Columbia ©nitierj^ftp College of ^f)?^ician2i anb ^urgeong Hitjrarp GIFT OF Frederick S. Lee Digitized by the Internet Archive in 2010 with funding from Open Knowledge Commons http://www.archive.org/details/surveyofindustriOOohio A SURVEY OF INDUSTRIAL HLALTH-HAZARD5 AND OCCUPATIONAL DI5LA5L5 IN OHIO By L. R. HAYHUR5T, A. M., M.D. DIRLCTOR. DIVISION OF OCCUPATIONAL DISLA5L5. STATE BOARD OF HEALTH PRLPARLD IN CONFORMITY WITH HOUSL JOINT RESOLUTION No. I2-LIGHTILTH GLNLRAL ASSEMBLY OF OHIO UNDER THE GENERAL SUPERVISION AND DIRECTION OF THE OHIO 5TATL BOARD OF HEALTH L. F. McCAMPBLLL, Ph. D., M. D. Secretary and Executive Officer FEBRUARY, 1915 Columbus, Ohio: Thk I<". J. Heer Printing Co, 1915 5 INDUSTRIAL HEALTH - HAZARDS AND OCCUPATIONAL DISEASES IN OHIO LETTER OF TRANSMITTAL. Columbus, Ohio, February i, 191 5. To the Members of the Eighty-first General Assembly, Columbus, Ohio. Gentlemen : — Pursuant to House Joint Resolution No. 12, (Laws of Ohio, 1913, Vol. 103, p. 975). On behalf of the State Board of Health I am herewith transmitting to the Eighty-first Gen- eral Assembly the results of the survey which was directed and au- thorized. This survey deals with the effect of various occupations upon the health of those workers engaged therein. The resolution authorizing and directing this investigation is herewith appended. Respectfully, E. F. McCampbell, Ph. D., M. D., Secretary and Executive Officer, Ohio State Board of Health. iii JOINT RESOLUTION Authorizing and directing the state board of health to make an investigation of occupational diseases. Whereas^ The employment of men and women in certain occu- pations is known to be attended with more than ordinary danger to health, giving rise to what is known as "occupational diseases", and Whereas^ Unnecessary sickness and shortening of life, from whatever cause, is a serious loss and of grave concern to the state and to all the people, and Whereas, It is believed to be possible, by public education and by the enforcement of proper measures, to largely prevent unneces- sary sickness and premature death among employes in various trades and occupation, therefore, Be is resolved by the General Assembly of the State of Ohio, That the state board of health is hereby authorized and directed to make a thorough investigation of the effect of occupations upon the health of those engaged therein with special reference to dust and dangerous chemicals and gases, to insufficient ventilation and lighting, and to such other unhygienic conditions as in the opinion of said TDoard may be specially injurious tO' health, and to report to the next general assembly the results of such investigation, with such recom- mendations for legislative or other remedial measures as it may deem proper and advisable. Be it further resolved. That the finance committee of the House and the Senate be requested to place in the general appropriation bill an appropriation of $7,000 for the year 1913 and $7,000 for the year 1914 for carrying on the above work by the state board of health. [Signed] C. L. Swain, Speaker of the House of Representatives. [Signed] Hugh L. Nichols, President of the Senate. Adopted February 13th, 19 13. OHIO STATE BOARD OF HEALTH, Division of Occupational Diseases, Columbus, January 31, 1915. Sir: I beg to transmit herewith the Report of the Survey of Industrial Health-hazards and Occupational Diseases, embodying the results of the investigation made in compliance with House Joint Resolution No. 12, of February 13, 1913. ■ The Report deals with the investigation of the effect of occupa- tions upon the health of those engaged therein, with special reference to health-hazardous conditions as opinionated by a special staff of investigators who have inspected the work places of about half of those employed in manufacturing industries and in some non-manufacturing industries in the State of Ohio. I am, very respectfully, Emery R. Hayhurst, Director, Division of Occupational Diseases, Chief, Survey of Occupational Diseases. Dr. E. F. McCampbell, Secretary and Executive Officer, Ohio State Board of Health. vi CONTENTS. PAGE Letters of Transmittal iv Table of Contents vii List of Illustrations ; ; xi Introduction xv PART I. Historical Notes 1-8 Legislative Enactments ' 3 Physicians' Reporting Form 6 PART II. General Principles of Industrial Hygiene .- 9_16 General Sources of Information 9 Definitions and Physiological Adaptations 10 Industrial Vital Statistics ■ 13 PART III. Industrial Health-Hazards 17-50 Dust .17 Dirt 20 Darkness 21 Dampness 23 Devitalizing Air 26 Heat 29 Cold. 32 Fatigue 33 Inactivity 38 Germs and Infection 39 Poisons 42 Compressed Air ' 48 Foul Odors 49 Venereal Diseases 50 Stimulantism 50 FART IV. Plan, Scope and Conduct of the Investigation 51-105 Definitions 54 Examples of Records in Certain Establishments 55 Industries Having a Known Association With the Use of Poisons 59 Industries Having a Know.n Association With Dust 77 vii Vlll PlaNj Scope and Conduct of the Investigation — Concluded. page Industries in Which Fatigue, Monotony or Inactivity are Health- Hazards 80 Industries in Which Heat, Cold. Moisture and Dampness are the Chief Health-Hazards 83 Industries in Which There is a Liability of Contracting Com- municable Diseases 89 Industries Having Miscellaneous Hazards not Included Under Previous Headings 100 Recapitulation of Industries Investigated 103 PART V. Health-Hazardous Processes 106-357 Scope and Methods of Inquiry .' 106 . General Processes 1 15-184 Factory Processes (General) 117 Gas Producing 121 Stationary Firing and Engineering 122 Furnacing 123 Forging and Blacksmithing 124 Coremaking 126 Iron Founding 128 V Brass Founding , 132 Metal Grinding 135 V Sand Blasting 139 Polishing and Buffing 141 Machine Shopping ; '. 144 Tempering 147 Brazing 149 Welding 150 ■^ Soldering and Lead Burning 151 ■ Pickling 153 Galvanizing 155 Tinning 156 Acid Dipping 159 Electroplating 160 Mixing Chemicals 1 63 Wood Working 165 Gluing, Pasting and Labeling 167 Painting and Varnishing 168 Shellacing and 'Lacquering 172 Enameling 1 ' 3 Japanning 1*^5 Lithographing 176 Upholstering 177 Sewing 178 Ironing and Pressing 181 Junk 182 IX PAGE Special Processes 1 85-356 Printing and Pu'l)lishin,(4- '. . . l^.j L Laundry 19,2 / Dry Cleaning 19(5 Eyeing '. 199 Storage Batteries 201 Dry Batteries 203 Incandescent Lam]).s 204 Rubber 206 Pottery 229 Glass 256 Stone 265 ^Grindstones 268 Emery Wheels 268 Porcelain Enameled Iron Ware 269 Mirrors 270 Soap and By-products 270 Baking ■ 272 Con f ectionery 273 Canning and Preserving 275 Carbonated Waters 278 Ice Manufacturing 278 Liquors, Malt ■ 280 Tobacco 282 Salt 289 Brooms 290 Street Cleaning 291 Dining Cars 291 Lime 293 Cement 294 Brick and Tile 295 Files 298 Iron and Steel 300 Leather Tanning 317 Boots and Shoes 321 .y Textiles .328 Cordage 331 Mattresses 3-33 Paper and Wood Pulp 334 Oil Refining .339 Chemicals 340 Matches .343 Explosives 344 Fertilizers 347 Paints and Varnishes 350 Oilcloth .355 PART VI. Classification of Occupational Diseases and Complaints by In- dust'ries and Processes 357-378 PART VII. PAGE Special Investigations and Publicity 378-400 Lead Poisoning — Its Diagnosis 378 Method for the Detection of Lead in Urine. 388 Lead Poisoning — How to Prevent. Instructions to Employes 393 Instruction to Employes in Dusty Trades 393 Four Cases of Sudden Death in a Silo 394 . PART VIII. Measures of Prevention 400-407 General Principles of the Prevention of Occupational Diseases 400 Corrective Measures Recommended 402 Index 409 Acknowledgement is m'^de to the following establishments, so- cieties and persons for photographs and cuts kindly submitted or loaned for the purpose of illustrating the Report — all in Ohio unless otherwise specified : American Encaustic Tiling Company Zanesville. Captain J. R. Harris, M. D., (Fort Slocum, N. Y.). Dean Edward Orton, Columtus. Dr. Ernest H. Cox, Cleveland. Dr. O. O. Fordyce, State Hospital, Athens. Dr. Arthur E. Osmond, Cincinnati. Dr. Raymond A. Ramsey, Columbus. Illuminating Engineering Society (New York City). Norton Company (Worcestei*, Mass). The Barnes Manufacturing Company, Mansfield. The Crooksville China Company, Crooksville. The Dayton Dry Cleaning Company, Dayton. The Faultless Rubber Company, Ashland. The Federal Glass Company, Columbus. The Firestone Tire and Rubber Company, Akron. The F. J. Heer Printing Company, Columbus. The French China Company, Sebring. The Miller Rubber Company, Akron. The National Cash Register Company, Dayton. The National Tube Company, Lorain. The Piqua Hosiery Company, Piqua. The Pottery Gazette (London, Eng.). The Pullman Car Company (Chicago). The Rubber Products Company, Barberton. The Selby Shoe Company, Portsmouth. Taylor Instrument Companies, (Rochester, N. Y.). ' The U. S. Bureau of Mines (Washington, D. C). xi LIST OF ILLUSTRATIONS. Fig. page 1 — Dry Grinding and Alixing of Ingredients 17 2 — Metal Polishing 18 3 — Iron and Steel Works Interior 19 4 — Clay Stock House 20 5 — Eyestrain 21 6 — Poor Illumination 22 7 — Well Lighted Factory Room 23 8 — Dark Wall Shades Affect Illumination 24 9 — Clay Preparation in Pottery Works 25 10 — The Wet-and-Dry^Blub Thermometer .\ . 26 11 — Smoke Nuisance 27 12 — To Convert an Ordinary Sash Window Into a Ventilator 28 13 — The Elements of Exhaust Ventilation 29 14 — Air-Conditioning Apparatus for Factory Ventilation 80 15 — Electric Fan 31 16 — The Rest Interval for Hot Process Workers 82 17 — Sanitary Provisions in a Modern Steel Works 83 18 — Sorting and Marking in a Laundry 84 19 — Ideal Working Conditions 35 20 — The Normal Position of the Feet in Standing or Walking 37 21 — Flat Feet '. 37 22 — Pressing Department in Clay House 89 28 — Two Health Protectors in Factory Life 40 24 — First Aid Kit 40 25 — Needed in All Work Places 41 26 — Lead Poisoning 48 27 — Paralysis from Lead Poisoning 44 28 — Death from Lead Poisoning 45 29 — Making Rubber Gloves 46 30 — The Meltzer Artificial Respiration Apparatus 47 31 — The Meltzer Artificial Respiration Apparatus 48 82 — Sanitary Drinking Fountain 49 33 — Industrial Tuberculosis 90 34 — Granulated Eyelids 93 85 — A Factory Rest Room lOS 36 — The Employer's Interest in the Welfare of Employes May Well Extend Beyond the Work Place 109 37 — Model Factory Conditions 119 38 — Cleaning Metal Castings 132 39 — Brass Foundry 133 40 — Sandblasting 140 41 — Buffing Metals ' 142 42 — A Model Machine Shop 145 xii Xlll Fig. page 43 — Blacksmithing and Tempering r 148 44 — Acid-Dipping in Plating Room 159 45 — Acid-Dipping in Plating Room 161 46 — Woodworking Shop 166 47 — Model Sewing Room in an Underwear Factory 179 48 — Proper Arrangement of Workmen to Light 185 49 — Linotype Room 187 50 — Recovering Type Metal . — 188 51 — Dry Cleaning 197 52 — Dry Cleaning 198 53 — Ru'bber Manufacture — Mill and Calender Room 209 54 — Rubber Mixing Mills 210 55 — Rubber Calender 211 56 — Rubber "Dipping Room" 216 57 — Making Rubber Specialties 220 58 — Rubber "Cold Cure" Process 222 59 — Rubber Works 223 60 — Mixing Rubber Cement 227 61 — The Slip House ; 230 62 — Sagger-Making Room 232 63 — Mold Making 233 64 — A Line of Jiggermen in the Clay House 234 65 — Pressing Department in Clay House 235 66 — Pressroom in an Art Tile Works 236 67 — "Green" Room 237 68 — Glaze Mixing 239 69 — Dipping Room 240 70 — Hand Glazing of Art, Floor and Wall Tiles 241 71 — Machine Glazing of Art, Floor and Wall Tiles 242 72 — Bisque Kiln House 245 73 — Glost Kiln House 246 74 — Finishing or "Dressing" Ware in Bisque Warehouse 248 75 — Finishing or "Dressing" Glost Ware, After Same Has Been Drawn from Glost Kilns 249 76 — Decorating Department 250 77 — Decorating Department • 251 78 — Pottery Tinting or Aerographing 252 79 — Decorating Kiln Room 253 80 — Shading and Sorting of Art, Floor and Wall Tiles 254 81 — Art, Floor and Wall Tiles 255 82 — Packing 255 83 — Batch House in Glass Factory 257 84 — Glass Furnace Room 259 85 — Glass Grinding Room 263 86 — Glass Factory — Finishing and Selecting 264 87 — The Blast Furnace 303 88 — The Base of a Blast Furnace 304 89 — Protection Against Heat 309 90 — A Health Appliance in a Modern Steel Works 310 XIV Fig. " PAGE 91 — Gas Helmet 312 92 — A Pipe Mill 314 93 — Boots and Shoes 321 94 — Boots and Shoes 322 95 — Boots and Shoes 323 96 — Boots and Shoes........ 324 97 — Boots and Shoes 325 98 — Boots and Shoes , 326 99 — Boots and Shoes 327 100 — Lead Poisoning 382 101 — Silos and Dairy Barns at Athens (Ohio) State Hospital 395 INTRODUCTION. Among the factors which are causing disaster in the onward march of civilization, there has been brought to light, in the last half century, afflictions called occupational diseases, which appear to be due to attempted or forced adaptations to unnatural environment. The present investigation of the State Board of Health has been popularly termed "The Occupational Disease Survey", but it was the intention of the legislature, which authorized the investigation, to go much deeper than this, as should have been the case, and endeavor to deter- mine the underlying causes which contribute to the "unnecessary sick- ness and shortening of life," which "is a serious loss and of grave concern to the state and to all the people." Consequently this report will be found to deal very largely with industrial hygiene (of the workplace, — not of the worker's home and other outside factors), and the extent to which health-hazards have been found to exist in the principal industrial processes in the state. The prevalence of occupa- tional complaints and diseases has not been overlooked, however, as may be seen from a scrutiny of the context. Inasmuch as the principal efforts and most of the time available were directed towards the subject of hygiene, it is well to say that the lists and citations of occu- pational diseases represent but a small part of those which actually exist, and these lists could have been greatly extended had the principal investigation been developed in that direction. The plan of the present report has been, first, to analyze the available vital statistics (Part II.) to define the principles of indus- trial hygiene which have served as guides to the survey itself (Part III.), to designate the chief industries and processes of concern and to show their relative importance in numbers employed (Part IV.) ; secondly, to determine the hygienic status of health-hazardous trades in the state through an investigation of them by a corps of physicians and hygienists (Part V.), to sum up and classify the authentic cases of occupational diseases which have been reported to the Division (Part VI.) ; and, thirdly, to give the results of some special investiga- tions of elemental importance and remedial character which have been undertaken (Part VII.), and to draw certain general conclusions (Part VIII.). In Part V., especially, it has been the endeavor to show the short- xv XVI comings in industries, in trade processes, and in workers themselves, which have contributed to the figures given in Parts II. and VI. It must be pointed out that this is but a survey, and as such is necessarily of a mantle character and has not aimed to go deeply into any particular part of the field. It has not touched upon industrial accidents nor their prevention. It has been devoted, principally, to the manufacturing pursuits, by no means all of which have been covered, but the principal ones, from a health point of view, have, it is believed, been included. The casual reader, however, can see in the report itself plenty of opportunity for more investigations and more intensive researches. The report is not a description of industries and processes, as sometimes such reports are, but is meant to be an application of about a dozen well defined health-hazards to workplaces and work processes, with subsequent gradings as "good," "fair," or "bad." Only enough description is given to define the various trade processes when looked upon from a health-conservation aspect. The findings of each process are taken up in the same manner, so tfiat the arrangement is an index of itself which can be easily followed. The use of capital letters has been adopted to specify definite industries or definite trade processes which are described in the report, and wherever such capitals are used the reader's attention is directed to the index for 'the corresponding subject matter. Arabic numerals have been used as much as possible to facilitate reading and to save space. The relationship between poisons used in industry and the symp- toms of poisoning which develop from contact with such poisons is easy to comprehend, and there is no hesitancy in calling such affections "occupational diseases". In the same way, certain infectious, deform- ities, calluses, and so on, can be determined as specifically occupa- tional. But the relationship between the health-hazards of industry and general diseases is more or less indefinite. I have attempted to opinionate some of these relations as closely as possible, and as fully as consistent with the findings on industrial hygiene and our present day knowledge of morbid conditions and the causes of these condi- tions. It is obvious that there is, and always will be room for difi^er- ences of opinion along these lines. However, I know of no better method than that which has been adopted here to correlate the indis- putable existence of preventable diseases and deaths among occupied persons on the one hand — both diseases and deaths having great varia- tions according to occupations — rwith the evidence which industrial mal- hygiene shows on the other hand. The truth of the matter is that occupational diseases are ex- XVll ceedingly common. They are, however, primary diseases and only httle attention is paid to their symptoms when they are calling loudest for recognition and at a time when they are easy to cure and control. On the other hand deaths directly due to them are among the rarest of happenings, this because degenerative diseases, which are secondary (of the heart, kidneys, lungs, etc.) prove to be the terminal afflictions. Thus, frequency of urination, in the case of the painter, characterizes turpentine poisoning, but nephritis is the ultimate cause of death. Such investigation as this would be greatly improved, were there extant accepted standards for all conditions. Such standards v\rould enable an investigation not only to determine exactly, then, the amount of dust, illumination, humidity, devitalizing air, temperature, etc., actually present, but the terms used in opinionating — "good", "fair", "bad" — could have a defined significance. Until these standards are set and agreed upon, it is necessary to do as has been done here — rely upon the opinions of qualified but disinterested persons. The next logical step in the field of industrial hygiene and occupational diseases is the establishing of these standards, and their adoption by a proper body having recognized authority. The immediate survey and field work has been conducted accord- ing to definite plans by the persons named below, exclusive of the Director. Attention was given to securing men who had some famil- iarity with industrial processes as well as academic, medical and hos- pital training and associations. The principal investigators were recommended by health officials in Ohio cities and were appointed on the authority of the executive officer of the State Board of Health : Raymond A. Ramsey, A. B., M. D Columbus Ernest H. Cox, B. S., M. D Cleveland Arthur E. Osmond, M. D , Cincinnati Roscoe P. Albaugh, M. D Columbus and Winchester Harry L. Rockwood, M. D Cleveland and Warrensville Halbert B. Blakey, M. D Columbus Assist. Prof. W. A. Starin, M. A Columbus John D. Schonwald, M. D Cincinnati Chas. P. Blair, A.M., M. D Peebles and Chicago (111.). In addition the following gentlemen devoted time as specified : Prof. Wm. L. Evans, Ph. D., directed chemical researches and participated in field investigations Chas. R. Parkinson, M. A., conducted special chemical researches. Cullen W. Irish (senior medical and university student), and Elmer A. George, A. B., M. D., assisted in clerical work and participated in field investiga- tions Prof. Ernest Scott, B. S., M. D., cooperated in the investigation of the fatal silo accidents at Athens, Ohio. XVlll In conclusion, I desire to acknowledge my indebtedness to Dr. Ludvig Hektoen, Director, Memorial Institute for Infectious Diseases and Professor of Pathology in Rush Medical College, Chicago, for valuable suggestions and advice in the conduct of the survey. Columbus, Ohio, Jan. i, 191 5. e. r. h. A SURVEY OF INDUSTRIAL HEALTH=HAZARDS AND OCCUPATIONAL DISEASES IN OHIO. PART I. HISTORICAL NOTES. In the First Annual Report of the Ohio State Board of Health, 1886, page 10, we read that the President appointed a standing com- mittee upon Hygiene of Occupations and Railway Sanitation, with Dr. John D. Jones, Cincinnati, as chairman. The Second Annual Report (1887) contains a five-page article by Dr. Jones upon ''The Effect of Occupation Upon the Health of Individuals", in wdiich occurs an account of the danger to lead-workers, white lead-workers. barrel-fillers, file-cutters, saw-makers and tool-makers, wool anJ cotton workers, icmployes in gas works, as well as a discussion of fresh air and light, the employment of women, and a table adopted from Dr. Wm. Ogle, of London, England, showing the mean annual death rate of males in various occupations. The next year (1888) a most masterly article in this field, en- titled, "The Luminous Beam", was written by Josiah Hartzell, Ph. D.^ Canton, Ohio, who is at present a member of the State Board of Health.* This paper was read before a Sanitary Convention held under the auspices of the State Board of Health at Akron, Ohio, January 25th and 26th, 1888, and is contained in the Second Annual Report of the State Board of Health, 1887. The opening statement in this paper is as follows: "All intelligent workers in behalf of good health clamor for ventilation. "Why? "To the end that the air to be breathed into the lungs may be abundant in supply and pure in quality." "Everyone is familiar with the appearance of a sunbeam pierc- ing the darkness of a darkened room." With this sunbeam as the theme, the author next discusses, in a most able and interesting man- ner, the dust particles, smoke particles, germ growths, and various *Dr. Hartzell died at his home in Canton, Ohio, on Xovcmhcr 11. 1014, at the age of 83 years. (n effusive matters, which can be seen to pollute this luminous beam. The author takes up the subjects of "sawgrinder's consumption", "potter's asthma", "brassfounder's ague", lead colic, matchworker's disease, etc., and states that in all these employments it may be shown that both the sick and death rate have been materially lessened by promoting ventilation; notably, by the application of certain devices for the protection of workmen from the inhalation of dusi and harm- ful fumes. Since the dates referred to above, laymen as well as medical men have repeatedly called the attention of the public to the subject of industrial hygiene and occupational diseases. Finally, in 1913, or twenty-nine years after the first citation above given, the Legis- lature of the State of Ohio passed two bills as follows: (i) House Joint Resolution No. 12, (see below) "Authorizing and directing the State Board of Health to make an investigation of occupational dis- eases", also authorizing the Board to make a thorough investigation of industrial hygiene; and (2) an act "To require the reporting of certain occupational diseases" to the State Board of Health, by every physician in the state, attending or called upon to visit a patient whom he believed to be suffering from occupational poisonings, or or any other ailment or disease contracted as a result of the nature of the patient's employment. In addition to the above two, which have laid the foundation for this report, there was passed an act "For the prevention of occupational diseases with special refer- ence to lead poisoning." But as this act particularized the manufac- ture of certain lead compounds, it has eventuated in applying to but two or three establishments in the state, and to the protection of some less than 300 employes. During the course of this survey, early in 1914, two very im- portant judicial decisions have been rendered, one by Judge Robert C. Pugh, of the Superior Court of Hamilton County, declaring "lead poisoning" to be a "personal injury", and allowing the complainant an indemnity against his employer of $500. The second decision was of much greater importance, and was made by Judge O. J. Cos- grave, of the Common Pleas Court, Hamilton County, overruling the position taken by the Industrial Commission of Ohio and declaring that an occupational disease is a personal injury and therefore should come under the new insurance law for compensating persons meeting personal injury while in the course of their employment. The funds for the establishment of the Survey of Occupational Diseases became available May ist, 1913. The investigations began May 15th, 1913, the first month being spent in statistical researches, the printing of forms, etc. The factory and workshop investigations began June 9th, 1913, and have continued without interruption up to the time of publishing this report. By the first of September, 1913, printed matter, calhng the attention of physicians throughout the state to the occupational disease reporting law, and blanks for re- porting the same were mailed to 7,500 physicians within the state. Realizing that publicity was, and is, a principal feature in a public health matter of this sort, the Division of Occupational Diseases has compiled and issued some twelve pamphlets upon this subject, each article being first printed in the Monthly Bulletin of the State Board of Health. A part of the Public Health Exhibit of the State Board of Health has been given to the subject of industrial hygiene and occupational diseases. In connection with the Exhibit a short lecture, accompanied by stereopticon slides, and moving pictures, has been given several times a month in various cities of the state. H: 4: 4: H< ^ House Joint Resolution No. 12 and House Bill No. 187, copies of which follow, are the two enabling acts which authorized the in- vestigation of occupational diseases by, and the reporting of the same to the State Board of Health. A copy of the blank certificate used for reporting and the instructions accompanying the certificate follow : (House Joint Resolution No. 12.) Laws of Ohio, 1913, Vol. 103, p. 975. JOINT RESOLUTION Authorizing and directing the state board of health to make an investigation of occupational diseases. Whereas, The employment of men and women in certain occupations is known to be attended with more than ordinary danger to health, giving rise to what is known as "occupational diseases", and Wheeeas, Unnecessary sickness and shortening of life, from whatever cause, is a serious loss and of grave concern to the state and to all the people, and Whereas, It is believed to be possible, by public education and by the enforcement of proper measures, to largely prevent unnecessary sickness and premature death among employes in various trades and occupations, therefore, Be it resolved by the General Assembly of the State of Ohio, That the state board of health, is hereby authorized and directed to make a thorough investigation of the effect of occupations upon the health of those engaged therein with special reference to dust and dangerous chemicals and gases, to. insufificient ventilation and lighting, and to such other unhygenic conditions as in the opinion of said board may be specially injurious to health, and to report to the next general assembly the results of such investigation, with such recom- mendations for legislative or other remedial measures as it may deem proper and advisable. Be it further resolved, That the finance committee of the House and the Senate be requested to place in the general appropriation bill an appropriation of $7,000 for the year 1913 and $7,000 for the year 1914 for carrying on the above work by the state board of health. C. L. Swain, Speaker of the House of Representatives. Hugh L. Nichols, President of the Senate. Adopted February 13th, 1913. 1918. Jan. 23 — First introduced by Mr. Acker. Jan. 23 — Laid over under the Rules. Jan. 27 — Referred to Committee on Labor. Jan. 29 — Referred back from Committee on Labor. Jan. 31 — Recommitted to Committee on Finance. Feb. 6 — Reported by Committee on Finance. Feb. 10 — Adopted by House. Feb. 12 — Passed by the Senate. Amended. Feb. 13 — -Concurred in bj^ House of Representatives. Feb. 25 — Enrolled and signed. Feb. 28 — Filed in office of Secretary of State. Laws of Ohio, 1913, Vol. 103, p. 184, (Sections 1243-1 to 4, G. C.) (House Bill Xo. 187.) AN ACT To require the reporting of certain occupational diseases. Be it enacted by the General Assembly of the State of Ohio: Section 1. Every phj'sician in this state attending on or called in to visit a patient whom he believes to be suffering from poisoning from lead, phosphorus, arsenic, brass, wood-alcohol, mercury or their compounds, or from anthrax, or from compressed air illness, or any other ailment or disease, con- tracted as a result of the nature of the patient's employment, shall within forty-eight hours from the time of first attending such patient send to the state board of health a report stating : (a) Name, address and occupation of patient. (b) Name, address and business of employer. (c) Nature of disease. (d) Such other information as may be reasonably required by the state board of health. The reports herein required shall be made on, or in conformity with, the standard schedule blanks hereinafter provided for. The mailing of the report, within the time required, in a stamped envelope addrssed to the office of the state board of health, shall be a compliance with this section. Section 2. The state board of health shall prepare and furnish, free of cost, to the physicians included in the preceding section, standard schedule blanks for the reports required under this act. The form and contents of such blanks shall be determined by the state board of health. Section 3. Reports made under this act shall not be evidence of the facts therein stated in any action arising out of the disease therein reported. Section 4. It shall furthermore be the duty of the state board of health to transmit a copy of all such reports of occupational diseases to the proper official having charge of factory inspection. C. L. Swain, Speaker of the House of Representatives. Hugh L. Nichols, President of the Senate. Passed March 25, 1913. Approved April 23, 1913. James M. Cox, Governor. Filed in office of the Secretary of State April 24, 1913. WRITE PLAINLY WITH INK THIS IS A PERMANENT RECORD. N.B. — Every item of information should be carefully supplied. The exact statement of OCCUPATION is very important. Physician should state DTAGNO'SIS in plain terms. See instructions on back of certificate. > U H O H 'O < r^ P-l OS +-> § IV (D 1/5 (L) c . 1 , l^TI tn o n"^ S (U '^<« a! Fi OW h-1 >^ w~ .§ I Dh p p l-l *5 u bo 05 CM H < w o p < o w H < H CO (on back of this certificate is printed the matter below). OHIO STATE BOARD OF HEALTH, Columbus. AN ACT — To require the Reporting of Certain Occupational Diseases — (Passed March 25, 1913.) SEcnoN 1. Every physician in this state attending on or called in to visit a patient whom he believes to be suffering from poisoning from lead, phosphorus, arsenic, brass, wood-alcohol, mercury or their compounds, or from anthra:!f, or from compressed-air illness, or any other ailment or disease, con- tracted as a result of the nature of the patient's employment shall within forty- eight hours from the time of first attending such patient send to the State Board of Health a report stating: (a) Name, address' and occupation of patient, (b) Name, address and business of employer, (c) 'Nature of disease, (d) Such other information as may be reasonably required by the State Board of Health. The reports herein required shall be made on, or in conformity with, the standard schedule blanks hereinafter provided for. The mailing of the report, within the time required, in a stamped envelope addressed to the office of the State Board of Health, shall be a compliance with this section. Section 3. -Reports made under this act shall not be evidence of the facts therein stated in any action arising out of the disease therein reported. AN ACT — For the Prevention of Occupational Diseases with Special Refer- ence to Lead Poisoning. Section 7. Every physician * * * finding what he believes to be symp- toms of lead poisoning shall * * * within forty-eight hours after such examination and finding * * * send a report thereof in duplicate, one copy to the State Department of Factory Inspection and one to the State Board of Health * * * 'pj^g examining physician shall also, within the said forty-eight hours, report such examination and finding to the employer. (Passed April 18, 1913.) These forms are furnished by the State Board of Health and should be used for all reports. In filling out, note carefully the instructions below. INSTRUCTIONS FOR FILLING OUT CERTIFICATE. /;/ General. The medical certificate on the right hand side the physician alone can furnish. The personal and statistical particulars on the left hand side must be secured by the physician either from the patient, or, in fatal cases, from the family preciseljr as for similar information in certificates of death sent to boards of health. Present Occupation. Precise statement of occupation is very important so that the relative healthfulness of various pursuits may be known. It is necessary to know both general trade or profession (for example, printer or brass worker) and also the particular kind of work or brancli of the trade (as hand compositor ov linotype operaiar for a printer, or polisher or buffer for a brass worker.) Date of entering present occnpation is important to determine how long the worker may have been exposed to the hazard before contracting the disease. Employer's name, address and business are necessary to ascertain dis- tribution of occupational diseases by industries, many trades (e. g., machinists) being common to dififerent industries. Previous occupations need to be known, if possible, because present illness may be due to a former rather than present occupation, and industrial disease is frequently a cause of change of occupation. Give simply the name of each distinct occupation which the patient may have followed, with the year he en- tered and the year he left, Previous Illnesses. This refers either to previous attacks of present dis- ease, or to any other disease, due to occupation. All that is required is the name of each such disease or illness with the year in which it occurred. Such information, when it can 'be secured, will show whether the case reported is the first attack or not, and when combined with statement of previous occupa- tions, will afford an outline history of the patient as to occupational disease. Medical Certificate. Only the last two items specified for this require any explanation. In making these reports it is necessary to consider the possible influence of factors other than occupation as causes of the disease. For this reason any complicating diseases should be noted, such, for example, as alsohol- ism or syphilis in connection with the arteriosclerosis in cases of lead or other metal poisoning. The possible effect of other factors, such as poor hygienic conditions in the home, or other personal conditions, must be considered, and when discoverable should be noted under additional facts. E. F. McCampbell, M. t)., Secretary. PART II. THE GENERAL PRINCIPLES OF LNDUSTRL^L HYGIENE. INDUSTRIAL VITAL STATISTICS. In order to avoid needless repetitions in the description of In- dustries and Processes investigated in the State during the course of the Survey, there will be discussed at this place and in Part III, those factors which are looked upon as the principles, or essential features, of industrial hygiene, avoiding, as far as possible, all niceties and refinements, and endeavoring to adhere strictly to the features which are primarily detrimental to health. For those who wish to go into this subject more fully, we recommend the following authoritative works and references : "Diseases of Occupation and Vocational Hygiene", edited by George, M. Kober, M. D., Professor of Hygiene, Georgetown University, President,^ Sec- tion on Hygiene of Occupations, loth International Congress on Hygiene and Demography, and Wm. C. Hanson, M. D., Massachusetts State Board of Health, Instructor in Harvard University and Massachusetts Institute of Tech- nology, with the assistance of various contributors, American and Foreign, P. Blakiston's Son & Co., Philadelphia, 1915 (in print). "The Modern Factory", George M. Price, M. D., formerly Director of Investigation, X. Y. State Factory Commission, John Wiley & Sons, 1914, 574 pp., $4.00. "Occupational Diseases", W. Gilman Thompson, M. D., Professor of Med- icine, Cornell University Medical College, New York City, D. Appleton & Co., 1014, 734 pp., price $6.00. "Diseases of Occupation", by Sir Thomas Oliver, E. P. Dutton & Co., New York, 1908, 427 pp., price $3.00. "Industrial Poisoning", Dr. J. Rambousek, translated from the German by Dr. Thomas M. Legge, Edward Arnold, London, England, 1913, price $3.50. "List of Industrial Poisons", by Summerfeld and Fischer. Reprinted from U. S. Labor Bulletin 'No. 100, by the Ohio State Board of Health, wth an Industrial Index. Discusses 54 common industrial poisons, branches of industry in which poisoning occurs, mode of entrance into the body, symptoms of poisoning, and measures for the protection of workers. A few copies of this are still obtainable from the Ohio State Board of Health. Enclose a two- cent stamp. "Fatigue and Efficiency", by Josephine Goldmark, 890 pages, Russell Sage Foundation, 1912, price $3.50. "Symposium on Ventilation", as reported in Journal of Industrial and En- gineering Chemistry, March, 1914. "Mortality from Consumption in Dusty Trades", by Frederick L. Hoflfman. U. S. Labor Bulletin, No. 79, Nov., 1908. Mortality from Consumption in Certain Occupations", by Frederick L. Hoffman. U. S. Labor Bulletin, No. 82, May, 1909. 9 10 Consult also any standard text-book upon Physiology (iHowell, Stewart, Hall) and upon Hygiene (Harrington, Bergey) for effects of light, heat, fatigue and other hazards, vital statistics, etc. The first fact to take cognizance of in the inspection of a work- place is the presence or absence of health-hazards. An industrial health-hazard may be defined as any condition or manner of working that is unnatural to the physiology of the human being so engaged. This physiology is adaptable tO' quite wide variations in environment, but the rule holds absolute that the sub- jection to conditions which are unnatural to the physiology and habit of man results in pathology or disease. Where a factory inspector looks for hazards to life, limbs and health, and is guided by the standards of protection which are pres- ent and which must not fall below a minimum required by law, the medical hygienist looks for hazards to health and longevity, and his standards are the presence or absence of well recognized hazards to health and the amount of occupational health complaints and diseases to be found. These latter he gets by interviewing and examining workmen themselves, their physicians, community health officials, vital statistics, etc. In a word, his business is to connect health-haz- ards with diseases and deaths. He is, then, both a hygienist and a diagnostician. There is nothing strange or new, as a rule, about these hazards, but a proper conception of them and their effects is a necessary pre- liminary to the reports which follow. Industrial health-hazards as they concern the industries of Ohio are listed, in an arrangement easy to remember, thus : DUST, ' DEVITALIZED AIR, INACTIVITY, DIRT, TEMPERATURE, INFECTIONS, DAMPNESS, FATIGUE, POrSONlS. 