4/3 "B7 ws Brooklyn Teachers Association 1 FREDERIC W. MAR, President I a AN AD-INTERIM REPORT OF AN IN- VESTIGATION OF THE ABSENCE OF TEACHERS OF NEW YORK CITY CAUSED BY PHYSICAL DISABILITY DURING THE SCHOOL YEAR 1913-14 WITH A VIEW TO DETERMINING THE POSSIBLE EXISTENCE OF OCCUPATIONAL DISEASES Conducted by the COMMITTEE ON SCHOOL PROBLEMS OSWALD SCHLOCKOW, Chairman 3 7 Brooklyn, N. Y., September, 191 5. Dr. Frederic W. Mar, President, Brooklyn Teachers Association. Dear Sir : — Your Committee on School Problems herewith begs leave to submit an AD-INTERIM REPORT OF AN INVESTIGATION OF THE ABSENCE OF TEACHERS OF NEW YORK CITY CAUSED BY PHYSICAL DIS- ABILITY DURING THE SCHOOL YEAR 1913-1914 WITH A VIEW TO DETERMINING THE POSSIBLE EXISTENCE OF OCCUPATIONAL DISEASES. Those who purpose to trespass on the time of a patient public by adding to the volume of the statistical matter of the community should justify themselves by showing that they are attempting to satisfy, in part at least, a real public need, and are not merely falling victim to that most unfortunate delusion so prevalent, that immortality can most easily be obtained by petrification in musty records. The Committee on School Problems should be pardoned, therefore, for prefacing its report with a statement of the reasons for undertaking this particular investigation. Curiosity is often aroused and attention fixed by seeming trifles, such as the mass of statistical flotsam and jetsam borne ashore by the cross currents of casual reading. Thus the public was informed, on page 375 of the Sixteenth Annual Report of the City Sup- erintendent of Schools, that in 1903 about 2.8 per cent of the total annual working time of the teachers of New York City had been lost by absence, and that in the year 1912 this per cent had increased to 5. These apparently insignificant figures may not attract atten- tion ; they become startling, however, when restated in the form, What causes, in the comparatively short span of nine years, resulted in an increase of almost one hundred per cent in the loss of time by absence of the teaching corps of the city? Again, on page 385 of the same report, we are informed that in the year 1912-1913 about 7,500, or 40 per cent of the total of 19,500 teachers of the city were absent from duty. Even if we make a small allowance for absence due to causes other than illness, the figures show a startlingly large remainder ascribable to the physical disability of the teachers. Turning to the Reports of the Secretary of the Board of Retirement of the Department of Education, we become interested in such excerpts as (page 5, Report for the Year 1910) : "There have appeared before the Board of Retirement during the first five years of its existence, 562 applicants. Of these, 219, or 39 per cent, were suffering from complete nervous affections The statement of causes for retirement given above, indicating as it does, the very great hazards of the teaching profession, will surprise most people who harp upon the 'easy' work of the teachers. The late President of Chicago University, Dr. Harper, once said : 'The number of physical wrecks furnished by the profession of teaching, is certainly larger in proportion than that of any other calling in life. In no other work can it be so truly said that the toiler gives forth his own strength to the one for whom he toils.' " Continuing, the Secretary states : "Those of us who have spent our lives in the school room are not at all surprised at these statements. We know of innumerable cases of physical breakdown and nervous pros- tration due entirely to close application to duty in stuffy and improperly cleaned and poorly ventilated school rooms filled with children who often transmit disease not only to their classmates, but also to their teachers. The teachers often have not the power of resistance to disease which more active children possess. When one realizes that it is becoming more and rnore certain that the school room is the distributing center for the contagious diseases of the community, the extra hazardous character of our profession becomes alarming indeed." As if to corroborate these statements, Lewis M. Terman (page 3, The Teachers' Health) remarks : "As will be shown later in detail, investigations indicate that the teacher becomes superannuated at a decidedly earlier age than the lawyer, physician, state official, "r man ni business." < >n page 25 of the same volume we read: "These statistics indicate a higher tuberculosis Mortality for the teaching profession than for the notor- iously unhealthful occupations of stone-cutter or saloon-keeper." Such statements and opinions emanating from individuals intimately