COLUMBIA LIBRARIES OFFSITE HEALTH SCIENCES STANDARD HX64077217 RA61 3 W73 Industrial hygiene, ,j.. lustrial Hygi RA6>I3 W7J Columbia Statoetsttp intl)fCttpDflmigork College of Pjrsicians anb burgeons Htbrarp Health -Education S#tew *«r*t INDUSTRIAL HYGIENE By - "J PROF. C.-E. A. WINSLOW College City of New York Curator of Public Health Museum of Natural History, New York "Mj> people ate destroyed for lack of knowledge." — Hosea iv. 6. Published by the Health-Education League 8 Beacon Street, Room 36 BOSTON, MASS. OFFICERS President, DUDLEY A. SARGENT, M.D. Vice-President . H. S. POMEROY, M.D. Secretary Rev. GEORGE H. CATE Treasurer A. L. DARROW DIRECTORS MMS. ELLEN H. RICHARDS CHARLES M. GREEN, M.D. HENRY J. BARNES, M.D. MILTON J. ROSENAU, M.D. HERMAN F. VICKERY, M.D. MBS. J. D. K. SABINE, M.D. Rev. CHARLES FLEISCHER FREDERICK H. PRATT, M.D. FRANK E. BUNDY, M.D. Copyright, mil. i>y Health-Education League Industrial Hygiene C.-E. A. WINSLOW Associate Professor of Biology, College of th» City of New York, and Curator of Public Health, American Museum of Natural History, New York " It is but reasonable that Physick (med- ical science) should contribute its quota for the safety of Tradesmen (industrial workers) , that they may follow their trades without injuring their health." — Ramazzini, " Treat- ise on the Diseases of Tradesmen " (1670). " The canker of industrial diseases gnaws at the very root of our national strength. The sufferers are at least a third part of our population. That they have causes of dis- ease indolently left to blight them and their work is an intolerable wrong. To be able to redress that wrong is one of the greatest opportunities for doing good that human institutions can afford." — Sir John Simon, Medical Officer, Report to Privy Council of Great Britain, 1861. " We do not wish to see productive energy sapped by excessive toil or by labor under improper conditions. We want men pro- tected from avoidable danger to life and limb, and to see a diminution in the shock- ing number of preventable casualties in our industrial employments, which constitute a disgrace to the country. " We seek the dissemination of informa- tion with regard to the practical conduct of life, so as to remove the ills which are due to simple ignorance." — Ex-Gov. Charles E. Hughes, " The Social Ideal." ' Conservation of the Living Machine EFFICIENCY is the dominant idea in modern industry. Ris- ing standards of living and diminishing natural resources make the haphazard methods of earlier days more and more inadequate. Raw materials are carefully conserved. Machinery is studied and simplified and made effective in the minutest detail. Special foremen are employed to superintend the distribution of work from hand to hand in the factory so that all waste of time and energy may be minimized. One side of the problem is however still strangely neglected. The most important machine in every workshop is the living machine. In the cotton industry in 1905 interest on the ordinary money capital at 5 per cent would have amounted only to 30 million dollars against 96 millions paid out in wages, as interest on the life capital invested. There is no other machine so directly responsive to slight changes in its sur- roundings as the human body. A few degrees change in temperature make a vast difference in the efficiency of the worker, and so in the service which the employer receives for his wages, in the quantity and quality of work and freedom from breakage and waste of material. If this is true for the employer it is of course far more true for the em- ployee. Not only his efficiency, which determines his earning power, but his happiness and his health, perhaps his life, may depend on the conditions under which he lives during his work- ing hours. Four out of five deaths in certain industries are due to industrial tuberculosis, which results from the breathing of irritating dusts. Yet the operative often unites with the factory owner in maintaining conditions which violate every principal of sanitation and hygiene, and lay upon both the burden that inefficiency brings in its train. It is not heartless cupidity on the one hand nor willful carelessness on the other. It is simply lack of knowl- edge of what is going on. The Waste of Life on the Railroad, in the Mine and in the Shop One of the most obvious and striking! preventable wastes is that due to in-[ dustrial accidents on railroads, in mines and in factories. About 10,000 per- sons are killed and 100,000 more or| less seriously injured on the railways of the United States every year. Some 3,000 fatal accidents occur annually in the course of mining operations, and| probably 5,000 deaths result from ac- cidents in the operation of machinery in factory and workshop. Much of the suffering and misery represented by these bald figures is pre- ventable, — is prevented in other coun- tries. Fatalities are four times as common among our railroad employees as among those of England, and other accidents seven times as frequent. Coal mining was nearly as fatal in Belgium between 1830 and 1840 as it is in the United States to-day, but the Belgians have cut their death rate down to less than one third of what it was. Preventable Industrial Accidents The responsibility for these condi- tions rests upon both parties to the in- dustrial partnership, — upon employer and employee alike. Everyone who examines the problem with an open mind