'DARKNESS, As an aftermath to the above, it is necessary to mention in- dustrial stimulantism which is usually alcoholism, coffeeism, or drug ism. Stimulantism is promoted by subjection to one or more of the above health-hazards; or, because of the absence of good drinking water; or, because of a tradition among workers in certain lines that alcoholic liquors tend to stimulate them and to protect them from the effects of poisons, dusts, gases, or hard work to, which they may be submitted; or to the fact that the employers promote alco- holism among their workmen by permitting the drinking of intoxicat- ing liquors while at work; and, finally, to the fact that there is an II absence of a welfare attitude, or an industrial efficiency department in connection with an establishment. — Coffeeism, in females, may represent alcoholism in males. The second most important feature in the relationship between work and disease is the problem of the worker himself. Some work- ers are very much more susceptible to the health-hazards mentioned above than are others, so much so that as hygienic as certain indus- tries and processes can possibly be made, still there are certain classes of persons who should not engage in them. This is exempli- fied today, in many instances, as a matter of natural selection; for instance, the more delicate and sickly disposed persons do not follow the more fatiguing or heat-exposing trades. Unfortunately this does not apply so closely to older workers who have been following the more hazardous undertakings for years, and who, hav- ing become weakened from various causes, still endeavor to remain at their chosen avocations, irrespective of the damaging effects upon the body. Much of this question of the human factor will be solved in the future by a selection of employes through physical examina- tions for occupations to which they are best fitted. As an economical principle this must be done for the benefit of employer, employe and society. Having picked the proper physically or mentally capable person for the position at hand, it is further necessary to eradicate health-hazards, as far as possible, if we expect to put a check upon unnecessary disease and a check upon the shortened span of life which exists among occupied persons today. A third feature requiring discussion is that of being able to "get used to" the various health-hazards. This, many times, is a de- fence put up by employers, and even by employes for taking various health risks. It has some substance when superficially considered. For instance, the newly apprenticed barber soon gets used to the dis- comfort, pain and stiffness which first appears in the hand and arm using the scissors ; the baseball player soon gets used to the muscular effort required in throwing the ball in the Spring practices, and is no longer inconvenienced by soreness, stiffness, etc. In this connec- tion it may be said that fatigue is the factor concerned, and it is well known that what proves to be fatiguing to a person today may be performed at perfect east after a few days of experience. This is because a physiological regulation has taken place in which more blood, a better circulation and nerve control are established in the parts used and fatigue anti-toxin is developed to protect the body from fatigue toxin. Since this is a physiological adaptation, it must be considered perfectly normal. In other words, what was primarily 12 fatig-ue, therefore a health-hazard, has, by a natural adaptation, be- come no longer fatigue. It is a phenomenon within the boundaries of physiology. The vital point is : How far can such physiological adaptations take place without ultimate damage to the organism? We may state it as fundamental, that > outside of the adaptation cited for fatigue, no other health-hazard can be "gotten used to". We mean accus- tomed to. in a physiologic, and therefore a normal manner. No per- son can become habituated to an existence in a damp, dark, or foul- aired place. Nor again to the inhalation of dust, to the constant exposure to high temperatures, nor to sudden changes in temper- atures. The physiologic mechanisms of the human body are not capable of adapting themselves to the conservation of health and vi- tality in the continued presence of such hazards. The subjection to poisons is absolutely incompatible with health and a normal span of life. It is commonly thought, for instance, that a person can soon become habituated to the inhalation of ben- zine fumes, so that the intoxicating effects, producing giddiness, diz- ziness, a feeling of elation and loquaciousness, experienced during the first week or so of exposure, but which, as a rule, pass off there- after, have been "gotten, used to". This is an erroneous idea. Apply the same argument to alcohol. Simply because it may take more to get the chronic toper intoxicated is no proof that he has become habituated because of a physiological re-enforcement. He has simply become tolerant. There is a vast difference between toleration and the physiologic normal. Toleration lasts only so long as the extra pow- ers, with which all vital organs are endowed, can meet and compen- sate for the oppression. For instance, it has been shown that as little as I /24th part of the normal amount of kidney substance will main- tain life in the individual, and, in a similar way, other organs and parts of the body are superiorly equipped. But the utilization of physiological functions to their limits of toleration is abnormal and unnatural, and a transgression of natural laws is bound to result in disaster. This is just as true of physiology as it is of physics. Hence toleration of unnatural environmental conditions which many persons look upon as "getting used to" situations is untenable, and will finally result in disease, perhaps in invalidism, and most certainly in im- timely death. This misconception of the ability of the human being to become accustomed to health-hazards, such as the ten fundamental ones above cited, is responsible for a very large percentage of the prevent- able sickness and mortality shown in statistics herewith : 13 (i) In Ohio, in the year 1913, there were 68,378 deaths. Over half of these would not bear scrutiny as either timely or justifiable. Most of the questionable deaths occurred in adult life and before 70 years of age: • ' QUESTIONABLE DEATHS. Lock Jaw 67 TOTAL CIRCULATORY Tuberculosis (Total) ........ 6,555 DISEASES 11,358 Cancer (Total) 4,049 Lung Diseases (other than Rheumatism 226 Tuberculosis) 6,850 Anemia 240 Bright's Disease (Total) 3,958 Alcoholism 815 Skin Diseases 212 Nervous Diseases 6,882 External Causes (violence, ORGANIC HEART DIS- etc.) 6,266 EASE 8,907 As against these there were but 822 deaths charged to OLD AGE, as such. (2) Diseases of the Circulation and particularly Organic Heart Disease are causes of death pre-eminent in adult life. The following table shows, for the State of Ohio, the increase in death rates per 100,000 population from these causes : DEATH RATES. All causes combined Circulatory Oi <'ganic Heart Year. {per 1,000) Diseases. Disease. 1909 12.76 155.95 108.26 1910 13.76 185.03 206.95 126.63 1911 13.09 157.32 1912 13.34 227.80 177.80 (3) Deaths occurring under 70 years of age from Circulatory or Heart Diseases should be considered preventable in the vast ma- jority of instances. In Ohio, in 1912, over ^ of all deaths were due to Circulatory Diseases and % of all deaths were due to Organic Heart Disease alone. As a cause of death Tuberculosis has been al- most doubly outstripped by these chronic degenerative diseases, 58% of which have occurred before 70 years of age, and 20% of which have occurred before -50 years of age. If the classification could en- able us to separate out the "farmers", these rates for the balance of the people of the state would be very much higher. A "Study of the Handicapped", made by the Council of Social Agencies and The Hospital Social Service in Cincinnati, states, "Car- diacs (i. e. persons sufifering from heart disease) constitute at once 14 the largest single class and the one that presents the greatest diffi- culties. Few of them, because, among other reasons, their handicap is not evident, at present obtain suitable employment. They are, therefore, constantly relapsing into incapacity for work and need hospital treatment." (4) An analysis of the General Mortality Statistics for the registration area of the United States shows the following for the census year 1909: MORTALITY AMON^ OCCUPIED MALES in Agricultural Pursuits. ~ Callings. Those in Agricultural ^TmdJs^ and Deaths from preventable causes (6/7 are diseases)... Ti A% of all deaths 43.0% of all deaths. Deaths from degenerative diseases (under 70 years of age) 26.5% of all deaths .31.0% of all deaths. Total deaths after 70 years of age 35.9% of all deaths 13.4% of all deaths. In the above "Occupied Males" includes professional persons, officials, proprietors, those in domestic and personal services, as well as those we term real workers, viz., in trade and transportation, man- ufacturing and mechanical pursuits, mines, quarries, etc. (5) The relationship between different callings and a given disease, such as tuberculosis, can be fairly satisfactorily determined. The following table furnishes an example. Compare the first column with the second column, and note that housing, habits, dietetics, etc., cut no figure, at least with the first four comparisons : TUBERCULOSIS DEATH RATE. Quarrymen and miners 9. % Stonecutters (indoor work). 29. % Carpenters 10 . % Painters 19 . % Iron and steel workers 16. % Brassworkers 31. % Domestics 19. % Stenographers 39. % Farmers, planters and over- 95 out of 100 callings 8.0 to 43. % seers ^-^^c In this connection the State Board of Health has issued a pam- phlet entitled, "Consumption and Preventable Deaths in American Occupations", which shows many other ratings for trades and callings. (6) Pulmonary Tuberculosis is a cause of death which con- cerns adults much more than children. Reliable statistics in Ohio 15 are only available since 1909. It must be remembered that many Ohio persons suffering with tuberculosis go to western states where many of them die. Because of this morbidity migration in the case of this disease, the mortality rates of states such as Ohio are not as high as they should be. Reports in Ohio show that there are seven cases of tuberculosis to every death. Hence, there are over 35,000 living cases in the state at present. The rates for the last five years in Ohio are, per 100,000 estimated population, as follows : Year. No. Deaths. No. Deaths. 1909 5,805 121.91 1910 6,176 129.70 1911 5,992 123.76 1912 5,679 115.80 1913 5,479 110.35 The table shows that the disease as a cause of death is gradually decreasing. But the table below shows to what extent young people bear the brunt of the plague: DEATHS FROM PULMONARY TUBERCULOSIS, STATE OF OHIO, I909-I912. Years of Age. No. of Deaths. 15-19 1,698 20-24 3,156 25-29 3,228 30-34 2,810 35-39 2,478 40-44 1,8'67 45-49 1,543 50-54 1,276 55-59 1 , 108 60 and over 3,187 (7) The following is abstracted from a paper entitled, "A Study of Causes of Tuberculosis", by Roy T. Nichols, Department of Hygiene, Western Reserve University. The study was made in Cleveland, and was devoted to the year 1912: 3,247 cases of tuberculosis were registered in Cleveland in 1912. Total number was probably 10% higher. 70% were estimated as charity cases. "It is doubtful whether more than 15% could be attributed to an inherited tendency." 4 months represents the average stay of each patient in an institution (based upon 250 cases studied). Cost for the care of each patient averaged $1.25 per day. i6 The report concludes as follows : "Is it not time that we not only recognize as one must, that tuberculosis is not the inevitable lot of certain races, or the inherited lot of 'Certain fam- ilies, but that it is largely due to the effect of the industrial and living condi- tions, and that we must therefore expend large amounts not only in combating the disease by sanitary instruction and segregation, but by appropriations for the safeguarding of workers in certain industries and for the improving of housing conditions? If any conclusions can be drawn from this report, it is that all efforts to combat the rapid spread of tuberculosis must fail unless it reaches down to the economic basis of life. This report shows conclusively that men are succumbing to tuberculosis, not because they are destined to or because they are ignorant or because they are willing to take bigger chances than other people, but because they are the slaves of our industrial system that decrees this man who toils for 10 or more hours a day in dust-laden, over- heated air, is the man with wages so small that he can buy for himself and his family only a few small close rooms for their place of habitation, rather than a place that has the recreative gifts of sunlight and fresh air. When we awaken to the fact that such industrial conditions and such living condi- tions must not exist, not only because they are not humane or decent, but because society cannot afford thern, because they too rapidly manufacture these helpless derelicts that must be supported by charity until death relieves them and us, we will have gone far towards removing the cause of tuberculosis." (8) The following Table, based upon U. S. Vital Statistics reports, compares the Proprietor and Professional Class (column A.) with the Working Class (column B.) in respect to the prevalence of six preventable causes of death. . The rates represent the number of deaths from each cause out of every loo deaths: A. B. Cause of Death. Death Rate. Death Rate. Tuberculosis 8.22 17.53 Accidents and injuries 5.20 11.85 Pneumonia • 6.89 8.48 Suicide 2.13 2.76 . Typhoid fever 1.88 2.35 Accidental poisoning .43 .78 All preventable causes 24. 75 43 . 75 In this connection the State Board of Health has a pamphlet which explains more fully these relationships. The above tables, we believe, will show the serious economical questions which are involved. PART III. INDUSTRIAL HAZARDS. We will next take up the individual health-hazard and discuss the elemental principles concerned. DUST. — Dust may be inhaled, or ingested, or affect the skin, the eyes and the ear canals. The daily subjection to dust, for more than brief intervals at a time, is always damaging. The skin and Fig. 1. Dry Grinding and Mixing of Ingredients. Inclosed ball-mill in use in a porcelain enamel works, equipped with exhaust, dust-tight doors and collecting drawer. Adaptable in many plants. the eyes may become physiologically inured to it, but not so with the internal organs. The least harmful dusts are those arising from the natural earth itself, such as the farmer is subjected to, although there are many exceptions to this in the case of alkali, sandy, or stony earths, etc. White flour and starch appear to be practically harmless to the normal person, soapstone dust and talc may be placed next in order, but a tuberculously-inclined person subject to these, 2 O. D. ^7 It if they do no more than irritate the nose and throat and promote coughing, is almost certain to see an increment in his disease. Next in order of harmfulness come wood dust, bran dust, coal dust, clay dust, ore dust, mineral dust and stone dust. It will be seen that the organic dusts are the least harmful. Dusts in general produce a chronic catarrh of the respiratory and digestive organs. This leads to a fibrosis, which is the same process that is gradually brought about by old age. These catarrhs and fibroses result in lowered re- sistance of the damaged parts, and invite secondary diseases, which are usually the cause of death. F"iG. 2. Metal Polishing. Ideal exhaust system for dust in a polishing department. Plenty of light. All diseases of the lungs, due to dust, are called pnenmonoconi- osis (lung-dust-disease) ; iron dust, produces a condition called sider- osis; sand, flint and stone, chalcicosis and silicosis; coal dust, anthra- cosis; cotton-fibre dust, byssinosis; clay dust, ahiminosis; tobacco dust, tabacosis; etc. Fibrous tissue is formed around these particles in the lungs, destroying the function of respiration in such parts, and resulting, in the end, in a condition called phthisis, which is .usually complicated by the presence of the bacillus tuberculosis, which is enabled to propagate because of the shutting off of the blood supply by the fibrous tissue. Two-thirds of a pint of coal dust has If 20 been found in the lungs of a former coal miner. One-third of the weight of the lungs of a rock-driller has been found to consist of rock dust. Probably the most harmful dust of all, with the exception of poisonous dust, is emery dust, which is composed of exceedingly hard, crystalline, sharp particles ; next to this comes sand or sandstone dust, to which workers are subjected in surfacing, polishing and crushing stone, in sandblasting, etc. No person should work in a dusty atmosphere. Either by me- chanical means, wet processes, and modification of processes, or by personal hygiene, as respirators, etc., dust can be kept out of the .human system. Dry sweeping during work hours is a most vicious practice. \^acuum cleaning not only for floors, but in many dusty processes, is especially recommended. In dust mixing processes much of the material can be handled by vacuum pipes instead of scoop shovels. Civilized man enjoys no immunity over the original or native man in this respect, for whom dust was not intended. ' DIRT. — Dirt is put in as a health-hazard, not because to the cultured it is undesirable, but because dirt and disease co-exist. Dirt accumulating* from trade processes becomes dust. A dirty place is the first place in which one is inclined to spit, hence dirt accumula- Ftg. 4. Clay Stoctc Hot-?f.. An electric motor car, upon which is iitted a weighing apparatus, gathers the clays from the various bins. 21 tions are very liable to harbor disease germs. Dirt often contains poisons accumulating from manufacturing processes, which dry out and become dust. Vacuum cleaning is again called attention to. We wish to give "Dirt", however, a broader scope. Disorderly accumulations of materials, by-products and waste products should be removed from workplaces because they have a sub-conscious de- teriorating efifect upon morals, upon the inclination and the ability to work, and upon the observance of health standards beyond the work- place, to say nothing of the hindrance to production itself. The in- sistence upon a clean and orderly place in which to work is funda- mental from three points of view — physiologic, psychologic and productive capacity, or output. DARKNESS. — Continual subjection to this health-hazard is ^universally acknowledged by practically all persons, as well as hy- gienists, as, incompatible with health. The best light in which to work Fig. 5. Pupil of eye dilated to let in plenty of light when illumination is dim. Same pupil contracted to shut out excessive light. Both Conditions Mean Eyestrain and Are Very Fatiguing. is, of course, daylight — the only modification of this being protec- tion from the direct rays of the sun, particularly for sedentary or confined workers. After this a good quality of artificial light does not appear to be detrimental to health. Illuminating engineers claim, and certainly, from a' physiologic point of view, with very good rea- son, that more than half of workplaces are improperly lighted; also too expensively lighted, considering candle-power. In other words, there is a vast amount of importance to be given to lampshades, re- flectors, globes, etc., as well as to positions. A flickering light, or a 22 dim lig-ht can be just as fatiguing, from its effects upon the human eyes, as the most laborious work. On the other hand, brilliancy is equally as dangerous. We see the extremes of this in some of the furnace and melting processes, where eyes are subjected to intense heat, as well as light, thus predisposing to ageing (cataracts, retinitis, conjunctivitis, etc.) Extremes are seen in the case of welding by the various types of blowpipes and electric methods now in vogue, in which not oply the eyes require to be protected by alternate layers of Fig. 6. Poor Illujiination. More light in the e3'es than on the work. Sharp shadows and much glare from the polished metal. Discomfort to the worker; loss to his employer. Danger of accidents. Many factories are too expensively, but very poorly lighted. colored glass, but even the skin, to prevent the consequence of can- cer. The eye also suffers from contrasts of light and shadows, as are seen particularly in rooms where furnace glares are mostly de- pended upon for lighting. Such conditions, of course, produce in- accuracies of execution, and lead to accidents, as well as curtailment 23 of production. Nystagmus, or dancing pupils, so commonly seen among coal miners, has been recently shown to be due essentially to poor lighting. The eyes are greatly fatigued by looking down con- stantly upon bright objects or reflecting surfaces. For instance, many persons suffer from headache when they look upon an expanse of river or lake water while the sun is shining. The retina of the human eye is normally adapted to high-lights (the sky) which come above the center of the field of vision, and to dark tones and colors in the lower field of vision. Looking down upon white reflecting surfaces, as upon paper, in ironing white goods, etc., is the cause of Fig. 7. Well Lighted Factory Room. A factor in safety, health and production. considerable industrial headache, much of which can be prevented by the wearing of eye shades or the use of dark glasses. DAMPNESS. — Again, it is obvious to most persons that work- ing continually in a damp place, particularly if within doors, is in- imical to health. By dampness we mean not only moist, but wet places, steamy atmospheres, or air in which the humidity is main- tained at a higher point than 65°. If, to such conditions, changes in temperature, either up or down from 68° take place, the risk to health becomes greater. Those whose work necessitates exposure to water and dampness should not be required to do sedentary work 24 unless temperature is carefully controlled, and recreation periods are arranged for. They should be provided with rubber boots, rub- ber aprons, etc., in addition to all mechanical means devisable to re- move water and steam. Where other health-hazards are associated with this feature of dampness and moisture, workers should have bathing facilities, such as the shower bath, and obviously, such necess- ities as lockers for street clothing. Some establishments wisely pro- vide drying rooms in which to hang damp working clothes. fr Fjg. 8. Dark Wall Shades Affect Illumination. Each of these two h'ttle rooms receives the same light. Dark walls absorbed most of the light in left-hand room. By far the vast majority of workshops and factories, however, are afflicted with the opposite condition, DRYNESS. An experiment made in almost any factory or workshop room,' office or store, dur- ing the months of artificial heating will show that the relative humid- ity, instead of ranging betvi^en 60° and 70° for a temperature of 68°, is very much below this. This applies to nearly all steam-heated, hot-water heated, or hot-air heated quarters. This dryness of the atmosphere also promotes disease, first evinced as an irritation of the nose and throat, the glands of which are forced to produce extra 25 moisture in order to enable these parts to perform their functions. In time acute colds and contagions are easily acquired. Then there are chronic coughs, and, from this on, a large variety of disease con- ditions are possible. Humidifiers, air exchangers, and especially fans to keep the air in motion are urgently needed almost everywhere in indoor workrooms. The readings of the wet-and-dry-bulb thermometer should reg- ulate these conditions. This is a most valuable instrument, and should be placed in almost every place of human habitation, especially mill-rooms, work-rooms, offices, stores, school-rooms, etc., in the state. It records "sensible temperature", as well as actual temper- ature, and its humidity readings will surprise, many times, as well as explain why rooms seem stulty and hot, or cold and damp when the ordinary thermometer is recording normal ! There are several forms of the instrument. The sling psychrometer is best, but aiiy of the stationary wall forms will suffice if the air is put in motion, as by fanning in front of them before taking a reading. The adoption of cloth windows in the lower frames of the ordinary window ap- pears to be capable of solving this question to a large extent. It has been shown that a medium grade muslin cloth of light color retains heat much better than glass and permits an exchange of air and moisture almost unhampered, while light is. if anything, better dil+used. I'lli. !'. LL.W pKt:i'.\R.\TI()N I.N FOITKRY WoRXS. Shnwiiiii liltcr i)ri,-.>;s voom oi mcHlel construction in an art tile plant. 26 Fig. 10. The Wet-and-Dry-Bulb Thermometer. This instrument gives relative humidit}^ and '"sensible" temperature. The most important health indicator made. A fan should be turned upon it to put the air in motion while taking a reading. DEVITALIZING AIR. — Bad air conditions in work places may be due to (i) deoxidation (presence of flames, furnaces), (2) contamination (escaping gases, vapors, fumes), (3) pollution (dust smoke, moisture particles from other persons' breaths), (4) unnat- ural temperature-humidity relations, and (5) stagnation. Of these, stagnation probably does the most damage to the largest nuinber of persons, since quiet, still, "dead" air fails to " promote evaporations from the surface of the skin, and to stimulate the sensory nerve end- ings located in the skin, both of which are necessary to maintain a good circulation of the blood. This good circulation is especially needed for a large class of workers while engage 1 in their various trade processes. The essential difiference betw een indoor and outdoor air is that the former is usually still quiet, or "dead", while the latter is in motion, is fresh, and "alive". If to stagnation are added any of 27 the other four conditions above mentioned, as is often the case in work places, the danger to health is much increased. Probably, abnormal temperature-humidity relations are next in hazard to stagnation as deleterious factors, although the physiology of the human organism can- adapt itself to quite wide variations in these if the air can be kept in motion. A person can exist (at least experimentally) in comparative comfort in a closed-up closet for a considerable time if these last mentioned features — temperature 68°, humidity (relative) 60°, and a motion of the air, as by fans — are provided for. It has been practically established that it is not the amount of oxygen which persons use up in breathing, nor the Fig. 11. Smoke Nuisance. No fresh air possible within work places in, this district. amount of carbon-dioxide they exhale, nor the emanations from the human body (except moisture particles from the coughing, spitting or sneezing of diseased persons in crowded quarters) which count for aught in vitiating the air, except under the most unusual conditions of crowding or confinement. There is a difference between the air of many work quarters, however, than that of homes, schools, offices, stores, etc. In shops, factories, mills, and many other establishments there are the ever- present air vitiators such as free flames without vents, gas heaters, salamanders, furnaces, gases from tanks and vats, and chemical vapors which are not confined or led away from the breathing at- mosphere. To these are multitudes of wage-earners exposed as well as to air stagnation and temperature-humidity factors. Practically 28 all such vitiation can be corrected by various types of confining cup- boards and enclosures, and by artificial ventilating systems, air-agita- tors, suction fans, etc. Of all factors which tend to promote high death rates, par- ticularly from the preventable causes, such as tuberculosis, pneumonia, Fig. 12. To Convert an Ordinary Sash Window into a Ventilator. Insert a board under bottom sash. It will be found that fresh air from outside will find its way into the room as indicated, with very little, if any. draft. This is a useful method for many workshops. bronchitis, and the like, atmosphere which is not that supplied by na- ture, is paramount. We might say, in a word, that if the out-door air could be breathed by workers in all lines of* activity throughout the work hours of the day, the preventable, degenerative and occupa- 29 tional diseases would be almost entirely done away with. In this respect, the person in a clerical position is just as much concerned as the operative in a factory or mill. Fig. 12. The Elements of Exhaust Ventilation. To collect the dust, vapors, or fumes which may arise from work processes a hood with stack is provided. The exhaust may be created by draft from a stove pipe (as shown), or a steam jet, or exhaust fan, or connection to a chimney of sufficient height. HEAT. — The exposure to heat produces prostration, heat ex- haustion, muscular cramps and acute colic when the effects are ex- treme, while in the long run it produces anemia, catarrh, rheumatism, Bright's disease, skin eruptions, gradual fibrosis and premature old age. Its effect upon the eyes has been commented upon under the head of DARKNESS. Many persons who are exposed to heat should wear glasses as much for protection against the heat as against the unnatural light which accompanies it. The raising of the body temperature, thermic fever, which takes place more or less constantly among heat-exposed workers, is accompanied by the production and accmnulation of definite poisons or toxins within the body, which are 3* Fig. 14. Air-Conditioning Apparatus for Factory Ventilation. This machine washes, strains, humidifies, heats and cools the air as well as forces its circulation. It maintains the dew point within 1° of a fixed point for three floors in a large factory building. responsible for the effects above noted. Hence he who shows effects of exposure to heat hasi been occupationally poisoned although the poison in this case has been elaborated within his own system. If combined with moisture, the effects upon health are still worse, since the failure of opportunity for the evaporation of the normal perspi- ration on the surface of the body is interfered with, thus disturbing, seriously, the heat-regulating mechanism. In practically all trade-processes heat can be kept away from workmen, or means can be adopted to nullify its effects. The adop- tion of modern appliances for handling and transporting heated mate- rials has done much in certain industries to solve this question. In addition, the use of shields and screens; of asbestos coverings; of water-cooled furnace doors; and particularly of airblasts, sufficiently 31 strong to blow back the heat currents, or, in some cases, to blow upon the exposed workman ; the adoption of powerful electric fans ; of water sprays; and so on, have done much toward helping it. Finally, we would mention particularly the short work day, and the frequent rest period, also the wearing of garpients arranged to protect from the heat, but at the same time permit of evaporation. Then, one of the most important necessities for the use of all heat-exposed work- ers is the shower bath. There is a good physiologic reason for this, Fig. 15. Electric Fan. Portable ventilating fan shown at "C" with fan motor completely covered and "A" with shields removed. These fans are 36" in diameter and are used where men work in high temperatures, and can be moved to suit conditions and obtain the best results. which in plain terms may be stated to be that it tones up the pores (sweat glands) of the skin, decreases the perspiration, and re-estab- lishes the circulation equally throughout the system. We may add to this that it cleanses the person and adds to the psychological effect which comes with self-respect, which in turn promotes health. Such bathing facilities will cut down rheumatism, lumbago, stiff joints, 32 colds, sore throat, etc., to a marked degree. It must not be forgot- ten that a person whose back muscles are full of "heat-toxins", which have not been property removed by a good circulation, will, on the next day, when he returns to work, and upon slight straining effort, develop an acute "kink" in the back muscles, which becomes a lum- bago that is as disabling, and takes as long to cure in many cases, as a broken hip. In connection with the shower bath, we would men- tion the necessity of providing, not a cold stone or cement floor upon which to step, but wooden treads or slats. Also^ all workers exposed Fig. 16. The Rest Interval for Hot Process Workers. Protection against heat. Men enjoyinj a fifteen minute rest between working spells at hot processes. These men are relieved in this manner every fifteen minutes while working in excessive heat. to this hazard should, by all means, have a double set of lockers, one for street clothes, and one for work clothes, this latter arranged so that warm, dry air may dry out the clothing between work periods. COLD. — ■ Working in the cold cannot be said to be dangerous to health. One or two qualifications should be made : the worker should get enough exercis ; to stimulate circulation, he should be properly clothed, and should not be subjected to alternations of cold exposures with heat exposures. This is where the damage to health is done in the case of most workers so exposed. Human beings work in the frigid zones and keep perfect health. Combinations, however. 33 of cold with hazards such as dampness, darkness and vitiated air, are, of course, decidedly injurious. A bad feature in many hot processes is that workers are exposed to all manner of cold drafts, especially during rest intervals and in the winter season. In this over-heated state they often step out of doors and sit down upon benches without putting on additional cloth- ing. Oftentimes they are compelled to go to an outside privy or through cold halls and area ways to toilets located perhaps in damp cold basements. Fig. 17. Sanitary Provisions in a Modern Steel Works. In the rear are shower baths and, around sides, lockers with fronts per- mitting air circulation. (Shower) baths are a physiological necessity to all workers in hot processes. FATIGUE. — Fatigue is one of the most common causes of occupational disability.* This is a prime cause of the fact that bodily development in factory classes remains inferior to that in other social classes. Fatigue is defined as loss of irritability and contractility brought on by functional activity. The sensation of fatigue is due to the accumulation of waste products within the system called fatigue poisons (definite chemical substances) and fatigue toxins. The poi- * "So tired" is an expression which sliould never be heard from any worker at the close of his or her work day. It signifies exhaustion. — {Sir Thomas Oliver.) 3 Q. P. .^'I sons are acidic in character. A fatigued muscle is acid in reaction, while one at rest is alkaline. Of the poisons, leucomaines are one type and are similar in action to ptomaines obtained from putrid meats. The presence of such substances is easily demonstrated, as for in- stance, in the dog experiment in which a few cubic centimeters of blood removed from the veins of a dog, which has been run until fatigued, and then injected into another dog, not previously exercised, within a few moments causes symptoms of fatigue to appear in the second animal ; even paralyzing effects and, finally, death may follow after a period of extreme exhaustion. There are many other ways Fig. 18. Sorting and Marking in a Laundry. Note stools without back rests. — A fatigue factor among sedentary workers. of demonstrating the presence of this fatigue substance. Fatigue poi- sons do not accumulate in the system if time intervals are sufficient for the circulation to counteract, and remove them between muscular efforts. These symptoms, when they appear, are usually not more prominent in the particular muscles or parts used than throughout the system in general. The brain, which is the source of motive power, always suffers in fatigue, no matter what part of the body is overworked. Workers who begin a new process at first feel the symptoms of fatigue very quickly, but gradually the period of continuous ap- 35 plication is extended until, as we have explained, the person has be- come used to the work. This is more than the matter of the establish- ment of a good circulation of blood to the parts used, and the train- ing of nerve-paths. It seems in part to be due to an anti-toxin carried within the blood which destroys the fatigue toxin at its source in the muscle. "Getting in training" is but the working up of this fatigue antitoxin. Fatigue symptoms should never be permitted to exist in indus- tries. These are, in a minor way, tiredness, sore muscles, stiff joints, aches and pains, etc., while in a more severe form we have such signs Fig. 1.9. Ideal Working Conditions. Sedentary work showing swivel chairs with backs and foot rests. Also lamps well placed and shaded. All are important factors against fatigue. Note machine parts protected to prevent accidents. as muscular c/amps, obstinate lumbago, wry neck, neuritis, neuralgia, and "occupational neuroses", in which any attempt to return to the regular work results in spasms of the muscles used, accompanied by soreness, constant aches and pains, trembling, gradual emaciation and partial paralysis of the parts. In time, ligaments weaken so that flat feet occur (perhaps with varicose veins, eczema and ulcers), round shoulders, bowed backs, and sunken necks. Internal organs drop downward (especially the kidneys and the female organs), caus- ing much chronic invalidism. Such signs are usually accompanied 36 with a mental condition of anxiety which is out of all apparent pro- portions to what can be seen, and along with headache and constipation make up the disease condition known as "neurasthenia." Neurasthe- nia is practically always occupational. In females ''hysteria" is a fre- quent associate. The next stage is "nervous breakdown". Many persons, of slightly unsound condition to begin with, develop a "fa- tigue psychosis", that is, insanity which may be sudden and violent, or just a gradual deterioration characterized as "played out", "no good any more", "can't make his day's wages", etc. Our hospitals, dispensaries, charities, various institutions and asylums are crowded full of these classes of persons. About 90% of them are over 40 years of age, which make a significant contrast with the age-group figures for wage-earners in manufacturing industries, about 90% of whom appear to be under 40 years of age. Fatigue which affects the steady worker causes anemia, enlarge- ment of the heart, increased blood pressure, circulatory diseases, kid- ney disease, and neurasthenia or nervous exhaustion. This latter is a very common complaint of the working classes. Chronic fatigue predisposes to weakness and paralysis of special parts, and to ner- vous breakdowns. The general fibrosis of all organs and parts en- croaches upon the reserve forces of these organs and parts. Prema- ture old age is a consequence. During the course of any of these chronic affections, which are usually progressive when once incited, the person is predisposed to all manner of acute diseases, one of which, in the end, is finally signed upon the death certificate as the ■cause of demise. Loud noises fatigue the ears, and are a common cause of partial or complete deafness. Cotton stuffed in the ears during work, and removed immediately afterwards greatly limits this deafness. Young persons, particularly those under 18 years of age, are per- manently and more seriously damaged by the poisons and toxins of fatigue than are those of maturity. This is because during the age- period from about 15 to 18 in boys, and about 14 to 17 in girls, a marked increase in growth should normally take place (greater than any other period of life, except the first two years of infancy), and, there is also, not only growth in stature, but a concrescence or "grow- ing together" for firm union for adult life of the muscles, bones, ten- dons, etc., which are concerned in voluntary acts. Furthermore, the cartilaginous parts and junctions, are, during this age, finally replaced by bony matter. During this age-period, then, energies must espec- ially be conserved for the functions of growth. Where fatigue sub- stances are allowed to factor, growth is stunted, concrescence is inter- :\7 fered with, and reserve forces so dissipated that there results de- formities, weakened constitutions, and a greatly increased liability to the inception of chronic diseases, particularly of tuberculosis and or- ganic heart disease. Fig. 20. The Normal Position of the Feet in Standing or Walking. The toes should be pointed almost straight to the front, which gives strength to the arch of the foot, while the walker covers more ground for given muscular effort. The fact that young persons' fingers are nimble, and their actions quick should not be taken advantage of by allowing disastrous ex- haustion to lessen their vitality at this most important period of life. Fig. 21. Flat Feet. This results from incorrect standing or walking, or prolonged standing (especially during youth or