traveUing canteens. The introduction of one such extra J-hour break in a cartridge factory, together with the abolition of the breakfast interval, increased the hourly output 5 per cent." 181. In the same Memorandum Dr. Vernon also records certain data he collected as to rests voluntarily taken by workers. In the case of some men engaged on hand-tapping fuses he found that : — " On an average they took 7 to 9 minutes of voluntary rest pauses in all except the first full hour of works and as they were aU of them men who had been engaged for many months on the operation and were paid at piece rates, there can be no doubt that they found by experience that such pauses improved their total output. It was curious to note, however, that they worked on no sort of system, but often took rests in a most irregular manner." 182. Dr. Vernon expresses the opinion that rest pauses are essential in active work for both men and women, though as might be anticipated he foimd that the extent of these voluntary rests varied greatly according to the extent to which the nature of the work involved enforced periods of inactivity. 183. So far as the Committee are aware, but few firms have made any endeavour to investigate scientifically the particular distribution of rest pauses needed to secure the best output in their own works. The following case of the advantage of such pauses may be quoted from the Memorandum on " Incentives to Work " included in the Committee's Interim Eeport : — " A group of workers, men and women, paid on a time wage, were found employed from 6 a.m. to 6 p.m. with two half -hour meal intervals at the process of emptying and filling a series of presses. Each press, after being filled, has to be left under hydraulic pressure for 35 minutes, during which time other presses in the series are emptied and filled. The management calculated the number of presses to each series, which would allow the work to be done in 35 minutes at a reasonable pace ; but the workers on their own initiative have adopted a difEerent method. They work with a rapidity so organised that the series of presses is emptied and filled in less than 25 minutes, after which they rest for 10 or 12 minutes until the time comes to begin again. The work entails the expenditure of a fair amount of physical energy ; and it was ihteresting to watch these operatives swing into their labour in order to obtain their rest pause." Holidays. 184. The Committee consider it most important that the ordinary factory holidays should be maintained. As a Trade Unionist put it — " If once in every two or three months a man could have two or three days off it would prove the finest medicine, much better than a bonus as extra pay." 185. The evidence leaves no doubt as to the beneficial effect of such holidays both on health and output. Dr. Vernon, in his further report on output in relation to hours of work (Memorandum No. 18), thus describes one case which he investigated : — " In the February-April period . . . the hourly output had risen to 123. . . . Though the hourly output during the February- April period was fairly steady the workers had not become completely adapted to the reduction of hours from a normal 12-hour to a normal 10-hour day which had been effected four weeks previously. After Easter, when they had a full week's holiday, their relative hourly output went up to 134 on the average and remained fairly steady for the next eight weeks although the actual hours of work were slightly greater than before Easter . . . " After a week's holiday at the end of August the hourly output went up again to its May-June level, but it was not until October or after another holiday (the four days ordered by Government) that a marked rise of hourly output set in. This rise continued in subsequent weeks until, in the fortnight before Christmas week, it reached the astonishing figure of 177." 186. In commenting on these figures Dr. Vernon points out that " The workers, refreshed and more vigorous, unconsciously start work on a higher level of speed and maintain that level permanently, whereas a reduction of hours unaccompanied by a holiday, i.e., by a chance of breaking through settled habits of work, is generally very much slower in conducing to the desired reaction." 187. Professor Loveday, in his Memorandum on " The Causes and Conditions of Lost Time " (see the Committee's interim report, pages 52-53), draws attention to the beneficial effect of a holiday in reducing the amount of broken time due to sickness. He quotes an instance in which the sickness rate for the three weeks immediately following a considerable holiday at the end of August and begirxning of Septem- ber, 1916, was 4.2 per cent, as against 5.4 per cent, in the week immediately preceding the holiday, and 8 . 6 per cent, in the week before that. The rate h'ad not been so low for many months previously. 188. Another aspect of the question of holidays is that they afford much needed opportunities for carrying out repairs to plant and machinery ; in the absence of such opportunities the defective con- ditions may become so serious as materially to affect output. 189. The Committee desire specially to emphasise the need for giving periodic holidays to members of the management and to foremen. They cannot take odd days off like the ordinary worker, and cases of temporary breakdown have been regrettably common. 44 Section .VII. SUNDAY LABOUR AND NIGHT WORK. Sunday Labour. "Man, man is the great instrument that produces wealth. The natural difierence between Campania and Spitzbergen is trifling when compared with the difierence between a country inhabited by men fuU of bodily and mental vigour, and a country inhabited by men sunk in bodily and mental decrepitude. There- fore it is that we are not poorer but richer, because we have, through many ages, rested from our labour one day in seven. That day is not lost. While industry is suspended, while the plough lies in the furrow, while the Exchange is silent, while no smoke ascends from the factory, a process is going on quite as important to the wealth of nations as any process which is performed on more busy days. Man, the machine of machines, the machine compared with which all the contrivances of the Watts and the Arkwrights are worthless, is re- pairing and winding up, so that he returns to his labours on the Monday with clearer intellect, with livelier spirits, with renewed corporal vigour. Never will I believe that what makes a population stronger, and healthier, and wiser, and better, can ultimately make it poorer." {Macaulay, Speech on the Ten Hours Bill, House of Commons, 22nd May, 1846.) 190. The most urgent problem awaiting the consideration of the Committee at the time of their appointment was that of Sunday labour. Partly on account of the heavy demand for output and partly through the attraction of the higher rate of wages payable, Sunday labour for men was common. Some- times the hours were the same as on weekdays ; sometimes they were shorter, work commencing later or finishing earlier. Elsewhere they were longer than on ordinary days as when the transfer from the 12 hour day shift to a 12 hour night shift was made by working for a continuous period of 18 hours, one shift working (say) from 6 p.m. on Saturday to 12 noon on Sunday, and the other from noon on Sunday to 6 a.m. on Monday. 191. The employment on Sundays of women and boys was much more restricted and was only allowed on special application to the Home Office. In October, 1915, for the whole of the United Kingdom there were in operation about 50 Orders allowing the employment on Sundays of women, girls and boys, and also about another 30 for boys only. As a rule such employment was only sanctioned when hours of work on 'other days of the week were limited, and even when it was allowed it was Msu^l to impose restrictions such as : — (a) that women and young persons should not be employed on two consecutive Sundays ; (6) that they should have time ofi on Saturday ; (c) that they should only be employed on Sunday in cases of emergency ; (d) that they should be employed for a portion of Sunday only. 192. Sunday labour is in itself unpopular. There exists a large body of opinion that the seventh day, asaperiodof rest, is good for body and mind. Employers object to it on the ground that supervision Is difficult, and that it imposes a severe strain on foremen, substitutes being difficult to obtain. In the early days of the war high rates of pay made Sunday labour popular with many workers, but this popularity has steadily decreased and any difficulties involved have generally proved capable of adjustment. High rates of pay on the other hand have been another objection raised by employers who have also complained of increased cost of running their works. Sunday labour is in fact only defensible if it can be shown to be productive of greater output over a longer or shorter period. 193. But Sunday labour is uneconomical. As has already been pointed out, fatigue may be mental as well as physical. Account has to be taken not only of the hours of labour, factory environment, and the physical strain involved but also of monotony, which may prove as serious an obstacle to good output as physical fatigue. The cure for fatigue, whether physical or mental, Ues in adequate periods of rest, and the problem of Simday labour is primarily one of the extent to which the worker requires weekly or periodic rests if he is to retain his health and energy over long periods. 194. The evidence is conclusive that Sunday labour by depriving the worker of his weekly rest offers him no sufficient opportunity for recovering from fatigue, and is not productive of greater output except for quite short and isolated periods. Employers stated in evidence, that though attendance on Sunday is generally good it is not always accompanied by a satisfactory individual output ; not infrequently a holiday spirit is apparent. Moreover, attendance at work on Sunday is often accompanied by bad time keeping on other days of the week. Statements have been made that seven days' labour only- produces six days' output, and that reductions in Sunday work have not in fact involved any appreciable loss of output. Trades' Union Officials have complained that their members were getting tired and needed more rest. In several instances they pressed for the reduction of Sunday work. 195. Evidence in the form of statistics of output in regard to Sunday labour is not easily obtainable. Even when the output of work has been such as would in normal circumstances permit of the collection of exact data, the rapid growth in the number of persons employed, the greater employment of women, the increasing efficiency of inexperienced workers, and other similar causes have generally rendered comparisons difficult, unreliable and impossible. Even where the data was available the management have not generally found it possible to arrange for its collection and tabulation. The representative of one important firm, however, informed the Committee that in one of their shops where heavy machine work was done by men of good average Trade Union type they had by extending the relief at the 45 week-end reduced the average weekly hours from 78^ to 65^. Though the normal hours were thus reduced by 13, the average number of hours (60) actually worked during the three months succeeding the change exceeded the average number of hours (59^) worked during the six months preceding the change. Moreover, in his opinion the output per hour was improved. 196. Professor Loveday, who conducted certain inquiries into Lost Time, states in paragraph 11 of his Memorandum (see the Committee's Interim Report on " Industrial Efficiency and Fatigue ") :— " In so far as long hours lead to loss of time by fatigue and sickness, insistence on them is most deplorable. The keenest men are not always the most robust, and it is the keenest who have most strain to bear. The hours gained are more costly than the hours lost. . . . The effects of Sunday labour are, as has now been recognised, stiU worse than those of overtime hours in the evening or on Saturday afternoon." 197. Dr. Vernon, in the course of his investigation* concerning output in relation to hours of work has shown that in the case of a body of 80 to 100 women that the reduction of the hours of employ- ment by the stoppage of Sunday work involved no reduction of output, though the full effect of the change took a few months to operate. A similar investigation in regard to a body of 56 men, sizing and fuze bodies, showed that though the number of nominal hours of work were by the cessation of Sunday labour reduced by six, the time-keeping was so much improved that the actual hours of work remained the same. The withdrawal of Sunday labour seems to have led the men to observe much more regular hours, and during their regular hours to increase their ordinary output some 16 per cent, above its previous level. The abolition of Sunday labour has sometimes been demurred to on account of the low Monday output, which frequently follows a week-end rest. Dr. Vernon, however, pointed out that in the cases quoted, though the Monday output was low compared to other days of the week, it reached a considerably higher level than was ever obtained in the absence of a week-end rest. 198. The Committee, in their Memorandum No. 1 submitted in November, 1915, to the Ministry on " Sunday Labour," expressed their conviction that if the maximum output was to be secured and main- tained for any length of time a weekly period of rest must be allowed. Except for quite short periods, continuous work in their view is a profound mistake and does not pay. Output is not increased. On economical and social grounds alike this weekly period of rest is best provided on Sunday. Speaking generally, the relief from work on Sunday is more urgent for women and young persons than for adult men, and for men on overtime than for those on double shifts. The need may also vary somewhat . according to the number of hours worked during the week and the environment and character of the work, but the Committee consider that the discontinuance of Sunday labour should be of universal application and should extend to all classes of workers, except that where the work must necessarily be continuous special arrangements will be necessary. 199. Acting on the recommendations of the Committee, the Ministry in December, 1915, issued a circrdar on Sunday labour to all Controlled Establishments, in which the following opinions were expressed : — " The Minister is of opinion that it is necessary in the interests both of the workers and of production that a weekly rest period — preferably Sunday- — shovdd be secured to all workers. "This recommendation applies equally to aU classes of labour, male and female, adult and juvenile, though there must be certain necessary exceptions in the case of labour such as that employed upon furnaces which could not be discontinued without grave dislocation. Even in these cases, though it may not be possible to arrange for a general rest on any particular day in the week, it would stiU be desirable so to arrange the work that all persons engaged upon the work had, if on different days, a regular period of rest. " It is in the opinion of the Minister preferable to work a moderate amount of overtime in the week, allowing a break on Sunday, rather than work continuously from day to day. It is stiU more strongly his view that where overtime is worked in the week Sunday labour is not desirable." 200. The Ministry subsequently appointed in consultation with the Home Office a Committee to consider demands for Sunday labour and to secure its discontinuance wherever possible. In April, 1917, a further letter was issued by the Ministry, in which it was stated that — " the Minister, after further consultation with the various Departments concerned, is of opinion that it is advisable that Sunday labour, with the exception of shifts beginning on Sunday night or ending on Sunday morning, or of work in connection with the necessary repair of plant machinery, should be discontinued as far as possible from the beginning of May, and would be glad if you would make arrangements in your estab- lishment to that end." t 201. During the past two years there has been a steady and continuous reduction of Sunday labour. From reports of the various Commissions appointed in July, 1917, to inquire into the Causes of Industrial Unrest it is evident that what Sunday labour still remains is unpopular and more than one Commission urged its discontinuance : — " The temptation to engage on Sunday labour so as to earn higher rates of pay has been pointed out to us as being fconducive to overstrain, and we believe that it will be generally recognised that Sunday labour (which StiU prevails to some extent) should be discontinued except to .meet absolute emergencies." (North East area.) " We consider that overtime and Sunday work should be reduced as much as possible. We do not believe that they increase production in the long run. We recognise that things are much better in this respect than they were, but there is still room for improvement." (West Midlands area.) " The amount of overtime and week-end and Sunday work should be reduced to a minimum, subject to the exigencies of the National requirements." (London and South Eastern area.) 202. The Committee recognise that the amount of Sunday labour at any moment must necessarily vary to some extent according to the nature and degree of the urgent demands for the immediate * See paragraphs 146-150 above. , 46 delivery of particular types of munitions. Figures, however, collected by the Ministry of Munitions show that in Controlled Establishments engaged on non-continuous processes the numbers of men and women employed on Sunday were, in January, 1918, very substantially smaller than they had been twelve months earlier. 203. As regards Orders made by the Home Office authorising the employment on Sunday of women and young persons (other than volunteer workers not employed during the week), the position on January 31st, 1918, was shortly as follows :— General Orders. — (i) The General Order (Munitions of War) allows the Sunday employment of workers employed on the three-shift system, and also (where authority is granted by the Superintending Inspector of Factories) of workers on the two-shift system, if a day off is given in lieu of Sunday. No information is avail- able as to the number of firms taking advantage of these concessions. (ii) An Order for National Filling Factories authorises the employment of women and young persons over 16 years on alternate Sundays, with a weekly limit of 60 hours (excluding meal times). little use is made of this alternative. Special Orders for individual works. — Particulars of these Orders are set out in the following table : — Total Number of Factories. Number of Orders affecting — Extent of Sunday work. Women (over 18). Girlst (14 to 18). Boys (14 to 18). A. — Every Sunday ... B. — ^la special emergency 0. — Cases in which a day off is allowed in Ueu D. — Cases under 8-hour shift systems E. — Other cases — Two Sundays in three One Sunday in two ,. three four 1* 6 33 17 1 9 5 6 1 5 29 16 7 5 6 3 4 4 2 2 5 8 6 1 4 Total 73t * In this case the women work not more than six hours on Sunday, and only three hours on two Mondays in three — ^the third Monday being free from employment. t In five instances the same factory is represented twice under the headings A to E. J Only one of these allows the employment of girls under 16 on Sunday. N.B. — ^The above statements take no account of course of cases where night work ends on Sunday morn- ing or begins on Sunday night. 204. Subsequent experience has fully confirmed the original recommendation of the Committee that it is essential for health and output alike that Sunday labour should be confined to : — (o) Sudden emergencies, including the making up of arrears in particular sections ; and ' (6) Repairs, tending furnaces, &c. (the men so employed being given a corresponding period of rest during some other period of the week). 205. Such temporary concessions as may be unavoidable should be confined within narrow limits and terminated as soon as practicable. Night Work. 206. There is no legal restriction upon night work for men. It is only legal for boys in certain specified continuous processes. The employment of women at night has been prohibited for more than 70 years in the textile trades, and has never been allowed in non-textile trades since they were brought under the provisions of the Factory Acts 60 years ago. It was finally abolished by international agree- ment from 12 European countries which signed a Convention drawn up at the International Conference held at Berne in 1906. These countries included, in addition to Great Britain, Austria and Prance, Germany, Belgium, Italy, Portugal, Spain and Switzerland. The agreement was based upon the results of inquiries into the effects — economical, physical and moral — of night work for women. The objections to night work may be shortly summarised as follows : — (a) It is uneconomical owing to the higher cost of wages, lighting and heating. (6) Supervision at night is not always so good as by day owing to less effective lighting or to the employment of fewer or less experienced foremen. (c) The inferiority of lighting may make work and especially fine work more difficult. {d) The workers may be unable to obtain adequate sleep by day. This may be the result of the dislocation of the ordinary habits of life or of social causes, e.g., noises and dis- turbances, or the care of cluldren. Workers are tempted to curtail their period of sleep through rising to join the family mid-day meal or to obtain some recreation and amusement. 47 (e) Social intercourse, recreation and amusement may be seriously interfered with. Suitable opportunities for attendance at instruction are impossible, unless special facilities are allowed. {/) Knally it is not natural to turn the night into day and to deprive the body of the beneficial effects of sunlight. 207. Under existing conditions night work at any rate for men and women is inevitable. It is the means by which the machinery is employed for the greatest proportion of the 24 hours and so long as the hours of work are not unduly long and due attention is paid to the environment of the worker, it is undoubtedly productive of increased output. Night work must therefore continue for men and women while the present emergency lasts, however conclusive may be the arguments against its introduction as a permanent part of the industrial organisation of the country. 208. The Committee are not satisfied that there is the same justification for the employment at night of girls and boys. The objections to night work for women are greatly accentuated in the case of growing girls and the Committee are strongly of opinion that all night work for girls under 18 should be terminated. As already stated in paragraph 144 steps have already been taken by the Home Office and the Ministry of Munitions to terminate all night employment of girls under 16 and to restrict within very narrow limits the employment of girls between 16 and 18. For boys also, and especially those under 16, night work is highly undesirable, and the Committee fully endorse the recommendation contained in the Eeport of the Departmental Committee* on " The Night Employment of Male Young Persons" that— " We are strongly of opinion that the employment of boys under 18 years of age at night in factories is undesirable and ought not to be allowed to any greater extent, or at an earlier age, than is absolutely necessary. This applies specially to boys between 14 and 16 years of age, when the rate of growth is most rapid, and when the conditions of life ought to be rendered as favourable as possible for mental and physical develop- ment." 209. A question of considerable importance in connection with the shift system is how long the workers should remain on night shift at any one time. A week is the most common period. Changes are sometimes made fortnightly or monthly and in some instances there is no alternation at all, the workers remaining continuously on day or night work, except for occasional changes amongst individuals carried out for the convenience of the persons concerned. On physiological grounds infrequent changes are to be preferred. The question is, however, one that is largely influenced by the social conditions under which the worker lives and works. In the Home Office General Order of Sept., 1916, no requirement is made as to periodical changes. The matter is left to the individual employers to settle with their work- people. 210. In view of its importance the Committee directed their Investigators to pay special attention to this subject. The data collected by them has been brought together in the Memorandum on " The Comparative Efficiencies of Day Work and Night Work " included in the Committee's Interim Eeport. An examination of the data suggests the following conclusions : — " Women. — (i) In monotonous processes which call for little physical effort, such as those concerned with cartridge-making, discontinuous night work of women gives an output which rarely falls much more than 10 per cent, below, and usually approximates closely to that obtained by day. " (ii) Continuous night work is productive of definitely less output than is the discontinuous system ; and the Committee have failed to obtain evidence that the output of the continuous day shift balances this inferiority. " (iii) The timekeeping of gir^s and of women of 19 years of age and upwards, working for alternate weeks of day and night shifts, is even better maintained than when they work on permanent day shifts. " (iv) Timekeeping of girls of 14 to 18 is practically the same whether they work on permanent day shifts or on day and night shifts. " The Committee, basing their opinion upon these conclusions, consider it undesirable to adopt for women continuous night shifts in any factory not at present so working or not yet open, and suggest that wherever practicable this system should be discontinued." " Men. — The conclusions arrived at with respect to women are true, with slight modifications, for men. " (i) There is no significant difference between the rate of output in night and day shifts managed on the discontinuous system. " (ii) With men, as well as with women, the discontinuous system is preferable to continuous night work." 211. The inferiority of continuous night work can probably be referred to a failure to secure proper rest and sleep in the day time. Women on continuous night work are likely to perform domestic duties, which when they work alternately in the two shifts, is impracticable. Evidence, indeed, exists of women employed in permanent night shifts who still carry on their ordinary day-time avocations, though it is not suffi.ciently extensive (statistically) to be offered as a proof of the suggestion just made. * Cd. 6503, 1912. 48 Section VIII. LOST TIME AND INCENTIVE. 212. The amount of time lost in industry varies widely in different forms and processes, and in accord- ance with varying conditions and circumstances of labour, environmental and personal. It rises in the bulk often to as much as half a day per week, though it varies in occurrence both in the day and in the week, being greatest as a rule at the two ends of the day and the two ends of the week, varying in relation to the length of the working day. It is for this reason that it is necessary, in the consideration of lost time, first to ascertain the time worked. It is of no value to determine the time lost unless it be co-related with the time worked, whether normal or overtime. The mere record of so many hours lost or such and such a percentage of lost time is valueless and even misleading. 213. Speaking generally the Committee have found that the whole subject of lost time calls for much more careful consideration and determination than it has hitherto received. The term is one which covers varying conditions. First; there is what may be described as gross lost time, namely, actual absence from work, for whole days or weeks, or substantial portions of days or weeks, a degree of broken time which gravely interferes with the management of a factory, and which is due to various dominant factors, social or industrial. Secondly, there is what is known as loss of " quarters," and particularly of the " morning quarter." In his investigations for the Committee, Professor Loveday examined this pojnt in fourteen classes of work — flight, medium and heavy (including approximately 17,000 persons)— working a normal day shift of 53 hours, commencing at 6 a.m. or between 6 and 7 a.m., with the result that he found that the percentage of lost time before breakfast varied from 20 to 58. Without deciding whether this loss was " avoidable " or not, the fact is that it occurred, and it occurred in the morning quarter, and was greatly in excess of any similar loss in factories which started work later than 6 a.m. All over the country munition works have had this experience of lost time in the " morning quarter " under the two-break system (which begins before breakfast and so involves two meal breaks during the day). The magnitude of this common experience, the actual number of absences, the futility of working before having had a morning meal, and the waste of time incurred in two breaks daily, have led many employers to the view that the two-break system might well be abolished. Thirdly, there is time lost in starting work, even by the good time-keeper, and similarly time lost in ending work. A statement* made to the Committee by Dr. Vernon may be quoted : — " In most works the motive power is electric, and in some the power supplied to each section is registered by a separate watt-meter. The machinery is started running shortly before work begins, and as the operatives get going, one after another, the power consumption steadily rises to a maximum, which is attained when all the operatives have started. By means of these power records the rate of starting and stopping work can readily be ascertained in many instances, though not in factories where time is spent in a preliminary collection of necessary tools and material, and in their adjustment. The accompanying figure records the increments of electric power over that required to drive the free-running machinery, on starting and stopping the after- noon spell of work. The continuous line represents the power supplied to a large shell shop which turned out 30,000 3-inch shrapnel shells per week. We see that the power supplied started mounting up two minutes T 1.0 1.10 starting work SAO S.SO ■ stopping work. 6.0 * See Memorandum No. 12 (Cd. 8344). 49 alter starting time, and reached half its full value in four minutes. The dotted-line curve, representing the power supplied to a section of 200 women turning fuze bodies, did not begin to rise till five minutes after starting time, and did not attain half its maximum value until 11 minutes after starting time. In other words, the operatives wasted about seven minutes more in starting than did the operatives in the shell shop most of whom were men. On the other hand, the fuze-turners finished more strongly than the shell shop operatives, as can be seen by comparing the two curves given on the right side of the figure, and it was found that both sets of operatives lost, on an average, about the same aggregate of time in starting and finishing during the course of the whole day, viz., 34 minutes. The shell shop operatives did not start much more promptly than the fuze-turners in the morning, partly because there was more delay in the arrival of their material, but in spite of this, if the operatives of both shops had started equally promptly,' and finished equally strongly, nine minutes out of the 34 would have been saved. There was no inherent reason why work should have been started promptly in one shop and not in the other. It was merely a custom of the particular shop, and even then the custom was not a fixed one. A series of meter readings of the women's section were taken for several days before and after the Easter holiday, and nine days before the holiday the average amount of time wasted in starting after dinner was found to be 11 minutes ; two days before it was 14 minutes. Two days after the hoUday it was 16 minutes ; three days after it was 15 minutes ; and five days after it was 12 minutes. That is to say, it increased with the slackness of the operatives caused by the immediate approach of the holiday, and stiU more with their post -holiday lassitude. " There can be no necessity for the waste even of 25 minutes in starting and finishing work. Ten or 15 minutes should be an ample allowance, and the 20 minutes thereby saved could be deducted from working hours without any reduction of output. At one large works the manager informed me that he made a point of going into the various shops at starting time, and seeing that the operatives began work promptly. In this way a considerable amount of time was saved." 214. Subsequently* Dr. Vernon was able to report a further investigation in regard to women turning aluminium fuze bodies. The machinery was started up a few minutes before normal starting time, the power (recorded by watt meter) required for this purpose being deducted from subsequent readings. The results were : — Time Lost in Starting and Stopping Work. Avera »e number of minutes lost when — Total number minutes lost. Time of year at which power records were taken. Starting work in morning. Finishing work in morning. Starting work in afternoon. Finishing work in afternoon. Relative hourly output. Aprill3-May 1, 1916 June 6-7, 1916 Jainuary 10-18, 1917 14.0 12.5 10.0 1.5 2.5 0.5 12.3 10.0 7.0 9.3 8.0 9.0 37.1 33.0 26.5 126 137 158 In an adjoining section, consisting mostly of women turning small brass time fuzes and primers, but including also the women engaged in mUling a screw thread, the total times lost in starting and stopping were 34*7, 33-5 and 28-3 min. in the April, June and January periods respectively. In the next two sections, occupied by men engaged in tool making and in controlling automatic machines, the average times lost were nearly the same throughout, but this may have been due to the fact that most of the workers were paid at a time rate and not at a piece rate. However, in two other sections of lathe workers, mostly women, which were situated in a different part of the factory, there was likewise no appreciable reduction in the time lost, though these workers were paid at a piece rate and must have had a bigger hourly output in January ,1917, than in April, 1916. It is very likely that they wasted less time by taking fewer and shorter rest pauses during the progress of their work, but on this point I made no observations. 215. It is of interest to note in passing that Dr. Vernon claims that the increased hourly output resultant on a reduction of hours is dependent, as a rule, on two factors. First, a speeding up of many or all of the actual movements required in the mechanical process ; and secondly, the avoidance of lost time by starting work promptly, by taking few pauses during the progress of the work, and by continuing the work more nearly to the nominal stopping time. This observation leads up to a fourth kind of lost time, namely, that due to unregulated rest pauses, absence of pauses, too long spells and other similar points in factory organisation of hours. The custom in many works is for operatives to work for a spell of five hours, and then after an hour's meal interval for another spell of four and a-half to five hours. Such spells, in the view of the Committee, are too long for most workers, and yet, if a second or third interval were introduced, extra time would be lost in starting and stopping. Under present circumstances, however, much time is often lost by the operatives taking rest at irregular or unsuitable times. The Cornmittee recommend a properly recognised system of rest pauses. A defijnitely fixed ten-minute break in the middle of the .morning and afternoon spells, during which operatives remain at their machines (and possibly take light refreshment conveyed to them), has been found in practice a valuable aid to the reduction of lost time and increase in output. Some types of work need longer and more frequent rest pauses than others, and the best times and occasions can be determined only by experiment. Lastly, there is the lost time due to too long hours of work and excessive over- time. " Overtime may act," writes Professor Loveday, " either as final or efficient cause of lost time." Employees may deliberately miss normal hours, or work slack, in order to make the better paid hours of overtime more expedient or even necessary. Or, again, overtime or too long hours, by their exhausting effect, result in lost time as a consequence. The prolonged hours and the Sunday labour during the early period of the war pressure on industry actually resulted after a time in many cases in reducing staying power and increasing lost time, owing to increase of fatigue and sickness, of decreased briskness and resilience among the workers. " There can be no doubt," according to Professor Loveday, " that for the average man high wages earned by long hours are too dearly earned." (B 12023) * See Memorandum No. 18 (Cd. 8628). D 50 The Ccmses of Lost Time. 21 6. A consideration of the character of lost time makes manifest its principal causes. Som,e of them are inherent in the circumstances of the present time, arising out of the war or the exceptional con- ditions of industry ; others are relatively more " avoidable." The more, however, that the causes are examined or considered in relation to the varying local or other circumstances, the less is it possible to classify with any degree of precision, or say of any given cause that it is inherent and uncontrollable, or that it is controllable and avoidable. It will be found in practice to be sometimes one and sometimes the other. It should be understood therefore that the following classification is merely made for convenience. (i) Causes mainly inherent. {a) Necessity of employing persons of inferior physique, irregular habits, and without experience of factory life or discipline ; (6) In many districts inadequate housing accommodation and insufficient transport facilities, both conditions made more acute by abnormal congestion of industrial population ; (c) Wintry weather, darkened streets and inequalities of food supply ; {d) Insufficiency or irregularity of supply of raw material, machinery or tools coming to the factory ; (e) Domestic duties of married women and war pre-occupations and exigencies of all workers ; (/) Sickness and disease caused by conditions external to the factory. (ii) Causes mainly controllable. (a) Fatigue, sickness, and accident of factory origin ; (6) Insufficient wage incentive ; (c) Faulty internal organisation, leaving the employee without work, leading to temporary and sporadic breakdown or delay in management, or failing to provide for the reasonably comfortable conditions (lighting, heating, rest, feeding, &c.) for maximum and sustained efiort ; (d) IndifEerence, slackness, laziness, discontent ; (e) The practice of early morning " quarters " or dislocation between shifts ; (/) Prolonged hours, overtime, insufficient rest periods or holidays ; {g) Excessive consumption of alcoholic beverages. 217. Other causes of less importance undoubtedly occur, and even those mentioned differ consider- ably, both in effect and in locality. Whilst the Committee decline to generalise or draw final conclusions, they are satisfied that the loss of time, directly and indirectly, due to fatigue and ill-health, is sub- stantial, and is, as a rule, greatly under-estimated. On the other hand, there would seem to be a tendency to over-estimate that due to slackness, laziness or wilful idling. On the whole, evidence from all parts of the country shows, beyond question or dispute, that a very remarkable and entirely excep- tional effort has been made by all grades of workers to meet the industrial demands of the national emergency. This long sustained will to serve the commonweal has played, in the Committee's view, a prominent part in the maintenance of output under difficult circumstances, and has contributed to reduce the lost time due to ill-health. In spite of the prolonged and heavy strain, the Committee's medical investigators have found an unexpectedly large measure of good health among both men and women, due as far as the evidence goes to the powerful impetus of a sense of patriotism, to increased sobriety, to high wages and their resultant home comfort, to the restriction of hours adopted none too soon, to division of labour, and to a vast improvement in the conditions of factory life, especially the arrangements for " welfare " supervision and the provision of canteen facilities. Without the operation of these favouring contributory factors the Committee believe that there would have been much heavier loss of time and widespread breakdown of health. Even as it is the Committee cannot escape the con- clusion that the immense industrial effort of the war is likely to leave behind many serious physical disabilities. 218. The causes and conditions of lost time are matters of national importance for the future, and the Committee hold strongly that the past neglect of this subject should be removed, once and for all. They advocate shorter hours, improved conditions of labour and a higher standard of efficient work- manship, if industry is to come into its own, and workers of all grades are to obtain their full reward, wdthout let, hindrance or impairment. To this end the Committee recommend that managers and other responsible authorities in factories should keep careful records — • (a) of lost and broken time ; (6) of absence or broken time due to sickness ; and (c) where practicable, of the output per worker per hour. The regalar study of these records cannot fail to prove valuable as a guide to the causes and con- ditions of lost time, and the means of its reduction or removal in individual workers. It is important to remember that the man or woman is not a machine, and should not be treated as such. What is needed is not a cast-iron system of employment, but a sympathetic and correct understanding of the physical and mental capacities of each worker, and their most satisfactory and economical application. 51 Incentives to Work. 219. Closely related to the question of lost time is that of incentive to work, and in the course of their investigations the Committee have observed a relation existing between such incentives and the health of the worker. Indeed, they are disposed to place the health and physical fitness of the individual worJcer as the first necessary condition of output, and to that end they desire to lay emphasis upon the extreme value of all factory conditions which contribute to such health — ^good lighting, efiective ventilation, sufficient heating, cleanliness, rest rooms, proper canteen accommodation, protection from industrial poisoning and dangerous machinery, surgeries, suitable welfare work within and outside the factory — all these are conditions of first and fundamental importance from the point of view of health and incentive to work. A hygienic environment at home and in the workshop is indeed the first necessity for securing a healthy population of wage earners to whom a wage system may appeal as an incentive to work. Secondly, the Comniittee would place a properly organised factory, good order and discipline, and suitable hours of work (combined with proper rests and pauses, and a minimum of night employment) as conducive to efficient workmanship. " When once industrial life has been entered upon," writes Professor Loveday, " the ordered and systematic routine of a modern factory is a direct stimulus during every 24 hours to the rhythm of activity and rest ; the better the organisation, and the better the hygienic environment the greater is the stimulus to activity." The third incentive, though probably the only one thought of by many employers, is that of wage. To be an incentive in actual practice, however, the wage system adopted must be equitable, well adjusted and clearly under- stood. The Committee have been the witnesses of not a few misunderstandings leading to lost time, reduced output and discontent, which arose not on the amoimt of wage, but on the system or manner of its payment. Fourthly, under conditions of repetition work, especially if monotonous, piece rates appear to provide better incentive than time wages, and time wages with a bonus than a fiat time rate. Finally, in relation to incentives to labour, it is necessary to remember the serious effect upon time- keeping and output of hours of labour which preclude attention to health and recreation and domestic life, and of a scale of wages which places the wage-earner above or beyond the ordinary and customary requirements of his standard of comfort. The Committee have seen lost time directly resulting from both of these conditions, and they have no doubt that much of the present labour unrest is due to the inter-relationship obtaining between wages and the standard of comfort. It is, of course, obvious that such conditions raise far-reaching and complex social issues which lie outside the scope of the present Keport. But they are matters which must be borne in mind in contriving schemes for reducing lost time and encouraging steady work. Section IX. FOOD AM) CANTEENS. 220. There is now an overwhelming body of experience which proves that productive output in regard to quality, amount and 'speed is largely dependent upon the physical efficiency and health of the worker. In its turn such physical fitness is dependent upon Nutrition. The purpose of nutrition is to secure the health, the proper development and growth, the repair and vital energy, of the human body. Food energy is spent in maintaining the tissues of the body and the body heat and in doing work. Nutrition is stimulated by the cooling effect of fresh air, and by bodily exercise, and its needs must be met by a food supply suitable in character and sufficient in amount to meet the expenditure on body heat and work. 221. The human body calls then for a constant supply of food, first for its growth, for the building up of its tissues and for repair, and secondly as fuel for the production of heat and energy. Both require- ments are indispensable, and from the necessity for these there is no escape. Though no hard and fast line of division can be drawn, it may be said that certain kinds of food which are relatively rich in protein and mineral matter (meat, cheese, milk, herrings, dried peas, beans, bread, oatmeal, flour) contribute both to the formation of the body and its repair and supply it with fuel for the production of heat and energy ; others kinds such as fat (lard, butter, dripping, margarine), sugar, sago and tapioca, afford an abundant supply of fuel, but cannot maintain growth and repair. Still other kinds of foods (fresh fruits, green vegetables) contain a small proportion of nutriment, but ensure the provision of the body with certain important principles conducive to good health.* The constituent parts of a dietary are important if the highest value is to be obtained, but, speaking generally, fresh digestible and appetising food is more important than chemical composition or proportion. It will be imderstood that digestibility is dependent partly upon the food itself being of a nature which is easily digestible and partly upon the organs of digestion being healthy and in good working order. Further, it should be noted that a variety of factors affect the relative value of food to the individual consuming it. For instance, there is the nature of the employment, whether sedentary or active, and the amount of energy called for. With increase of work there must be proportionate increase in quantity and in nutritive * When work is nervously exhausting, e.g., night work, the food of the worker requires to be particularly light and digestible, well cooked and appetising, for the organs of digestion then lack an adequate supply of nervous energy, and cannot deal successfully with heavy indigestible and unappetising meals. The warmth of the food is of great importance. Hot drinks stimulate the tired worker. The proper adjustment of the food to the expenditure of nerve energy saves a great deal of indigestion and the minor complaints and lost time which result. (b:12023) D 3 52 value of the food eaten. Ill-paid labourers and others whose food amounts only to a bare minimum cannot either put forth the same energy or work at the same speed as a well-nourished man. The man who has to work hard, long or rapidly, needs a proportionately ample food supply, composed of highly nutritive ingredients to withstand the strain. Fatigue both prevents digestion and demands food. Age, sex, weight and constitution likewise exert influence. Women require on an average about four-fifths of the food supply of a man, and an adolescent about seven-tenths. Season and climate also affect the question. Lastly, the predisposing influence upon the alcoholic habit of malnutrition, bad feeding, and long periods of work without refreshment should be borne in mind. There can be no doubt that " industrial alcoholism " is, in part, due to the lack of cheap good food. 222. What, then, in general terms, is the necessary dietary for a worker ? Broadly, the answeris a dietary containing a sufficient proportion and quantity of nutritive material, suitably mixed, which is easily digestible, appetising and obtainable at a reasonable cost. Character of Food Required. — The amount of physical force expended in daily work and the environment of the work have a great effect on the requirements of the body for food. Hard labour and exposure to open air together call for increased food supply ; sedentary work in an artificially heated and confined atmosphere, on the other hand, reduces the output of energy and leas food is required. Natural foods 5rield the essentials required to replace the energy expended and for the repair and growth of the body. They contain these essentials in the form of protein, fat and carbohydrates, and also supply salts and certain substances of unknown nature, called vitamines, which exist in minute quantities in fresh foods and are necessary for the growth and health of the body. Vitamines are removed by some of the processes of milling, e.g., in the preparation of white flour, and polished white rice. They are destroyed by prolonged cooking, and are absent from foods preserved in tins ; they are present in butter, dripping and margarine when made from beef fat, though absent when it is made from vegetalsle fat. For the preservation of good health it is essential that fresh natural foods shoidd be eaten in sufficient amount. Fortunately the potato affords such a cheap natural food, and makes a good diet with bread and tinned food. Protein is the chief solid con- stituent of lean meat ; it is also present in milk, cheese and eggs, and occurs in all vegetables, particularly in flour (bread), peas and beans ; it is not only a source of energy, but it is also a body builder, and no dietary can be complete without it ; the body requires protein in the food in order to build up its own living substance, and cannot do so with the aid of fat and carbohydrate alone. Protein stimulates the body to a greater ex- penditure of energy than does an equivalent value of carbohydrate or fat. There is reason to believe that more protein is required by those who work forcibly and rapidly, than by those who work in a slow, steady manner, e.g., soldiers in the front line require more protein than agricultural labourers. Fat is chiefly derived from animals ; nuts (from which one kind of margarine is made) also are rich in fat, but other vegetables only contain fat in a much smaller degree. Carbohydrates are mainly derived from vegetables in the form of flour, potatoes or sugar. Fat and carbohydrate can replace one another in a diet, but the body digests and deals best with a certain proportion of each. Fat, however, jdelds weight for weight more than twice as much energy as carbo- hydrate, and so in cold climates and cold weather more fat is naturally eaten. Experience shows that the diet should include raw food, fruit, or salads, in order to secure the vitamines which prevent scurvy. Fruit which is not over-ripe is particularly valuable.* Potatoes, cabbage, onions, carrots and turnips also contain the vitamines which prevent scurvy. Eight ounces of potatoes a day wiU supply sufficient. Particularly in times of scarcity when there is any restriction of diet, it is advisable that vegetable food, such as potatoes, should form a large proportion of the available diet, for the vegetables contain salts which neutraUse the acids formed in the vital processes of the body. Fortunately, the cheaper foods (bread, margarine, porridge, milk, herrings, cheese, beans, onions, cabbages, swedes and the cheapest cuts of meat) provide all the requisite-nourishment, and are probably better adapted to maintain health than are more highly flavoured and expensive foods which artificially stimulate the appetite. The drinking of strong tea many times in the day is physiologically unsound, as also is the con- sumption of sweetmeats between meals, especially by boys and girls. Sugar is not a natural food, but an artificially separated foodstuff. It should not be allowed to lessen the appetite for the natural complete foods. Calculation of Energy Value of Foodstuffs.- — The energy value of a foodstuff can be determined by burning a weighed quantity of it in a suitable apparatus caUed a calorimeter, and ascertaining how much heat it gives off. The large calorie, which is used as the unit of energy value, is the amount of heat required to raise 1 kilogramme (If pints) of water from 15 degrees to 16 degrees Centigrade through 1 degree Centigrade (1.8 degrees Fahrenheit). Calculation has shown that, when dried, foodstuffs possess the following energy value : — One grammef of-— Protein is equivalent to 4 . 