acquainted with their subject, proved a sufficient incentive t<> the Committee on School Problems to under- take a carefully conducted investigation of the morbidity among the teachers of New York City in order to determine the hazard of teaching as compared with other pro- fessions and occupations, and. incidentally, to serve the cause of our teachers by creating in the public mind a proper understanding of the true nature of teaching. This general desire was Converted into a solemn obligation on the unexpected development of a sit- uation which deeply concerned the teaching staff. The Board of Estimate and Apportionment, owing to questions of policy and finance, withheld the usual appropriation for summer schools for the year [915, and suggested that a part of the regular teaching force he drafted to serve during the summer, thereby, of necessity, curtailing tin- highly prized summer vacation of the teachers. The latter naturally opposed this recommendation emphatically, alleging that the hazardous nature of teaching requires long periods of rest and relaxation. The sceptical, hard headed man in the street, critical in his estimates and prone to express personal judgment based on opinion rather than knowledge, took issue with this contention, and as firmly assever- ated that nothing could he easier than "bossing little children', adding that the ordinary worker, in general, is well content with vacations ranging from one to two weeks annually. The contest between the opposing forces soon developed into an indeterminate trench war- fare, as neither side had the necessary facts to bring the controversy to a fair and logical conclusion. The community, it must be conceded, has the power to coerce teachers to s t rve during the summer, but fairness compels us to admit that no thought of com- pulsion would be entertained, were the community fully convinced that the comparatively long summer vacation of teachers is really needed foi the conservation of teaching energy and the ultimate welfare of the pupils, and is not a luxury demanded for mere personal sell -gratification. The question at issue is, therefore: Is teaching a hazardous profession demanding special consideration, or is it to be classed with the normal occupations of the community ? The attempt to find an answer to this question is tie justification of the committee's effort; and even should the committee fail in this, its labors will not have been in vain should they stimulate interest in the problem and induce abler minds successfully to ter- minate what good intentions have awkwardly begun. PLANS OF PROCEDURE. At the very OUtsel of tin- investigation, the Committee discovered the almost total lack of statistical information bearing on the subject under investigation. It was a source of some surpri-e t<> note what little attention i* given in official reports to matters pertaining to the personal interests of teachers. Certain departments are. at present, Collecting the most minute statistical information concerning about 800,000 children at- tending our schools; there is information on the circulation of library books, and we can easily determine the financial value of the entire educational plant, but we know next to nothing about the teaching corps, upon which the ultimate welfare of the school system depends. Under these conditions, a great ileal of time, ubicb could have been used to better advantage turned by the Committee in collecting data. Added t<> this drawback was another of even greater in. port. Candor compels the admission that while the members of a committee of a teachers' association may be actuated by fervent zeal to the interests of their fellows and willing to sacrifice time and leisure in the pursuit of scientific investigation, thej uoly handicapped by the demands of their regular school work, which prevents that steady and COntinous application which research work requires. Laymen, moreover, working without any of the mechanical aids employed in modern statistical investigations are greatly hampered in tabulating large numbers of items and are. therefore, apt to commit slight inaccuracies I "he Committee is quite ready to concede that its work could have been more ably performed by the technically trained experts on the staffs of many of our public bureaus, but as such aid was not available, the Committee endeavored to overcome by dint of effort the lack of mechanical appliances. The Committee after due consideration, decided that the most feasible plan of conducting the investigation was to analyze the information contained in the application blanks submitted by teachers to the Board of Superintendents for the refund of salaries deducted