during a weakened condition). Particularly does this apply to the permitting of piece-work, and monotonous or steady-straining processes. Also to night work, and to weekly alternation between night work and day work. If we add 38 to these deleterious fatigue toxins the poisons which are produced by exposure to heat, the disastrous results are us.ually more than double. Any who doubt this may consult the Vital Statistics Reports. In a word, fatigue, or a tired feeling, means for all persons: Take a rest ! The sensation is simply nature's warning. Rest, at least during the daytime, very rarely implies a cessation of voluntary activities altogether, but implies a change of work or process for a brief interval, by which strain is relieved and recreation is brought about. The entire cessation of. voluntary activities, which normally occurs in the adult for a period of about eight hours during the night, is essential for the recreation of the vital organs, which, though in constant activity from the day of birth until the day of death, require about one-third of the time each twenty-four hours to compensate for the extra duties imposed upon them by the acts of voluntary activity. In summing up the chief factors which cause fatigue in the steady workers — who, as we have shown above, should never show symptoms of exhaustion — there are (i) laborious work, (2) long- hours, (3) piece-work, (4) speeding up, (5) monotony, (6) constant standing. (Constant standing upon cement, stone or brick floors should be provided against by supplying wood platforms or even plain boards upon which to stand. Correct methods of standing — the toes and heels parallel — should be taught). (7) constant strain, (8) chairs or stools without backs, (9) faulty postures, (10) jarring processes, (11) pressing or holding objects against the body, (12) eyestrain, (13) loud noises, (14) irregular hours for sleep, and finally, (15) the absence of work variation or periods of relaxation and re- creation, which, in case of females, means, also, rest rooms. INACTIVITY. — For a period of about 15 to 16 hours of the day, the average normal adult may remain awake and exercise for the most of the time his physical and mental ecjuipments, provided there is diversity of application. This is essential to keep these parts in normal tone, but more especially to aid in the circulation of the blood and lymph, so that food products are properly assimilated, and waste products are properly eliminated. If such opportunity for ex- ercising the voluntary functions is not given, there is a tendency for assimilating powers and processes, to surpass the powers of distribu- tion and elimination. In common parlance this "sluggishness" pro- duces self-poisoning. In reality gouty and other poisons accumulate, and produce damage to blood vessels and organs, not very dissimilar to the effects of fatigue-poisons. Those persons who do sedentary work, whether at desks, at ma- chines, or at benches all day, are, in a way, doubly poisoning them- 39 selves, first, through fatigue-poisons, due to the over-use of certain parts without rest intervals, and secondly, to the accumiulation of poisons from a sluggish circulation due to general muscular, and respiratory inactivity. Where monotony in work is a factor, it is physiologically necessary that workers be taught, and allowed to work at at least two different processes. Frequent physical exercise is necessary to maintain health. Fig. 22. Exercise for the Office Force. Once in the morning and once in the afternoon. A great stimulant for all inactive workers. GERMS AND INFECTION. — Vast numbers of persons are exposed through methods and environments of work to infections, blood poisonings and communicable diseases. In the first place, ( i ) over-crowding in workshops enhances the spread of all communicable diseases. (2) the common use of towels, cups, wash basins, clothes, etc., spreads diphtheria, colds, tonsilitis, pneumonia, consumption, syphilis, trachoma (granulated eyelids), and any of the more strictly contagious diseases. Other sources of industrial infections are (3) improper closets, (4) spitting upon the floors, (5) sweeping dtu-ing work hours, or by dry methods, (6) absence of cus])idors, (y) the handling of infectious materials (hides, wiping rags, wool, oil, etc.), (8) the handling or 40 Fig. 23. Two Health Protectors in Factory Life. The model cuspidor for factory use, showing "backstop" and floor protector, all easily cleaned. The garbage can is a sentinel for order and cleanliness. Fig. 24. First-Aid Kit. !Each department of the plant should be supplied with a "First-Aid in Case of Accident" kit, which is conveniently kept in a glass jar. 41 mouthing of articles just previously handled or mouthed by another person, etc. Infections are also invited through (9) frequent trivial injuries, (10) flying particles, (11) cracking or fissuring of the skin, eczemas, etc., due to the careless use of solutions, gases and vapors. Also (12) through calluses, which, when incised or punctured, as by slivers, etc., have very poor resistance to infection and subsequent blood •poisoning, and to lock-jaw; hence, in this connection, the great value of "first-aid" to take care of the most trivial injuries, foreign par- ticles in the eyes, etc., and (13) a surgical emergency room, and, for Fig. 25. Needed in All Work Places. Emergency equipment for first-aid to the injured. Prevents blood poisoning. larger establishments, the presence of (14) a trained nurse, (15) a supervising physician and surgeon, and (16) hospital arrangements. Smallpox, plague and other diseases have been spread by (17) the use of wiping rags, waste, etc., which, unsterilized, have come from almost anywhere. (18) Typhoid fever has proved a menace to thousands of workers in this state ; in one place where strike- breakers were confined behind factory enclosures without proper san- itary arrangements ; in' another where the offal from a quarry dis- trict, which was almost without sanitary provisions, eventually polluted the water supply; etc. Trachoma has proven a serious >42 menace to factory districts, mostly (19) through housing conditions, and the question at once arises whether employers have not a right to demand certain standards in this direction, in return for the value of the money which is paid in wages. •Hookworm disease is liable to develop (20) among miners, tun- nel workers, brick makers, quarrymen, construction-camp workers, lumber and saw-mill hands, where no closets or privies are provided, and especially in seasons of the year which permit persons to wear open or "holey" shoes, or go barefooted, or handle the earth directly. Obviously, typhoid fever is constantly to be feared under such con- ditions, with the added risk which contaminated water gives. Work- ers about animals (21) are liable to anthrax, glanders, cow-pox, milk sickness, lumpy jaw, hoof-and-mouth disease, catarrhal jaundice (Weil's disease), pemphigus, erysipelas and lock-jaw. A medical supervision of workers in all places employing persons working in close quarters is essential. It will prevent much "indus- trial" tuberculosis. This should include (22) the physical examination of new employes, and careful thought given to the selection of work- ers from a health point of view. Further factors that will tend to keep down infections are the supplying of (23) gloves, (24) goggles, and (25) the posting of placards of instruction. POISONS. — Workers in poisons are very liable to develop specific occupational diseases due to the particular poison to which they may be exposed. The extent to which poisons are used in the, industries is enormous, and new industries utilize the same poisons in new and dangerous methods. As health-hazards, no poisons need to be dispensed with in industry, but what is necessary is that in their use as much attention be given to- their effects upon health, both acute and chronic, as to the methods and purposes for which they are used. The more common poisons used in the State of Ohio are about in order of their frequency of use and their liability to produce occupa- tional disease : lead, benzine and benzol (naphtha, petrol, gasoline, etc.), turpentine and similar dryers, brass or zinc in the form of fumes ; acids, alkalis, wood alcohol, analin oil, carbon bisulphide, antimony, illuminating and fuel gas, sulphurated hydrogen, arsenic, phosphorus and mercury. (The State Board of Health has a special pamphlet entitled "Industrial Poisons" which covers all of these poi- sons and many more. After naming and describing the poisons, the industries in which each is commonly used are given, and, finally, a concise description of the symptoms produced, as well as methods of preventing and treating such cases of poisoning.) 43 Occupational poisonings occur because the amount of risk is not appreciated by either employer or employe. Also, because of the physiologically impossible assumption that a person can "get used to" a poison. No metallic or inorganic poison can be absorbed in the human system without evidences of "damage resulting. In fact, in this respect, arsenic and phosphorus are apparently the least harmful of all because they have, to a limited extent, alterative powers, if assimilated in very minute quantities. Even this much cannot be said for any of the other poisons mentioned in the above list. None can Fig. 26. Lead Poisoxing. The black line due to lead is well shown on the teeth, marked in the gum margins. It was also well be physiologically handled by the human body. Their preseiue in the body is incompatible zvith the maintenance of health. A great mistake which is made in the conception of poisons is the question of mistaking toleration for halbituation. The fallacy of this has been fully described in the beginning of this chapter. In a ^i Fig. 27. Paralysis from Lead Poisoning. This man, aged 22, a kiln room laborer in a lead-works, was admitted to Cincinnati Hospital in the Spring of 1914, with acute lead poisoning. He rapidly recovered and was strongly advised upon discharge to keep away from any occupation dealing with lead. In spite of this he returned to his former work. After 6 weeks he returned to the Hos- pital (June 6, 1914) again suffering from lead poisoning and paraylsis of both wrists. -ISii -<^' * .ia!iiL - _ 45 G. o- ^- ?* ^ 13 r; v> ^ t-" tr ^ „. ? 46 word, toleration at least implies utilization of reserve force, and this always results in early decrease in capacity, with gradual fibrosis of the organs and parts, similar to that seen in old age. In addition to fibrosis, poisons invariably cause protoplasmic changes of destructive character in the vital organs. Occupational poisonings will not cease until the following fac- tors have been met and overcome: (i) keeping workers in ignorance of poisons used, (2) misbranding of poisons, (3) fancy branding of articles containing poisons, (4) lack of instructions, (5) disregard of instructions, (6) wrongful instructions, (7) harmful regulations, (8) Fig. 29. ^I.\kixg Rubber Gloves. Dipping Room. Benzine vats are covered between operations. Floor is exhaust- vented and fresh air forced in continually from above. absence of medical supervision, (9) and of mechanical health appli- ances. Further, fio) the eating-at-work or in workrooms, (11) lack of personal cleanliness. — even the wearing of mustaches or beards are vital factors with some poisons. Finally, there must be con- sidered, for given poisons, the use of (12) gloves, (tt,) respirators, C14) proper clothes, (15) lockers in outside rooms. (16) good wash- ing facilities, (17) water closets. (t8) eating places, and the develop- ■ment of inventions along the lines of dg) confining poisons, and pos- sibly of the (20) substitution of certain poisons, by non-poisonous. ^7 even though, perhaps, more expensive substances. This latter, we be- lieve, is rarely, if ever, necessary. One feature, if borne in mind, would do away with nine-tenths of all industrial poisoning, and would seem easy of accomplishment. This is to keep poisons from entering the system by way of the nose or mouth. The wearing of a respirator would seem to accomplish this as far as inhalation is concerned, but the question of preventing Fig. 30. The Meltzer Artificial Respiration Apparatus. (Recommended by the Committee on Resuscitation from Mine Gases of the U. S. Bureau of Mines which disapproved of the puhnotor and other apparatus. See Technical Paper 77, U. 'S. Bureau of Mines). The pharyngeal tube method. P. T., pharyngeal tube ; R. V., respiratory valve; turning to the right 'brings an inspiration and to the left an expiration; S. v., safety valve (bottle should be shorter and wider) ; S. T., stomach tube (this may be omitted provided sufficient pressure is made on the abdomen to prevent gaseous distension of the stomach) ; B., bellows, (an oxygen tank may be substituted). the ingress of poisons to the mouth, as from licking the lips, or using the uncleansed hands to put tobacco, or foods, or drinks into the mouth, seems to be almost impossible of accomplishment, hence the necessity of curtailing the amount of poisons by mechanical means to the utmost extent. In the end, a periodic examination of all work- ers in poisons is necessary in order to rid these industries of those who are unusually susceptible, or who cannot be made, or taught, to 48 follow instructions. The rotation of workers is another admirable means of meeting the situation, but this cannot be intelligently con- trolled without periodic medical examinations. There are some further health-hasards in industries, some of which we will briefly mention. Working in COMPRESSED AIR, that is, in caissons, is one of these. So far as we know, very little work of this character was performed in the State during the course of our Fig. 31. The Meltzer Artificial Respiration Apparatus. Face mask method. A well-fitting face mask may be used instead of the pharyngeal tube shown in figure 3. M., mask; Infl., inflation tube for inflating rubber ring around rim of mask; R. V., respiratory valve; S. V., safety valve. Insufflation pressure provided by oxygen tank. Heavy weights should be placed upon the abdomen. The pressure may be reinforced by a belt, or a belt press- ing downward on a broad board may replace the weight. The belt alone is insufficient. The tongue should be pulled well forward by means of a proper tongue forceps. survey. Suffice it to say that in bridge-building, tunneling, (partic- ularly under water), and sometimes in the -construction of buildings, it is necessary that the work be done under compressed-air. On the top, or in connection 'with all such caissons within which men have to work, should be provided air-locks within which workmen should be required to spend from 15 to 30 minutes at the close of each work period in order to undergo depression before coming out into the 49 normal air-pressure, and thus prevent the formation of air bubbles (air emboH) within the blood vessels, which, being carried to the vital organs, particularly the lungs, spinal cord and the brain, pro- duce the symptoms' called "the chokes", "the bends" and "the stag- gers". Such symptoms often result fatally, sometimes within a few minutes. To a certain extent FOUL ODORS may be considered health- hazards, because of the nauseating effect which they tend to produce. Fig. 32. Sanitary Drinking Fountains. Plenty of good water, properly cooled, in the workplace tends to limit alcoholism outside of the workplace. Nausea is usually accompanied by an excessive secretion of gastric juice, which, in time, if continued, produces mucous gastritis. The condition especially invites alcoholism, but even by itself would result in emaciation and debility through loss of appetite and of the digestive powers. However, this is one subject in which the personal factor is uppermost. What is nauseating to one may prove quite inoffensive to another. To this question of odors, workers will usually select themselves of their own accord, before any material damage is done 4 o; D. 50 to the system. In this connection we would mention especially the furnace odors' so frequently complained of by workers around oil- blast furnaces, particularly when these are being started up as in the early morning of each day. For these persons, proper ventila- tion is essential. Oftentimes indoor closets are installed in workrooms, without proper ventilation arrangements, perhaps only partially partitioned off with no ceiling over the same, so that odors escape and permeate the w^orkroom. Some of the loudest complaints of the work people have been in connection with this type of an indoor closet. If much used, it is a constant source of irritation to the workers and produc- tive of much bad feeling towards managements. The acquisition of VENEREAL DISEASES through industry is possible through the common handling or mouthing of articles; through a lack of supervision where both sexes work together; and, through the unmind fulness of employers of generally immoral sur- roundings, such, for instance, as are created by questionable pictures, "wall waitings',, loose language, etc. The subject of ALCOHOLISAI, as an industrial health-hazard, both as cause, and effect, has been discussed in an early part of this section under the head of "Stimulantism." PART IV. THE INVESTIGATION OF INDUSTRIES M OHIO. The plan has been to make a hygienic survey of the principal manufacturing industries of the state. An idea of their type, extent and number of persons concerned can be obtained from the U. S. Census of Manufactures. Such a classification, however, is not well adapted to a hygienic survey, since a great mass of wage-earners may be employed in comparatively non-hazardous callings. Hence it is more proper to speak of health-hazardous processes than health- hazardous industries. For our purposes, industries have been divided into six classes as follows : ( I ) Those using poisons as a chief hazard. (2) Dusty industries. (3) Those in which fatigue and inactivity are the chief hazards. ^4) Those in which heat, cold, moisture, or dampness predom- inate. (5) Those in which there is a more than usual liability to con- tracting communicable diseases. (6) Industries having miscellaneous hazards not included above. About half of the wage-earners of the state in manufacturing pursuits have been included in the industries investigated. In some instances strikes and business depressions interfered with the survey in certain lines of industry, but. outside of coal mining, not to any extent. The survey has not included non-manufacturing pursuits, such as general construction work, mercantile and trade pursuits, transportation, agricultural, animal, forestry and personal service pursuits, and those callings which engage professional, semi-profes- sional and clerical persons. There are a number of manufacturing industries and processes, of course, which the survey was unable to get to because of limitations in time and funds, but those described constitute the principal ones and represent the vast majority of wage- earners. In this Part, then, are described, in a general way. the in- dustries investigated, and the extent to which they have been sur- veyed, as well as the types of health-hazardous processes found to exist in them. The description of these processes will be taken up in the next Part. It will be seen that irrespective of the number of in- dustries and the number of trades, health-hazardous processes are 51 - - - 52 comparatively few in number. From a hygienic part of view, many trades and callings are so similar that they can be grouped together under one common head. Any peculiarities, due to certain trades or operations, are described when they occur. A large class of wage-earners are simply doing factory work. Such have been classified under the head of "factory processes" in the next Part. Except for dexterity, which experience develops, all such work is unskilled labor. This is the most convenient heading under which to describe the hazards of many processes which in- volve routine machine operations and hand work, such as assembling, inspecting and finishing of products. Every survey has a limit to the fine subdivisions into which it may go. It was the intent orig- inally to make investigations which would cover i/ioth of the wage- earners in each particular industry, guided, of course, by the relative hazards of such industries. Later, this was reduced to i/5th of the total wage-earners, as given in the U. S. Census of Manufactures for the State of Ohio (1910). It will be seen, however, that in many instances the survey has considerably passed this mark, even to the extent of reporting upon more places and more workers than the census figures give for the totals. In all cases our figures are limited strictly to the wage-earners, and do not concern office and managerial forces. To make the survey representative and fair, the aim has been to investigate large, medium sized and small plants in all industries reported upon, and to carry the investigation of each industry into small cities, and even villages, in dififerent parts of the state, as well as to include the large cities. To anyone who has perused the previous sections of this report (Parts I, II, and III), it Avill be seen that any establishment employing workers at regular applications is certain to have some health-hazard- ous situations, even though naught but general factory processes are engaged in. The question with the survey has been the methods used, if any, to circumvent all such hazards to health. The prime object of the survey has been to lay bare the industrial conditions which are inducing or promoting the preventable and degenerative diseases pointed out in the tables given in Part II and Part VI. Almost invariably our representatives, after presenting their cre- dentials at the various establishments have been most courteously received. It is only fair to state that managements not only tolerated our investigations, but in 95% of instances, at least, did everything in their power to enable us to get at the facts, often at considerable inconvenience to themselves and the loss of valuable time, Our 53 investigators always came unannounced. Itineraries were so arranged that none knew where nor when these inspections would be made. Hence conditions were seen as they really were, in, we believe, all instances. It is necessary to say that in many places certain hygienic improvements were under contemplation, or under way at the time of investigations, so that any subsequent survey would probably find them better. Unquestionably, in many instances our own investiga- tions, without necessarily intending to do so, initiated hygienic im- provements. The investigators, unless upon special missions, inspected all plants from basement to loft, where wage-earners were employed, inquired freely, into the nature of processes, and endeavored to get at all facts which had any bearing upon the health of the wage- earners, both good and bad. For each plant a summarized report was made, covering the following features : character of business, total employes, total wage-earners (males; females; youths, i6 to 20; and minors under 16), trade processes,, mechanical health appliances, health instructions and placards, benefit organizations covering sick- nesses, pensions and death, general sanitation features covering toilets, washing facilities, shower baths, time allowance for washing, change rooms, lockers, clothing and by whom' supplied, rest rooms for fe- males, luncheon quarters, seasonal influences, welfare work outside of the factory, and the general appearance and contentment of the workers. (For the hygienic features of special processes see Part V.) In connection with some of the industries, here described, are various vital statistics which have been available. Only such have been used whose source is authentic, and then only such figures as are large enough to mean something. One fault which oftentimes employers, as well as others, fall into is that of quoting a few in- stances, and attempting to draw general conclusions therefrom. For instance, it may be shown that in a given process ^4 oi the workers have remained so engaged for years without apparent health effect. The fallacy lies in not being able to state what has happened to the other 34 of the wage-earners who have been employed. Instances are known where, of 10 persons employed, 2 have remained steadily, while in the course of a year's time, 50 different individuals worked in the remaining 8 places, nearly all leaving because of health complaints. An especial appeal is made to employers to keep sick records. We are glad to say that this is now done by some of the most pro- gressive establishments. Such records should include, not only ab- sences due to sickness, but all health complaints reported to foreman or others, not only concerning the work, but of any or every nature. 54 Employers are not hygienists nor physicians as a rule, and if they attempt to judge upon the relationship between these complaints and work they make mistakes. It is only natural, also, that certain fea- tures bearing upon the conservation of public health should escape the notice of the layman, or appear too trivial to warrant attention. Right here is where an establishment would be immensely benefitted through the services of a good physician. The physician could, at intervals, go over the records of absences, sicknesses, and health complaints, and suggest many remedies. In all processes involving the handling of poisons, and in trades in which the known death rate from pre- ventable diseases is high, especial attention should be given, such as a physical examination at the time of employment, and a health inquiry at intervals thereafter. In poisonous industries, for instance, a five minute health inquiry, by a physician, of each worker about once a month would be all that is usually necessary. Furthermore, the physician is a very good person through whom to get to the em- ployes. His services, although only occasionally employed, would be of immense help to the employer, not only in the supervision of the health of his employes, but in instilling the principles of personal hygiene among them, and in overcoming indififerences to efforts which employers and others may make in this direction. There is no sadder picture than the employer whose welfare efforts have been un- appreciated, misunderstood, and, perhaps, scoffed at by his employes, until he has dropped his well-meaning intentions, locked up his shower baths, speeded up his machinery, and, perhaps, lengthened the work- day. The reason for this is that along with every improvement must go education. Education in industrial hygiene is a part of the re- sponsibility of the employer. There is no better man to help him out in this situation than the occasional services of a physician who is well respected in the community. DEFINITIONS. Industry. — Any single branch of productive activity; as. the iron industr)^ the soap industry, etc. Establishment. — A place of business with its buildings, grounds, equipments a:nd personnel. Plant. — Same as "establishment". Place. — In Parts IV. and V. this word is used very often and is a shorter term for the word "establishment". Departfitent. — Branch of an establishment, especially when such is located in quarters by itself; as, painting and varnishing depart- ment, foundry department, etc. 55 Process.- — Particular trade, calling" or manipulation; as, painting process, pickling process, etc. An indtisiKy is represented by many establishments (plants or places), each of which has several departments, while in each de- partment there may be one or several trade processes, each engaging a number of zvage-eariiers. Wage-earners engaged in similar trade pro- cesses usually are subjected to similar health-hazards, while if there are several trade processes in the same department, wage-earners may be subjected to the health-hazards of other processes than their own. A RUBBER COMPANV'S REPORT. The following tables (abbreviated) show what one rubber com- pany, employing some 650 workers, accomplished in the winter of 1913-14 in the matter of Illness Records, Physical Examinations and Sickness Records of their employes: "We find that there was a total of about 380 examinations at the regular examination and since that time the total has risen to 443. Now out of these 443, the items show as follows : I. Last illness ran the whole list almost, malaria predominating with 6, measles -5, penumonia 4, rheumatism, pneumonia, sore throat, stom- ach trouble, typhoid, scarlet fever. — Only 45 cases, all told, of close enough dates to report, that is within the last four years, n. Physical Examination. Finding: Eyes: Vision, right 5, left 5. Hearing: Right 2, left 2. Chest and contained organs: A total of 19 cases : Heart Diseases, 12. Arterial iSclerosis, 6. Pleurisy, 1. Abdomen and contained organs — 44 cases: All pertaining to hernia. Rectum and Genito-nrlnary organs — 28 cases: Varicocele, 27. Hydrocele, 1. Mental Alertness, poor — 6 cases: Illiterate — 10 cases: "In the case of the hernial cases above mentioned, with the exception of probably a dozen, they were very slight and these were or are now all properly supported by truss so that they cause no inconvenience. There were probably a half dozen cases of varicocele, and the hydrocele was bad. These cases were all instructed to wear proper support to prevent aggravation of the trouble. TTT. Following is a list showing Hospital information for months desig- nated, there being no major illness cases, and with but one or two exceptions, all parties returned to work immediately: 56 November (1st month of Hospital) Illness cases 93 — Male 61, Female 32. These cases included migraine, toothache, throat affection, in the most part, with a number of other trivial diseases. Surgical cases 177 — Male 156, Female 21. Mostly contusions, abrasions, infections from scratches, and sprains, nothing serious, excepting one contused heel and one elbow abrasion and puncture, both cases reported to State. December. Illness cases 57 — Male 26, Female 31. Practically same as November. Surgical cases 61 — Male 51, Female 10. Same as for November, excepting one crushed hand, one hand and leg injured, one side bruised, all reported to State Commission, the crushed hand having to be amputated. January, 1914. Illness cases 77 — Male 38, Female 39. 'Same as former months. Surgical cases 72 — Male 64, Female 8. Usual, two cases reported to State, neither being serious. February. Illness 118 — Male 67, Female 51. Surgical 42 — Male 39, Female 3. Two cases reported to State, neither being a major accident." There is no question but that from the manner in which the superintendent of this firm has taken hold of the question of physical examinations and medical records of his employes, he is getting to- gether a working force which is superb, one in which the defective worker is properly fitted to his job (not discharged), and one in which the constant repetition of minor health complaints are having their causes discovered and (whether occupational or not) these causes eliminated when preventable. A prominent eastern establishment has been able to improve cases of heart disease by selecting proper work for such persons, not only saving lives thereby, but keeping worthy and productive men on their jobs. A large steel company, which employed an average of 5,602 workers during a period of 38 months, supplied us with very care- fully compiled tables of sickness taken from its sick benefit associa- tion records, which covered all employes. (No accidents, or venereal diseases included.) In all , cases workers were genuinely sick for at least one week. Classifications showed as follows : s? /. General Charactef of Sickness in an Iron and Steel Establish- ment. No. Yearly Sickness. Claiins. Percentage. Preventable diseases 1,150 5.750 Degenerative diseases 227 1 . 135 Other diseases 67 .335 Total : 1,444 7.220 //. Systemic Classification of Sickness in an Iron and Steel Estab- lishment. No. Yearly Systematic Diseases. Claims. Percentage. Respiratory' 391 1 .955 Digestive" 285 1 . 425 Communicable' 218 1 .090 Musculo-osseous^ 184 . 920 Nervous" 79 .395 Skin' 65 .325 Circulatory' 63 - .315 Urinary' ' 45 .225 Strain, etc." , 41 .205 Constitutional 27 .135 Special Senses fears, 15) ' 17 .085 Chronic Infections 18 .090 Lymphadenoid 6 . 030 Neoplasms 5 . 025 Total 1 ,444 7.220 '^ Bronchitis, 145; Pneumonia, 75; Tuberculosis, 51; Pleurisy, 39; Tonsil- litis, 34; Miscellaneous, 47. /Gastritis, 102; Appendicitis, 53; Liver Trouble, 34; Enteritis, 30; In- digestion, 19; Miscellaneous, 41. 'La Grippe, 100; Typhoid Fever, 72; Mumps, 10; Measles, 9; Misc., 27. * Rheumatism, 141; Lumbago, 37; Miscellaneous, 6. 'Sciatica, 18; Neuralgia, 13; Neurasthenia, 12; Neuritis, 9; Paralysis, 8; Miscellaneous, 19. 'Boils and Carbuncles, 40; Conjunctivitis, 9; Miscellaneous, 16. ^ Heart Trouble, 31; Varicose Veins, 13; Apoplexy and Cerebral Hem- orrhage, 8; Miscellaneous, 11. 'Kidney Trouble and Nephritis, 39; Cystitis, 6. •Hemorrhoids, 16; Hernia, 13; Heat Prostration, 4; Miscellaneous, 7, ^"Auto-intoxication, 24 1 Diabetes, 3, 5« ///. The Average (Yearly) Morbidity Figures in the Various De- partments of an Iron and Steel Establishment During a Period of 5 Years, ipii to 1Q13 Inclusive. (The greatest variation of numbers employed did not exceed 15% in any one department.) Average Average Average Number of Number Per cent Departments. Employes. Sick. Sick. (a) Heat E.vposcd. Bessemer 393.3 33. 8.39 Open Hearth 145.3 7.' 4.81 Rail and Shape Mill 500. 43.3 8.66 Blast Furnaces 261. 35. 13,41 Foundry 163.3 12.7 7.77 Shelf Mills 348.3 33.3 9.56 Pipe Mill 1,764.7 162. 9.18 (b) JVcalhcr Exposed. Police 35. _ 2.7 7.o2 Railroad (yards) •. . . . 156.3 ' 9. . 5.76 Section Hands 110. 10. 9.09 l^ard Labor ..-. 468'. 28.7 6.13 Ore Docks... 90.3 ,8.3 9.19 Bricklayers 72.7 2.7 3.66 Building Construction 106.3 9.7 9.07 (c) Indoors (mostly). ^lechanical 472.3 47.7 10.09 Electrical 181.3 4.8" 2.37 Miscellaneous 351.6 11.3 3.21 Total 5,619.7 460.7 8.20 The above tables are very important — First, because they show the type and the minimum amount of sickness that can be expected at the present day in an iron and steel establishment which has the highest attainments in sanitation and hvgiene of worlcing quarters, and medical supervision of it^s employes. Second, because the last table (No. III.) shows definitely which departments have the most and which have the least percentage of cases of sickness, and hence where the greatest precautions are neces- sary. Third, because average sickness figures are shown for a number of "weather exposed" groups of workers who are under organized welfare and medical supervision — figures hard to obtain for these classes. It may be added in conclusion that a large percentage of these workers are foreigners, Eastern European, and therefore the most difficult class to instruct and supervise, but a strong overseers' 59 and foremen's organization with high ideals, patience and persistence has developed a working force in a health-hazardous line of industry in which the average yearly sickness is only 8.2 per cent. (The sta- tistics supplied give the exact types of sickness in each department, but the necessarily small numbersl for each disease do not make it advisable to publish the same here. Suffice it to say that respiratory and digestive diseases lead in practically all departments.) INDUSTRIES HAVING A KNOWN ASSOCIATION WITH THE USE OF POISONS. (See Part V and the general index for description of the health- hazardous processes mentioned. It is, of course, undersood that many hazards other than poisoning exist in the various industries here listed.) AGRICULTURAL IMPLEMENTS. According to the Census there are 55 firms employing 5,997 wage-earners, or 1.3% of the total wage-earners in the State. Our investigations covered 12 plants, in 6 cities, employing 4,560 wage- earners, of whom 4,499 were males and 61 females. The industry is made up of several processes which are more or less health-haz- jardous, viz.. Iron Founding, Brass Founding, Core Making, Metal Grinding, Forging and Blacksmithing, Machine Shopping, Polishing and Buffing, Wood-working, Painting. AUTOMOBILES, INCLUDING Br:DlES AND PARTS. This industry, according' to the Census, includes 75 establish- ments, employing 12,130 wage-earners, or 2.7% of the total wage- earners in the state. (Jur investigations covered 34 firms, in 10 cities, employing 17,783 wage-earners, of wliom 17,404 were males and 379 were females. The industry is made up of several processes which are more or less health-hazardous, viz.. Iron Founding, Brass Found- ing, Core Making, Metal Grinding, Forging and Blacksmithino-. Ma- chine Shopping, Brazing, Soldering, Welding, Polishing and Buffing, Acid Dipping, Pickling, Furnacing, Tempering, Electroplating, Paint- ing and Varnishing, Ja]ianning, l*ji:uneling. Facquering and Shellacing. BABBIT METAL AND SOLDER. The Census shows 6 firms employing 74 wage-earners. Our in- vestigations covered 2 firms, in 2 cities, employing a total of 8 wage- earners, all males. — Furthermore, bal)bitting of journal bearings is 6o an auxiliary process in railway shops and many large plants in the foundry and machine shop, and iron and steel branches of industry. One of the two plants visited had melting pots well hooded, so that risks from lead poisoning were only nominal. General working conditions were fair. The other plant had no devices for removing lead fumes. Foreman admitted trouble from lead poisoning in the past. General conditions of working very. poor. One case of lead poisoning was seen. BICYCLES, MOTORCYCLES AND PARTS, AND SEWING MACHINES, CASES AND ATTACHMENTS. The Census gives lo establishments engaged in this industry, em- ploying a total of 4,773 wage-earners, or i.i% of the total wage- earners in the state. Our investigations covered 3 establishments, in 3 cities, employing a total or 2,795 wage-earners, of whom 2,685 were males, and no were females. The chief processes of health- hazardous character were found to be : Brass Founding, Forging and Blacksmithing, Machine Shopping, Brazing, Tempering, Metal Grind- ing, Polishing and Buffing, Acid Dipping, Electroplating, Wood-work- ing, Painting and Varnishing, and Enameling. BOXES, FANCY AND PAPER. The Census reports 46 firms employing 2,530 wage-earners, or 0.6% of the total wage-earners in the state. Our investigations covered 4 firms, in 4 cities, employing 581 wage-earners, of whom 351 were males and 230 females. Outside of general factory processes the industry was found to have the, following processes of health- hazardous character : Wood-working, Gluing, Painting and Varnish- ing, Shellacing and Lacquering, Staining, Bronzing, Printing. BRASS AND BRONZE PRODUCTS. The Census shows 82 firms in this industry, employing 2,232 wage-earners, or 0.5% of the total wage-earners in the state. Our investigations covered 55 firms, in 6 cities, employing 4,532 employes, of whom 4,450 were males, and 82 females. The industry consists of several health-hazardous processes, of which the following are the chief: Brass and Bronze Founding, Core Making, Metal Grinding, Polishing and Buffing, Machine Shopping, Forging and Blacksmithing, Soldering, Brazing, Furnacing, Pickling, Acid Dipping, Electroplating, Painting and Varnishing, Shellacing and Lacquering, Enameling. Japanning. In addition, some plants were concerned in Iron Founding. According to the Vital Statistics Reports for the State of Ohio, for the years 1910, 191 1 and 1912', there were reported 43 deaths of Brass Molders and Brass Workers, of whom 14 died of puhnonary tuberculosis, or 32.72% of their total deaths. While the number of total deaths reported is small, the high rate of consumption is in har- mony with observations concerning this industry reported elsewhere. This rate is to be compared to the pulmonary tuberculosis death rate of all occupations in the state combined, for the same years, which was 13.3%, and is also to be compared to the pulmonary tuberculosis death rate of those engaged in Agricultural Pursuits during the same period, which was 7.13%. Tables submitted by the General Secretary-Treasurer and Editor of the Brassworkers' (Metal Polishers, Buffers, Platers, Brass and Silver Workers) Union of North America for the 5 year period from 1909 to 19 14, covering the death claims paid, show the chief causes of deaths, numbers and percentages to be as follows : Cause. No. Per cent. Tuberculosis 77 31.9 Pneumonia .'' 