1 calories. Carbohydrate „ „ 4.1 „ Fat „ „ 9.3 „ The energy expended in mechanical work can also be expressed in calories, for one calorie has been found by experiment to be equivalent to the energy expended in lifting one kilogramme through 425.6 metres, which is about the energy expended by a man 70 kilogrammes (11 stone) in weight in walking up a staircase 6 metres (about 20 feet) in height. Such a man would require one extra calorie in the energy value of his food to make good this expenditure of energy. Even in walking on the level the body is raised at each step, and the calculation has been made that to walk 2.7 miles in an hour on a level road calls for the expenditure of 160 calories in a man of 11 stone. * It should, however, be remembered that at the present time fruit, with few exceptions, is a prohibited import, and that foreign fruit is consequently in very short supply. Supplies should, therefore, as far as possible, be drawn from home-grown fruit or salads and vegetables. Raw fruit can be replaced by raw swede turnip. Children will eat this raw, or it can be grated down and eaten on bread. t To express in terms of calories per pound it should be remembered that one pound is equal to 453.6 grammes ; one ounce is equal to 28 . 35 grammes. Example. — Suppose one pound of roast beef contained — Protein 26 . 75 per cent. Pat 12.90 in this case there would bp (26 . 75 x 4 . 1) -f (12 . 90 X 9 . 3) = 229 calories per 100 grammes. In the pound of meat there would, therefore, be 229 x 4 . 536 = 1,040 calories. For fuller information reference should be made to " An Inquiry into the Composition of.Dietaries, with special reference to the Dietaries of Munition Workers," by Viscount Dunluoe and Captain M. Greenwood, R.A.M.C. (T.), published as a Special Report by the Medical Research Committee. 53 Investigations made by a number of scientific workers indicate that about 15 per cent, of the energy expended is derived from protein, and about 80 per cent, from fats and carbohydrates combined : that is to say, that normaUy protein supplies only one-fifth of the total energy expended. Numerous investigations have shown that the energy daUy required by a man engaged in moderately light munition work is about 3,500 calories of food as purchased. Where calculations are based on food as eaten, the minimum diet may be taken to be about 3,000 calories when balanced among the three classes of foodstuffs in the following proportions of dried weights : — Protein ... 100 grammes. Fat 100 grammes. Carbohydrate 400 grammes. Such would be contained in the following diet* : — Lean meat 5 ozs. Fat Butter ... Bread .. Potatoes Oatmeal Milk ... 1 oz. 1 oz . 16 ozs. 16 ozs. 3 ozs. f pint. Men engaged in hard physical work, especially in the open air, require a good deal more energy-producing food, and may consume as much as 4,500 calories with advantage. On the other hand, the energy required from food by a man clothed, lying at complete rest, at ordinary room temperature, in a still atmosphere, is about 1,600 calories of eaten food ; while for a man engaged in a sedentary occupation, tailor or clerk working in a warm room, as little as 2,200 calories may suffice. t An average adult woman worker requires rather less (about . 8 or . 9) than a man. A Statement of the Peoblem. 223. Thougli there is little doubt that workers, on the whole, are getting a better type of food than a generation ago, it must be admitted that large numbers of workers of both sexes are not getting an effective dietary day by day. Much evidence is forthcoming that this is being increasingly recognised both by employers and workers. The difficulties in the way of adequate feeding arise mainly where the worker must have his meals away from home. In past years, and even now in normal times, the worker lived fairly close to his work, and was frequently able to return home for his meal. At present (apart from food shortage) the difficulties of securing adequate food are increased owing to the prevalence of night labour and to the facj} that the large number of men and women who have to travel a consider- able distance to their work. («) In such cases the simplest alternative is for the worker to bring or receive from his home or lodgings food ready prepared for eating. The objection to this arrangement is the limita- tion in the kinds of food suitable, and that it is necessarily cold, and liable to be stale. There is a special danger of its being confined to what can be most quickly prepared the night before without much regard to its nourishing character. When the weather is warm, or the food is kept for any length of time in a hot workshop, it readily undergoes degenera- tion. (b) A second alternative is for workers to bring food which can be either warmed up or cooked at the factory. This is sometimes done by the worker himself, or facilities for the purpose are provided by the employer. Arrangements on these lines are probably better than those under which the worker brings his food with him ready prepared. On the other hand, it is to be remembered that warmed-up food is generally not so nourishing as freshly cooked food, that if a large amount of food is to be warmed up it is always difficult to deal satis- factorily with widely varying kinds of food, and that valuable time is lost if the worker is compelled to cook his own meal. (c) In some districts workers can obtain a substantial meal at public-houses, cook-shops or other proprietary establishments in the neighbourhood, but the accommodation in these places is often inadequate and imsuitable. {d) Lastly, there is the industrial canteen at or near the works. f 224. This then is the problem — to supply suitable food at a low price for large numbers of persons at specified times. The modern progress of factory management reveals a variety of efforts to find a solution. There has been, it is true, considerable development in the provision of proprietary concerns in the form of improved coffee-houses and refreshment-rooms. Philanthropic movements have also been initiated with a similar purpose. But by far the most hopeful enterprise has been the establish- ment by employers of Industrial Canteens, or workpeople's dining-rooms in or near the factory itself. Hitherto there has been no statutory obligation upon the employer, though action in this direction has received the whole-hearted commendation of the Factory Department of the Home Office and the Ministry of Munitions. The earliest and best examples of such restaurants in factories are to be found * Temporary shortages of supplies of particular articles of food may, of course, involve modifications of this diet. ■!• There is evidence that the workers in Germany are not getting more than this value in their ration, and the remainder of the civil population considerably less, receiving, in fact, a ration which has not been regarded hitherto as sufficient for maintenance. J In Memorandum No. 19 (Cd. 8798) will be found the results of a number of analyses made by Dr. Leonard Hill, F.Br.S., of the caloric value of various work peoples dietaries. Canteen meals yielded 806-1,433 calories (163-305 dry weight in grammes) ; "carried food," 683-1,719 ; and women's dietaries, 397 (tea-shop) to 1,143 (carried food). Particulars are also given of caloric value of hostel dietaries, food substitutions and rations. (B 12023) D 3 54 in the food industry, but makers of soap, paper, cloth, tobacco and tin boxes, have followed suit, and now in all parts of the country accommodation of greater or less degree of suitability and attractiveness is being provided. This pioneer practice has abundantly justified itself from a business and commercial point of view, and in the opinion of the Committee the time has come for a large extension of this method of solving the problem. 225. Speaking generally, it may be said that the accommodation provided accords with one or other of the following types : — (a) An available room for the workers to eat their prepared food ; (b) A room furnished with a " hot-plate " or " warming cupboard "* and provided with hot water; (c) A refreshment barrow to perambulate the workshops at appointed hours (particularly useful for light refreshments during long spells or night shifts) ; (d) A fixed refreshment bar or buffet ; (e) A dining-room or canteen supplying cheap hot and cold dinners ; (/) Such a dining-room associated with an institute or club, with facilities for rest and recreation (e.g., rest-rooms, recreation or reading-rooms, portable gymnasium, baths, roof garden, or educational classes, &c.). 226. Some of these types may be suitably combined, and although arrangements indicated in (c) and {d) may prove sufficient and satisfactory in certain circumstances, the provision of proper meals seems obtainable only in the types (e) and (/). The Committee recognise that the necessity for, and character of, an Industrial Canteen are dependent upon the nature of the need and its degree in each factory. They are, however, convinced that in the highest interest of both employer and worker, proper facilities for adequate feeding arrangements should be available in or near, and should form an integral part of the equipment of modern factories and workshops. Essential Characteristics of the Industrial Canteen. 227. In order to ensure effective results from the establishment of Industrial Canteens, certain conditions seem to be essential. Speaking generally, these conditions concern— (o) establishment and (6) management, the former including questions of site, building and equipment. Establishment. Site. 228. The first important consideration in the erection of a new canteen is the question of a site for the building. The site should, if possible, have a pleasant, open outlook and southern aspect, and should be central and easy of access for the workers. With high buildings adjoining and mess rooms looking out upon blank walls not many yards distant, the canteen may prove unattractive and its success be to a great extent impaired. The canteen should, if practicable, be placed where water, gas, and electric mains are adjacent, as well as drainage capable of carrying off the discharge of soil and rainwater pipes and of sinks and lavatory wastes. An appropriate proximity to the works must also be considered. Buildings. 229. Much will depend on the nature of the scheme adopted, whether it is (a) a mess-room, with or without hot closet, hot plates or hot water ; (6) a buffet bar ; or (c) a full restaurant canteen with kitchen, scullery, larder, stores, &c. There may be a combination of the three types. The amount and character of the accommodation necessary depends : — (1) On the situation of the factory and the opportunity for all or any of the workers to go home for meals ; (2) On the proximity of outside restaurants ; (3) On the hours of work (day or night) and the meal intervals ; (4) On the character of the work (heaviness, exposure, poison or danger zones) ; (5) On the usual customs of the district and the particular food necessities of the workpeople. The seating accommodation must also be considered from the point of view of shifts and relays. 230. The attached plans have been prepared showing canteens suitable for 200 and 500 diners (facing pages 164 and 166). The question which immediately arises is whether the building shall be of-^(a) temporary or (&) permanent construction. During the early stages of the war there was much to be said for the erection of a temporary building, mainly on the ground of cost, rapidity of erection, and the smaller demands made upon labour. * " Warming cupboards " can be installed in or near the mess-room and heated by steam. The cabinet may be constructed of sheet iron (finished off with asbestos and wood covering), with shelves of perforated sheet iron. Employees deposit their food in basins or dishes when they come to work, the cuplDoard is closed and steam applied under regulation for a specified time. At the dinner hour the employees fetch their food. Cantsen Kitchen. Kitchen of a Large Canteen. Canteen Scullery. Canteen Kitchen. Canteen Storeroom. 55 231. Permanent buildings naturally take longer to erect, the cost varies from 25 to 40 per cent, more than in the case of a temporary building, and the demands made upon labour are greater. On the other hand, a permanent building is, of course, more satisfactory, and costs proportionately less than the tem- porary building for maintenance. In normal times the case for the permanent building is a strong one, but at the present time for canteen purposes the temporary building should be considered, though it may be found in practice that even now a permanent building is preferable. 232. The construction of suitable buildings is indicated in sufficient detail on the drawings. It should not- be overlooked that the wear and tear of the floors is considerable, whether in the mess rooms or in the Idtchens, and, in view of this, the floors generally should be of concrete, finished with a grano- lithic face. This type of floor is smooth, hard, durable, and impervious, and is easily washed down after meals. Advantage should, wherever possible, be taken of using local material to save carriage, '&c. 233. In a large number of canteen proposals it may be fonud that the dimensions of available sites will not admit of the buildings being erected in accordance with the suggested designs but the principles are the same. The canteen or dining hall, being the principal apartment, should be arranged with the most convenient methods of egress and ingress for the workers and with direct approach to the serving coimter, so that traversing the whole or any great portion of the dining hall to obtain food is avoided Short barriers in front of the counters are advisable to allow of each diner obtaining his or her food in the order of arrival and to prevent congestion and disorder. Adequate gangways or passage-ways for each diner to proceed to the dining tables without interruption to other diners are essential. From 8 to 10 square feet superficial area should be allowed per person seated. Separate dining rooms are usually provided for men and women, but they may be so designed as to be thrown together for social recreative or educational purposes. The kitchen should be situated as centrally as possible with regard to the dining room, which it should adjoin in order to facilitate counter-service. It may " central " or " terminal." The wash-up or scullery should open out of the kitchen and should abut immediately upon the main dining hall. A counter or shelf with communicating hatch should be provided to admit of dirty crockery being handed direct to the sinks. In addition to the sinks in the scullery, such accommodation is also required in the kitchen for the use of the cook in the preparation of food. The sinks should be supplied with hot water from an independent boiler, which should be placed as near as practicable to the sinks. The larder and store should open upon a yard with easy access for tradesmen's carts. They should be fitted with shelving of deal, 1-inch thick supported on 2-inch by IJ-inch framed bearers and uprights. The shelving should be kept 1-inch away from the walls. The larder should if possible face north and be permanently ventilated by perforated zinc panels. The sanitary accommodation for the canteen should preferably be situated in an isolated block of buildings adjacent to the canteen, but the requirements in this respect depend upon the sanitary accommodation already existing in adjoining buildings, and each case will have to be considered on its merits. Ventilation, Warming and Lighting. 234. Ample window space (with a large proportion of the windows opening) is desirable for light and ventilation, and in no case should the total glass area of the windows be less than one-tenth of the floor area of the various rooms in which they occur. The fanlights for casement windows should be hinged at the bottom and fall inwards. Glazed cheeks or gussets should be provided to admit of continuous ventilation, and at the same time prevent down draught. All casement windows should be made to open for use in warm weather, and to flush the rooms with air after the principal meal. Louvre ventilators under the roof or in turrets provide ventilation for the main mess room. A simple cord attachnient to wooden flaps should be provided to admit of these ventilators being closed during cold or windy weather. The kitchen should be provided with a continuous louvre ventilator, as indicated on the drawings. It is desirable, where electric or other power is available, that an exhaust fan should be placed in the kitchen to extract the heat and steam from the kitchen and scifllery, and incidentally assist in the general ven- tilation of the dining rooms. Larders should face north and have nearly haKthe glass omitted in the window paneg and perforated zinc panels substituted to provide suitable ventilated storage f orperishable food. 235. Central heating by radiators or hot water pipes would, no doubt, provide the most satisfactory means of heating the building. The cost, however, of such a heating installation adds so considerably to the initial cost of the whole scheme that it becomes extremely doubtful if the expenditure is warranted especially in view of the fact that for four or five months of the year no artificial heating is required. "Where central heating is not provided, use may be made of independent stoves, standing on the concrete floor, the stove pipe being carried up through the roof. Such stoves may be obtained from any iron- founder or ironmonger at varying prices. 236. The steps to be taken for the prevention and extinction of fires should be fully considered. The method of carrying the stove pipe through the roof should be carefully planned, as, owing to the com- bustible nature of the timber in roofs, defective construction at this point may prove a source of danger to the building from fire. The construction may simply consist of asbestos packing, a sheet iron sleeve piece, with l|-inch space between the sleeve piece and the stove pipe, and hood to keep the rain out. 237. Where electricity is available it is, no doubt, the most satisfactory means of artificial illumina- tion, otherwise gas should be used. (b 12023) D 4 56 External and Internal Materials. 238. For inexpensive permanent construction walls may be 9-inch brickwork rendered externally with Portland Cement f inch thick and finished with rough cast surface ; with large span roofs, brick piers of greater thickness will be required under the roof principals. Roofs may be boarded and slated, and floors made of concrete with granolithic surface. 239. The selection of materials, owing to the high prices obtaining, presents some difficulty at the present time. Formerly one of the most favoured external coverings for temporary buildings was galvanised corrugated sheet iron. The cost and supply of this material, however, is now prohibitive and alternatives must be sought in felt and other forms of roofing. Felts are usually laid on the boarding with a lapped joint and patent cement supplied by the makers, the sheets being then secured with gal- vanised clout or large flat-headed nails. Only the stoutest material of the respective makers should be used to ensure a watertight roof. Light asbestos slates also provide a satisfactory, although somewhat heavier, roof covering. All roofing felts need careful laying, otherwise bulging occurs, which, in addition to being unsightly, is a frequent cause of a defective roof. 240. A large variety of materials have been available during the war for the external coverings of the walls, amongst which" may be mentioned feather-edged weather boarding (treated with creosote), ungalvanised painted sheet iron, plaster finished in cement, secured to the wood framing by expanded metal, asbestos slates, or other materials. Internally, plaster and cement on expanded metal, asbestos sheets (the joint covered by a small fillet), match boarding, or various other materials have been used above the dado. The dado should, however, be somewhat stronger ; |-inch match boarding is suitable. Thin sheet iron (painted) has also been used ; or linoleum on flat-jointed boarding provides a suitable dado, and is easily cleaned. The interior of the building should present a clean and cheerful appearance and distempers of a fairly light tint are preferable. Straw colour, primrose, duck's egg green, or French grey are suggested as suitable. An alternative colour scheme would be a dark green dado about 5 feet high with 2-inch black line, and the remainder of the walls, including the roof, finished white, the roof principals being stained a dark brown. Cooking Apparatus and Kitchen Equipment. 241. The cooking arrangements in an industrial canteen naturally form an important part in the equipment of the building. There are various means of cooking food, but for canteen purposes attention may be confined to : — (a) Gas. (6) Coal. (c) Steam. (d) Electricity. 242. Gas by reason of its cleanliness, efficiency and the saving in labour which results from its use is probably the best cooking factor in small and medium sized canteens. In large canteens while the roasting is done by gas, it is economical to use steam for boiling, steaming and for warming the hot- closets. The use of steam is especially economical if it can be drawn from the factory boilers, but in the larger canteens it is worth while to instal an independent boiler to supply the steam for cooking purposes if it cannot be supplied otherwise. Coal is used where gas is unobtainable or expensive. It is most efficient as a means of cooking, but is less cleanly than gas and is objectionable in summer on account of the heat developed by large coal-ranges. Electricity is the newest means of cooking ; not only, however, is the original installation costly, but unless the supply of current is exceptionally cheap the running cost is high. 243. The relative position of cooking apparatus naturally varies with the type of apparatus used, but generally speaking, it has been found better to have the stoves and roasters in the centre of the kitchen with the steamers or boilers behind, and the carving table and hot closets adjacent to the serving counter. The serving of tea, &c., should be kept quite separate from the general service table. 244. It is most essential that there should always be a plentiful supply of hot water through the sink taps for washing up purposes. There are several alternative methods of producing this, among which are the following : — (1) Circulator boiler connect to a storage system. (2) Large hot water geyser. (3) Separate boiler over each sink. 245. The maintenance of cleanliness is one of the most important points in the whole scheme of a canteen, and it is one that the workers are quick to appreciate. In the mess room all floors, tables, seats, and windows should be thoroughly cleansed every day, and in the kitchen all cooking apparatus should be well scoured and kept scrupulously clean. The table equipment should always be well washed and polished. The immediate surroimdings of the canteen should be kept free from accumulated rubbish and refuse, as by this means trouble from flies is greatly reduced.* * Cost. — ^About 6d. per foot cube, exclusive of central heating and lighting is now (1918) the standard cost for building the fabric. Equipment varies from 30s. to 60s. per person seated. Total cost for building and equipment of canteen for 500 persons will work out from £7 to £9 per place. 57 Management. 246. In the early part of the war excellent and devoted work was accomplished by some eight or ten public-spirited voluntary societies, including the Y.M.C.A., Lady Lawrence's Munition Makers' Canteen Committee, the Salvation Army, the Church Army, the Women's Legion, &c., in regard to canteen management. On the whole, however, the Committee are satisfied that the Industrial Canteen should be undertaken by the proprietors of the factory (whether public or private) and should be regarded as an integral and permanent part of the factory organisation, controlled like any other branch of the works under a duly appointed and competent manager or manageress. The proprietor should scrutinise the accounts of. the trading, or arrange for their proper audit. He should watch the working and satisfy himself that full value is being obtained in the shape of increased nutrition, efficiency and contentment of the worker, and that current charges are reasonable. The selection of the canteen manager demands no less care than the selection of a head of any other department of the business. The qualifications principally required are organising ability, powers of discipline, a thorough knowledge of buying foodstuffs and a fair working knowledge of the economical preparation and cooking of food. Sympathy, tact and an understanding of the purpose of the canteen are also necessary. Food and Dietaries. 247. The food supplied should be varied, fresh and good ; suitable in quality and sufficient in quantity ; well cooked, appetising and obtainable at low cost. It is obvious that the tariff must differ in accordance with food prices, and administrative charges and incidental expenditure. It will often be found expedient to allow the workmen's committee of management to examine the trading accounts periodically. The following figures show approximately the nature of a canteen tariff during the earlier war period : — Dinner — meat or fish, two vegetables ... ... ... 4d. to 8(i. Hot-pot, cottage pie, meat puddings 3d. to 6rf. Meat pies and other prepared meat dishes Zd.to&d. Soup, bovril, 0X0, &c. (with bread) 2d. to Srf. Puddings and stewed fruits 2d to 3d, Suet, bread, currant, jam or fruit puddings ... ... 2d. to 3d. Bread and cheese Id. to 2d. Vegetarian and cheese dishes 2d. to 4d. Cakes, buns, tarts, bread and butter, sandwiches Id. to 3d. Tea, coffee, cocoa, mUk, lemon, barley, aerated and mineral waters, &c., per cup or glass ... ... ... ... Id. to 2d. (Grood quality important.) Fresh fruit in season, as practicable. 248. In certain districts and in special circmnstances, there may be a case for the establishment of a " wet " canteen, where alcoholic beverages may be obtained. Special supervision and restrictions are necessary in such cases. Prompt Service. 249. The quick service of meals is essential. Three methods are practicable. (Method (1) is probably best, as a rule for large numbers) : — (1) Long serving counters (with short barriers as at railway booking offices) from which workers fetch their food. A number of portions should be prepared beforehand and stored in hot closets under the counter. Portions should be standardised. (2) Food placed ready on the table before workers admitted. This may be convenient for breakfasts or teas, or where the food provided is cold and the same for all, but it is not always practicable for hot dinners. (3) Waiters or waitresses, organised in shifts. Convenient Hours. 250. The canteen should be open at any hours which meet local needs and circumstances. Mid-day is clearly the principal occasion of its utility. But in many works it should also be open in the early morning hour for breakfast, and at supper time. Where there are night-shifts meals and refreshments should be available as by day. Provision should also be made for the supply of water, milk, tea or coffee at specified times. Payment. 251. Different methods of payment are in vogue, but if payment at the time by bill or check is found, which is usually the case, to be impracticable, the most appropriate method is for workers to buy books or series of tickets or checks previously to the meal or at the door. Accounts. 252. The factory account should bear the capital oharges and certain current expenses, leaving to the canteen account the cost of food, wages and general administrative charges. 58 253. The Committee have been impressed with the importance of proper economical and effective organisation of industrial canteens. Their purpose, it must be clearly recognised, is to provide sufficient and suitable food and not to yield a revenue. The revenue of a canteen is improved health, content- ment and physical efficiency of the workers, and not a cash balance. 254. Speaking generally, three methods of organisation are available and are not mutually exclusive. First, the employer may manage directly ; secondly, he may hand over the management to a properly constituted committee of the workers, or of the workers and the staff conjointly ; or thirdly, the entire direction may be contracted out to a professional or voluntary caterer. Jn not a few of the most successful canteens joint control is exercised by employer and men {e.g., an elected shop committee with a chairman representing the management) who may or may not contract out the catering. The method of control is materially affected by the proprietorship. In all cases it should be disinterested "'and solely for the benefit of the workers. Exploitation in any form should be avoided, and efficiency, economy and smooth working kept steadily in view.* It must be borne in mind that money cannot be deducted from wages by the employer for food or drink without a contract under the Truck Act.f 255. It is not possible for the Committee to lay down hard and fast rules or methods for the successful organisation of canteens. In one district or set of circumstances, one condition or factor, and in another district another condition, is predominate. But whatever be the local circumstances to secure an effective industrial canteen it is necessary (a) that it should be accessible and attractive ; (6) that it should be suitably constructed and equipped ; (c) that the diet offered should be fresh, varied, good and in accordance with popular taste ; (d) that the service should be prompt ; (e) that the canteen should be open at convenient hours of day or night and (/) that the arrangements for payment should be simple and convenient. 256. The Committee recognise that since the issue of their first memorandiun on the subject (Cd.8133) in November, 1915, substantial progress has been made, due in no small degree to the activity of the Canteen Committee of the Central Control Board. The industrial canteen is rapidly becoming a social agency. The Committee welcome the Police, Factories (Miscellaneous Provisions) Act of 1916, S. 7 (see Appendix H.) as a statutory enactment likely to make universal and permanent the advantages of this agency. Eesults. 257. The Committee have been impressed with the consensus of opinion which they have received from all parts of the country as to the substantial advantages both to employers and workers following the establishment of an effective and weU-managed canteen. These benefits have been direct and indirect. Among the former has been a marked improvement in the health, nutrition and physical condition of the workers, a reduction in fatigue and sickness, less absence and broken time, less tendency to alcoholism and an increased efficiency and output ; among the latter has been a saving of the time of the workman, a salutary though brief change from the workshop, greater contentment, increased opportunity for recreation, and a better mid-day ventilation of the workshop. The Committee are satisfied that the evidence of these results is substantial, indisputable and widespread. In the isolated cases where the canteen has failed it has been evident that its failure has been due to exceptional circumstances, misuse by the workers or mismanagement. In almost all large Works the Committee find that there is a body of men or women (averaging at least 25 per cent.) who in the interest of physical health and vigour need canteen provision at the factory. They are convinced that this group of iU-fed workers accoimts in a large degree for such inefficiency as exists, and that its energy and output is reduced in the absence of suitable feeding arrangements. Whilst it is impossible to separate the benefit derived from canteens from other welfare agencies or to render statistical evidence as to the effect upon output, the Committee have received a number of statements in favour of Industrial Canteens from which they select the following : — {a) " In answer to your inquiry as to the effect which our canteen arrangements have had upon the health and efficiency of our own workpeople, we were so fuUy alive to the importance of this as to erect a complete installation, separated from the factory proper, for the use of those who live too far away from the works to dine at home. From 1,500 to 2,000 workpeople make use of these rooms daily. " The building has a weU-equipped kitchen, but the majority of those who dine at the works, although buying tea and light refreshments, bring their own dinner. This habit obtains elsewhere. We make a point, however, of having, in addition to other things, one or two cheap and very nutritious dishes, e.g., a Id. basin of soup or stew, of which some hundreds are sold daily. In planning the Dining Block, we felt it was not merely a question of supplying food, but of doing so under restful and comfortable condi- tions, in rooms well lighted and ventilated and properly warmed. A great deal more was done than was * The tariff can be kept low only by careful management. The food materials can usually be made to pay, but the incidental expenditure is relatively heavy. Workers are not accustomed to paying for food in canteens, and wiU not always purchase the most nutritious food. Tact, discretion, and an appropriate menu of popular dishes are necessary. Constant supervision and the careful adaptations of means to ends are needed to prevent loss if good food is to be sold quickly, at the low price the worker can afford to pay. t The Truck Act, 1831, Section 23, provides that "no deduction shall be made from the wages of a workman in respect of victuals dressed and prepared under the roof of the employer unless an agreement or contract for such stop- page or deduction shall be made in writing and signed by the artificer." Such an Agreement can be readily made and may prove to save time and prevent waste. 69 required for bare efficiency, and it is not necessary to build on so costly a scale. We have never had a moment's doubt as to the importance of a comfortable dinner hour for our people from the point of view of their efficiency in the afternoon. " The health of our workpeople has imquestionably improved in recent years, and we feel sure that the Dining Room has helped to bring about this result. At the same time, as there are many factors which have come into play, it is impossible to value with any approach to accuracy the part that each of these has played. The proper ventilation of the workrooms, medical and dental attendance freely given at the works, with facilities for those in poor health getting to a convalescent home, are among the many factors which have each exercised an influence." (6) " A large number of our men workers still prefer to bring their own food with them and to infuse their owp tea, in a building which we have supplied for the purpose. " About 80 per cent, of our female workers earn a perfect time-keeping bonus each week, which means that they have not lost a minute, whereas the percentage of men who do so rarely exceeds 65 and is generally under that figure. 1 do not suggest that the whole of the credit for these differences is due to the fact that the women feed in the canteen and the men do not, but I have no hesitetion in giving it as my opinion that this is one of the factors of the question. " Especially as this factory is placed, 11 miles from Glasgow and miles removed from the nearest village, we simply could not do without a canteen, and I think you wiU agre«?that it is very satisfactory to know that although all our workers have to spend practically an hour morning and evening in getting from their homes to the factory and vice versa, which has the eSect of keeping many of them out of their homes for a rotmd of the clock, we have an excellent bill of health and have so far been able to resist very satisfactorily even the special dangers to health which attend working with amatol, T.N.T., and cordite. " At the present moment in our whole staff of 10,000 workers we have not a single T.N.T. sickness case. " I might add that our medical officer fuUy concurs in the opinion given as regards the value of a canteen from the health point of view. " At first we had some trouble in getting our girls to take a substantial meal in the middle of the day. The home conditions of many of them had evidently been such that they were accustomed to a diet consisting largely of tea, bread and butter, pastry, &o., and they preferred to continue to feed themselves in that way even when they did buy food in the canteen. There are clear evidences that their tastes in this respect are improving and they are appreciating a properly cooked meal It has taken a good deal of efEort on the part of the management to get as far in this matter as we have, but I feel certain that once they fully experience the advantages to their own health with better food the workers will not readily return to their old methods." (c) " Whilst our experience in this respect is principally in regard to women workers, we are certainly of opinion that the benefit is a very considerable one, as not only have the canteens conduced to better time-keeping, but the direct effect of the substitution of weU-cooked food for the cold (often tinned) or even re-heated food brought by the workers and eaten under uncomfortable and often insanitary conditions, has certainly had an excellent effect on the health and appearance of the women. " The provision of canteens where the workers can obtain weU-cooked and suitable food at a minimum cost is, therefore, advantageous — ^apart from whether there are other means for them to obtain their food in the neighbourhood of the factory — ^whilst the provision of hot drinks and soups on cold nights tends considerably to improve production. " The institution of a canteen is also essential if a three-shift system (as in the case of our women workers) is to be adopted without an undue loss of time for meal hours." {d) " (One solution of the problem both from the point of view of the girl herself, who will get a good meal cheaply (owing to wholesale buying and more expert cooking) and from that of the factory, both as to health and output of energy, is undoubtedly the provision of meals by the canteen for all workers. " Practical proof of this is shown by this factory, where incidentally the provision of two square meals a day with 1 J hours each to take them in and get out in the fresh air afterwards has put a stop to the far too frequent fainting whilst at work, to much constipation and other disorders due often to defective nutrition, and to much dissatisfaction among the workers themselves, really due to their feeling out of sorts from these causes. " Proper feeding and proper ventilation, with cleansing of the workers before food and after leaving work, and attention to the flushing of the internal drainage of the body, wiU produce the maximum of immunity to T.N.T. poisoning or any other infection which may be prevalent, provided the worker starts healthy. Of this I am quite convinced. The Medical Department is occupied in sifting applicants for work in order to exclude obviously unsound persons, and to put less unsound persons into worlang order — by regulating their bowels and cleansing their mouths from the far too frequent sepgis before allowing them to work in T.N.T. It is the privilege of the management to see that these reasonably sound workers get suitably fed and housed, that there work is suitably apportioned and that they are trained up by competent persons to do this work with as little waste of energy as is compatible with the perfect performance of the particular duty on which they are engaged." (e) " The advantage of having freshly cooked meals, well served in the canteen, removed from the noise of machinery, and the odour of the factory has had a marked beneficial efiect on the health and spirits of the workers. The meal hours in the canteen are now welcome breaks in the monotony of what was previously too often a 12-hour 'shift.' Since the introduction of canteens the employees have really worked in a ' shift ' which consists of three parts with added initial energy for each part. The increased energy, good spirits, improved health and ' staying ' power is appreciably noticeable to the most casual observer. " An experiment has been tried in this factory of having concerts in the canteen dming the long meal hour. The conduct of the workers is the best index of their success. The employees have packed the canteen ; the best of their talent has been freely given for the benefit of their workers, the audience has been ideal in discipline and appreciation of the efforts of the entertainers." (/) " A canteen properly managed and in which the management of the factory take as great an interest in regard to its efficiency as they would do in any department of their work presents an unlimited scope for aU high thinking employers, for the betterment of their workers. The first advantage of this is that it wiU draw employees and employers together on domestic matters, as I consider that the management of the canteen should be under the factory control, and that all supervision should be undertaken by a committee of the employees with the manager or some high official as ex-officio chairman. The various little questions that arise for discussion though small in themselves wiU be found to be of that nature which wiU inevitably result in the chairman having the opportunity of displa3dng a ' human touch ' which he may rarely have an opportunity of at present — I do not wish to be misunderstood by this that the manager would be reduced to coddling or merely sentimental action, such would be strongly resented by the workers themselves, but the very fact that there would be the ' chief ' taking an interest in the questions of their daily livelihood will be, I venture to believe, a big advance in bringing the two together." 60 (g) " Knowing your interest in the details of these matters, we would like to mention how useful has been the installing of a number of small tea dep6ts, distributed throughout the shops, which are open for a quarter- of-an-hour in the afternoons, and again for a quarter-of-an-hour during the night shift, for the sale of tea and cakes. This has been done that we might put an end to the promiscuous tea making that went on previously. The running of these tea depots has been only possible by the existence of the canteen, and from an administrative point of view, we are indebted to the canteen management that it has been possible to adopt this system of tea depots." 258. Such declarations are, after all, substantial evidence and they confirm the conviction of the Com- mittee as to the benefit arising as a result of a good Industrial Canteen. The Committee have been impressed not only with the improved nutrition manifested by the users of the Canteen, but by a lessened tendency to excessive consumption of alcohol, by the prevalence of the spirit of harmony and content- ment engendered, and by a declared increase in efiiciency and output. Conclusions. 259. From what has been said in the present Section it will be understood that the Committee were convinced at a very early stage of their inquiries of the value and, indeed, necessity of establishing industrial canteens in order to provide for the proper nourishment of munition workers. As, however, the Central Control Board (Liquor Trafiic), of which Lord D'Abernon was Chairman, had in June, 1915, appointed (under the statutory powers conferred on them by Defence of the Realm Regulation No. 5 of 1915) a Canteen Comnuttee (the Chairman of which was Sir George Newman), the Health of Munition Workers Committee deemed it inexpedient to intervene in the work which that Canteen Committee had already commenced. Accordingly the burden of work in connection with the establishment of industrial canteens has fallen upon the Canteen Committee of the Liquor Control Board, assisted by His Majesty's Office of Works, who have thus facilitated the supply of proper and sufficient nourishment for the munition worker not only in the interests of sobriety, but also in the interests of industrial efficiency.* In the first enthusiasm of this great movement a number of voluntary assistants and voluntary workers undertook the responsible duties in connection with the establishment and main- tenance of canteens. Eventually, however, it became necessary owing to the magnitude of the under- taking that the State should shoulder increased responsibilities in the matter. The Munitions of War Act, 1915, provided that " controlled " employers, in which category were included practically all manufacturers of munitions, in the wide meaning that modern warfare imparted to the term, were to receive only their standard pre-war profits plus one-fifth, the remainder being paid to the Exchequer. It seemed hardly reasonable to expect them to sacrifice profits so rigidly limited in order to provide canteens for their workers, and it could fairly be argued that, as the advantages of the increased output anticipated from the establishment of industrial canteens would accrue to the State, the State should find the money. On the initiative of the Liquor Control Board it was therefore decided that " controlled " employers should be allowed to charge to revenue the expenditure which they might incur with the approval of the Board on the establishment of canteens at their works ; in other words, that the cost of the establishment of canteens should be borne from funds which would otherwise accrue to the Exchequer. At the same time the Minister gave instructions for the provision, where necessary, at all Government Munition establishments (Royal Arsenals, National Factories, &c.) of adequate canteen accommodation at the expense of the State, and entrusted the Board with the general responsibility for the organisation of the canteens at these establishments. 260. The Liquor Control Board have thus been the responsible authority for the organisation of industrial canteens in munition works throughout the country. They established the necessary depart- mental and expert staff for the effective performance of this duty, and in its execution have through their representatives visited all the larger and many of the smaller munition works, and have urged the provision of canteens wherever a real and undoubted need was found to exist, whether that need arose on grounds of liquor control or of nutrition of the munition worker. The Board have made it their study to do all that was possible to assist employers in the design, equipment and management of canteens. The services of their expert staff have been placed freely at the disposal of employers, and they have published a handy compendium of information on these subjects in the form of a pamphlet entitled " Feeding the Munition Worker," to the usefulness of which they have received numerous testimonies. 261. The policy of the Liquor Control Board; with which the Committee have fully concurred, has been first to encourage the employer or owner to make suitable provision for canteen accommodation where necessary ; secondly, to facilitate such provision by voluntary or other agencies ; or thirdly, to establish a canteen themselves, either managing directly or handing over the management to a properly constituted committee of employers and workmen. At the end of 1917 some 840 industrial canteens had been established in National and Controlled Munition Factories and at docks concerned in transport in connection with the war (at an approximate cost of upwards of 1 J millions). The canteens estab- lished under the auspices of the Liquor Control Board have been, with few exceptions, known as " temperance " or " dry " canteens — that is to say, no intoxicants have been supplied. In a few excep- tional cases the Liquor Board have made special Orders providing for the " on " sale and consumption of beer limited in specific gravity and in quantity purchaseable. Exceptional conditions in various * See First [Cd. 8117], Second [Cd. 8243], Third [Od. 8558] and Fourth [Cd. 9055] Repbrts of the Central Control Board (Liquor Traific) appointed under the Defence of the Realm Consolidation Act, 1914, and the Defence of the Realm (Amendment) (No. 3) Act, 1915. 61 areas owing to concentration of munition workers, congestion of population, the building of large factories in isolated places, the employment of women and night employment, have necessitated excep- tional arrangements. Speaking generally, the ' Committee are glad to recognise that the Liquor Control Board have initiated, guided or assisted, a social and industrial reform which force of circumstances has rendered imperative in the present emergency, and which has, the Committee are satisfied, contributed substan- tially to the successful output of munitions. The industrial canteen has, in fact, proved itself one of the most eSective instruments in securing and maintaining a high standard of industrial work. It has contributed to increased sobriety ; it has reduced " industrial drinking " ; it has served as a counter- attraction to the public-house ; it has supplied improved nutrition to the worker, which has led to a reduction in sickness and to increased energy, better time-keeping and improved output. The Com- mittee earnestly trust that these substantial gains may be maintained in the future and that the Industrial Canteen will become a permanent and essential factor of the modern factory. Section X. SICKNESS AND ILL-HEALTH. 262. The effect of industrial occupation upon the health of the worker has been a subject of medical investigation since the seventeenth century. Early in the nineteenth century similar inquiries were instituted in England, and in 1831 Thackrah showed that the environment and conditions of factory life, or the mental and physical strain entailed, were associated with exceptional disablement, disease, or mortality among the persons employed. Numerous Commissions have been appointed by the Grovem- ment to ascertain more precisely the exact causes of such effects, and these have considered successively the general circumstances of the worker, the injurious influences of the factory system, the special con- ditions of certain occupations, the risks incurred in the use of machinery, and the results arising among those employed in dangerous trades. Thus has been accumulated a body of medical experience, growing with the growth of industry and with the increase of our knowledge of the causes of disease. Concurrently with the appearance of evidence of a medical and social character further light has been thrown upon the subject by actuaries, insurance agents, and statisticians. As long ago as 1853, Finlaison, the actuary of the National Debt, said that " the real practical difference in the distribution of sickness seems to turn upon the amount of expenditure of physical force," and fifty years later, in 1903, Watson, who had studied the subject from an actuarial point of view, wrote that " the proportion of members sick during any year varies with occupation." Again, the experience of insurance authorities confirms the same view. The Eeport on National Health Insurance for 1913-14 states that "in many cases the rate of sickness is affected by occupations or by the conditions incidental to particular occupations." Lastly, there is the incontrovertible evidence furnished by the Bills of Mortality steadily accumulating in proof as the years pass. The Decennial Reports of the Registrar General demonstrate that certain occupations have a high comparative mortality, that this mortality is due to weU-defined and preventible diseases, that the occupation may exert a greater influence on mortality than the aggregation of popula- tjion and its associated conditions, and that occupational mortality is affected by the age incidence of the worker. Causes of Sickness. 263. Sickness due directly or indirectly to the industrial occupation takes various forms and degrees from the passing headache to serious organic disease of fatal issue. The lungs, the heart, the digestive organs, the nervous system, the muscular system — each or all may be affected with results harmful both to industrial efficiency and output, and also to personal health and expectation of life. Moreover it must be remembered that an undue proportion of sickness in any group of workers usually represents among those not actually sick lessened vigour and activity which cannot fail to reduce output. Disabling conditions or influences which injure some have a tendency to mark all. Employers and their work- people should therefore have a general appreciation of these injurious conditions if they are to be on the outlook to guard against or mitigate their evil effect. Speaking generally, attention should be given to the following points : — {a) Excessively long hours of work, particularly by night, if continued produce fatigue, irritation and sickness. " You will find," writes Sir James Paget, " that fatigue has a larger share in the promotion or transmission of disease than any other single causal condition you can name." (6) Cramped and constrained attitudes or postures during work which prevent the healthy action of the lungs and heart. (c) Prolonged and excessive muscular strain, e.g., the lifting of heavy weights, or prolonged standing may produce rupture or varicose veins. {d) Machinery accidents. (e) Working in unventilated or insufficiently ventilated shops predisposes to disease and interferes with individual energy and physical capacity. The effect of continuously working in a stagnant or polluted atmosphere is not trifling or insignificant. 62 (/) The air, even if fresh, may be too hot or too cold, too humid or too dry ; either extreme should be avoided if reasonable bodily comfort and the most efficient work are to be ensured. (g) Imperfect lighting, whether by day or night, conduces to eye stra-in and headache. (h) Working with, or in the presence of gases, vapours, poisons, or other irritating substances, may lead to direct poisoning. (i) Dust produced in certain industries unless effectually safeguarded may produce lung disease. (/) The manufacture and use of high explosives involves risks to the workers. 