knows that few railroad officials and factory managers have done all that they might to provide safety appliances and to frame and enforce regulations against the dangers of the occupations for which they are responsible. Every- one knows that in mining and in man- ufacturing many accidents arise directly from the employment of children and ignorant persons at tasks for which they are manifestly not equipped. On the other hand it is equally clear that the employee frequently displays a reckless carelessness and a readiness to take chances which are so common in this country as to be almost a national characteristic. At times, notably in railroading, the resources of labor organizations have been vigorously and successfully em- ployed to thwart the enforcement of rules which were more beneficial to them than to either their employers or the public. In Crystal Eastman's admirable study of work accidents in Pittsburg it appeared that out of 410 fatal accidents, the victim or his fellow- workers were responsible in 188 cases and the employer in 147 cases. The phrase "Life is cheap," is worse than cynical, it is foolish. Aside from the moral issues involved in human suffering all waste must be paid for. Is it not time that the employers of America set themselves to remedy a condition that Governor Hughes rightly called a national disgrace by providing the safeguards that are now available, — the guards for belts and saws and re- volving parts, such as are to be seen in the American Museum of Safety Devices in New York? Is it not time that the workers of America addressed themselves seriously to their part of the problem and moved actively through their unions for the enforcement of a new standard of con- scientious co-operation in the task of freeing their crafts from the prevent- able dangers that attend them? The Inevitable, Residual Burden of Industrial Accidents A large proportion of the injuries and deaths in railroading, mining and factory work could be prevented by the installation of safety devices and by proper care on the part of the oper- ative. On the other hand a certain risk is essential to many employments. You cannot mine coal or make steel or operate railroads without a sacrifice of human lives. There is a noble saying over the door of the Sailors' Home at Lubeck, "It is necessary to sail the seas. It is not necessary to live." After all preventable risks have been minimized there must remain the stern fact that service means de- votion, — even at times, of life itself. There is a note of high and unsuspected heroism underlying the most prosaic of modern industries. It is important that the risk of in- evitable accident should be recognized and appreciated and placed where it belongs. It is as much a necessity of production as the wearing out of machinery, and like the wearing out of machinery that part of it which can be repaired — the money loss — should be charged against the industry itself and paid by the purchasers of the product. Our American system of the past was as far as possible from accom- plishing this end. The maimed em- ployee or the widow of the fatally injured received no compensation at all unless legal proceedings were in- stituted in each special case, and then not unless it could be proved that the employer had been guilty of special negligence, the employee being held to assume all the ordinary risks of the employment and those due to the negli- gence of any other fellow-servants. The practical result has been that on the one hand large expenditures have been made by employers for insurance and for the legal expense of contesting lawsuits, and that on the other hand a few employees with financial re- sources and acute legal assistance have mulcted their employers, while the great mass of the needy sufferers have received nothing or almost nothing. Thus in the study of work accidents at Pittsburg it appeared that of 235 married employees killed, 59 received nothing, 65 received $100 or less, and 40 between $100 and $500. The bur- den of necessary accidents therefor falls under this system, — first upon the family of the innocent victim and then upon the community at large whose charitable agencies must be called in to furnish relief. "Workmen's Compensation Laws The rational method of dealing with inevitable work accidents has been worked out successfully in all the principal European countries, and con- sists in a system of Workmen's Com- pensation, by which the victim of industrial accidents, except when caused by his own clear neglect, is entitled by right and without legal proceedings, to a proper money equivalent for the injury received. Steps have recently been taken for the introduction of such a system in this country along two distinct lines, by the voluntary initia- tive of manufacturers and by legal enactment. The United States Steel Corpora- tion, the International Harvester Com- pany and other employers of labor have introduced of their own accord plans by which their employees may receive automatic compensation; and in New York and Montana and Maryland laws were passed in 1910 making such an arrangement optional or compulsory for certain classes of occupations. In 1911, ten different states, Cali- fornia, Illinois, Kansas, Massachu- setts, Nevada, New Hampshire, New Jersey, Ohio, Washington and Wis- consin, have already enacted laws bear- ing on this subject. The movement for compulsory com- pensation has been