31 12.9 Heart Disease 31 12.9 Violence (including 6 suicides) 19 7.9 Other preventable deaths 20 8.0 Other Deaths from Degenerative Diseases 57' 23.5 Permissible deaths 7 2.9 Total 242 100.0 The following quotation is from the letter accompanying the tables : "You will note from the report, the large percent of our members that die from Pulmonary. Tuberculosis. All of these deaths we believe were con- tracted by working at this trade, but the sad feature is that at least 95% of those that contract Consumption, working at our dangerous trade, will not acknowledge they have the disease until they are too far gone for recovery. They then quit the trade and try to get a position out in the air, often as collectors, driving laundry wagons, or a farm, or, if fortunate enough, go West. These we believe eventually succumb to the disease contracted while working at the trade. We lose all track of them and have no record. If it were possible to keep this record, the percentage of deaths in our trade would be enormous." The average (median) age at death of the 242 brassworkers was 40.1 years, while for those who died of tuberculosis it was 37.27 years. (Since this is a long-period occupation the median age at 62 death has some significance.) Hence occupation cut oil about 21 years from the expected life of each worker when he began to learn the trade at 16 to 18 years. of age. CARRIAGES, WAGONS AND MATERIALS. The Census shows 407 establishments engaged in this industry, employing 8,815 wage-earners, or 0.2% of the total wage-earners in the state. Our investigations covered 53 establishments, in 1 1 cities, employing a total of 2,484 wage-earners, of whom 2,443 were males and 41 females. The chief processes of health-hazardous character were found to be : Wood-working, Forging and Blacksmithing, Ma- chine Shopping, Aletal Grinding, x\cid Dipping, Electroplating, Shel- lacing and Lacquering, Painting and \"arnishing, Staining, and Up- holstering. CARS MADE BY RAILROAD COMPANIES. The Census shows 71 establishments employing 20,728 engaged in both the construction and repair of cars by steam railroad companies, and 49 establishments employing 1,318 wage-earners engaged in gen- eral shop construction and repair by street railroad companies. The two classes combined employ 4.9% of the total wage-earners in the state. A large- amount of this work is carried on in the open, or in very openly constructed buildings. The vast percentage of it is gen- eral repair and round-house work, in which health-hazards are only nominal. Our investigations covered 6 establishments, in 4 cities, em- ploying a total of 5,534 wage-earners, all males. The chief health- hazardous processes were found to be : Forging and Blacksmithing, Brass Founding, Machine Shopping, Soldering, Tinning, Storage Bat- teries (repairing), Wood-working, Painting and Varnishing, Shellac- ing and Lacquering, Welding, Babbitting. CARS NOT MADE BY RAILROAD COMPANIES. The Census shows 10 establishments so engaged, employing 3,016 wage-earners, or 0.7% of the total wage-earners of the state. Our investigations covered 7 firms, in 7 cities, employing a total of 6,464 wage-earners, of whom all except 5 were males. The chief health- hazardous processes v/ere found to be the same as for Cars Made by Railroad Companies fz'. s-,). CASH REGISTERS AND CALCULATING MACHINES. The Census shows 8 establishments so engaged, but the number of wage-earners is not stated. Our investigations covered 5 estab- 63 lishments, in 2 cities, employing 7,472 wage-earners, of whom 6,940 were males and 532 females. The chief processes of health- hazardous character were found to be : Brass Founding, Forging and Black- smithing, Machine Shopping, Metal Grijiding, Polishing and Buffing, Tempering, Pickling and Acid Dipping, Electroplating, Sandblasting, Wood-working, Painting and Varnishing, Shellacing and Lacquering, Electrotyping, Printing. CHEMICALS. The Census gives 33 establishments engaged in the manufacture of chemicals, employing 1,132 wage-earners, or 0.3% of the total wage-earners in the state. Our investigations covered 4 establish- ments, in 3 cities, employing 1,101 Avage-earners, of whom 1,100 were males and i a female. The balance of the establishments are small firms. The following were found to be the chief health-hazardous processes" of this industry : Chemical Manufacturing. Forging and Blacksmithing, Machine Shopping. COFFINS. BURIAL CASES, AND UNDERTAKER'S GOODS. The Census gives 24 establishments engaged in this industry, em- ploying 1.245 wage-earners, or 0.3% of the total wage-earners in the state. Our investigations covered 8 firms, in 5 cities, employing a total of 922 wage-earners, of whom 745 were males and 177 were females. Some of these establishments make only wood coffins, others metallic burial vaults and metallic coffin trimmings. The following processes were found to be the chief ones of health-hazardous concern : Found- ing (see Brass), Metal Grinding, Polishing and Buffing. ^Machine Shop- ping, Welding, Soldering, Electroplating, Engraving. W^oodworking, Sewing, Painting and Varnishing, Shellacing and Lacquering. COPPER, TIN AND SHEET-IRON PRODUCTS. The Census gives 221 establishments engaged in this rather am- biguous industry, employing a total of 6,598 wage-earners, or 1.5% of the total wage-earners in the state. Our investigations covered 8 establishments, principally tin can and galvanized can manufacturers, which we have classified under this heading, located in 5 cities, employ- ing a total of 1,307 wage-earners, of whom 840 were males and 467 were females. The chief processes of health-hazardous character were found to be : Tinning, Galvanizing, Soldering, Machine Shopping, Welding, Polishing and Buffing. Acid Dipping, Pickling, Electroplat- ing, Painting and A^arnisbing, Enameling.- Japanning, Lithographing. CUTLERY AND TOOLS. The Census gives 70 establishments engaged in this industry, em- ploying a total of 2,820 wage-earners, or 0.6% of the total wage- earners in the state. Our investigations covered 25 establishments, in 6 cities, employing a total of 4,202 wage-earners, of whom 3,949 were males and 253 were females. The chief processes of health-hazardous character were found to be : Brass Founding, Iron Founding, Forging and Blacksmithjng, Tempering, Welding, Furnacing, Hot Shaping (Iron), Metal Grinding, Machine Shopping, Polishing and Buffing, Sandblasting, Pickling, Acid Dipping, Electroplating, Tinning, Wood- working. Painting and Varnishing, Enameling, Etching. DRY CLEANING AND DYEING. This non-manufacturing industry is not, of course, included in the Census reports. Our investigations covered 2"j establishments, in 6 cities, employing a total of 698 wage-earners, of whom 263 were males and 435 were females. The chief processes of health-hazardous char- acter were found to be: Dry (and Steam) Cleaning, Dyeing, Ironing and Pressing, and Carpet Cleaning. In addition, one establishment was engaged in laundry processes and another in the manufacture of rugs. ELECTRICAL MACHINERY, APPARATUS AND SUPPLIES. The Census gives 115 establishments, employing 8,073 wage- earners, or 1.8% of the total wage-earners in the state. Our investiga- tions covered 29 establishments, in 11 cities, employing a total of 8.982 wage-earners, of whom 6,576 were males and 2,368 were females. The chief processes of health-hazardous character were found to be : Brass Founding, Iron Founding, Core Making, Forging and Blacksmithing, Metal Grinding, Polishing and Buffing, Machine Shopping, Soldering, Tempering, Pickling. Acid Dipping, Electroplating, Sandblasting, Fur- nacing, Storage Battery Manufacturing, Dry Battery Manufacturing. Wood-working, Mixing Chemicals, Shellacing and Lacquering, Paint- ing and Varnishing, Incandescent Lamp Manufacturing, Pottery Processes. ELECTROPLATING. The Census gives 29 establishments engaged in this industry, em- ploying a total of 205 wage-earners. Our investigations covered 8 .establishments, in 5 cities, employing a total of no wage-earners, all males. In addition, electroplating processes have been considered else- where in connection with a great many lines of industry. The chief 65 processes of health-hazardous character are : Metal Grinding, Polish- ing and Buffing, Acid Dipping, Electroplating, Shellacing and Lac- cjuering. ENAMELING AND JAPANNING. The Census gives 5 establishments in this industry, employing a total of 145 wage-earners. Our investigations covered 5 establish- ments, in 3 cities, employing a to'.al of 115 employes, of whom 102 were males and 13 were females. The chief processes of health- hazardous character were found to be : Furnacing, Machine Shop- ping, Acid Dipping, Pickling, Mixing Chemicals, Sandblasting, Enam- eling, Painting and Varnishing, Japanning. ENGRAVING AND DVE-SINKING. The Census gives 8 firms engaged in this process, but the number of wage-earners is not stated. However, engraving is a process asso- ciated with a number of industries and figures cannot be considered at all representative. Qur investigations covered 5 establishments, in 3 cities, employing a to^tal of 105 wage-earners, 95 of whom were males and 10 were females. The chief processes of health-hazardous char- acter were found to be: Engraving, Chemical Processes (Photog- raphy), and sedentary work in the nature of Designing and Illustrat- ing. (See also Photo-Engraving.) EXPLOSIVES. The Census gives 11 establishments in this industry, employing 358 wage-earners, or 0.1% of the total wage-earners in the state. Our investigations covered 7 plants, in 7 city vicinities, employing a total of 994 workers, of whom 755 were males and 239 were females. (These figures include one large ammunition factory, the majority of whose employes were not concerned with explosives directly.) The chief processes of health-hazardous character were found to be : the Manu- facture of Explosives, in addition to which were Founding (see Brass). Machine Shopping, Soldering, Wood-working, and Painting and Var- nishing. FERTILIZERS. The Census gives zj establishments in this industry, employing 841 wage-earner.'i, or 0.2% of the total wage-earners in the state. Our investigations covered lo establishments, in 4 cities, employing 849 wage-earners, of whom 839 were males and 10 were females. The chief health-hazards were found to be: Fertilizer Manufacturing, Oil Refming. Glue Making. 5 o. D. FILES. The Census shows 7 establishments engaged in this industry, employing 139 wage-earners. Our investigation covered 4 establish- ments, in 3 cities, employing 108 wage-earners, all males. The chief processes of health-hazardous character were found to be : Temper- ing, File Cutting, Metal Grinding, Machine Shopping. FLAVORING EXTRACTS. The Census gives ^il establishments in this industry. The total number of employes is too small to be mentioned. Our investigations covered 2 establishments, in i city, employing a total of 18 wage- earners, of whom 16 were males and 2 were females. The chief health-hazard is Mixing Chemicals. FOUNDRY AND MACHINE SHOP PRODUCTS. This industry, which is the first in importance in the state, com- prises, according to the Census, 1,218 establishments, employing a total of 64,817 wage-earners, or 14.5% of the total wage-earners in the state. Our investigations covered 47 establishments, in 11 cities, em- ploying a total of 14,484 wage-earners, of whom 13,857 were males and 627 were females. The chief processes of health-hazardous char- acter were found to be : Iron Founding, Brass Founding, Core Making, Forging and Blacksmithing, Tempering, Welding, Metal Grinding, Machine Shopping, Furnacing, Pickling, Tinning, Galvan- izing, Soldering, Brazing, Hot Riveting, Mixing Chemicals, Acid Dip- ping, Electroplating, Babbitting, Polishing and Buffing, Sandblasting, Tumbling, Oil Refining, Wood-working, Painting and Varnishing, Shellacing and Lacquering, Staining, Enameling, Japanning. According to the Vital Statistics Reports for the State of Ohio, for the years 1910, 191 1 and 1912, there were reported the deaths of 605 molders, of whom no died of pulmonary tuberculosis, or 18.18% of their deaths. During the same period there were reported the deaths of 1,195 machinists, of whom 224 died of pulmonary tubercu- losis, or 18.74% of their deaths. These rates are to be compared to the pulmonary tuberculosis death rate of all occupations in the state com- bined for the same years, which was 13.3% ; and are also to be com- pared to the pulmonary tuberculosis death rate of those engaged in Agricultural Pursuits during the vSame period, which was 7.13%, 67 FUR GOODS. The Census gives i8 establishments, employing 167 wage-earners. Our investigations covered 4 establishments, in 3 cities, employing a total of 44 wage-earners, of whom 21 were males and 23 were females. No curing of furs was done. The chief health-hazards were found to be: Sewing, and the use of hard-wood dust (oak and mahogany) and corn meal flour to clean the furs. One case' of chronic conjunct- ivitis and blepharitis was reported, due, probably to the effects of this dust. Also it was found that yellow furs were dyed yellow with anilin dyes, used dry. No workers were at the time so employed. Whether this yellow dye is poisonous or not we are unable to state, although saffron yellow and anilin orange are regarded as suspicious or injurious to health. Furs collected in Ohio are "fleshed" and then sent elsewhere for tanning and curing, then returned and made up here. The fur animals of the state are mink, muskrat, skunk, ferret, raccoon, fox and squirrel. FURNITURE AND REFRIGERATORS. The Census gives 228 establishments engaged in this industry, employing a total of 8,232 wage-earners, or 1.8% of the total wage- earners in the state. Our investigations covered 19 establishments, in 8 cities, employing a total of 3,953 wage-earners, of whom 3,837 were males and 116 were females. The chief processes of health-hazardous character w^ere found to be : Machine Shopping, Wood-working, Acid Dipping, Electroplating, Brazing, Painting and Varnishing, Shellacing and Lacquering, Staining, Enameling, Gluing, Tinning, Upholstering. (See Wood-working for Vital Statistics.) GAS, ILLUMINATING AND HEATING. The Census gives 38 establishments engaged in this process, em- ploying 666 wage-earners, or about 0.2% of the total wage-earners in the state. Our investigations of this industry covered but 2 inde- pendent concerns, employing a total of 55 wage-earners, all males, but in connection with a number of establishments the gas-producing plant was investigated. The chief health-hazards of this industry are given under Gas Producing. GALVANIZING. The Census gives 5 establishments, but the number of wage- earners is not stated. Our investigations covered 2 establishments, engaged solely in galvanizing, in 2 cities, employing a total of 33 males. 68 However, the great bulk of galvanized goods are made in Iron and Steel Rolling Mills, where it is reported upon elsewhere. The chief processes of health-hazardous character were found to be : Pickling and Galvanizing. GLASS. CUTTING, STAINING AND ORNAMENTING. (Glass manufacturing is considered elsewhere.) The Census gives 34 establishments engaged in this industry, but the number of employes is not stated. Our investigations covered 10 establishments, in 4 cities, employing a total of 347 wage-earners, of whom 329 were males and 18 were females. The chief processes of health-hazardous character were found to be : Glass Finishing, Glass Etching, Mirror Making, Sandblasting, Soldering, Electroplating, Painting and Gilding. There is also Transfer Work (Decalcomania), and some Glass Blowing, but only a few so employed. HATS, FUR-FELT. The Census gives 3 establishmen'.s engaged in this industry, em- ploying a total of 9 wage-earners. Our investigations covered 2 estab- lishments, employing a total of 166 wage-earners, of whom 64 were males and 102 were females.- The health-hazardous processes were found to be: Dyeing, Ironing and Pressing, Sewing, Shellacing and Varnishing, also Founding. In addition, the process of Steaming, to shape the hats over molds, was found to be a work largely done by foreigners, who barely understood English, although a fair amount of skill was necessary; There was considerable exposure to humidity, due to steam and vapors of undetermined character, windows being the only method of ventilation. Work was rather- warm. Fatigue was more than a moderate hazard, due to piece-work, monotony, constant standing, body pressure, eye-strain and noise. A 9-hour day, with i hour off for noon was the rule. The men ate in the workrooms, and there was no medical supervision. instruments; professional, scientific. The Census gives 17 establishments engaged in this industry, but the number of wage-earners is not stated. Our investigations covered 2 establishments, in 2 cities, employing a total of 175 wage-earners, of whom 120 were males and 55 were females. The chief processes of health-hazardous character were found to be: Machine Shopping, Soldering, Welding, Polishing and Buffing, Electroplating, Glass Fin- ishinsf. 69 IRON AND STEEL DOORS AND SHUTTERS. The Census gives 3 establishments, without stating the number of wage-earners. Our investigations covered i establishment, in i city, employing 90 wage-earners, all males. The chief processes of health- hazardous character were found to be: Machine Shopping and Painting. JEWELRY. The Census gives 35 establishments, employing a total of 356 wage-earners. Our investigations covered 3 establishments, in i city, employing a total of 23 wage-earners, all males. Apparently there is no diamond cutting as a regular process done in this state, hence the dangers of lead poisoning and dust from this source may be considered almost nil. One health-hazardous process is Soldering, in which the worker has his face very close to the fumes which arise, and another is the inhalation of metallic dusts from Polishing and Buffing. At two of the places inspected good exhaust systems were present. Another hazard is fatigue, due to eye-strain, monotony, faulty postures, blow- piping, etc. There is also Engraving, Etching and Electroplating. There is some' risk from lead fumes, cyanid fumes from hot baths, mercury vapor and acid fumes, as well as shellacs, which are used. No cases of eczema or skin trouble were found. JUNK. (Sorting Rags and Scrap Metals.) The Census gives no figures for this non-manufacturing industry. Our investigations covered 22 establishments, in 4 cities, employing a total of 406 wage-earners, of wdiom 334 were males 'and 72 were females. These figures do not include those engaged in sorting and handling of rags in paper-stock companies. The chief health-hazardous processes were found to be : Junk Sorting, and occasionally melting down of non-ferrous metals. (See Brass Foundry; also Paper Manu- facturing.) LEAD. BAR, PIPE AND SHEET. The Census gives 2 establishments engaged in this industry, but the number of wage-earners is not stated. Our investigations covered 3 establishments, in 2 cities, employing a total of 34 wage-earners, all males. This does not include establishments considered as lead oxide manufacturing (see Paint Manufacturing). The chief health-hazard is the handling, melting and pouring of lead — in other words, Foun- ding. (See Foundry, Brass.) In one plant efficient hoods and venti- 7'» lating stacks were provided. In the other 2 these were absent. There was a general ignorance of personal hygiene respecting lead poisoning, and the workers were allowed to eat anywhere. Washing facilities were very inadequate. One lead poisoned worker was seen in one of the places. LEATHER. TANNED, CURED AND FINISHED. The Census gives 36 establishments, employing 1,884 wage- earners, or 0.4% of the total wage-earners in the state. Our investiga- tions covered 8 establishments, in 4 cities, employing 1,120 wage- earners, all males. The chief processes of health-hazardous character were found to be : Leather Handling, Leather Dyeing and Leather Chemical Processes. LIME. The Census gives 39 establishments engaged in this industry, em- ploying a total of 1,273 wage-earners, or about 0.3% of the total wage- earners in the state. Our investigations covered 7 establishments, in 6 cities, employing 556 wage-earners. The process is considered under the head of Lime Burning. There is also Quarrying and Gas Producing. MATCHES. The Census gives 4 establishments engaged in this industry, but does not state the number of wage-earners. Our investigations covered 3 establishments, in 3 cities, employing a total of 1,782 wage-earners, of whom 1,313 were males and 469 were females. The chief processes of health-hazardous character are given under Matches (Part V.) (Most of the workers are in General Factory Processes.) MIRRORS. The Census gives 8 establishments, employing 94 wage-earners. Our investigations covered 5 establishments, in 3 cities, employing a total of 89 wage-earners, all males (these are in addition to Mirror Making done by firms in the art glass business). The chief processes of health-hazardous character were found to be: Mirror Making (Sil- vering) , Glass Finishing, and Polishing and Bufiing. MUSICAL INSTRUMENTS, PIANOS, ORGANS AND MATERIALS. The Census gives 30 establishments engaged in this industry, em- ploying 1,841 wage-earners, or 0.4% of the total wage-earners in the state. Our investigations covered 5 establishments, in 3 cities, employ- ing a total of 851 wage-earners, of whom 4 were females. The chief 71 processes of health-hazardous character were : Brass Founding, Iron Founding, Core Making, Metal Grinding, Tumbling, Polishing and Buffing, Furnacing, Machine Shopping, Soldering (also Welding, Braz- ing), Acid Dipping, Electroplating, Wood-working, Gluing, Painting and Varnishing, Shellacing and Lacquering, Japanning and Bronzing. OILCLOTH AND LINOLEUM. The Census gives 3 establishments, but the number of wage- earners is not stated. Our investigations covered 3 establishments, in 3 cities, employing a total of 240 wage-earners, all males. The chief processes of health-hazardous character were found to be: Oil Cloth and Linoleum ^Manufacturing, Oil Refining, Printing and Dyeing. OIL (linseed) and petroleum refining. The Census gives 14 establishments, employing 1,872 wage- earners, or about 0.5% of the total wage-earners in the state. Our investigations covered 5 establishments, in 3 cities, employing 1,007 wage-earners, all males. The chief processes of health-hazardous char- acter were found to be: Oil Refining, Lead Burning (Soldering), Machine Shopping and Wood-working. PAINT AND varnish. The Census gives 87 establishments, employing 1,535 wage- earners, or 0.3% of the total wage-earners in the state. Our investiga- tions covered 40 establishments, in 6 cities, employing a total of 2,379 wage-earners, of whom 2,041 were males and 338 were females. The chief processes of health-hazardous character Avere found to be : Manu- facturing Lead Compounds, Paint and Varnish, Filling Paint and \'ar- nish Containers, and Labeling; also Founding (See Brass), manufac- turing Tin Cans and Soldering. patent medicines and COMPOUNDS, AND DRUGGTSTs' PREPARATIONS. The Census gives 261 establishments engaged in this industry, em- ploying 905 wage-earners, or 0.2% of the total wage-earners in the state. It will be observed that the average number of wage-earners per each establishment is very low. Our investigations covered i establish- ment, employing 95 wage-earners, of whom 47 were males and 48 were females. Health-hazards in tliis industry are chietl\- lliose of Factorv Processes in General. .See also Mixing Chemicals. 72 PHOTO-ENGRAVING. The Census gives 20 establishments, employing 277 wage-earners. Our investigations covered 2 establishments, in 4 cities, employing 36 wage-earners, all males, in addition to those in conjunction with print- ing and publishing establishments. The principal health-hazards were found to be : Art and Designing, Photography, Copper and Zinc Print- ing and Etching, and Blocking. (Photo-engraving has been considered under Printing — Art, Half-tone, Etching, etc.) PORCELAIN ENAMELED IRON WARE. The Census does not give this industry by itself, but probably in- cludes it in Foundry and Machine Shop Products. Our investigations covered 5 establishments, in 3 cities, employing a total of 504 wage- earners, all males. The chief processes of health-hazardous character were found to be : Porcelain Enameling of Iron Ware, Brass Found- ing, Iron Founding, Core Making, Machine Shopping, Metal Grinding, Sandblasting, Wood-working, Painting and Varnishing. POTTERY, TERRA COTTA AND FIRE CLAY PRODUCTS. The Census gives 186 establishments, employing 16,519 wage- earners, or '^.J% of the total wage-earners in the state. Our investiga- tions covered 56 establishments, in 16 cities, employing a total of 9,494 wage-earners, of whom 6,800 were males, and 2,694 were females. The branches of the industry investigated were : No. of Potteries. d) White, China and Sanitar_v Ware 34 (2) Yellow, Art and Utility Ware 8 (3) Stoneware 8 (4) Tiles (decorative) 4 (5) Porcelain (electrical) .' 2 Total 56 The principal processes of health-hazardous character in this in- dustry were found to be : Slip Making, Glaze Making, Sagger Making, Mold Making; Clay-room Processes, Glaze Dipping, Biscuit and Glost Kilning, Biscuit and Glost Finishing, Decorating, Assorting ( Shading), and Packing and Shipping. According to the State Vital Statistics Reports, there were 225 deaths among male Potters in the state during the years 1910, 1911 and 1912, of whom 53, or 23.6'^ didl of pulmonary tuberculosis. Tlic 73 rates for females in this industry are not given. It must also be borne in mind that this rate is conservative, since a certain percentage of con- sumptive potters leave the state and die elsewhere, or lea\-e the industry and take up other callings before death ensues. This rate is to be com- pared to the pulmonary tuberculosis death rate of all occupations in the state combined, for the same years, which was 13.3% ; and is also to be compared to the pulmonary tul^erculosis death rate of those engaged in Agricultural Pursuits during the same period, which was 7.13%. PRINTING AND PUBLISHING. The Census gives 1,655 establishments, employing 15,756 wage- earners, or 3.5% of the total wage-earners in the state. Our investiga- tions covered 34 establishments, in 5 cities, employing a total of 2,725 wage-earners, of whom 2,325 w^ere males and 390 were females. The principal processes of health-hazardous character were found to be : Composition and Miscellaneous Small Work, Type-Machine Processes, Printing Press Processes, Bookbinding, Artistic Work, Half-tones, Etchings, etc.. Lithographing, Compounding Chemicals, Gluing, Found- ing (Brass). No type-founding of consequence appears to be done in the State of Ohio. According to the Vital Statistics Reports for the State of Ohio, for the years 1910, 191 1 and 1912, there were a total of 273 deaths reported among Printers, Pressmen and Compositors, of whom 58 died of pul- monary tuberculosis, or 21.25%. This rate is to be compared to the pulmonary tuberculosis death rate of all occupations in the state com- bined, for the same years, which was 13.3% ; and is also to be compared to the pulmonary tuberculosis death rate of those engaged in Agricul- tural Pursuits during the same period, w^hich was 7.13%. ROOFING MATERIALS. The Census gives 11 establishments, but the number of wage- earners is not stated. Our investigators covered 3 establishments, in 3 cities, employing a total of 141 wage-earners, of whom 135 were males and 6 were females. The roofiiig materials in question consisted of the various types of roofing paper. The chief processes of health-hazard- ous character were found to be : Rag-Sorting and Handling, Paper Manufacturing, Machine Shopping, and Mixing Chemicals. RUBBER GOODS. (Not elsewhere specified.) The Census gives 37 establishments, employing 10,382 wage- earners, or 2.4% of the total wage-earners in the state. Our investiga- 74 tions covered 32 establishments, in 14 cities, employing a total of 25,060 wage-earners, of whom 22,173 were males and 2,887 were females. Two or three of the large companies had sick benefit associations among the employes, but only a portion of the latter were members. There were no unions. The attitude toward employes was usually very good, while all the larger companies maintained welfare and efficiency depart- ments. No organized instructions along health lines were given to employes, nor were placards, other than "Don't Spit" signs, observed. The chief poisons used in the industry were in the order of their dan- ger to users: Anilin oil, carbon bisulphide, benzol (benzenej, lead com- pounds, antimony compounds, mineral acids, alkalis, benzine (naphtha, petrol, gasoline), wood alcohol, sulphur chloride, carbon tetrachloride, mercuric sulphide, and turpentine; in some processes there were also the risks of leaks from illuminating and fuel gas. A considerable part of the work was done on the two or three shift plan extending over the 24 hours. The chief processes of health-hazardous character were found to be : Rubber Washing, Compounding, Mixing Mills, Calender- ing (including Warming Mills), Tire Building, Pit Curing, Hot-Press Curing, Dipping, Cold Curing, Vapor Curing, Making Inner Tubes, Buffing, Reclaiming, Cement Mixing, Specialty Manufacturing. In addition, there were the following processes of health-hazardous char- acter : Forging and Blacksmithing, Machine Shopping, Wood-working, and Mixing Chemicals, while the vast lot of workers were engaged in General Factory Processes. According to the Vital Statistics Reports for the State of Ohio, for the years 1910, 191 1 and 1912, there were 118 deaths among Rubber Factory Operatives (males), of whom 23 died of pulmonary tubercu- losis, or 19.49% of their deaths. This rate is to be compared to the pulmonary tuberculosis death rate of all occupations in the state com- bined, for the same years, which was 13.3% ; and is also to be com- pared to the pulmonary tuberculosis death rate of those engaged in Agricultural Pursuits during the same period, which was 7.13%. (See also Special Health Report of a Rubber Company, Part IV.) ' SAFES AND VAULTS. The Census gives 10 establishments, employing 2,014 wage- earners, or 0.5% of the total wage-earners in the state. Our investiga- tions covered 4 establishments, in 3 cities, employing a total of 1,074 wage-earners, all males. In one other plant the painting department alone was visited, employing 68 men at this work. This does not in- clude establishments investigated, which were also engaged in the manufacture of stoves. The chief health-hazards of this industry were 75 found to be: Iron Founding, Metal Grinding, Machine Shopping, Polishing and Buffing, AA^elding, Electroplating, Sandblasting, Painting and Varnishing, and Enameling. SALT. The Census gives 8 establishments engaged in this industry, em- ploying a total of 648 wage-earners. Our investigations covered i establishment, in i city, employing 150 wage-earners, of whom 135 were males and 15 were females. The chief processes of health- hazardous character were found to be : Salt Manufacturing and Coop- erage (Wood-working). SCALES AND BALANCES. The Census gives 6 establishments engaged in this industry, but does not state the number of wage-earners. Our investigations cov- ered 3 establishments, in 3 cities, employing a total of 700 wage- earners, of whom 650 were males and 50 were females. The chief processes of health-hazardous character were found to be : Forging and Blacksmithing, Metal Grinding, Polishing and Buffing, Machine Shopping, Tempering, Acid Dipping, Electroplating, Wood-working. Painting and Varnishing, Shellacing and Laccjuering. SHIPBUILDING, INCLUDING BOAT BUILDING. The Census gives 39 estabHshments engaged in this industry, em- ploying a total of 3,200 wage-earners, or 0.8% of the total wage- earners in the state. Our investigations covered 3 establishments, in 2 cities, employing a total of 1,480 wage-earners, all males. The chief processes of health-hazardous character in this industry were found to be : Iron Founding, Forging and Blacksmithing, Machine Shopping, Soldering, Wood-working, Painting and Varnishing (Caulking), Shel- lacing. SIGNS AND ADVERTISING NOVELTIES. The Census gives 28 establishments engaged in this industry, em- ploying 1,096 wage-earners, or 0.2% of the total wage-earners in the state. Our investigations covered 12 establishments, in 4 cities, em- ploying a total of 1,043 wage-earners, of whom 790 were males and 253 were females. The chief processes of health-hazardous character were found to be: Machine Shopping, Soldering, Furnacing (Kiln- ing), Acid Dipping, Electroplating, Mixing Chemicals, Printing Proc- esses, Lithographing, Artist's Work, Painting and Varnishing, Enam- eling, Paint Mixing, Bronzing. Wood-working, and Factory Processes such as Leather Skiving, Celluloid Finishing, Assembling, etc. 76 SMELTING AND REFINING. (Not from the Ore.) The Census gives 6 establishments, employing 57 wage-earners. Our investigations covered 4 establishments, in 2 cities, employing 45 wage-earners, all males. The chief processes of health-hazardous character were found to be : Junk Sorting and Handling, Soft Metal Melting (see Founding, Brass). SPRINGS. STEEL CAR AND CARRIAGE. The Census gives ' 5 establishments engaged in this industry, but does not state the number of wage-earners. Our investigations cov- ered 6 establishments, in 4 cities, employing a total of 653 wage-earners, all males. The chief processes of health-hazardous character were found to be : Furnacing, Hot Rolling, Forging and Blacksmithing. Machine Shopping, Metal Grinding, Tempering, Electroplating, and Tool Making (see Cutlery and Tools). STEREOTYPING AND ELECTROTYPING. The Census gives 14 establishments engaged in this industry, em- ploying a total of 207 wage-earners. Our investigations covered 6 establishments, in 3 cities, employing a total of 229 wage-earners, all males. The processes were also investigated in several printing estab- lishments (see the various Printing Processes, especially Type Ma- chine Work). The chief processes of health-hazardous character were found to be: Founding (Brass), Mixing Chemicals, and Electro- plating. Some of these establishments were also engaged in the Print- ing Processes. STOVES AND FURNACES. The Census gives 102 establishments engaged in this industry, employing a total of 7,274 wage-earners, or 1.6% of the total wage- earners in the state. Our investigations covered 15 establishments, in 9 cities, engaged mostly in the manufacture of stoves rather than fur- naces. The manufacture of safes was found to be an auxiliary feature with some of these companies. The total wage-earners in the plants covered by our investigations were 5,160, of whom 5,104 were males and 56 were females. The chief processes of health-hazardous charac- ter were found to be : Iron Founding, Core Making, Metal Grinding, Sandblasting, Tumbling, Polishing and Buffing, Machine Shopping, Welding, Soldering, Acid Dipping, Pickling, Electroplating, Enamel- ing, Japanning, Painting and Varnishing, Wood-working. 77 TIN PLATE AND TERNE PLATE. The Census gives 4 establishments engaged in this industry, em- ploying a total of 676 wage-earners, or 0.2% of the total wage-earners in the state. Our investigations covered 5 establishments, in 5 cities, employing a total of 2,989 wage-earners, but of these only 616 were engaged in the tin and terne plate processes, including 74 females. (The balance are considered under Iron and Steel Rolling Mills.) The chief processes of health-hazardous character were found to be : Pickling, Tinning, Machine Shopping, Forging and Blacksmithing, and Lacquering. TOYS AND GAMES. The Census gives 19 establishments engaged in this industry, but does not state the number of wage-earners. Our investigations cov- ered 4 establishments, in 2 cities, employing a total of 625 wage- earners, of whom 569 were males and 56 were females. The chief processes of health-hazardous character were found to be : Metal Grinding, Machine Shopping, Welding, Tinning, Electroplating, Brazing, Enameling, Painting and Varnishing, Upholstering. INDUSTRIES ^HAVING A KNOWN ASSOCIATION WITH DUST. Comment. — The chief health-hazard of the industries considered here is DUST. This does not imply that dust is not also a chief health- hazard in industries considered elsewhere, nor that dust is the only health-hazard of concern here. BRICK AND TILE. The Census gives 517 establishments engaged in this industry, employing a total of 7,466 wage-earners, or 1.7% of the total wage- earners in the state. Our investigations covered 9 establishments, in 7 cities, employing a total of 716 wage-earners, all males. The chief processes of health-hazardous character were found to be: (Brick) Clay ]\Iixing and Grinding, Pressing and Kilning. BROOMS. The Census gives 82 establishments engaged in making brooms, employing a total of 393 wage-earners. Our investigations covered 10 establishments, in 2 cities, employing a total of 86 wage-earners, of whom 82 were males and 4 were females. The hazards of the process are stated under Broom Manufacture. 78 CEMENT. The Census gives 9 establishments engaged in cement making, employing 887 wage-earners, or 0.2% of the total wage-earners in tthe state. Our investigators covered 2 establishments, in 2 cities, employ- ing 162 wage-earners, all males. The hazards are considered under the heading "Cement Making." COOPERAGE AND WOODEN GOODS. (Not specified elsewhere.) Under this heading the Census gives 113 establishments, employ- ing a total of 1,663 wage-earners, or 0.4% of the total wage-earners in the state. Our investigations covered i establishment, employing 390 wage-earners, all males. The chief processes of health-hazardous character were found to be: Wood-working; also Forging and Black- smithing, Machine Shopping, Metal Grinding, Sandblasting, and Painting. In addition to the above figures, our investigations covered this industry in a large number of establishments where it was auxil- iary to their principal processes. As noted from the processes named, there is nothing hygienically peculiar to the industry as such. CORDAGE, TWINE, JUTE AND LINEN GOODS. The Census give 8 establishments engaged in this industry, em- ploying a total of 791 wage-earners, or 0.2% of the total wage-earners in the state. Our investigations covered 5 establishments, in 3 cities, employing a total of 510 wage-earners, of whom 434 were males and 76 were females. The chief processes of health-hazardous character are considered under the head of Cordage Making (Breaking, Spread- ing, Drawing, etc.). Spinning, Rope and Twine Making, and Finishing. EMERY AND OTHER ABRASIVE WHEELS. The Census gives 3 establishments engaged in this industry, but does not state the number of wage-earners. Our investigations coh- ered 2 establishments, in 2 cities, employing a total of 112 wage- earners, all males. The chief processes of health-hazardous character were found to be : Emery Mixing, Emery Wheel Truing, Furnacing. Babbitting. FLOUR AND GRIST MILL PRODUCTS. The Census gives 673 establishments engaged in this industry, em- ploying a total of 2,585 wage-earners, or 0.6% of the total wage- 79 earners in the state. Our investigations covered but 2 establishments, employing a total of 85 wage-earners, all males. As flour itself is prac- tically a harmless dust, and occupational complaints are very rarely reported from this type of industry, we did not take time to investigate this line further. Cooperage is an auxiliary process, and is considered elsewhere. The manufacture of cereal products is not considered here. GRINDSTONE. The Census gives 9 establishments engaged in this industry, em- ploying 1,277 wage-earners, or 0.3% of the total wage-earners in the state. Our investigations covered this process in 4 establishments, in 3 cities, employing 878 at this process. The balance of the workers are considered under Marble and Stone Workers. MARBLE AND STONE. The Census gives 198 establishments engaged in this industry, employing a total- of 2,012 wage-earners, or 0.5% of the total wage- earners in the state. Our investigations were directed principally to the Sawing and Finishing of Stone, Monuments, and Grindstones, rather than to Quarrying, and covered 19 establishments, in 5 cities and vicinities, employing a total of 705 wage-earners, all males. The chief processes of health-hazardous character were found to be : Surfacing, including Designing and Polishing, Sawing, Cutting, Machine Shop- ping, Forging and ^Blacksmithing, and the Making of Grindstones. According to the Ohio Vital Statistics Reports, there were, for the years 1910, 191 1 and 1912, 163 deaths reported among Marble and Stone Cutters, of which number 45 deaths were due to pulmonary tuberculosis, or 27.61% of their total deaths. This rate is to be com- pared to the pulmonary tuberculosis death rate of all occupations in the State combined, for the same years, which was 13.3% ; and is also to be compared to the pulmonary tuberculosis death rate of those engaged in Agricultural Pursuits during the same period, which was 7.13%. MATTRESSES AND BED SPRINGS. The Census gives 38 establishments engaged in this industry, em- ploying 961 wage-earners, or 0.2% of the total wage-earners in the state. Our investigations covered 6 establishments, in 5 cities, employ- ing a total of 205 wage-earners, of whom 152 were males, and 53 were females. The chief processes of health-hazarodus character are given under Mattresses and Feathers, Sewing and Finishing. 