264. In considering the physical capacity of a woman for withstanding the fatigue consequent upon prolonged industrial employment, it has to be remembered that her body is physiologically different from and less strongly built from that of a man. Her muscular system is less developed. Account must also be taken of the fact that at the present time many workers have until recently lived a sedentary or domestic life and have not been in the habit of taking active and regular exercises. Certain ailments and forms of physical disability to which women are liable are readily caused or at least accentuated by inattention to these considerations ; among such conditions are : — (i) Disturbances of digestion due to unsuitable food, irregular and hurried meals, or to fatigue ; (ii) Anaemia, with possibly associated disease of the heart and circulatory system ; (iii) Headache ; (iv) Nervous exhaustion ; (v) Muscular pain and weakness, flat foot, etc. (vi) Derangemen' of special physiological functions. 265. Though these conditions may not in all cases be immediately incapacitating, they frequently tend to become chronic in nature and far reaching in effect, and they lead directly to mal-nutrition and to reduction of bodily energy. If allowed to persist they invariably lay the foundations of ill-health and disease in later years. 266. Special problems also arise in the prevention of sickness amongst boys and girls. Both physically and mentally they are less capable than adults of prolonged effort or sustained attention to work. They need vital energy not only for the maintenance of health but for growth ; even though there are no signs of immediate ill-health their future growth and development may become stunted. 267. Though these are a sufficiently formidable list of disabling conditions, or conditions which without proper care and precaution may readily cause disablement, they do not complete the inventory. At least as important as any of these occupational influences, but inseparable from them, is the predisposi- tion to disease arising from < he absence of personal hygiene. The necessities of individual health are few and simple, but they are essential. Suitable and sufficient food, fresh air, warmth, moderation, cleanliness in ways and habits of life, the proper inter-relation of work, repose and recreation of mind and body are laws of hygiene, the elements of vital importance for which facilities must be provided if the maximum industrial output of the individual is to be secured and maintained. These matters need consideration by the management just as much as the healthy supervision of the external circum- ances of the factory and its technical processes. Indications of Sickness. 268. In addition to the clinical signs and symptoms of ill-health and disease, there are three general indications of sickness in a factory which can be gauged by the Management : — (a) Absence, broken time irregular time-keeping, or diminished output of the individual worker. (b) Sickness register. (c) Death certificates. These, though few in number, form important indications of the health of the workers as a whole. 269. Every case of lost time or absence calls for inquiry. It should be properly recorded. The study of such records is certain to disclose the existence of adverse influences or circumstances previously un- suspected which may denote the beginning of sickness. Unfortunately the niimber of instances where reliable records are kept is comparatively few. Even when their importance is recognised difficulties have arisen owing to pressure on the time of the Staff, or owing to the unsatisfactory character of many of the medical certificates supplied by workers. These certificates frequently give no information as to the cause of illness or as to its probable duration. They seldom state whether immediate absence from work is essential, or whether it can be postponed for a brief period until a particular job has been completed. Apart from these, certificates are sometimes given on odd slips of paper, or do not show the address of the Medical Practitioner. In their Memorandum No. 16* the Committee have suggested the need for a form of Medical Certificate which, if adopted, should do much to obviate these difficulties. A model form is given in Appendix G. 270. Professor Loveday, in his memorandum on " The Causes and Conditions of Lost Time " which is included in the Committee's Interim Eeport on " Industrial Efficiency and Fatigue," sets out the results of a series of investigations which he made on behalf of the Committee into the Lost Time. He concludes that nearly all records under-state, and most records under-state greatly, the proportion of lost time due to sickness and other unavoidable causes. This is partly due to the difficulty in regard to medical certificates already referred to, and partly to the fact that many absences for which no medical certificates * Cd. 8522. 63 are or can be forthcoming are attributable to fatigue, colds or other minor ailments. While such absences may in a sense have been avoidable, they frequently serve to prevent future breakdown. He gives reasons in support of the view that except where there is an undue degree of slackness more than half of the time lost is lost through unavoidable causes. Various methods are suggested for testing the accuracy of sickness records : — (a) If the returns of bad time keeping and sickness coincide in direction. (6) If the number of whole weeks lost through sickness is abnormally high when compared with the shorter periods similarly lost, (c) If the number of days lost through sickness is abnormally high when compared with the number of "quarters " similarly lost. 271. An affirmative answer to any of these questions, unless explicable otherwise, gives good reason for supposing the rate of sickness to be under-stated. While no doubt in some places and in some trades time-keeping has really been slack, there seems little doubt that the under-estimate of sickness and unavoidable absence generally has led to many misinformed and unjust statements about the lethargy and irregularity of the whole body of workers in controlled factories. 272. In scrutinising sickness returns and in studying their rise and fall, account must be taken of various causes of fluctuation : — (a) Climatic Conditions. — It may be assumed that the rate of sickness will be above the average in January, February, March, April and occasionally in November. In the remaining months it will or- dinarily be below the normal. If the sickness rate does not respond to considerable changes in weather, or fluctuates independently of them, other causes of fluctuation must be operative and should be determined. (5) The approach oj a holiday. — A worker, though feeling unwell, may hold on if a holiday is approaching, and a reduction in the sickness rate may accordingly result. (c) A holiday just past. — ^If the sickness curve fails to respond to a holiday, and especially to a break of several days, or if its steadiness or rise cannot be attributed to worsened climatic conditions, epidemics or the like, there is reason for receiving statements as to sickness with caution and sometimes with suspicion. (d) Patriotic enthusiasm. — ^Many workers will keep at work when they are convinced of its urgency and national importance even though they may be unwell and need rest. Consequently when a period of relaxation occurs the rate of lost time and also of sickness may rise substantially. (e) Long hours, much overtime, and especially Sunday labour undoubtedly exercise a most deteriorating efiect. Professor Loveday quotes the case of a factory where there was much Sunday labour during the Spring and where no fewer than 22 per cent, of the men were at one time sick. During the following August when Sunday labour had been much reduced (but overtime on week days remained heavy) the sickness rate was little over 4 per cent. This reduction was partly attributable to the change of season, but the figures of a neighbouring factory showed that in that district the weather during the Spring, though inclement, was not abnormally unhealthy, and Professor Loveday sees no reason to doubt the Manager's view that the weather was less accountable for the improvement than the restriction of Sunday work. 273. As regards the signs of ill-health most commonly met with amongst mimition workers, a large body of information has been rendered available as the result of the medical examinations of male and female workers which were-conducted on behalf of the Committee. Full particulars of the ailments and defects found by Dr. Agnew as the result of examining over 3,000 men and boys are given in a table set out on pages 98 and 99 of the Committee's Interim Report on " Industrial Efficiency and Fatigue." Dr. Agnew reports : — " There is no one defect that points conclusively to overwork or strain, but many of the symptoms taken collectively indicate severe strain, and I would suggest that sleepiness on the night shift, headache, foot-ache and muscular pains are probably the most common signs of overwork. The nervous symptoms added to these go far to complete the picture. The effect of noise upon the individual and its contribution to feelings of over- tiredness and exhaustion must be considerable. In many of the factories, though the work was not heavy, the noise was such that the result' of lengthened periods in these factories was almost as severe as exposure to high temperature coupled with hard work." 274. On pages 120 and 121 of the same Report similar particulars are given of the defects found as the result of examining over 1,300 women and girls ; the results of these examinations were thus summarised : "The ailments most frequently observed included indigestion, constipation, headache, anaemia and muscular pains. These are all frequently met with among women workers and cannot be attributed especially to munition work. The great difficulty in estimating their precise importance is the lack of any control investigation or data. In some cases the aUment had rmdoubtedly been caused or accentuated by conditions of factory work. In other cases it has existed before beginning munition work. In others again the workers expressed themselves as in better health than formerly." Methods of Remedy and Treatment. 275. At the foundation of any sound system of dealing with industrial diseases lie two elementary principles : First, that prevention is better than cure ; and secondly, that for treatment to be imposed efiectively it must deal with the beginnings of disease. Bearing these in mind, the preliminarv safeguard 64 should be to provide for the medical examination of all workers in order to secure as far as may be their physical fitness for employment. In some munition works, and especially in those where dangerous substances are manipulated, a preliminary medical examination of all workers is usual. Dental treat- ment is also sometimes provided. Such examinations are specially important at the present time owing to the strain involved by the conditions of employment and owing to the large number of persons who are taking up industrial employment for the first time ; but such examinations are always likely to be desirable where the work involves any special strain, and particularly so in the case of women. Apart from their value in detecting early signs of ailment or defect, medical examinations dre valuable as affording convenient opportunityfor the inculcation of sound doctrines as to personal hygiene, cleanliness and healthy habits. Periodic re-examination is practically confined to certain dangerous trades and processes, the workers in which have to be periodically examined under the Regulations of the Home Office or the Ministry of Munitions. Where they can be arranged for, such examinations might usefully be extended to workers engaged in other processes involving special strain or risk. 276. It is true that under Section 63 of the Factory and Workshop Act it is necessary for every boy and girl under 16 to be certified by the Factory Certifying Surgeon* as physically fit for employment in the factory. Unfortunately, this certificate is not always adequate for its purpose. The decision of the surgeon has normally to be based simply on one brief examination. More often than not he has no previous knowledge of the boy or girl, and generally, the records of the School Medical Service are not available. After a young person has once been admitted to a factory, no further medical examina- tiori is required except in the rare instances where the Factory Inspector may specially require it. In view of the strain which industrial employment may often impose on growing boys or girls, it would undoubtedly be an advantage if arrangements could be made for their periodic re-examination. It may be pointed out that the Departmental Committee on " The Night Employment of Male "Young Persons " emphasised the need for such periodical examinations once at least in every six months, and recommended that records of the results should be kept. 277. The second step is to reduce to a minimum any unfavourable conditions obtaining in the factory by providing proper sanitary conditions and accommodation, safe-guarding machinery, controlling hours of labour, furnishing canteen facilities, and securing sufficiently-warmed, lighted and ventilated workrooms. 278. Thirdly, arrangements should be made for adequate medical and nursing schemes. Medical attendance is obtainable under the National- Insurance system, or may be made available by the special provision of a medical and hospital service for the factory. Nursing can only be obtained by the employment of one or more trained nurses to undertake duties in the factory by night as well as by day. Such arrangements have been instituted in many mTinition factories, especially where women are employed, and have proved of great value to employers and workers alike. The duties of the factory nurse may include : — (a) Supervision of the health of the workers. (b) Superintendence of the rest-room for those who are temporarily indisposed. (c) Following up cases of sickness at home. (d) Taking charge of Pirst-Aid treatment of injuries. (e) In the absence of medical advice, observing and controlling in its initial stages any threatened outbreak of the influenza type of sickness, which, if it extends, may temporarily paralyse output. 279. The Committee are glad to recognise the increasing frequency with which nurses are now being employed in factories to perform some or all of the duties mentioned above. The employment of doctors is, of course, less common. In factories engaged-upon the manufacture or manipulation of poisonous substances and gases, 51 medical officers are at present employed. Of these, 14 are whole- time officers and 37 part-time. Their duties include the preliminary medical examination of the workers, the supervision of their health while at work, a constant inspection of the working conditions of the factory, and the regulation of suspensions. In addition, they are constantly concerned with other matters more or less directly affecting the health of the workers. They report periodically to the Ministry on medical problems arising in their work. At many of these factories dentists are employed by the management to treat new workers, who require to have carious teeth removed before they can be safely employed. In other factories the employment of medical officers is still rare, though it is increasing, and development is likely to be encouraged through the need for securing the proper super- vision and maintenance of the first-aid appliances, the provision of which is required by the recent Home Office Order. f The need for training workers in the use of these appliances will also require to be provided for. The three cases quoted below indicate other directions in which development may be anticipated : — (a) At an engineering factory employing about 2,250 workers (mostly men) a whole-time medical officer has been appointed, who acts also as panel doctor for most of the employees. He makes a medical examina- tion of all new employees. Absentees are followed up by him if they have not seen him before leaving work, and they again see him before resuming work. The number of patients seen varies from 60 to * See Memorandum on " Certificates of Fitness," issued by the Home Office in 1915, and obtainable on application to that Office. t See paragraph 289 and Appendix I. 65 75 a day, and the medical officer's work consists in the supervision of the dressing carried out by his male dresser, ordinary diagnosis, minor surgical treatments, and any attendance on the workers where necessary in their homes or at the neighbouring cottage hospital. (6) At an engineering factory, where about 2,500 men and women are employed, a medical officer attends at the surgery daily from noon till 1 p.m. He sees cases of injuries which have been held over for his inspection or which have come up to be redressed. He also examines all workers before engagement, when any physical defects, such as hernia, hydrocele, varicocele, varicose veins or heart trouble, are entered in a book and the entry countersigned by the worker ; in this way claims in respect of that particular defect at some later date are avoided. The medical officer also treats at his own house cases sent to him by the nurses on duty. Employees have to report every accident, no matter how slight, to the foreman, who passes the case on to the ambulance room. The workers are in no case allowed to treat any wound themselves. All wounds are dressed by nurses under the supervision of the medical officer. Patients are not sent to their own doctor, for the latter have not time for, and cannot be expected to, treat daily a large number of _ minor and apparently trifling injuries. Under the system adopted every wound, however slight, is dressed within a few minutes of its occurrence, and is properly cared for until it is healed. As a result, the proportion of workers who lost time on account of accidents was markedly lowered, and there was an increase in the proportion of cases that lost no time at all. This scheme is also of interest because the firm on starting it decided to carry their own insurance for aU claims less than £100 and they found after due aUowanoe was made for the doctor's salary and the expenses associated with the nurses, that they had at the end of 18 months a credit balance of nearly £500. To this balance must be added the indirect though considerable value of workiug hours and weeks saved. (c) A group of factories are employing one medical man, paid on a capitation basis, to make not less than four health inspections annually. His inspection includes the organisation of first-aid treatment ; records of the health and progress of each worker ; the condition of the sanitary conveniences ; the cleanliness of the windows ; the ventilation, temperature and cleanliness of each workplace ; the facilities for obtaining food and drinking water ; and the cloakroom and washing accommodation. He also advises on any medical subject comiected with the work of the factory and as to the health of any worker specially referred to him. Any necessary observations or suggestions are entered in WTiting for the information of the management and for reference on subsequent visits. Section XI. INJURIES AND ACCIDENTS. 280. The provisions of the Factory and Workshop Act in regard to accidents fall into two main cate- gories — the prevention of accidents, and the notification and investigation of certain kinds of accidents. The provisions forthepreventionof accidents include the proper fencing of machinery (Section 10), safety valves for boilers (Section 11), the position and operation of self-acting machines (Section 12), the clean- ing of machinery by women and young persons (Section 13), means of escape in case of fixe (Section 14), and the making of doors to open outwards (Section 16). The occupier of the factory is required to notify to the factory inspector all fatal accidents and all accidents sufficiently serious to necessitate absence from work for a period of one day in some cases and of seven days in others. Notification is also required of dangerous occurrences such as fires, or certain types of explosions or accidents to machinery or plant. Under the Police, Factories, &c. CMiscellaneous Provisions) Act, 1916, Section 8, it is the duty of the factory certifying surgeon to investigate and report upon certain kinds of injury caused by exposure to gas, fumes, or other noxious substances, and also upon any other cases which may be specially referred to him. 281. How grave is the amount of disablement caused by injuries and accidents is shown by the fact that though only accidents of a certain degree of severity are notifiable, the number notified annually amounts to over 150,000. To these must be added a vast number of minor injuries and accidents which in the aggregate cause perhaps an even larger amount of interruption to work. A somewhat formidable return of accidents is therefore to be anticipated in munition factories, which include not only metal and engineering work, but certain dangerous trades and the manufacture of explosives. Moreover, the introduction of new labour, and of employees unaccustomed to the processes concerned, particularly in conjunction with the need for speed and pressure, overtime and night work with the consequent fatigue, must inevitably lead to greater risk of accident. The injuries in a typical munition works are not only open wounds, contusions and abrasions, injuries to the eye, sprains, simple and compound fractures, and injured limbs, but also scratches, cuts, bums, and other minor injuries which may readily lead to more serious conditions by neglect. The slightest wound may become infected with germs, and a greater or less degree of sepsis or blood poisoning supervene, with the resultant serious loss of time and efficiency, and possibly even risk of life and limb. An insurance company reports that out of 27,500 accident claims in 1917, 2,700 were septic claims, over 2,000 of these being septic conditions caused through woimds on the hand. 282. Much valuable and suggestive information on the relation of the incidence of accidents to output and to fatigue is contained in Dr. Vernon's Memorandum on " An Investigation of the Factors concerned in the causation of Industrial Accidents."* The inquiry is of the greater importance in that so far as the Committee are aware no inquiry of a similar nature had previously been conducted at any rate in this country. As he points out previous inquiries on the subject have .suffered from certain defects. In the first place the accident data are in no case correlated with the output data. Secondly no allowance has been made for the considerable psricd of time often lost at the beginning and end of a spell. And thirdly no allowance has been made for the time which has elapsed between the occurrence of the accident and the time when the worker applies for treatment. This period is always appreciable, and in the case of some types of accident (e.g., sprains) may be considerable. * Cd. 9046. (B 12023) E 66 283. As to what are the principal causes of accidents Dr. Vernon states : — " Speed of production is the essential factor in accident causation which can never be neglected. Its action depends especially on the degree of nervous and muscular co-ordination possessed by the worker, and on psychical conditions such as his alertness and attention. " The various factors concerned in accident production may be classified vmder two main headings, accord- ing as they depend on the worker himself, i.e., are of personal origin, or depend on external conditions not directly under his control. {I. Nervous and muscular co-ordination in relation to speed of production. IIL Psychical influences. IV. Nutrition and alcohol consumption. r V. Lighting. Factors of external origin. < VI. Temperature, humidity and ventilation. LVII. Defects of machinery, and absence of guards." 284. For an adequate appreciation of the character and scope of Dr. Vernon's inquiry, reference should be made to the report itself ;* here it must suffice to give a brief summary : — ■ Accident data were collected at four factories, for periods of 9 to 25J months. The accidents (over 50,000 in number) were classified separately under the headings of cuts, foreign bodies in the eye, burns, sprains and injuries incurred one or more days before they were first treated. Eye accidents afford the most reliable index of accident incidence, as they are almost invariably treated within a few minutes of their occur- rence. Cuts are fairly reliable, but sprains are quite unreliable, as the workers generally do not come for treatment till some time after they are incurred. Hence their incidence resembles that of ' previous injuries,' or depends on the inclination of the worker to attend the dressing station. This inclination varies greatly at difierent times. For instance, day shift women attended three times more frequently towards the end of the morning spell than at the beginning, but night shift women attended most frequently at the beginning of the shift, and only a fifth as frequently towards the end of it. Speed of Production. — Output determinations at a fuze factory -were made by measuring the excess electric power supplied to the valrious sections of the works, and verifying the results by direct enumerations of the articles produced. The output rose steadily during the morning speU and was 11 per cent, greater in the fourth hour of fuU work than in the first hour. It remained high dUSring the first hour of the afternoon spell, but fell off during the rest of the afternoon. The incidence of accidents showed a qualitative resemblance to these output variations but not a quantitative one, for accidents increased 10 to 30 times more rapidly than output during the morning spell. Nevertheless it was concluded.that varying speed of production is the factor largely responsible for the day shift variations of accidents in men,' arid not fatigue. Though the night shift output followed a similar course to the day shift output, the accident incidence, except that of eye accidents, was entirely different. It was at a maximum at the beginning of the shift, and fell gradually the whole night through to about half its initial value. This was due to the fact that the night shift workers ,; ■ started, work in a careless and excited state, and calmed down gradually during the night. At the other factojries, where 6, 9-2 and 15-in. shells were manufactured, there was very little hourly variation in the speed with which the operations on these shells were performed, and in correspondence therewith the hourly incidence of accidents incurred by the day shift was fairly steady. The night shift accidents dwindled rapidly the whole night through, because of the psychical factor. j*~, . - /., liTbe- diurnal variatiOnS'bf accidents at the fuze factory generally corresponded with the output variations, as both rose to a maximum in the middle of the week and declined at the end of it. This correspondence held for night shift as well as day shift, and the diurnal variation of eye accidents was especially marked. In th^ shell factories the night shift accidents rose rapidly in the course of the week, and in women were 47 per cent, more numerous on the last day than on the first day. This w^s a fatigue effect. The monthly varia- tions of accidents at the fuze factory corresponded with output variations, for the accidents gradually increased about 40 per cent., whilst the hourly output at the same time increased 30 per cent. Fatigue. — The influence of fatigue on accidents to women was strikingly shown at the fuze factory when the operatives were working a 12-hour day, or 75 hours a week. The women's accidents were two and a-half times more numerous than in the subsequent 10-hour day period, but the men's accidents were not afiected. The women's accidents showed a fivefold increase during the course of the morning spell, as compared with a threefold increase during the subsequent 10-hour day period, but the men's accidents did not change as between these two p?riods. The women's accidents were 45 per cent, times more frequent in the afternoon spell than in the morning spell, whilst the men's accidents were only 7 per cent, times more numerous. Also the women were treated for faintness nine times more frequently than the men, and were given sal-volatile 23 times more frequently, whereas in the subsequent 10-hour day period they were treated for faintness and given sal-volatile only three times more frequently. When the hours of work at one of the shell factories were equalised lor the men and the women, whereby the women were made to work 9f hours more than they had done previously, and the men 9^ hours less, the ratio of women's accidents to men's accidents (corrected for the alteration of hours) increased 19 per cent, for the day shift and 61 per cent, for the night shift. Psychical Influences. — At all the factories the night shift workers suffered fewer accidents than the day shift workers, the average defect being 16 per cent. This was not due to the output being smaller, as at the fuze factory it was distinctly bigger by night than by day. It was psychical in origin, and due to the night shift workers settling down to a calmer mental state than the day shift workers, and so becoming less careless and inattentive. The psychical factor is one of the most important in accident causation. Alcohol Consumption. — Indirect evidence as to the effects of alcohol consumption was obtained by assuming (a) that the increasing restrictions on the alcohol consumption of the nation in general during the war applied also to the munition workers ; (6) that such of the night shift workers as took alcohol did so shortly before coming on to work. It was found that the accidents treated during the three spells of the night shift at the fuze factory fell off much more rapidly in men than in women — as one would expect them to do if the excess of accidents in the first spell were due partly to alcohol consumption — and that between February, 1916, and December, 1917, the fall steadily became less. Again, in the 12-hour day period (November, 1915, to January, 1916) the accidents were at a maximum on Monday and fell gradually to a minimum on Friday, which was 30 per cent, less than the Monday value. Then they shot up again nearly to the maximum on Saturday. This suggests week-end drinking, as no such variations were observed during the subsequent 10-hour day period. * See Committee's Memorandum No. 21. (Cd. 9046.) 67 LioMm.— Accidents due to foreign bodies in the eye were 7 to 27 per cent, more numerous in the night shift than in the day shift, though aU the other accidents were considerably less numerous. This was ue to thed artificial lighting, as the excess of eye accidents was most marked in the worst lit factory. During day shaft the eye accidents to men were most frequent in the winter months, and most infrequent in the summer months, but this relationship was not observed in the women. Other accidents were not affected, for during day shift they were not more numerous in the hours of artificial lighting than in those of natural lighting. Temperatvre.—T:he temperature at the fuze factory was recorded continuously for six months by means of a thermograph. Accidents were at a minimum at 65° to 69° ¥., and increased rapidly at higher temperature b {e.g., by 30 per cent, at temperatures above 75°), and slowly at lower temperatures. Continuous records were obtained of the exterTial temperature of the town in which the shell factories were situated, and it was found that in aU of them the accidents increased considerably as the weather grew colder, and diminished as it grew warmer. In one factory the women's accidents were nearly two and a-half times more numerous when the temperature was at or below freezing point than when it was above 47°, whilst the men's accidents were twice as numerous. Prevention of Accidents.— Various directions in which accidents could be diminished were suggested by comparing the accident frequency of men and women at the different factories. The women suffered twice as frequently as the men from sprains, and were especially liable to wrist sprains at the fuze factory as they had not sufficient strength to push home the clamping lever of the lathes. Both men and women suffered many more sprains at the 6-in. shell factory than at the other shell factories, as they often moved the 90 lb. shells by hand, instead of with the tackle provided. The women at the shell factories suffered three times more bums than the men, chiefly from the hot metal turnings. Accidents arising from carelessness and inattention can be -diminished by preventing the workers from talking to one another in the shops. Means of Pkevention. 285. It has been estimated that from 25 to 40 per cent, of all industrial accidents are preventable if all practicable means are taken. In America it has been estimated that roughly 30 per cent, of accidents are due to illness or to imperfections in machines or in guarding dangerous parts, that 60 per cent, are due to apathy and lack of appreciation of danger on the part of operatives and only 10 per cent, to wholly unpreventable causes. "Whatever the proportions may be, there is no doubt that a large number of accidents are preventable, and the State which desires the maximum output of munitions, the employer who pays compensation, the Unions who subsidise absentees, and the operative who undergoes suffering and pain and, perhaps, permanent disablement, are alike concerned to secure a reduction in the number of accidents. 286. It is obvious that much can be done by adopting various methods of prevention such as the proper and effective guarding of machinery, the provision of safety appliances, the proper regulation of dangerous processes, the adequate lighting of the factory, and the more careful cleaning of machinery. But however complete the provision made for securing the safety of the worker, its success must largely depend upon the intelligent co-operation of workers and foremen in the maintenance and use of the appli- ances provided, and in the enforcement of precautionary regulations. As already suggested, many accidents occur throiigh ignorance or apathy, " familiarity breeds contempt." One method of securing the necessary co-operation which might with advantage be more widely adopted is by the establishment of committees of workers. The duties of such committees are to study the causes of accidents, to suggest and advise suitable means for prevention, to keep careful records, to make frequent inspection of machinery and plant, and to note any defects or dangers. The interest of the workers may be further encouraged by giving prizes for suggestions or by awards to the committee of the department where the greatest reduction of accidents has been secured. In some instances monthly pamphlets or bulletins have been published dealing with the safety and hygiene, with particulars of accidents, with notes as to their prevention and illustrations of safe and dangerous methods of working. 287. However perfect and complete may be the methods of prevention adopted, accidents will always occur, and provision must therefore be made for their suitable treatment, and particularly for the first aid treatment of minor injuries. Wherever possible training in the essentials of first aid should be given to a sufficient number of workers to provide that in each shop there are at least one- or two persons who know how to render first aid in case of injury, and much valuable work has been accomplished in spreading knowledge of first aid practice by the St. John Ambulance Association and similar organisations, with a result that in many munition works there are employees who possess the requisite training. Unfortunately at the present time long hours of work and the difficulty of obtaining teachers makes training difficult to organise. Distribution may also usefully be made of leaflets or placards of instruction and advice. Any instruction or advice should be simple and precise, and should emphasise the need for treatment in all cases as well as methods of treatment.* 288. In the majority of factories some provisionis made forthe treatment of injuries, butinspection indicates that there is great and urgent need of improvement, especially for treating minor injuries. While one factory may possess a weU-equipped surgery with a trained nurse in charge, at another provision for treatment may be wholly absent, or the surgical equipment may be represented by a soiled roll of some so-called " antiseptic " lint or gauze, an open packet of absorbent wool, a few bandages, some antiseptic lotion, or an unclean pair of scissors, all kept in a dusty drawer. It is obvious that provision of equipment for first aid is worse than useless unless it is properly kept and maintained. 289. What is required is an adequate though simple organisation which provides — (a) a local dressir g station or aid-post in each workplace for minor injuries ; and (h) a central dressing station or surgery * A leaflet (see note at end of Section) has been issued by the Home Oflfice and is obtainable on application. (B 12023) . E 2 68 for more serious cases or cases requiring continuous treatment. An Order* recently made by the Home OflB.ce under tlie Police, Factories, &c. (Miscellaneous Provisions) Act, 1916, Section 7,t requires that in the case of blast furnaces, copper mills, iron mills, foundries and metal works, a first-aid box shall be provided in the proportion of at least one to every 150 persons, and an ambulance room wherever 500 or more persons are employed. Arrangements should also be made for the immediate conveyance to hospital of cases which cannot be treated on the spot. Local Dressing Station or Aid-Post. 290. In order to be effective under industrial conditions any form of treatment for minor injuries must be extremely simple, easily understood and readily applicable. Elaborate provision for the treat- ment of minor injuries is the less necessary, because of its unsuitability under factory conditions, and because in machine shops wounds are usually comparatively free from germs. Further, the treatment must be always and promptly available. The workman who sustains a slight injury while at work will often decline to surrender a quarter of an hour of time and earnings in going to and from a central surgery to have his wound dressed. Time is a consideration, and the exigencies of factory life do not allow of an elaborate procedure. The aid-post may take the form of a cupboard or box containing first-aid materials, with brief, simple and clear instructions as to their use. The box should contain packets of sterilised dressings, a supply of iodine solution (alcoholic solution containing 2 per cent, iodine), a bottle of " eye drops," a pair of dressing scissors, some triangular bandages, safety-pins, and a roll of plaster (1 inch wide). The sterilised dressings may suitably be of three sizes : — J (a) Three dozen small size, for fingers, composed of a strip of gauze or lint 8 inches long and 1 inch wide, with narrow tape attached to one end. The tape should be rolled up inside the strip, which is then wrapped in a cover of ordinary non-absorbent wool and the whole sterilised. In use the wool is first removed and the dressing unrolled round the injured finger, when the tape is disclosed- ready for tying the dressing in position. (&) One dozen medium size, for hands or feet, similar to the above, but 18 inches long and Ij inches wide ; and (c) One dozen large size, for which the ordinary field dressing may be taken ai a pattern. The aid-post should be under the care of an ofl&cer, preferably the foreman or forewoman, trained in first-aid work. This officer should keep a note of every case dressed, and should be responsible for seeing that the box is kept stocked and in proper order. Ordinarily one such aid-post should be pro- vided in each workplace, but in large engineering shops several may be required. Central Dressing Station or Surgery.^ 291. The central dressing station|| should be easily accessible and specially constructed or adapted for the purpose. The room or rooms should, in large factories, provide for a surgery, a rest room, and a storeroom and nurse's room. Where a surgery is used for workers of both sexes a second small room will be found advantageous. The walls should be covered with glazed tiles, enamelled iron sheets, or washable paint. The floor should be of smooth, hard, durable and impervious material ; the natural and artificial lighting should be ample ; hot and cold water should be laid on or be immediately avail- able ; the room should be warmed in winter. A glazed sink is needed, the waste pipe opening over the drain, and trapped outside the surgery. A footbath, preferably fixed and provided with hot and cold water, is desirable. The furniture should consist of a table, a couch, chairs, and cupboards. The room should not contain a carpet, rugs, curtains, table-cloth, window blinds or wall pictures. The keynote should be simplicity and cleanliness. The floor should be washed once a day with antiseptic fluid, and the walls at least once a week. 292. The object of the central dressing station being the treatment of more serious cases than can be dealt with at the aid-post, and the re-dressing of cases of minor injury, it is desirable that it should be properly equipped. It may also be convenient to use it for the medical examination of applicants for work. 293. The station must be in charge of a competent person with knowledge of ambulance work. Wherever possible a trained nurse should be on regular duty, ambulance assistants being selected from employees trained in first-aid work. Many large works now have a medical oificer on the staff, who is responsible for the supervision of the surgery and available for serious cases before removal to hospital. * The terms of the Order are given in Appendix I. t The terms of the Section are given in Appendix H. t Such dressings may be obtained, amongst others, from Messrs. Cuxson, Gerrard & Co., Oldbury, Birmingham ; and Southall Bros., and Barclay, Birmingham. Dressings are also prepared by Messrs. Burroughs, WeUcome & Co., Re5Tiolds & Bransom, 13, Briggate, Leeds ; C. P. Thackray, Great G«orge Street, Leeds ; and the St. John Ambulance Association, St. John's Gate, Clerkenwell. § For information as to the conditions under which capital expenditure on an ambulance room can be regarded as an expense for the purposes of the excess profits duty, see Appendix K. II See illustration facing page 96. 69 The equipment of the surgery will largely depend upon the character of the accommodation provided and the experience of the person in charge, but the following will generally be required : — (i) Stretchers, splints and strong bandages for major accidents ; (ii) Bandages and dressings for minor injuries (a stock should be kept to replenish the aid-posts); (iii) A simple steriliser and necessary surgical instruments such as scissors, forceps and tourniquet ; and (iv) Simple lotions and drugs (with sufficient enamelled basins). Where a medical officer is employed at the factory he should be provided with accommodation adjoining the central dressing station. The accommodation should ordinarily include a consulting room (fitted with hot and cold water and a steriliser), a clerk's office and a waiting room. If arrange- ments are made for men and women to attend at different hours separate waiting rooms will not ordinarily be required. 294. The following statement is of interest, as showing the arrangements made at a large National Filling Factory for dealing with cases of sickness and injury : — " Ambulance Equipment- — At each of our two factories we have a roomy ambulance building with accom- modation for doctors' consultations, first-aid dressings, sickness cases, &c. Each ambulance building has two separate casualty dressing rooms, one for men and one for women, a ward with eight beds where sickness and accident cases can be treated at ordinary times, and where in the event of an explosion the victims can be promptly attended, a small emergency operating room with sterilisers for dressings and instruments and a roomy cupboard for surgical emergency appliances. At the other end of the ward there are two doctors consulting rooms, patients' waiting room, store room, &c. " The stafi of the ambulance consists of two doctors, one sister and four nurses in the shell filling factory (where we have 7,000 workers and a night shift as well as a day shift) and one sister with two nurses in the cartridge filling factory (where we have about 3,000 workers and a day shift only). " In connection with our ambulance station, we have an ambulance wagon, which is at our disposal day or night for removing patients to their homes or to hospital. " Arrangements are also made with the Local Ambulance Association for the expedition of ambulance wagons in the event of any serious explosion at the factory. " Two large local hospitals have arranged to receive our urgent cases when required in the event of explosion or otherwise. Liberal contributions are made by the factory workers to these institutions. " Any of our T.N.T. cases who have been iU enough to require hospital treatment have been sent to the . . . Infirmary, where I am in touch with the Superintendent and also with the House Doctors and the Pathologist, who inform me immediately of any matter of importance concerning a worker. " Convalescent Home for Workers. — The Y.W.C.A. very kindly opened a convalescent home about 6 miles from here in a bracing part of the country, and this has been kept almost entirely at our disposal and has been of inestimable value to us. The expenses of this establishment are defrayed partly by the Y.W.C.A. and partly by donations from our Workers' Hospital Fund. " Home Visitation of Workers who are Sich. — Chiefly in order to obviate the risk of girls suffering from T.N.T. poisoning lying ill at home, undiagnosed, and possibly untreated, we adopted from the begin ni ng a system of Jiome visitation. A postcard is sent to all workers in T.N.T. parts of the factory who are reported absent for two days or more. As soon as the postcard is returned asking for a visit, our health visitor calls at the house and immediately reports to me. If, as a result of this visit, it seems necessary that the doctor should call, that is done later. Girls who are in financial difficulties are assisted and infectious cases may be reported. Workers requiring'subscribers' lines for admission to hospital or to convalescent homes are notified, and so on. In connection with this home visiting department, we have a weKare secretary and a health visitor. The welfare secretary deals with aU returned postcards. She arranges the work of the health visitor and makes reports to the doctor, keeps a card index of those visited, deals with the subscribers' lines for con- valescent homes, infirmaries, &o., keeps the " Comforts Fund " money and the accounts connected therewith, and so on. The health visitor is not a trained nurse, but is sympathetic, tactful and conscientious, and is liked by the girls, who give her their confidence. " Financial Aid to Sick Workers. — A fund has been in our hands for about a year and a half. The money is spontaneously voted by the workers' committee at their monthly meetings, and it is entirely subscribed by the workers themselves. Help is given from this fund to any worker who seems to be in financial distress especially through illness or accident and who is unable to provide herself with the necessary food and comfort. It is also given at times to provide holidays for necessitious casesj The money is chiefiy distributed through the health visitor on the recommendation of the doctor. This systera has the advantage over other systems of financial aid that it is given for necessity observed by the doctors, nurses or health visitors, and does not conduce to begging." 295. The following is an account of the arrangements ^^'hich have been made at a munition works in the Midlands : — " I commenced work here in 1914 ; forabout two years I did the welfare work and nursing, but by that time the number of employees had increased so much that I had to give up the welfare work and specialise on the work I was engaged for (nursing). We'have two ambulance rooms in different parts of the works but new and larger ambulance rooms with rest rooms attached are under consideration. " We are starting classes in connection with St. John Ambulance and hope to have four St. John Ambulance people — two men and two girls — in each department, in charge of an ambulance cupboard. At present all accidents are attended to by myself in the daytime and a night nurse at night. Serious cases only are sent to hospital and minor cases attended to here. Repeated dressings are done each day at the works : this is more satisfactory as it keeps us in touch with the people and we know when to expect them back at work. We also give electrical massage to those patients recommended by the doctor. Besides this I am qualified to treat simple medical cases, and we find this prevents a great loss of time by the employees. We keep a report of all accidents. "AU children under 16 are examined by a doctor when engaged ; if they have bad teeth, a note is given them and they are sent to the dental hospital for treatment ; if anything is wrong with their eyes, to the eye hospital ; if anything is wrong with their throat, to the Ear and Throat Hospital, and so on. " The employees pay Id. per week and from this fund so subscribed they receive hospital notes and obtain free treatment at the hospitals. The major portion of this fund gees to the Lccal Hospital Saturday Fund, (B 12023) J5 3 70 and our employees can, when recommended by their doctor for a change of air, get a fortnight's free treatment at a convalesceflt';home ; there are two at Llandudno, one at Malvern and one at Droitwich (for rheumatic subjects). Through-the Hospital Saturday THind our people can be supplied with artificial appliances, such as glasses and elastic stockings. The children of our workpeople obtain thesame benefits, the convalescent home for children being The Red House, Great Barr, near Birmingham. The distribution and the clerical work in connection with these note's is done entirely by the Nursing Department. The Welfare Superintendent looks the cases up and refers them all to me." ^Systematic Records. 296. As already suggested, it is important that a full and accurate Register should, he kept of all cases of sickness and accident, with particulars of dressings, re-dressings, and treatment. 297. A case book should be drawn up somewhat as follows : — Identifi- cation number. Date. Name of injured, person. Nature of injury or illness. How caused. Progress of case with dates of subsequent dressings, and the occurrence of any sepsis. Date of final dressing. 1 25.11.15... Mary Smith ... Crushed thumb Pall of shell... 25.11.15,26.11.15,30.11.15 ... 3.12.15. Each case when first treated may appropriately receive a card, numbered to correspond with the entry in the case book, to be brought on the occasion of subsequent dressings. This card must he brought to the surgery each time the patient comes for treatment. Identification Number. Name. Nature of injury or illness. Date. Instructions. 1 Mary Smith Crushed thumb 25.11.15 To come to-morrow. 26.11.15 To come on 30th. 30.11.15 To come on 3rd Dec. Note. — Extract from First Aid Leaflet issued by the Home Office : — ■ TREATMENT OF MINOR INJURIES. The following suggestions have the approval of H.M. Medical Inspectors of Factories in rendering first-aid in factories and workshops so as to prevent subsequent septic infection or blood poisoning. A Scratch or Slight Wound. Do not touch it. , Do not bandage or wipe it with a handkerchief or rag of any kind. Do not wash it. Allow the blood to dry and so close the wound naturally ; then apply a sterilised dressing and bandage." If bleeding does not stop, apply a sterilised dressing and sterilised wool ; then bandage firmly. If the wound is soiled with road dirt or other foul matter, swab freely with wool soaked in the iodine solutionf and allow the wound to dry before applying a sterilised dressing. A Burn oe Scald. Do not touch it. Do not wash it. Do not apply oil or grease of any kind. Wrap up the injured part in a large dressing of sterilised wooLf An Acid Buen. Do not touch it, or apply oil or grease of any kind. Flood the burn with cold water. Sprinkle it (after flooding) with powdered bicarbonate of soda. Apply a sterilised burn dressing of suitable size.J However slight the burn, if the area affected is extens've a doctor must be consulted. Do not remove any dressing, but, if the injured part becomes painful and begins to throb, go to a doctor at once. Destroy all dressings, which have been opened but not used ; they soon become infected with microbes and then are not safe to use. Note. — -Danger from minor injuries arises from blood poisoning which is caused when microbes infect a wound. The majority of wounds are at first " clean," that is they are not infected with microbes ; such infection usually occurs later and comes from handkerchiefs or other materials applied to stop bleeding or to wipe away blood, and, in the case of eye injuries, from efforts to remove fixed particles with unclean instruments. It is better to leave a wound alone than to introduce microbes by improper treatment. The congealing of blood is Nature's way of closing wounds against infection, and should not be interfered with. * Minute wounds can be efficiently closed by applying collodion. t An alcoholic solution containing 2 per cent, of iodine. J This would not exclude treatment by prepared paraifin or picric acid. 71 Buro3 and scalds whpnthe skin is not broken will heal if left alone ; all that is necessary ia rest and a pro- tective covering. When blisters form they must not be pricked, except under medical advice. Rest is an important aid to healing. A short rest at first allows healing to commence and often saves a long rest later. An injured hand or finger can be rested in a sling, and an injured eye by a bandage, but an injured foot or toe can only be rested in bed. Results. 