temporarily checked by the decision that the New York law of 1910 was unconstitutional, but busi- ness men, labor leaders and economists are united in the conviction that in some way the system of Employers' Liability must be introduced in order that the burden of inevitable industrial accidents may be placed where it justly belongs. Industrial Poisons There are other classes of industrial dangers less obvious than mine ex- io plosions and railroad accidents, but none the less serious for those exposed to them. If a pound of lead drops on a workman's head the catastrophe is more obvious than if minute quantities of lead salts are taken into the system day by day, but the poisoning is as fatal as the accident, although only the medical man may perceive what is going on. Dr. Hamilton of the Illinois Com- mission on Occupational Diseases was able to discover 578 cases of lead poisoning occurring in three years in the state of Illinois alone. The white lead industry, lead smelting and re- fining, the making of storage batteries, the making of dry colors and paints and the painting trade were the five principal industries affected, but occa- sional poisoning occurred in many other crafts. The victim, after a period of general disturbance, headache, loss of appetite, etc., is usually seized by an acute attack of colic, "painter's colic," as it is rightly called. If he continues at work and adds day by day to the stock of poison in his system, by ii breathing lead dust or by getting small particles of it into his mouth with his fingers or on his food, the condition becomes chronic. Gradually the whole system is poisoned, and death results from the injury to some vital organ ; or acute nervous symptoms may set in, paralysis of local muscles, " wrist drop, " so-called, or epilepsy and insanity. John B. Andrews in Bulletin 86 of the United States Bureau of Labor re- ports that 65 per cent of the employees in American match factories are work- ing under conditions which expose them to the fumes of phosphorus and the danger of "phossy" jaw, a loathsome disease in which the bones of the jaw ulcerate and are gradually eaten away. The New York and New Jersey sec- tion of the National Civic Federation in three months' time found 60 cases of mercurial poisoning, a nervous disease called in the trade "the shakes, ' ' among the hat makers of Brooklyn, Newark and Orange as a result of their poison- ing by the mercury salts used in pre- paring felt. Thirty other industrial poisons are 12 listed in a recent German report, of which most are less deadly, but some like benzine and wood alcohol are per- haps even more serious because of the large number of operatives exposed to their effect. Prevention of Industrial Poisoning All these industrial poisonings are preventable, — are largely prevented, — by other nations. Fumes can be drawn off by special ventilation, and the in- troduction of the poison by the mouth can be forestalled by cleanliness, the separation of workrooms and lunch rooms, washing of hands and change of clothes on leaving the workroom. In many instances less poisonous sub- stitutes can be introduced, as in the case of matchmaking. The use of white phosphorus (the poisonous kind) is forbidden by law in France, Denmark, Italy, Germany, Great Britain and several other Euro- pean countries; and a law having the same effect has been introduced in our own Congress. The use of poisonous lead com- pounds is still permitted, but in Eng- l 3 land and Germany is so hedged about with stringent regulations as to be robbed of its worst dangers. Large English white lead factories under the most careful supervision frequently show not a case of lead poisoning for several successive years, while Dr. Hamilton found 25 cases during one year in a ''model" Illinois factory em- ploying 200 hands. Strict sanitary regulations and regu- lar medical inspection must be intro- duced in American trades exposed to such poisons if the employees are to be protected against these unnecessary dangers. Tuberculosis in the Dusty Trades There is another problem more seri- ous still, — one which is perhaps indeed the central problem of factory sanita- tion, — that of industrial tuberculosis. The trades exposed to lead and phos- phorus and other acute poisons are small ones, and, serious as the danger is for those exposed, the death roll is not a long one. On the other hand the bad air and the dust to which the workers in many of our greatest in- dustries are exposed work their insid- ious effects upon hundreds of thou- sands. Tuberculosis is pre-eminently a social and an industrial disease, for the reason that it is a disease due to bad living and working conditions, to insanitary tenements and workrooms. Two factors must contribute to every case of consumption, — the germ and a lowered vitality on the part of the patient. Preventive measures must therefor follow two lines, the care of sputum of the consumptive, which is the chief agent for the distribution of the germ, and the maintenance of con- ditions which will keep those not seri- ously infected in condition to resist the ravages of the occasional germs which are sure sooner or later to gain an en- trance. The normal body has its "fighting edge" and can protect itself against the tubercle bacillus if given a fair chance, but the lung tissue which is lacerated by sharp particles of granite or steel quickly succumbs to the bacterial invader. In