8o PAPER AND WOOD PULP. The Census gives 47 establishments engaged in this industry, em- ploying 4,673 wage-earners, or 1.0% of the total wage-earners in the state. Our investigations covered 13 establishments (exclusive of Roofing Materials), in 7 cities, employing a total of 2,967 wage-earners, of whom 2,304 were males and 663 were females. The chief processes of health-hazardous character were found to be: Rag Sorting, Paper Beating, Paper Machining, Printing, Forging and Blacksmithing, Mixing Chemicals, Sewing, Engraving, Gluing and Pasting. WOOD, TURNED AND CARVED. The Census gives 83 establishments engaged in this industry, but does not state the number of wage-earners. Our investigations covered 2 establishments, in i city, employing a total of 85 wage-earners, of whom 81 were males and 4 were females. (See also Furniture and Refrigerators.) The chief processes of health-hazardous character were found to be : Wood-working, Shellacing and Lacquering, Stain- ing, and Factory Processes. INDUSTRIES IN WHICH FATIGUE, MONOTONY OR INACTIVITY ARE PRINCIPAL HEALTH-HAZARDS. BOOTS AND SHOES. The Census gives 72 establishments engaged in this industry, em- ploying a total of 16,026 wage-earners, or 3.6% of the total wage- earners in the state. This is the fifth industry in importance in the number of wage-earners employed in the State. Our investigations covered 29 establishments, in 9 cities, employing a total of 11,806 wage- earners, of whom 6,727 were males and 5,079 were females. The chief processes of health-hazardous character were found to be : Leather Cutting, Fitting, Lasting, Finishing and Packing. According to the Ohio Vital Statistics Reports, there were 121 deaths reported during the years 1910, 191 1 and 1912, among male Boot and Shoe Factory Operatives, of which 31 were due to pulmonary tuberculosis, or 25.62% of their deaths. According to the same Re- ports, there were only 31 deaths reported among female Boot and Shoe Factory Operatives, but of these 18 were due to pulmonary tubercu- losis, or 58.06% of their deaths. The numbers of deaths are too small to be given much significance. These rates may be compared to the pulmonary tuberculosis death rate of all occupations in the State com- bined, for the same years, which was 13.3% ; and also may be compared to the pulmonary tuberculosis death rate of those engaged in Agricul- tural Pursuits during the same period, which was 7.13%. The following paragraph is taken from the Cincinnati Tubercu- losis Hospital Report for the year 1912: "Twenty-seven shoemakers were admitted. This occupation seems to be especially dangerous. Ninety-five per cent of the Union Shoe- makers who died in Cincinnati in 1912 died of tuberculosis. These men work at benches in teams of five, the unfinished product being passed to the next man and so on. Each man occupies about two and one-half feet of the bench. Any infected case, talking or coughing, ejects a spray of saliva which is inhaled by his neighbor. This man is known as a tuberculosis carrier." CLOTHING AND TEXTILE MANUFACTURING. (Including Cotton and Woolen Goods.) While Men's and Women's Clothing are separately considered in the Census, there is no sufficient reason for considering them sepa- rately in this report. According to the Census, the combined industries represent 495 establishments, with a total of 18,793 wage-earners, making it the fourth in importance in the number of wage-earners in the state. It employes 4.2% of the total wage-earners. If the Cotton Goods, including 4 establishments with 177 wage-earners, and the Woolen Goods, including 20 establishments with 2,566 wage-earners, are added, the Cothing and Textile Manufacturing Industry becomes the third in point of wage-earners in the State. Our investigations covered only a very small part of this field, but we have endeavored to spread out the inquiry into enough branches of the industry to give the chief hygienic facts. Our investigations covered 17 establishments, in 6 cities, employing a total of 7,158, of whom 2,277 were males and 4,881 were females. The smallest place seen employed 32 workers, the largest, 1900. The chief processes of health-hazardous character are conveniently grouped as follows: Wool Sorting, Washing (including scouring, drying, shrinking). Carding (with combing, warping, twist- ing, winding and spinning; napping and fleecing). Weaving and Knit- ting, Sewing, Ironing and Pressing, Cutting Cloth, and General Fac- tory Processes, such as cleaning, finishing, burling, mending, splicing, inspecting, packing, boxing, etc. Designing is about the same as else- where described. According to the Ohio Vital Statistics Reports, there were in the years 1910, 1911 and 1912, 522 deaths reported among male tailors, of which 90 were due to pulmonary tuberculosis, or 17.25% of their deaths. According to the same Reports, there were 610 deaths among 6 o. D. 82 females (tailoresses, dressmakers and seamstresses), 138 of which were due to pulmonary tuberculosis, or 22.62% of their deaths. There were, in addition, some deaths from tuberculosis of other parts than the lungs, making the total tuberculosis death rate still higher. These rates are to be compared to the pulmonary tuberculosis death rate of all occupations in the State combined, for the same years, which was 13.3% ; and are also to be compared to the pulmonary tuberculosis death rate of those engaged in Agricultural Pursuits during the same period, which was 7.13%. FLAGS, BANNERS, REGALIA, BADGES AND EMBLEMS. The Census gives 13 establishments engaged in this industry, em- ploying a total of 1,262 wage-earners, or 0.3% of the total wage- earners in the state. Our investigations covered 2 establishments, in 2 cities, employing a total of 949 wage-earners, of whom 340 were males and 609 were females. The chief processes of health-hazardous character were found to be : Sewing, Ironing and Pressing, Cutting Cloth, Brass Founding, Electroplating, Polishing and Buffing, Shellac- ing and Lacquering, Painting and Varnishing, Bronzing, Artist's Work (see Printing), Wood-working, Gluing and Pasting. Our atten- tion was drawn to some sickness complaints among one or two felt hat workers, but an industrial relationship could not be established. In- vestigations showed that they were slightly exposed to ammonia, but not to mercury, as was feared. IRON AND STEEL BOLTS, NUTS, WASHERS AND RIVETS. (Not Made in Steel Works or Rolling Mills.) The Census gives 17 establishments engaged in this industry, but does not state the number of wage-earners. Our investigations cov- ered 4 establishments, in 2 cities, employing a total of 1,584 wage- earners, of whom 1,090 were males and 494 were females. The chief processes of health-hazardous character were found to be; Forging and Blacksmithing, Tempering, Galvanizing, Electroplating, Fur-' nacing. Machine Shopping and Wire Manufacture. TOBACCO MANUFACTURE. The Census gives 1,146 establishments engaged in this industry, employing a total of 12,631 wage-earners, or 2.8% of the total wage- earners in the state. This appears to be the eight industry in point of wage-earners in the state. Our investigations covered 27 establish- ments, in 13 cities, employing a total of 6,254, of whom 1,791 were 83 males and 4,463 were females. This industry is one of the largest female-employing in the state. The chief processes of health-hazard- our character were found to be : Tobacco Moistening, Stemming, Rolling, and Miscellaneous Processes. According to the Vital Statistics Reports there were, for the years 1910, 191 1 and 1912, 261 deaths among male Tobacco and Cigar Fac- tory Operatives, of whom 50 died of pulmonary tuberculosis, or 19.15% of their deaths. The industrial reports for females were too incomplete to be taken as representative, but of 36 authentic deaths reported, 16 were due to tuberculosis, or 44.44%. The Mortality Sta- tistics of the U. S. Census for the Registration Area in 1909 gives the pulmonary tuberculosis death rates for male Tobacco and Cigar Fac- tory Operatives as 24.3%, and for females as 40.5%. INDUSTRIES IN WHICH HEAT, COLD, MOISTURE AND DAMPNESS ARE THE CHIEF HEALTH-HAZARDS. BAKERIES. The Census gives no statistics concerning this . industry. Our in- vestigations covered 8 establishments, in 3 cities, employing a total of 974 wage-earners, of whom 653 were males and 141 were females. The chief processes of health-hazardous character are considered under the head of Baking Processes. A large number of the workers are engaged in what may be considered ordinary Factory Processes. qANNING AND PRESERVING. The Census ogives 107 establishments engaged in this industry, employing a total of 2,009 wage-earners, or 0.4% of the total wage- earners in the state. However, these are pre-eminently short-season workers. Our investigations covered 13 establishments, in 11 cities, employing a total of 1,346 wage-earners, of whom 685 were males and 661 were females. The chief processes of health-hazardous character were found -to be: (Vegetable) Preparing and Cooking, and Filling and Sealing. CARBONATED WATERS AND SOFT DRINKS. The Census gives no figures concerning this industry. Our in- vestigations covered 3 establishments, in 2 cities, employing a total of 24 workers, all males. The processes of concern were (Carbonated Water) Compounding and Bottling. 84 CONFECTIONERY. The Census gives 114 establishments engaged in the manufacture of confections, employing a total of 2,493 wage-earners, or 0.6% of the total wage-earners in the state. Our investigations covered 14 establishments in 3 cities, employing a total of 1,266 wage-earners, of whom 362 were males and 904 were females. The chief processes of health-hazardous character were found to be: Confectionery Processes and Chocolate Dipping. GLASS MANUFACTURE. The Census gives 45 establishments engaged in this industry, em- ploying a total of 10,159 wage-earners, or 2.3% of the total wage- earners in the state, making it the eleventh industry in importance in point of employes in the state. Our investigations covered 28 estab- lishments, in 16 cities, employing a total of 9,606 wage-earners, of whom 8,742 were males and 864 were females. Under this heading we have included manufacturers of glass table ware, bottles, shades, incandescent blubs (the blowing only), tubing, window glass, orna- ments and novelties. Under a separate heading is included the indus- tries engaged solely in glass cutting, mirror making, and art-glass manufacture. The chief processes of health-hazardous character were found to be : Glass Ingredient Mixing, Glass Blowing by Hand, Glass Blowing by Machinery, Glass Pressing, Glass Cutting, Grinding and Polishing, Glass Etching, Glass Crucible Manufacture (about the same as Sagger Making and Mold Making in Pottery, q. v.), and Art Glass Manufacture. According to the Ohio Vital Statistics Reports for the years 1910, 191 1 and 1912, there were 188 deaths among glassworkers, of which number 40 were due to tuberculosis, or 21.28% of the total deaths. Thirty-five of the deaths were due to tuberculosis of the lungs. This rate is to be compared to the pulmonary tuberculosis death rate of all occupations in the State combined, for the same years, which was 13.3% ; and is also to be compared to the pulmonary tuberculosis death rate of those engaged in Agricultural Pursuits during the same period, which was 7.13%. ICE MANUFACTURE. The Census gives 97 establishments engaged in this industry, em- ploying a total of 892 wage-earners, or 0.2% of the total wage-earners in the state. Our investigations covered 12 establishments, in 3 cities, employing a total of 280 wage-earners, all males. This does not in- clude Ice Manufacture by Breweries (see Liquors, Malted). The 85 chief processes of health-hazardous character were found to be: Ice Manufacturing, and, in the case of some firms, Bottling. IRON AND STEEL BLAST FURNACES. The Census gives 40 establishments engaged in this industry, em- ploying a total of 7,295 wage-earners, or 1.6% of the total wage- earners in the state. Our investigations covered 6 establishments, in 3 cities (in addition to those noted in connection with Iron and Steel Rolling Mills), employing a total of 2,100 wage-earners, all males. The chief processes of health-hazardous character were found to be : Blast Furnacing and Gas-producing. IRON AND STEEL FORCINGS. The Census gives 30 establishments engaged in this general indus- try, but does not state the number of wage-earners. Our investiga- tions covered 8 establishments, in which a large percentage of workers were engaged at forging or welding, in 5 cities, employing a total of 886 wage-earners, of whom 875 were males and 11 were females, the latter engaged in core-making. The chief processes of health-hazard- ous character were found to be : Iron Founding, Core-Making, Pud- dling, Forging and Blacksmithing, Machine Shopping, Welding, Riv- eting, Tempering, Wood-working. IRON AND STEEL WORKS AND ROLLING MILLS. The Census gives 75 establishments engaged in this industry, em- ploying a total of 38,586 wage-earners, or 8.6% of the total wage- earners in the state ; in point of wage-earners this is the second indus- try in the state. Our investigations covered 23 establishments, in 13 cities, employing a total of 28,195 wage-earners, all males. (These figures include 524 at galvanizing, in 7 firms.) Also the galvanizing (103 males) and tinning (104 males and 12 females) departments in 3 other large firms were seen. The chief processes of health-hazard- ous character were found to be : Blast Furnacing, Bessemer Furnac- ing, Open Hearth Furnacing, Gas-producing, Iron Founding, Brass Founding, Welding, Tempering, Metal Grinding, Machine Shopping, Forging and Blacksmithing, Furnacing, Hot Rolling and Shaping, Cold Rolling, Painting and Stenciling, Core-Making, Wood-working, and Chemical Manufacturing. See also Wire Manufacture, Foundry and Machine Shop Processes, Galvanizing and Tinning. According to the Ohio Vital Statistics Reports during the years 1910, 191 1 and 1912, there were 710 deaths reported among Iron and " 86 Steel Workers, of whom -ji died of pulmonary tuberculosis, or 17-69% • This rate is to be compared to the pulmonary tuberculosis death rate of all occupations in the State combined, for the same years, which was 13.3% ; and is also to be compared to the pulmonary tuberculosis death rate of those engaged in Agricultural Pursuits dur- ing the same period, which was 7.13%. (See Special Report of Sick Benefit Association of an Iron and Steel Company — Part R".. Introduction.) LAUNDERING. The Census gives no figures concerning this T non-manufacturing) industry. Our investigations covered 28 establishments, in 4 cities, employing a total of 2,394 wage-earners, of whom 527 were males and 1,867 were females. The chief processes of health-hazardous charac- ter were found to be : Listing, Sorting and ^larking, Washing, Man- gling, and Ironing. A few laundries were also engaged in Dry Clean- ing and Dyeing {q. v.). According to the Ohio A'ital Statistics Reports during the years 1910, 191 1 and 1912. there were 149 deaths among Laundresses, of which 35 were due to pulmonary tuberculosis, or 23.49% of their deaths. This rate is to be compared to the pulmonary tuberculosis death rate of all occupations in the State combined, for the same years, which was 13.3%.; and is also to be compared to the pulmonary tuber- culosis death rate of those engaged in Agricultural Pursuits during the same period, which was 7.13%. A number of laundries were found to have good lunch rooms or restaurants (supplying coffee free), lockers and clothes rooms; also to have anti-spitting placards pasted up, and otherwise to take a decided interest in the health and welfare of their employes. MALT LIQUORS (bREWING). The Census gives 105 establishments engaged in this industry, employing 4.356 wage-earners, or 1.0% of the total wage-earners in the state. Our investigations covered 11 establishments, in 3 cities, employing a total of 1,055 wage-earners, all males. The chief proc- esses of health-hazardous character were found to be : Brewing, Bot- tling, Keg Filling, Washing, and Ice Manufacturing. The following is abstracted from an Editorial in The Brewery Workers' Journal, January 17, 1914: Our Dead in 1913. The number of deaths occurring among the members of our International Union for the year 1913 is considerably higher than in the ^7 year previous. The cause for this seemingly unfavorable condition is the fact that last year those local secretaries who formerly did not pay close attention to their duties, have sent in their death notices more promptly. So for the first time since these statistics are published it can be said that the figures given below are as nearly correct as possible. Reports of 732 deaths were received from 179 local unions with an aver- age membership during the year of 42,218. The death rate is accordingly 17.34 per thousand, or 3.11 per thousand higher than in 1912, where 180 local unions with a membership of 40,895 reported 581 deaths, or 14.23 per thousand. The six leading causes of death during 1913 were : Consumption, acci- dent, pneumonia and bronchitis, heart disease, cancer and liver and kidney trouble. Then follow suicide, dropsy, stomach trouble, paralysis, heat, appendi- citis, rheumatism, murder and old age, in the order named. In the following tables the figures given in parenthesis are those for 1912. Of the 732 deaths reported, there were caused by: Consumption 167 — 22 . Accident 89—12, Pneumonia and Bronchitis 87 — 11 . Heart Disease 73 — 10 , Cancer 39— 5 , Liver and Kidney Complaint 35 — - 4, Suicide 30—4 Dropsy 29— 3 Stomach Trouble 21 — 2 , Paralysis 19 — 2 Heat 5— , Appendicitis 5 — ■ Rheumatism 5 — ■ Murder 3-0 Old Age 2-0 Miscellaneous Diseases 87 — 11 , Cause of Death not given in report 36 — 4, There died at the age of : Under 20 years 7 — Between 20 and 30 years 79—10, Between 30 and 40 years 141—19, Between 40 and 50 years 243 — 33 , Between 50 and 60 years 102 — 26. Over 60 years 62— 8, Age not given in report 8— 1 , The deceased were of the following descent : German Irish American Austrian Swiss Bohemian All others 81% 16% 88% 00% 33% 78% 10'% 96% 87% 59% 68% 68% 68% 41% 27% 88% 92% ,96% ^79% 26% 20% 23% .47% 09% 12 21.34%) 78—13.43%) 50— 8.81%) 78—13.43%) 17— 34— 28— 25— 11— 20— 2.92%) 5.85%) 4.82%) 4.30%) 1.89%) 3.44%) 4- 0.69%) 4— 0.69%) 9- 1.55%) 2— 0.34%) 3- 0.53%) 7-3-12.56%) 21— 3.. 61%) 2- 0.34%) 59—10.16%) 124—21.34%) 197—33.90%) 133—22.89%) 49— 8.44%) 17— 2.93%) 430 109 103 14 10 10 56 (369) ( 65) ( 62) ( 10) ( 8) ( 13) ( 50) Rheumatism caused the death of five members — three brewers, one bottler and one laborer. Five members succumbed to excessive heat — one brewer, one bottler, one driver, one fireman and one cooper. The percentage of the three most numerous categories of brewery workers participating in the six leading causes of death during last year is as follows: Of the 246 deaths among brewers, 166, or 67.46%, were caused by — Consumption 59—23.98% (35—17.00%) Accident 32—13.00% (25—12.12%) Cancer 23— 9.35%> ( ) Pneumonia 22— 8-.94% (19—9.23%) Heart Disease 22—8.94% (37—17.96%) Liver and Kidney Complaint 8— 3.25% (10— 4.86%) Of the 212 deaths among drivers, 150. or 70.75%, were caused by — Consumption 46—21.70% (33—18.96%) Accident 31—14.62% (32—18.89%) Pneumonia 30—14.15% (16—9.20%) Heart Disease 23—10.85% (18—10.34%) Liver and Kidney Complaint 15— 7.08% (10— 5.75%) Cancer 5—2.35% ( ) Of the 125 deaths among bottlers. 79, or 63.20%, were caused by- — Consumption 28—22.40% (29—31.52%) Pneumonia ' 14—11.20% (10—10.87%) Heart Disease 14—11.20% (10—10.87%) Accidents 11— 8.80%o ( 5— 5.43%) Liver and Kidney Complaint 8— 6.40% ( 5 — 5.43%) Cancer I 4_ 3.20% ( ) While in 1912 dropsy was among the six leading causes of death, in 1913 cancer was more frequent. The order of the ten most frequent causes of death are as follows: Consumption, in 1913, 1 (in 1912, 1; accident, 2 (2); pneu- monia, 3 (4) ; heart disease, 4 (3) ; cancer, 5 (9) ; liver and kidney complaint, 6 (5) ;. suicide, 7 (6) ; dropsy, 8 (7) ; stomach trouble, 9 (10) ; paralysis, 10 (8). SOAP MANUFACTURING. The Census gives 44 establishments engaged in -this industry, employing 1.774 wage-earners, or 0.4% of the total wage-earners in the state. Our investigations covered 12 establishments, in 3 cities, employing a total of 2,020 wage-earners, of whom 1.57S were males and 442 were females. The chief processes of health-hazardous char- acter were found to be: Soap Manufacturing and By-Products, Mix- ing Chemicals, Oil Refining, some specialty processes as well as Ma- chine Shopping, AA^ood-working, Printing and Labeling. WIRE AND WIRE WORK. The Census gives 66 establishments engaged in this industry, but does not state the number of wage-earners. Our investigations' cov- 89 ered 6 establishments, in 4 cities, employing a total of 1,972 wage- earners, of whom 1,908 were males and 64 were females. Of these plants 2 were engaged in the manufacture of wire and 4 in wire prod- ucts. The chief processes of health-hazardous character were found to be: Furnacing, Hot Shaping, Wire Drawing, Fluxing (Flour- Water Vats), Pickling, Tinning, Electroplating,- Galvanizing, Paint- ing, Iron Founding, Brass Founding, Machine Shopping, and Wood- working. (See also Foundry and Machine Shop. Produces.) INDUSTRIES IN WHICH THERE IS A LIABILITY TO CONTRACTING COMMUNICABLE OR INFECTIOUS DISEASES. It is impossible to attempt to cover all of the relations between communicable diseases and industry, or even to touch upon all of the most important. We give in this place the results of some special studies and some casual observations which have been made in the State during the period of this survey. INDUSTRIAL TUBERCULOSIS. ("Reprinted from Monthly Bulletin, Ohio State Board of Health, April, 1914.) Industrial tuberculosis is a term which is being used to associate the occupation of an adult person as a distinct factor in the causation of his or her consumption. In the propaganda against the great white plague, every effort conceivable is being directed toward the bettering of housing and living conditions, the correction of habits and the elimination of moral hazards. Almost to the present time little constructive thought has been given to the 10 hours or so which the individual S'pends in occupational pursuit. If foul air, abnormal humidity, fatigue, inactivity, poisons, etc., predispose to tuber- culosis between 6 :00 P. M. and 6 :00 A. M., must they not also during the day when heat and dust are also added, and respiration and other vital pro- cesses are much accentuated? This situation is remarkable, for a little investigation shows that where the factors at which the propagandists are chiefly aiming remain constant, and perhaps excellent, workers in certain pursuits succumb to tuberculosis in numbers suggesting a black plague. For example, professional men, men and women in agricultural pursuits, millers, quarrymen and carpenters have a death rate from consumption, which according to statistics, lies between 6.6% and 10.1%. On the other hand, clerks, book-keepers, telephone girls, stenographers, teachers, textile-workers, tobacco-, glass-, brass-, rubber-, and pottery-workers, printers, stone-cutters and the like, range between 10 and 43 Agricultural Implements . . . Automobiles & Parts Babbit Metal & Solder...... Bicycles, Sewing Machines. Boxes, Fancy & Paper Brass & Bronze Products... Carriages, Wagons & Ma- Cars Made By R. R........ Cars Not Made By R. R... Cash Registers & Calculat- ing Machines Chemicals Coffins, Burial Cases, etc. . Copper, Tin & Sheet-Iron.. 'Cutlery & Tools Dry Cleaning & Dyeing.... Electrical Apparatus Electroplating I Enameling and Japanning.. Engraving & Die-Sinking. .. | Explosives | Fertilizers I Files I Flavoring Extracts I Foundry & Machine Shop | Products I Fur Goods Furniture & Refrigerators...] Gas, Illuminating & Heating,! Galvanizing I Glass, Cutting, Staining, etc. I Hats I Instruments — Professional ..I Iron & Steel Doors & Shut- | ters I Jewelry I Junk Lead — Bar, Pipe & Sheet...! Leather — Tanned, Cured & | Finished | Lime I Matches I Mirrors ! Musical Instruments I Oilcloth & Linoleum I Oil — Linseed & Petroleum. . | Paint & Varnish 12 34 2 3 4 55 53 6 25 27 29 8 5 5 7 10 4 47 4 19 10 2 3 4 6 11 4 3 5 5 G 6 11 5 3 3 7 4 3 1 11 3 8 2 1 2 2 1 10 1 4 2 1 1 2 1 2 1 ! 1 8 1 oo 4 3 1 1 2 i 8 1 4 7 1 n 3 3 5 3 5 1 3 •". 1 3 •'') 1 3 40 1 fi 4,499 17,404 61 379 2,685 110 351 230 4,450 82 2,443 41 5,534 6,459 5 6,940 532 1,100 1 745 177 840 467 3,949 253 263 435 6,576 2,368 110 102 13 95 10 755 239 839 10 106 16 2 13,857 627 21 23 3,837 116 55 33 329 18 64 102 120 55 90 23 334 72 34 1.120 556 1.313 469 89 847 4 240 1.007 2,041 338 4,560 17,783 8 2,795 581 4,532 2,484 5,534 6,464 7,472 1.101 922 1,307 4,20-2 698 8,944 110 115 105 994 849 108 18 9 18 1 12 7 16 10 11 11 14 3 12 13 19 6 22 5 9 3 6 4 4 1 14,484 29 44 1 3,953 12 1 55 3 1 33 2 1 347 9 1 166 6 1 175 1 6 1 90 1 23 5 I 406 •9 1 • 34 1 1 1 1 . 120 3 1 556 4 1 1,7S'2 7 1 89 3 1 851 19 1 240 4 1 1.007 4 1 2,379 6 General Factory Processes not included. • . ■ 104 RECAPITULATION OF INDUSTRIES INVESTIGATED — Continued. Name of Industry. Patent Medicines & Com- pounds Photo-engraving Porcelain Enameled Iron Ware Pottery, Terra Cotta, etc.. Printing & Publishing. Roofing Materials Rubber Goods Safes & Vaults Salt * Scales & Balances Shipbuilding & Boatbuilding. Signs & Advertising Novel- ties Smelting & Refining Springs — Steel Car & Car- riage Stereotyping & Electroplating Stoves & Furnaces Tin Plate & Terne Plate. . . . Toys & Games Total Dust. Brick & Tile Brooms Cement Makino- Cooperage & Wooden Goods ' Cordage, Twine. Jute, etc.. Emery & Other Abrasive Wheels Flour & Grist Mill Grindstones Marble & Stone Mattresses & Bed Springs... Paper & Wood Pulp Wood — Turned & Carved... Total Fatigue. Monotony, Etc. Boo'^s & Shoes Clothin? & Textiles Flags. Regalia, etc Iron &• Steel Bolts, etc Tobacco Total General Factory Processes not included, I05 RECAPITULATION OF INDUSTRIES INVESTIGATED — Concluded. Name- of Industr}'. W 6 (J 6 o .P-i Ko Heat, Cold, Etc. Bakeries Canning & Preserving Carbonated Waters Confectioneries Glass Ice Iron & Steel Blast Furnaces. Iron & Steel Forging Iron & Steel Rolling Mills.. Laundering Liquors, Malt Soap Wire & Wire Work Total 13 3 14 28 1-2 6 8 23 28 11 12 6 172 Miscellaneous. Caisson Work Total .., I 2 Recapitulation. \ Poisons I 712 Dusts 75 Fatigue 79 Heat, Cold I 172 Communicable Diseases, Misc. (Caisson Work).. Grand Totals 1,040 3 11 2 3 16 3 3 5 13 4 3 653 685 24 362 8,742 280 2,100 875 28,195 527 1,055 1,578 1,908 141 661 904 864 11 1^867' 442 64 46,984 53 4,954 53 135,572 6,102 12,225 46,984 53 81t 200,936 794 1,346 24 1,266 9,606 ■ 280 2,100 886 28,195 2,394 1,055 2,020 1,972 51,938 53 13,768 800 15,526 4,954 53 149,340 6,902 27,751 51,938 53 35,048 235,984 1 3 2 2 9 3 2' 9 99 7 14 * General Factory Processes not included. t Different cities and villages. PART V. HEALTH-HAZARDOUS PROCESSES. THE SCOPE AND METHODS OF INQUIRY. This section of the report takes up the description of particular processes in the industries and gives a summary of the findings for each. Under "Comments" are stated the principal corrective measures suggested to conserve the health of the workers in such processes. Most of these measures are those which our investigators discovered were being used in the better regulated plants. It will be seen that this is a very important section of the report since it deals directly with working conditions. While instances are cited throughout this section of persons suffering from occupational diseases, the reader should consult Part VI. to learn the total number of such diseases which have been reported to the State Board of Health during the course of the survey. From a hygienic point of view there were numerous establish- ments employing large numbers of wage-earners in which but two or three processes were considered health-hazardous, and these, perhaps, engaged but a small number of employes. On the other hand, many small establishments had most of their employes engaged in processes "which were considered more or less dangerous to health. Hence, the . size of, and number of employes in an establishment has no relation to the number of dangerous processes nor the relative number of persons engaged in the same. * While a lack of technical knowledge upon the part of the physi- cian-investigator interferred more or less with his ability to describe processes, it did not interfere with his ability to observe the presence or absence of the lo or 12 health-hazards for which he was seeking in each place, and to report upon the same according to the blank forms and the instructions under which he worked. ' While errors may have crept into the statements which follow they are invariably upon the conservative side and are usually errors of omission rather than com- mission. In summarizing, the rule has been followed to give the benefit of the doubt to the figures representing the better conditions. Where the number of "fair"or "bad" conditions only is mentioned, the balance are to be considered "good." 106 I07 In nearly all the processes here described some reports were received from field workers too late for classification, but any unusual features from such reports have been mentioned herein. In order to have sufficient time to compile the mass of information collected, it was necessary to close up reports upon given processes when a suffi- cient number had been received. In most instances it is believed there have been enough places and processes described to give a fair repre- sentation of general average conditions. A great many trade processes, both patented and secret, were dis- closed to the investigators in full confidence of their proper usage, and we have endeavored in all respects to honor such confidences in the descriptions of processes given here or elsewhere. It has been the aim also to make this report one upon industrial hygiene and occupational diseases, and not one upon the des.cription of manufacturing processes. Inquiries into manufacturing processes have also been made for the sole purpose of determining the amount of risk to the health of the worker. In nearly all cases, indeed, such information was voluntarily given to our representatives even before inquiries were made. In all establishments visited, which are included in the summaries herewith, work was going on at the time of the visit of inspection. In addition to the observation of working conditions the investigators questioned employes while at work, and examined for the more easily demonstrable "ear-marks" of occupational diseases, devoting as much time to this feature as seemed warranted in most places. The percent- age of employers who objected to this, even without explaining to them that such was the prerogative of the Board of Health, under the enabling Act, was so small that this alone, if nothing else, shows the magnanimous attitude of the great body of employers throughout the State. Investigators were carefully instructed in this respect not to pass opinions upon working conditions to employes, nor to express to any employe who was questioned or examined any opinions concerning his or her state of health as determined by the physician-investigator. The principle adopted throughout this report has been to conceal individual incidents, places, establishments, and even cities, as much as possible, and to render a summary of findings and opinions uninflu- enced by local coloring. In nearly all places, names, addresses, ages, health histories, and work complaints, if any, of part of the emplo3^es were taken. Both older workers and old employes, as well as newer ones, were so consulted. In some places materials which workmen were handling and the substances of which they did not know (perhaps even employers did not know) were collected and sent to our labora- tories for analysis. io8 For each process the following facts were ascertained : 1. The location of the process in the building. 2. What that part of the building was constructed for. 3. Whether such construction was generally hygienic, that is, amply spaced, properly enclosed against weather conditions, well lighted, properly heated, ceilings high enough, walls, floor and ceilings of a character to be kept easily clean, the conveniency of toilets, and the amount of available space left to the workers. 4. The division of employes by sexes. 5. The approximate number of employes over 40 years of age, between 20 and 40, under 20 years, and under 16 years. The reason for the 20-year division is that the adult does not usually attain his or her full stature and development before the 20th year. In very few shops were workers Fig. 35. A Factory Rest Room. This "sick bay" is maintained by a pottery company which employs a large number of girls. under 16 years of age employed in any of the industries investigated. Here and there, especially during the summer seasons, children were found employed who acknowledged their ages as less than 14. Such in- stances, however, were very rare. Since there is a law under the admin- istration of the State Industrial Commission governing the hours of em- ployment for females, we did not check up this feature with any regu- larity. 109 6. A brief description of the process. 7. Were other processes in the same quarters, and, if so, the number of employes engaged in such. This is very important, since oftentimes one set of workers is subjected to the hazards of processes other than their own. 8. Were modern or crude methods used. Such were judged by using as a criterion the better known hygienic methods, but "crude" or "antiquated" methods is a term which was only applied to such places as were par- ticularly endangering the health of employes ,when much better methods of accomplishing the same purposes were found to exist elsewhere. 9. The presence or absence of unions or workmen's organizations. Fig. 36. The Employer's Interest in the Welfare of Employes May Well Extend Beyond the Work Place. Flying rings, and other equipment of a public playground, which is equipped and maintained by an industrial corporation. 10. The attitude toward the workers. This was determined by the presence or absence of welfare efforts, workers' complaints, and the immediate in- terest which foremen or managers appeared to take in the employe. As is well known, the best efforts of an employer towards his employes de- pends very largely upon the personality, tact and attitude of the foreman who is immediately over them. 11. The type of workers, whether intelligent, responsible, and capable of under- standing instructions or whether an ignorant and usually non-Englisli speaking class. 12. The retention of workers, or the steadiness which they evinced in remain- ing at the place of employment, ■ / no 13. The number of work shifts in 24 hours, the hours per shift, night work, overtime, noon time, and other recesses. 14. The approximate number of skilled and unskilled at the process. 15. The seasonal influence of the work, whether rush seasons and dull sea- sons characterize it. 16. The presence or absence of health appliances, that is, mechanical devices to promote ventilation and confine or remove fumes, dusts, etc., from the vicinit}' of the workers. 17. Health instructions, regarding the use of poisons and the avoidance of other health hazards which might be present. An attempt was made to ascertain how much attention was given to this by employers and fore- men, and how well they were qualified in this field, which in most in- stances requires a thoughtful physician. 18. The presence or absence of health placards, inspiring aphorisms, legends. etc. 19. The presence or absence of a proper or safe place in which to eat lunches. 20. The presence or absence of change rooms and lockers for clothing. 21. Sanitary provisions, including washing facilities, drinking facilities, and whether time was allowed for personal hygiene along these lines, par- ticularly in poisonous, heat exposing, or dirty processes. Below is a fac-simile of the card used by our field investigators to report working conditions and health-hazards to the office. A simple code enabled each feature mentioned to be designated "good," "fair," "bad," or "absent," while the blank spaces permitted of brief remarks. II I H P^ O Ph w H ^; H < P^ Q Q Q O o .n P^ ^ PL^ J ffi W o •^ O p ^ G ;=; : S M-H O l- S OJ -a u> rt ■ J3 OJ ■^ t/i (U ■^ Ic ^ u w Q h::; u u o k4 ,2 o m u ^ r- c^ c: t/) T3 o -^^ C ;ti ^ >z:, -^^ 'r^ c^ X K J H 112 m > t ? K P P^ . «-M < N < K s X H c J ^ < " W K h-! o < ^ S P ^ Q ^ :S < a o a -2 >> T; 60 ^ o :2 .- E •" 5P >> bo (L> - E t^ OJ *^ bfl 4.) cd G — ' ni ^ "5 H « o W W Pi O HH W U fe « • (U ,— , 5 .i5 •z 5 r : o ~ "D "o ■° "S 1) o. M u C '" ^ ■_ o o - -r" ca H-t o o « J3 ^ u. «r (U c u ij a ^ 'c. e ■a o 5 i-i .2 .> •C .2 :5 > ? to u «j .- ._ tJJ u I? 5 -S 01 o O ^ -2 SE ^ ^ E E X! o 3 g w - S P-i •3 < o ^ „- <-^ s, „ m „ bo ^ § < n ^ W u O t_j •9 ^ § ^ •i w ■S? rt u n E wj 1) c E bo c P^ _c E W2 s c ■a ^ 2" < fa 1—) rt p J ^ J •^ < < - w fai K 12 p:; <; w w u « g PL, hJ !> w CM < > < 113 In the summaries which follow it will be found that the same terms and expressions have been used again and again. If value of repetition means anything, it is hoped that these repetitions will effect their purpose, and, where indicated, bring about the remedial measures necessary. Some facts stand out : Owners and managers of plants hygi- enically well-regulated and who have been giving attention to the same for years, perhaps, often refuse to believe that conditions dangerous to the health exist in other plants engaged in the same lines as their own. Again, because owners and managers are not hygienists nor physicians, they many times fail to correlate causes and effects and to have knowledge of or to see occupational complaints and diseases which are right before them. A solution of this situation, we repeat again, is that the employer have his own physician at hand, who, ac- cording to the risks involved, shall make periodic inquiries and render suggestions. There is no question, however, but that a considerable amount of intelligent thought has been directed to these matters in the majority of the places investigated. The processes summarized in the following pages have been divided into two groups : General Processes and Special Processes. The former are those which are apt to be found in any industry or es- tablishments ; the latter, those which are peculiar to certain industries. GENERAL PROCESSES 115 GENERAL PROCESSES. FACTORY PROCESSES (GENERAL). A large percentage of employes in shops and factories are employed in numerous operations, which, while more or less peculiar to each industry, are very similar in nature. Such operations do not require special skill or training, as a rule, although experience develops great dexterity and speed in many in- stances. The workers are capable of being interchanged between various operations. Especially do they change from one establishment to another, and usually take up new operations with each change. Such workers constitute a class slightl}^ in advance of common laborers, and we have classed them as "general factory help". In a rough way they may be grouped into certain processes such as "routine machine operations", "assembling", "inspecting", "finishing", "packing", and the like. General factory processes were investigated in 100 plants, representing .35 different industries, located in 18 cities, employing a total of 7,946 wage- earners, of whom 5,045 were males and 2,901 were females. According to the Vital Statistics Reports for Ohio for the. years 1910, 1911 and 1912, there were 14,379 deaths among males engaged in Mechanical and Manufacturing Pursuits, of which number 1,977 died of pulmonary tuber- culosis, or 13.7%. This is about the same as the rate for all occupations com- bined (13.3%). The figures for females were too few to be utilized, but in- dicated, so far as they went, a much higher tuberculosis rate (45.8%). Ac- cording to the U. S. Mortality Statistics for the Registration Area, pulmonary tuberculosis claims 27.4% of the deaths among females engaged in Mechanical and Manufacturing Pursuits, the rate- for males being 15.5%. So far as could be ascertained, modern methods obtained in 81 establish- ments investigated, fairly so in 10 more, not so in 4, while the remaining 5 were not reported upon in this respect. Unions, of course, were rare among this class of workers, although in 4 plants these workers were admitted into various "locals" because they were helpers and the like. A managerial in- terest in workers' welfare was well manifested in 72 places, fairly so in 20 more, not so in 4, and not reported upon in 4. An intelligent type of at least English speaking persons prevailed in 67 places, fairly so in 19 more, while ignorant foreigners, largely non-English speaking, made up the general factory workers in 13 places (the 1 remaining place was not reported upon). There appeared to be no objection to the character of the work performed on the part of the workers, and accordingly they remained steadily as far as this feature was influential in 79 places, fairly so in 9 others; while in 9 more work- ing conditions appeared to be the chief cause of unsteadiness of employment (8 places were not reported upon). In 18 places every reasonable health ap- pliance was found to be present, including appliances for changing the air in the workrom where needed, as well as locally ventilating, or otherwise render- ing hygienic, the processes in which the workers were engaged. Such appliances were fairly efficient in 6 more establishments, but in the remaining 76, in most of which there was need of the same, they were either absent or very inade- quate. Definite and oganized instructions along health lines, especially in rela- 117 ii8 tion to the work being performed, were given in 8 of the plants investigated, and to some extent in 2 others. Such were more or less needed in the re- maining 90. In 8 establishments this class of workers was included in sick benefit and similar associations. Regarding the question of skill, in 15 proc- esses in as many places, considerable skill was required, while those in 25 addi- tional places were somewhat skilled. In the remaining 60, such factory proc- esses could be carried on with very little interruption to business or production with a constantly changing work force. Factory workers were employed in hygienically well constructed buildings and workrooms in 51 places, fairly so in 16 more, not so in 29, while this feature was not reported upon -in the re- maining 4. There was a great tendency to carry on various factory processes in the same quarters or room, and oftentimes along with processes requiring skilled work, so that oftentimes workers were subjected to the hazards of neighboring processes, when, perhaps, those in which they themselves were engaged were without hazard to health. Age-group estimations for this class of workers summed up as follows : Age groups. Over 50 years. . . From 45 to 50. . From 40 to 45 . . From 20 to 40.. Under 20 years. No. of Wage-earners. 