298. The Committee are satisfied of tlie urgent necessity and value of some such organisation as that suggested above. They have been much impressed in visiting munitions works with the useful part performed by competent nurses and the large number of cases of injury and sickness which receive treatment. Thus in one munition works enlploying rather over 4,000 workers the ambulance department during December, 1917, dealt with 1,260 accidents (including 635 cuts, 291 bruises, and 150 eye cases), 1,703 redressings, and 1,428 medical cases (including 415 indigestion, &c., 486 headaches, and 351 colds), a total of 4,391. For January, 1918, the figures were 1,186 accidents (including 670 cuts, 218 bruises, and 202 eye cases), 1,956 redressings, and 296 medical cases (including 118 indigestion, etc., 71 headaches, and 70 colds), a total of 3,438. Section XII. EYE INJURIES. The Effect of Industrial Conditions upon Eyesight. 299. The rapid extension of munition work has brought in its train a great increase in the number of accidents and injuries to eyes. The result has been not only personal suffering and inconvenience but also serious loss of time and a reduction of output. The eyes are among the hardest worked of all the organs of the body and they are extremely sensitive to external conditions. It is therefore not sur- prising that a number of special eye diseases and injuries from accidents to the eyes have come to be associated with particular processes in certain industries. Diseased conditions of the eye and defective eyesight are very common, and are a serious and widespread cause of inefhciency. Every effort, therefore, should be made to prevent them. The following statement emphasises the point : — " The treatment of superficial injuries of the eyes is a subject which has, during the past year, acquired increased importance, on account of the large number of superficial injuries occurring daily to the eyes of workers in munition factories. The out-patient book kept at the Ophthalmic Department of the Glasgow Royal Infirmary shows that the number of those suffering from ' fires ' and other trivial eye injuries who ■applied for relief during August, 1916, was more than double the number of those who had come sufEering from similar injuries during the corresponding month in previous years. The figures in 1914: and 1915 are practically identical, and a scrutiny of patients during 1916 shows that the great increase has been brought about almost entirely by the attendance of men and women engaged in the manufacture of munitions. In such cases it is a matter of national importance that patients should receive skilful medical help as soon as possible after the occurrence of the accident, in order that there may be no unnecessary delay in their return to work." 300. The following statements are also of interest : — " I think that it is somewhat of an exaggeration to say that each of these cases loses three days' work. If we take an average I should put it as more than half a day and less than a whole day. I think that I can safely say that these small accidents cause the loss of about 2,000 days' work in the town of Coventry alone. The more serious ones are responsible for the loss of weeks for each man, and I have in the past year had to remove about a dozen eyes after industrial accidents. Practically all of them could be avoided by the use of goggles. Most of the trivial accidents would be prevented if the men would wear goggles at the emery wheel and for grinding." " At the Northumberland, Durham and Newcastle Bye Infirmary there has been an increase in the number of patients in 1914 and 1915, and this is largely due to the number of people engaged on munition work. For example, in 1914, 2,491 eye cases were referred for treatment from the Elswick Works ; in 1915 there were 4,973 similar cases ; and in 1917, 4,567 in spite of the present attention at the spot by ambulance workers." 301. Industrial work may cause impairment of eyesight in three principal ways :— (a) Injuries due to exposure to intense heat or industrial poisons. (&) Accidents due to flying particles, &c. (c) Eyestrain due to uncorrected errors of refraction or other causes. 302. Apart from the immediately irritative effect associated with such work as acetylene welding, the influence of prolonged exposure to intense heat and light may take so long a period to manifest itself that the damage which may result is not likely to appear during the war. The effect also upon eyesight of certain industrial poisons, such as lead, is in the bulk small and no special action in regard to this matter is called for. , ^^, _. 303. Accidents. — It has been estimated that normally in any general group of industrial accidents over 5 per cent, must be ascribed to eye injuries. There is reason for belief that eye injuries in munition works are relatively more frequent thanin normal times and that for engineering factories these cases probably represent about 7 per cent, of all accidents, a total which may, however, be greatly exceeded. The accidents are mainly due to particles of metal which enter the eye, the majority are slight in character (B 12023) E 4 72 and should give rise to no permanent damage. To the damage which results from injuries sufficiently- serious to come imder observation must be added the graver conditions arising from infection following upon " fires " or other trivial eye injuries. Account must also be taken of the time lost and temporary- inconvenience suffered from a much larger number of slight causes which may only incapacitate the sufferer for short periods, perhaps half a day. In so far as immediate reduction of output is concerned, these slight cases have probably a greater effect than the more serious injuries. Speaking of these cases, an ophthalmic surgeon in Glasgow writesf :— " In most instances the actual physical damage is slight, and the -Hforker -mil be able to resume his duties in a iew hours, or utmost in one or t-wo days, if only the injury to the eye be promptly and skilfully treated. If, on the other hand, the injury be neglected or if it be treated by anyone who is unskiHul or careless sepsis ■will almost certainly occur ; and all experience teaches that infection of the wound is a far greater danger than the actual physical damage to the ocular structures. The occurrence of sepsis at once transforms a very trivial injury to the cornea into a suppurative keratitis, which may run a prolonged course, lead to more or less impairment of sight, and in serious cases even destroy the eye." 304. Eye Strain. — Broadly speaking, eye strain may be due to defects of vision or to the nature and conditions of work. It may be accentuated by age, fatigue or unsatisfactory health of the worker, by near-distance work, insufficient or excessive illumination, abnormal position, or long hours. For munition work the eyesight of the worker should never fall much below that of normally useful vision. For fine work the eyesight should be approximately normal. Notwithstanding the important bearing of good eyesight upon output, the question has not hitherto received adequate attention. Evidence has been forthcoming of eyestrain and headaches resulting from (a) inadequate light, both artificial and natural ; (b) artificial lights, adequate in amount, but so placed as to throw a glare upon the eyes of the workers ; (c) employment of workers (whose eyesight should be aided by suitable glasses) to carry out fine work without first testing their eyesight. Eye strain, including headache, may be one manifestation of general fatigue. It is thus likely to become more marked when long hours are worked, when night shifts are necessary, or when workers are under-nourished, anaemic, or of poor general physique. 305. Several of these points are exemplified by the report on a medical investigation in regard to the health of woman workers, in the course of which an inquiry was made into the eyesight of 156 workers engaged in different departments of a factory. Most of the eye defects were found in the Fuse Department where fine processes were in operation, involving close attention and considerable likelihood of eye strain. In the work of machining shells only about 19 per cent, of eye defects were noted, but in the fuse depart- ment the proportion reached 64 per cent. The results of the Inquiry were thus summarised :— " It wiU be noted that in the Fuse Department 8 per cent, of the workers were obliged to obtain glasses since starting factory work, 19 per cent, complained of eye strain, of whom 12 per cent, found sight difficult on the night shift, and 2 per cent, found the eye strain increasing in severity. Besides these, 10 per cent, appeared to have latent eye strain as shown by severe headache, blepharitis, &c., and probably required to have their eyes tested. Conjunctivitis was present in 11 per cent. Many workers complained of the artificial light falling directly on their eyes, and others said that the reflection of the brass work of the fuzes was dazzling. The artificial lighting in the factory was by electric lights placed over the benches. Owing to difficulty in train service it was not possible to visit the factory during the night shift in order to watch the effect on the girls, or to observe if shade could be adjusted without undue interference with the work, but this point appeared to need consideration. " On the other hand, it must be remembered that cases of eye strain or frequent headaches may not be due entirely to factory conditions. Several girls had been warned at school by the school medical officer that their sight was defective, and had neglected to obtain glasses. Five workers had obtained glasses, but did not wear them ; in one instance the previous occupation of dressmaking was probably respon- sible for the initial eye strain, and in another case a girl who had pre-viously been a domestic servant now visited the cinema three times a week, although suffering from marked eye strain. It is also probable that some of the employees were still feeling the effects of overtime and seven days' weekly work, which had recently been discontinued, and some visual improvement might be expected on subsequent examinations." Prevention and Treatment. 306. Many conditions likely to cause temporary or permanent damage to the eyesight of munition workers are admittedly preventable, while prompt and efE9ctive treatment of the injury when it has occurred will reduce suffering, hasten recovery and lessen the chance of permanent injury. 307. Methods of Prevention consist first of general measures designed to improve the physical health of the workers, and so to enable them to resist the effects of fatigue, and secondly of special measures designed to avoid undue strain on the eyesight or to reduce the liability to accident to a minimum. The general measures include the provision of suitable lighting, the establishment of canteens, the allowance of adequate time for sleep and rest and have already been dealt with elsewhere. The special measures naturally vary according to circumstances. The following suggestions may, however, be made : — 308. Examination of EyesigJd.— When op ^ratives are being engaged for fine work their eyesight should be tested by a medical officer, or, if he is not available, a nurse or welfare supervisor should apply simple eye tests* to discover whether the vision is normal. Any worker who fails to reach the standard adopted should be referred to an ophthalmic surgeon or eye hospital for regular examination and if necessary be supplied with glasses. When workers are examined for glasses the nature of the work to be performed should be specified whenever possible. For many people, and particularly those past middle-life, the * Each eye should be tested separately, and the following standard is suggested as a minimum : — 6/9 n both eyes (Snellen's types), though -^^ in one of the eyes may be sufficient in some cases ; and the ability to read standard type 0.45 at 1 foot distance. The necessary standard types can be procured from any optician. tt " The Treatment of Supevfioial Injuries of the Eyes."— Paper by A. Maitland Ramsay, M.D., Lecturer on the Eye, University of Glasgow. 73 glasses which give the best acuteness of distant vision would not enable the owner also to do fine work at close range and vice versa. Workers who complain of frequent headache, pain in the eyes, or show signs of conjunctivitis should also be tested. 309. Eye-guards and Goggles. — Under certain conditions^the eyes should always be guarded from flying particles of metal. On this point the observations of an official American publication * may be quoted : — " The one feature of safety in nearly all of these occupations is the use of suitable goggles in those occupa- tions known to cause injuries to the eyes. No other protection can take the place of this one. It is one of the most difficult measures in accident prevention to carry out. Workmen object to the use of these protectors, and even when provided they are not worn. The fault for this lies often in the type or kind of goggles that have been provided. Many of these not only decrease the efficiency of the worker who wears them, but they cause injury to the eyes of the wearer. Many conscientious workers refuse to wear goggles that are provided for the common use of all workers in the establishment. In this they are justified, as many infections of the eye are capable of transmission by means of eye protectors. The remedy is a better mutual understanding between employer and employee, and an insistent educational campaign on the value of this protection. Frequently the nature of the work is such that the lenses become clouded with steam or perspiration, j^nti- sweat pencils should be provided to prevent this. The goggles worn should of such a thickness of glass that they will withstand a hard blow and of such a quality and so securely fitted into the frame that if broken the glass will not fly into small pieces but will remain in the frame. Goggles should be fitted to the wearer." To be effective, an eye-guard should : — (a) prevent particles reaching the eye from in front, from either side or from belcw. Prrclically nothing enters from above ; (h) be light and comfortable, allowing free play of air ; (c) not impsde vision or become obscured by the impact of particles ; [d) be strong and cheap. 310. Two forms of eye-guard are here illustrated which have been designed to meet the require ments stated abovef. That shown in Figure If has the advantage that spectacles required to correct any error of refraction can be worn behind it. The eye-guard shown in Figure 2§ is composed of a strip of leather with detachable eyepieces {see Figure 3) pierced with holes for ventilation. FiGtnsE 1. Figure 2. BostoJm?™'"""'^^*^''' °* Massachusetts, St^te Board of Labour and Industries, Industrial Bulletin Number 5. t Some oouUsts recommend Crook's glass No. 1 or No. 2, with fine gauze side pieces. % From a design prepared by the Mentor Safety Appliance Company. § I'rom a design prepared by Messrs. WaUach Bros. 74 311. The fact that no particles are likely to enterfrom above is important, because the upper part of the goggle can be left open to allow of ventilation. A closed screen is not only hot and uncomfortable, but the transparent mediimi, usually glass, may become obscured by condensation of moisture. Where fine work has to be executed there must be clear vision and for this there is no better medium than glass. The objection has been raised that glass broken by a flying particle may be driven into the eye and cause a worse injury than if it were not present. Such accidents appear, however, to be very exceptional and a foreign body of considerable size would be required to inflict it. Glass, such as is used for shooting goggles, of sufficient strength to stand the impact of pellets of shot should be employed. The main objection to glass, or indeed to any other transparent medium, is that after a time it becomes pitted and obscured. Eyeguards should therefore be so made that the glass can be easily removed and cleaned or replaced. Where there is exposure to bright light, as in the process of acetylene welding, the glass should be tinted or specially prepared to obscure the chemically active rays at or beyond the violet end of the spectrum. Dark blue glass is usually employed for the purpose, though as the following statement suggests, it is not that best suited for the purpose. " My own experience has been that workmen at acetylene welding have generally been provided with very dark neutral smoked protection glasses, and not with dark blue glasses. These would certainly be better than dark blue glasses, and of all the tints which could be employed, probably a very deep rose tint would be the best that could be selected — dark blue would, in my opinion, certainly be unsatisfactory. As regards the use of Crooks' glass in protection goggles, this glas is very expensive, and is certainly unnecessary for ordinary mechanical protection purposes. The virtue of it is the same as that of rose-tinted glass, for it has the power of excluding the actinic rays. I should think it could hardly be necessa,ry to employ this glass, of which I believe only a limited quantity is available, for workers' goggles." 312. While goggles must be regarded as the principal and most effective protection against eye accidents, it is possible in some grinding and chipping processes to fix a wire or glass screen to the machine in such a manner as to protect the workers' eyes. Such an arrangement may, for example, be useful in emery wheel grinding where the machine is used by many different workers irregularly through the day. 313. Treatment of Accidents. — First aid treatment is all that can be rendered effectively in the factory. Every precaution should be taken to avoid increasing the injury by well meant but mis-directed efforts to give relief. Where a surgery exists all eye injuries should be sent direct to it, no treatment being attempted in the workshop. If a doctor is available the case should be referred to him at once. If the injury is not serious and he is not available the nurse in charge of the surgery should render first aid, the patient being then sent to a doctor or hospital, even though the injury is apparently slight. At any factory where such injuries are common the nurse should have had some ophthalmic training. The following statement emphasises the importance of suitable provision for first aid. " In every factory where such accidents are of frequent occurrence there ought to be a rule that injuries should be reported at once, and provision should be made whereby ' first-aid ' may be given with the least possible delay. Such an arrangement would not be difficult to carry out, and timely first-aid would effect a cure in the mildest cases and prevent as far as possible extension or increase in severity of the injury in those that were more serious." 314. If there is no ambulance provision or a nurse, first aid can only be given by a fellow workman who shoidd be instructed as to the routine treatment which may suitably be applied. He should be forbidden to exceed his instructions, otherwise, though he may be successful in removing the offending particle, infected ulcers may follow the operation or he may even perforate the cornea. First aid is mainly needed to relieve pain and should usually be limited either to the use of eye drops which may be applied from a suitable bottle, or to a pad and bandage.* A camel-hair brush kept in the appropriate solution may be provided for the removal of visible particles which are not impacted or embedded, but its use should not be encouraged. After relief from pain the patient should be sent at once to a doctor or hospital. * Eye Injuries. (Home Office Pirst-Aid Leaflet) :■ — Apply the eye dropsf to the affected eyeball by means of the camel-hair brush in the bottle. Do not try to remove any particle which cannot be brushed away. Tie up with a clean handkerchief or bandage. Go to a doctor at once. Prevention is better than cure ; therefore, if your work entails danger to the eyes, Wear Goggles. Goggles have saved hundreds of eyes ; thousands have been lost for want of them. t Instructions to chemist for making eye drops : — Cocaine ... ... ... ... ... ... ... ... ... ... 0.5 per cent., Hyd. Perohlor 1 in 3,000, in castor oil. Weigh 95 grammes of castor oil into a flask capable of holding twice the quantity- Add 0.5 gramme of powdered cocaine. Warm n a water bath till dissolved. While the solution is still warm (but not hot) add 1 cubic centimetre of a solution containing 3.3 grammes of mercuric chloride in 100 cubic centimetres of absolute alcohol. Mix the solution.^ by rotating the fiask. About half an ounce, or 15 c.c, of this solution should be supplied in a bottle from the cork of which a camel-hair brush is pendent in the fluid. 75 Section XIII. SPECIAL INDUSTRIAL DISEASES. 315. The manuf actureand manipulation of toxic chemical substances upon the immense scale required in warfare have brought many special dangers to the health and lives of munition workers. To some of these the Committee made reference in their Memorandum No. 8 (Special Industrial Diseases) issued in April, 1916, in which they gave a brief account of the information which was then available and likely to be useful. Legislative Provisions. 316. The Factory and "Workshop Act, 1901, contains numerous provisions for safeguarding the health of workers employed in certain " dangerous and unhealthy industries." Section 73 requires the notification to the Chief Inspector of Factories of cases of poisoning from lead, phosphorus, arsenic, naeicury and anthrax by the medical practitioner attending the case. By an Order of January, 1916, toxic jaun- dice was added, that is to say jaundice due to tetrachlorethane, T.N.T., or other nitro or amido derivatives of benzine, or other poisonous substance. The employer must also notify these cases to the Inspector of Factories. Section 79 gives the Secretary of State power to certify that a process is dangerous, and to make such regulations as appear to him reasonably practicable and to prescribe the conditions under which employment in the process shall be carried on. These regulations impose duties on both the employer and the worker. Such regulations have been made for various lead processes, and also in connection with the manufacture of T.N.T. Section 82 requires that the regulations shall be posted up in conspicuous places where they may be conveniently read by the persons employed. Acting under powers conferred by Regulation 35 A.A. of the Defence of the Realm Regulations, the Ministry of Munitions, with the concurrence of the Secretary of State, has made regulations dealing with the use and manipulation of T.N.T. Under Section 8 of the Workmen's Compensation Act, 1906, the Secretary of State has power to make Orders extending the provision of the Act to diseases contracted in the course of employment. Several Orders* have been made extending the provision of the Act, under certain conditions, e.g., to toxic jaundice, dermatitis, and other diseases arising from the manipulation of T.N.T. and other industrial poisons. Trinitrotoluene (T.N.T.). 317. At the very beginning of their work the Committee had their attention called to cases of sickness apparently due to the explosive trinitrotoluene (" T.N.T."), of which the manufacture and use was then rapidly increasing. This substance had hardly been regarded as toxic before the war ; no ill-effects had been traced to the small quantities previously used, and it was generally believed to be much less toxic than dinitrobenzene, which had been manufactured and used in this country for many years. A fatal case of toxic jaundice, however, definitely ascribed to T.N.T. poisoning, was reported to the Home Office in February, 1915, and this appears to have been the first recorded fatality from this cause. At the time of the appointment of the Committee in September, 1915, the first fatality from toxic jaundice due to the manipulation of T.N.T. had just occurred at a Pilling Factory, and during the succeeding winter months sickness due to T.N.T. poisoning became generally recognised as a growing menace plainly concomitant with the introduction of new labour in rapidly expanding processes of manufacture and manipulation which had necessarily been hastily organised. 318. The urgent calls for an increase both in the volume and rate at which T.N.T. could be supplied made the position one of grave anxiety, and had it not been for the preventive measures, based on previous knowledge and experience of the nearest analogies, which were then promptly advocated by the Home Office, the mortality from this poisoning, which advanced during 1915-16 until the autmn of 1916, when it reached its greatest height, must have been far higher. In July, 1915, the Home Office had warned the factories then concerned that T.N.T. might be absorbed through the skin, or by the inhalation of dust and fumes, and had recommended accordingly that suitable precautions should be taken against both avenues of entry. 319. During these months the Committee gave their cordial co-operation towards bringing to bear upon the problems confronting the Ministry the advice which the skill and experience of the Factory Department of the Home Office could suggest, as well as the knowledge gained by scientific investigations organised for this purpose. From the autumn of 1915 the resources of the Applied Physiology Department of the Medical Research Committee under the direction, for this purpose, of Dr. Benjamin Moore, F.R.S., had been applied to the determination of the mode, or modes, of entry of the poison to the body with a view to its efiective prevention ; and other collateral enquiries were set on foot. The symptoms of T.N.T. poisoning already reported seemed closely similar, in respect at least of the fatal cases in which jaundice was characteristic, to those which had occurred earlier in 1915 as due to exposure to the fumes of tetrachlorethane, used as a constituent of varnish applied to aeroplanes — a cause of industrial poisoning to which further reference will be made below. This coincidence in time of the two forms of poisoning made it natural to look then upon the inhalation of the fumes or the dust of T.N.T. as probably the chief cause of this new and unexpected danger at the Filling Factories, in spite of the fact that the path of * Statutory Rules and Orders, 1913, No. 814 ; 1914, No. 1007 ; 1915, No. 660 ; 1916, No. 286. 76 entry to the body in the most familiar examples of poisoning from the industrial use of nitro-compounds was well known to be by way of the skin. Administrative measures at the factories were chiefly addressed during the spring and early summer of 1916, as new factories sprang into existence, to the perfection of ventilation and the removal of dust and fumes from the air. Although it was well known that dinitro- benzene and other nitro-compounds could rapidly enter the body through the skin, the apparent immunity with which the great majority of persons could freely handle T.N.T. without signs of poisoning had done much to divert general attention from the explicit warning given by the Home Office in 1915 that absorp- tion of T.N.T. by the skin was to be guarded against. 320. With the advent of warm weather in the summer of 1916, coincident with the preparations for the Somme ofiensive, a large increase in the amount of T.N.T. sickness occurred ; and a conference upon this was held on 25 August, 1916, at the Ministry, when representatives of the Health of Munition Workers Committee met those of the Factory Department of the Home Office and of the factory managements. The experience of one very large factory in which up to that time no death had occurred was brought f orw'ard to show that, if proper ventilation was secured, the risk of poisoning was small in spite of an almost universal distribution of T.N.T. powder over the factory floors and furniture, as well as upon the skin and clothes of the workers. In the following month, however, several cases of fatal toxic jaundice were notified from this factor,y while at the same time experiments conducted by Dr. Moore and his colleagues both in the laboratory and in factories showed conclusively not only that the poison could enter the system freely by way of the skin, but that poison having so entered could be held within or under the skin itself and so remain for continued absorption even after, and sometimes for many days after, the worker had been altogether removed from the neighbourhood of T.N.T. The experimental evidence gave no ground for attributing any important share in the poisoning to the inhalation of dust or fumes ; the value of ventilation from this point of view appeared to consist in aiding the maintenance of the chemical balance of the blood and in removing dust which might otherwise settle upon, the skin or food, or enter the noses and mouths, of workers, and for these purposes ventilation was nugatory in the face of manual processes involving the scattering of T.N.T. dust upon every exposed surface of the workshop and of the workers. It became apparent that a campaign had to be fought in detail for the reduction of danger by the trial and adoption of every expedient for minimising physical contact between the workers and the manipulated T.N.T. For the introduction of the necessary measures when devised, and further for their general enforcement, new legal powers were required. 321. With a view to an immediate concentration of efiort upon these problems, Mr. Montagu in October, 1916, appointed a Committee to consider and advise him as to (1) the prevention of poisoning in Filling Factories, and (2) the treatment of cases of such poisoning, and to make such enquiries and experiments as they might deem desirable for these purposes. This T.N.T. Advisory Committee con- tained representatives of the Factory Department of the Home Office, members of the Health of Munition Workers Committee, the Medical Officer for the Filling Department, together with engineering and administrative representatives of the various departments concerned within the Ministry. This Com- mittee, sitting daily at first, worked actively towards the framing of defensive regulations against T.N.T. poisoning. They made recommendations upon the organisation and functions of the medical officers of the Filling Factories, upon the probable scope of the legal powers likely to be required by the executive, and they considered and advised upon the best modes of translating into practical preventive methods the knowledge then being gained of the possible modes of T.N.T. poisoning and of their pathological results. In December, 1916, Dr. Addison, having succeeded Mr. Montagu as Minister, reappointed the Advisory Committee, who submitted to him in January, 1917, a detailed code of regulations governing the use of trinitrotoluene in all factories and workshops in which it, or any mixture containing it, is used or manipulated. The necessary powers having been obtained, these rules were formally given legal effect in February, 1917, though during several preceding months they had been widely introduced into practice, owing to the dissemination of knowledge of the dangers of T.N.T. by the Ministry's medical officers and the scientific workers engaged, and no less to the goodwill of the factory managements. These regulations, still in force, are given below in summary form. H^ 322. Before outlining the pathology of T.N.T. poisoning as such, reference may be made to the remarkable practical results which have coincided with the progressive application of the findings cf scientific investigation to practical measures for the preservation of the T.N.T. workers. The Returns of the Home Office of cases of toxic jaundice from T.N.T. for the quarter October- December, 1916, show 86 cases, including 23 deaths, as compared with 29 cascs(four fatal) in the corresponding quarter of 1917, though the number of the workers exposed in the latter year to risk was far greater than in 1916. Accompanying the cases of jaundice there has also been an unmeasurable volume of minor illness, which has shown a parallel reduction in all faci ories ; in one of the largest factories for instance, in which the sickness returns have been generally the highest, sickness attributed to T.N.T. has declined from being 11 per cent, of the operatives in August, 1916, to 1 per cent, in January, 1918. The latest returns show that T.N.T. sickness has been almost abolished, while no fatal case has been reported since February, 1918, and there is now good ground for believing that when all factories have reached the standards attained by the best of them from this point of view, and now within the reach of all, T.N.T. poisoning may become so rare as to be almost unknown. The results so obtained must be regarded as a striking testimony to the value of close co-operation between research work on the one hand, carried out not only in the laboratory but also in the field of itspractical application, and administrative action en the other. They show, further, the benefits of a co-operation between factory doctor and factory manager established now to a degree almost unknown before. 77 323. While tte experimental analysis of the paths by which T.N.T. may enter the body, the new testa which have been devised for tracing its elimination in changed form, and other gams m knowledge have gone to secure the present successful measures of prevention, much still remains to be discovered with regard to the detailed nature of the complex toxic effects of T.N.T. or of its derivatives, when it has once gained access to the system. When Mr. Winston Churchill succeeded Dr. Addison as Mimster ot Munitions in the summer of 1917, the practical problems of T.N.T. poisomng had been so far solved, and the maintenance of the preventive measures so organised in the Health and Welfare Section of the Ministry, that he found it unnecessary to reappoint the former large T.N.T. Advisory Committee, whose work had been in the main completed, and instead he formed a small Committee of medical experts for the purpose of maintaining and co-ordinating further enquiries into this subject and of advising him with a view to administrative action that might seeem desirable in the light of f lesh knov/ledge. Further researches are being actively prosecuted into the toxicology of T.N.T. and in this direction a defimte advance in the curative treatment is still be to hoped for. But while these studies have great theoretic interest and are likely to have importance in the study of toxic jaundice known to be produced in special conditions, or in persons specially susceptible, by other poisons and certain drugs, the present success of preventive measures against T.N.T. poisoning allows the hope that these investigations may have only an academic interest for the Ministry of Munitions as such. 324. The Pathology of T.N.T. Poisoning.— It would be out of place here to give detailed descriptions of the pathological results that may be produced by the absorption of T.N.T. For these, reference may be made conveniently to the following : — " Trinitrotoluene Poisoning." (An accoufit communicated on behalf of the T.N.T. Advisory Committee. References to earlier work may be found here.) British Medical Journal, December 16, 1916. Report of Discussion at the Royal Society of Medicine. Proceedings Royal Soc. Med., January, 1917. " The Causation and Prevention of Trinitrotoluene (T.N.T.) Poisoning," by Dr. Benjamin Moore, F.R.S Medical Research Committee, Special Report Series, No. 11, 1917. " The Effect of Trinitrotoluene upon the Blood," by Dr. P. N. Panton. The Lancet, July 21, 1917. " Preventive Measures against T.N.T. Poisoning," by Dr. W. D. O'Donovan. Proceedings Roy. Soc. Med., April, 1918. 325. T.N.T. when manufactured and used in a pure condition or compounded with ammonium nitrate (amatol or ammonal) is by far the most important of the dangerous substances used in the production of high explosives. Danger arises not only from its explosive power but from its liability to affect the health of the workers exposed to it. Operatives engaged in its manufacture, packing or loading, may become affected. Apart from this, unless the incidence of poisoning is rigidly controlled other workers may become disorganised through fear of contact, and fresh labour may become difficult to obtain. 326. T.N.T. may be absorbed through the skin or through the digestive tracts, or by inhalation of fumes or dust. Poisomng may take one or more of the following forms : — (a) T.N.T. stains the skin yellow. Skin disease {Dermatitis) is due to a direct irritant action. Some workers are more susceptible than others. The effects, like those of other irritants, are increased by flushing, perspiration, and mechanical friction. Localised rashes, especially where there is pressure or friction as from bands or ill-fitting clothes, are common. The parts most frequently affected are the hands, wrists, face, neck, and feet. There is ground for the view that dermatitis is distinct in its incidence from other forms of its poisoning. (b) Digestive troubles. — Gastritis, shown by pain in the stomach, vomiting, and constipation, is the most common of the ill effects of poisoning. (c) Blood Cha'igei-. — Blueness of the lips and, rarely, breathlessness on slight exertion are evident signs cf absorption of T.N.T. These signs are an indication for cessation from T.N.T. work, during which they will generally disappear rapidly. They must be taken as a warning that the absorption of T.N.T. is going on, and if this cannot be explained by faulty factory conditions or by careless and unnecessary handhng- — when proper precautions ought to prevent recurrence- — they point to a special susceptibility, and the worker should be transferred to other employment. Pallor does not necessarily signify anaenua, which is uncommon among T.N.T. workers. A rare and fatal form of anaemia (aplastic anaemia) has occurred in a very few instances and is characterised by a slowly, increasing debility or by sudden un- explainable subcutaneous or uterine haemorrhages. (d) Liver degeneration, " toxic jaundice." — Jaundice is here a sign of gravely serious illness, and will be shown by a yellow tinge first of the whites of the eyes and later by yello-wness of the skin. (This must not be confused with the yellow staining which T.N.T. itself may cause in the skin by direct contact.) Jaundice may appear without obvious warning, though rarely before the fourth week of employment, and it is possible that in half the cases it arises after a preliminary warning, which has been given by the bleed changes just mentioned but which may have been overlooked. Every effort should be made to recognise the first beginnings of this illness, and to take them as an indication for immediate cessation f i om all T.N.T. work and for proper medical treatment. Many cases are now known of apparently complete recovery after serious illness of this Idnd. 78 327. To detect a case of T.N.T. "poisoning care must be taken to avoid confusion with digestive disturbances due to other causes. Accounts given by patients may be unintentionally misleading. The yellow staining which usually, occurs with T.N.T. cannot be taken as in itself a sign of poisoning. The following points are the more important indications of T.N.T. poisoning : — (a) Pallor of the face and an ashen grey colour of the lips, tending to disappear if the worker becomes excited, as by medical examination. Sometimes the lips and tongue are purple in colour ; the tongue is generally free from fur. (6) The character and situation of the stomach pains. (c) The presence of constipation and stomach distention. Treatment when jaundice is absent should be simple and successful. It should include (i) the immediate removal from contact and all the fresh air possible, (ii) rest in bed for a day or two, (iii) a diet consisting of milk, milk puddings, fruit and green vegetables, with drinks such as barley water, tea and coffee. If jaundice is present, hospital in-patient treatment is necessary. Milk should be given in small quantities to begin with, the amount being slowly increased to two pints a day. The occurrence of T.N.T. poisoning depends sometimes upon personal idiosyncrasy. Women do not appear to be more readily affected than men. Boys and girls may be more susceptible than adults, and, in consequence, their employment has been forbidden under the age of 16, and is only allowed under the age of 18 with the special consent of the Ministry. Serious poisoning seldom occurs within the first four weeks of employment. While the great majority of workers are insusceptible and remain so, a small minority are susceptible and liable to succumb between the fifth and fifteenth week of exposure. The few affected are not always those who owing to ill-health or malnutrition might be expected to be especially liable. Industrial conditions, though important, have perhaps less influence than personal idiosyncrasy. 328. It is essential that strict measures should be taken for prevention. The precautions prescribed by the Regulations of the Ministry for the use and manipulation of T.N.T. are as follows : — (o) Exposure to dust and fumes should be reduced to a minimum by cleanly methods of work and by ventilation and cleaning of workplaces. (6) No person may be employed for more than a fortnight without an equal period of work at a process not involving contact with T.N.T., unless such employment has been specially approved by the medical officer of the factory. (c) It is of the utmost importance that all workers should obtain ample and suitable food. Every person employed should be supplied gratis daily with half-a-pint of milk, or some equally nutritious substitute. {d) Special working costumes should be provided for all persons employed. These should be cleansed or renewed at least once a week. (e) Cloak-rooms should be available where clothing put off during the working hours should be placed . (/) Washing facilities are essential, with a suitable supply of soap, nail brushes and towels. (g) A constant medical supervision should be exercised not only by formal medical examination but also by scrutiny of the workers while at work. The medical officer should have power of immediate suspension where necessary. Careful health records should be kept. (h) A special official should be appointed to secure the carrying out of the prescribed regulatiors. A woman welfare supervisor is also essential wherever women are employed. 329. Similar preventive measures are required by the Home Office and the Ministry for the manufacture of T.N.T. The following statement describes the medical arrangements made in a large National Filling Factory : — " In the early days we were confronted by the spectre of T.N.T. poisoning in a wide variety of processes — shell filling with amatol and T.N.T. blocks, liquid filling, ' hot mixed ' filling press houses, incorporating houses, trotyl bag fiEing, &c. — and no one could tell us how it might be exorcised. " Cleanliness. — Our first preventive measure was cleanliness. The method was to watch the shops from day to day, instruct workers and overseers in the meaning of ' physiological cleanliness,' and devise means of perventing T.N.T. from entering the bodies of the workers by any of the possible channels of abeorption. After some initial difficulty with the management (who were naturally chary of moisture) we were allowed to introduce our system of damp dusting of benches and damp mopping of floors. A slightly moistened cloth was used for dusting the table and the girls were instructed that the powder on tables and floors must be ' kept damp and kept down,' in order to prevent it getting into the air and being thus swallowed and inhaled. The method of dusting was to ' coax ' the powder off the table with the slightly moistened cloth inttcad of flicking it about and contaminating the atmosphere. The floors were twept with damp sawdust. " This method was easily adopted in the Trotyl bag-filling shops and was most successful. In other parts of the factory, such as the melts, press houses, rectifying rooms, &c.,it was a much more difficult matter to obtain perfect physiological cleanliness and it was only after many months of hard uphill work that any approach to this was reached. " Every foreman, forewoman and worker had to be convinced of the necessity of this cleanliness, and we had a long educative campaign. Then we had to introduce a new T.N.T. cleansing department with reliable overlookers whose duty it was to keep all T.N.T. shops free from powder. The stafE of this cleansing depart- ment has been large and the expense to the factory has been considerable, but the results have afforded ample repayment." 79 " Lectures to Overloohers.-A necessary part of the doctor's duty in a T.N.T. factory is the education of overlookers, foremen, &c., in the rationale of the prophylactic measures to be employed. In this factory it has been our practice, as each new group of overlookers wa.s engaged, to devote one lecture of the course of preliminary instruction to the question of T.N.T. poisoning and its prophylaxis. The overlookers are thus from the outset co-operators with the doctor in all efforts to prevent T.N.T. sickncf s. " Mouth-wash and Gargk.— As an additional precaution each worker is made to wath out her mouth and throat at lunch hour, and after each shift with a fluid provided (popularly called ' the gargle ^ Special ' gargling lavatories,' with numerous basins, are built for this purpose in connection with each T.N.l. shop. These basins are also supplied with hot and cold water and the workers are encouraged to wash their hands thoroughly with hot water and soap before proceeding to the shifting houfe. N.B.— Cold water has no advantages and many disadvantages. " Ventilation and other such obvious health measures are also kept under medical supervision. " Questions of Suitable Clothing, boots, gloves, &c., are discussed jointly between the doctor and the lady superintendent. " Questions of Food and Canteen arrangements are discussed with the lady superintendent and the canteen superintendent. "The doctor advises regarding suitable menus, adequate food substitutes, &o. On the advice of the doctor a free breakfast consisting of porridge and milk, sausage or egg, bread and butter and tea is given to all workers while employed on T.N.T. This takes the place of the milk originally recommended by the Health of Munitions Workers' Committee. " In our early days it was difficult to persuade the women workers to eat substantial meals, and the doctor was asked to publish a leaflet making an appeal for more adequate feeding on the grounds of health and patriotism. ' Post hoc ' (but due also to many other causes) we now find that the great majority of our workers take a substantial mid-day dinner in the canteens. " Choosing of Suitable Workers fw T.N.T. Processes. — No worker is engaged for any occupation involving exposure to T.N.T. without being passed by the doctor as suitable. "During the first few months we engaged girls at the rate of 500 to 600 per week. As, according to present knowledge, the chief dangers of T.N.T. are to the liver and the bone marrow, the attention of the doctor is directed chiefly to the detection of anaemia and ' biliousness ' or any liver trouble. No girl vidth any trace of cyanosis of lips or yellowness of sclerotics is admitted as, although possibly healthy, such a girl would lead to difficulty for the doctor at her weekly medical inspection. The result of this prehminary medical examination is that the T.N.T. workers in the factory conloim to a certain standard which, although arbitrary, is of great assistance to the doctor in her subsequent work of inspection and diagnosis. "Enquiry into Epidemics, {Workers' Union). Mr. J. E. Grobey J Sheffield — Mr. WiUiam Ireson {Messrs. Thomas Firth & Sons, Ltd.). Mr. G. H. Wilkinson {Chief Assistant Overseer of the Townships of Sheffield and Eccleshall). Mr. William Marshall {Messrs Vickers, Ltd., Sheffield) Mr. A. J. Bailey {National Amalgamated Union of Labour). Mr. Green and Mr. R. E. Jones {Amalgamated Society of Engineers). ' ' '' Mr. M. Humberstone {National Steel Workers' Association, Engineering and Labowr League). Mr. A. R. Fearnley {General Manager, Sheffield Corporation Tramways). Newcastle-on-Ty'ne — Mi. Thom.SiS BowmakeT {Arnalgarnated Society of Engineers). ._: Mr. "El. Gilhert {Blacksmiths' Society). Mr. I. D. Hebron {Pattern Makers' Society). Mr. J. Wile {Brass Founders' and Turners' Society). Mr. D. S. Marjoribanks {Messrs. Armstrong, Whitworth <& Co.). ;;; Miss's. Badlei {H.M. Senior Lady Inspector of Factories). _-. Mrs. Fawoett {National Federation of Women Workers). : Mr. G. B. Hunter {Messrs. Swan, Hunter and Wigham Richardson, Ltd.). Glasgow- Sir W. Weir {formerly Director of Munitions for Scotland). Mr. Harold D. Jackson {Messrs. Barr and Stroud, Ltd.)! Mr. H. J. Wilson {H.M. Inspector of Factories). , Dr. Alexander Scott {Medical Referee for Industrial Diseases for the West of Scotland District, Workmen's .' Compensation Act, 1206). Mr. G. Moore "| Mr. Walter Hicks > {Representative Munition Workers). Mr. R. Polgrean J Representatives of Womjen Workers — Miss Lois Young {Secretary, National Federation of Women Workers). Mrs. Gibb "l Miss Fanny Workman /-nr 7 » Miss Anna Howatt ^ (Workers). Miss Nellie McGregor Miss Vines {H.M. Senior Lady Inspector of Factories for Scotland). Woolunch Arsenal — Royal Gun Factory Department — ' Messrs. Cardwell, Keir, MiUs, Savage, Stratton. Mechanical and.Inspection Department — - Messrs. Ilsley, Taylor, Blake. Royal Laboratory — Messrs. Pendrey, Falconer, Franks, Cage, Hill. Royal Carriage Department — Messrs. Thompson, Leighton, Wallis. Manchester — Mr. Robert H. Coates {United Machine Workers' Association). Miss A. Tracey {H.M. Senior Lady Inspector of Factories). Representatives of the National Union of Gasworkers and General Labourers — Messrs. Eccles, J. Cummings, Masterman. Mrs. Annot E. Robinson {Women's War Interests Committee): Mr. Edward Hopkinson {Messrs. Mather and Piatt) . • Mr. M. A. McLean {The British Westinghouse Electric and Manufacturing Company). - i ■" Mr. E. Reid {Sir William Armstrong, Whit/worth & Company). 131 Coventry — Mr. C. Green way {Amalgamated Society of Eiwineers). llr. W. T. Smith (Toolmahers' Society). Representative of the Trades Council — , Mr. Chater, Secretary. Representative of the Workers' Union — Mr. Morris. Representatives of the Coventry Branch of the National Federation of Women Workers — Mrs. Lewis, Mrs. H. E. Givens. Representatives of the Women's Co-operative Guild and the Women's Hostel Committee — Mrs. CoUington (Hostel Committee). Miss Selina Dix {President, Women's Hostel Committee). Averal C. Wilks ^ Mrs. Eleanor Ejrkman Gray ^ {Women's Hostel Committee). Annie E. Corrie J Mrs. Mary A. Keene {President, Woman's Co-operative Guild, Poor Law Guardian). Emilv Clmlker f {Hostel Committee and Poor Law Guardian), Hon. Mrs. Baillie {Chairman, Voluntary Committee on Supply of Labour). Mr. A. Wall {Coventry Labour Exchange). ^^ L..j^^u^iii Dr. T. M. Legge {Home Office). Mr. Leon Gaster {Hon. Secretary, Illuminating Engineering Society). Mr. John Hodge, M.P. {Secretary, British Steel Smelters, Mill, Iron, Tinplate and Kindred Trades). Mr. C. E. B. Eussell {Chief Inspector of Reformatory and Industrial Schools). Dr. E. F. Armstrong, D.Sc. {Technical Adviser and Managing Director of Messrs. Grossfield & Co., and of Wm. Gossett & Son). Mr. T. North {Superintendent, Tickers & Co., Cray ford). Miss Macarthm' > {National Federation of Women Workers). Mr. P. B. Brown {Director and General Manager of Messrs. Hadfields, Ltd., Sheffield). Right Hon. Sir W. Mather {Messrs. Mather and Piatt). Representatives of the following bodies concerned with the Welfare of Women and Girls — Women Police Service. l"^ational Association for Women's Lodging Homes. National Association for Women's Lodging Houses. Young Women's Christian Association. Church Army. Salvation Army. Catholic Women's League. League of Honour. National People's Palace Association. (6) Persons who assisted in the Medical Laquiries conducted by the Committee included the following : (i) Medical Officers — Dr. Ethel Stacey. Dr. Mary Phillips. Dr. Beatrice Webb. Dr. Ehoda Adamson. Dr. Ethel Williams. Dr. Lilian Wilson {Board of Education). Dr. Mabel Campbell. Dr. John Bradley. Dr; L. M. Chesney. Dr. Ada Whitlock {Home Office). Dr. Margaret Thackrah, (ii) Inspectors and others^ Mr. P. A. Heath. Miss Miller. Miss E. G. Woodgate. Miss Irene Whitworth {Home Office). Miss C. M. Thompson. Miss H. C. Escreet {Home Office). Miss E. M. Gardner. Miss Isabel Taylor {Home Offi^). Miss Ho watt. Miss Elizabeth Macleod {Home Office). Miss Workman. Miss Carbutt {Home Office). Mrs. George Young. Mrs. C. D. Rackham {Home Office). Mrs. Osborne, M.So. Miss E. G. Colles {Board of Education). Miss Gordon. Miss G. M. Broughton {Ministry of Munitions). Mrs. Bankes. Miss Hilda Walton {Ministry of Munitions). (c) Amongst other persons who have by the submision of memoranda or by other means, placed their special knowledge at the disposal of the Committee were :^- Lord Levei'liulme ; Mr. B. Seebohm Rowntree ; Mr. A. H. Self and Miss Lilian Barker, C.B.E. {Woolwich Arsenal) ; Mr. A. Maitland Ramsay {Ophthalmic Surgeon, 'Glasgow) ; Dr. Elizabeth Butler {National Filling Factory, Georgetown) ; Miss Hilda Cashmore {Bristol University Settlement) ; and Miss Elizabeth Macadam {University of Liverpool) ; Mr. R. A. Bray, Viscount Dunluce and Miss G. Ei Hadow {Ministry of Munitions) ; Mr. A. F. Agar and Mr. P. E. Higgins {CanteenCommittee of Liquor Board), [3 (8^^12023) 12 132 APPENDIX B (I). A Further Inquiry into the Health of "Women Munition Workers. By Miss Janet M. Campbell, M.D., M.S. (A Senior Medical OfBcer of the Board of Education), In accordance with the instructions of the Health of Munition Workers' Committee, an Inquiry was arranged in the Autumn of 1917 to follow up the medical investigation of the health of women munition workers wHch had been made in 1915 and 1916, and with a view to ascertaining in a general way the efEect of continued munition work upon the health and physique of women. The Inquiry was carried out by Dr. Lilian Wilson (one of the Medical Officers of the Board of Education), Dr. Mary Phillips and Dr. Rhoda Adamson, assisted by Miss E. G. CoUes (Board of Education), Miss Hilda Walton (Welfare Department, Ministry of Munitions), Mrs. George Young and Mrs. Osborne, M.Sc The factory conditions were reported on by H.M. Factory Inspectors, Miss Irene Whitworth, Miss H. C. Bscreet, Miss Isabel Taylor, Miss Elizabeth Macleod and Miss Carbutt. Miss Gordon, Mrs. Bankes and Miss Miller of the Welfare Department gave assistance in following up workers who had left the factory. Every endeavour was made to secure comparable results, and the following Report has been compiled from the accounts written by the investigators. GENERAL ARRANGEMENTS. The Inquiry was made at eight factories at which the general conditions may be regarded as reasonably typical. Five of them were chosen on account of the heavy nature of the work done by the women. At aU the factories the management and welfare stafi were most courteous and considerate and gave every facility for the Inqiury. The women examined were chosen at random and were not selected on account of physical weakness or strength. As a general rule, only women who had worked for at least nine months were seen. A considerable number was drawn from heavy operations likely to cause strain or fatigue, and from operations at which women had only recently been tried. The proportion of married women seen was also intentionally high. No com- pulsion was exercised and women were free to refuse to be examined if they wished. The numbers examined were as follows : — 193 264 116 157 199 73 67 114 Factory No. 1. (North East Coast) 2. (Midlajida) 3. (Yorkshire) 4. (London) , 5. (Torkshire) 6. (Midlands) 7. (Near London) .... , 8. (Near London) .... Total .... Description of Work undertaken by the Factories. 