for absence caused by illness during the year 1913-1914. In this connection, it should be noted that these applications do not represent the total absence of the teaching force, as many absentees do not submit refund applications for short periods of absence. While, therefore, the investigators realized that the totals obtainable from this source were below the actual figure, there was no practical way of overcoming this difficulty. The refund applications referred to contained the following information ; which the Committee decided to tabulate and interpret : (a) Sex of the applicant (b) Duration of the illness and (c) Nature of the illness. The following precedure and plans were then proposed : PLAN I. To tabulate and interpret the facts directly obtainable from the refund blanks, including the age of the applicant as one of the factors of the problem. PLAN II. To obtain similar information relating to other professions and occupations for pur- poses of comparison, and to determine, thereby, the relative hazard of teaching. It was hoped to secure such information from insurance companies writing so called 'Health Policies'. PLAN III. To induce other agencies to undertake a study of the etiology of any prevalent diseases disclosed by this investigation in order to remedy, as far as possible, the causes undermining the health of our teachers and destroying the efficiency of their work. This ad-interim report presents only the results obtained in accordance with the purposes set forth in Plan I. Even these results are not presented with any claim to finality, and the Committee is prepared, circumstances permitting, to undertake a similar investigation for the school year 1914-1915, in order to confirm or modify the results herein set forth for the year 1913-1914. The carrying out of Plans II and III will depend largely upon the cooperation extended by out-side agencies. A scientific classification of the diseases reported on the refund blanks was the first need of the investigators. This classification was prepared by Dr. Henry Fleischman, who for excellent reasons, adopted an anatomical system rather than one based upon symptoms or causes. The classification adopted is given in TABLE I. ANATOMICAL CLASSIFICATION OF DISEASES FROM WHICH TEACHERS SUFFERED. DISEASES OF THE RESPIRATORY SYSTEM (a) Bronchi and Trachea (b) Larynx and Epiglottis (c) Lungs (d) Nose, Nasal Passages and Accessory Sinuses (e) Pleura (f) Pharynx II. OPERATIONS Insufficient data for proper classification III. DISE VSES I IF THE NERVOUS SYSTEM IV. DISE ^SES OF THE EAR V. INFECTIVK DISEASES (a) Brain, Spinal-cord and Meninges (iii Functional Nervous Disorders ir) Cranial and Spinal Nerves (a) Influenza (1>) Chicken-pox (c) Whooping-cough (d) Carbuncle i(e) Diphtheria (f) Dysentery (g) Measles (h) Mumps (i) Erysipelas (j) Malaria |(k> Rheumatic Fever (1) Typhoid (in) Scarlet Fever (n) Relapsing Fever VI. MISCELLANEOUS DISEASES AXD CONDITION'S VII. DISEASES OF THE DIGESTIVE SYSTEM VIII. DISEASES OF THE URINARY ORGANS IX. DISEASES OF THE CIRCULATORY SYSTEM X. INJURY TO REGIONS XI. TUMORS XII. DISEASES OF THE SKIN. HAIR AXD NAILS XIII. DISEASES OF THE BLOOD XIV. DISEASES OF THE MIND - XV. DISEASES OF Till'. EYE XVI. DISE \M- OF l HE REPRO- DUCE E ORGANS XVII. DISEASES OF ill!-. BONES AND ( ARTILAGES XVlli. DIS1 >F Till-. DUCT - LESS GLANDS AND SPLEEN XIX. POISONINGS AND INTOXICATIONS (a) Rheumatism (li) Diahetes (c) Insomnia /(a) Tonsils (b) Stomach (c) Appendix and Intestine (d) Liver, Gall-hladder, and Gall-duct (e) Rectum and Anus (f) Teeth, Gums and Alveoli •j (a) Kidneys ( (a) Arteries and Veins \ (b) Heart j (a) Face and Scalp "j (b) Lower Extremities (a) Anaemia j | Dist ' do Ace seases ommodation and Refraction Errors \ ( a ) Male /(!>) Female (Uterus Functional) XX. DISEASES OF MUSCLES, FAS- CIAE AND TENDONS XXI. DISEASES OF THE JOINTS XXII. DISEASES OF THE LYMPHATIC SYSTEM XXIII. PARASITES AND FUNGI XXIV. UNCLASSIFIED The tabulation of the diseases reported was, at times, beset with difficulty, for in a number of instances physicians gave as the cause of absence such illness as sore throat, cold, nervousness, dyspepsia, etc., loose terms which make scientific classification impossible. In addition to this difficulty the reputed mysterious chirography of the medical profession cast an occasional veil of inscrutability over certain ailments. It is also very interesting and not less remarkable to note that certain diseases which are generally supposed to be prevalent among teachers are found to be of such rare occurrence as to make either one of the following deductions possible; that contrary to prevailing opinion teachers do not suffer from the