dusty trades, like stonecutting and i5 cutlery working and emery grinding, 75 per cent of all the deaths among operatives is often due to tuberculosis, against 25 per cent for the normal adult population. This may be fairly interpreted as meaning that the actual death rate from tuberculosis in these trades is from two to four times as high as in a corresponding average popula- tion ; in other words, three or four or five out of a thousand of these workers are sacrificed every year to the condi- tions under which they labor. In other industries where there is less dust, or softer less irritant dust of ani- mal or vegetable origin, the damage is less serious, but is nevertheless real and important. The investigation made by the Massachusetts State Board of Health in 1907 showed that of 4,399 dust-producing machines in shoe fac- tories 2, 769 were not properly equipped with devices for dust removal. Such conditions exist in very many of the large and small industries of this country; and though the total resulting cost in life and health is impossible to estimate with any accuracy it is un- questionably a very large one. 16 Protection of the "Worker from Harmful Dusts This damage like that which results from accidents and poisonings is in large degree preventable. There are three principal methods of dealing with it. In the first place there are some industries in which the original discharge of dust into the air may be prevented without any serious impair- ment of efficiency. Wet grinding for example may be substituted for dry, or the process which evolves dust may be carried on in a closed vessel as is done in certain of the newer lead factories. Secondly, where the formation of dust is essential it can usually be removed and the worker protected from its effects by the installation of hoods equipped with ducts and fans by which the dusty air may be drawn away from the part of the machine where it is formed. The provision of such a device is required by law in many states, but the require- ments are general and as a rule inade- quately enforced. It is morally the duty of every em- ployer who maintains emery wheels, 17 buffing wheels or any other dust pro- ducing device to see that they are equipped not merely with hoods and suction but with hoods and suction adequate to secure real protection against the dangers to which his work- men are unknowingly exposed. Respirators Finally, in certain trades, the elim- ination of dangerous dusts is practi- cally impossible. This is true in some processes of granite working. In such cases there remains only one remedy, the wearing of respirators of some efficient type which will keep the dust surrounding the worker out of his nose and throat and lungs. Respirators are uncomfortable and annoying; and here comes in the worker's responsibility for industrial disease. Often he refuses to protect himself in this way, and even in the case of the suction device which guards him from the dust of grinding wheels he fre- quently removes the hood if it be de- tachable in order that he may work a little more conveniently. In these pre- cautions and in the prevention of pro- iS miscuous spitting which spreads the germs the employee must do his part if the burden of needless industrial disease is ever to be lifted. Air Conditioning' for the Living Machine Even dust is perhaps less important as a menace to the health and effi- ciency of the worker than the over- heating and under-ventilation which is so general in factories and workshops of all kinds, and which though far less immediately serious in its action grad- ually undermines the strength and vigor of the whole industrial army. There is no single factor which so directly and strikingly affects the tone of the human body as the physical con- dition of the atmospheric ocean in which it is bathed. The contrast between one's feelings and one's effectiveness on a close, hot, muggy day in August and on a cool, brisk, bright October morning is suffi- ciently obvious, yet many a factory operative is kept at the August level by an August atmosphere all through the winter months. He works list- 19 lessly, he half accomplishes his task, he breaks and wastes the property and the material entrusted to his care. At the close of the day he passes from the overcrowded, overheated workroom into the chill night air, and with lowered vitality falls a prey to minor illness, colds and influenzas, if not to the great enemy, tuberculosis, always lurking in the background. The Danger of Overheated Air Sanitary opinion in regard to air supply has made great advances in recent years, — notably in the recogni- tion that it is no mysterious poison that makes bad air harmful but rather its physical condition in regard to tem- perature and humidity.* The chief thing that produces discomfort and danger in an ill-ventilated room is the fact that the air has become overheated and either too moist or too dry. The human body is adapted to a temperature of 68° to 70° and a relative humidity of 60-70 per cent, and great deviation from these limits means an inevitable deterioration in efficiency 20 and a lowering of health tone that makes it a prey for any sort of disease.