1,183 Factory No. 1 {North East Coast). Workers were selected from nine departments doing heavy work and including the following processes : — 6-inch shell All machine processes. 18-pdr. shell A few of the heavier machine prooesBes, copper bending, gauging, filling with shrapnel. Making fuses Most machine prooesBcs. _ . iv Cartridge cases Shovelling coke in brass casting shop, oiling machinery and wheeling bogeys in rolling mill, on acid tanks in annealing shop, automatic presses, all heavy machine processes. Traffic department .... Unloading and loading waggons — 18 pdr. shell only. • Factory No. 2 (Midlands). Shells. — Women are employed on practically all processes of manufacture of 9 . 2 and 6 inch shells in various stages of heaviness. They are also employed on overhead cranes and as slingers. Guns. — About 60 women are employed as assistant operators to men on machines in this section. The work is less heavy than that of the shells as the articles manufactured are very large and the work consists of machine minding pure and simple. Some of the operations take as long as 10 hours. Factory No. 3 {Yorhshire). The main part of the factory is used for the manufacture of 4-5-inch and 60 pounder shells. A small part is used for the manufacture of gun parts. The great majority of the workers concerned in the output of shells can be divided into three classes, machine operatora labourers and inspectors. The factory is arranged in such a way that so far as possible the first process starts from the n»t hand side of the factory on which the rolling way for billets is situated and the shells are then worked gradually along *°w*™^ the left. With the exception of the initial process of centreing, the machine operator is not concerned with the transit of sheUs and her heavy work consists in lifting the shells in and out of the machine and in the necessary " tightening up <" *™ machine. No lifting tackle is provided for the 4-5 shells, but it is provided for the 60 lb. shells up to the process of fuse hole boring when the shell is reduced in weight to 53 lb. 4 oz. The centreing is done on rather a different system. AU the labouring and machine work is done by a gang of four women to each machine, so that in addition to lifting the shell into the machine they load up the trolleys and pull them towards the tables and unload them at the tables. The primary work of ths labourers is the moving of shells from one process to another. This is done by means of trolleys OD to which the shells are loaded. In the early processes the trolleys and the tables on to which the shells go are about the same height so that in moat cases the shells can be roUed on and off the trolleys instead of being lifted. This considerably lightens the work but the trolley loads seem in many cases to be unnecessarily heavy. As the shells proceed down the shop and gradually b30ome lighter the trolleys in many cages are lower, and shells, owing to lack of table space, are stacked on the floor, so that they have to ba lifted up coastautly from the floor to tables, about 3 feet high. By this time the 4-5 shells have bsen redaoe4 in ^freight to under 30 lbs., but the 60 lb, shells stiU weigh about 50 lbs. 133 Factory No. 4 (London). Women are employed on about 30 different processes, on lathes, milling and drilling machines, examining, cleaning and checking, and also in the tool room. Although the majority of the work entails handling 6-inch shells which weigh 130 lbs. in the rough and nearly 90 lbs. in the complete state, practically aU the heavy handling is done by men, and the placing of the shells in the machine is done by sliding them down a sloping plane so that there is no particular strain placed on the workers when they are actually handling the shells. Factory No. 5 {Yorkshire). Factory (a) is engaged in the manufacture of 9.2-inch shells, and women are machine operators on most operations. Owing to the size of the shell (the initial weight of the forging is about 440 lbs.) women were not employed as labourers or shell movers in this factory until recently. Now since the introduction of the rolling bench and hydraidic cranes the men labourers have been extensively replaced by women who assist in craning up the shells with the women operators. Some women do their own craning in. As a result of the introduction of the afore-mentioned rolling bench system the energy required forlabouring has beenconsiderably reduced and the shells have merely to be craned from the bench to the machine, instead of, as formerly, from the ground. Men fix practically all the shells into the machines and all through sMUed men act as tool setters. In Factory (6) 6-inch shells are made. Women are at work on practically aU the operations to which the shell is submitted and these vary very considerably in time occupied per shell, and in the skill required. The forging at its heaviest stage weighs about 130 lbs. and before it leaves the shop its weight has been reduced to about 86 lbs. The machine operator fixes her own shells in the lathe, and the methods of fixing vary very con- siderably from automatic clamps to chucks, the fastening of which requires a series of violent jerks at the end of a long crow bar. Factory No. 6 (Midlcmds). The women are engaged in making fuzes. The work is light -in character and in itself involves little or no physical strain. Factory No. 7 {near London). The firm is now mainly engaged on gaines and gaine caps, having only a small number of 12 and 14-lb. shells in hand to finish a contract. Therefore practically all the work is light. The women are employed on turning the shells throughout after the first two operations (cutting ofi and roughing out) : melting and centreing fuze plugs ; parting off, drilling, screwing and forming gaines ; boring, screwing and forming caps ; besides lacquering and inspection. Factory No. 8 {near London). The firm makes and assembles ball bearings which consist of " races " and balls or rollers, and in some cases of "cages" and balls, and vary in size from those having a bore of 5 millimetres to the large ones with a 12-inch bore, whilst the balls vary from one-sixteenth of an inch to 4J inches in diameter. The women are engaged in making and assembling the small ones throughout, but only on some lathe processes and on viewing parts of the larger ones. They are employed on the automatic and semi-automatic machines, grinding on the presses, viewing, gauging, ball viewing, assembling, testing and packing. It is aU unskilled or semi-skilled work and does not entail any heavy lifting, but is monotonous and in certain cases demands great concentration. Hours op Work. Factory No. 1 {North-East Coast). Most of the work is done on the two-shift system. Typical hours are given below : — Hours. Meals. Total. Day .... 7 a.m.-6.30 p.m. Monday-Friday. 12-1 p.m. 55 hoiiis. 7 a.m.-12.30 p.m. Sat. 4-4.30 p.m. (10 min. tea.) Night .... 7 p.m.-6.30 a.m. 11-12 p.m. 60 hours. Sunday-Friday. 2.30-3 a.m. (10 min. tea.) Factory No. 7 {near London). Hour^, Meals. Total. Day 7 a.m.-7 p.m. M.-F. 10-10.10 a.m. 57J hours. 7-12 a.m. Sat. 12-1 p.m. 4r-4.20 p.m. Night 7 p.m.-7 a.m. M.-F. 10-11 p.m. 521 hours. 3.30-4 a.m. Factory No. 8 {near London). Day 7 a.m.-6 p.m. M.-F. 8.30-8.45 a.m. 52J honis, 7-12 a.m. Sat. 12-1 p.m. 3-3.15 p.m. Night 7 p.m.-6 a.m. 10.30-11 p.m. 50 hours, M.-F. 3-3.30 a.m. (b 12023) 1 3 134 At Factory No. 2 (Midlands) tke work is anjanged on both two ^nd three shift systems. Broadly speaking, the supervisors {e.g., foremen, tool setters, etc.) work two shifts, the day shift 11 hours, the night shift 13 hours, with mealtimes of one hour and 1^ hours respectively. The actuE^l operators work on a. three-shift system, the shifts being slightly uneven, and a meal time of half-an-hour being given in each case. Where men and women work together on a lathe the women work the same hours as the men. . ' f , At Factory No. 3 {Y6rks}i,ue) practically all women wfirk on the three-shift system., Morning shift. Monday to Friday, 7 a.m. to 2.30 p.m. Meal, 10-10.30. Saturday, 7 a.m. to 5 p.m. Meals, one hour. Weekly total, 44 hours. Afternoori .shift. ■ . i, Monday to Frjday, 2.30 to 10 p.m. Meal, 6-6.^0, p.m. Weekly total, 35 houis. ' Night shift. Monday to Friday, 10 p.m. to 7 a.m. Meal^, 2.30-3 a.m., and about 10 minutes for tea at 11.40. Weekly total, 42^ hours. At Factory No. 5 (YorksMre) until June, I9lt, women in Factory (a) were working on eight-hour' shifts with a half-hour meal break, the men being on 12-hour shifts^so that each set of men worked with two sets of women each day. In June, 1917, a change over was made-^the hours then being 10 hours shift for day and llj for night work. Work starts at 8 p.m. on Simday and finishes at noon on Saturday. It is noticeable that the night shift is of longer duration than the day shift, and the work in addition includes a long Sunday night. No reason has been discovered as to the object of haying longer night work than day, other than tha^i tMs scheme of hours fits in wi;th the existing train service, for this factory is situated some four miles out of the city in almost rural surroundings. It is not unlikely that the train service could readily be modified to suit the conveniencp of the large numbers of daily workers if it were proved desirable to equalise the length of shift. There can be little doubt that from an e£S.ciency point of view it is desirable, where other than automatic work is being done, that the shifts should be of equal duration, as the worker must be tuned to a certain speed dependent on length of shift, and a variation in: duration of Shift weekly must necessitate some loss of ef&ciency. In Factory (b) the hours are as follow : — Shift. Time. Meals. Longest period without break. Total hours worked per week. Day. Week-day Saturday 6 a.m. to 6 p.m. 6 a.m. to 1 p.m. 9-9.30 a.m. 1-2 p.m. Unofficial break. 3.45-4 p.m. 9-9.30 a.m. 3i 34 B^ Night. Sunday-Friday Saturday 6 p.m. to 6 a.m. Nil. 9-10 p.m. 1.15-1.45 a.m. Unofficial break. 3.45-4 a.m. 3i 63 Just at the time of the investigation the question of shortening the hours had been considered and prac- tically decided on, when it was announced that the matter had been postponed. In order to fit in the working time of the men on tWo shifts with that of the women on three, the working hours of the women on the new shifts were to be 7^, 7^ and 6^. This reduction of hours to 6| naturally caused many of the women to feel that they would not be able to earn a *' living wage." An endeavour was made to ascertain the views of the women thfemselves on the question of the two and three-shift systems. The main objection to the eight-hour shift seems to b^ that less money can be earned. On the other hand, the short shift is obviously more convenient for women with children and home duties and provides a reasonable opportunity for rest and recreation. The Factory No. 2 {Midlands) report states " the general impression was gathered that married women prefer shorter hours as they like to undertake the management of their own homes without outside assistance. The immarried women, on tlie other hand, evidently feel that they ought to be helping in home work when they are not at the factory, and prefer the increased pay of the longer shift to indefinite unpaid home duties. One J)oint raised against short shifts was that on two out of three shifts workers were always about at 10 p.in. either ceasing afternoon work or starting on the night shift ; and with decreased lighting and lonely roads some found the journey a considerable strain to their nerves. On the whole, it appeared that there is less disturbance to home life if the shorter shift is in use, but the question of strain for individual women needs careful consideration, as the eight hours factory shift in addition to heavy household work involves a heavier day's toil than factory work alone through a 12 hours shift when it is obviously impossible to undertake home duties." The report on Factory No. 1 {North-East Coast) states — " On the point of shorter shifts (e.^f., the substitution of eight-hour shifts I gathered that many shop managers would welcome it and would expect to obtain the same output in two eight-hour shifts as they do at present, but that the many difficulties in the way include (1) the strong opposition of the men fitters and tool setters ; (2) the objection of the women themselves who are in most shops on the premium bonus system and who would object to the lower wage (this objection does not hold in the piece-work shops) ; and (3) the re-organisation of the transit arrangements which in a factory of this size would be a big problem. Many women themselves told me that they could easily produce the same output in an eight-hour shift ; in all cases there appeared to be considerable waiting about for work owing to the work not coining through quickly enough from the men on the previous process ; in one shop at least the daily output is limited and when 135 . the, girls have finished they hang about the shop sometimes for an hour or an hour and a half — ^being on the premium bonus system (which is based partly on a time wage) they have to put in their hours at the shop. In no shop on the premium bonus system did it appear to me that much work was done during the last hour of the sliift." At Factory No. 5 {Yorkshire). " The general impression gathered from the women in Factory (6) is that the large majority would be gla4 to return to the eight-hour shift even though their weeldy earnings were reduced. A mmority composed of very strong women who had reached middle age after hard worldng lives and the yoimger single women with no home ties are satisfied with the 12 hours and feel quite able to continue at this rate and to earn their present rate of pay. There were on 12-hour shifts many who openly wondered how long they could continue to work under present conditions, and a few definitely intended to give up munition work this winter as they felt the long hours were ruining their health. , , "The geperal impression gathered from the women in Factory (a) is that there is a greater appearance of well-being and satjs'f action with the work and hours. The weekly f amings for each process appear a little higher than those earned in cor- responding processes in 6-inoh shells." Night Shifts. As a rule day and niglit sliifts were worked alternate weeks. At Factories 7 and 8, towever, only a proportion of tke workers were required for night work and there was no regular alternation. At Factory No. 8 {near London) 16 permanent night shift workers were examined. Nine were classified as A and six as B. Workers in Caase A had worked continuously on night for periods varying from SJ to 11 months, the average time being 4J months. The average time of the remainder wa^ also 4J months. The nutrition and general health of the night workers examined (and they were picked at random) was much better than that of the day workers. This is probably because it is only the stronger girls and women who " can stick it." There is no regular alternation of day and night work, and if a worker agrees to go on night she is left on until she " knocks up." It was said that numbers of girls had had to give up night work because they could not stand it. Several had left because they were not allowed to change to day work. The night workers examined were satisfactory. Their feeding is better on night shift as they have two good hot meals one before coming out in the evening and a good breakfast. The breakfast of the day workers is nothing but tea, bread and butter, as they have to leave so early that there is no one to prepare a meal for ttiem The majority of the night workers apparently preferred night because of the long week-end. They work five nights and rest from Saturday morning tiU Monday night. Even those who complained that they were tired at the end of the week said that they got rested during the week-end. At Factory No. 7 {near London) where there is also no regular alternation of day and night work, 19 workers on different processes were examined. Twelve were classed as A and seven as B. The average time worked continuously on night was 13-§ months in Class A and 15 months in Class B. On the whole night work was not unpopular among the women, partly because of the higher wages earned, partly because they found more opportunities for shopping and personal afiairs. Most workers found no difficulty in sleeping during the day, though many, for reasons which were often unavoidable, did not allow themselves sufficient time for sleep. Work on Sunday night was disliked, few women cared to spend Sunday in bed and many used this day for heavy domestic work for which they had no opportunity dming the week. Seats. Although in some cases seats had been provided for use when workers have proper opportunity for resting, this was by no means general. For example, .The report on Factory No. 1 {North-East Oocwt) states — " There is a great grievance in certain shops. Sitting is generally not allowed and in many cases this appears to cause quite unnecessary fatigue to the workers. There is no provision of stools- or benches except for certain drilling machines and benches where the work must be done sitting. No stools are provided for workers on such processes as rough turning (6-iuch shell and 18-pdr. shell) and on certain automatic machines where the worker might often sit for some minutes at a time." The report on Factory No. 4 {London) calls attention to the lack of seating accommodation. At Factory No. 7 it is stated that " only the viewers and lacquering girls have stools ; in none of the other shops is provision made for sitting, though I noted many times when workers were waiting either for the tool setter or material." Many women complained that they could not sit down while waiting for work as no seats were provided and they were not allowed to sit. In this factory the proportion of tired and swollen feet was noticeable. On the other hand, the report on Factory No. 8 states : " In nearly every department seats were provided for the workers ; some had metal backs for support, while some were merely stools." The provision of seats and the use made of them unfortunately often appears to depend too much on the caprice or prejudices of individual managers and foremen, who do not yet realise that, if suitably used, seats reduce fatigue and do not encourage habits of idleness and slackness.. Seats are particularly needed where the operations are long and cannot be accelerated, where waiting is apt to occur for material or assistance and where the two-shift system is followed. Nutrition. Canteens had been established in connection with all the factories visited and on the whole were suitable and convenient, though not always as popular with the women as had been hoped. In spite of the provision of cheap, appetising dinners, many women still prefer to bring the main portion of their food from home, merely supplementing this with " extras " or tea from the canteen.* On an eight-hour shift a disinclination to purchase a full meal is understandable. The sliift is relatively short and allows time for meals at home, while the factory meal time is only half-an-hour and does not correspond with any of the ordinary principal meals of the day. At Factory No. 2 (Midlands), for example, only 20 of the workers stated that they used the canteen entirely, getting their dinners there. The remainder took their solid meaJs at home, and brought sandwiches, cake and bread and butter to the factory, getting " what they fancied," in the canteen, and making tea there. This incomplete use of the canteen may be attributable to the short meal times to which workers have grown accustomed on the three shifts, and to the consequent difficulty of serving rapidly enough to allow proper time to eat. Factory No. 5 {Yorhshire). At Factory (a) the girls take all their meals in the canteen — afair proportion actually buying all their food there ; that is to say, on day shift they buy good breakfasts and good dinners, whilst the remainder bring their food from home, often prepared dishes which they can warm up in the canteen and which they supplement with small purchases at the canteen. On night shift the usual plan is to have substantial food before leaving home, many having a good meat meal often with the members of the household who have returned from day work. They make this their main meal and purchase light suppers. * Since the Inquiry was made the difficulties of shoppmg have become greatly accentuated and the demand for food at canteens has correspondingly increased, (B 12023) I 4 136 aad breakfasts during the night or bring light meals with them. The women have certainly learned the lesson, and act on it, that they cannot oodtinuously work at their strenuous occupations raJess they get adequate food. Occasionally one would say " we are really doing men's work, we cannot expect to do it on bits of thing that would keep us going at home, we have to have real meals." These inquiries were made at the time when the great difficulties in obtaining certain provisions arose and many of them told of the hardships which were being experienced by themselves or their mothers in obtaining food. It was common at this time for the women to leave work in the early morning after the 11 J hours of night shift, with perhaps two hours' travelling in addition, and line up in the food queues in order to obtain supplies. In many cases this resulted in the women not getting home until midday, so that their rest was hopelessly interfered with. At this time, too, the weather was very cold, heavy snow having fallen. The women on the heavy work in Factory (b) have also realised that they require substantial food, if they aie to carry out their duties continuously. Of the women interviewed the following analysis gives roughly the system in food taking : — 124 good meals every day at home. 24 buy good meals at canteen. 64 buy some light food at canteen. 45 buy no food at canteen. An interesting comparison between the two factories is to be noted. The average wages are lower in Factory (b) though the hours are longer, A relatively small proportion is buying full meals at the canteen and a relatively large proportion buys nothing at all at the canteen. Apparently the higher wages ensure a greater expenditure on food by these workers on heavy operations. On the 12-liour shift and at nights the practice of buying a full meal seems to be increasing, and in some cases, if more vrere done to meet the wishes and tastes of the workers, the meals would probably become much more popular. It is not an easy task always to satisfy and meet the likes and dislikes of factory workers unused to restaurant meals and very ready to criticise, but at the same time there is room for improvement in canteen management. For example, one factory has a canteen to seat 4,000. It is run by an outside caterer so, badly that very few will use it. The supervisor offered to take it over but was refused. The caterer has been reprimanded and it is hoped the management will be improved. At Factory No. 4 (London) the canteen is too small to hold the workers, the food is only fairly good, the service is inadequate, especially at night, and the tea is particularly bad and strong. In other cases, although the food at the canteen is good, the workers, through force of habit, prefer to take their meals in the shops. This is unsatisfactory from every point of view, but it seems practically impossible always to exclude them from the shops in certain factories. Typical prices are as follows : — (1) Meat and vegetables 9d. Soup 2d. Pudding 3d. (This is considered too dear by some girls.) (2) Boiled beef and vegetables 6d. Steamed pudding 2d. Custard Id. Rice pudding Id. Soup with dumpling 2d. Bread and cheese Jd. (The food appeared well cooked and of good quality.) (3) Tripe and onions id. Savoury (a kind of rissole) .... .... .... .... .... 2d. Ksh 5d. Pudding 3d. (The quality of the food seemed good but the dinner is not often purchased, although there is a big trade in meat pies, cakes, beverages, chocolate, &;c.) The nutrition of the workers was generally satisfactory except in the case of Factory No. 8, where " the nutrition was very poor and the diet unsuitable and insufficient for women working long hours. Bread and butter and tea formed too large a part of the dietary and 41 out of 114 examined were considered to be sufiering from under-feeding." This malnutrition is due mainly to long established habit and cannot be ascribed to war conditions. It may be hoped that the well-managed canteen which the firm have now provided will encourage a better and more substantial dietary. Transit. Convenience of transit varies greatly. At Factory No. 1 {North East Coast) the difficulties of transit still, form an unsolved problem. Of 193 workers examined 39 Walk to work, 64 travel by train, 2 by the factory bus, 1 by boat, 1 cycles — ^the remainder travel by tram. The journey occupies one hour or more in 41 cases, two hours and more in 19 oases, three hours in 3 cases, f oiir hours in 1 . The train service is stated to have improved, but the tram service is stUl wholly inadequate and unsatisfactory. The large majority of workers, men and women, is obliged to use the trams, and the extreme overcrowding and bad air are certainly responsible for much of the tiredness among the women. The crowding in itself may be dangerous, and one girl examined had recently been seriously crushed and injured in the attempt to find a place. At Factory No. 2 {Midlands) a considerable number of workers (118) are able to walk or cycle to and from the factory if they wish. The remainder come by bus or train. Thirty-eight workers complained of difficulty in transit, or mentioned conditions which involved considerable addition to their hours of work in getting to and from the factory. The decreased service of trains proves most inconvenient in certain cases ; workers who arrive by train may have to wait an hour at the factory before their shift begins. In one instance a worker on the afternoon shift (2.30 to 10 p.m.) arrived regularly at her home at 12.30 a.m., and for the morning shift (7 a.m. to 2.30 p.m.) she rose at 4 a.m. The tram service varies. Many of the workers have no complaint to make, but on some lines cars are crowded, and women stand habitually, travelling an hour each way. 137 At Factory No. 3 {Yorkshire) practically all tie workers come bycarWtrain : — 15 minutes and under. 16-30 minutes. 30 minutes -1 hour. 1 hour and over. Walk, Tram or Train. A B ..„ c ;;;; ;;;; 4 4 25 18 i 32 24 2 2 1 4 6 59 41 7 Total (116) 8 47 58 3 9 107 Certain trains were said to be crowded, and th,e women complained of the cold and fatigue of waiting in queues at the end of the day's work. ■ At Factory No, i {London) 114 out of 167 were able to walk home. 138 take less than 10 minutes for the journey and only two more than an hour. 15 minutes and under. 15-30 minutes. 30 minutes -1 hour. 1 hour and over. Walk. Bus or train. A .. B .. .. Total (167) 64 16 2 37 18 1 10 6 1 1 1 83 28 3 29 13 1 82 56 27 2 114 43 At Factory No. 8 {near London) 90 out of 114 walk home, and in 88 cases the journey occupies less than 30 minutes. The firm has arranged for a special train morning and evening, and should any fare exceed 4s. weekly the firm pays the excess. Lost Time. No attempt was made in the course of this Inquiry to obtain accurate data in regard to lost time and its causes. In the case of women working long hours there are clearly numerous more or less legitimate reasons for broken time in addition to temporary Ul-health. There is, for example, genuine fatigue and the not unnatural desire for an occasional " day off." There are also domestic duties or emergencies in regard to the home or children which, in the case of married women, almost necessarily exert a prior claim to the factory. At Factory No. 1 (ifortAi^cwfCoosO. for example, the report states :— " I gathered on all hands that most workers deliberately stay away from work one day a week or a fortnight : this is sometimes for domestic reasons, but often because they feel the need of a day's rest. The time-keeping records are consequently bad. In two shops where the time-keeping is much better I found that this was due to the strict discipline ; any girl who stays away for a week, except it be on sick leave, loses her machine— she is put on some time work such as labouring and has to wait her turn to get a machine again. It is interesting that these were the only shops ia which I had emphatic complaints from the girls as to the length of houra. Roughly speaking and simply from the general statements given, the time-keeping in these two shops was 60-75 per cent, better than in the other At Factory No. 5 {Yorkshire), the mformation given by the workers themselves indicated that the lost time at Factory (a) was low. There was in general a high sense of duty in this respect, great pride being taken in the possession of a " clean slate " both m respect of absence and lateness. Occasionally a woman stopped away as she was " just done up " or " dead beat " and felt that she must rest. The records of time lost during the last six months (since the introduction of longer hours) compared with the records for the previous two months when the women were on eight-hour shifts, show a rise in the total percentage of time lost which must be due largely to increased fatigue. ' In Factory (6) there is the same pride in many of the women m having " no broken time " to show. The machine operator who 13 fond of her work dislikes very much to stay away, for she is always anxious lest she should have " her machine taken away. Some cases were noted of women who took " breakfast time," because they felt '• too done up " to come, but felt that the three hours extra rest they would obtain would set them up for the rest of the week. Welfare Supeevision. In all factories visited Welfare Superintendents had been appointed who were charged with the general oversight of the physical well being of the workers. At Factory No. 1 {North-East Coast) the Lady Superintendent has a large staff of supervisors allocated to the different shops Bach supervisor has under her at least one assistant supervisor and an adequate number of attendants for cloakrooms, cook- houses. &o. The workers say that conditions have much improved smoe the appomtment of these officers and evidently regard them as valuable acquisitions. Welfare Supervisors have nothing to do with the management of the canteens, and the ambuiance atraugements are m charge of the firm's Medical Officer. The ambulance rooms are staffed by nurses and firat-aid attendants who have no relation to the Welfare Supervisors. rri, f * -^c^ors/ No. 2 (Midlands) a Welfare Supervisor with three shift supervisors under her is in charge of the welfare work. Ihe department is a branch of the Labour Department of the factory and the Welfare Supervisor is consulted by the management on questions ooncemmg women. There are two surgeries in charge of nurses which can be used as rest-rooms if required. At Factory No. S (Yorhshire) there is a welfare staff of 19. This includes the Head Welfare Superintendent, 15 supervisors m tue works, one m the record office and one for engaging the workers. The various processes are divided into five sections and each of the 15 supervisors has her own section under her control on each shift. She has a desk in the middle of her section and IS therefore always accessible to the women. Of late a large number of athletic and social societies have been instituted in connection with the factory, and a Welfare Committee, which brings matters to the notice of the management, has also been formed. Various classes are also soon to be started in co-operation with the Local Education Authority. An e^remely weU eqmpped surgery with a separate department for men and women is in charge of the firm's Medical, Officer and staffed by nurses. At Factory No 5 (YorMire) the care of the workers at Factory (a) is in charge of a weU-developed WeHare Department ,W w^^ tK» 1?!"' f -J- !^?mT°'' T^ Assistant Supervisor. In each shop there is a Shop Supervisor who takes a personal ^^h.i^« !l™Tf,; .^fi^ Matron has charge of the weUare of the girls during the night shift. A good spirit of comradeship ?^rf »rrf T *'^°'ig«"'?«.^°'"_?° d^e to the energy of the Welfare Department, otmes, footbaUand cricket on Saturday S^ct?™ ofTT«^f4,XI;!t'»P^**''^-'^ ^J the women with great enjoyment. The weHare work at Factory (b) is under the S^ora ^ Supervisor and assistants, and workmg in the shops under the direction of the Lady Superior are the shops 138- At both factories all the women who are engaged are required to undergo a medical examination by a Woman Medical Officer within the first week or two after engagement. Practically all the women who are employed have been examined, or will have been, in a very short time. Recommendations of the Medical Officer as to transference of women to light work are attended to by the Lady Supervisor and any other recommendations made by the Medical Officer are followed ftp by the Welfare Department. At Factory No. 7 {near London) the Welfare Superintendent does not engage or dismiss workers but interviews them after the assistant manager has taken them on. She is responsible for first aid and supervises the mess room. She engages mess-room and lavatory attendants. For first aid the supervisor has a well-fitted Red Cross box in her surgery for the treatment of minor injuries. Serious cases can be taken to the hospital close at hand. In her absence a lavatory attendant applies bandages, &o. At Factory No. 8 (reear London) two Welfare Supervisors have been appointed, but they have notaa yet any very effective grip of their work. Tlie canteen is not under their control and the first-aid arrangements are separately managed. The present ambulance room is only temporary. It is well equipped, but there is no waiting room. Different hours are arranged for men and women. Three nurses take spells of eight hours each. . , , , , Gbneeal Hygiene. Apart from the long hours usually worked and difficulties of transit in some cases, the general arrangements for the health and comfort of the workers appear reasonably good in most cases. The conditions of the shops as regards ventilation, heating, lighting, removal of fumes, etc., have often been much improved, and special . contrivances have been designed to ease the strain of heavy work. The cloakrooms, lavatories, etc., are usually fairly satisfactory, though there is often no provision for drying wet garments. Overalls of a suitable pattern are now generally provided, together with special means of protection (clogs, waterproof aprons, etc.) for wornen carrying out wet or dirty operations. Rest-rooms for workers temporarily indisposed are usually available, although they are probably not made full use of. In the person of the Welfare Supervisor an officer exists to whom women may brijig personal complaints or requests for advice or help. The organisation is by no means perfect, but it represents an immense advance on the conditions which obtained two or three years ago. " ' All endeavour is often made by the factory to arrange lodgings for workers. It is found that women usually prefer to live at home even though this entails a long daily journey, than in lodgings close at harnd. At Factory No'. 8 {near London) as the number of women employed increased and it became necessary to draw workers frora a distance the housing question became urgent. The firm persuaded the Local Authorities to make a canvass in the town and find out the householders willing to take lodgers and the prices they would charge. The names are kept on a card register and given to workers who require rooms. Unfortunately the register has not been kept up to date. The firm has also provided two small houses to be used as reception houses, one for men and one for women. These are placed under the management or the Canteen Supervisor, and workers may remain for three nights while looking for permanent lodgings. A woman cleans both houses and cooks, the charge being 2*. 6d. pep day. The houses are well kept, are furnished with single beds, not more than two in a. room, and chests of drawers. Each house has a bath with hot water. MEDICAL EXAMINATION. The arrangements were generally similar to those of the previous Inquiry. Each woman went first to the assistant investigator, who asked various questions in regard to general and social conditions, and then to the doctor who made the medical examination Except at Factory No. 5. (Yorhshire), where the medical officer was personally known to many of the women, this examination was necessarily somewhat cursory in nature, partly because of the circumstances under which the Inquiry was conducted, but mainly because it was essential to avoid alarming or irritating presumably healthy women by requiring much undressing or by making a searching examination. The Inquiry was voluntary and its results depended entirely on the success with which the investigators were able to overcome the shyness or even suspicion of the women. For example, in some factories where numerous dismissals happened to be taking place, the workers naturally supposed that the Ihquiiy might be intended to weed out the most unfit. In another factory in a town where the Medical Officer of Health had recently published a report on ill-health and especially " chest trouble " among munition workers, a number of those who were not in the best of health refused to be examined as they feared subsequent action. No detailed examination of the chest was made as a routine. The doctors endeavoured to elicit the medical history by sympathetic enquiries. As before, the workers were classified into three groups — A, B and C. A denotes apparent good health. B denotes some signs of fatigue or ill-health. C denotes marked fatigue or ill-health. England. Number A (healthy). B (slight fatigue). C (marked fatigue). of workers examined. Nuriiber. Percentage. Number. Percentage. Numbei:, Percentage. Factory No. 1 193 110 56-9 70 36-2 13 6-7 . »f 2 264 199 75-3 63 20-07 12 4-5 »» 3 116 63 54-3 46 39-6 7 6-03 „ 4 157 112 71-3 41 26-1 4 2-5 t» 6 199 77 38-6 114 67-2 8 4-02 »» 6 70 45 61-6 19 26-02 9 12-3 7 67 35 52 '2 30 44-7 2 ' 2^9 tf 8 114 51 44-7 52 45-6 11 9-6 1,183 692 68-4 425 35-8 66 6-5 13^ Causes of Fatigue in Women Workees. Tte cases classified as " C " were those regarded by the medical officer as definitely unfit for the work they were doing. In some instances the physical condition appeared due to the nature of the work alone, but in most to heayy work combined with domestic duties and perhaps mental anxiety. The cases classified as " B " were those in which signs of weariness and the beginnings of ill-health were obvious to the examiner. No scientific tests of fatigue were applied. The opinion formed was based upon appearance, signs or symptoms of ill-health, physical and social history, etc. At times obviously tired women were loath to admit any signs of fatigue, for example, at Nottingham, as they feared dismissal. Tiredness and " nervousness " were commoii complaints among these women. At Factory No. 1 (North. East Coast) where all the wbrkers had been working for at least a year, and many for over two years, a nimiber of workers stated that one of the first signs of fatigue noticed by themselves is that they " dread the belt." Sleeplessness and restlessness were relatively common ; indigestion, loss of appetite, headache, &c., were often associated with the tiredness. Some had definitely Ipst weight, m9,ny looked pale, thin and worn. Among the special causes of fatigue may be mentioned heavy work, especially when associated with long hours, age aud general unsuitability for particular work, length of service, insufficient attention to " welfare " inside the factory, home duties, mental a,nxiety, transit, dietary, etc. Some of these have been referred to already, others may now be considered in some detail. (a) Heavy Work and Long Hours. As an example of fatigue due to these causes, the results of an examination of 199 women at Leeds may be mentioned. At Factory No. 5 {Yorkshire) of 146 women employed on 6-inch shells the medical officer reported that 51 were physically fit and able and willing to continue at the present pressure of work. Of these the greater number were women living in lodgings or in homes where they had no work to do after their munition shift ; a few had spent many years as charwomen working hard for little remuneration, and these looked upon the regular long hours of munition work as a well paid rest. Of the remainder 95 women showed signs of fatigue varying from those who were moderately tired and unable, to spare any energy for recreation to those who were completely exhausted and unfit for recreation or work. Of these, seven were entirely broken down in health. The most noticeable point about these women was a general appearance of weariness and loss of tone. There seemed to be a general want of alertness as though it needed a definite effort of concentration before they could bring their minds to bear upon any given question. Many had the appearance of a rapid loss of weight, and those who did not know their weight could remember that their clothing had to be definitely taken in to make it fit the present waist measurement. Women suffered from loss of appetite with fulness and epigastric pain after food, having the appearance of atonic dyspepsia in varying degrees. A few suffered from cough, the result of bronchitis which was started or aggravated by work in a Munition Factory. Many showed signs of cardiac insufficiency with weak heart sounds, irregular in time and force, while a few had definite cardiac dilatation. Some of these women were dyspnoeic while at rest and more were definitely so on moderate exertion. The evidence of nervous fatigue varied from staleness with loss of interest in, or inclination for, amusement or work in the milder oases, up to exhaustion of a marked degree with nervousness, loss of control of temper and depression in the more marked cases. The loss of voice occurring in. women especially on the night shift appears to be the outcome of exhaustion and loss of tone. The general impression gained from these women (working on 12-hour shifts) suggests that they are not physically fit to continue indefinitely on these long hours. Some will voluntarily leave at an early date, and others from economic riecessity will continue to work above their strength and wiU become permanently damaged members of society. The ones who will remain at work at all costs are those who have many dependents. These threaten to become prematurely old, losing all the joy of life and continually haunted by the fear of a breakdown in health. As regards the examination of 53 women working on 9-2-inch shells (10-hour day and llj-hour night shifts) they cannot by any effort lift them from place to place as they do in the case of the 6-inch shells. The chucks of the machines are tightened by men and the result is that though the shells are heavier and the machines larger the women actually carry out lighter work than they do when working on 6-inch shells. Of those examined, 23 were physically fit ; and again those were usually women with few home duties. -The' remaining 27 showed signs of varying degrees of fatigue. But their fatigue, generally speaking, was not so obvious as the fatigue of those on the Ughter shells. At Fadory No. 2 (Midlands) where the women are engaged on 9-2-inch and 6-inch shells (8-ho\ix shifts usually), it appears that the processes which caused most strain were those of boring, drilling and rough turn body. The latter involves an upward jerk to tighten the shell in the machine, which the majority of women find fatiguing, especially on night work or during men- struation. On the other hand, seven young women and four elder workers of an especially wiry type had suffered no inconvenience of any kind bfeyond a temporary musciJar stiffness. - At Factory No. 3 ( Yorkshire) the women are engaged on 4 • 5 and 5-inch shells (8-hour shifts) ; 24 workers on the rough tuiii body process were examined for the purpose of com|)arispn with findings at other factories where similar work is imdertaken. It was observed at Factory No. 2 (Midlands) that robust young women suffered little inconvenience at this work beyond temporary stiffness, but that there was a tendency to cause pelvic disorder in elderly married women with weak abdominal muscles. Here it appeared usual to employ younger women. Seventeen out of 24 examined at this factory were under 24 years of age and only two women were 30 years old. Some of the more delicate workers had found this work too heavy and had been transferred to other operations. There were four cases of dysmenorrhoea, seven of irregularity of menstruation, where it was said that the complaint had arisen or had become worse since working at the factory. It is evidently most desirable that workers should be carefully selected for heavy work such as rough turn body, ripping and centreing if undue fatigue or physical injury is to be avoided. The length of the shifts is clearly of great importance. (b) Aye and General UnMiitahility for WorJe. Other things equal, workers under 18 and those of middle age may naturally be expected to show fatigue more readily than those in the prime of life. Young Workers. — At the previous Inquiry considerable fatigue was manifested by girls under 18 who were working exceptionally long hours under somewhat unfavourable conditions. A large number was not examined in the course of the present investigation, but in the factory where these findings were noted the conditions of work and comfort have been greatly improved and the fatigue has diminished accordingly. At Factory No. 7 (near London) 9 workers under 18 were examined, 8 were classified A and 1 as B. Their general condition was Bitisfaotory. One strong girl of 16 is in the foundry sand placing, another girl of 17 has already worked three years at munitions. 140 Middle-aged workers may be divided broadly into two divisiona — (1) The thin wiry women who have worked all their lives and stand heavy work more easily than many yoimger and apparently stronger women ; and (2) the women who may appear strong and well nourished but whose abdominal muscles are lax and flabby from Jackof exercise, frequent child bearing, &c. The latter type is apt to sufEer unduly from fat gue or internal injury when on heavy machine work or .on operations which entail jerks or the lifting of heavy weights. (c) Length of Service. It is only to be expected that workers employed for long periods under arduous conditions will tend to show increasing signs of slackness and fatigue. The re-examination of workers at Factory No. 6 (Midlands) who had already been examined twice before is of interest in this cormection, although the numbers are small. January, 1916, July, 1916. October, 1917. A B Per cent. 38 49 13 Per cent. 62-6 33-7 13-7 Per cent. 66 22 22 100 examined. 80 examined. 27 examined. The figures indicate that women showing slight signs of fatigue in 1916 are now feeling increased strain. (d) Insufficient Attention to Welfare. It is obvious that discomfort inside the factory — for example, damp floors, no seats, cold rooms and lack of ventilation, unsatisfactory arrangements for meals and so forth — will tend to cause avoidable fatigue and minor ailments. At Factory No. 4 (London), for example, many of the women wlio complained of special " tiredness " on the night shift stated that they brought "their own food instead of purchasing a hot meal from the canteen. The night service of this particular canteen was evidently so bad that workers had often given up the attempt to obtain food within a reasonable time. The conditions of factory (6) at Factory No. 5 (ForfoAire) where a largenumberof the women appeared definitely fatigued is another case in point. In the shell shop there is considerable congestion. The number of machines installed is probably much too high, leaving the alley ways too narrow, with the result that the continual passing up and down of the bogies with and without shells, bookers, gangers, labourers, sweepers, barrows, &c., causes an unpleasant overcrowding. The factor most to be criticised in the building is the existence of wooden galleries, which are used as a fuze department and in which approximately 400 people are constantly at work. The presence of these galleries removes all feeling of air space and gives a depressing overcrowded sensation in the shops. The hanging of clothes in the shops, the absence of provision in cloakrooms and elsewhere for shoes and garments which are changed by the girls, contributes to the sense of congestion. Large gates at the one end swing open to admit truck loads of forgings. Until recently these gates opened directly on to the machines in this part of the shop, giving rise to pronounced fluctuations in temperature and in the cold weather to great dis- comfort for the workers. But recently a high screen has been erected which should be some protection against the sudden changes of temperature. As to the general cleanliness, sweepers are continually at work, but the crowded state prevents the work being carried out as well as might be. The splashing of the cooling liquor from the machines leads to an unwholesome dampness of the floor ; sawdust is sprinkled to absorb the wet and standing boards are provided, but too much wet remains lying about. (e) Home Duties, etc. The relatively large number of married women now employed increases the amount of fatigue likely to be observed among the workers. A certain proportion of these women are the recently married wives of soldiers and have no children or domestic responsibilities. The majority, however, are older women with children and homes of their own. At Factory No. 2 {Midland-i) 105 cut of 264 women were married, 66 had young children and about half of these were doing heavy housework. Fourteen women had sick husbands at home in some cases needing special diet. As a rule the children were left with neighbours or were sometimes taken charge of by other relatives. At Factory No. 3 {Yorkshire) 48 out of 116 women were married, 37 had children at home. Of the latter, 20 were classed as A, 16 as B, and 2 as C 18 had heavy housework and 26 lighter home duties. Of the 18, seven were classified as A, eight as B, and three as 0, while of those with lighter housework eighteen were A, seven B, and one was C. At Factory No. 8 (Near London) only 16 out of 114 women were married. Eight had children at home and five were doing considerable housework. Two of these were classified as A, two as B, and one as C. At Factory No. 4 (London) 63 out of 167 women were married. 26 had children at home, and of these twenty-one were classified as A, four as B, and one as 0. Of 26 married women who had considerable housework, eighteen were classified as A, seven as B, and one as C. It may be added that there was little evidence of fatigue in this factory. Married women are often fully competent physically to carry out duties at the factory. It is only when these duties are supplemented by home work after long hours of factory work, by the difficulty of making proper arrangements for the children during their absence, by the ever increasing difficulty of shopping during the limited interval, and often by worry or anxiety in regard to husband or relatives at the front, that the burden becomes too heavy to bear without mental or physical damage. If married women must be employed, either because they need money to support themselves or their families, or because the Government need their labour, some special arrangement ought to be possible by which they could be relieved of a portion of the work which now devolves upon them. 141 Genebal Ailmektb. Table of Chief Defects Detected. Factory Factory .2 Factory 3 Factory 4 Factory 6 Factory 6 Factory 7 Factory 8 Total per cent. Number examined 193 264 116 167 199 46 67 114 1,156 Percentage of defects noted 100 100 100 100 100 100 100 100 100 Digestive system — Indigestion (pain, flatulence, &c.) .... 