diseases in question or : — that for one reason or other the physician through kindly regard for his patient failed to give a sufficiently definite diag- nosis. We have, however, limited ourselves in this report to the actual facts revealed by this investigation. TABLE If. Total number of Applications for Excuse of Absence of Teachers and Supervisors (All Causes) Year 1912-1913 : 7,500 Estimated Number of Applications for Excuse of Absence Caused by Illness 6,500 Estimated Number of Teachers and Supervisors in Service, Year 1912-1913 19,500 Per cent of Absence Caused by Illness 33 Total Number of Applications for Excuse of Absence Caused by Illness During the Year under Investigation ( 1913-1914) 4,148 Total Number of Teachers and Supervisors in Service 20,141 Per cent of Absence Caused by Illness 20^2 Total Time Lost by Absence Caused by Illness (days)68,64i Average Number of Days Lost per Teacher Absent 16^ Table II requires elucidation. The great decrease in the percentage of absence from the year 1912-1913 to that reported for the year 1913-1914 — a drop from 33 per cent to 2054 per cent — is probably accounted for by the unexpected suspension of all refund moneys for absence during the latter year. An unkind critic, unfamiliar with the high profes- sional standards of our teachers, might hastily infer that this decrease in absence was the result of the suspension of refunds and indicative of malingering; those, however, who know the loyalty and fidelity of the overwhelming number of the teachers of the city, are fully convinced that many teachers, who under normal conditions would and should have remained at home because of physical disability to teach, forced themselves to report for duty they could not properly perform. Whether the schools are ultimately benefited by service of this nature, is a question not requiring protracted discussion. Great as is the percentage of absence reported for the year 1913-1914, 20J/2 per cent of the entire teaching and supervising corps, it is the conviction of the Committee that this figure fails to give a correct measure of the total illness existing among teachers, not only because of the unusual conditions referred to in the preceding paragraph but also because absence refund blanks are not generally submitted for brief periods of illness. What a figure the totals would have reached had the investigators been able to determine the number of cases of chronic invalidism existing among teachers performing service! In a report of this kind, dealing with the general health conditions of all the teachers, such uld receive attention and be included in the totals, but, unfortun- ately, the Committee could find no official records bearing on teachers' morbidity, and for the ».ikr of statistical accuracy had to limit itself to the refund blanks for absence. That we are not dealing with the total invalidism existing among teachers is confirmed by the figures reported by Dr. Sigel, who iii 1895 examined nil the teachers in Leipzig and found that -jj.s per cent were suffering from definite diseases, mostly affections of lungs, heart, throat. <>r nervous system. (Terman. page 10. I The average time lost by teachers on account of illness was l6$4 school days, or more than three school weeks. This, however, does not measure the actual time of illness, as intervening Saturdays. Sundays and holidays should be added in order to arrive at the actual number of days during which teachers sufk"-ed disability. In other words, we may safely increase the calculated figure by .4, which gives 23.1 days as the actual average dur- ation of illne>> covering a period of only ten calendar months — the length of the school year. TABLE III. SEX DISTRIBUTION OF CASES The 4 1 4S cases of illness under investigation were divided according to the sex of the applicant as f< illows : Men 211 Women 3937 Percent of Women. Calculated on the Total Number of Cases of illness 05 Percent of Men Calculated on the Total Number of Cases 01 Illness 5 According to the unrevised Age-Table for Teachers furnished by the Municipal Pen- sion Commission, there were 2,594 men and 17.820 women in service during the year under investigation. On the basis of these figures the lVr cent of Absence of all thw Men in Service was 8 Per cent of Absence of till the Women in Service was 22 Time Lost by the ,VU7 Women 65,894 Days Time Lost by the ji 1 Men 2.747 Days Average Time Lost by Women Absent 17 Days age Time Lost by Men Absent 13 Days Table III confirms a general belief that women show a proportionately larger per- centage of absence due to illness than men. The numerical relation is as 22 to 8. but the Ige time lost by the two sexes approaches