* In particular a rise of the thermometer over 70° should never be permitted ex- cept when the outdoor temperature is above this limit; and a superintendent who does not keep a thermometer in every workroom and see that it is kept below 70° is unconsciously neglecting his own interests as clearly as if he permitted his lifeless machines to run in such a way as to rack themselves to pieces. How to Secure Fresh Air In small workrooms which are not overcrowded, proper air conditions may be maintained without special ventilation by the intelligent use of doors and windows. Hot vitiated air tends to rise, and the Hygienic Window is one which is open a little at the top *The relative humidity or moistness of the air is best measured by the use of a wet and dry bulb ther- mometer. The temperature of the thermometer whose bulb is kept moist by a saturated cloth is lowered by evaporation which is more rapid the drier the air. The best form of wet and dry bulb thermometer is the Sling Psychrometer described in Bulletin 235 of the United States Weather Bureau, and both this and a simpler and fairly accurate instrument, the Hygrodeike, may be bought of any instrument maker. 21 to allow the exit of foul air and open a little at the bottom to permit the en- trance of a fresh supply. Even strong draughts are less harmful than is com- monly supposed and everyone is more comfortable if the heat and the odors which the body gives off are swept away by moderate steady currents. A screen of copper wire may be made to fit into the lower window opening in order to prevent excessive draughts, and in cold weather perhaps re-enforced by covering it with cloth. At the lunch hour and before and after hours every workroom should be thoroughly flushed out and cleansed by throwing open all the windows available. With large and crowded workrooms special ventilation must be provided by means of ducts and fans. In the design of such systems care should be taken to secure efficient distribution of air to all parts of the room. A factory is not a simple box in which air will automatically distribute itself if only the requisite supply is forced into it at one or a few isolated points. Furthermore a ventilating system 22 must be intelligently operated as well as scientifically installed. The air which is supplied must be of the proper temperature and humidity, and if the engineer in charge of the system cannot give skilled attention to such details disappointment is almost cer- tain to ensue. The Economic Value of Factory Ventilation All these provisions cost money and require care in construction and in maintenance. For a large establish- ment where such special ventilation is required there is however little doubt that the time and money spent will bring a direct return in increased effi- ciency of production. There is plenty of evidence that such has often been the case. The ventilation of the United States Pension Bureau reduced the days of absence of employees from illness by 46 per cent. The installation of a simple ventilating system in the Cam- bridge telephone toll room cut the winter absences by 58 per cent. 23 Mr. D. D. Kimball, in a recent arti- cle, quotes Townsend Grace Company as claiming that a ventilating system in their straw hat factory paid for itself in one year; and he cites a printing establishment in New York in which "a ventilation system was installed because of the insistence of the State Department of Labor that the law be complied with, the order having been resisted for two years. After the system had been in use a year the proprietor said that had he known in advance of the results to be obtained no order would have been necessary to have brought about the installation. Whereas formerly the men had left work on busy days in an exhausted condition, and sickness was common, now the men left work on all days in an entirely different condition, and sickness had been very much re- duced. The errors in typesetting and time required for making corrections were greatly reduced. " Eye Fatigue and Eye Strain Another point in which there is ample opportunity for practical im- 24 provements beneficial to employer and employee alike is in respect to the lighting of factories and workrooms. The Massachusetts State Board of Health in the report to which refer- ence has been made points out that: "It is a well-established fact that either the over-use of the eyes, or the use of eyes under bad conditions, may give rise to eye fatigue or to eye strain; and many eye specialists be- lieve that at least 80 to 90 per cent of headaches are dependent on eye strain. With these facts in mind it is im- possible to ignore the probability that many individuals working by gaslight, or even electric light, in dirty, un- painted, overheated rooms, with im- pure air and excessive moisture, for ten hours a day, or merely for the last two hours during the day, use up a great deal of nervous energy and suffer from eye fatigue or eye strain, and its consequences." The danger from accidents is also undoubtedly increased by eye strain, defective vision and dim light. Yet the Massachusetts Board found that little thought had been given in 2 5 mill construction, particularly in the textile industry, to providing proper lighting for the work to be done. Many rooms were of old construction, with low ceilings, small windows and small panes of glass. In the middle of large rooms and in basements con- ditions were particularly bad. Aside from structural defects, too, the failure to keep walls and ceiling clear and white and the infrequent washing of the windows contribute in large degree to make lighting inade- quate and harmful. Where artificial light