23 15-5 25-5 16-5 24-5 13 31 37-5 23 -6 12-5 Constipation 14-5 7 9-5 14-5 16 26 16-5 12 Teeth- Several carious 31 26-5 20 29 32 17 24 29 27-5 Oral sepsis 8 10-5 13-5 6 20-5 8-5 7-5 3-6 10-5 Artificial teeth 32 15-5 20-5 12-5 36-5 10-5 18 10-5 21-5 Nervous system (tired, nervous, irrit- able) 30 13 20 18 26-5 15 16 17-6 20 Headache (frequent) 42 13-6 33-5 24 19 28 59-6 41 28-6 AnsBtaia 13 12 23 14-5 22-6 15 22 60 20 Aching and swollen feet 10 5-5 4 3 21 — 19-6 9-5 9-5 Muscular pains (including rheumatism) 14-5 8 20 7-5 14 4 28 14 12-5 Nose and throat (pharyngitis, un- healthy tonsils, &o.) 6-7 2 3-5 18-5 3 2 10-5 22-5 7-5 Eye strain, &c 6 2-5 22-5 5 5-5 17 15 17-5 8-5 Disorders of menstruation 35 17-5 27-6 25 19-5 28 37 29-5 26 Digestive Disorders. — Loss of appetite and pain after food were the most common symptoms. Constipation was comparatively seldom complained of. This was partly due, no doubt, to the fact that aperients (salts or seidlitz powders) are often taken as a routine. At Factory No. 7 {near London) 21 out of 67 complained of indigestion, and here bad cooking and catering seemed the main cause. Bread and butter and tea formed far too large a portion of the dietary. At Factory No. 8 {near London) 43 cases of indigestion were noted among 114 examined. This was not due to bad teeth but seemed caused partly by hurrying over meals before a long bicycle ride, by bad cooking and an inadequate dietary and partly by fatigue. Forty-oue girls were noted as under-fed. Decayed Teeth and Oral Sepsis were common, especially in some factories, though as far as the workers' own statements went they appeared to have little direct effect upon the digestive system. Sooner or later they are bound to affect the health adversely and are indeed responsible for malaise, headaches, etc., with which the workers do not associate them. At Factory No. 6 {Midlands) some of the youngest workers had excellent sets of teeth and had been educated in good habits of dental hygiene, thus illustrating the effect of the School Medical Service which in Birmingham pays special attention to the care of the teeth. At Factory No. 4 {London) " the women are paying increased attention to dental hygiene. During last year several had visited the dentist and had carious teeth out and plates in." At Factory No, 2 {Midlands) " the teeth were usually extremely bad, dental hy^ene seemed unknown and pyorrhoea occurred in most of the women over 30 years of age. Considerable reluctance waa shown at the prospect of a visit to the dentist and conservative treatment -was rarely sought in time even by young girls of otherwise good appearance. There was a general impression that stopping always hurt more than having a tooth out and as a result no treatment was sought." At Factory No. 8 {near London) the teeth were exceptionally good. Only 33 out of 114 had carious teeth, and it was noticed that those who had bad teeth lived out of the District. Headache is probably often merely a symptom of general tiredness and may be caused or aggravated by noise in the factory and bad conditions of transit (e.g., Newcastle), insufficient fresh air and exercise. In other cases it appeared to be associated with anaemia or with digestive disturbances. At Factory No. 7 {near London), where the factory is old and crowded with machines, 40 out of 67 complained of headache, many attributing it to the noise of the machinery — ^thelonghours and constant standing also made them "eotiied and headaohey." At Factory No. 8 {near London) 47 out of 114 complained of headache and it was often attributed to noise. For the most part the girls were unused to factory life. The high temperature at which the work has to be carried out in some of the rooms is also responsible for headache. Ancemia was seldom marked in type and usually no special treatment was being obtained. At Factory No. 4 (London), for example (where little fatigue was observed), only 3 well-marked cases were observed, and 20 slight ones, among 157 women. At Factory No.5( Yorkshire) on the contrary, where there was much fatigue, 45 cases were noted among 199 women. An exception was also noted at Factory No. 8 where 57 out of 114 girls suffered with ansemia, which in 19 cases was severe with dyspnoea and haemic murmurs. Many of these girls were under 18, their diet was unsatisfactory and the conditions of their work in hot, stuffy rooms would naturally predispose to anteniia. Muscular Pains and Swollen Feet. — ^Muscular pains, aching back, shoulders and arms were often experienced at th^ commencement of factory life, and afterwards tended to disappear as the worker became accustomed to the physical exercise. In other cases, however, where the work was heavy and the worker not robust, muscular pains were frequently complained of towards the end of the shift and especially after night work. The prevalence of swollen or aching feet appears to depend a good deal on the conditions of work and especially on the nature of the floor and the provision of seats. I At Factory No. 7 {near London), for example, the heating of the factory was not good and the floors were complained of as uneven and wet, making the feet very sore. Muscular pains and swollen, aching feet were common. At FaOory No. 5 (Torhshire) many women in J'oc(or^(6)complainedof sore or swollen feet which they attributed to standing on a concrete floor ; the condition was sometimes improved by the wearing of clogs or standing on a board. Varicose veins were relatively common among the older workers and often associated with aching legs and feet and swollen ankles. 142 Gynascologicdl' Conditions. Disorders of menstruation occurred with some frequency and apj)e'ared to be associated particularly with heavy work, especially if other causes of fatigue were present. They usually took the form of dysmenorrhxiea, which in some cases had appeared since factory work had commencedj menorrhagia or increased frequency. The dysmenorrhcea did not seem as a rule to be severe iii type, but the pain was sufficient to cause consider- abletiredness and malaise even when it did not entail absence from work. ' Af Factory No. 1 (North-east coast) 58 out of 1 85 complaiined of dysmenorrhcsa, for which 15 lost time every monrh, lU suilered from menorrhagia. Serious complaints having been made of the bad effect of the work in a particular shop on menstruation, 11 girls about whom the supervisor was concerned were specially examined in this respect. Of these, four oases were norma , six had dysmenorrhcea, two suffered from menorrhagia. In two cases the girls were obliged to lose time, but in only one case had the symptoms appeared since the work was commenced. The medical officer came to the conclusion that there was no special cause for alarm and that the conditions were fairly typical of the factory as a whole. At Factory No. 2 {Midlands) 30 out of 264 suffered from dysmenorrhcea, and nine from frequency. An inquiry among 34 women engaged on the rough tiim body process showed that considerable pelvic discomfort occurred in those women whose pelvic and abdominal muscles were weakened either through pregnancy, over-fatigue or lack of muscular power. In six of the cases women had observed irregularity of menstruation, in eight there was some degree of menorrhagia, three cases of prolapsus uteri had occurred and three suffered from some weakness of the bladder. Dysmenorrhcea had increased in three cases ; one woman had undergone spontaneous extrusion of a fibroid while engaged on this process and was feeling considerably better in health. At Factory No. 3 {Yorkshire) 23 out of 116 women suffered from dysmenorrhcea, and in about half the number of oases the pain was 'sufficiently severe to necessitate absence from the factory. Eleven severe cases and five slighter ones were stated to have arisen from or to have been aggravated by factory work. Two women complained of menorrhagia and seven of increased frequency, At factory No. 4 {London) 39 women out of 157 suffered from menstrual disorders, 12 losing time every month. In one case improvement had taken place siuoc working at the factory, in six cases the reverse. At Factory No. 5 {Yorkshire) of 146 women engaged on6-inohshellsmenstruationwasunchangedin88oase8, decreased in 12 and increased in 5 cases. In the last group the loss was so excessive as practically to amount to actual flooding. These latter cases were women who had borne children and were working on processes involving heavy lifting, such as tightening the chuck of machines. A few complained of backache and bearing down sensation, amounting to deiinite prolapse ill one case. These were directly attributable to over-strain and gave a fairly typical picture of endometritis following hard worlt and want 6f 'rfest. Of 53 women engaged on 9-inch shells menstruation was increased in 9 oases and diminished in 10. There was no history of severe flooding. At Factory No. 7 {near London) 20 out of 67 girls complained of dysmenorrhcea, and 2 of menorrhagia. 7 lost time every month. At Factory No. 8 {near London) 31 out of 114 suffered from dysmenco-rhoea, of whom 19 lost time every month. 2 stated that they were worse since coming to the factory. Very few women who sufiered from dysmenorrhcea had ever consulted a doctor. They appeared to con- s'der it a necessary evil tp be put up with and made the best of. Many women were surprised that it should be regarded as an abnormal condition for which medical advice and treatment should be sought. There seemed indeed a great disinclination to consult their doctors, and " he's no time for such things " was a common reply, to the question as to. whether advice had been obtainpd. At Factory No. 3 {Yorhshire) "there was a tendency for mothers or elderly women relatives to prescribe gin as a specific remedy, and though the younger women disliked its taste at first its use might easily lead to alcoholism in later years. In some cases the medical treatment obtained appeared to be palliative rather than curative, powders and liniment being given." Other gynaecSlogical conditions which were noted (in addition to backache and symptoms possibly due to chronic pelvic trouble) were prolapsus uteri and miscarriage. Both these conditions may be caused partly or entirely by the heavy work, but without detailed inquiry it is difficult to* attribute the cause solely to factory jWorls:,, when the woman may also be undertaking heavy or unsuitable work at home. Addenda.. In the course of the inquiry the attention of the medical oiScers was directed to two processes which for different reasons presented features of special interest, namely (a) Copper band turning ; (6) continuous work in artificial light ; (c) following up workers who have left the factory. (a) Copper Band Turning. During this process workers are apt to inhale metallic dust or fumes, and symptoms suggesting irritant poisoning were noted in a number of cases. At Factory No. 1 (Norlh-East Coant) there was an unusual amount of digestive disturbance among the workere in copper and brass. The girls themselves have a fixed idea that the copper " gets on their stomach " or " on their chest." They complained of dust in the mouth like " Verdigris " and purgatives are taken regularly to counteract this. In 11 cases inflammation of the gums and nausea and vomiting were noted, while diarrhoea and vomiting occurred in four. At Factory No. 2 {Midlands) 28 women on copper band turning were examined, and, generally spealdng, the work was popular, but a fairly large number appear to h»'Ve had symptoms suggestive of mild poisoning, possibly due to the inhalation of impurities in copper dust. About 18 were aware of a metallic taste in their mouths, 10 had noticed dryness of the throat and about seven suffered at intervals from nausea, indigestion and diarrhoea. Actual vomiting occurred in four cases. Others who did not complain of nausea suffered from nose bleeding with occasional loss of voice, especially after night duty. A certain amount of eye strain was noticed from the dazzling reflection of the rotating copper band. It was observed that about 10 of the workers who complained of a metallic taste with digestive disturbance or nose bleeding had extremely bad teeth with marked oral sepsis. Conversely 10 women with clean and well-kept teeth had remained healthy at this work. Only two employees were examined who had good teeth but yet showed some symptonis on this process ; and one of these stated that her sister had been away for some weeks with " copper poisoning " so that allowance may be made for personal siisoeptibility : ' At Factory No 3 ( Torkfhire) an examination of 26 women showed that at least 20 of the workers- were conscious of a metallic tastewi-th dryness and pricking of the throai;, especially after night duty. Nausea was present in 16 and four had occasional attacks of vomiting and diarrhoea. Kose bleeding occurred in two workers. . .^ Fatigue of the eyes and headache were observed in a large number of oases from the glare of artificjal light on the rotating copper band These symptoms suggest that women are occeisionally suffering from mild attacks of irritant poisoniig due to impurity in the copper dust, and it seems possible that arsenic may be the exciting cause. This is supported by a conversation with tlie manager, who statedthat arsenic is frequently foxmd as an impurity in the copper and that the amount varies at different times ; occasionally the copper bands are undiily soft und more dust is produced in rotation. 143 In favour of arsenic is the apparent connection between the condition of the teeth and the BusceptibiUty °fth^e worked thns pointing to the existence of a volatUe irritant. Forty per cent, of the workers who showed Bymptoms Iff ^^f^^ ^""°^ teeth, often with marked oral sepsis. Conversely, five workers with good, well-kept teeth had rema,.,ed l^^^^^l^^^'^^^^^ women with excellent teeth who had attacks of vomitmg or colic admitted that they never used a tooth brush. The known variation m susceptibUity of persons to the influence of irritants such as arsenic should also be taken mto account. At Factory No.5{ YorksUre) the work of the copper band turners is highly paid and not so exacting physically as m the case of some other operations. It involves deftness and close visual attention and the girls employed are picked at the outset. ^ tne summer of 1917 it was recognised by the medical officer of the factory that the girls working in brass and copper were suSenng to a certain extent from copper absorption as shown by a taste of copper in the mouth, sore dry throat and nose, pam atier food, colio, constipation and in some cases a green line of the gums corresponding to the lead line produced m oases ot plumbism. At that time the worst cases were recommended for transfer to other work, washing before meals encouraged, salme draiJss suppuea in the ambulance room and a half-pint of milk per shift given to each worker. After this line of treatment the condiuons improved greatly, so that the girls examined for the purpose of this inquiry showed no very marked evidence of mjunous results. In 10 girls examined there were six oases of irritation, as shown by a copper taste in the mouth, and sore nose and throat, three oases of mild absorption ; one girl had no evidence of injurious effects. ' Tkese findings point to the desirability of special attention being devoted to workers in this process ^ possible means should be taken for preventing the inhalation of irritant dust, and the women so employed shouidbe under the observation of the Welfare Staif, who should at once report symptoms suggestive of poisoning to thfr medical officer. Attention should be paid to dental hygiene, and personal cleanliness should be encouraged. (6) Continuous Work in Artificial Light. Ball-viewing is a most trying type of work as it has to be done in strong electric light, except in the case of lapping- viewing whfere diffused light is used. For this process the women and yoimg persons have to trork in a, room whence daylight is excluded by shutters ; strong arc lamps, hanging low over octagonal tables and shaded by cartridge paper, throw a diffused light on to trays containing a certain number of balls (varying according to size). Each worker keeps her tray continually rotating whilst she watches intently for any flaw, removing any defective ball she may find. In order to detect any flattened surfaces the balls are examined again in the " twilight " room, similarly shuttered, but with the ordinary electric Kght so dimmed that the room is in a state of semi-obscurity, in which the irregularities are said to be more quickly seen. . The work is very light and requires no physical strength. It therefore attracts girls who are perhaps unfit for ordinary factory employment. The workers say that their eyes ache and they have headaches for the first week, but after that they become accustomed to the light. At Factory No. 8 some women had been working for several years in diffused light and appeared well. The pauses in this work are frequent. There are two additional breaks at 10.45 and 2.15 and the work is not continuous for more than 2J hours. During these breaks the girls are sent out on to a roof-playground for exercise and recreation. At Factory No. 8 {near London), there were seven girls in the " twilight " room and five were examined. AH five suffered from enlarged cervical glands which were presumably tubercular, two had scars of old abscesses, and one had had four operations for the removal of glands. In the latter case the last operation had been done three weeks previously, and the worker, who suffers from indigestion and is subject to fainting, had already been back at the factory for a week. Nineteen girls were examined who work in diffused artificial light. Of these, six had enlarged cervical glands, seven were ansemic and seven had eye affections. Of the 24 workers, seven were classified as A, 13 as B and four as C. The presence of so many enlarged and possibly tuberculous glands, not a common complaint among munition workers, associated with continued work in the absence of sunlight, is worthy of notice. It suggests that continued employment in artificial light is undesirable and that there should be some arrangement by which alternation of employment could be provided for workers in this process. (c) Following up of W or Jeers who have Left the Factory. It is clear that the examination of women actually employed at any given moment in the factories will not reveal a complete picture of the effect the work is having upon health and physique. Those who have been able 'to remain for a year or more in continuous employment without a breakdown are to some extent the results of a physiological selection and represent the most physically fit among the women workers. An examination of this kind takes no account of the women who have dropped out of enpiployment because they were unable to support the strain of long hours, night shifts or heavy work. It is not an easy task to trace workers who have left the factory, especially when the workers are drawn from a wide area. Lack of time and opportunity have prevented any extensive inquiries being made in this direction. At the same time it was thought that even limited investigations might be worth making and the following results are therefore given. Factory No. 2 (Midlands). Home visits paid to 56 workers who had recently left showed that women liked the factory and were usually sorry to leave. The cause of absence as entered in the records of the Welfare Superintendent agreed closely with the results of private inquiry in the homes of workers. The following table shows causes of leaving : — Ill-health Left for other work Care of children or home duties Long hours Left district Long distance from work Not traced 18 oases. 11 „ 7 2 2 56 Cases of iU-health included four women who left for approaching confinements, and one woman who gave up factory work owing to severe haemorrhage during the menopause. One single woman who worked until three weeks before the birth of her childihad a difficult confinement and the child was said to be very delicate. This was attributed by the doctor in charge to the prolonged work during pregnancy. The mother was at a nursinw home for four weeks, but has now recovered and is working on munitions elsewhere. Another married 144 woman was a machine operator and worked at her lathe until the day of her confinement when she had a seven months still-bom child. Among the women who left for other work are included certain cases who gave in notice to secure employment elsewhere fearing dismissal owing to shortage of work. The eight cases who found hours long were unable to stand the fatigue of the 12-hours shift. Factory No. 6 (Midlands). Visits were paid to 37 workers who had been examined at the previous inquiry but who were not available for inspection by the medical officer on this occasion. The results showed that only two workers left actually on account of illness. Factory No. 4 (London). Visits were paid by the Medical Officer to 14 cases who were said to have left the factory on the grounds of ill-health. The results were as follows : — 1. Aged 18. Normal pregnancy, no oomplicationa. 2. Aged 20. Normal pregnancy, together with a mastoid abscess not attributable to factory conditions. 3. Aged 22. Left on account of slackness of work — in good health. 4. Aged 26. On base facing process. Miscarriage at four months attributed to pulling levers. Work probably too heavv. Normal health at present. i' 5. Aged 38. Engaged in sweeping floors. Left on account of hsemorrhage from piles. Found work too heavy. At , present thm, worn, subject to bronchitis. 6. Aged 22. Worked on base plates. Constantly got steel splinters in her eyes — wore no goggles. Left on this a.cconnt. Is in normal health now. 7. Aged 19. Left on account of slackness of work. Is in good health. Working at a tailor's shop. 8. Worked as a checker. Sight was poor and could not do work properly. Left on this account. Thin, delicate girl, 9. Aged 38. Found standing tiring and got varicose veins. Left on this account. 10. Aged 25. Found work too hard — refused to be medically examined. 11. Aged 18. Left because she could not stand the night work. Is anaemic but now works at a tailor's. 12. Aged 28. Worked on base plates at first and then on boring. The latter operation caused menorrhagia. She became very tired and worn out, especially as she did her own housework, including washing. Is at present strong and well and menstruation is normal. 13. Left on account of night work. Is now a guard on a tram, strong, healthy and well. 14. Left on account of pregnancy — ^normal confinement. Quite well now. Factory No. 8 (near London). The total number (according to the firm's records) of workers who have left since August 1st, 1917, i.e., during four months, was 134. The foUowiag reasons for leaving were given : — 1. Ill-health 34 5. Own accord 18 2. Unknown 7 6. Home duties 11 3. Bad time-keeping 13 7. Not suitable 15 4. Other disciplinary reasons,,.. 20 8. Leaving town or to be married .., 16 An endeavour was made to visit the whole of these workers to ascertain whether the reasons given to the firm corresponded generally with the reasons given on inquiry. The results of 102 visits were as foUows ; — Visited at addresses recorded — (o) Effective. Seasons for having. 1. Ill-health 34 2. Maternity cases 3 3. To be married 7 4. Home duties 7 6. Still working at same factory .... .... .... 1 6. Dismissed 5 57 (6) Ineffective. 1. No information 3 2. Left addresses — ^forms sent in, 12 ; no forms, 17 29 3. Not traced or out — forms sent in, 8 ; no forms, 5 13 45 It is of interest to note the present occupations of 17 of the women visited : — Laundry 2 Work at same factory 1 Shop 2 Munition work 4 Flour mills 1 Work in recruiting office 1 Gas works 1 Domestic service .„.. 5 Factory No. 7 (near London). The total number (according to the firm's records) of workers who have left since August 1st, 1917, i.e., during four months, was 42. The following reasons for leaving were given : — 1. ni-health 9 5. Own accord 13 2. Prolonged absence 3 6. Not required (probably owing to slackness) .... 6 3. Bad time-keeping 4 7, Not suitable 1 4. Other disciplinary reasons 4 8. Left town 2 Visits were paid to the homes of the workers with the following results in 14 cases : — Visited at addresses recorded — !t»e. Seasons for leaving. 1. ni-health : 9 2. Maternity cases 2 3. To better position 1 4. Dismissed 1 6. Still at same factory 1 14 145 Eight of the women visited are now employed as follows : — ' Shop 1 Ticket ooUeoting ^ Waiting at aeroplane canteen ^ Work at same factory .... ^ Work at munition factory 2 W.A.A.C. Baker 1 Domestic service 1 In only a few cases was it practicable for the women to be examined by a doctor, so unfortunately few details are available as to bhe precise ailments of those who left work because of ill-health. As far as they go, these findings do not suggest that an unduly large proportion of women is leaving the factories on account of physical breakdown. The numbers are highest at Factory No. 8, where 34 out of 57 interviewed had left for reasons of healt^. The physique of the women at this factory, however, was decidedly below the average of workers examined, and a large number of women appeared to be under-nourished. Such workers might be expected to be unable to stand the strain of munition work and all that it entaUs even when the work is light in character. JANET M. CAMPBELL, M.D. February, 1918. APPENDIX B (II). General Findings or Inquiries into the Health of Women Munition Workers. By Miss Janet M. Campbell, M.D., M.S. The rapid multiplication and growth of munition factories since the commencement of the war have been associated with correspondingly wide and urgent demands upon women to enter industrial life. There has been ample response, not only from women already accustomed to factory work, but from large numbers of others who entered upon such employment for the first time. Latterly many places have been fiUed by married women, some of whom offered themselves because of the urgent National need, but most perhaps because they were unable otherwise to support themselves and their children. The existing conditions of employment are in many respects abnormal, but it is important to consider their effects on the health of the women with a view to present and future guidance. It was for the purpose of obtaining some reliable da;ta and first-hand evidence of the efiect of employment upon the individual woman that the Health of Munition Workers Committee made arrangements for two medical inquiries which were carried out in various factories in 1915-16 and in 1917. In the First Inquiry 1,326 women were examined in 11 typical engineering factories. In most cases the work was fairly light in character, nothing heavier than 4.5 inch shells being handled. The hours of work were often excessive. In one case women were employed 77 hours weekly and here 15.5 per cent, showed evidence of severe fatigue. In other cases the hours, excluding meals, were 68J, 63, 67 and 69 a week. Sunday work was general. On the whole, the women realised the need for an adequate dietary and usually had sub- stantial meals, but the canteen and mess-room accommodation at the factories was wholly insufficient and sometimes non-existent, welfare supervision was little developed and the arrangements for the personal hygiene and convenience of the workers often left much to be desired.* In the Second Inquiry 1,183 women were examined in eight typical factories. Practically all the women had been engaged in munition work for at least nine months and most of them for longer. Those examined included a large proportion of married women with domestic responsibilities, and the difiiculties of shopping and providing food were beginning to be severely felt in some districts. Many women were employed on heavy work (5, 6 and 9.2 inch shells). The general conditions of employment had considerably improved. The hours had been shortened, there was no overtime or Sunday labour (except Sunday night in some cases), good canteens were available for meals, and the " welfare " of the workers was carefully organised. The conditions of work deserve a brief recapitulation. Character of the Work. In the earlier days of the war women were only employed on the lighter processes of munition work and in the making of smaller shells up to 3-inch shells. Then after some hesitation they were allowed to begin work on 4-5-inch shells which weigh 48 lbs. in the rough and about 27^ lbs. in the complete state. For these and heavier shells they now carry out all the different processes, which include working on lathes, milling and drilling machines, examining, cleaning, checking, and also loading and unloading waggons. They are employed as crane drivers and slingers. No lifting tackle is provided for the 4- 5-inch shells and the total weight of shell handled daily is considerable. For 5 and 6-inch shells lifting tackle is usually available but is not always used by the women who sometimes find it quicker to lift the shell than to adjust the tackle. The 6-inch shells weigh about 130 lbs. in the rough and 90 lbs. when finished, so that the women are just able to lift them. For this reason this type of shell is perhaps the most likely to cause overstrain and fatigue, although much has been done in many factories to reduce the strain of manipulation by arranging rolling ways, trolleys of the right height, etc., and giving the machine operators the assistance of labourers to lift the shells into the machines. The 9-inch and all heavier shells cannot be handled except by tackle, and the risk of strain from lifting is much reduced, though the machines themselves are often heavy to work.t * A report on this Inquiry was published in the Interim Report of the Health of Munition Workers' Committee on Industrial Efficiency and Fatigue, 1917. t The number of shells and consequently the weight handled by individual women varies greatly on the different operations. In order to give some indication the average individual output per 12-hour shift at one factory engaged in 6-inch shells may <,e cited for the different processes : ripping, 79 ; rough turning, 35 ; rough and base bormg, 37 ; finish and counter boring, 26 ; face base, 82 ; counter boring and chase, 50 ; rough profile, 120 ; finish turn, 43 ; grooving, 110 ; waving, 218 ; rough recess, 114 ; finish recess, 58 ; copper band turning, 130. (b 12023) K 146 Women engaged in loading and unloading shells are usually organised in gangs and given due rest between eacli spell of work. Mucli can be done to minimise energy by preventing unnecessary lifting as from tie ground or a low trolley to a higb bench or waggon above. Forge work, for example, lifting shells out of the furnace or carrying them out of the forge press, is done by a few women. At one factory the larger shells so handled weighed 96 lbs. and the smaller ones 45 lbs. Women took turns in lifting and changed after every 20-30 shells. It is astonishing how deft women become in dealing with heavy weights, and they often take great pride in their muscular strength and dexterity. But clearly it is most important first to select the workers properly and next to watch that they do not attempt too much in their eagerness to do well. The Long Hours of Work. Even though the excessive hours worked at the beginning of the war have now been reduced, it is still permissible for women to work 60 hours a week irrespective of pauses and meal times. This usually means in practice two 12-hour shifts with no Sunday day work. In many factories working the two-shift system the hours are somewhat less than this (55 or 57|) and a half-holiday is given on Saturday. A 12-hour shift means in .practice 13-14 hours away from home. The whole of the remaining time ought to be occupied with meals and sleep if the women are to have sufficient rest to overcome fatigue. But though many of the younger women are fairly free from domestic responsibilities most of the older ones are burdened with the care of house or children after working hours. Their " leisure " is occupied with shopping, mending, cleaning and other duties. The time for sleep is perilously reduced and recreation is impossible. Even Sunday, which should bring reUef, must often be spent in doing the weekly washing, baking or cleaning, and if such a day is followed by a night shift it is small wonder if the output of work is not as good as it might be. Even girls who have few or no home duties only obtain the time they desire, and indeed r,equire, for exercise in the fresh air, recreation and amusement at the expense of much needed sleep. It may have been necessary, and even desirable, at the beginning of the war to impose these long working hours. For a time it was possible, by giving up many things that make life worth while, for women to stand the physical strain reasonably well, but after more than three years of war domestic conditions have become more arduous, staleness and fatigue are being experienced by many women who have worked cheerfully until now, and the question whether, having regard to the present and future health of the women, these long hours can rightly be continued becomes ever more urgent. To put the case at its lowest it is not economically sound to exhaust and cast aside women who have become experienced and capable workers. Even if there were no disadvantages in constantly training new relays of workers, it should be remembered that the best of the available women have probably already been attracted to the munition factories, and if they become physically unfit they can only be replaced by the less efficient. Some factories, recognising the need of their workers for proper rest and recreation and for at least a minimum of time to devote to their own afiairs, are working a three-shift system of about eight hours each. This involves a weekly total of 35-44 hours. In some respects the hours of work are not altogether convenient, but the main objection on the part of the workers to the shorter shift is the reduction in their possible earnings. From the factory's point of view there is the difficulty of providing women for three shifts instead of two and of suiting the hours worked by the women to those worked by the men. If it is considered impossible to efEect a general reduction of working hours for women it might at least be practicable to arrange for shorter hours for certain groups, for example : — (a) All women engaged in heavy work should not work longer than eight-hour shifts. A sufficient minimum wage would be necessary as many of the operations are lengthy and cannot be much accelerated by the skill of the worker. (6) The hours for light work, the output of which can he increased by skill and industry, might be reduced either by working two shifts of, say, 9 or 10 hours in length (e.g., beginning after breakfast instead of before) or three shifts of eight hours each. It might even be possible in some cases to work two eight-hour shifts and abandon the night shift without materially affecting output. Proposals have been made at times for reducing the hours of work for married women, allowing them to come later, leave earlier, or work half-shifts. Such arrangements would not seem to be practicable, at any rate on a general scale, from the point of view of the factory, and the only true remedy lies in a general shortening of hours, so that as long as women having other duties must be employed they may have reasonable time in which to perform them. It has been shown so repeatedly that unduly long hours do not yield a correspondingly large output that it seems not unreasonable for the sake of the health of the women to ask urgently for a further re-consideration of this matter even though a reduction in hours of work would involve difficult questions of factory re-organisa- tion, wages and adjustment with the hours of men workers. Nutrition. Women are now beginning to realise that a heavy day's work in a factory under discipline and in touch with the rhythm of machinery requires a better and more substantial dietary than miscellaneous work at home. Most working women have never acquired the habit of taking solid and regular meals, partly because when food is not abundant the woman goes short rather than the man, partly because women as a whole have never commanded sufficiently good wages to enable them to purchase adequate food as well as the various other articles, necessities or luxuries, which they also desire. The bread and butter and tea dietary is practically a thing of the past as far as munition workers are concerned, though the evidence from one factory visited indicates clearly the disadvantages to health of unsuitable food. This is due to the higher wages wliich allow better food to be bought, to the increased appetite and desire for solid food following upon regular work under fairly good conditions of hygiene, and to the growing taste for the substantial middle-day meal in place of sandwiches brought from home and supplemented by sweets, pastry, tinned pineapple, &c., from the canteen. The increase in the number of well-equipped and managed canteens, and the daily object lesson of cheap, appetising meals, nicely served, are gradually promoting a habit of eating well which has undoubtedly saved many women from unnecessary fatigue and physical disability or breakdown. Swee;ts, pastry, &c., are popular, as they always will be Taken in excess by themselves and instead of proper food they are unwholesome in many ways. It is quite another matter when they are eaten as part of a full, well-proportioned dietary. The custom of drinking tea frequently is widespread, but as the tea is almost always freshly made it probably does little if any harm, and it forms the best and most acceptable stimulant for the tired worker. 147 Transit and Housing Difficulties. Transit and iousing diffictdties have pressed hardly upon women and much of their fatigue is certainly due to conditions incidental to the factory life rather than to the nature of the work itself. The waiting m all weathers for the often crowded tram or train, the struggle for a place, the frequent obligation to stand for part or the whole of the journey, is fatiguing to men but usually far more so to women. Most men have few, if any duties once they are free of the factory. Practically aU women return home to some work, which vanes from their personal washing and mending to the care of a house and family. It is this combination of home and factory duties which bears so hardly on the women. The Importance of Welfare Work. All available evidence goes to show the value of welfare supervision when suitably organised, at any rate as far as girls and women are concerned. It is valuable not so much from the point of view of increasing out- put, though this usually follows when workers are healthy and contented and the factory environment satis- factory, but primarily in order to raise the standard of health, contentment and happiness as a whole. Women have become so accustomed to work for low wages and under bad conditions that they are only beginning to learn what is needful for their mental and physical health. Someone, therefore, is required to supervise on their behalf conditions which do not belong to the actual technical work, for example, to make sure that the lavatory and sanitary accommodation is convenient for the women and is properly used and supervised ; to see that there are opportunities for drying wet clothing ; to watch that minor accidents and injuries receive prompt and con- tinued treatment ; to ensure full and suitable use being made of the rest-room for temporary illness ; to encourage wholesome outside interests and recreation, such as games, gymnastics, dancing, classes, clubs, etc. ; in short, to make the well-being of the women her chief care and to establish such friendly relations with them that they will not hesitate to seek from her help, advice or guidance. W hsther the welfare supervisor should remain an ad hoc ofBcer, as is common at present, is relatively unimportant, provided her chief function is not in any way overshadowed or lost sight of. Medical Findings. The medical examination cotdd not be made as complete and exhaustive as might have been wished, partly because suitable accommodation was not always available, partly because the time was limited, (women were summoned from their work), but chiefly because presumably healthy women are naturally shy of searching medical examinations. In estimating the physical condition and the amount of fatigue reliance had to be placed to a large extent on statements and descriptions of symptoms volunteered by the women. The heart, lungs and abdomen could not be fully examined as a routine. As in the previous inquiry the workers were classified into three groups — A, B, and C, and it will be interesting to observe the results of the two inquiries which, in spite of the difierent conditions of the examination, are surprisingly similar. Number of workers examined. Class A (healthy). Class B (some fatigue or Ul-health). Class C (marked fatigue or ill-health). Inquiry No. 1 Inquiry No. 2 1,326 1,183 Per cent. 763 = 67-5 692 = 58-5 Per cent. 451 = 34-0 425 = 35-8 Per cent. 112 = 8-5 66 = 5-7 Fatigue. These tables indicate generally the amount and degree of fatigue observed among typical workers chosen at random. The following points clearly emerge : — (1) The proportion of serious fatigue amounting to marked ill-health and incapacity for work is relatively small, approximately 5 to 6 per cent, of the cases examined. (2) There is a considerable amount of slight fatigue which varies from 20 to 57 per cent. (3) The total proportion of women exhibiting definite signs of fatigue is about 40 per cent, of aU cases. This proportion, namely 40 per cent., does not however represent the full burden of fatigue for the following reasons : — (a) Much early fatigue is latent and objectively unrecognisable. (6) The women most seriously affected tend to drop out of factory life before they have served for any long period. (c) Women knowing themselves to be fatigued did not volunteer for examination. (d) The examination was necessarily superficial and only such as could detect defiuite and relatively well-marked fatigue. (a) Latent or undetected fatigue. Fatigue, apart from reduced capacity and diminished output, is always difficult to measure, and particularly so when the investigator is dependent upon the statements of workers who may be interested in exaggerating or minimising the efEects on their work. A tired woman who fears in any way to prejudice her position at the factory may make a point of appearing bright and cheerful to the medical officer and give an excellent account of her health. Although from her nutrition, complexion and general appearance, the doctor may be disinclined to accept her statements as accurate, it is almost impos- sible in a short interview to elicit the whole truth. Again, the beginnings of fatigue may show themselves in ways unrecognised by the workers, A greater number of accidents, more spoilt work, diminished output often pass unnoticed because unrecorded, and even when fatigue becomes objective and pathological many of (B 12023) ^ 2 m tlie physical symptoms, sucli as teadacte, indigestion, sleeplessness, irritability, and so forth., are disregarded or made light of because they have often been experienced before and are taken as a matter of course. Working women are so accustomed to being weary and over-tired that they frequently accept patiently a condition of physical malaise which would be the subject of definite complaint by women in better circumstances. (6) Disappearance of women most affected. The fact that a woman is able to work regularly for many months is in itself evidence of good physique. The less robust women who are unable to stand the strain tend either to leave voluntarily or to be dismissed for bad tiijie-keeping. No accurate estimate of the fatigue caused by the conditions of work can be made unless the women who drop out on physical grounds are examined as well as those who remain. (c) Women knowing themselves to be fatigued are likely to have refused to present themselves for examina- tion, especially in factories where dismissals were taking place or known to be pending, for fear that the de- tection of physical disability might, if reported to the management, result in their discharge. The examination was, in point of fact, wholly confidential but no compulsion was exercised and any woman approached was free to decline to see the doctor. (d) The necessarily superficial character of the examination made it impossible to detect anything but fairly well marked fatigue. No special tests were employed and there was no opportunity of examining thfe records of individual workers as regards lost time, accidents, etc., even had such records always been available. Fatigue in its earliest stages is therefore not recorded. » Thus it is clear that the amount of fatigue revealed by the Inquiry is less, and possibly much less, in amount and degree than the actual fatigue experienced by the workers as a whole. On the other hand there are various reasons why the fatigue should not be so great as might be anticipated from a mere recital of hours and processes. For example : — (a) The interest of the work. Interesting work is less fatiguing than duU and monotonous work. Women have taken extremely kindly to machine work. The former tailoresses, mill hands, domestic servants, charwomen, etc., find engineering work unexpectedly congenial and they enjoy it for its intrinsic interest apart from added incentives such as high wages, responsibiUty, etc. (b) Patriotism and a desire to " do their bit " have also had considerable efEect in maintaining interest and keenness. The women are. glad to feel that they are releasing men for other service and are anxious to play an efiective part in the defence of their country. (c) The higher wages obtained are in themselves an incentive to good and regular work, but they have im- portant secondary results in that they lead to a higher standard of living, better food and clotMng, and so to improved nutrition and a greater power of resistance to fatigue and disease. (d) Previous harder work had been carried out by many of the women under less good conditions. Such women are accustomed to long hours, they derive benefit from an improved environment and their health is likely to become better rather than worse. (e) The immense advance of welfare supervision. — The attention now givenby themanagement to the health and welfare of the workers was almost unknown in ordinary factories before the war. The develop- ment of welfare supervision in the broadest sense has led to astonishing improvements in the circumstances of the work and has prevented the estabhshment or continuance in many factories of conditions likely to be harmful to the workers. For instance, hours of work have been shortened, there is practically no Sunday day work, and overtime has been largely aboHshed. It is reahsed with increasing clearness that women cannot profitably work for five hours without a break, and the spells of work have therefore been shortened in many cases, and unofficial " breaks " of 10 minutes or so for tea have been found to assist the workers without reducing output. The greatly extended provision of canteens and rmss-rooms on a scale never before contemplated has not only made cheap, well-cooked food easily accessible to the workers, but has enabled those who remained at the factory to spend their mealtimes under conditions of reasonable comfort and restfulness. The improvement in canteen accommodation is still going forward, and in view of the difficulties of shopping, &c., it is likely to become even more welcome and needful. Rest-rooms for women workers are now provided in most factories, though their proper use is not always fuUy appreciated by the factory stafi. Malingering must, of course, be guarded against mainly by eSective super- vision, but an hour or two's rest in a comfortable room may enable many women temporarily unfit for work to return to the shop and continue to work satisfactorily instead of experiencing physical discomfort or malaise daring the whole period and doing bad work in consequence. Well-equipped surgeries for the treatment of minor accidents and ailments have replaced the Red Cross boxes kept in the workshop. Prompt and continued treatment has prevented many slight wounds from becoming serious and has saved much physical distress to the workers. Great attention has been given to the provision of suitable and comfortable protective clothing, including goggles, caps, foot- wear, &c., with good results on the health of the workers. This is particularly important where ordinary clothing is apt to catch in machinery or become wet or soiled during the work, where the liability to burns, &c., is great or where workers are exposed to the weather. The protective clothing in filling factories in particular is of the highest value. Welfare supervision by trained, experienced women acting in the interests of the workers, co-ordinates the various means by which comfort and well-being are promoted and physical disabilities,likely to cause more serious ill-health if neglected, removed.* In the second Inquiry the greatest amount of fatigue was observed at Factories No. 5. 3, 7, and 8. At Factory No. 5 (Yorkshire) the women were engaged in making 6-inch shells (which it is just possible for them to lift without tackle), and they were working 12-hour shifts in an unsatisfactory environment. Many were married women with heavy domestic responsibilities. Transit was reasonably good and the food taken satis- factory in quality and quantity. The women themselves were the pick of the available workers, independent, * In addition to the general supervision special arrangements have been made for the supervision of all filling factories and especially those where T.N.T. is handled. These are not dealt with in the present report. 