equality, a natural condition when one considers that the duration of illness is not vitally affected by sex. The New York City experience shown in this table is far more favorable than that reported for the city of Amsterdam (Terman, page 14) where _' (.; per cent of the 1203 male teachers (against 8 per cent in N. Y. city) lost time by illness during the year 11)03, and 34.2 per cent of the 909 female teachers (against jj per cent in X. Y. city). TABLE IV. Table IV A, clearly discloses the existence of four prevalent ailments from which tiers in New York City suffered — Diseases of the Respiratory System, constituting more than one third of all the diseases reported; Infective Diseases; Diseases of the Nervous System; and Diseases of the Digestive System. These four groups, in the order named) constitute the Occupational Disease of our teaching corps. To determine whether the percentages reported for these diseases are higher than those for other pro- ns and Occupations, b to be the aim of a future investigation. I lie figures submitted in Table IV A admit of interesting comparisons with inves- tigations reported by Terman (The Teachers' Health, Chapter II). Allowance must be made, however, for differences in the classification of diseases as well as for the operation of local causes which may affect the tabulation : Absence Caused by City of Amsterdam Sweden N, Y. City Nervous Affections 34 per cent 36 per cent 15 per cent Throat and Lungs (Resp.) 16.5 per cent 22.8 per cent 35 per cent Acute Contagious Diseases | 6.5 per cent 16 per cent Digestive Disorders 7.6 per cent 11 per cent Except for Nervous Affections, which, as will be shown later, are not fully recorded in our investigation, the New York City experience is far more unfavorable than those reported for the two places abroad. Table 4- A Percentage Distribution of Ailments CausingThe Absence of4I48 New York CityTeachers DuringThe School Year 1913- 1914. 5 S5 5 David Bar-shell PS 62 Man X <0 <0 K to 8 5: IS 3 V) M to % ft 2 o: £> U. 5k <0 o to 8Mb h£ S! Ui >, m P 5 3 52'oS! to <0 £ k (o o 10 S3* sis I 2* $.3 •0 "0 Hi to d 3 ( . ( . ( .._.. ! . , |||( . 35% l6°fo l5°/o ll°fo 333222 8% =/00°fo PERCENTAGE. OF TOTAL NUMBER ABSENT. Table 4- B Percentage Distribution of Time- 68 64/ Da ys Lost By The *>AME Group ofTeachers on Account of Diseases Shown in Table A. M ft ft ej a: tf) (/) UJ 3 to o log B P X JO CO > I 2 (j tqtu cc lu the four Occupational Diseases. A comparative study of Tables A and B also indicates that the time lost on account of these four prevalent diseases is not proportional t>> the number of cases reported under each class. Diseases of the Nervous System made heaviest inroads on school time and In- fective Diseases bast. TABLE V. Ibis table is an extension of Table III to determine the existence of 'critical' age periods of illness among our teachers. While the graphs indicate age fluctu- ations, it should be noted that these fluctuations are confined to certain zones and that the fluctuations are, therefore, zonal rather than periodic, if we ignore the extreme Table 5 Percentage Distribution oeJllness CausingThe Absence-of4I48Teacher3 Arranged AccordingTo SexandBv Age Groups. Percentages Calculated on The Total Number ofTeachers in Each Age Group. Lavitt BarsMI . PS. 62.. .Ian 30% 56% 1 , \ / * ' / "O 25% / / \ \ \ V \ \ \ / \ 1 • ' \ / s \ — .-— • " \ / \ \ / \ 5°fo \ \ t \ n $ V w to n o "> o 10 o «o o v * in 10 uj \o n ■ 1 1 • 1 1 , ■^o«no«oomoiooio iq f ^lOintoio LEGEND M£N NOMCN TOTAL limits of the graph 'Below 20' and '65-70', which ar« not significant, being based upon too few instances to warrant generalization. It is true there is a tendency toward maxima in age-groups '35-40' and '50-55'; but. on the whole, the fluctuations are too moderate to warrant the assumption of 'critical' periods. The graphs also emphasize the marked differences between the per cents of illness of the two sexes. TABLE VI. The graph for women in Table VI shows a slow and steady increase in the average time lost by illness with advancing years, while that for men presents such marked and unaccountable fluctuations as to require future verification. Considering the entire teach- tC Table 6 A verage Number of School Days LostBy4I48 Teachers on Account Da^ s OFlLLNe:ss During 1913-14 Arranged AccordingTo SexandByAge Groups /36 Days Oavid Bavshell. PS. 62 hrttn. LEGEND MEN WOMEN TOTAL ing staff, it may fairly be asserted that the average time lost by absence steadily increases with age. Here, also, we shall have to ignore the extreme group limits as based upon an insufficient number of cases. TABLE VII. A comparison of the per cents of illness for the four Occupational