113 171 550 6,900 212 Females tended very largely to younger years. A synopsis of the exposures to the various health-hazards, arranged in relation to the number of workplaces, shows as follows : Amount of Exposure of Workplaces.) / (No. Health Hazard. c o .h 1 X)' ^^ (U H Dust 63 49 89 76 44 77 93 (See 20 30 10 14 38 19 5 16 21 1 10 18 4 2 41 19 19 5 1 2 100 Dirt • 100 Dampness 100 Darkness 100 Air 100 Heat 100 Cold 100 Fatigue Inactivity (See Relnw^ Infections 15 m 25 53 42 15 56 37 100 Poisons 100 Stimulantism 100 Several unhealthy appearing persons 100 Fatigue was a hazard as follows: hurrying piece-work, 41; monotonous application and reduplication of movements, 37; constant standing (still), 25 119 (sometimes holes worn in the floor ahiiost the shape of feet); ej'e-strain, 16; prolonged faulty postures, 15; jarring processes, 13; loud noises, 12; speeding up, 11; laborious work, 9; long hours, 8; chairs without back rests, 8; constant and prolonged strain, 6; and body pressure (pressing objects against body, or the body against objects, more or less constantly), 5. In 13 establishments there were rest rooms for female help, in 14 establishments workers were changed between processes, thus avoiding exhaustion, while in a smaller number of in- stances, various recreation schemes combined with outdoor and gymnasium privileges were devised. To overcome the effects of physical inactivity, pro- visions for exercise or recreation were arranged for in 4 establishments. Much profitable thought could have been given to this in a good percentage of other places. In these 100 establishments the workday was found to be 8 hours in 4 Fig. 37. Mocel Factory Conditions. Note chairs with backs and foot rests for sedentary workers. well-lighted room. Spacious and places, 8 to 9 hours in 37 places, 9 to 10 hours in 49 places, 10 to 11 hours in 2 places, over 11 hours in 1 place, and not ascertained in the remaining 7, in some of which there were no definite hours observed. The noon recess was 1 hour in 32 places, f hour in 9 places, J hour in 58 places, and not reported upon in 1. Overtime was of considerable frequency in 3 places, while a night shift was worked in 1. The liability to the contraction of communicable diseases (infections) was dete'rmined as negligible in 15 places, a fair hazard in 42, bad in 41, the remain- ing 2 not being reported upon. The hazards were all of those discussed in previous Parts (II. and III.), but especially would we call attention here to promiscuous spitting upon floors in workplaces by persons who are employed without physical examination and who work without medical supervision. This 120 single factor is overwhelmingly important in the the spread of some 20 in- fectious and contagious diseases, which involve the nose, throat and lungs, and the germs of which are transferred from person to person by means of the excrement from these parts. The universal use of cuspidors where persons are employed for hours at a time in which to deposit such excrements seems the first logical step in the solution of this question. The association of appendi- citis with Avork requiring the use of the right foot or leg, as among machine operators and press workers, was w^ell illustrated by a series of four cases brought to our attention among girls in a shoe factory where they were em- ployed at box-making on machines. They made from 8,000 to 12,000 move- ments with the right foot daily. The work was also very jarring and wearing upon them. One had acute appendicitis, one chronic appendicitis (possibly complicated with ovaritis), while the other two had continually recurring at- tacks of right iliac pain with indigestion. The poison hazards to which general factory workers were exposed in the 35 places shown in the table were lead and lead compounds, wood alcohol, turpentine, benzine (petrol, naphtha, gasoline), corrosive salts, amyl acetate, shellacs, lacquers, acids, alkalis, dye stuffs, stains and colors. The industrial inducement to sti)nulantism (alcoholism, coffeeism, teaism and drugism) was determined as negligible in 25 instances, a fair hazard in 56, and bad in 19. It was due in many instances to the inadequacy of proper drinking water and thirst-assuaging facilities, as well as to the depressing influences of the various hazards given in the table above. Complaints, covering all manner of health-hazards, insanitary working conditions, and irritating inconveniences, which workers made were too vari- ous and numerous, and sometimes trivial to warrant discussing here, but it suffices to say that our investigators, who occasionally stopped to talk with these workers in the course of their factory inspections, reported among them 11 occupationally diseased persons, divided as follows : industrial tubercu- losis, 6; lead poisoning, 3; conjunctivitis, 1; and dermatitis, 1; while there were a great many hearsay instances, based upon good evidence, — the hazards were certainly present, — • which our investigators had not the time to follow up. Hospitals, dispensaries, charitable institutions, societies and private physicians get tfae information upon these, but practically none of them keep records and files classing "occupational complaints," hence this source of in- formation was not available to this surve}^. Comments. — -This class of workers represents such a large group that it should be given more thought, probably, than any of the special processes, to which attention is naturally more definitely directed. However, these workers are prone to get the least attention because of the ever-changing personnel, and lack of skill, and, unlike machinery, each unit which proves defective can be replaced without cost to the manufacturer as long as the supply of labor remains good. It is pre-eminently from this class of workers that the material for crowding hospitals, dispensaries and charitable institu- tions is collected ; it is also from this class of workers that the vast majority of unemployable persons develop. Such persons are rendered unemployable usually fairly early in work life, — one reason for the comparatively small number who are found engaged in industry after 40 years of age. This unemployability is the result, chiefly, of such factors as chronic alcoholism, maiming and crippling, chronic diseases of degenerative character, and social 121 disgust or loss of ambition. In all of these, industrial relations unquestionably have been the chief causes. Probably the greatest good that can be done for this class of workers to keep them "on the job," from a manufacturer's point of view, is to institute brief but concrete instruction along health conserva- tion lines in conjunction with work. Medical supervision should be gradually adopted. The employer is further responsible, of course, for the general sanitary and hygienic features of his place of employment, as well as his methods of working his employes. Moral and housing hazards among em- ployes are so closely associated with industrial relation that it would appear that the employer is, of all persons, the most responsible, especially in that he can demand "his money value for his expenditure for labor," which gives him the right to normal healthy workers and the refusal of such as endanger themselves and their fellow workers by disastrous indulgences and social delinquencies. GAS PRODUCING. A comparatively few plants in the State of Ohio make their own pro- ducer or generator gas. This is made from coal in a combustion chamber, the fuel being burned to cinders. Illuminating gas is made in a few large cities in which coke is a by-product. Most of the 'blast furnaces utilize the gases produced for fuel purposes — a continuous mechanical process. The charging with coal and removal of clinkers was mechanically done in all except the smallest plants. The manufacture of special by-products, outside of coke and tar, was not observed anywhere. Ammonia liquor is also produced. Our investigations covered 7 plants making producer gas and emploj-ing a total of 80 men. These were seen in connection with rolling mills, glass works, and lime kilns. In addition, the illuminating gas plants in 2 cities employing a total of 55 men were also seen. (In two plants 4 men were employed in the process of making water-gas.) The employes were nearly all immigrants, foreigners or negroes. Owing to the fact that they worked prac- 'tically out-of-dcors, — most of them engaged as pokers on top of the produc- tion furnaces — workers were very little protected by health appliances. The work required very little skill. With the exception of 1 man the workmen seen were all between 20 and 40 years of age. Workers did not remain long in most plants, especially in the summer season. The chief hazards were to the persons who endured exposure to dust, scot, smoke, hot gas fumes and flames during the time that the}' were required to open the caps over the poke holes on top of the producer furnaces. This happened about every 10 to 15 minutes and lasted 2 or :"! minutes each time. At this time a severe blast poured forth from the opening, against which the workman who stood over the opening in order to break clinkers up, had no protection except to lean back as far as he could. The blast extended from 2 to 10 feet high, and consisted of flames and invisible gas, or was accom- panied with immense volumes of smoke, soot and dust. Exposure tn licat was a hazard for all workers, especialh* to coke drawers, but the alternatin\;' exposure to cold between operations during the winter season was a greater hazard. The stokers were usually high up in the air, with only a roof for protection against the weather. Cuke wheelers were exposed to clouds of steam from the sprinkled coke. The work itself was not fatiguing for healthy laborers; the 12-h()ur workday, which obtained in nearlv all places, with the 122 absence of a noon recess (a half-hour was allowed in two places), were objectionable features. One place found it expedient to work three 8-hour shifts. Night shifts, of course, were the rule. In small plants, 2 men divided the 24 hours, working 12 hours each. The risk of gas poisoning was a fair hazard in all places. It was influenced by. the condition of the weather and wind, and especially by the persistency with which the pokers faced the blasts. Producer gas is over four times as rich (34%) in carbon monoxide gas as is illuminating gas (8%). There was every opportunity for the effect of chronic gas poisoning, due to short-intervalled inhalations of gas frequently repeated. Many of the workers were seen to stagger around for two or three minutes after each exposure. In water-gas manufacture there was some risk of carbon monoxide poisoning during sampling, and more, due to leaks ; there was also slight risk, due to ammonia fumes, and napthalin which was de- posited in clouds at the time of cleaning tanks. Several workers were seen who showed the effects of the work. One case of mental deterioration and another of spinal trouble and anemia were called to our attention, both following severe "gassing" in gas house workers. Two fatalities occurring in 1911 were also reported. CoviplOiints included the breathing of gas and smoke, dizziness, "swelling up," the heat during hot weather, getting of foreign particles in the eyes, coughing, difficulty in breathing, indigestion, and rheumatism. The industrial inducement to alcoholism was, of course, con- siderable in most instances. Coiiuncnts. — One company furnished blue glasses, which protected the eyes against foreign particles as well as the heat and intense light. Through the spread of the "safety first" idea, greater precautions are being taken when it is necessary to enter gas chambers and passageways, such as providing oxygen apparatus, pulmotors and other first-aid equipments, in addition to gas helmets provided with compressed air blasts, and the careful watching of workers while so engaged. In 1 place a scheme was 'being worked out to prevent all exposure to the gases and flames as well as the loss of the same while poking, by means of a steam blast placed just inside of the poke hole, which would operate automatically on opening the cover to the same, and would also' help in the moistening of the gas. These workers should be provided also with shower bath facilities and proper change-rooms, while medical supervision would prevent the employing of any who had a tuberculous tendency. It is said that even mechanical stokers and mechanical poking of the fuel in the producers is not free from exposure to escaping smoke and gases. STATIOXARY FIRIXC AND EXGIXEERIXG. CBoiLER Rooms axd Power Production.) The power plants, including the boiler rooms, engine and dynamo quar- ters, were inspected in a large number of establishments. Only the boiler rooms appeared to present health-hazards worthy of notice. The workers here were firemen, coal heavers and laborers. Dust, dirt, ash and coal heaps scattered a'bout, and a certain amount of contamination of the atmosphere with escaping gases and occasionally steam, were features in about half of the places. In addition, damp and dark quarters were frequently seen. In many large places automatic stokers did practically all the work, so that work- men were few and very little exposed, but heat was a considerable factor in nianv places. It was rendered worse bv the tendency of tlie workmen to 123 step out-of-doors between stoking and shoveling to cool off. Another hazard is fatigue, which depends no so much upon hard work as upon long hours, especially for workers in hot processes. In practicalh- no places were workers engaged for less than 10 hours, while usually two shifts divided the 24 hours between them. One day's rest in seven was least often observed in this process of any investigated. The liability to the contraction of coiiuiiunicable diseases was a considerable hazard in most boiler rooms, due, principally, to promiscuous spitting into places where the dust might carry infection to fellow workmen, to the absence of cuspidors, of adequate washing facilities, poor closets, and the common use of the same drinking cups and towels. In some places, however, all of these features were guarded against. The liability to industrial alcoholism in this process is directly in proportion to the in- adequacy of proper thirst-assuaging facilities, and wash-up places, as well as too great exposure to heat, and subjection to long hours. Various ones of these factors were complaints in the places investigated. Comments. — As with' all heat exposed workers, these men should have the advantage of a properly protected shower bath, change rooms in which to dry out clothing, hours in inverse proportion to the amount of exposure, blue glasses to protect the eyes from heat, light and foreign bodies, and medical supervision to warn those who have a tuberculous tendency to keep out of the process. According to the Ohio Vital Statistics Reports for the years 1910, 1911 and 1912 there were 649 deaths arnong Engineers and Firemen (not locomo- tive) of which number &6, or 10.17%, died of pulmonary tuberculosis. This is better than the combined rate (13.3%) for all trades during the same period, and nearly as low as that of Agriculturists (7.13%). The accident, injury and accidental poisoning rate among them for the country at large is 12.2%. FURNACING. In addition to the processes concerned in the boiler, power and firing rooms, in a great number of industries, a certain number of employes are engaged in taking care of furnaces, baking ovens, kilns, and drying rooms, which are located within the interior of buildings, and oftentimes in the midst of surrounding processes, such as in foundry work, heating furnaces for cutlery and tools, enameling and japanning' ovens, and the like. None of these furnacing operations are on the scale of the large heating furnaces, annealing ovens, etc., which are found in iron and steel mills, and which are considered under that heading. This process of Furnacing was investigated in l") establishments, cover- ing a wide range of products, and employing a total of 157 wageearners, all males. An unskilled class of workers was usually employed, there were no unions, and they were apt to be a changing set of employes. In 7 places health appliances consisting of means to prevent the effects of excessive heat were present, such as movable screens, asbestos coverings to furnaces, electric .fans, air blasts, and various mechanical contrivances to permit the workers to keep at a distance from the openings of the furnaces. In addition, some places had a large hood, connected with a stack, over furnaces areas, as well as exhaust fans and air-agitators within the quarters to remove escaping fumes, smoke or odors. Too often open windows, or roof vents (always more or less closed up in the winter time) were the only means depended 124 upon for such ventilation. There was a tendency to employ j-ouths and younger men at such work, while only 12 of the total of 157 workers were over 40 years of age. The work was of a hazardous dusty character in 7 places, while dirt and disorder characterized the vicinity in 8 places. In 2 places the furnaces were located in very damp and steamj- quarters, and, in 4, light was very poor. This occasionally was made much worse by the presence of smoke from the furnaces. In some instances, on the contrary, workers were compelled to face brilliant lights and intense heat, both tending to produce disturbances of sight (temporary blindness, blood shot eyes, corneal opacities, cataracts, and actual blindness from acute retinitis). The general room ventilation appeared good in 5 places, fair in 5, and bad in 5 (the latter due to deoxidation from the presence of the furnace in a closed-up room, contamination with the escape of gases from the furnace, pollution with dust, and sometimes smoke, steam and spray particles, stagnation from the absence of any means to promote circulation of the air, and greatly abnormal temperature-humidit}- relations). In the latter respect it was extremely hot in 3 places, where workers had to be, and more or less so in 8 more, while in but 1 or 2 instances were any shower baths at hand for the use of the furnacemen. In some 7 plants fatigue was a hazard, due to laborious work, and occasionally to piece-work. The workday ranged from 9 to 10 hours in all places, while in 10 places, only ^ hour was allowed for a noon recess. Other recesses depended upon the character of the work. The liability of contracting communicable diseases bore the same hazards as for other processes in the vicinity, but usualh^ was great. There was also con- siderable hazard of chronic poisoning for most of this class of workers, the poisons extending over a large range, depending upon materials being baked or furnaced. The risk came usually from fumes and gases, but there were the additional hazards of poisonous dusts, and of handling poisons in many places. The opportunity for chronic gas poisoning from coal gases and unburned- natural gas was good in numbers of places. The industrial induce- ment to alcoholism was quite pronounced in most places, and due to many factors (dust, heat, vitiated atmosphere, poisons, and the lack of opportunity for personal cleanliness). The general appearance of these workers was usually below the average of those in surrounding processes, while in some places they complained bitterly of' some one or another of the hazards above mentioned, all of which were usually plainly present. Coiiuiients. — The above delineation suggests the corrective measures necessary. In particular would we mention the in- stallation of shower baths for all workers in such processes, both for ph\-siological reasons as well as personal respect, while ever}- effort should be made to keep the atmosphere which the workers are required to breathe, and to be otherwise subjected to, as nearly like that meant for their use by nature as possible. In no two places were hazards alike, so it is impossible to suggest spiecific improvements. FORGING AXD BLACKSMITHING. This process is reported upon as investigated in 52 plants located in various parts of the State and in connection with the following industries : Agricultural Implements; Automobiles and Parts; Brass Manufacturing; Car- riages, Wagons and Parts ; Railroad Cars ; Electrical Apparatus ; Ship Build- 125 iiig; Steel Alanufacturing; Foundries and Alachine Shop Products; Marble and Stone Cutting; Iron and Steel Products; Scales, Balances and Cash Registers; and Rubber Works. In a general way the process was about the same wherever investigated. In the o2 plants there were 1,608 wageearners, all males, engaged in forging and blacksmithing. The number of employes varied in different plants from 2 to •250. Methods appeared to be modern in 32 places, fairly so in 13 more, and not so in the remaining 7. There were no labor unions. The attitude toward employes appeared good in 41 places, fair in 9 more, and bad in 2 other (small) places. In 36 places the workers were of an intelligent type, while in the remaining 16 they were largely ignorant foreigners. Workmen appeared to remain \\ ell in 46 places, fairly so in 5 others, and not so in 1 place. Health appliances, consisting principally of hoods and stacks over furnaces and forges to remove fumes and smoke, were good in 24 places, fair in 2 others, and absent in the remaining 26. In 9 plants there were either placards or special instructions along health lines. In 7 plants the workers enjoyed the privileges of sick benefit associations. In 17 places (usually small) practically all the workers were skilled, in 6 more about half were, while in the remaining 29 the large majority were unskilled labor. Of the total number of workers 225 were over 40 years of age, 1,373 between 20 and 40, and 12 under 20. The general construction of the shop was good in 23 places, fair in 11 more, and poor in the remaining 18. In 14 places other processes were going on in the forging and blacksmith shop. Dust was a negligible factor in 22 places, a fair hazard in 19, and bad in the remaining 11 places, the latter including some of the larger plants. It consisted chief!}- of sand, metal, forge deposits and soot. Quarters were clean and orderh", considering the nature of the work, in 16 places, fairly so in 16 more, and not so in the remaining 20. Dry sweeping during work hours was frequently observed. Dirt floors existed in many places. Dampness, due to wet grinding processes, dirt floors, and poor location, was bad in 3 places, fairly so in 4 others, and no factor in the remaining 45. Light was bad in 8 places, only fair in 14 more, but good in the remaining 30. Artificial light was very poor in numbers of places. In others some workmen were con- stantly exposed to the effect of excessive light and heat upon the eyes with- out the use of dark goggles to protect them. The ventilation of the shops was good in 15 places, fair in 20 others, and bad in the remaining 17, due, principally, to the absence of hoods or other means of drawing off fumes from forges and furnaces, of good roof ventilation for smoke and fumes, and to gas yielding salamanders and heating stoves, and occasionally oil fumes. The exposure to heat was a fair hazard in 23 places, and bad in 7. The effects of cold, due to inefficient heating, drafts, and passing from hot places to cold places, was bad in 14 shops, and a fair hazard in 6 others. For the type of men who are employed in blacksmith shops, the work is not ordinarily par- ticularly fatiguing, but in 10 places hurrying piecework was evident, while in about half this number laborious work, long hours, speeding up, constant standing in one place, steady strain, faulty postures, jarring processes, and constant pressure of objects against the 'body, were hazardous features. In all places loud noises were present, and in about 1/3 were reverberating and so excessive and frequent that workers were necessarily deafened thereby. The workday was found to be 8 hours in 5 places, 8^ to 9 hours in 4 places, 9i to 10 hours in 40 places, and lOJ hours in 3 places. The noon recess was 1 hour in 14 places, | hour in 8 places, and ^ hour in the remaining 30. The 126 liability to the contraction of communicable diseases was considerable in 30 places, fairly bad in 16 more, and negligible in the remaining 6, the chief hazards being spitting upon dusty floors, absence of cuspidors, common drinking cups, common towels, absence of inadequate washing facilities, improper closets, the lack of medical supervision (so as to keep out consumptive work- men especially), and the damaging influences of dust, dampness, fumes, heat, and cold, in places above mentioned. Further than this, overcrowding in some places, absence of first-aid equipment to prevent blood poisoning from trivial injuries, absence of hand pads or gloves, goggles, and the use of wiping rags from doubtful sources, were all noted. Poisoning by fumes or other- wise was a serious hazard in 23 plants, fairly so in 6 more, and negligible in the remaining 23. The chief danger was from chronic gassing, due to the escape of fuel fumes and smoke. In addition tempering and case hardening with lead, potassium cyanide and oil, were carried on in a number of black- smith shops, (these processes are described elsewhere). The industrial in- ducement to alcoholism was considered negligible in 24 places, fairly so in 12 more, but considerable in the remaining 16, the principal features being in- adequate drinking water facilities, and the exposure to the breathing of dust and fumes, and, in 7 places, of excessive heat without provisions to counteract its effects. The general appearance of workmen was good in 28 plants, fair in 15 others, and bad in 4. (Reports on this were not returned in the case of 5 plants.) The chief complaints of the workmen were headaches, coughs, colds, rheumatism, and lumbago, which they charged to fumes and exposures ; also excessive light, loud noises, in some places jarring processes, and in others the exposure to the hazards of other processes. A fairly common observation among workmen was impaired hearing. Comments. — The general effects of forging and blacksmithing are along the lines of wear and tear, with emphasis upon the breathing of contaminated air in a large number of places. Im- provements should consist of impervious flooring instead of dirt floors, efficient hoods and exhausts over all furnaces, forges and grinding processes, cool air blasts and screens for workmen in hot positions, dark goggles for excessive light, cotton for the ears where noise is excessive, and, as in all hot processes, the providing of shower baths. The hazards mentioned above indicate further corrections. According to the Ohio Vital Statistics Reports, there were 986 deaths among blacksmiths for the years 1910, 1911 and 1912, of which number 77 died of pulmonary tuberculosis, or 7.91%. This compares very favorably with the death rate from the same cause for all occupations in the State combined (13.3%), and even with agriculturists (7.13%). However, the vast majority of blacksmiths are in small, open and naturally well ventilated shops, rather than the large plants such as our investigators covered. According to the U. S. Census, 18.8% of blacksmiths died of heart disease, 11.4 of pulmonary tuberculosis, 10% of apoplexy, 9.7% of Bright's disease, and 8% of pneumonia. COREMAKING. This foundry process is too well known to require description here. It was investigated in the following lines of industry : Brass Founding, Iron Founding, Iron and Steel mills, Agricultural Implements, Automobiles, Elec- trical Apparatus, Stoves and Safes, and several Machinery Manufacturing 127 firms. Our reports are based upon investigations made in 31 plants. There were a total of 989 employed at the process, of whom 861 were males and 128 were females, the latter in 6 different plants. Union organizations existed in 2 places. An intelligent type of workers was employed in 2 places, fairly so in 9 more, and, in the remaining, the employes were largely ignorant foreigners. An excellent welfare attitude toward employes existed in 24 places, fairly so in 2 others and not so in the remaining 5. The workers in 27 places appeared to remain well at the process, fairly so at 3 places, and not so in 1. Health appliances, consisting of hooded drying ovens, workroom ventilating apparatus, goggles and respirators (the latter where needed), were good in 3 places, fair m 5, and absent in the remaining. In 6 "places the employes had privileges of sick benefit and pension associations. The most of the workers were skilled in 18 places and unskilled in the remaining 13 (this feature depended chiefly upon differences in process). Workrooms were hygienically constructed in 16 places, fairly so in 8, and not so in the remain- ing 7. The work was done in the foundry room in 18 places (in none of which were females, although some were in places only partly partitioned off from the foundry atmosphere). . On the other hand the core drying ovens were nearly always in the coremaking workroom. Dt{st^ consisting of sand, earths and mold powders, was a bad feature in 5 places, fairly so in 5 more, and negligible in the remaining 21. Quarters were cleanly in 20 places, fairly so in 4 others, and not so in the remaining 7. Dvnpncss, due to the nature of the work and poor location,^ was a bad feature in olaces. Light was bad in 4 places, only fair in 2 others, and good in the rem. ing 25. The general aeration of quarters was good in 14 places, fair in 14, ai.' bad in the remaining 3, the factors being fumes and smoke, either •from til ■ foundry or escaping from the drying ovens. Heat was no factor in 22 plact:, was a fair hazard in 6 and bad in 3 places, due to proximity of core ovens which were improperly shielded and ventilated. On this account workers were often subjected to the effects of alternation between heat and x:old drafts. Fatigue was a considerable hazard in 18 places, fairly so in 11 more and negligible in 2, due principally to hurrying piecework, monotony, constant standing, and less often to such features as laborious work, pro- longed faulty postures, and loud noises. The workday was 8 hours in 2 places and from 9 to 10 1/6 hours in all but 1 place, where it was 11 hours. The noon recess was 1 hour in 2 places, f hour in 3 places, and \ hour in the remaining 26. The risk of contracting communicable diseases was negligible in 4 places, fairly so in 21 others, and bad in the remaining 6, due principally to inadequate washing facilities, poor toilets, promiscuous spitting, absence of cuspidors, use of common cups, and occasionally to overcrowding. Physical examination of workers was practically unheard of, although first-aid pro- visions were good in the majority of places. For a more or less dirty class of work such as this is, it is questionable from a health point of view whether sexes should be permitted to work together. The liability to occupational [poisoning was negligible in 11 places, a fair hazard in 11 others, and con- siderable in the remaining 9. due to escaping gas fumes and smoke, principally from core ovens, and the breathing of brass fumes in many brass foundries where frequent pouring was done, and the coremaking was (Iniie in tlu' saim' quarters. The inducement to stimulants was bad in 11 places, and considerable jn 15 more, due to the lack of adequate drinking water facilities, places other 128 than the work rooms and saloons in which to eat, and to the depressing in- fluences above mentioned. The general appearance of workers was good in "25 establishments^ a goodly number were below par in 5 others, and especially were they so in the remaining place. The chief complaints of workers were the breathing of burned gas fumes and smoke which escaped from baking ovens, causing headache, nausea, and general ill health, also odors from inside toilets which were improperly ventilated. Comments. — Corrective measures consist in sepa- rating this process from the general foundry, providing seats with backs, and the proper ventilation or separate location of the drying ovens, to which must be added features of general sanitation. Less than 1/6 of the places .were above criticism for hygienic, airy, light and sanitary quarters. IRON FOUNDING. Iron founding includes, properly, the melting of iron and pouring it into molds, which have been previously prepared by the molders and their helpers, and the subsequent opening of the molds, freeing the castings from mold dirt, and cutting off the "gates" from the castings. In the iron foundry the molders are the skilled workers, the firemen and furnacemen (see Furnacing), semi- skilled, while a considerable percentage of unskilled labor is employed as helpers. Iron founding was investigated in 43 establishments, in 14 cities, empi v- ing a total of 4,721 v^^ageearners, all males. The process was investigat in 11 industries, arranged in descending order as follows: Foundry and JV .line Shop Products, 15; Iron and Steel Mills,. 7; Stoves and Furnaces, '' Agri- cultural Implements, 5; Automobiles and Parts, 2; Musical Instfj ; ents, 2; Brass and Bronze Products, 2; and one each of the following:: Enameling and Japanning, Electrical Apparatus, Safes and Vaults; and Iron and Steel Forgings. The Mortality Statistics among Molders, according to the Ohio Vita! Statistics Reports have been discussed in Part IV, under the heading of Foundry and Machine Shop Products (q. v.). — According to the figures sub- mitted by the Financier of the International Molders' Union of North America, the Ohio branch of the Molders' Union suffered 204 deaths during the five- year period from 1909 to 1913 for which death benefits were paid (there were 87 additional deaths not coming under the benefit privilege), the chief causes of death being, in order, pneumonia, 30 ; heart trouble, 30 ; tuberculosis, 27 ; and violence, 18. The Sick Fund of the same organization presents, also, through its Financier, the following statements and figures for Ohio, for the year 1913: ''The following list gives the ailments, the number of members receiving benefits, the number of weeks' benefits receivd under each heading and its percentage to the total number of weeks' benefits paid during the year (1913) : 129 No. Members (Ohio) Paid. 1. Throat and Lungs 262 2. Rheumatism 207 3. Accidents : 255 4. Burns 132 5. Heart, Kidney, Liver, Bladder 56 6. Lumbago, Sciatica, Neuritis.. 107 7. Intestines and Rectum 59 8. Stomach 81 9. Tuberculosis 12 10. Miscellaneous 313 Totals 1,484 No. Weeks Percentage {Ohio) of Benefits Received. Paid. 620 10.7 580 15.6 613 16.5 286 7.7 137 3.7 231 6.2 185 5.0 200 5.4 41 1.1 821 22.1 3,714 100.0 "With but few exceptions in the months of January, February and Marcl; of each year the amount of Sick Fund collected has been exceeded by the sick benefits paid out. The only explanation for the large outlay that characterizes the first quarter of each year is the severity of the weather that particularly affects those who are subjected to the heat of the foundry during cast time, comhined with the poor facilities that obtain in so many places for keeping the shops warm during the daytime. "We can well understand that foundry conditions are such as to promote the prevalence of both throat and lung disorders, and also rheumatism. Tht violent changes in temperature, the drafts and dampness of the foundry, are conducive to suffering of this kind. It might truly be said that rheumatism in its several forms appears to be the nearest approach, if any, to what might be designated as an 'occupational disease.' We are not making this as a positive statement, but rather as a deduction from our records of 1913." The places which our investigators inspected were non-union in 30 in- stances, union in 10 others, while this was not reported upon in the remaining 3. The employers' interest in the workers' welfare appeared good in 31 places, and at least fair in 8 more. The general type of workers was good in 24 places, fair in 8 more, but largely ignorant foreigners in 9 others. The majority of the workers appeared to remain steadily at the process in 37 places, fairly so in 2 others, and not so in 3. Especially devised health appliances, such as hoods and exhausts over furnaces, and exhausts and air conditioning systems for the foundry quarters, were good in 6 places, fair in 4 more, poor in 1, and absent in 31. Instructions concerning the conservation of health were given in an organized way in 4 places, and to some extent in 4 more. In 6 of the places investigated benefit associations existed among the employes (these do not include the benefits provided by the Holders' Union). Foundries were hygienically well constructed in 15 places, fairly so in 10 more, not so in 14, and not reported upon in the remaining 4. Other processes than Iron Founding were carried on in the same quarters in 19 of the plants visited. These con- sisted of Core-Making, Pattern Making (Wood-working), Metal Grinding, Brass Founding, Tempering, Machine Shopping and various others. The age- group estimations summed up as follows: 130 No. of Age Groups. Iron Founders Over 45 jears 149 Between 40 to 45 386 Between 20 to 40 4,082 Under 20 15 Not ascertained 89 Total ! 