is provided it may frequently be wrongly placed so that the workbench is insufficiently illuminated or, what is quite as bad, so that a direct glare is thrown into the worker's eyes. The Physical Condition of the Worker So far reference has been made chiefly to the environment of the worker, to the light and air which surround him and affect his activities, to the poisons and dust and dangerous machinery which may work injury to him. There is another factor to be con- 26 sidered however, — the living worker himself and his varying conditions of health and disease which interact with the external world about him. Special foremen are provided to in- spect machines, to replace worn parts, to regulate speed with painstaking care. As a rule there is no depart- ment to care for the men who run the machines, the human factor in pro- duction. Yet in some cases the em- ployer may well go beyond the pro- vision of sanitary surroundings and concern himself directly with the phys- ical condition of the worker himself. Medical Supervision In highly dangerous occupations like those which involve exposure to lead or other acute poisons medical supervision of the employee is almost imperative. In England it is required that men who are to work with dan- gerous lead compounds must be exam- ined before doing so in order that it may be certain they are in good enough condition to warrant the risk, and they must be periodically examined during 27 the period of their employment in order that if disease develops it may be detected in its early stages before it is too late. The Massachusetts law- makes a similar provision for minors employed in factory work. In establishments like the American Steel and Wire Company and the Cleveland Hardware Company, where much dangerous machinery must be used, emergency rooms are equipped for the prompt treatment of minor in- juries ; and they have more than proved their worth in preventing slight acci- dents from developing into serious dis- abilities. Certain large industrial plants have gone farther still, and have engaged nurses or doctors to be regularly at the factory for consultation and to visit employees who desire it in their homes and there give them free medical care. Of such a plan for a visiting nurse as worked out by the Waltham Watch Company it was stated: "It is almost impossible to estimate the ground which has been gained in preventing absences from work, prevention of 28 contagion and infection, especially at times when there is a prevalence of disease or possibly a threatened epi- demic. " Overstraining and Overspeedingf of the Human Machine There is still one more problem which deserves brief notice in any con- sideration of the factors which affect the health and comfort and productiv- ity of the worker. Work that is too severe or too long continued for the strength gradually saps the vitality and brings sickness and suffering and in- capacity in its train as surely as the factory conditions which produce lead poisoning or industrial tuberculosis. The operative is as easily injured by overspeeding as the most delicate machine, and prolonged effort leading to undue accumulation of the so-called 1 'toxin of fatigue," gradually under- mines the strength and vigor of the strongest. The legal regulation of hours of labor and of the conditions under which women and minors may work in 29 various industries is a complex prob- lem with its social and economic as well as its physiological and humani- tarian sides. Rash and ill-advised interference with the inter-relations of society may do more harm than good. Yet it is clear that labor which works permanent damage to the worker is harmful to all parties concerned. Life capital must not be wan- tonly wasted if industrial leadership is to be maintained; and, in par- ticular, working conditions which are injurious to women and children must be controlled, for on the next genera- tion the future of the nation must depend. Welfare Work a Separate Problem It should be recognized quite clearly that such sanitary and medical provi- sions as have been discussed bear no necessary relation to the sort of semi- philanthropic effort which has come to be known as Welfare Work. In mak- ing provision for the safety and com- fort of his operatives an employer may recognize one or all of three distinct motives. 30 In the first place working conditions in harmony with safety and healthful- ness are due to the employee on the ground of simple right and justice. It is clearly unfair that preventable dangers should be allowed to kill and maim and invalid the worker without his fault and in the course of his necessary daily toil. Most of the problems which have been considered belong in this class, and the employer need only be actuated by a sense of common justice in dealing with them. In the second place an employer may do more for his workers than they can demand of right, from a motive of intelligent self-interest. This impulse and that of justice combine to inspire improvements in light and ventilation which bring direct return in the pro- ductivity of the worker. The estab- lishment of d i sp ens ar i es and the employment of doctors and visiting nurses is not a response to any inherent right of the worker; but in certain cases it has proved so advantageous to the employer as to be justified on broad business grounds. 