149 sturdy and keen. The number of women classified as B was high (57 per cent.), and in many in this group the evidence of fatigue was decidedly greater than in the same group in other factories. The reports on individual women give the impression that if the conditions of work continue a considerable number will either drop out or pass into the C group. It is interesting to compare the proportion of B cases with those m other factories doing similar work. At Factory No. 2 (Midlands) 22 per cent, of cases were classified as B. Here eight-hour shifts are worked on 6-inch shells and the general conditions are reasonably good. At Factory No. 4 (London) (mainly 6-inch shells) the proportion of B cases was 27 per cent. Twelve-hour shifts are worked and the factory conditions and environment are good. At Factory No. 3 (Yorkshire), where the proportion of B cases is 40 per cent., 4-5-inch and 60-pounder shells are made and the factory conditions are satisfactory. The physique of the women is less robust than, for example, at Factory No. 4, and this may explain the greater amount of ill-health revealed. Factories No. 7 afid 8 (near Ijondon) fall into another category. Here the work is not heavy, but the hours are somewhat long and the physique of the workers poor. At Factory No. 7 the B cases were 44-5 per cent, of the total. The hours worked are 57J a week. The factory is crowded and ill-ventilated and heated. There is as yet no canteen and no properly equipped surgery and rest-room. At Factory No. 8 the B cases amounted to 45 • 5 per cent. The factory conditions are good on the whole. The hours are 52| a week. The workers, on the other hand, were markedly ill-nourished aijd of poor physique. In both these cases the workers are drawn from a small town and rural district where low wages have always been the rule, and the people are habituated to an inadequate dietary. Generally speaking, the workers were younger than those engaged in the heavier processes, and in the circumstances it is not surprising that even though occupied in light work many are unable to withstand the strain of continuous employment on 12-hour shifts. The results of the Inquiry indicate therefore that although the amount of existing fatigue probably con- siderably exceeds that discovered by the investigators, the women at work in the factories are as a whole bearing the 'fatigues of munition work surprisingly well. At the same time there are evident signs that where heavy work is combined with long hours and possible domestic duties the strain is beginning to produce a serious degree of weariness, ill-health and fatigue, which is likely not only to prevent the workers from continuing to give efficient service in the factories, but may cause more or less permanent physical incapacity. The longer the war continues the greater the evidence of staleness and fatigue is likely to become unless conditions of work can be further improved. It should not be forgotten that any physical unfitness which exists at the time of demobilisation will probably be considerably accentuated by the reaction which will then take place and the financial anxiety which wiU have to be faced-by many of the women now employed in munition factories. Physical Disabilities. The ailments most frequently observed included digestive disturbances (indigestion and constipation) headache, anaemia, muscular pains and various " nervous " symptoms. Disorders of menstruation also occurred with some frequency. Digestive Disturbances. — Common causes of indigestion among women are dietetic, e.g., insufficient, unsuit- able or improperly prepared food, the persistent use of certain unwholesome articles of diet, such as strong tea, unduly rich substances or food containing excess of carbohydrates. Alcohol may be a cause especially in older women, but this was not observed in the present examination. It had been expected that complaints of indigestion, &c., would be far more frequent than proved to be the case. Long hours and the alternation of night and day shifts lead to hurried meals, eating when tired, meals at unusual times and a consequent dis- turbance of regular habits of bodily function. Although many women stated that they were not hungry on night shift, and some did in fact take inadequate and unsuitable meals at night, while many others said that they had occasional attacks of pain after indigestible food, the abnormal arrangement of the work appeared to have resulted in much less indigestion or chronic dyspepsia and constipation than might have been supposed. Constipation was usually avoided by the regular taking of aperients, but few who complained of indigestion were receiving medical treament. BBstory pointing to severe gastritis or gastric ulcer was very seldom obtained. The improved nutrition resulting from better food is likely to diminish digestive disorders unless counterbalanced by increased fatigue. Defective teeth and oral sepsis were only too common. In some factories complete upper or lower dentures were frequently observed. The dentistry had apparently been fairly rough and ready, all upper or lower teeth having been extracted, regardless of the possibilities of conservative treatment, in order to make a complete job. The women were not alive to the advantages of stopping the teeth, but even if they had been, few facilities were available for such treatment and the provision of efficient dental treatment at moderate charges seems to be one of the most pressing needs for working women. Bad teeth were not often directly associated with complaints of indigestion, but many ill-defined symptoms of malaise were doubtless due to the efiects of absorption of toxins from unhealthy teeth, and these effects are likely to become more pronounced as the woman becomes older and the teeth decay stUl further. Headache was fairly common. It could often be attributed to one or more causes, such as fatigue in transit, noise in the factory, eye strain, general tiredness, and was often associated with anaemia, indigestion or carious teeth. " Neuralgia " was complained of by a number of workers evidently sufiering from nervous fatigue. Sleeplessness, especially among women on night shift, was frequently accompanied by headache. Anwmia is most common among ill-fed, overworked girls in industrial districts who have to work in badly ventilated and badly lighted rooms, under conditions which prevent proper exercise especially in the open air and sunshine. Associated menstrual disturbances are not uncommon. Indigestion and constipation are frequently observed. Breathlessness on exertion, palpitation or a tendency to fainting may be noted. The proportion of anaemia observed was unexpectedly small. A large number of the workers classed C showed signs of more or less severe anaemia frequently accompanied by haemic murmurs. A higher percentage was noted in one or two factories where it was mainly due to pre-war rather than post-war conditions, such as chronic mal- nutrition or work in artificial light. The improved diet and the usually healthy factory environment have no doubt acted as preventive of anaemia, and as far as can be judged on general grounds, munition workers compare favourably in this respect with young women workers in other trades and industries, (B 12023) K 3 150 Indigestion, constipation, ansemia and headache are so closely associated that it is often dif&cult to say which is primary and which secondary. They all depend in considerable degree upon environments and hahits of life, and they are remedied less by drugs or direct medical treatment than by improved hygiene and nutrition. Sunshine, fresh air, exercise, good food and sufficient sleep are the most potent factors in the restoratioin to health. Muscular pains, including aching or stifiness of the neck or limbs, are naturally common during the early weeks at the factory until the workers become habituated to unaccustomed muscular exercise. Among more experienced workers muscular pains may be complained of towards the end of a shift or attributed to a particular operation. They may indicate the commencement of fatigue in the worker or that the work is unduly heavy or otherwise unsuitable. Aching or swollen feet were not complained of to any considerable extent, except where the floor surface was unsatisfactory or damp. Most women, except a few who sufiered from varicose veins, soon became accus- tomed to standing, especially when allowed to sit down during prolonged operations. The pain was often stated to be relieved by the provision of wooden boards to stand on and the wearing of suitable thick shoes or clogs. Nervous symptoms, such as neuralgia, irritability, nervousness, sleeplessness, or an undue tendency to worry, were complained of by many women who were beginning to feel tired and worn. The symptoms were dependent on the general state of health rather than upon any organic defect. Disorders of menstruation may bo due to local organic causes, but they also depend to some extent on general derangement of health. Ansemia, for example, is often associated with amenorrhcea or dysmenorrhcea. The most serious departures from the normal are dysmenorrhcea and menorrhagia, which may be combined with metrorrhagia. Dysmenorrhcea may vary from quite bearable pain to total physical disablement. Its degree is difficult to estimate from the workers' statements, some being inclined to regard severe pain as a natural and necessary burden, others, probably much fewer in number, being somewhat apt to exaggerate the dis- comfort. The severity can to some extent be estimated from the numbers who regularly lose time on this account. For example, at Factory No. 8, 19 out of 34 who complained of symptoms lost one or more days work each month. At Factory No. 1, 7 out of 25 lost time each month. At Factory No. 1, 19 out of 31 lost time regularly, and at Factory No. 4, 12 out of 39. Many who suffered much pain, however, endeavoured to continue their work in spite of it. There was some evidence of increase in pain since undertaking munition work and this was most noticeable among women engaged in heavy work. . On the whole there is probably not a serious increase in dysmenorrhcea, though the total number of women afiected is considerable. Menorrhagia was complained of by a much smaller number of women. It seemed more directly due to conditions of work {e.g., constant standing, strain) though sometimes attributed to a miscarriage. The disorders of menstruation averaged 26 per cent, and, broadly speaking, they were most common in factories where the greatest amoimt of fatigue was observed. Both dysmenorrhcea and menorrhagia exercise a definitely harmful effect upon the general health whether through recurring pain, malaise and disablement, or through ansemia consequent upon undue haemorrhage. A disturbing element in the Inquiry is the almost negligible amount of medical treatment being obtained for such conditions. This is partly because the girls take the discomfort as a matter of course and use only domestic remedies, which unfortunately sometimes include alcohol, partly because they hesitate to consult a doctor about a matter of this kind, but also because expert medical advice is not always obtainable. It is suggested that steps might be taken by welfare supervisors, at any rate in some cases, to arrange for women who sufier in this way to consult a medical practitioner, preferably a woman, who would be prepared fully to investigate and treat the condition. Much unnecessary suffering and injury to health might thus be saved. Maternity and Child Welfaee. Although not strictly arising out of the findings of these Inquiries, some reference to maternity in its special relation to munition workers seems not inappropriate. The problems which arise in connection with maternity cases among munition workers are the same as those which affect the commimityas a whole, but from causes associated directly with the making of munitions they are apt at times to become acute and urgent in an unusual degree. The exceptionally large numbers of married women engaged in factory work, the over- crowded condition of many mimition areas, and the large influx of women into these areas naturally strain to the breaking point the always inadequate provision for maternity which exists locally. The impression gained from inquiries at numerous factories and among many of those responsible for the supervision and welfare of the workers is that the problem in an acute form is limited to a relatively small proportion of women workers, but that there is urgenb need for some immediate action in regard to the care of those expectant mothers, married and single, who are unable to make suitable arrangements themselves. The cases naturally fall into three groups — pre-natal, natal, and post-natal. (a) Pre-natal. — The married woman with a home of her own usually leaves the factory in the early months of pregnancy, or at least as soon as her condition becomes obvious. No special provision is required for her apart from the provision for women as a whole. A certain number of women, however, are obliged to work almost until their confinements are due as they have no other means of support. In filling factories it is usual, on account of the danger due to explosion or the handling of poisonous materials, to discharge a woman as soon as she is known to be pregnant. In engineering factories the practice varies. Where the work is heavy and it is not possible to transfer women to lighter processes they may be discharged as soon as their condition is recognised. Where lighter work is available and the general environment suitable they may be retained until, say, the 7th or 8th month. There is often employment for a few as checkers or cloakroom attendants, and welfare supervisors usually do all they can to find suitable work for at least the most necessitous cases and to arrange for them to work day shifts only. As regards unmarried women, public opinion in a factory is usually kindly, but at times it is averse to their remaining after they are known to be pregnant. The question of lodgings is another difficulty. Many landladies refuse to keep pregnant women, even when married, though they may be willing to do so if arrangements are made for the confinement to take place 151 elsewhere. In most cases there is necessarily a period of one, two or more months before leaving the factory and the birth of the child, during which time the woman may find herself with no home and little means of support. The fear of dismissal may thus lead the women to conceal their condition for as long as possible, and they are often successful in doing so for a considerable time." Such concealment may result in disaster to mother and child. The following example is typical : — A woman was engaged on heavy nmnition work (6-moh Bhells and working night and day shifts). Because of her need , for money to keep her home together she concealed her condition and remained at the factory until she was five months pregnant and could no longer stand because of the swoUen condition of her legs. When she finally had to give up work she miscarried. Her general health suffered considerably from the prolonged physical strain and she is now neither the mother of a healthy child nor a useful machine operator. (6) Natal.—Tho number of lying-in homes and hospitals is notoriously inadequate to the needs of the coimtry as a whole. In many munition areas the workhouse is the only institution to which women, unable to be in their own homes, can go for their confinements. This is naturally repugnant to most women. (c) Post-natal— The care of the mother's own health is now complicated by the need for suitable arrange- ments for her child. Where is she to live ? How is she to support herself until fit to resume factory work ? What is to become of the child while she is absent night or day ? The only statutory provision which relates to the employment of pregnant women or nursing mothers is Section 61 of the Factory and Workshop Act, 1891, which states that a woman must not be employed within four weeks of giving birth to a child. It is obvious that the mother's first duty is to her young infant and that in the interests of its health she should not return to the factory for a much longer period than four weeks. But she may have to choose between remaining with her baby without adequate means of support or returning to well-paid work as soon as possible, even though this entails virtual separation from the child. A breast-fed infant is more likely to thrive than one which is brought up by hand, but an ill-nourished mother is either unable to nurse her baby or continues to do so only at undue cost to herself. Until the State is prepared to recognise the claims of nursing mothers to assistance and financial aid the lesser of the two evils may be for the mother to go back to work as soon as she is physically fit to do so, provided that she can ensure the care of the baby during her absence. The practice in regard to the employment of mothers with young infants varies in different factories. In some, with a view to encouraging breast feeding, no woman is supposed to be employed who has a child under nine to twelve months. In others no general rule exists and cases are judged on their merits. In others, again, no attention is paid to the age of the child. It is, of course, impossible to investigate aU cases fully and a woman who is badly in need of employment has often little difficulty in evading inquiries. Children are thus commonly left with relatives or " minders " or sent to a day nursery when there is one. A Maternity Scheme for the assistance of munition workers might properly include the following : — (a) Skilled supervision of pregnant women is necessary, both factory and domiciliary, by a qualified and competent ofilcer, in order to ensure that suitable arrangements are made for the confinement at home or in lodgings (engagement of the midwife or doctor, ante-natal care, post-natal care, &c.), and for the care of the infant after birth. Such an oflB.cer would be able to bring the women into touch with local agencies for assis- tance. She would also encourage thrift and proper preparation for the confinement. This supervision might be arranged by the welfare stafi of the factory, though in large factories an extra officer with midwifery qualifications might be desirable for home visitation, &c. (b) The provision of light employment may be made available inside or outside the factory during the later months of pregnancy, say from the 4th or 5th to the 8th or 9th month and also after the birth of the child. In some factories this might be arranged as part of the general organisation ; in other factories all the work is too heavy or the general conditions too unsatisfactory to admit of pregnant women being employed at least after the early months. In such cases separate workrooms would be necessary, which might serve more than one factory, where lighter work, such as sewing and mending, might be undertaken (e.g., the sewing of exploder bags, the making of light boxes, the manufacture of overalls, &c.). Such small separate departments might also be used by other women temporarily ailing from one cause or another. (c) Favourable welfare conditions are essential for all pregnant women, including the abolition of night work and, where possible, reduction in the length of the day shift. Arrangements for an adequate supply of suitable food, including milk, through the canteen or otherwise, is also advisable. (d) Maternity Homes should be established for women who camiot be confined at home or in their lodgings. — These Institutions should also provide where necessary for pre-confinement residence and lying-in accom- modation. Maternity homes might be organised : — (i) As a branch of an existing lying-in hospital available for normal and abnormal cases ; or (ii) As an ad hoc maternity home of six or a dozen beds in charge of a competent midwife. In connection with these Homes, but not necessarily under the same roof, there should be accommodation for women before and, if necessary, after confinement. Arrangements should be available for married or unmarried women, and as far as possible the schemes should be self-supporting. Exchequer grants would be necessary for the establishment of such Homes and also to make good deficits in the cost of working and maintenance, but the greater part of the maintenance expenses should be met by payments from the women themselves. (e) Lastly, in many districts a creche or day nursery is necessary for the children, where they may be cared for during the absence of the mother. The number of available " minders " to whom children would ordinarily have been sent has steadily diminished, largely because these women have themselves sought regular employ- ment. Mothers working long shifts are physically imable to devote as much attention as they would wish to the care of their homes and children. There is thus a substantial case for an increased provision of nurseries which would take charge of children under school age by day, and if necessary, by night. Sympathetic administration is essential to the success of such a scheme, the aim and intention of which is to encourage the women to report their condition at an early stage and to afford them such advice and assis- tance as are needed, without exercising a burdensome or inquisitorial supervision. (b 12023) K 4 152 Conclusions. To sum up, the general results of these Inquiries indicate : — (1) That there is definite burden of fatigue, which though relatively small in amount as regards severe fatigue is considerable as regards that of a less severe character ; (2) That the fatigue and ill-health are less than might have been anticipated having regard to the hours of work and the nature of the employment, and that this is due, broadly speaking, to the greatly improved attention to the health and welfare of the workers ; (3) That fatigue and sickness are greatest where heavy work is combined with long hours at the factory and associated with onerous domestic duties after factory hours ; (4) That unless brought under control, the considerable amount of moderate weariness and ill-health now present is likely to reduce immediate efficiency and also exercise in many cases an injurious effect on subsequent health and on capacity for maternity ; (5) That although there has been substantial improvement in the conditions and circumstances of women's work in factories further action is necessary if the amount of fatigue is to be diminished rather than increased. In particular the findings of this Inquiry seem to indicate the necessity — (a) for further shortening of the hours of labour for women ; (6) for restricting women's work in the heavier branches of industry to those who are young, physically fit and capable and who have not arduous home duties to perform ; (c) for the continuation and development, wherever women are employed in factories, of hygienic conditions and especially " welfare " arrangements (including industrial canteens) ; and (fl!) for making appropriate provision for efiective medical supervision, both on entrance to the factory (in heavy and exceptional occupations) and subsequently, by means of the services of medical officers (women preferred) and nurses, and in the form of suitable accommodation as to rest rooms, first-aid appliances and well-equipped surgeries. JANET M. CAMPBELL, M.D. Fehntary, 1918. ^53 APPENDIX C. A Comparison of the Systems Employed foe Dividing up Working Hours into Spells and Breaks. By H. M. Vernon, M.D., Fellow of Magdalen College, Oxford, and University Lecturer in Chemical Physiology. The systems employed in various factories for dividing up the weekly hours of work into spells and breaks differ greatly, and it is a matter of considerable importance to select the system which yields the most advantageous results in respect of output, and of the comfort and convenience of the workers. Direct and exact evidence upon the merits of rival systems is very dif&cult to obtain, and so the informa- tion adduced below is necessarily incomplete. Nevertheless it is sufficient to indicate that the systems employed in the majority of factories are capable of considerable improvement, and to suggest the lines on which such improvements should be made. First, if a night shift is being run as well as a day shift, what ought to be the distribution of working hours as between the two shifts ? In my own experience the night shift hours are iisually longer than the day shift hours. For instance, in the four factories (A to D) referred to in another Memorandum*, the following hours were usually worked : — Factory. Day shift hours. Night shift hours. Excess of night shift hours over day shift hours. Factory A, from February to August, 1916 August, 1916, to March, 1917 March, 1917, to October, 1917 „ „ October, 1917, onwards Factory B, from October, 1916, to March, 1917 „ ,, April, 1917, onwards Factory C, from July, 1916, till May, 1917 (for men) „ „ May, 1917, onwards (for men and women) Factory D, from August, 1916, till March, 1917 (for men) ... „ „ April, 1917, onwards ... Factory E, before June, 1916 after June, 1916 Factory F 64.5 58.5 54.5 54.5 63 59 57 48 63 or 62 58 56.8 52.3 53 (or 64) 62.5 62.5 62.5 (or 52.5) 60 (or 50) 63 63 69.5 60 63 63 61.5 57 57.5 (or 67) —2.0 4.0 8.0 5.5 0.0 4.0 12.5 12.0 1.0 5.0 4.7 4.7 4.5 Grouped with these factories are two others, dz.. Factory E, which was chiefly devoted to the manu- facture of rifle ammumtion, and Factory F, where 3-inch shells and aeroplane engines were made. -These data show that the night shift was generally several hours longer than the day shift, and in one instance was 12 . 5 hours longer. This system of division is undoubtedly erroneous, as night shift work imposes a greater strain than day shift work, and so the hours ought to be shorter rather than longer. The cause of the difference in the total hours worked is frequently due to the fact that only a half day is worked on Saturday by the day shift, whilst six full nights are worked by the night shift. In corre- spondence with the Saturday afternoon relaxation, the night shift might be allowed some reduction of hours on Sunday evening, but the workers object to this plan as they lose the double time pay which is usually granted on Sunday evenings up till midnight. It would be better, therefore, to recog- nise the greater strain of night work by reducing the time worked each night to an hour less than that worked each day, and regard nine hours per night, or a 54-hr. night shift week, as the equivalent of 10 hrs. per day, or what is generally a 55 or 54-hr. day shift week. Similarly 8 hrs. per night would be equivalent to 9 hrs. per day. If the number of working hours per week be fixed at, e.g., 54, the question arises as to the best system of dividing them up throughout the week. Theory might suggest that they should be divided up nearly equally over the seven days, or that, for instance, 8 hrs. should be worked each day from Monday till Friday, and 7 hrs. on Saturday and Sunday. Though some such system was adopted in many factories in the early months of the war, it is now generally recognised that every worker is entitled to one day's rest per week, and that such a relaxation tends to the increase of the total output rather than to its diminution. f But ought the 54 hrs. to be divided up equally over the remaining six days, so as to give an evenly distributed 9 hr. day, or ought there to be only a half day's work on Saturday, with the resultant neces- sity of 10 hrs. work per day from Monday to Friday 1 An even 9 hr. day is undoubtedly the best for such workers as are prepared to put every ounce of their available energies into the production of munitions. Such patriotic workers exert themselves to their limit each day, the said limit being such that it does not prevent complete or nearly complete recovery of vigour as the result of the night's rest. If the limit is surpassed, so as to induce a state of fatigue which is no longer properly recovered from, output is diminished and the worker is no longer capable of exerting his maximum powers of production. Un- fortunately not many workers have the strength of mind to exert themselves in this manner month * Committee's Memorandum No. 21 t Cf. Memorandum No, 18, 154 after montli, and year after year. They crave for some relaxation from the monotonous grind of work, and this they can get best on Saturday afternoons.. Hence the Saturday afternoon work, which was enforced in many factories in the earlier years of the war, is now usually remitted, and the 54-hr. week is accomplished by working 10 hrs. per day from Monday to Friday, and 4 hrs. on Saturday. In a few factories six full days of work are put in, but the day of rest from work is on Saturday, not Sunday. By this, procedure the workers get plenty of opportunity to enjoy themselves, and, moreover, get a whole day of double time pay. The system, though not morally defensible, permits of freedom from work (until the evening) on alternate Sundays, supposing that the workers are employed on alternate weeks of day and night shift. Two-Break and One-Break Systems. Supposing that a 10-hour day be considered necessary, what is the best way of dividing up the hours into spells and breaks ? The method most frequently adopted is on the two-break system, though this is gradually being replaced by the one-break system in many industrial areas. In the two-break system the workers start at 6 a.m., or less frequently, at 6.30 or 7- a.m., and work for about two hours, when they have a breakfast interval of half-an-hour. There is an hour's dinner interval from 12.30 to 1.30, or from 1 to 2, or the working day is usually cut up into spells of 2, 4 and 4 hours. On the one-break system, the workers usually start at 7, and work two spells of 5 hours each, with an hour for dinner in between. Upon the disadvantages of the two-break system a large amount of valuable evidence has been collected by Professor Loveday.* His main conclusion may be quoted : " Work before breakfast gives inferior output, lowers health, and leads to great loss of time as the first short spell is so frequently missed. Experience shows that in certain descriptions of work the early quarter has been advantageously abolished both prior to and even during the course of the war, and under similar conditions it ought not to be instituted in new factories opened during the further course of the war." Though Professor Loveday adduces plenty of evidence in proof of his contention that work before breakfast increases lost time, he does not quote any direct observations to support his statement that it gives inferior output. Hence, it is worth while for me to record such information as I have been able to collect upon the subject. Output observations were made at Factories A to D by the method described in Memorandum No. 21. It consisted in determining the power consumption, either by the reading of watt-meteis, or from automatic power records, deducting the power required to drive the machinery apart from that required in the actual machining operations, and verifying the results by direct enumeration of the articles produced. A number of these output determinations are quoted for every hour of the day and night shifts, but for my immediate purpose it is necessary only to consider and compare the output during the first few hours of the corresponding day and night shifts. The night-shift workers have invariably had a good meal before they come on to work, or start work in full vigour. How does their output compare with that of the day shift, who are presumed to have had an adequate breakfast before work when employed on the one-break system, but to have had little or no breakfast when employed on the two-break system ? In Fig. 1 we see the output curves for the first 3J hours of the day and night shift at Factory A, where the day shift worked a 5-hour spell from 7 to 12. This output relates to seven sections of lathe workers (some 1,000 to 1,800 individuals), who were for the most part engaged in machining fuse parts. The output was determined for three consecutive days and for three con- secutive nights in January and July, 1917, and the mean relative hourly output taken as 100 in each case. We see that the output variations of the day and night shift workers corresponded closely both in winter and summer, and increased from about 55 per cent, of the average during the first half -hour of work to 100 per cent, of the average in the next hour, and 110 per cent, of the average in the next hour but one. If anything, the day shift worked up their output more rapidly than the night shift. IZO 110 too 1- 90 o i 80 ^-. •< -J. 70 60 50 DAY SHIFT 1 J 1 J 1 NJCHTSHJFT \ J-ANUARY i /9/7 DAy SHIFT NIGHT SHIFT JULY 1917 ' 1 X 3 O ' 2 3 TIME IN HOURS FROM START OF WORK Fig. 1.— Output at Factory Working on One-Break System. * Cf. " Interim Report," pp. 41 to 67, 1917. 155 Very different is the comparison of day and night-shift output shown by workers on the two-break system. At Factory B, where 6-inch shells were made, the day shift started at 6 a.m., and had break- 110 — 1 , , 1 NIQHT SHIFT 1 ■■ 1 1 1 ■> 1 ! - NICHT SHIFT 1 r— ■> 1 100 4— ■ ^ *-- a j 0. 1 ij 90 - 1 j o ! _ 1 DAY SHIFT !y 1 ^SO . 1 DAY SHIFT „.J ] <:. J ~j UJ -*• /O ' AUCUST — ' AUGUST 1916 I9iy 60 - - <-o 1 • 1 1 1 . .1 ._. .1. J.. 0/230/ 23 TIME IN HOURS FROM START OF WORK Fig. 2. — Output at Factory Working on Two-Break SyBtem. fast from 9 to 9.30 a.m., whijst the night shift started at 6 p.m., and in corresponding fashion had their first break at 9 p.m. Power records for the whole factory were obtained for five consecutive days and 110 •J' 70 60 NIGHT SHIFT NISHT SHIFT I DAY SHIFT AUGUST 1917 DAY SHIFT JANUARY I9ia 1 2 I Z TIME IN HOURS FROM START OF WORK Fig. 3.— Output at Factory Working on Modified Two-Break System. nights in August, 1916, and for three consecutive davs and nights in August, 1917. From Kg 2 it will be seen that in 1916 the day-shift output during the first half -hour was only 58 per cent of the average, whilst that of the night shift was 76 per cent, of the average. Even in the next three-quarters of an hour period it was only 75 per cent, of the average in the day shift whilst it was 97 per cent, of the average in the night shift, and, in fact, the day-shift output lagged behind the night-shift output so much throughout the spell that the mean hourly output during the spell was only 80 per cent, of the average for the whole day, whilst that of the night shift during the corresponding spell was 97 . 5 per cent, of the average for the whole night. In August, 1917, the difference was not so great, the mean hourly output during the first spell of the day and night shifts being respec- tively 95 per cent, and 102 per cent, of the average. ° ^ In factory C, where 9.2-inch projectiles were exclusively manufactured, the day shift started work at 6 a.m. until May, 1917, when their weekly hours of labour were reduced from 57 to 48 and thev started work at 7.15 a.m. They had a breakfast interval from 9 to 9.30, or 9.30 till 10 and so under the two-break system, but owing to their late start it is probable that most of the workers got more breakfast before coming to the factory than the workers at factory B. Power records for th whole factory (from four automatic recorders) were obtained for 48 consecutive hours in August 1917 and January, 1918, and the relative output during the first If hours of the day shift and first 2' hour' of the night shift, is shown in Fig. 3. It will be seen that in August, 1917, the day-shift output was considerably behind that of the night shift, but in January, 1918, there was very little difference between them. This may be due to the workers having by that time acquired the one-break-svstem habit f taking a good breakfast before work, whereas in August, 1917, they still retained the custom thev followed when they started work at 6 a.m. However, the power records did not extend over sufficientlv long an interval to warrant a definite conclusion. ^ It should be stated that the conditions of supply of material to the day and night shifts was lust the same in all three factories. There was never a shortage at any time in factories A and C and though there was at times a shortage in factory B, it came towards the end of the day and night ie the shift always started with plenty of material. Hence the smaller initial output shown by thedav shift in factories B and C is a genuine phenomenon, dependent on smaller capacity for work 156 Proof thai Five-hour Spells of Work are too long. If it be admitted that the two-break system, with work before breakfast, is a mistake, must the 10-hour day be worked on the one-break system of two five-hour spells ? As the result of conversations with workers, and of my own experience, I am convinced that five hours of continuous work are too long for a man, and considerably too long for a woman. With the possible exception of passive work such as the watching of automatic machines, no type of labour ought to, be run continuously for more than four hours if it can be avoided, or it is important to split up the 10-hour day by at least two breaks, only the first break must not occur so early in the morning that it can function as a breakfast interval. Methods of overcoming this difficulty are suggested later on, but I wish first of all to adduce a numerical proof that the five-hour spell is too long. It is an indirect proof which has been briefly referred to previously,* but it is none the less convincing. It was obtained at factory A, where the day shift worked for two five-hour spells, viz., froni 7 to 12, and 1 to 6, whilst the night shift worked for three spells, viz., from 6.30 to 10.30, 11.30 to 3, and 3.30 to 6.30, or for intervals of 4, 3J, and 3 hours respectively, separated by breaks lasting 1 hour and half an hour. That is to say, they put in 10| hours of labour instead of 10 hours, but they worked their longest spell of four hours when they were fresh and vigorous, and worked for shorter and shorter spells as they became more fatigued. Hence a com- parison of the output of the day and night shifts, if made under valid conditions, will demonstrate the relative.efficiency of the two systems of breaks. In the " Interim Report " (pages 26 to 40) are quoted very large numbers of data, collected by Capt. Greenwood, Mr. P. S. Florence and myself, to show the relative output of day-shift and night- shift workers. Eight sets of data concerning women were obtained at different factories where the shifts changed over every week, and these data, which relate to the manufacture of cartridges, fuse parts and 9.2-inch projectiles, show that, on an average, the hourly output of the night shift was 3 per cent, less than that of the day shift, whilst in no individual factory was it more than 1 . 3 per cent, greater than that of the day shift. Data relating to men were obtained at three factories, and they showed a night-shift output which averaged 2 per cent, more than that of the day shift. If the women's and men's data be grouped together, the average night-shift output for the whole of the workers comes to 1 per cent, less than that of the day-shift workers. Factory A forms a striking exception to this general average, for the hourly output of its night shift was most distinctly greater than that of its day shift, in spite of the longer hours worked. By no means all of the workers went on to night shift, but such as did do so worked for alternate fortnights of day and night shift, and in order to compare output, it is convenient to group these workers in four-weekly periods, during a fortnight of which they were on day shift, and a fortnight on night shift. The women turning aluminium fuse bodies generally remained on continuous day shift, but a group of 21 workers were put on the day and night shift system for two months in February and March, 1916, and a group of 26 workers were put on it for three months in April-July, 1916. In March, 1917, most of the women were put on this system, and a block of 70 workers was obtained for a three month period. In Table I is shown the relative hourly output of each of these groups during the first and second weeks of the day shift fortnight, and the first and second weeks of the night shift fortnight. The general mean Table I. — 21 to 70 "Women Turning Aluminium Fuse Bodies. - Number of workers Relative hourly output. Weekly hours of actual work. Pour-week period extending from Day shift. Night shift. Day shift. Night shift. 1st week. 2nd week. 1st week. 2nd 1st week. 2nd week. 1st week. 2nd week. Jan. 31 to Feb. 27, 1916 Feb. 28 to March 26 Aprill7 to May 14, 1916 May 15 to June 11 June 12 to July 9 Feb. 25toMaroli24, 1917 ... March 25 to April 21 April 22 to May 19 21 26 70 101 111 124 133 135 170 163 167 Ill 117 117 133 142 172 172 170 Ill 130 134 145 157 181 186 184 118 126 121 136 140 193 185 183 56.6 62.2 56.6 61.1 55.9 53.4 40.1 49.2 59.4 57.1 49.8 61.9 55.4 52.1 49.0 49.2 56.6 56.8 49.8 60.2 54.7 57.4 40.9 55.6 53.3 55.0 42.7 53.7 59.8 54.9 50.0 57.4 Mean 138 142 154 160 54.4 V . _ 54.2 J 54.0 V, 53.4 >r 140 1£ 2 -y 54.3 53.7 " Interim Report," p. 29, 157 shows that during the nigtt shift fortnight the hourly output was 9 per cent, greater than during the day- shift fortnight, the mean excess of output for the separate blocks of women amoimting to 10, 6 and 10 per cent, respectively. Taking each fortnight of the general mean separately, we find that the output was 3 per cent, less in the second week of the night shift fortnight than in the first week, whilst it was 3 per cent. grecUer in the second week of the day shift fortnight than in the first week. Undoubtedly, therefore, night shift work exerted a depressant effect upon output (this is well shown in the " Interim Report " when permanent night shifts were found to have 5 per cent, to 10 per cent, less output than permanent day shifts), but the effect did not show itself for the first few nights, and it continued to exert its influence for the first few days of the subsequent day shift fortnight. In order to eliminate this depressant effect of night shift work, and obtain a more genuine comparison of output under the two systems of work speUs, it is better to compare the output of only the first week of the night shift and the day shift fortnights, and we then find that the output under the three spell system was 12 per cent, greater than that under the two spell system. The rapid increase of output observed during the three statistical periods examined — for it averaged 116, 135 and 177 respectively — was dependent on the reduction in the hours of labour. These averaged 57.1, 55.1 and 50.8 hours per week in the respective periods.* In Table II is shown the output of a group of 90 men engaged over a seven month period (March 11th to September 22nd, 1917) in the very active and somewhat heavy labour of sizing aluminium fuse bodies. In spite of the average hours of work daring the night shift fortnight being 5'8 more per week than during the day shift fortnight, the hourly output was 3 per cent, greater. Taking each fortnight by itself, we find that the output during the second week of the night shift was 2 per cent, less than in the first week, whilst that in the second week of the day shift was 4 per cent, more than in the first week, or the same sort of relationship held as in the fuse-turning women. The output during the first week of the night shift fortnight was 5 per cent, greater than that observed during the first week of the day shift fortnight, or this is the genuine improvement dependent on the substitution of three spells for two. Both the fuse-turning women and the sizing men were actively employed throughout working hours, so a suitable system of work spells was much more important to them than to workers who stood passively watching automatic machines for most of the time. Two classes of such workers were examined, and in accordance with expectation, it was found that their night shift output corresponded more closely with their day shift output than in the active workers. The first class consisted of women who were milling a screw thread on the fuse bodies, and in this operation they stood passively watching their machines for four-fifths of the total time taken. The output of 26 women over a three month period , and of 42 women Table II. — 90 Men Sizing Fuse Bodies. Relative hourly output. Weekly hours of actual work. Four-week period extending from Day shift. Night shift. Day shift. Night shift. 1st week. 2nd week. 1st 2nd week. week. 1st week. 2nd week. 1st week. 2nd week. March 11 to April 7 April 8 to May 5 May 6 to June 2 June 3 to June 30 July 1 to July 28 July 29 to August 25 August 26 to Sept. 22 138 130 142 135 135 141 144 137 138 143 139 137 158 148 150 136 145 143 148 143 152 135 141 140 144 142 148 149 50.9 31.2 37.5 42.5 38.4 44.5 48.2 48.1 46.4 36.6 47.3 51.3 52.7 47.9 61.1 41.2 51.6 49.6 36.7 46.3 57.9 55.0 50.2 38.0 48.7 50.7 61.1 56.8 Mean 138 143 145 143 J 41.9 47.2 49.2 51.5 140 144 V 44.5 50.3 over a two-month period was obtained, and average values for these periods are quoted in Table III. Taking the results as a whole, the night shift output came to 1 per cent, less than the day shift output. The other class of worker* consisted of youths of 16 to 18 who were boring top caps, an operation in which Cf. Memorandum 18. 158 Table III.— 26 or 42 Women Milling a Screw Thread. Number of workers. Relative hourly output. Weekly hours of actual work. Period extending from Day shift. Night shift. Day shift. Night shift. Ist week. 2nd week. 1st week. 2nd week. 1st week. 2nd week. 1st week. 2nd week. Nov. 19 to Feb. 10 March 25 to May 19 26 42 133 135 132 135 i31 J33 13S 133 43.7 39.9 45.6 46.5 46.2 46.0 45.1 49.4 Mean 134 133 132 134 41.8 46.0 J 46.1 47.2 134 133 43.9 46.6 A they stood passively watching their machines for seven-eighths of the total time taken. A group of 15 workers was examined for a six-month period, and another group of 24- workers for a five-month period. As can be seen from Table IV, the night shift output was 1 per cent, less than the day shift output, just as in the mill thread women. Table IV. — 15 or 24 Youths Boring Top Caps. Number of workers. Relative hourly output. Weekly hours of actual work. Day shift. Night shift. Day shift. Night shift. Period extending from 1st week. 2nd week. 1st week. 2nd week. 1st week. 2nd week. 1st week. 2nd week. July 3 to Deo. 16 Dec. 31 to May 19 15 24 129 128 126 127 129 133 126 119 64.1 54.4 55.1 53.4 57.9 56.7 68.5 56.5 Mean 128 1 127 1 131 I. 123 64.3 V 54.2 J 57.3 57.6 128 127 54.2 ■t 57.4 The conclusion to be derived from the whole of the observations may be summarised by saying that when men and women are engaged in active work, their output is 5 to 12 per cent, greater if working hours are divided up into three spells of suitable duration {e.g., 4, 3 J and 3 hours) than if they are divided up into two five-hour spells. How Can Five-hour Spells be Avoided ? The five-hour spells can be avoided in two ways. The first way is to split up the day shift hours in the same way as the night shift ho\irs at factory A, viz., by a long first spell of work followed by two shorter spells. As workers are not usually accustomed to having their dinner before midday, the simplest arrangement of spells would be :— 8 to 12 4 hours. lto4 3 hours. 4.30 to 7.30 3 hours. This system has the disadvantage that work ends too late to give the workers a chance of doing their shopping, so the following system might be adopted : — 7.30 to 11.30 12.30 to 3.45 4 to 6.45 4 hours. 3i hours. 2f hours. On this system only J hour is allowed for tea, and this is too short an interval to enable the workers to leave the workshops and go to the canteen, so it would be necessary to supply them with refreshment by means of travelling canteens. This plan is now adopted with success in many factories, and is often nm by volimteer helpers. The second and probably the better method of dividing up working hours is that adopted at a large cartridge factory (Factory E), where each of the two five-hour spells was cut in half by means of J hour 159 breaks. During these breaks tbe machinery was stopped, and the workers were supplied with tea and food by travelling canteens. The hours of work were the following : — 7.30 to 10 10.15 to 12.30 1.30 to 4.15 4.30 to 6.30 2^ hours. 2^ hours. 2f hours. 2 hours. These hours include no spell of longer than 2| hours duration, whereas they had previously been :— 7 to 8.30 9 to 1 2 to 4.15 4.30 to 6 or 7. 1| hours. 4 hours. 2J hours. IJ or 2J hours. i.e., they were on the two-break system, or they had a breakfast interval which was followed by a four- hour spell. The night sliift hours during the two periods were the same as the day shift hours with p.m. substituted for a.m., and vice versa, except that on Sunday night the full hours were worked whereas no work was done on Saturday afternoon. Hence the total weekly hours of work during the two periods were'generally Ql\ and 57 hours respectively for night shift, and 56| and 52i hours respectively for day shift. The output of five groups of experienced workers in the factory was investigated for 38 consecutive weeks, during 23 of which (January 2nd to June 10th) they were under the two-break system, and during 15, under the one-break system. As the workers changed over from day shift to night shift in alternate weeks, they were grouped in fortnightly periods, and the output of the whole group was calculated for a week of day shift and a week of night shift. The groups relate to four cartridge case operations, viz. 29 women on the " second draw," 39 on " head trimming," 26 on the " second cut off," and 20 girls on " mouth reamering," and one bullet operation, viz., 36 women engaged in cutting off bullet sheaths. The average hourly output for both day and night shift on each operation during the two break period was taken as 100, and we see from Table V that the average output of all the workers on day and night shift improved very slowly during the two-break period, being approximately 99, 100 and 101 during the three consecu'-ive 7 or 8 week intervals into which the total period was arbitrarily divided. When the one- break system was adopted, however, the average output jumped to 105 during the seven week period immediately following, and to 108 in the subsequent eight-week period. Assuming that if the system of hours had not been changed the gradual rise of output previously observed would have continued at the same steady rate, we may say that the change from the two-break to the one-break system improved the hourly output by 5 per cent. The average hours of actual work are given on the right side of the Table, and they amounted to 51 .7 hours per week for the day shift, and 56.0 hours for the night shift during the two-break period, and to 50.3 and 54.5 hours for the respective shifts during the one break period, i.e., they averaged 1.4 hours per week less. The total output of the workers may be reckoned thus : — For the two-break system . . . . 103 X 53 . 8 = 5541. For the one-break system .. .. 108x52.4 = 5659 or the total output would have been 2 per cent, greater under the one break system than under th"? two- break system. Hence the introduction of the J-hour break during the middle of the morning of the first five-hour spell, though it was still reckoned as work time and paid accordingly, more than justified itself. The total lost time of the workers could not be determined from the data available as there was uncertainty about absent workers, but the average " broken time " is given in the last two columns of the table. This " broken time " included only the time lost when the workers put in at least 45 hours a week out of a nominal 57 hours or more, or 40 hours out of a nominal 52 hours, and so on. It averaged 160 o 0) ooocO"<*co-^t>^r— (t^oqcOfHCoooCiOteqid 00«Di-ii-l>Ot-05t--*05a5»OTH05'*TlOlM OTC0»00i05OfflC0lNt»00Of-lr-H IS IS ^ f5^ o 3 o o o o o o 00 o eq 1-1 t O O c 1 « to OS >o > O Ca OS C3 O TO lO O CO IN "!|l03>n05!OQ0t-(NX:)O OOOOOOOOOOOi-iOi-i o H p o K H o g o 6 m bO ^ O C5 pits o o e<5iMtDo>Ttioocooo>o<»05i-ii>>o«iTtiiNOTtH«o ooodOio^oioacacdOdO^ooo^oadooooooo OOK300000S050-*50— lO IN o o CO o o , (N ^ CO O I o o CO o :2 ,2 1=: ,2 i§ 5 -a >:! o ^ o 03 O o o (N.t-.©©Oi©03© Ui00e0CD00t^CNCDT^lOW5O5e^Tl4 OS©05©05000©©00©'H 111 o M 02 1-1 © W5 -I I -I I p o o -J=^ 60 a © I 05 © © © o -a cl § a !H ° o o o ^ in to rt 60 .9.9 05 a IN § "* .J « § I o § g 0 1N OS ° IN en CO "* ^ rH IN - IB 00i-ieO'-ii-iiN.ijja.jaja" li . . . . o o o c3 ra ^ JS ^ tS d IB OJ 0) 03 iS ,« jg ^ & H CO CO «3?3§^^pg5|j °10(N05 0„-,,^ ° oo-jtj5jOOrH^^Ou^{j55Qg OiBOOnnoooiol-!'-Heq3S O'^'^s; ° °iffl5 >i >-> >:>^ M a Sb aol' cLcuce es.eefli g 3' 3 3ppp e3 p 3 3 3 5i id © 57 161 5.3 per cent, and 4 . 6 per cent, for day sMf t and night shift during the two-break period, and 6 .0 per cent. and 4 . 7 per cent, for the respective shifts during the one-break period , or was practically the same. The " actual hours of work " quoted in the table relate only to workers who put in more than 45 hours per week of work out of 57 hours, or 40 hours out of 52 hours, and they are in consequence about three hours per week longer than if all lost time had been taken account of. The Need for Rest Pauses. Repeated observation showed that the nominal J-hr. breaks just mentioned meant an average stop- page from work of 20 to 25 minutes, and yet we saw that this considerable loss of working time more than justified itself. The reason is that no worker will, or can, work continuously for several hours without taking occasional rests. Especially is this so in all kinds of work requiring continuous activity and attention, as was proved by direct observations upon various groups of workers. In observations made upon four men engaged in hand-tapping fuse sockets, an operation requiring continuous and very considerable muscular activity, it was found that on an average the men took 7 to 9 minutes of voluntary rest pauses in all except the first full hour of work, and as they had all of them been engaged for many- months on the operation and were paid at piece rates, there can be no doubt that they found by experi- ence that such pauses improved their total output. It was curious to note, however, that they worked on no sort of system, but often took rests in a most irregular manner. In Fig. 4 are shown the actual times when rests were taken, no pause of 2 minutes or less being registered. We see that the best workman, whose output was 34 per cent, more than that of the worst workman, took frequent rests at fairly regular intervals in the morning of both days he was under observation, but was not so regular in the afternoon. OUTPUT IZ4 OUTPUT 120 OUTPUT I OB OUTPUT 100 12 I TIME OF DAY Fig. 4. — Rest Pauses of Men Hand-Tapping Fuse Sockets. The next best workman, however, though he took regular rests in the morning of one day, worked con- tinuously for four hours in the afternoon, whilst workman C on one day worked continuously for 2f hours in the morning and 3f hours in the afternoon. Workman D took an unnecessary number of rests on both days, and accordingly had a low output. Hence these few data indicate that a greater regulation of rest pauses would have conduced to a better output, and that the best system of all would have been to take about 7 minutes ofE regularly in each hour. In the less severe operation of sizing fuse bodies observations were made upon 16 men, i.e., four on each day of four days,* and the data recorded in Table VI. show that they took on an average about Table VI. — Average Duration of Eest Pauses, calculated per hour. Men hand- tapping fuse sockets."!" Men sizing fuse bodies. Women turning fuse bodies. Time. Avoidable pauses. Unavoidable pauses. Total pauses. 7 to 7.30 7.30 to 8.30 8.30 to 9.30 9.30 to 10.30 10.30 to 11.30 11.30 to 12.0 1 to 1.30 1.30 to 2.30 2.30 to 3.30 3.30 to 4.30 4.30 to 5.30 6.30 to 6.0 25-7 2-6 9-4] 9-4 l8-6min. 7-lJ 11-3 13-2 2-4 7-4^ 8-2 W-8min. 7-8j 20-3 26-8 12-0] 10-5 1 6-2 r8-7min. 6-oJ 9-9 15-9 4-91 9-0 1 11-4 r8-2min. 7-4j 34-6 30-6 3-9 4-4 0-4 3-5 3-6 20-4 2-0 4-5 4-8 2-2 20-2 4-0 12-0 12-6 9-2 2-4 2-7 4-9 6-3 4-9 2-9 4-7 2-6 34-6 15-9 17-0 5.9|7'8min. 6-3 25-3 . 8-31 9-4 1 rj,,j r8-lmin. 6-9. 22-8 * These observations, and those on women turning fuse bodies, were made by Mr. W. Neilson Jones, ■f The houis of work in this operation were half-an-hour later than those recorded. (12023) 162 8 minutes of rest per hour, though the rest pauses were not so evenly distributed over the hours as those of the hand-tappers. The very long rest pauses taken in the initial and final hours of the morning and afternoon spells were due to the men beginning work some considerable time after nominal starting time, and knocking off before the nominal stopping time. In lathe operations the lathes generally need a good deal of attention at the hands of the tool setters, or the workers take " unavoidable " rest pauses : but such rests fulfil their object as well as " avoid- able " pauses, and so the observations upon women turning aluminium fuze bodies (made for five days on 27 women in all) showed that the average avoidable plus unavoidable rest pauses in the last two full hours of work in the morning spell, and the fourfuU hours of work in the afternoon spell, averaged a fairly steady eight minutes per hour, or the same time as was observed in the men engaged in sizing and hand-tapping. As can be seen from the data in Table VI., this eight minutes might be made up almost entirely of unavoidable pauses (e.g., between 9.30 and 10,30), or chiefly of avoidable pauses (e.g., between 3.30 and 4.30). In operations involving the passive watching of machinery for most of the working hours the avoid- able rest pauses are naturally reduced very greatly. For instance, five women engaged in boring 9.2- inch shells were found, in the 3| hour spell for which they were watched, to lose only 3.7 minutes per Table VII.— 5 Women Boring 9-2-inch Projectiles. Time intervals. Active work, reckoned per hour. Passive work, reckoned per hour. Eest pauses, avoidable and unavoidable. 10 to 10.15 10.15 to 11.15 11.15 to 12.15 12.15 to 1.15 1.15 to 1.30 ,. 