Diseases with similar per cents reported by Terman (Teachers' Health, page 13) for the Provident Branch of the National Society of English Teachers embracing 18,000 members, emphas- izes the more unfavorable morbidity experience disclosed by the investigation for New York City. Disease English Teachers New York City Teachers Nervous Complaints -9 P? 1 " cent Diseases of the Respiratory System | 343 per cent per cent 7.25 per cent Diseases of the Digestive System 1.58 per cent 2.2 per cent Disregarding the age-groups at both ends of the graphs as inconclusive because of the paucity of cases, we again note that all the graphs for the four prevalent diseases show zonal rather than periodic fluctuations; nowhere are there distinct signs of 'critical* ages of susceptibility to these diseases. Whatever else may be inferred from these age distributions, one fact appears evident, that illness among our city teachers appears to be no respecter of age and throws its burden indiscriminately on old and young. This being at variance with surmise, warrants further study to determine the accuracy of these results and their applicability to school years other than that under investigation. Nor should several important factors be overlooked in analyzing the foregoing tables. Only 24 cases of. tuberculosis were reported by the teachers' physicians, an insignificant number when one considers that Terman concludes that "statistics recorded indicate a 10% 5% Table 7. Percentage. Distribution of Absence Caused By The Four Occupational Diseases Disclosed ByThis Investigation Arranged According To Sex and By Age Groups. Percents Calculated on The Total Number ofTeachersin Each Age Group 3i7? Respiratory d/seases^-467 cases- 7±percent ofteach/ng corps. \ — __ _— """' N ~— — ~. _ _— — " S " . __ — - __ — ~~~ — «^^_ y y / _ i Uavid flarshell. PS bi: Man LEGEND MEN WOAfCN o i o 10 o 10 10 o 10 10 (0 O O cm 10 C\J o to to o lO o 10 10 o U5 l3 %° Infective diseases-678 cases- 3$ percent of teaching corps. 10°1o 5% — T \ \ \ „. ~~~ — ^^ _ ^— " ~~~- -~ ,^ ,---' "^^^^ ^ s \ ^^~ \ _^— ■ —^ \ s 10 (0 10 10 O 10 10 10 O <\J 10 ro 10 10 O in IT) lO IO LEGEND Af£ N WOMEN Diseases of the nervous system-6is casesspercent ofteaching corps. 10% 5% 1- ■ — — — — ■ ■- ■ ' 3 c ^ m r *• *; 1 10 K) Ml fO w 10 (VJ rO 10 ro LEGEND MEN WOMEN Diseases of digestive organs^-56 cases -2i percent op teaching corps. \0% 5°Jo ^ m , ^ m w ~-~~ 4 1 10 CVJ to. to 10 10 1 10 to * in LEGEND MCN WOMEN higher tuberculosis mortality for the teaching profession than for the notoriously un- healthful occupations of stone-cutter or saloonkeeper". The small number of reported cases in this investigation does not necessarily mean the non-existence of tuberculosis among the teachers of the city. Considerate physicians may have used more euphonious termin- ology to designate the ailment. A teacher reported as suffering from active tuberculosis would receive the immediate attention of the Health Board, an ordeal which many physicians would wish to spare their patients. Again, the total number of cases of Nervous Diseases reported in this investigation does not adequately set forth the situation existing in our public schools. The cases recorded are only such as resulted in absence. No notice whatever was taken of the thousands of teachers suffering from neurasthenia, who to the best of their ability are attending to their daily work. The well known type of teacher, in a state of constant pathological fatigue, nervously unstrung, who by sheer dint of heroic effort is sacrificing her remaining vitality in the cause of public service, has not been considered in this inves- tigation. Should the Committee pursue this inquiry for another year, an attempt will be made to determine how many such teachers are serving in our schools. SUMMARY OF CONCLUSIONS 1. On behalf of future investigators the hope is expressed that the educational authorities of the city will soon embody in their official reports essential statistics relating to the causes of absence of teachers and supervisors to compensate for the almost total lack of official information bearing on this subject. A reliable table of the ages of all the teachers in service, figures indicating the number cf cases of illness arranged by sex and according to ages, and the time lost by absentees, would furnish valuable material for investigations of great importance to our teachers. 2. The fact disclosed by this investigation — that over one-fifth of the entire teach- ing and supervising corps of the city was absent because of illness during one school-year — indicates the existence of an administrative problem of great moment. 