3i Finally, in the third place, some factory owners have gone beyond the demands either of justice or of direct self-interest, and have embarked on undertakings which can only be re- garded as philanthropic in character. The establishment of libraries, edu- cational centers, clubhouses and gym- nasia, the conduct of picnics and other festivities, the foundation of sav- ings and loan associations, and the con- struction of homes, model villages, etc., are beyond the scope of the busi- ness itself and are in the nature of voluntary benefactions of the employer to the employee. An Important Distinction These activities, to which the term Welfare Work properly applies, belong to a different class from those pre- viously considered. Anything which directly promotes the conduct of the business may be offered by the em- ployer and accepted by the employee without hesitation. Favors however can only be given and taken when a spirit of real sympathy exists. 3^ This is the reason why Welfare Work as such has sometimes been a success and sometimes a disappointing failure. When gifts are bestowed in a patron- izing spirit or in order to cover the denial of important fundamental rights they are not likely to find a cordial response. The worker has been described as a living machine. He is a machine from the standpoint of physiology; but in the sphere of human relation he is not a machine but a human being. He has a right to be consulted as to what shall be done for him. In the matter of receiving favors he must have the opportunity to accept or to decline with dignity and self-respect. Philanthropy between employer and employee may or may not be a good thing, depending on the spirit in which it is offered and the tact with which it is carried out. The measures which directly promote the safety and health and effectiveness of the worker by ensuring to him the most favorable conditions under which to labor, — these measures stand on a wholly dif- 33 ferent basis and are always and every- where justified by their results. The Common Interests of Employer and Employee In certain aspects of their common work employer and employee inevitably find themselves in a position of an- tagonism. What is given to one is taken from the other. The controversy may be acrimonious or it may be firm and good tempered; but it is there. In the matter of hygiene and sanitation however there is no conflict of interests. Sickness and inefficiency help no- body. It is just so much taken out of the sum of human happiness and prosperity, — a burden whose load is shifted from one to another in the complex scheme of society until each one bears his part. In preventing the careless and ignorant waste of health and strength the mill owner and the labor leader can stand shoulder to shoulder as workers for their common good. 34 Human Engineering To the far-sighted employer human engineering should be an integral factor in his business. The selec- tion of workers physically adapted to their labor, the maintenance of the best practical conditions for its prose- cution, the elimination of all possible dangers and the proper compensation for those risks that must occur, these are as essential to the successful conduct of a great business as any of its me- chanical or financial problems. Along with the Finance Department, the Mechanical Engineering Department, the Sales Department and the rest should go a Department of Human Engineering; and if it be conducted in the proper spirit so as to invite co- operation rather than distrust and hos- tility this is one department in which the intelligent employee will be every whit as actively interested as the men who have it directly in their charge. Is it too much to hope that a broad and comprehensive policy in regard to these common problems of hygiene and sanitation might so bind together 35 employer and employee as to make for mutual comprehension in a much wider field? Beyond the limits of physical efficiency are other less defi- nite but fundamental interests, for after all industrialism at bottom is not a class struggle but a part of the fight all mankind is making against the common enemies of want and igno- rance and disease. In a deep and a real sense we are all shoulder to shoulder, and the enemy is not so much human selfishness as human ignorance and human limited capacity. It has been well said that,* "If a company can be prompted and sustained by a spirit that industry can do something more than to produce products and profits, then if a man falls in the ranks whether he is a private or a general he has fallen in a cause that is worth while." *Mr. E. A. Bancroft, International Harvester Co 36 HEALTH AXIOMS AND MAXIMS FOR THE WORKER Compiled by the Secretary, Health-Edu- cation League* My people are destroyed for lack of knowledge. — Hosea iv. 6. " A law of Nature is as sacred as a moral principle." — Louis Agassiz. " The conservation of our national resources is only preliminary tt) the larger question of national efficiency. " — Theodore Roosevelt. "Nothing too much." — Aristotle. u If pure air could be breathed in factories, stores, houses — including bed- rooms — it is probable that one half of the hospitals could be closed and one half of the world's diseases could be prevented." — Ellen H. Richards. u Windows were made to be opened." — Florence Nightingale. " The preservation of health depends in great part upon food well cooked and carefully eaten.' ' — Dr. William Osier. " When and how is often more im- portant than what one eats. Do not sat when very tired or worried or angry. 