23-2 min. 14-8 20-6 190 19-2 19-2 min. 45-2 38-2 34-2 39-2 17' 6 min. 0-0 1-2 6-8 1-6 Weighted mean 18-6 37-8 • 3-7 hour in rest pauses (avoidable plus unavoidable), the reason being that they were doing active work on the machines for only 19 minutes per hour, and were passively watching them, either in a sitting or standing position, for 38 minutes per hour. The principle of rest pauses being admitted, it is evidently better to control these pauses to some extent for the workers, rather than to leave them to their uncontrolled and haphazard initiative. For this reason the J-hour break in the middle of the 5-hour morning and afternoon spells is valuable, as the workers are thereby precluded from working very long continuous spells such as the hand-tapping men did sometimes. The probability is that they would get into the habit of spontaneously taking a further short rest pause in the middle of each 2|-hour spell, or would thereby secure a pause in every IJ hours of the working day. If a shorter working day than the 10-hour day be adopted, somewhat similar plans of dividing up the hours could be employed. If a 9-hour day be worked, the hours might be divided up into a 3|-hour spell from 8 to 11.30, a 3-hour spell from 12.30 to 3.30, and a 2|-hour spell from 3.45 to 6.15 ; or what would probably be better, two 4|-hour spells might be worked, but with J hour breaks in the middle of each. If an 8-hour day be decided on, the simplest plan would be to work two 4-hour spells, and this might likewise prove the best for many types of labour, but for very vigorous and active work it might still be best to split up the eight hours by two breaks into spells of, e.g., 3, 2f and 2^ hours, or by i hour breaks in the middle of each 4-hour spell. Summary. The total weekly hours of night shifts ought to be shorter than those of day shifts instead of longer, as is the usual custom. If 10 hours be worked each day (or a 54 to 55-hour week) only nine hours should be worked each night. Day shift workers on the one break system were found to work up to their maximum output each morning rather more quickly than the night shift worked up to their maximum : but day shift workers on the two break system, in which work was begim at 6 a.m., and was followed by a breakfast interval at 9 a.m., had 7 per cent, to 18 per cent, less output in these three pre-breakfast hours that the night shift workers had in their first three working hours. This was presumably due to the night shift having had a good meal before starting work. Five-hour spells of work are too long, for it appeared that by cutting up the 10-hour day into three spells of, e.g., 4, 3 and 3 hours, separated by two breaks (the first of which is too late to function as a breakfast break) the output might be increased 5 per cent, to 12 per cent, above that experienced when two five-hour spells were worked. What is probably a better system still of avoiding five-hour spells is to stop work for J hour in the middle of each spell, and provide the workers with refreshment by means of travelling canteens. The introduction of one such extra J-hour break in a cartridge factory, together with the abolition of the breakfast interval, increased the hourly output 5 per cent. Eest pauses are essential in active work, for both men and women engaged on it were found to stop work spontaneously for about eight minutes per hour, on an average. H. M. VERNON. M.D. 163 APPENDIX D. Summary or Captain Greenwood's Memorandum on " Lost Workers." At the request of the Committee, Captain Greenwood undertook to collect information* in regard to the admission, discharge or disappearance of women workers in munition factories, and as to the principal causes. In the course of his inquiries he made investigations in 16 factories, or sections of factories, emplojdng, together, 40,000 wofnen workers. Although the majority o£ operations carried out in munition factories do not require a high degree of manipulative dexterity, hardly any are such that practice does not lead to increased precision of work and therefore of rapidity of output. Thus in the manufacture of cartridge cases— perhaps the simplest type of operation — it is generally agreed that a woman worker cannot obtain her maximum degree of efficiency until she has been engaged some weeks on her task. It follows that a factory at which the operators are constantly leaving and being replaced cannot attain the same level of output as one in which the working population is stationary. The problems at issue differ in certain respects in war time and peace time. Under war conditions there has been a constant and urgent demand for labour. As a result, discontinuity and intermitteucy due to seasonal or other causes are practically'non-existent. On the other hand, this urgent demand for labour has probably tended to encourage workers who were for any reason discontented with their present surroundings promptly to seek other forms of employment. They have not been deterred by the fear that when a job ia lost no other may be found. Further, the demand of the MiUtary Authorities for recruits and the schemes of dilution have not only directly affected the wastage amongst men but indirectly the wastage amongst women. No similar inquiries have hitherto been attempted in this country. In America the results of certain recent investigations by Mr. Joseph H. Wilhts carried out in Philadelphia have been published under the title " Steadying Employment" in the annals of the American Academy of Political and Social Science for May, 1916. One example may be quoted : — A particular shop in a Carpet Mill was selected for intensive study. The dates of engagement and discharge of the employees were tabulated for the period 1907-15. As a result it appeared that 48 per -cent, of the men and 38 per cent, of the women remained in the service of the firm less than 10 weeks. A wider and less detailed study was made by Mr. Alexander, of the General Electric Company, of a large number of factories of all sizes in the United States and Europe. From the figures collected it appeared that on 1st January, 1912, 38,668 persons were employed in the factories and on 31st December 46,796, or an increase of 8,128. The records also showed that during the period 44,365 persons had been engaged, so that 36,237 had dropped out of employ- ment during the year ; that is to say, five and a half times as many people had to be engaged as constituted the increase in the number employed at the end of the period. From a large munition factory Captain Greenwood collected the following figures : — Month. Number Employed. Number Started. Number left for various reasons. Number bit without reason . Number employed at end of month. June 4,340 622 138 253 4,571 July 4,571 695 48 87 5,131 JSiagust 5,131 4C4 67 220 5,308 September , 5,308 578 . 174 45 5,667 October 5,667 1,054 236 248 6,237 It will be seen that during the four months from the end of October 2,791 women were engaged and 1,125 left the number of engagements was thus 167-5 per cent, of the net increase in four months. Further, during these four months together with the previous month the firm lost 1 ,51 6 women workers. In only 663 of these cases or 43 • 7 per cent. — -was the cause of leaving known to the firm : the balance had simply vanished. The facts are next given in regard to the Cordite Department of a large Munition Factory. From these it appears that during the 12 months ending 28th August, 1916, an increase of 624 workers resulted from 1,031 new engagements amongst men ; while an increase of 914 was obtained from 1,527 new engagements amongst women — percentages of 165 and 167 respectively, figures which compare favourably with those previously quoted. More detailed investigation was found to be practicable at a factory at present organised in two main departments — one producing oases and bullets, the other carrying out cartridge and grenade filling operations. The two sections are denoted by the figures L 1 and L 2 respectively. Records have been kept by the firm of the name, age, previous occupation, character and reason for leaving, which permitted of data being collected for the periods January 1st 1911 — 4th August, 1914, and for the neriod 4th August, 1914, to 1st December, 1916. ' Causes of leaving were classified by Dr. Greenwood into three categories : — (i) Those who left on account of ill-health ; (ii) Those who left for some sufficient reason other than that of health, including : — (o) Girls who left to be married ; (6) Girls moving from the district ; (c) Girls required at home on account of illness there or, in the case of married women, to keep house ; (d) Girls who found the wage earned insufficient ; (e) Girls discharged from the firm not for misconduct but because they were unsuitable, or because the factory was slack ; (/) Girls considered by the Factory Surgeon to be physically unfit though not complaining of iUnesa. (iii) Those who left for no reason or for an insufficient' one, including : — (o) Girls discharged for misconduct. (6) Girls leaving for other employment without a signed reason ; (c) Girls wanting a change, or dissatisfied, or stating the work to be unsuitable. The great majority in this category gave no reason at all. * Captain Greenwood's Memorandum on " The Causes of Wastage of Labour in Munition Factories employing Women " is being published, as a Special Report, by the Medical Research Committee. i" J 6 (b 12023) JL, 2 164 Analysis shows that of 1,000 girls entering the factory during the war period 132 did not outstay the second month. Even if there had been no loss from sickness or other reasonable cause, 1,000 would still have been reduced by 10 per cent, for no sufficient reason. Moreover, these figures are an imder-estimate, since the records take no account of the large number of girls who have worked in the factory only for a few minutes or days. Further, the workers were not generally removed from the register until after they had left for some time. Even disregarding these considerations the figures show that at a factory of high standing; thoroughly familiar with the industry, which they have not entered upon for the first time since the war, the absolute loss of workers occurring was serious. Workers leaving with less than two months' service can on the average have made but a very small contribution to the output of mimitions ; while on the debit side of the account is the trouble to which they have put the Officials of Labour Bureaux and the Administrative StafE of the factory, as well as in some cases the demands made upon the transport faciUties of the country. A comparison of the figures shows that the war time experience is somewhat more favourable than that of peace time, but this advantage is decidedly less when only losses without reasonable cause are considered. The loss of effectives amounting to at least 10 per cent, of the original strength in a period of employment so short that little useful service has been rendered must be,attributed to some or all of the following causes : — (i) The default of the employee herself, such as caprice, unwillingness to submit to discipline, love of the excitement of change ; , (ii) The fault of the employer as displayed in want of judgment in the selection of a candidate for employ- ment, the conditions of which are unknown to the applicant but known to the employer ; (iii) Similar lack of judgment on the part of the Officials of the Labour Bureaux. No National system of organisation can eliminate these causes of wastage, but it may be possible to diminish them. The next factory considered (L 7) is in the open country, six miles by rail from the nearest town, and still further from any large city. It is very isolated. There is no village in the immediate neighbourhood, and no sleeping accommodation. The vast majority travel at least six miles to and from their work. The work is divided into that of the Cordite and the Gun Cotton Departments, and is therefore roughly similar to that of L 2. Ample provision is made for the care of workers' health and comfort. In these respects the factory is probably unsurpaased by any other in the country. Any woman absent for more than two days without commimicating with the management is automatically discharged, but in practice all these cases are followed up and the sick visited. Comparison of figures shows that the loss in L 7 was little more than a third of that in L 2. Two possible causes for this dlfEerence may be suggested : (i) A smaller proportion of the women were previously engaged in industrial employment, and it is possible that those who have had no previous experience of factory life are really more fikely to remain steadily at work than old factory hands ; or it may be that country people are less prone to change than those drawn from urban districts. (ii) The more favourable conditions of employment have more than counterbalanced any initial instability of the population. One point must at least be regarded as definitely established, viz. : that existing rates of loss in many factories are tmnecessarily high, and that so long as they continue the effective mobilisation of labour for National service has not been even approximately realised. When expressed in terms of the whole munition making female population the avoidable losses must amount to many thousands. The third factory examined was situated in » Midland Industrial City. It is organised in two branches, one manufacturing fuses (L 4), the other loading them (L 6). The general conditions of employment were good, being intermediate between those of the two factories previously considered. The general result of the investigation is that the factory as a whole is better off than L 1 and L 2, and worse off than Factory L 7 in the matter of wastage, whUo it occupied a similarly intermediate position between the two factories in welfare efficiency. Three factories employed on manufacturing projectiles of 6 inch or larger caUbre were next examined. Taking the figures of these three factories together it appears that the rates of loss at ages above 22 are significantly greater than for girls between 18-22. It appears that the unusually heavy losses are seriously contributed to by ill-health and other sufficient causes — causes of leaving for which the employees themselves are not responsible. No doubt the accuracy of statements purporting to describe reasons for leaving are not likely to be of a high order ; however, there is no reason to suggest that the proportion of inaccurate rephes in one factory is likely to differ sensibly from the percentage in another. The information as to the nature of previous employment was incomplete, but it would appear that the percentage of industrially employed women is greater than in L 1, L 2 or L 7, and it is possible that this contributes to frequent changes of employment, there being good opportunities to obtaiii another place. While women at these factories undergo no specific medical examination their work is appreciatively heavier than the work o£ the Fuse and Cartridge Factories. The large percentage of women — especially older women — who leave on alleged medical 'grounds is clearly consistent with the view that the occupation is on the whole unsuitable for such women. Inquiry was next directed to 10 further factories doing heavy work and to an Explosive Supply Factory and a National Cartridge Shop doing light work. The figures in regard to these factories hardly admit of the same degree of detailed consideration. It was not possible to the same extent to eliminate variations of production or programme though aU reasonable endeavours were made to do so. Such variations, while they should affect only losses due to reasonable causes, indirectly affect also losses due to insufficient reasons. Looking, however, at the figures as a whole, certain general considerations are suggested. In the first place while the survival rates diminish with age almost invariably among heavy factories, this is not so in the light group. The age group 18-22 is in a more favourable position than the later groups amongst the " heavy " employees, while the differences observable in the "light" group are almost negligible. The older women differ from the younger not only in age but also in that a higher proportion of them are married. It appears that the double handicap of age and home duties is insufficient to diminish perceptibly the resisting powers of the older women so far as light physical labour in factories is concerned. For the heavier type of work this ceases to be true. It would appear to follow that the recruitment of women over 22 for heavier factories is relatively disadvantageous. A comparison is made between an H .3 Factory and an L 6 Factory, both of which are situated in the same part of the country and conform to high standards of general management. The conditions in fact are closely similar except as regards the type of work. The figures for three months' wastage are not significantly different at the ages of 18-22 nor at the ages of 23-27. At ages over 28 the light factory loses appreciably fewer women than the heavy factory, and it seems legitimate to infer that labour in the heavy factories is really less suitable for older women. Much importance cannot be attached to the recorded insistence of sickness. The data are not attested by medical evidence and may be no measure of the true incidence of sickness upon munition workers. Still it is worth noting that out of nearly 37,000 women under observation for at least a month, illness or medical unfitness is given as the cause of leaving 1,651 times. The losses from iU-health are practically the same at aU ages in light factories while they increase after the age of 22 in the heavy factories. Under 23, girls" have fewer sickness losses in the heavy than in the light factories. The data at present available are insufficient to enable any conclusions to be drawn as to possible relationships between wastage and hours of labour. Captain Greenwood thus summarises his general conclusions : — (i) It has been proved that the magnitude of the wastage amongst women workers in mimition factories is considerable, and that there is much discontinuity of eniployment even in the best organised factories which must prejudicially affect output. (ii) It has been shown that much of this wastage is inexplicable, or at least unexplained. The greatest proportion of the losses is unaccoimted for. Of a total number of about 11,000 women who left, about 6,700 gave no Design YOk Canteen Accommodation for ioo mm A 3 OVtlS GA5 m^l & VtGETAfSlt roilZR. C HOT CUPBOARP P WATETl BOILEE E HOT ClO^tTi h. HOT PiATE!> f 4 Gallon uiiN!) R 15ADIAT0C^ 'Al TREtirl Aie INLET ^^. I I I i. 1 to S o I I I I I I I I I I . _1_ J2: H-"Xl4"B!aCK PIERS mOMlNT ,' CtMtNT CENDiye.)NCi TWO THICK NKSK Of WhTCHT r'ATamcr-i slocks and v &PACP MTNX^M KAiUli HTML!) Of WALL CDN5TIIUCTION ^M *o D.X.DYKt AR.1B^K H.MOITICE a WDKKS '7n aj I a -^ S 4-. 6 ' 9'J. :.C-0^ J\ B J C & S (_'-'" 165 reason for doing eo or an insufficient one ; this is not a satisfactory state of affairs. There is no panacea for the disease, but there is one promising remedy. This is organised welfare work. It has already been suggested that in factories where there are organised welfare departments the wastage unaccounted for is below the average. While no absolute connection can be proved, the importance of welfare work is certainly suggested. Intelligent and sympathetic following-up of absentees is likely to produce good results. It is suggested that wherever any factory loses more than 20 per cent, of its entrants within three months, a special inquiry into the reasons should be instituted. In some cases of course sufficient reasons — such as housing difficulties — may exist. (iii) It appears that the general strain of factory life in itself was not worse borne by older than by younger women, even in factories engaged on chemical work which has often been associated with specific danger to the health of certain individuals. On the other hand, when the general strain of factory conditions is combined with more than a very moderate degree of actual physical work, women over 23 come less well through the ordeal. The difference is sufficiently distinct to make an attempt at systematic recruiting of the older women for the physically lighter labour, and the younger women for the more strenuous tasks, worthy of practical attention, the reason being that the older women — of whom a larger proportion are married and have young children than of the girls under 23 — have not sufficient reserves of energy to meet the double demand made ipon them. ♦ APPENDIX E. Catering Equipment. The following is a list of articles required. The number to be ordered wiU depend on the size of the canteen and the accommodation for which it is to provide, but the undermentioned basis of calcxdation may be of assistance to determine the original equipment of a canteen : Knives, forks, spoons (dessert and tea), cups and saucers, one for each person seated, allowing for a few dozens over ; plates, double and seating accommodation. The same size of plates should be used for meat and pudding. Tumblers, egg cups, soup bowls and small plates, half the seating capacity ; jugs, sugar basins, mustard pots and salt cellars, tablespoons, about one- tenth of the seating capacity. The cost of equipment, &c., is steadily increasing, and it is, therefore manifestly impossible to give any fixed figures. Speaking generally, however, the complete equipment should cost approximately : — 47s. per head for 100 persons seated. 32s. „ 500 30s. „ 1000 Chairs. Catering Office Equipment. Desk. Safe for money. Cash till. Covering for tables and counter (o). Chairs or benches (6). Dining Room. Curtains or blinds for window (dark). Scraper mat at door. Tables (c). Wastepaper baskets {d). Carving knives and forks. Forks, 7 -in. in length (e). Knives, 9-in. in length (e). Cutlery. Spoons (dessert), 7-in. in length. Spoons (mustard). Spoons (salt). Spoons (table), 8-in. in legnth. Spoons (tea), 5-in. in length. Steels. Basins (sugar). Bowls (soup), liquid capacity 1 pint. Cups and saucers, liquid capacity, 8pz. Egg' cups. Jugs (milk). 6lass and Crockery. Jugs (water). Meat dishes (assorted sizes). Mustards. Peppers. Plates (meats and puddings), OJ-in. one size only (/). Plates (small), 7-in. Salt pourers. Teapots (g). Tumblers, liquid capacity, \ pint. Vinegars. Dusters. Glass cloths. Hand towels (small). Linen. Kitchen rubbers. Muslin strainers. Roller towels and roller. Swabs. For 100 persons. — One double-oven range for roasting and baking, with hot plate for boiling, frying, &c. One hot closet and warming cup- board, about 48-in. long by 30-in. high by 24-rn. deep. One 15-gallon boiler for vegetables, &. One 15-gallon boiler for tea water, &o. Apparatus for supplying hot water through the sink taps. (b 12023) Cooking Apparatus (h). For 250 persons. — One 3-oven range for roasting and baking, with hot plate for boiling, frying, &c. One hot closet and warming cup- board, about 72-in. long by 30-in. high by 30-in. deep. One potato and pudding steamer. One 20-gallon boiler for vegetables. One 25-gaUon boiler for tea water. One 10-gallou boiler for soup. Apparatus for supplying hot water through the sink taps. For 500 persons. — One large roasting oven. One 3-oven range. Hot closets and warming cupboards to form part of each serving counter. Carving table with hot closet under for warming plates. One potato steamer. One pudding steamer. One 25-gallon boiler for vegetables. Two 25-gallon boilers for tea water. One 20-gallon boiler for soup. Apparatus for supplying hot water through the sink taps. r L 3 Basins (pudding). Basins (pudding, one person). Bins (flour). Bins (sanitary). Bowls (enamelled). Bread knife. Bread cutting machine. Broom (bass). Brushes (scrubbing). Brushes (sweeping). Bucket. Canister (tea). Meat hooks. Meat safe. Milk measurer. Mincing machine. Oval pots with covers. Pastry board and rolling pin. Pie dishes (enamelled). Plate covers (tin) (/). 166 Kitchen, Scullery, and Larder Requisites, 4AjQEMENT Office Sta^ f FOT^EMEM fAEN ToTAd. 364 Extension for 156 Men or totm, of 500 dwer5 The Size of KiiCHt-N as Drawn is oh the ^K'^as OF 500 DlMFTlS \ „ Mens RrruRE Extension 11 i < ^ FOR Canteen ODATION FOR 564 DlNERS TENSION TO 500 Diners ^ ^^-^ 1 '"l! J! tS « ■ " 1 41 H__« a £ ■< ^ t " »p.'^ * »* ft t ^ U, ■HH Itpiu-a Si ■ a u_l H -—k s. -Jl fL » » » * 2 = r "" -- " -^ , t - "' — Hj — UL Elevation of Ca-hteek Section A-B v' 7P JofEET _J D-M.DYKE A.R.IBA H.M.OiTlCE OF W)RK5 lOKDOK 167 Recreation Rooms.— The recreation rooms should be ample in space for the number of tenants. For the dimensions in proportion to the number of tenants, see details in Table I. In a large hostel, the recreation rooms should consist of : — (1) A large hall for dancing, concerts, social evenings, &c., with a stage and dressing room. (2) A quiet room where tenants can read and write and see friends undisturbed. (3) A small common room attached to each sleeping block. (4) A staff common room (servants' hall) where the staff can rest apart from the other tenants of the hostel. (5) A matrons' common room, not attached to the sleeping blocks, where they can be undisturbed by the tenants. Dining Room and Kitchen.—The kitchen and sculleries should be adjacent to the dining room and divided from the dining room by a counter which, in the case of the scullery, should be fitted with hatch- ways through which the dirty plates are passed. It is desirable in large hostels that two or more dining rooms should be provided rather than that one dining room should accommodate all the tenants, the unit for a dining room being preferably 100. The dining rooms should be divided by folding doors, which can be thrown open for entertainments. Sleeping Accommodation. — Single cubicles are preferred by the tenants, though a certain number of double cubicles are useful. The cubic area of a cubicle should not be less than 400 cubic feet. 6 feet by^ 9ieet by 8 feet forms a satisfactory cubicle. Cubicles should be partitioned* from each other right up to the roof. The windows may be either sliding or casement. A space of 6 inches should be left between the bottom of the door and the floor to allow for ventilation. Drying Room and Laundry. — There should be a drying room attached to each sleeping corridor for airing clothes, and for drying wet outdoor clothes. This room should be fitted with hot pipes and hooks. A laundry where tenants can do their own washing is also essential. ^m^Mtg'.— Central heating should be installed in all temporary hostels, radiators should be fitted for the Hving rooms and a hot water pipe of 3-inch bore should be passed through each cubicle about a foot from the floor. LigMing. — Electricity is the best form of hghting for a temporary hostel. Table I. — ^Approximate superficial area of floor space per person for the various rooms in connection with the erection of Hostels for Girls. 1 2 3 4 5 Stores, larder, 6 No. of girls. Dining hall. Kitchen. Scullery and food preparation. vegetable, milk, and meat stores. Recreation room. 30 10 ft. super. 8 ft. super. 4 ft. super. 4 ft. super. Up to 50 girls allow 8 ft. 50 8 6 3 „ 3 super, for each. 100 8 4 2 „ 2 50 to 100 girls allow 5 ft. 250 8 24 „ li „ u „ super, for each. 400 8 2 1 to 1 ft. sup. 14 „ 100 and above 4 ft. super. 800 8 14 „ 4 ft. Jft. for each. 1,000 8 1 fft. 4 to f ft. Stage, ante and class rooms to be added extra. N.B. — The figures in column 2 allow 20 in. space for each girl at table, tables 24 in. wide, about 4 ft. space between tables, gangways 4 ft. wide, and ample space in front of counter. The above figures do not include provision for the stafE dining room, sitting room, office and lavatory, or for the boiler house. Table II. The above table would permit of the following space in a hostel for 400. Room. Ft. super, per person. Total area of room. Dimensions of rooms. Dining hall 8 ft. 3,200 ft. 100 ft. by 32 ft. Kitchen... 2 ft. 800 ft. 40 ft. by 20 ft. Scullery and food preparation , i ft. to 1 ft. 350 ft. to 400 ft. Say 2 rooms each 20 ft. by 10 ft. or 1 room 15 ft. by 15 ft., 1 room 15 ft. by 10 ft. Stores, larder, vegetable, milk and lift. 450 ft. These would be divided up as meat stores. best suit plan. Reoreatipa roon; 4 ft. 1,600 ft. Say 50 ft. by 32 ft. or 55 ft. by 30 ft. Ante-rooms extra. * Cement slabs have been found preferable to matchboarding owing to — (1) The liability of wood to harbour vermin. (2) The scarcity of wood in war time. (3) The security from fire. (b 12023)) ' L 4 168 Equipment. Furniture for Recreation Rooms. — The recreation rooms should be fumislied with strong easy chairs, sofas or settees, writing tables in the quiet rooms, and iji the large recreation room there should be a piano and a stage with a small dressing room attached. It is difficult to give the number of sofas and chairs which should be supplied in relation to the number of tenants housed, as all the tenants seldom use the common room at one time owing to the different shifts worked. It will, however, probably be sufficient if the easy chairs are provided at a ratio of about 1 to 12 of the tenants housed. Oubide Furniture.— lion bed, size 6 foot 6 inches by 2 feet 6 inches, spring mattress, cleaned wool overlays, two sheets and four blaiikets. One small chest of drawers or large locker, one looking-glass. WasMvg and Sanitary Accommodation. — Basin in iron frame in cubicle or separate washing cubicles in the lavatories. The former are preferable from the point of view of the tenant, but they entail a large amount of extra work upon the staff. One lavatory basin should be provided for every 10 tenants, if separated ; one for every 15 should suffice if for common use. One bath should be provided for every 20 tenants. There should be one w.c. for every 12 tenants. A schedule of equipment is given at the end of this Appendix. Pood in Hostels. Amount. — The primary consideration in catering for munition hostels is that the food suppUed should be sufficient to provide the energy necessary for the work which the residents have to do. Memorandum No. 19 gives 3,500 to 4,000 calories*t per day to a man employed on medium work, an average adult woman worker requires rather less (0 . 8 or . 9) than a man. Sample diets are given showing how the desired amount of calories can be obtained and the proportion of the three different classes of foodstuffs (protein, fat, carbohydrates) can best be distributed. The following amounts of the three main foods given in hostels (before the Eegulations of the Ministry of Food were in Force) have been tested and found satisfactory : — fMeat Women < Bread L Margarine fMeat Men <. Bread I Margarine! 3J ozs. to 8 ozs. per head per day. 3 lbs. to 6f lbs. per head per week. 4 ozs. to 8| ozs, per head per week. 6J ozs. to 12 ozs. per head per day. 6 lbs. to 7 lbs. per head per week. 4^ ozs. to 8i ozs. per head per week. Variety. — Variety affects efficiency both physically and psychologically. One of the secrets of successful hostel management lies in preserving the tenants' interest in their meals. It is a common experience in hostels that the nerve strain of heavy munition Work on operatives produces a disposition to be difficult about food, and in hostels where there is little discontent it is generally found that variety of food is studied. Meals provided. — The number of meals given in the hostels varies from two to four. Four are given when the works are near enough for the residents to return home during the intervals. The tj^es of meals provided are as follows : — Breakfast. — Porridge (in some parts of the country) ; a meat dish, e.g., fish, bacon, sausages ; tea, bread and margarine, jam. Dinner. — Meat, two vegetables, pudding or stewed fruit. A cup of tea is sometimes given. In some hostels, mostly in poorer ones, meatless days are observed. Tea. — Bread and margarine, jam, cake, tea. Suffer. — Cold meat or a made-up dish, or a milk pudding, bread and cheese, tea, coffee or cocoa. In men's hostels a hot meat supper is often provided. Food provided. — It is important to provide the staple dishes of the district, because the digestive organs find it easier to digest food to which they are accustomed. Among such dishes the following have been noted. In the southern Midlands and the south the kind of food which is popular is heavier than that which is customary in the north. More meat is eaten on the whole, and suet puddings, jam rolls, &c., are included more frequently. In the north of England and Scotland more porridge is eaten. In many Scottish hostels no meat dish is provided at breakfast in addition to porridge. Fried fish and chips are favoured by many Yorkshire and Scottish workers in preference to meat. Meat turnovers and shepherd's pie, broth and boiled beef are popular Scottish dishes also. In general, meat is not considered so indispensable by Scottish working people as it is in England. This applies especially to women. * The energy expended in mechanical work (1 calorie) is equivalent to the energy expended in lifting 1 kilogram through 425-4 metres. t For the calorie values of individual food stufEs see a report drawn up by a Committee of the Koyal Society and published by H.M- Stationery Office under the title of " The Food Supply of the United Kingdojn," Cd. 8421, price 4d Typical Hostel for 500 G/rls Scale 30 Ft = I 1 ... ! 1 ! 1 ! 1 i ' 1 i 1 ! 1 1 i i i 1 ! ! 1 ! i i 1 i 1 I 1 i i ! , 1 j 1 1 1 i 1 i 11,1,, \ ! 1 1 i 1 ' 1 ! . , ' 1 ! 1 1 ' ! 1 1 i 1 1 1 1 L \ 1 1 : . 1 1 \ r ! 1 i 1 1 i i i ' , . i '\ t- — r T ! Cubicle Cubicle Sr/kr-p J I L ICUBICLC CuSICLEiCuSlCLX Lavatory, Open Ya r o "K^i B [lauk* OWV Yard DirstNG Room ^v m V -. BathJ I Dining Room icovC.-^EO OESTRUCTOp *VAV I , ! ReCEtVING STOKch ornce i J Iw/ci MeatStore. i Kitchen -J j Staff Ni£AT Store Room P-l J^ y-ri U_i ^ Uj Kitchen Store w Ve R A N D A H 4'l N C s COMMON RT "-^M-ilA _gir- -RECREATION Roof^- J L Cubicle! Cubicle "1 — \ — r- :>f<~r>^ -^ CueiCLejCueiCUCuStCLElMATRoN —J I Co n R I D O B. KrcHEN EH", S-roftE Super's SnTmcRoo> , ,Ekii}uiot Sectvs office Office 5- — roHTERSL ReCEFTigNRB OFFICE -a^ iStaff Staff |- -J — DiNINC SEC^I SEc"B"r ^ \ /i-Vpi^. ,"Si- ■^'t ^ *.'/ ^^ /'■&; 734-7. l6«-a4-. 6190. 5000. 5. ig VI «G ICt 1 CHEN rAFF OOM Sulk Store i DtNi'HG Room D H- / ^, 1 DiNiNC Room Verandah -J/ fT'= f?- \k if — C PI 169 For tea and breakfast oatcake and barley meal scones are eaten in the north. Potato dishes have been tried with considerable success. IV^aize has been found to be unpopular and indigestible. Suet puddings and rolls are thought by the workers to be sustaining. Meat pasties are also popular. Provision of lunches to be taken to the factory is a difficult matter. Carried food is found to be un- satisfactory for two reasons : — (1) It becomes dry and unpalatable if in the form of sandwiches. (2) If it is in a made-up form its digestibility is certain to suffer in the process of re-heating. It is not, however, possible to abolish the system entirely. It is much cheaper for girls to pay an inclusive fee and take lunch from the hostel. There is a strong prejudice, especially in the north in favour of bringing food to work rather than buying it at the canteen. In many small works there is no canteen, only a mess-room. The following lunch, provided at a women's hostel where catering is satisfactory, gives an idea of what is necessary : — 1 slice of meat roll (made with very little meat and strongly flavoured with onion). 1 square of jam tart. 2 rounds of bread and cheese. J round of bread and butter. Dry tea or cocoa. In one women's lodging house the lodgers feed themselves on Is. 3d. per day. For this they are only able to have meat twice a week. Typical meals are as follows : — Breakfast. — Bacon or kipper, tea, bread and margarine. Dinner. — Fried fish, tea, bread and margarine. Tea. — Bread and margarine, and tea. On the days when meat is bought the women have only a cup of tea in the morning, and combine breakfast and dinner in the meat meal. The feeding of men in navvy huts is receiving much attention now. One managing contractor who had had experience of housing navvies in various parts of Scotland has decided to aboUsh the mess- room altogether, and to have the canteen only, so that he may have the feeding of the men under his own control. In this connection comfort in the canteen is of importance. Navvies are notoriously restless, but men who are comfortably fed are more likely to stay on the work, and managers are beginning to try the effect of more attractive surroundings. Methods of buying. — Skilful buying combined with the most economical use of foodstuffs is the secret of successful catering. Those hostels which are attached to a large factory have a great advantage in this respect in that the buying is done centrally, and the hostel reaps the benefit of wholesale prices, and in some cases will avoid competition with other hostels. Large hostels have a similar advantage over small ones. There is, however, great scope for a matron's abihty in retail buying, because prices often vary in different parts of the same town, although seeking out the best and cheapest shops is a severe tax on her time and strength. The difficulty and cost of transport 'has to be reckoned with if , supplies are brought from a distance. Good storage accommodation is essential if buying is done on a large scale. Methods of buying are, of course, materially affected by rationing or other war-time emergency conditions. The prevention of waste. — Waste on the part of the tenant can be prevented in two ways : — (1) By making dishes so palatable that very little is left on the plates at meals. (2) By using up all scraps. Variety and attractiveness are the most difficult quahties to ensure in catering. Monotony in menus leads to food being left. Twice-cooked food soon becomes unpopular if served too often, and the traditional British method of cooking vegetables is unattractive in the extreme. The second method, viz., using all scraps of food left, is carried out by most matrons according to their abihty. In some places, if the tenants know what is being done in this way, they are apt to object on hygienic grounds. It was found in the case of two hostels under the same management that in one the tenants thought it unwholesome to use bones taken from the plates for the stockpot, while in the other hostel the tenants quite approved of it. As to the ways in which saving is effected, it is found that educated cooks are the most enhghtened and expert. All bones and scraps from plates, except starchy scraps and green vegetables, can be used in the stockpot. Waste bread can be used without danger if it is baked and grated. It can be mixed 170 with flour for puddings, etc. In connection with methods of cooking it has been established by experi- ments made in King's College that slow cooking of meat in a gas oven effects a saving of 9 lbs. in every cwt. Experiments in the methods of cooking dried pulses have shown the economy of using the water in which these are cooked as a basis for stock of soup. A la carte catering, though in other respects more difficult, may be a method of avoiding waste in so far as workers can choose what they wish to eat. This cannot be carried out in small hostels. It is also open to objection on the ground that many girls cannot be relied on to select a suitable and nourishing diet. Management. The superintendent is the most important factor in hostel management. A hostel superintendent should possess a tactful, sympathetic and understanding personality. In Women's Hostels she should be an educated woman, and to be really successful she must, as far as possible, know her tenants personally and take an interest in the social side of their hfe. To manage a colony composed of people differing widely as to age and social standing, is not easy. Nor are the tenants the only persons to be considered, for the management of_ the staff often requires considerable skill, especially in large hostels. The value of having educated women as canteen workers is well known. Where they have been employed it has been observed that not only has the waiting been more efficient, and the food better served, but there has been a marked improvement in the tone and general behaviour of the girls. Voluntary workers to organise recreations and amusements in the hostels have been found to be a great asset. They bring an outside element into the hostel which is much needed. In some instances the hostel staff has been drawn entirely from voluntary workers, but this has not proved to be altogether satisfactory. Tenants' Committees. — The committee is elected by the tenants from among themselves and in co- operation with the superintendent, makes and enforces all rules, hears complaints, and is generally responsible for the behaviour of the tenants. It is noticeable that in hostels where these committees are working there is a feeling of esprit de corps among the girls to an extent unknown in other hostels. Rules in Hostels. — It has been found in hostels that the minimum amount of rules produces the best results in behaviour. Where there are few restrictions the girls feel that they are being trusted, and this is a fact which they appreciate. In no instance has it been found that the girls have taken advantage of the greater amount of freedom. Recreation in Hostels is an important factor in making for happiness and good feeling among the tenants. Hostels are often situated in isolated areas where outside recreations and entertainments are beyond the reach of the tenants. At many hostels therefore regular schemes for outdoor and indoor recreation have been organised. Wom,en Patrols are doing a valuable work at some of the large hostels, but their employment must be considered as an emergency precaution rather than a part of an ideal form of management. Men's Hostds. — Good male warders are necessary for all men's hostels, and there should be one on duty all night as well as in the daytime. In every possible case tenants committees should be formed, and the hostels run as residential clubs. The household work of the general run of the men's hostels is best done by a staff of maids under a competent matron, if suitable quarters can be arranged. A good standard as regards cleanliness and minor comforts has been secured in some hostels for skilled men by the appointment of an educated woman to supervise the household work. Staff. — The following are suggested as the average proportions of staff to tenants required in munition hostels : — Housing 100 and over : Proportion of staff to tenants, 1 to 10. Housing between 50 and 100. Proportion of staff to tenants, 1 to 8. Housing under 50. Proportion of staff to tenants, 1 to 6. The following are the usual rates of pay at women's hostels : — Superintendents Assistant superintendents Secretaries Head Matrons ... Nurse Matrons ... Matrons ... Games Mistress Canteen Superintendent Canteen Supervisors ... Storekeepers Cooks Maids £200 to £250 per annum all found. 20s. to £3 Is. 6d. per week all found. 25s. to 30s. per week all found. £2 10s. to £4 4s. per week all found 36s. to 40s. per week all found. 12s. 6d. to 30s. per week all found. 25s. to £2 5s. 2d- per week all found. £3 17s. all found. 20s. to £2 10s. per week all found. 25s. to 35s. per week all found. 16s. to SSs, per week all found. 12s. to 16s. per week all found. 171 The following are the usual rates of pay in men's hostels, which are generally less well staffed than women's hostels : — Superintendents* and Head Matrons Assistant Matrons Cooks Waitresses and maids ... £100 to £200 per annum all found. 21s. to 25s. per week all found. 20s. per week. 12s. to 15s., except in one group of hostels where the head maid gets 19s. per week. Recreation foe Hostels. Ofosses. —Educational schemes are being much discussed at present in connection with hostels, chiefly because hostels seem to be good centres for developing classes. The following considerations show, however, that great caution must be used in starting schemes in hostels : — (1) The hostels are, or should be, homes for the time being. Residence is entirely voluntary and therefore rules and restrictions should be the minimum necessary. Educational schemes imposed from outside may tend to destroy this home feeUng. (2) Most munition work is heavy, and the shifts are long. Tenants have not much energy at the end of the day to devote to serious study. Classes, however, are becoming more and more popular in hostels. The best way to develop them is as a rule to ascertain from a committee of tenants what is wanted, and then to propose a scheme. The large hostels are obviously the most interesting fields for development. The Y.M.C.A. have set on foot a scheme for giving courses of lectures at hostels and canteens. Eight of the large hostels have taken advantage of this scheme. The tenants have chosen the subjects of the lectures from a syllabus issued by the Y.M.C.A., the most popular being descriptions of the various fronts illustrated with lantern shdes. The object of lectures should be not so much to increase knowledge of particular subjects as to increase breadth of view, and to provide distraction from the strain of long and monotonous work. In the case of hostels which belong to societies such as the Y.M.C.A. and the G.F.S., there is often an institute out of which the hostel originally grew, and non-resident members attend lectures and classes there. In the past, sewing, dressmaking, singing and Bible-classes were chiefly carried on. Since the war, lectures on hygiene, sick nursing, and first-aid, dancing classes and hterature have become more popular. In one hostel, housing girls from 16 years of age, the old-fashioned Scottish plan is followed of having the schoolmaster twice a week at the hostel to teach arithmetic, hterature and singing. In some of the small North Country hostels, the matrons have domestic circles for sewing, reading, etc. Libraries. — There is great demand for libraries of modern books in hostels. There are hbraries which have existed for many years in the Institutes of various societies, but some of them would be improved by the addition of new books. A certain sum has just been set aside by the Welfare and Health Section of the Ministry of Munitions out of which small grants will be made for books and pictures in hostels. These books should be chosen by the residents themselves and made the nucleus of a hbrary to be formed gradually by subscription. Newspapers and magazines should be taken in. In one Government hostel the public hbrary sends books, and changes them periodically from lists selected by the girls. This is a good plan, but a hbrary which is subscribed for is more valued. Gomes.— Games are much easier to provide in large than in small hostels. In one or two hostels there is a trained games mistress, and hockey and football are played in winter, lawn tennis in summer. In small hostels there is rarely any ground available. Where there is sufficient space a tennis court or Badminton court to which men friends can be invited may be provided. Organised games are not' always popular, chiefly because the girls have not played them at school. Where quite young girls are housed, hockey, football, etc., are more hkely to succeed. Organised games are being tried in factories and hostels, but in many cases the hours of work prevent workers from taking advantage of them. In one hostel drills are held by the Woman Pohce Inspector, and are well attended. In the case of small hostels matrons may be able to encourage outdoor recreation by advising girls to join their factory athletic clubs, local clubs, etc. Gardening. — Grants have been made for gardening tools and seeds from the fund which the Maharajah Scindia has given to the Ministry of Munitions. The results have been very satisfactory. The girls have taken up gardening with great zest, and the waste ground between the blocks of cubicles has yielded good crops of vegetables. Hostel Finance. Cost of huiMing a temporary hostel of wood, concrete blocks or other temporary material necessarily varies with the size, local conditions and changes in cost of labour and materials. It may however, be roughly estimated at Id. per cubic foot for structure only, or at from £40 per head for a small hostel to £20 per head for a large, one. This figure should cover the requisite dining and recreation rooms, but is exclusive of drainage, fencing, paving and road making. Cost of furniture and equipment may be put at from £17 10s. to £20 a head in adapted hostels* including kitchen equipment. In large temporary hostels the cost is only about £8 to £10 exclusive of kitchen equipment. * At our large hpstek the Superintendent's salary averages £327 10s. 172 Cost of maintenance. — The cost of catering to the management may be estimated on the basis of the prices prevailing in November, 1917, at : — Men. Women. Number provided for. Cost. Number provided for. Cost. s. d. s. d. 50 15 10 50 13 9 100 14 6 100 13 2 300 13 6 300 12 7 500 12 6 500 11 3 1,000 12 1,000 10 8 Other expenses of maintenance (e.g., salaries, rent, rates, lighting, heating, etc.) may be estimated at from 5si to 7s. per head per week. Hostd charges. — The above figures suggest that in order that a hostel may be self-supporting it is necessary that a charge of from 21s. to 17s. a week should be made to men, and from 19s. to 17s. to women. Admittedly in theory hostels should be self-supporting, but in practice there are grave difficulties in the way of doing so. It would involve in general hostel charges being higher than those for lodgings. Many workers live in hostels because there is no other decent accommodation available, and it is in their own and the national interest that they should do so, on the other hand it is unjust that circum- stances beyond their own control should place them at a financial disadvantage, especially as they have often showed considerable patriotism in volunteering for employment in places remote from their own homes. This particular difficulty might be met by paying them higher wages, but to do so would involve fresh difficulties through their being paid at a higher rate than their fellow-workers, who are able to live in lodgings or at home. Moreover hostels vary in cost, the smaller and more popular being the more ex- pensive. In consequence of these, difficulties it has been usual for charges to be determined according rather to the circumstances of the locality than to the cost of working, and recent inquiries suggest that they tend to be fixed somewhat below rather than above the local charges. Hostels are, in fact, normally run at a loss. Grants from the State. — Since it is in the interest of all parties to encourage the provision of hostels by voluntary bodies, grants are payable in aid of initial charges in cases where it can be shown that if these charges are paid off the hostel would be self-supporting. Under certain conditions private firms have been allowed to charge initial cost against excess profits ; loans for a similar purpose can also be granted within certain limitations. In view of their special importance and their difficulties of working, clearing hostels may under certain conditions receive a maintenance grant of Qd. per person per day. Suggested Schedule of Equipment and Furniture for a Hostel to Accommodate 400 Girls. (This schedule may also be taken as applicable to a skilled workmen's hostel, though not to one for navvies.) (o) Administration Block. Office— 1 knee-hole writing table, 5 ft. by 2 ft. 9 in. 1 armchair. 1 writitig table 4 ft. by 2 ft. 3 in. 2 small chairs. 1 scuttle and shovel. 1 safe. 2 cupboards, 3 ft. Staff Boom — 1 rug, 7 ft. by 5 ft. 1 dining table. 1 sideboard. 6 small chairs. 2 elbow chairs. 2 cupboards, 3 ft. Superintendenfs Bedroom. 1 3-ft. iron combination bedstead. 1 mattress. 1 canvas platform. 1 wool bolster. 1 feather pillow. 4 sheets. 3 pUlow slips. 3 blankets. 2 counterpanes. 1 down quilt. 1 dressing chest. 1 washstand. 1 toilet set. 1 chair. 1 water bottle and tumblei. 1 bedside rug, 4 ft. 6 in. by 2 ft. 3 in. 1 large rug. 1 coal scuttle and fire irons. Superintendenfs Bath Boom. 1 chair. 1 toilet fixture. 1 hanging mirror, Superintendent's Sitting Boom — 1 carpet. 1 table with drawer, 4 ft. 6 in. by 2 ft. 6 in. 1 circular table, 3 ft. 1 table cover. 4 small chairs. 1 armchair. 1 easy chair. 1 curb fender. 1 coal cauldron. 1 fire set. Staff Kitchen — 1 kitchen table, 6 ft. by 3 ft., and 1 drawer. 3 Windsor chairs. 1 hearth rug. 1 pair house steps. 1 clothes horse. Kitchen Utensils, Hardware, Cutlery, Crockery, Table Linen Towels, cfic, for Staff— 1 dinner service for 6 persons. 1 tea service for 6 persons. 12 meat plates. 12 soup plates. 12 tea plates. 2 meat dishes. 12 large cups and saucers. 12 small cups and saucers. 12 egg cups. 12 tumblers. 3 China cruets. 6 milk jugs (assorted). 1 l-quart-mUk jug. 1 1-pint milk jug. 3 sugar basins. 2 slop basins. 2 jam dishes and spoons. 2 glass water jugs. 2 enamelled pails. 2 12-in. enamelled pie dishes. 173 Kitchen Utensils, Hardware, GuUery, Crockery, Table lAnen, Towds, 175 Staff Dining Roomn- Laundry— 4.tables{5ft. by2ft. 6in.). 1 wringer. 24 small chairs. 2 buckets (3 gaUons). 1 cupboard (3 ft.). 20 yards ironing felt. 6 easy chairs. 1 ekiit board. Scuttle and fire irons. 1 sleeve arm. 10 iron stands. Canteen Superintendents Roomr- ^^ waging boards. 1 writing table. 2 laundry brushes. 1 armchair. 2 clothes baskets. 1 table with drawer. 1 large clothes horse. 2 chairs. 4 dozen clothes pegs. 6 pot sticks. Recreation Room {with Annexes). ' 12 easy chairs. General — 75 chairs. Door mats. 12 tables (2 ft. by 2 ft.). Scraper mats. 4 cupboards (3 ft.). Dust bins. 3 writing tables (5 ft. by 2 ft. 9 in.) ]For Linoleum to floors. ltable(4ft. by2ft. 3in.). ^Ante- Blinds to windows. 1 blackboard and easel. J rooms. Fire extinguishers. APPENDIX G. Medical Certificates of Inoapacity for Work. [Booklets of medical certificates on the lines set out below can be obtained on application to the Health and Welfare Section of the Ministry. They are intended to be used for persons employed on Munitions of War who are found to be unfit to follow their present occupation. They are for factory purposes only.] Ministry of Munitions Factory Certificate. I hereby certify that on....20.; *i;T^;fJ:'-\:' ■" . LONDON: PUBLISHED BY HIS Mf JESlT'S STATIONEEY OFFICE. To be purchased Ijhrouglu'dji^iBooksellisr or- directly from , H,M. STA'l'IONEEY OlElGE: at tlje following: addresses':;.^ ., . IMPERIAL House, Kingsway, London, WlC; 2, and- 28,,' Abingdon 'Stkeet.J'ONPON, S.W. 1 , 37, Peter Street, ManohestebV 1, St. ANDEEW'sX.fiiisOENt, OifitJiB^i'] ■ 23, Forth STRKBt, EDiSf,BxrriG|t; \ ?y or from K BONS0NBY, LiJD., 11 $, GEAyroN Sxiseet, DjtatiN [Cd. 9()65.] I918-; , Price 2s. iS%«. 3 1924 092 432 966 'lililiiiiM