4,721 The presence of foundry dust appeared a negligible hazard in 7 places, fairl}- so in 17 more, and bad in the remaining 19. This dust was composed chiefly of mold sand, iron oxides, iron, dross, slag, cinders and dirt. Of these the first is to be considered the most harmful. While it is practically impossible to avoid dust in iron foundries, the presence of sub-processes, such as Cast- ting Cleaning, and Furnacing, as well as other processes (mentioned above), which might be carried on in separate quarters, add greatly to the amount of fine dust floating in the air. A foundry is also a difficult place to keep clean and orderly, but in 10 places quarters were found exemplary, while, in the remaining 33, heaps of mold sand, slag, cinders, castings and patterns were allowed to accumulate more or less promiscuously, while little attempt was made to clean up quarters, windows, skylights, etc. Dirt floors were found to exist in about one-third of the places, while, on the other hand, in about the same number the work was done upon concrete floors. Dampness was a bad hazard in 5 foundries, fairly so in 5 more, due to the wetting down of the earths used, careless cleaning of castings, wet grinding, and the absence of floor drains, as well as the difficulty of drying out earth floors within a build- ing. Natural light was good in a total of 30 plants, fair in 7 more, and bad in the remaining 6. A great many plants were supplied with eye-damaging, expensive and inefficient artificial lighting by naked electric lamps (without reflectors or other illuminating enhancements). The air content appeared good and capable of being kept fairly free of contaminating gases and smoke in 18 places, to a less extent in 17 more, while it was bad throughout most of the day in 11 more. The usual contaminations were mold fumes, gas fumes, smoke, dust, and steam, while in a number of places the air was badly vitiated during the winter seasons by the presence of coke-'burning salamanders used for heating, placed about in the quarters, and yielding immense amounts of invisible coke gas due to the absence of flue connections to the outside. While there is a necessary exposure to heat in the foundry process, it was usually short-intervaled, and a negligible hazard to the workers so employed in 20 plants, fairly so in 15 more, but bad in 7. In a number of places it could have been greatly lessened by protective devices, more room for its diffusion, ven- tilating fans, air blasts, and the like. On the other hand, cold, due either to the absence of inefficient heating, or the rush of cool drafts through areaways, was considered a hazard to many workers, in at least 15 places. This was so, particular!}', for workers about the outskirts of the quarters who were stand- ing before benches the greater part of the day. It is but natural that chilling of certain muscles and groups of muscles, which at intervals must be called into sudden severe straining actions, usually in hot places, should be greatly affected with sprains and rheumatism, shown as lumbago, wry neck, sciatica, neuritis, severe chest and shoulder pains, stiffness of joints, etc. Particularly 131 is this condition favored by the going out-of-doors to closets, or at noontimes, or going home while wearing sweaty underclothes. Foundry work cannot be considered unduly fatiguing to the average normal adult, but it may be made so by such factors as the following, which were found to be present to the extent mentioned: hurrying piece-work, 22; speeding up, 8; overly laborious work, 7; monotony, 9; long hours at the manipulations concerned, 7; jarring processes (pneumatic tampers), 5; prolonged strain, 2; constant standing in stooped and awkward positions, practically all. The workday was 8 hours in 2 places, 8 to 9 hours in 12 places, 9 to 10 hours in 19 places, 11 hours in 1 place, and 12 hours in 1 place. The noon recess was 1 hour in 9 places, | hour in 6 places, and J hour in 27. Overtime was quite unusual. The liability to the contraction of communicable diseases was a considerable risk in all except pos- sibly 6 places. The chief reasons were promiscuous spitting into places in which the dust was being continually "kicked up," the absence of cuspidors, and, somewhat less often, to poor washing facilities and closets, as well as crowding together of workers. In a very few plants medical supervision pro- tected against the presence of the consumptive worker and in all such first-aid equipment and hospital arrangements were excellent. There was not much liability to poisoning, outside of the intervalled 'breathing of certain amounts of gas, as far as iron founding itself was concerned, but in a number of places brass chills, from the escape of brass fumes, and tempering, or case hardening with lead and potassium cyanid were a hazard to the founders as well as to the special process workers. The relationship of industrial alcoholism to iron founding may be stated as directly in proportion to the subjection to the hazards named, especially fumes, smoke and dust, absence of proper washing facilities, and inadequate thirst-assuaging provisions. Furthermore, in numbers of places foundrymen ate their lunches largely in saloons, unquestionably as much from a desire to get out of the foundry air as for any other reason. The general appearance of the average of foundrymen was considered good in 18 places, fair in 12, and much below par in 8 (the remaining 5 not being reported upon). The chief complaints of foundrymen were the inefficiency of ventilating arrangements, which necessitated the breathing of gases and smoke, particularly in the winter time, the absence of local exhaust systems to handle slag dust, dust and noises from other processes, and shortcomings in sanitary arrangements. Of specific occupational diseases, our investigators ob- served 2 cases of lead poisoning, due to lead tempering in the foundry quarters. The effects of great heat upon the face and skin were commonly noted. There v/ere lots of complaints of bronchitis, rheumatism, diarrheal attacks and cramps in warm weather (the last two usually laid to drinking cold water, but recog- nized as due to poisons generated within the system by over-heating and fatigue), inefficient winter heating, poor or distantly located closets, and other questions under general hygiene. Comments. — Probably the greatest single need in foundries is "back stop" cuspidors and warnings to keep sputum confined so as not to contaminate the dust in the atmosphere. Next, and equally as important, the presence of a shower bath with instructions upon its physiological purport. Next we would mention the doing away with dirt floors as soon as possible, and the presence of other poisonous or hazardous processes. The subject of drinking water is a most important one, and attention should be given to bubbling fountain sup- plies conveniently located, and the water supplied at a proper temperature, neither too warm nor too cold. This was done in some places. In certain 132 processes men should wear dark goggles- to protect the eyes from excessive heat, as well as light, while there should always be respirators available to be worn temporarily for unavoidably dusty manipulations. Hand protectors should 'be provided for handling hot scrap and iron. As there is some danger from "gassing" in all foundries, first-aid equipment should include a resuscita- tion apparatus as well as a tank of oxygen. Founding is an example of an industry which in itself should be harmless, in fact, should promote health and longevity the same as any application requiring the general use of nearly all of the body functions. It is rendered dangerous chiefly because it is done indoors. On this account a great many precautions are necessary to be taken, as indicated, including the general medical supervision of the workers. Pneumatic Tampers are veritable engines of destruction to the human Fig. 38. Cleaning Metal Castings. An unavoidably dusty and gaseous work. Note exhaust pipe beneath table, which has openings into table top. Also respirators are necessary. Glo^■es furnished. nervous system, and mechanisms should be introduced to take the jar off the worker as well as instructions in the proper physiologic use of the same. Casting Cleaning is necessarily very dusty as usually performed and whether done by hand with steel brushes, or with sand and air blasts, or by knocking and tapping, laborers so engaged should be protected from the dust, probably best by helmets supplied with compressed air blasts. Tumbling of small pieces or cleaning within cabinets, or other dust confining means should be used where possible. BRASS FOUNDING. Brass Founding is very similar in methods of procedure to Iron Found- ing, except that a number of small melting furnaces are commonly used. These 133 may be sunk beneath the floor level and crucibles placed within them to hold the metal or small steel furnaces mechanically handled and furjiished with a strong blast may be used. There are many other types of furnaces. The cast- ings made are as a general rule much smaller than those turned out in iron foundries, and in much greater variety of shapes. In the brass foundry prac- tically all non-ferrous metals may be melted down, but the commoner ones are zinc, copper, lead, aluminum, bismuth, tin and antimony, as well as some phosphorus, nickel, manganese. In this connection we have included in Brass Founding all processes requiring the melting down and pouring into molds of non-ferrous metals, with the exception of some printing and engraving special machine processes. ... . ,!,.,=^^^-^ ' 1 Fig. 39. Brass Foundry. Each furnace (in the floor) is covered with an iron lid. The furnaces form a circle around the flue or chimney, the base of which is shown on the left. Note the pipe above frorn which fresh air is blown upon furnacemen when opening furnace tops. Our investigations covered 106 establishments, located in 8 cities, and employing 2,148 wage-earners, all males. Non-ferrous metal melting was in- vestigated in connection with the following industries, arranged in descending order: Brass and Bronze Products, 54; Electrical Apparatus, 10; Stereo- and Electrotyping, 5 ; Iron Founding and Machine Shop Products, 5 ; Smelting and Refining, 4; Lead Bar, Pipe and Sheets, 3; Coffin Fixtures, 8; Automobiles and Parts, 3; Iron and Steel Mills (brass foundries), 2; Printing and Publish- ing," 2 ; Cutlery and Tools, 2; Junk, 2; Cash Registers, 2; Paint and Varnish Manufacturing, 2; Flags and Regalia, 1; Stencils, 1; Musical Instruments, 1; Railroad Cars, 1; Street Cars, 1; and Rubber Manufacture, 1. 134 Vital statistics unfortunately do not distinguish between Iron Holders and Brass Holders, as a rule. (Attention is called to the statistics given in Part IV under "Foundry and Hachine Shop Products," and to "Brass and Bronze Products;" also to "Iron Founding," Part V.) We call attention to the relative rates given in the U. S. Hortality Statistics for pulmonary tuber- culosis as occurring among Iron and Steel Workers and Brass Workers. In the former it is the cause of 16.3 deaths out of every 100, and in the latter 31.3 deaths in eVery 100. The plants investigated employed from 1 to 275, a large majority ranging from 8 to 20. The molders belonged to unions in 6 of the plants. The general attitude toward employes seemed good in 50, fair in 21, and quite bereft of personal interest in the remaining 35, usually smaller places and engaged in some of the odd lines mentioned. The class of workers was good and very largely skilled in 65 places, fairly so in 29 more, and not so in the remaining 12. In 25 of the places investigated the workers were only of short tenure, and not much better in 14 more. In 16 places exhaust hoods and vents were found over furnace areas, while in 25 more various arrangements to improve the atmosphere, such as air blasts and exhaust fans, were present. In no place were means adopted to confine and remove brass fumes during pouring. In 8 places instructions concerning the conservation of health were given in^ an organized way, and some attention was given to this in 6 more, but com- paratively nothing in the remaining 92. Brass foundrymen were privileged to join sick benefit organizations in 10 establishments. The general construction of 'brass foundries was determined as hygienically good in 42 places, fairly so in 21 more, and not so in the remaining 43. In 29 places other processes than those concerned with brass founding were being carried on, chiefly, Core- making, Hetal Grinding, Casting Cleaning, Hachine Shopping, Polishing and Buffing, Assembling and Finishing Processes (see Factory Processes). Age- group estimations summed up as follows : No. of Soft Age Groups. Metal Founders. Over 50 years 40 45 to 50 years ' 120 40 to 45 years 296 20 to 40 years •• 1,670 Under 20 years 22 The general hazards of dust, dirt, dampness, darkness, heat, cold, fatigue and infections did not differ materially from those already described under Iron Founding. The workday was found to -be 8 hours in 5 place, 8 to 9 hours in 42 places, 9 to 10 hours in 58 places, and between 10 and 11 hours in 1 place. The noon recess was 1 hour in 13 places, 54 hour in 14 places, Y2 hour in 76 places, and not strictly observed in the remaining 3. A morning lunch interval was occasionally observed, but with piece-workers this was quite a question of their own choice. The air conditions in these founding processes were determined as good in 17 places, only fair in 41, and decidedly hazardous to the health of the workers in the remaining 48. While quarters were usually spacious enough, the air was subjected to vicious contamination with brass fumes, usually, also, some lead fumes, in addition to the features mentioned under Iron Founding. While these fumes were only a matter of ten to fifteen minutes during pouring in smaller places and once or twice a 135 day, they became very detrimental to health where they were more or less continuously present. In addition to brass fumes (the poisonous element of which is pre- eminently zinc, and causes when inhaled "brass chi'Us," or "brassfounders* ague"), and lead (present as a hazard through handling, chiefly, but also in the form of dust and fumes), the following poisons were reported by in- vestigators ; antimony, sulphur dioxide, carbon dioxide, carbon monoxide, benzine, phosphorus and "salamander gases." These were usually present in small amounts only, but very liable to produce slow poisoning. Because of the element of zinc, and ajlso antimony when present, (the breathing of the hot fumes and sublimation products of which cause a drying harshness and soreness in the nose, throat and chest, and oftentimes a nausea and loss of appetite) the industrial inducement to alcoholism is much greater among these workers than among Iron Founders. It seems to be a tradition with brass molders to resort to stimulants for the sole purpose "of cutting the slug" in the throat, and to reduce the likelihood of brass chills, as well as "metal poisoning." The average appearance of the workers was good in 62 places, fair only in 27 more, and bad in the remaining 17. In 42 places brass chills were com- plained about, while other complaints were about the same as those mentioned under Iron Founding. In 35 plants our investigators encountered the follow- ing cases of industrial disease complaints : brass poisoning (including "chills" mostly, but occasionally "brass itch") 104, and 40 others who said they had had chills in the past, or in places where they had previously worked. In some places 1/3 to ^ of the workers were suddenly stricken, usually in the winter time, during snowstorms, when the fumes hung about especially heavy within the quarters. As is the rule, these chills came on at night time several hours after the workers left the foundries. The wholesale manner in which they appeared was occasionally mistaken for an epidemic of some sort, resembling influenza. In addition to the above, our investigators discovered 4 cases of chronic lead poisoning, 4 others which were tentative, and 3 others who had been afflicted in the past with lead poisoning. There was also reported 1 case of chronic eczema, 1 case of benzine dermatitis, and many complaints of catarrhal conditions of the nose, throat and stomach. _^Comrments. — In addition to what has been said under Iron Founding, means should be taken to locally ventilate brass pouring areas. This may be done by means of broad hoods, connected with tall stacks, or a suction fan, and each hood capable of raising and lowering over the pouring area. Another method is to apply an exhaust hood, connected with a flexible duct, immediately over each crucible and its pouring edge, and lead th^ fumes off to a collecting chamber. While crucibles are being transported from furnaces to molds, prac- tically all the fumes can be kept down by covering the surface of the metal with a little slag or sand. A hood or apron applied over the furnace area will usually provide for removing fumes which arise when the furnaces are opened and the crucibles are removed, and lead and other ingredients added. A factory check upon the reasons why employes absent thems-elves from work would prove instructive lo employers and bring out the preponderance of preventable causes. METAL .GRINDING. The process of metal grinding is one closely associated with foundry work *and assembling processes upon both iron and soft metals.- It properly includes 136 also the dressing of castings by other means than grinding, such as "sand- blasting," "rattling" in tumbling machines, and "chipping" by means of steel tools. Sandblasting has been considered elsewhere, while a word will be given here to each of the other subsiduary processes. Metal grinding is usually per- formed with emery wheels, which may be stationary, or may be moved about, over large surfaces by means of a swing-belt attachment. Occasionally it is done mechanically by a series of traveling emery wheels, which pass up and down over the surfaces to be ground. Sometimes it is done by belts covered with emery or other exceedingly hard abrasive substances. Carborundum and corundum, two substances of diamond-like hardness, are the chief abrasives used. The process was investigated in 64 establishments, employing a total of 1,979 wage-earners, all males. Modern methods appeared to obtain in 42 places, fairly so in 14 more, but were crude compared to other places in the remain- ing 8. In but few places were the workers members of a union. Th« general attitude of employers toward this class of employes appeared good in 45 places, fair in 17 more, and poor in the remaining 2. A fairly intelligent class of workers were employed in 36 places, while more or less ignorant foreigners, often non-English speaking, were employed in the remainder. A fair per- centage of the workers were comparatively old-time employes in 48 places, while the personnel appeared to change very often in 13 places (the remaining 3 were not reported upon). Health appliances, especially those consisting of blower systems to remove the dusts created, were good in 20 places, of only partial efficiency in 13 places, and absent in the remaining 31. These latter were places where workers were employed either on traveling belt grinders, which they steered about, and which were difficult to protect, or were engaged at the process for only a part of their time, as, for instance, stove-mounters. Definite instructions regarding the health-hazards of the work were given in an organized , way in 8 places, and fairly well in 2 more, but the remaining 54 very little thought was given to the effect which the work might he having upon the health of the workers, and in a number of places very little attention was given to the efficiency of the blower systems present. In 8 places the workers were members of sick benefit associations, conducted by the industry itself. The work was considered skilled in 7 places, semi-skilled in 15 more, while entirely unskilled labor performed it in the remaining 42 places. The workroom quarters were hygienically constructed in 27 places, fairly so in 12 more, and not so in 21 (the remaining 4 not being reported upon in this regard). In 20 places other processes than metal grinding were carried on in the same quarters, such as Sandblasting, Machine Shopping, Foundry Processes, Forging and Smithing, Welding, Brazing, Furnacing, and Polishing and Buffing. The age-group estimations summed up as follows : No. of Age Groups.. ' Wage-Earners. Over 50 years 19 45 to 50 years 20 ■ 40 to 45 years 104 20 to 40 years 1,803 Under 20 years 32 The process was investigated in 16 different industries, arranged in descending order (by number of places investigated) as follows: Foundry 137 and Machine Shop Products, 11 ; Cutlery and Tools, 11 ; Brass and Bronze Products, 7; Automo'biles and Parts, 6; Iron and Steel Mills, 4; Stoves and Furnaces, 4 (this was also separately investigated in the stove-mounting rooms in a total of 15 establishments); Agricultural Implements, 4; Musical Instru- ments, 3 ; Steel Springs, 3 ; Scales and Balances, 2 ; Electrical Apparatus, 2 ; Electroplating, 2 ; Coffins and Burial Cases, 2 ; and Sewing Machines, Safes and Vaults, and Files, each 1. Vital Statistics for Metal Grinders are not given separate classification in the State reports. In this connection it is probable that country-wide statistics would be much more accurate, both because the larger number of deaths concerned, and because persons with bronchial or respiratory diseases have a strong tendency to migrate to western states. In this connection we publish the following, taken from a report submitted by the Stove Mounters' International Union (United States and Canada). These workers are engaged about one-fifth of their time in metal grinding, usually without any protective devices, while they are in an atmosphere more or less contaminated with the fine dust created most of the time. Figures submitted by the Secretary-Treasurer of the Stove Mounters' International Union for death benefits paid in the United States and Canada for the past 5 years, show the four leading causes of death and percentages as follows : Cause of Death and Percent from Each Disease Among Stove Mounters to Whom Death Benefits Have Been Paid by Their Organization During the Past Five Years in the United States and Canada (Under Date of September 17, 1914). Tuberculosis 27.95% Heart Disease 20.93% Accidental Deaths 11 . 67% Pneumonia 9.31% The remaining deaths were as follows : Deaths due tcT Preventable Causes 13.88 Deaths due to Degenerative Diseases 9.28 All other Deaths ! ■ 7.03 Total 100.00 The total deaths chargeable to lung diseases was 43.5%. The hazard of breathing dust from the process was determined as neg- ligible in 9 places, of" a fair risk to the average worker in 24 places, and bad in the remaining 31. This dust was invariably of a most harmful character because of its hardness, crystalline character, and fineness, making it easy of inhalation and swallowing. In 12 places quarters were kept clean and orderly, fairly so in 17 more, and not so in the remaining 35. Methods of cleaning were oftentimes at fault, such, for instance, as dry sweeping or brushing up during work hours. Only dirt floors were present in some places, and in others, floors, walls and ceilings were of such construction as to make them 138 very difficult to keep clean. Workers were found engaged in very damp quarters in 6 places, and fairly so in 4 others. Sometimes the virater used in connection w^ith the grinding process was the cause of the dampness. There seemed to be a tendency to put metal grinding in dark quarters. In 12 places this was especially noticeable, while light was inefficient in at least 13 more. In many of the 39 remaining the light would have been efficient, providing windows and skylights were kept reasonably clean. Heat was a negligible factor in the process itself, but in 5 places workers were exposed to this hazard from their proximity to furnaces and other hot processes. While heating was frequently done by stoves and indoor furnaces, occasionally the ordinary salamanders filled /with coke were used, without stack and hood to remove fumes. In at least 5 places entirely inefficient heating methods were justly complained of, particularly for workers who stood or sat still all day with their backs toward windows, or drafty areaways. The general room ventilation of grinding quarters was good in 12 places, fair in 39 more, and bad in 21 (the remaining 2 not being reported upon). This feature in about one-third of the places, however, was influenced by the nature of other processes present, par- ticularly founding, forging, and the like. In many instances these workers were exposed to fpundry and cupola smoke, core-oven fumes, etc. Occa- sionally workers were just as much subject to brass fumes and "brass chills" as were the brass founders themselves. Fatigue was considered a bad hazard in 31 places, and fairly so in 29 more, the chief features arranged in descending order of importance being : monotonous application and reduplication of move- ments, 26; hurrying piece-work, 24; constant standing (still), 19; loud noises, 13; speeding up, 6; jarring processes, 6; laborious work, 5; faulty postures long maintained, many; seats without back rests, many; long hours, several; constant pressure of the body against objects, many. In 4 places work arrange- ments were adjusted to permit variation and recreation. For a large per- centage of workers, especially those engaged upon small pieces, inactivity was a considerable hazard. The workday was 8 hours in 2 places, 8 to 9 hours in 13 places, 9 to 10' hours in 44 places, and 10^ hours in 1 place. The noon recess was 1 hour in 13 places, % hour in 6 places, and ^ hour in 45 places Overtime was an occasional feature. A morning lunch hour or respite from work was seldom observed, although piece-workers suited themselves about this. The liability to the contraction of communicable diseases was a consider- able hazard in 31 places, fairly so in 21 more, negligible in 8, and not reported lipon in the remaining 4. While the whole gamut of hazards as listed in Parts II. and III. was encountered here, the chief ones were ; promiscuous spitting upon the dusty floors, the absence of cuspidors, use of common drink- ing cups, inadequate or absent washing facilities, poor closets, crowding together of workers in a small space in the room, and the lack of medical supervision (particularly to keep consumptive workers from endangering others). Liability to poisoning existed in 17 places, and especially so in 9, due to work upon lead, lead alloys, and the breathing of brass fumes. Where lead is over 5% in an alloy, the dust from such alloy may produce lead poisoning. Most brasses and bronzes do not exceed this. The industrial inducement to alcoholism appeared negligible in 7 places, a su'bject for consideration in 34 places, and a decided hazard in 23, due, in addition to the depressing influences of the various hazards above cited, to the inadequacy of proper drinking water facilities. While any place employing a large number of workmen would be almost certain to have some who appeared below par in health, this was particularly so among a rela- 139 tively large number of employes in 13 places, and more or less so in 31 more. In 25 of the establishments visited the workers made complaints, which were worthy of notice. These consisted chiefly of the constant breathing of dust, causing all manner of nose, throat, bronchial and lung troubles, as well as dyspepsia, bowel trouble, and middle ear gatherings. Most of the complaints concerned general sanitary matters, and occasionally the breathing of fumes, vapors and smoke from other processes. In 17 plants the investigators came across 24 cases of industrial sickness, as follows : Chronic Lead Poisoning, 5 ; Pulmonary Siderosis, 5 positive and 4 tentative; frequent attacks of Brass Poisoning, 2; Bronchitis, 2; Tuberculosis, 2; Pneumonia, 1; Tubercular Emp- yema, 1; Brush burns of the hands, 1; Conjunctivitis, 1. As stated under Factory Processes, here too, the vast majority of such cases are in hospitals, dispensaries and various institutions, or at home, to which the existing system of morbidity statistics does not extend to any degree of efficiency at the present time. (See, however, Part II. and Part VI.) Comments. — Our analyses show that only 5 plants could be considered entirely healthy places in which to work. The better control of the dust (in 11 places no attempts whatever were made to control it) is the first essential, while shorter work hours, alternation of work to overcome monotony, and the features mentioned under the respective hazards above, as' well as medical examination and supervision are necessary to control health in this entirely unnatural and hazardous process. The wearing of a piece of board or metal prevents harmful pressure against the person. TUMBLING consists in placing a number of castings (usually small ones) in a revolving cylinder, called a "rattler", in order to shake mold dust oi¥ of them, as well as tO' smooth down certain imperfections. The cylinder, which should be -entirely enclosed, since it creates an immense amount of dust, was found not to be so in a number of instances. However, in some places, a very efficient air exhaust or blast system controlled all dust arising therefrom. The process is very noisy. CHIPPING of iron and steel castings is another exceedingly dusty and also dangerous procedure. from the flying particles which are created by the use of both hand or pneumatic tools, and from which a considerable part of the 1,220 working men (this was the number compensated for) lost their eyesight in the State in the year 1913. Outside of the use of respirators, individual goggles (to prevent the spread of eye diseases), and cotton in the ears, it is exceedingly difficult to protect the workers in this procedure. Where pneumatic tools are used the noise is deafening, while the shocks produced to the nervous system by holding the tools is most damaging. Short hours, work variations, physical examination upon employment, and medical supervision, should be instituted. SAND BLASTING. Sand blasting is a process in which fine sand or similar hard substance is forced through a pipe by compressed air against objects either for the purpose of cleaning their surfaces or of giving them an etched, frosted or rough effect. Hence, the process is used upon a considerable variety of materials. As it is very rapid, usually only a few workers are so employed even in very large establishments. Our investigations covered the process in 9 diff'erent industries, viz.. Automobiles, Cars, Carriages, Electrical Apparatus, Brass, Iron, Glass, Cutlery I40 and Tools, and Machine Manufacture. There were 51 wage-earners, all maks, found so emplo3'ed. For some work, considerable skill is necessary, but in the majority of instances it is a process for unskilled labor. Retention at the process was good in 3 places, fair in 3, and very brief in the remaining 3. Health appliances, consisting of isolation of the process in a room by itself and within a cupboard through which the worker inserted his hands, or 'the wearing of a helmet covering the entire head,- — these features were found good in 8 places, fair in 3, and practically absent in the remaining 3. Instructions to limit the dust in order to conserve the health of the worker were good in 5 places, but very little attention was paid to the same in the remaining 4. In but 1 place did the workers enjoy the privilege of a sick benefit association. The work Fig. 40. Saxdelastixg. The worker needs protection from breathing fine dust incident to this class of work, even though it is done out-of-doors. Note besides respirator, special suit and cap. was done in the same quarters with other processes in 8 instances, so that other workers were exposed to the fine dust created. Of all the employes, 13 were over 40 years of age and 38 under 40. Dust in the breathing atmosphere was a negligible factor in 2 places, a fair hazard in 4, and bad in 3. Cleanliness of quarters took about the same propor- tions. Dampness was no feature of the process, nor were harmful light effects. Heat, due to the proximity to other processes as a rule, was bad in 1 place, fair in 2 more, and no feature in the remaining 6. Cold weather, due to performing the work, protected only by a roof, was a feature in 2 places. Fatigue was not a special hazard, although hurrying piecework, monotony, and constant standing were features in J of the places. The workday was from 9 to 10 hours in all 141 places. The noon recess was 1 hour in 1 place, f hour in 3, and J hour in 5 places. The liability to the contracting of communicable diseases was negligible in 3 places, a fair risk in 5, and bad in 1, due, principally, to the breathing of fine dust in quarters where there was promiscuous spitting, absence of cuspidors, inadequate washing facilities and improper closets, and the failure to inquire into the fitness of the workers for such work. Poisoning was no feature. The general factors favoring stimulantism were the irritating effects of fine dust inhaled and swallowed, and the absence of good drinking water facilities in some places. The health appearance of the workers was not good in J of the places. The workers' complaints were the breathing of dust, skin irritation in hot weather, and the inefficiency of some of the hoods used, while in 1 place the manager said they were having it done at night, because it made so much dust! Comments. — Snch work should' he done in a manner to keep the dust away from the employe, such as confining the process within an impervious cupboard, through which armholes are made, or having it done in a dust-tight room in which the worker should be supplied with an impervious suit and helmet to which is attached an'air tube supplying him with fresh outdoor air under pressure. The simple wearing of respirators, even of helmets, without such air tubes is not at all efificient, as can be demonstrated by noting the amount of fine dust settled upon the workmen's features when such coverings are re- moved. ■ Many places substitute sandblasting by cleaning small pieces in a rattler. For large work, the Wedemeyer sand blast rooms should be investigated. POLISHING AND BUFFING. The processes of Polishing and Buffing are so similar and work is so often interchanged that they are considered together. Polishing is done on emery wheels, or spindles covered with a composition of abrasive material, which gives a smoothness to castings , much in advance of that secured by metal grinding, where the action is rougher. Buffing is a follow-up process which glosses the metal parts still further after they liave been polished. Buffing is usually done with wheels composed of layers of fabrics tightly compressed and sometimes infiltrated with finely abrasive powders. The process was investigated in 51 plants, located in 11 cities, and em- ploying a total of 864 wage-earners, all but 2 of whom were males. The number of employes varied from 2 to 125 in a single plant. The females were engaged in a fibre comb factory. The industries in which this process was investigated were as follows : Brass and Bronze Products, 15; Electrical Apparatus, 5; Mirror Making, 5; Cash Registers, 3; Stoves and Furnaces, 3; Foundry and Machine Shop Products, 3; Coffin Fixtures, 3; Cutlery and Tools, 3; Copper, Tin and Sheet Metal Goods, 2; and 1 each of the following — Automobiles and Parts; Jewelry; Regalia; Scales and Balances; Sewing Machines and Parts; Scientific Instruments; Fibre Combs; Aluminum Combs; Signs and Advertising Novel- ties. The metals or alloys usually worked upon were brass, bronze, aluminum, lead and nickel plated objects. The State Vital Statistics do not give sufficient reports to include here, but the following is taken from a report submitted by the General Secretary- Treasurer of the Metal Polishers, Buffers, Platers, Brass and Silver Workers Union of North America ; 142 Of 197 deaths which occurred among Polishers and Buffers in the five- year period from June 1st, 1909, to -May 31st, 1914, according to the record of death claims paid, the chief causes of death and the percentages were: — Polishers and Buffers. No. of Cause of Death. Cases. Percentage. Tuberculosis 65 33 . Pneumonia 26 13 . 2 Heart Disease 22 11.1 Violence (including 6 suicides) 16 8.1 Other preventable deaths 14 7.1 Other deaths from degenerative diseases 47 23.9 Permissible deaths 7 3.6 Total ........' ■ 197 100.0 The average (median) age at death of these 197 workers was 39.7 years. Three of the plants visited were union places, the balance being non-union or open shop. The employers' interest in employes' welfare appeared good in 30 Fig. 41. Buffing Metals. Note goggles, gloves, chest protector, good natural and artificial light, as well as ventilating system. 143 places, fair in 10, and poor in 7, the remaining 4 not being reported upon. An intelligent type of workers was found in 38 places, fairly so in 8 more, and ignorant foreigners in the remaining. There was a good degree of steadiness at the trade in 35 places, fairly so in 12 more, and not so in the remaining 4. Health appliances, consisting of blower systems to remove dust, lint, etc., from the process, were present in 38 places where needed, and absent in 4 (brass, combs, coffins, jewelry). In 19 of the places where they were present, they were not efficient; occasionally they were not in working order at all. Occasionally other appliances to improve room ventilation were also found. In 3 places organized instructions concerning the conservation of health were well given, and some attention was directed to this in 3 more. In 3 places the wage-earners enjoyed the privileges of sick benefit associations. The general construction of work quarters was hygienically good in 15 places, fairly so in 9 more, 'but not so in the remaining 27. In 22 places other processes were also being carried on in the same quarters, such as Electroplating, Machine Shopping, General Factory Processes, Founding, Lacquering, Metal Grinding, Soldering, Glass Melting, and Tinning. Dust in the breathing atmosphere was a negligible hazard in 12 places, fairly so in 17 more, but was bad in the remaining 22. It consisted chiefly of iron, steel, brass and bronze alloys, other soft metals, glass, etc., which were being- worked upon, as well as the components of the polishing wheels (emery, silica, etc.) and of the buffing wheels (cotton and lint fibres, glue substances, etc.). In some places it was kicked up from tfie floors because of inefficient cleaning, and also dry sweeping during work hours. These dusts are of course the most harm- ful to which workers may be subjected, since they are exceedingly hard, crystal- line, and very fine, or irritating, and, in the majority of instances, poisonous. There are so many consumptives in the trade that the infection factor is also added. The general cleanliness of quarters was determined as good in 15 places, fairly so in 15 more, and not so in the remaining 21. This usually was due to negligence in cleaning up, but oftentimes also to the type of quarters occupied. In many such places windows and skylights were apparently very seldom cleaned, or walls painted or whitewashed. In 7 places dampness and poor light were hazards. General room ventilation was very good in 16 places, fairly so in 17 more, but close and confined, and often contaminated with various fumes and gases from other processes in the remaining 18. In but 2 places were workers exposed to heat, and here it was not bad. In practically all places polishers and buffers were subject to the effects of fatigue, and particularly so in 22. The chief reasons for this were steady, monotonous piece-work under constant application and considerable strain with eyes and body almost rigidly fixed for a total of hours at a time throughout the day. Constant standing in partially stooped postures with very little variation were also other hazards. The workday was found to be 8 hours in 1 place, 8 to 9 hours in 14 places, 9 to IC hours in 30 places, and 10 to 11 hours in 2 places. The noon recess was 1 hour in 11 places, | hour in 7 places, and J hour in the remaining 33. The question of other recesses was very largely a matter of the workman's own choice, since they were employed at piece-work. The liability to the contrac- tion of communicable diseases was great in 24 places, and considerable in at least 18 more, due particularly to promiscuous spitting on dusty floors and the absence of cuspidors, while in a fair percentage of places washing facilities were absent or very inadequate; often closets were poor and common cups 144 used by all workers for drinking purposes. In some places workers were un- duly crowded together. Occasionally, some were seen who were wearing respirators and endeavoring 'by this means to filter out the dust from the air which they inhaled. Liability to industrial poisoning existed in 38 of the plants visited, and especially so in 21. This was due in about half of the instances to the presence of other processes (see those mentioned above), in the balance it was due to working upon poisonous metals and alloys, particularly those com- posed of lead, or rich in lead component. The various poisons mentioned to which polishers and buffers were found subjected were lead, potassium cyanid, nitric acid fumes, phenol, amyl acetate, benzine, alum, crude paraffin, and "metal dust", furnace gas fumes, brass fumes, plating fumes, and acid-dipping fumes. The exposures varied greatly as to frequency, amount and workplace. The industrial inducement to alcoholism and to other forms of stimulantism were considered a marked hazard in 12 places, and more or less so in nearly all of the balance, based chiefly upon the fatigue factor concerned, the dust breathed, and the opportunities for slow poisoning. However, in 24 plants the general health appearance of the workers was good, in 14 it was determined as fair, and in 13 bad. The principal complaints of the workers were monotony, danger, metal dust, acid fumes, blowers and exhausts inefficient, and poor sanitary arrangements, while their more personal complaints were coughs, indigestion, rheumatism, and skin affections. In- vestigators encountered 17 cases of industrial diseases in 8 plants as follows : chronic lead poisoning, 5 positive, 1 tentative, and 1 past ; brasi poisoning, 1 . positive, 1 tentative, and 6 with "brass itch" ; severe bronchial affections were particularly mentioned in 2 instances. Comments. — As the constant breathing of harmful dust and the con- tinual assuming of unnatural and strained postures are foreign to the physiology of the human organism, it is highly necessary that dust be kept out of the breathing atmosphere and to introduce measures which will vary the work for this class of workers. Unfortunately, it is looked upon as a skilled trade and this makes it difficult to introduce work variations. This does not detract, however, from its hazardous character. The toll of deaths from preventable causes bears this out. It is a process of modern times. One point which particularly impressed our investigators was that where blower systems were intalled they were often very inefficient at the time of inspection and were said to be so most of the time. There appears to be but one way of getting around this — to make it somebody's business in each such room to see that such systems are in working order and to provide for compensation for this purpose. A metal or wooden "chest-protector" prevents harmful pressure against the person. Other features, the liability to poisoning, etc., require the same precautions as elsewhere. Especially should medical supervision be adopted for this class of workers, as they are at a process which appears to take about 20 or 25 years off of their lives. MACHINE SHOPPING. The process of Machine Shopping includes a considerable number of sub-processes and operations upon cast metals. These consist, principally, in turning, lathing, planing, drill-pressing, punch-pressing, threading, tapping, cold riveting, sawing, cutting, assembling, and the like. All of these processes are 145 characterized by the fact that they are not carried on ordinarily with the aid of heat, nor is there much necessary creation of fine dust. The workers usually are more or less skilled. (Strictly routine machine operations carried on as piece-work by unskilled laborers have been considered mostly as General Factory Processes.) Machine Shopping was especially investigated in a total of 56 plants, located in 8 cities, and employing 4,082 wage-earners, of whom 3,897 were males, and" 185 (engaged in 2 factories), were females. These latter were working upon machines which threaded bolts, nuts, etc. Fig. 42. A Model Machine Shop. Maintained by a glass factory. The process was investigated in connection with the following industries, arranged in descending order : Foundry and Machine Shop Products, 16 ; Cutlery and Tools, 13 ; Automobiles and Parts, 6 ; Brass and Bronze Products, 4 ; Elec- trical Apparatus, 3 ; Agricultural Implements, 2 ; Springs, 2 ; and 1 each of the following: Cars; Coffins, Copper and Tin; Files; Furniture; Shipbuilding; Stoves; Bolts and Nuts; Scales and Balances; Stamps and Stencils;' and Iron and Steel Forgings. Mortality Statistics for Machinists have been stated in Part IV., under Foundry and Machine Shop Products. Only one plant visited was a union shop, the balance being "open shop". The employers' interest in the workers' welfare appeared very good in 42 places, fair in 7 more, bad in 3 (and not reported upon in the remaining 4). 