3. The teachers' health ultimately determines the efficiency of the entire educational system of the community. This self-evident fact impels the Committee on School Problems to urge competent agencies having mechanical and technical facilities for scientific research to conduct further careful statistical study of all the factors that may give rise to the heavy morbidity among teachers. Among such factors should be considered : (a) Position of the absentee — whether teacher or supervisor. (b) Size of class taught, or school supervised. (c) Sex of the pupil taught. (d) Nationality of the pupil taught. (e) School district in which the teacher is employed. (f) After school occupations of the teacher. (g) Years of service. (h) Hygienic condition of the class-room with special reference to heating, lighting and ventilating. 4. (a) The investigation has clearly disclosed the existence of four prevalent or Occupational Diseases among the teachers of the city viz. : Diseases of the Respiratory System, Infective Diseases, Diseases of the Nervous System, and Diseases of the Diges- tive Organs, these four groups comprising JJ per cent of all the cases reported and account- ing for 72 per cent of the entire time lost by illness. The teachers who suffered from Respiratory Diseases constituted 7*4 per cent of the entire teaching staff ; those suffering from Infective diseases 3.33 per cent; from Nervous Disorders 3 per cent; and from Disorders of the Digestive Organs 2.2 per cent. (b) The few instances in which comparisons could be made between the New York City morbidity experience of teachers and those of other cities, are, on the whole, decidedly unfavorable to New York City. Teachers in New York show a far heavier per- centage of illness caused by Diseases of the Respiratory System and Digestive Disorders that) those recorded for the teachers of the city of Amsterdam, the teachers of certain sections of Sweden, and by the National Society of English Teachers embracing 18,000 members. id The exceedingly heavy morbidity rate ascribable to Respiratory Diseases, desi the cart tul consideration of the school authorities. The .suspicion has been frequently voiced that the ventilation <>f our school rooms may be causative of serious physical disorders, ami the marked prevalence of ailments which may he attributed to this cause lends color to the suspicion and brings it into the realm of probability. It is also evident that should this cause operate against the health of the teacher, it must also jeopardize the physical well-being of the pupil. 5. A marked difference i^ shown in the ahsence records of the two sexes. During the year under investigation, 8 per cent of all the men, and 22 per cent of all the women employed a- teachers were absent on account oi illness. The average number of school days lost by men was 13, by women 17. 6. The graphs showing the distribution of the four prevalent Occupational Diseases arranged according to sex and by age-groups do not reveal the existence of critical age periods of illness, during which ahsence is markedly greater than at other times. The distribution, in other words, is zonal rather than periodic, indicating that no age group can claim special immunity from the four prevalent disorders. This applies to both sexes. 7. The graphs showing the distribution of time lost by absence arranged according to age-groups, disclose a gradual average increase in time lost with advancing years. In bringing this preliminary report to a clo?e. the Committee on School Problems wishes to express its deep obligation to the many individuals who have aided its work with advice, suggestions and encouragement. The thanks of the Committee are due to Dr. Albert Shiels, Director of Reference and Research, for his valuable cooperation in secur- ing documentary information; to Dr. Henry Fleischman, Administrator of the Educational Alliance, for the preparation of Table I; to City Chamberlain Henry Bruere and to Auditor George Buck for their courtesy in furnishing age-tables of the teachers of the city ; to Dr. C. Ward Crampton for helpful suggestions on the conduct of the work ; to Principal Lyman Best for furnishing important statistical data; to Principal Leon W. Goldrich, for helpful constructive criticism during the progress of the work; to the Misses Lavinia and Jessie Allen and Mr. Abraham Cohen, devoted and self-sacrificing teachers of our city, for giving so freely of their time to the laborious statistical compilations involved in the preparation of this report. All of which is respectfully submitted. Oswald Schlockow, Chairman, Committee on School Problems, Principal, Public School 109-B, Brooklyn. LIBRARY OF CONGRESS 029 483 176 9