37 " A good joke or laugh is often better than a pill to aid digestion." — Dr. H. Sterling Pomeroy. "It is quite probable that half or two thirds of the food we now eat, if prop- erly cooked and thoroughly chewed, would serve us amply." — Ellen H. Richards. "Many dig their graves with their teeth." 44 Keep the sewers of the body open. There should be one good free move- ment of the bowels regularly every day." " Sleep as much as you can, — never mind about the old proverbs, — and always in pure, fresh air. Get up, if possible, only when you have had your sleep out, and feel rested. To wake growing boys and girls out of their un- finished sleep is harmful." 44 Sunlight, the great and potent de- stroyer of disease germs, is a guardian angel of your household." "A reasonable amount of work is essential to physical and mental health ; but overwork, over-speeding, fatigue beyond a certain point, whether in in- 38 I Pi; fle dustry or athletics, are poisoners and wasters of life." "Play, recreation, is almost as neces- sary for right living as work, but it must be wholesome, neither the kind nor the pace that kills." "Even the moderate use of intoxi- cants interferes with the steadiness and swiftness of nerve action and reaction, and increases very much the danger of accidents." " Habits of cleanliness can be main- tained even in the grime of work. They mean health and life. Never eat or landle food without first thoroughly washing your hands. "FOREMEN: Never spit on the 'actory stairway or floor, especially when you have a cold, nor allow your nen to do so. Precept and example >n your part will greatly help to pre- sent filthy, unsanitary spitting and the ipread of contagious diseases." "The use of the promiscuous drinking :up in shop or factory, or in any public )lace, is forbidden by law in many tates, and is always and everywhere a nenace to health." 39 44 Pain is usually a danger signal for some violation of a law of health. •• Do not drug the pain to silence — except under the advice of a good physician. 11 Heed the warning. Find out the cause of the pain. Take the path of recovery and safety in season." " Worry is a foe of the mind and of health. ''There are things that can be helped, and things that cannot be helped. Worry is useless in either case. ''''Just so far as you can, avoid the causes of worry, excess, disease and debt, by means of intelligent thrift, care and moderation." 44 Our best protection against diseases of all kinds is the power of a strong vital resistance, due chiefly to the white cells of the blood. 44 Anything that weakens this resist- ance, whether it be excessive alcohol, chilling, exposure, dust, over-fatigue or anything else, cripples our defense and exposes us to the attacks of the enemy." t""l< Health - Education League 8 BEACON STREET, Room 36 :: :: BOSTON More than 250,000 Booklets Nos. 1-24 are in Circulation One fourth to one half of their cost is given for many kinds of benevolent work. Membership,: Members are entitled to a copy of each of the publications of the League free. The annual membership fee is one dollar. BOOKLETS No. 1. Hints for Health in Hot Weather Two cents each, $1.50 per hundred. No. 2. Milk By Charles Harrington, M.D. Three cents each, $2.50 per hundred. No. 3. "Colds" and their Prevention Two cents each, $1.50 per hundred. No. 4. Meat and Drink By Ellen H. Richards. Three cents each, $2.50 per hundred. No. 5. Healthful Homes Four cents each, $3.00 per hundred. No. 6. The Successful Woman By William R. Woodbury, M.D. Four cents each, $2.50 per hundred . No. 7. The Boy and the Cigarette By H. Sterling Pomeroy, A.M., M.D. Five cents each, $3.00 per hundred. No. 8. The Care of Little Children By R. W. Hastings, M.D. Three cents each, $2.50 per hundred. No. 9. The Plague of Mosquitoes and Flies Four cents each, $2.59 per hundred. BOOKLETS (Continued) No. 11. Tonics and Stimulants By Ellen H. Richards. Two cents each, $1.50 per hundred. No. 12. Emergencies By Marshal] H. Bailey, M.D. Eight cents each, $5.00 per hundred. No. 13. Microbes Good and Bad By Anne Rogers Win slow. Four cents each, $3.00 per hundred. No. 15. The Efficient Worker By Ellen H. Richards. Four cents each, $2.75 per hundred. No. 16. Sexual Hygiene By An Experienced Physician. , Four cents each, $2.50 per hundred. No. 17. Health in Labor Camps Three cents each, $1.75 per hundred. No. 18. Tuberculosis (Consumption) By Edward O. Otis, M.D. Five cents each, $3.00 per hundred. No. 19. When to Call the Physician By George W. Gay, M.D. Four cents each, $2.50 per hundred. No. 20. Habits of Health By Paul W. Goldsbury, M.D. Four cents each, $2.50 per hundred . No. 21. Wastes and their Disposal By Heni'y J. Barnes, M.D. Four cents each, $2.50 per hundred. No. 22. Typhoid Fever, Infection and Prevention By Mary Hinman Abel. Five cents each, $3.00 per hundred. No. 23. The Observance of Health Day in Schools By Thomas F. Harrington, M.D. Four cents each, $2.50 per hundred. No. 24. Industrial Hygiene l'.\ Prof. C K. A. \Yin>lnw. Seven cents each, $4..">o per hundred. Sample copies of these booklets will be sent to any address on receipt of price COLUMBIA UNIVERSITY L This book is due on the date indicated be expiration of a definite period after the date as provided by the rules of the Library or rangement with the Librarian in charge. DATE EORROWED DATE DUE DATE BORROWED C28(23B)M100 I KABlb ns low