10 O. D. 146 In some 14 plants a good percentage of ignorant workers were employed in various helping and routine processes. Retention of workers at the places em- ployed seemed to be good in all except 4 instances. Usually, special health ap- pliances for machine shop processes are not needed. Safety devices were almost everywhere present. In 6 plants excellent arrangements were found for general room ventilation. Organized instructions along health lines were given in 7 places, and some attention to this in 1 or 2 more. The workers had sick benefit privileges in factory organizations in 6 instances, although in 2 of_ these only a part were covered. The general construction of machine shop quarters was good in 35 places, fair in 6, and bad in 10 (the remaining 5 not being reported upon). In 22 places, other processes were at hand, such as Metal Grinding, Polishing, Tempering, Wood Working, Painting, Welding, Blacksmithing etc. Age group estimations summed up as follows : Number of Age Groups. Wage-earners Over 50 years 75 45 to 50 271 40 to 45 491 Under 40 ' 3,245 Dust was no hazard in 35 places, and in but 3 was it marked enough to de- mand attention and here it was due to other processes (grinding, polishing). Thirty-two places were kept very clean and orderly, 10 more fairly so, and the remaining 14 not so. Cuspidors and refuse cans were present more often in machine shops than most other places investigated. Dry sweeping during work hours was occasionally observed. In 5 places quarters were rather damp, due to location, and, occasionally, wet grinding. Natural light was good in 46 places, fair in 5 more, and poor in the remaining 5. In a considerable number of places artificial lighting was done chiefly with naked electric lamps, sus- pended overhead, and often very inefficient as regarded general room illumina- tion. In 1 .place mercury arcs wefe used for lighting. The air condition of the various machine shop processes seemed good in 41 places, fair in 12 others, and poor in only 3. This high percentage of good air condition is due to the usually spacious quarters, and the absence of industrial factors in the process to contaminate it. Fatigue, in the general routine of machine shop work, is a negligible factor, but a good percentage of the employes were found to be sub- jected to various hazards as follows: hurrying piece-work, 14; excessive noise, 1 12; constant standing still, 8; monotonous application, 3; while sedentary ! processes on chairs or stools without backs, faulty postures, jarring processes, (pneumatic tools, drop presses, etc.) and prolonged pressing of objects against the person were observed in many manipulations. The workday was found to be from 9 to 10 hours in all except one place, where it was lOJ. Saturday afternoons were about evenly "off" and "on". The noon recess was 1 hour in 1 place, I hour in 48 places, I hour in 2, and not determined in the remaining 1. The liability to the contraction of communicable diseases was considerable in 6 places, fair in 21 more, and questionably negligible in the remaining. The chief factors, where present, were the use of common drinking cups, poor closets and washing facilities, and promiscuous spitting. The oil-soaked floors 147 and lack of dust, however, in a great majority of places, rendered the hazard less likely. Another hazard observed w^as the likelihood of infections from the use of wiping rags and waste from any and all sources. Particularly should be mentioned here virulent pus infections (blood poisoning), erysipelas, lock- jaw, as well as the problematical acquisition of contagions, such as smallpox, diphtheria, measles, tuberculosis, and other communicable diseases like typhoid fever. Our attention was called in 1 place to the fact that tubercle bacilli had been isolated from the oil used in screw machines, evidently due to the fact that workmen spit into it during its flow through the machines. It was found that the "safety first" idea had spread the principles of "first aid" in preventing infections in a number of places. The only poisons encountered in machine shopping were occasional exposures to lead (in tempering, soldering, in rich lead alloys worked upon), benzine, paint solutions, and brass. Occasionally forge gases and potassium cyanide tempering or case-hardening were carried on. The industrial inducement to alcoholism, and stimulantism was considered a fairly negligible factor in almost all places. Where present, such was due to fatigue factors, the absence of good thirst-assuaging facilities, and the depress- ing influence of general insanitary conditions. The general appearance from a health point of view of the mass of workers in this process was good in 43 places, fair in 8 more, and not good in the remain- ing 5 — the latter including some large places where a poor class of help and females were employed. The complaints which workers made were localized to certain insanitary conditions in their own plants. Our investigators came across 2 cases of open consumption, and here and there skin afflictions, such as "brass rash" and certain numbers of pale, anemic and unhealthy looking workers. Comments. — The reduction of certain monotonous and hurrying piece-work operations for workers in some plants, and attention to general sanitary and hygienic features are the suggestions offered. The more general use of goggles, gloves, cotton in the ears for noise, and first-aid equipment is needed in many places. Obviously, the presence of other noxious processes should be separated from that of machine shopping. Boiler Making is a procedure in which at least two hazards were found to exist : excessive noise of a reverberating character, producing in practically all workers deafness usually of considerable extent ; and heat, where workers were in confined spaces during the process of hot riveting. Riveting is a process in which excessive noise is produced, which is con- siderably worse if in confined quarters. Workers who handle pneumatic riveters have the same hazard to the muscular and nervous systems as do all workers using these vibrating types of tools. "Occupational neurosis" is the term applied to the condition which develops. TEMPERING. The process of tempering, that is, hardening of metals and metal surfaces, was found to be carried out by several methods : simply heating and cooling, or heating and dipping ihto water or brine, or dipping into hot baths of lead, oil or potassium cyanide, or sprinkling on potassium cyanide and heating in an oven. Case hardening was done chiefly with potassium cyanide. The process was investigated in 31 establishments in 9 cities, and employed a total of 326 wage-earners, all males. It was found to be used in connection 148 with the following industries : Cutlery and Tools ; Foundry and Machine Shop Products ; Springs ; Automobiles and Parts ; Bolts ; Nuts ; etc. ; Electrical Ap- paratus; Files; Sewing Machines; Bicycles and Parts; Iron and Steel Mills; Stamps and Stencils; and Cash Registers. Tempering was usually done in connection with the blacksmithing and forging quarters, but, occasionally, elsewhere. It required expert men for some purposes, while a considerable .number of ignorant foreigners were en- gaged at it for other purposes. Health appliances consisting of hoods with vents (and sometimes air blasts and fans' to blow back heat and fumes) were found efficient in 5 places, fairly so in 8 more, and absent in 18 (in a few of which but little tempering was done). Some instructions concerning avoidance Fig. 43. Blacksmithing and Tempering. Note ventilating hoods and stacks over furnaces. The stove-like furnace to the left is where tempering is done in molten lead or potassium cyanide. of poisoning were given in 4 places, but in the majority of places, where the most deadly poison was used (potassium cyanide), ignorant workmen were employed in handling it. In 7 of the places visited the workers had the privilege of sick benefit associations. In 9 of the 31 places, other processes were conducted in the same quarters with tempering (Forging, Machine Shopping, Metal Grinding, Pickling, etc.). Age group estimations showed 3 over 50; 75 between 40 and 50; 228 between 20 and 40; and 15 under 20 years of age. The hazards of dust, dirt, dampness, poor light, heat, cold, infections and industrial stiumulantism were practically the same as for Forging and Black- smithing. The fatigue factor appeared to be somewhat less. In a few places one cause was hurrying piece-work, along with monotonous application. In some instances the work was very sedentary. Noise from air blasts and other 149 processes was also noted. The workday was found to be 8 hours in 2 places, 8 to 9 hours in 4 places, and 9 to 10 hours in the remaining 25. The noon recess was j4 hour in 2 places, and ^ hour in the remaining 29. Overtime was seldom called for. Poisoning was found to be a great hazard in this process. In 15 of the plants there was a liability to lead poisoning, and in nearly the same number to acute and chronic poisoning from potassium cyanide. Both of these were dangerous in the form of handling, and hot fumes. It was very common to see large pieces of potassium cyanide lying on the edge of melting pots, or nearby, where it was handled by working men of the most ignorant class, often unable to speak English. Other poisons encountered were sulphuric acid, and the decomposition products of hot oil, as well as escaping furnace fumes. The general appearance of workers was good in 19 places, fair in 8 more, while most were sickly looking in the remaining 4. The complaints of workers were the metallic and oil fumes, heat exposure and drafts. In 8 plants our investigators found 13 instances of industrial disease, as follows: lead poison- ing, 12 (7 positive and 5 tentative) ; dermatitis from potassium cyanide, 1. In another instance a peculiar death was called to our attention which may have been due to potassium cyanide. Comments. — As potassium cyanide is the most deadly poison used indus- trially, and as the form in which it is used is the straight chemical compound itself, none but well instructed workers should be employed in its use. All pieces of it should be kept securely locked up, while melting pots should be well hooded and the fumes carried to the exterior. The same precautions should be taken concerning lead as described elsewhere. The workers in many places should also be protected from heat by such means as screens, asbestos shields, air blasts, dark goggles, and, as for all hot-process workers, shower bath provisions. Gloves should be furnished and their wearing insisted upon. In only 2 plants were anything like sufficient precautions taken against poison- ing by lead, or potassium cyanide. The use of patented substances to replace potassium cyanide and claimed not to be poisonous has been called into question by chemists in the case of one of them at least. It is declared that this sub- stance broke up and yielded the poisonous cyanide radical when melted for use. BRAZING. Brazing consists in the heating of two metallic objects in contact until they fuse, usually with the aid of a hard solder, which contains the elements of brass. It is usually done in forges, or at benches by means of a blowpipe or blast. It is adaptable especially to non-ferrous metals. Our investigations covered the process in 4 establishments, in 3 cities, representing 53 wage-earners, all males. The work is more or less skilled. There were no unions. There were also no appliances to remove fumes from the vicinity of the workers. In 1 place goggles were furnished, and the workers were also privileged members of a benefit association. The workday was 10 hours in all places, with ^2 hour noon recess, except in 1 place, where 1 hour was allowed. In 2 places the work was done- in very poorly ventilated quarters, while in 3 places other processes were carried on in the same quarters. There were a total of 10 workers over 40 years and 3 under 20, leaving the balance (40) between 20 and 40 years. The chief hazard was found to be the fumes which arose during the process, and were composed very largely of zinc, mixed with fuel gas. In 3 I50 places, 7 workers were found who were subject, off and on, to "brass chills" or "braziers' disease." In 1 case a grinder in a neighboring room also suffered similarly. The condition was said to be much worse in the winter. In addition to this hazard, the general ventilation of quarters was bad, the Heat was rather oppressive, while no particular precautions were taken against any of the fea- tures which tend to promote communicable diseases. Because of the peculiar drying and irritating effect of these fumes upon the throat, there was great inducement to industrial alcoholism among workers so employed. Comments. — With few exceptions all brazing stands should be carefully hooded and a good draft provided to remove zinc oxide, and other metallic fumes and gas, as they escape. WELDING. The processes included here are those of acetylene, oxyhydrogen, and electric welding. A brief intervaled contact, such as one sees in the working upon street car rails, was the nature of the electric process occasionally ob- served. Usually, however, the low voltage and high amperage welding were the processes seen. The other forms were less brilliant, but apt to be more prolonged. Welding was investigated in 18 establinshments in 7 cities, and employed 159 wage-earners, all males. The industries concerned were Coffins and Burial Cases ; Copper, Tin and Sheet Iron Goods ; Automobiles and Parts ; Iron and Steel Forgings ; Stoves and Furnaces ; Toys and Games ; Cutlery and Tools; Scientific Instruments; Cars; Iron and Steel Rolling Mills; and Safes and Vaults. More or less skilled hands were employed in 11 places, but ordinary labor in the remaining. Such work was done only at intervals in a number of places. In some 6 places, the workers were, clearly, difficult to keep at the process. There were no union organizations. In 2 places the workers had sick benefit privileges. Appliances consisting of shields to protect the eyes were good in 3 places, and fair in 4 more, while in the remaining 11, in which the brilliancy of light was not quite so great, such protective appliances were not worn. Welding was usually performed in a room by itself, but in 5 places it was done in connection with Machine Shopping, Forging, Tinsmithing, and Metal Grind- ing. The age group estimations were as follows : over 50 years, "2 ; between 45 and 50 years, 2 ; from 20 to 40 years, 155. The chief hazard of this process was the exposure to the light, and, in the case of high voltage electric welding, at least, to the effect of actinic rays. The dazzling brilliancy of the light (said to reach 8,000 candle power and a tem- perature of 7,000° F.) was rendered even more harmful by the fact that it was performed in poorly lighted quarters in a number of places. The light was found to be not only a hazard to the eyes, but also to the skin, even beneath the clothing. In 2 places workers were found suffering from conjunctivitis. Others complained of inability to read at nights, headaches, sore eyes, weak eyes, of the breathing of fumes, and the showers of sparks produced, while hearsay cases of ophthalmia electrica were brought to our notice. This is a condition in which, after a brief exposure, the eyes later become greatly in- flamed and swollen, and exceedingly painful, the condition lasting from a few hours to several days. The extent of permanent damage to the sight and color sense is not fully known, but permanent weakness and cataract has followed. The rays, particularly from high potential electric welding, also produce "sun- 151 burning" of the skin. This was a feature complained of in 5 instances. Being similar to the X-Ray, there is danger of a subsequent formation of cancer, as well as the production of sterility in workers so exposed. In 7 places workers were found to be employed at piece-work. In 4 places there was danger also of poisoning, especially from lead and brass alloys, upon which the work was being done. Comments. — All persons with weak eyes should avoid this process. An oculist should see all employes before they are engaged. All such workers should be provided with protection to the eyes, both against sparks and for the light. While in some forms of the process the amount of light produced can . be easily borne, its alternate flashing and disappearing is damaging to the human eye. In a number of places, complete helmets or head shields, equipped with layers of red and blue glass in front of the eyes, were provided. These should have been used in some other places where only common dark glasses were provided. For the actinic and X-Rays produced, the worker should wear gloves, and at least heavy leather aprons, if not some form of lead foil incorpo- rated in special cloth. Some forms of glass (Euphos and Hallaner glass) are said to absorb electric and actinic rays. Where fume is produced, suction fans, hoods and other exhausts are necessary. SOLDERING. Soldering may be done by hand, or by machinery, the latter especially in the case of the manufacture of tin cans or the sealing of the same in canning factories. In this place we have also included LEAD BURNING, as such work is practically the same as that of soldering (see also Storage Batteries). Solder contains from 30 to 60 per cent of lead. (For hard solder- ing see "Brazing".) The industries in which soldering was investigated were as follows : Cop- per and Tin Goods, 6; Electrical Apparatus, 7; Stoves and Furnaces, 4; Paint Manufacturing (making tin cans), 3; Automobiles and Parts, 3; Instruments, 2; and 1 each of the following : Brass Goods ; Cars ; Coffins ; Art Glass ; Oil Refining; Shipbuilding; Advertising Novelties; Machine Shop Products; Rub- ber; and Chemical Manufacturing. There were a total of 35 establishments in 10 cities investigated, employing 749 employes, of whom 584 were males and 165 were females. A union organization existed in 1 establishment. The employer's interest in workers' welfare appeared good in 29 establishments, and fair in the remain- ing 6. An intelligent type of workers was engaged in 27 establishments, while in the remaining 8 a large percentage of ignorant foreigners were employed at the work. Workers appeared to remain well at the work in at least 27 places. Health appliances, consisting principally of hoods and exhausts, or blow fans to remove solder fumes and gas fumes from the vicinity of the workers, appeared good in 2 places, of fair efficiency in 12 more, but absent in the remaining 21. In 4 places some organized instruction was being given in health conservation. In 6 places workers had the privileges of factory benefit associations. In 19 plants the work was practically all unskilled, and in some of these machines performed the actual process. Workrooms were hygienically constructed in 16 places, fairly so in 11 more, and not so in the remaining 8. There was an estimated total of 10 persons over 50 years, 20 152 between 45 and 50 years, 74 from 40 to 45 years, 610 between 20 and 40 years, and 41 under 20 j^ears. In 14 places other processes were carried on in the same premises, such as Machine Shopping, Polishing, Welding, and Factory Processes. In 2 places dust was a bad feature, due to the presence of other processes, and the same was true to a less extent in 7 more. Such dust helped to spread solder-dust accumulations. Quarters were clean and orderly in 21 places, fairly so in 10 more, and not so in the remaining 4. Natural light was bad in 2 places and only fair in 4 more, while the same faults were to be found with artificial lighting, as discussed elsewhere. (See Machine Shopping.) General room ventilation was good in 9 places, fair in 12 more, and bad in the remaining 14, due to close, stuffy quarters in which the air had no movement; to devitalizing of the air through the presence of gas flames, used in heating the solder; and to the contamination of the air with the products of gas fumes, solder fumes, smoke and acid fumes. In 10 places heat from the process was" some hazard to health, due largeh- to the absence of hoods, protective devices, or air blasts to direct it awaj' from the workers. The process of soldering is not particularly fatiguing in itself, but, in a number of hand-work methods, hurrying piece-work, speeding up, monotonous application at similar movements, and constant strain, mvolving also the eyes, were features, particularly as a fairly large number of youthful persons were so engaged. The workday was found to be 8 hours in 1 place, 8 to 9 hours in 12 places, 9 to 10 hours in 20 places ; while in 1 place, employing 2 men, it was 11 hours per da}-, and 13 hours at night. The noon recess was 1 hour in 7 places, ^ hour in 4 places, J^ hour in 23 places, and "as desired" in the remaining 1. Where there was no night shift work, there was apt to be a little overtime. The liability to the contraction of coininumcable diseases appeared negligible in 6 places, a fair hazard in 16 more, but a con- siderable hazard in the remaining 13. The chief reasons for such hazards were spitting upon floors, the absence of cuspidors, inadequate washing places, the use of common towels and drinking cups, poor closets, and the lack of medical supervision. The chief hazard in soldering is tha.t of poisoning, due to lead (handled, in the shape of fumes, or as fine dust accumulations) ; acids, such as hydrochloric, and acetic (chiefly as hot vapors) ; and zinc chloride fumes, resulting from work upon zinc alloA'S with hydrochloric acid and a hot soldering iron. Near-sighted persons, and others, through habit, often kept their faces dangerouslj- close to the fumes arising during hand-soldering. Occa- sionally wood alcohol was also used. With machine soldering the hazards of poisoning were somewhat less, although the extra quantity of fumes present increased the danger unless ventilation about the machines was very good. In 5 places, employing 70 persons, the risks of poisoning appeared negligible ; in 15 more there was considerable hazard, Avhile in the remaining 15 it was bad. Inadequate washing facilities and eating at the work benches or around the machines were decided factors, in addition to the methods of working. The industrial inducement to stiniulantism was about in proportion to the effects of the poisons, since the other hazards were not considerable. Added to this was the frequent inadequacy of drinking water facilities in a number of places. The general appearance of the workers averaged good in 21 places, fair in 10 more, and bad in the remaining 4, although here and there a pale or sickly looking worker was found in nearly all place?. The chief complaints of the 153 workers were the obvious danger from breathing lead fumes, the effects of acid and other fumes upon the nose, eyes, and throat, the poor ventilation of work quarters, and the danger of getting foreign bodies in the eyes. Personal complaints were sore nose, sore throat, pains in the chest, nausea, loss of appetite, coughing and headaches, in addition to various digestive and nervous disorders which were often clearly due to slow lead poisoning. In 12 places our investigators reported the following instances of occupational diseases: lead poisoning, positive, 6; tentative, 4; partially recovered from, 3; a number of hearsay cases were reported; in addition there were cases of tuberculosis, which the fumes appeared to activate. Comments. — None but healthy workers, who have passed nose, throat, eyes and chest examination should be employed as hand-solderers ; work should be so arranged that either the worker is not continually bent over the soldering iron, or a local flexible exhaust arrangement is provided to remove fumes. Particularly is this so where workers have to enter confined spaces, as installing refrigerators in cars, etc. Needless to say that in all rooms in which gas flames are burning constantly, extra efforts towards renewing the air, and especially towards keeping it in motion should be made. Placards warning employes upon how to prevent lead poisoning should be posted ^, while in certain sub-processes, workers should be examined periodically for evidences of lead poisoning, when, if found present, they should be put at some other work for a time. — There is also danger of arsenic poisoning wherever acids are used upon metals (the arsenic being present in both the crude acids used and in the metals). Symptoms are apt to come on hours after breathing the fumes with difficulty in breathing leading to pneumonia-like signs, pains in the abdomen, passing of blood in the urine, onset of jaundice and finally death perhaps after several days. (Arsine is the poison inhaled.) PICKLING. "Pickling" is a process to remove the "scale" to which sheet iron, black plate, etc., is subjected in preparation for galvanizing or tinning. It is prac- tically always done with the aid of machinery, which dips the sheets up and down in the pickling solutions, the sheets standing on edge in the racks of a cradle. It is the duty of the workers to place the sheets in the cradle, move or revolve the cradle from one vat to the other, and to take the sheets out when finished. In the case of pipes and other articles the mechanical process. of course, differs somewhat. The solutions used are usually a double acid bath, "black pickle" and "white pickle," in which sulphuric acid, in comparatively weak solution in hot water is used, or hydrochloric acid may be used in cold water. Thereafter the pickled material is rinsed in running water, or in alkali water and then plain water. The process was investigated in 16 establishments, in 12 cities, and in the following industries: Iron and Steel Mills; Tinning; Galvanizing; Auto- mobiles; Wire; Foundry and Machine Shop Products; Signs and Advertising Novelties. There were a total of 180 wage-earners employed, all males. In but 1 small place was the process done by hand. As a rule, but a comparatively few men were required to perform this work, even in large establishments. In the places investigated, the attitude toward employes seemed very good in 10 places, fair in 5 more, and bad in 1. The type of workers was good in 6 154 places, fair in 4, and largely ignorant foreigners in the remaining 6. The men appeared to remain fairly well at the work in 14 of the 16 places. In 3 places health appliances, consisting of hoods covering the pickling vats, were good; in 2 places they seemed fairly efhcient, in 1 place, bad, while in the remaining 10 they were entirely absent. Some instructions were given concerning em- ployes' health in 1 place, and in 4 places sick benefit associations existed. The work quarters were hygienically well constructed in 7 places, fairly so in 4 more, and not so in the remaining 5. Other processes were present in 6 places, usually Galvanizing, but in large mills various kinds of work were done in the same premises. Age-group estimations summed up as follows : over 50 years, 3 ; between 40 and 50 years, 14 ; and between 20 and 40 years, 163. Dampness was a considerable hazard in 5 places, and to some extent in 8 more, due to the splashing of floors from the process and the absence of good drainage. In 4 places light was very poor and in 2 others it should have been much better. The ventilation of quarters was not good in half of the places. In 4 places exposure to heat was a hazard, and particularly so in 1. There was also some risk, from cold drafts, combined with working in a humid and steamy atmosphere. For the type of men employed the work itself was not fatiguing, although considerable lifting, constant standing, monotony, and hurry- ing piece-work, combined with evidences of "speeding up," were present. In addition, hours were uncommonly long in some places. The workday was found to be under 9 hours in 2 places, 9 to 10 hours in 7 places, and from 11 to 12 hours in the remaining 7. The noon recess was 1 hour in 5 places, % hour in 2 places, ^ hour in 8 places, and "as desired" in 1. Night shifts were the rule in some of the places. There was some risk of contracting com- municable diseases in all except, possibly, one place, due to the use of common drinking cups, absence or inadequacy of washing facilities, crude sanitary con- veniences, frequent injuries and cuts, short-intervaled handling of materials by different workers, etc. While few precautions were observed as to spitting, the floors were usually wet, and dust was not a feature. The liability to poisoning lay in the effects of acid fumes and in one or two instances, alkali vapors, as well as hot cyanid solutions in adjacent electroplating processes. While sulphuric acid itself is not volatile, steam particles easily carry it. The same may be said of the alkali solutions. The effects of such poisonings are local upon the nose, throat and digestion, and especially upon the teeth ; as the fumes also incite coughing, they are very predisposing to lung diseases. The solutions are usually not strong enough to affect the skin or eyes, except in the case of overly susceptible persons. The inducement to industrial alcoholism depends, first, upon the amount of nausea or gastritis which the breathing of the fumes may produce; second, upon the depressing influences of long hours, lack of good drinking facilities, and washing facilities. The workers perspire very freely. The work is sloppy and steamy. The general appearance of the workers was good in 6 places, fair in 9 others, and bad in the remaining 1. Their chief complaints (although a com- paratively few complained at all) were irritation of the nose and throat, cough- ing, heat, fatigue, and breathing of sal ammoniac fumes from nearby galvanizing processes. Our investigators found a considerable number of workers with very bad teeth, as well as pyorrhea, the effects, unquestionably, of the small but constant amount of acid vapors which they breath. Comments. — In 1 place the employer remarked that "the men get fat on it," but all who were seen were sickly looking, while the Tuberculosis Depart- 155 ment in that city had notified us of a case of consumption which had come from the pickling room of this plant. In addition to hoods and stacks to draw off fumes, or drop-partitions around pickling vats, workers should be supplied with every convenience to keep dry, and to enable them to go home properly clothed, such as rubbed boots and aprons while at work, and locker rooms, shower bath quarters, etc., for bathing and changing purposes at quitting time. — See Comments on arsenic poisoning under "Soldering," whenever acids are allowed to act on metals. GALVANIZING. Galvanizing consists in the dipping of previously "pickled" sheet, pipes, or other metal ware (iron or steel) into baths of molten zinc, in order to give them a very thin coating of this metal. The process is usually done with mechanical cradles, or other forms of conveyors, but small pieces may be handled by hand. The process was investigated in 16 establishments. Our report covers 14 establishments, located in 11 cities, employing a total of 724 wage-earners, all males. In a few instances in the state. Galvanizing is done as an independent business, but the vast amount of the work is turned out of Iron and Steel Rolling Mills. The process was very similar in all of the mills investigated. The employers' interest in workers' welfare was very good in 11 places, while in only 1 did it seem to be quite lacking. The general type of workers was good in 8 places, fair in 3, and poor in 3. In 11 places the workers were very well retained, while in but 2 places, employing a total of less than 20 men, were they of an unsteady character. Health appliances, consisting of hoods with stacks or other arrangements to draw off zinc and other fumes, were found present in 7 places, in 4 of which they were only partly efficient, but in the remaining 7 they were entirely absent. In 5 places instructions along lines of health conservation were given to workers, and in an organized way in 3 places. In 5 places workers had the privileges of sick benefit associations. The work quarters were hygienically well constructed in 10 places, fairly so in 2 others, and not so in the remaining 2, the latter employing a total of 32 workers. Other processes found present in half of the places were : Pickling, Acid Dipping, and some Machine Shop Work. Age-group estimations summed up as follows : % No. of Age Groups. " Wage-earners. Over 50 years 2 45 to 50 " 4 40 to 45 " 57 20 to 40 " 661 The damp character of the work was a hazard in 9 places, particularly in 1, due to the proximity of the pickling process. The ventilation of quarters was good in 2 places, fair in 7, and bad in the remaining 5, due to contamination with various fumes. The heat from the process was some hazard in 8 places, particularly in 1, while exposure to cold drafts when leaving the vicinity of the galvanizing furnaces, and vats was another risk which a majority of the workers ran. The work may be more or less fatiguing. In this respect investi- gators commented upon the following features, arranged in descending order : 156 long hours, hurrying piece-work, monotonous application, constant standing, and, in one or two instances, loud noises as well as laborious work. In mosl places there was some opportunity of work variation. The workday was found to be 8 hours in 1 place, 8J in 1 place, 9 to 10 hours in 5 places, 10 to 11 in 3 places, and 11 to 12 in 4 places, while night shifts were the rule in 7 of the places investigated. In 6 of these latter, two shifts made up the twenty-four hours, and in the remaining one, three 8-hour shifts were engaged. The noon recess was 1 hour in 2 places, ^ hour in 7 places, while with night shifts in the other places, it varied from "as desired" to J hour. The liability to the contraction of com- municable diseases had the usual hazards as mentioned under Pickling, although they were rather less present in the places in which galvanizing was seen. The chief hazard in the process is poisoning, which may be due to zinc fumes (less marked than in brass founding) ; lead (a small amount of which is usually added to the zinc bath) ; to sal ammoniac (used to keep the zinc from burning) ; and to the fumes from the pickling processes, if located nearby. There was little risk of acute or sudden poisoning from any of these. The risk of slow poisoning was considered negligible in 1 place, fairly so in 7 more, but con- siderable in the remaining 6. The forms of poisoning which may be present are: "zinc chills", chronic lead poisoning (except to the person who handles lead this risk is only nominal), catarrhal trouble, due to the sal ammoniac fumes, and carious teeth as well as pyorrhea, as noted among the "picklers". The industrial inducement to alcoholism is about in proportion to the exposure to fumes, to which should be added the depressing effects of fatigue, long hours, lack of washing facilities, and good drinking water properly supplied. The general appearance of workers was good in 6 places, and fair in the remaining. There were not many complaints made by workmen (few could speak English), but these consisted of the irritating effects of the fumes, as well as of "metal chills". The investigators reported specific occupational com- plaints, as follows : 3 with burns, 2 who mentioned "zinc chills", and 1 in whom the breathing of the fumes had produced chronic bronchitis. In addition, skin irritations and ulcers were brought to notice. Foremen in a number of places spoke of "chills", if the zinc got too hot. Comments. — As stated above, only half of the places were supplied with hoods and arrangements to remove the fumes. While an endeavor is made in all places to keep temperature down, so that the zinc does not burn up, there is some escape from this in most places at different times of the day. The white fumes of sal ammoniac are constantly present. Workers should also be supplied with proper gloves, aprons, and footwear to protect them from burns and other mishaps. In some places they were found equipped with old gunny- sacks for aprons. Where lead is used, workers should be examined at intervals for any evidence of slow lead poisoning. Being hot work, change rooms, shower baths and lockers should be provided. — See, also, comment upon arsenic poisoning under "Soldering", whenever acids are allowed to act on metals. TINNING. Tinning or tinplating is a process in which a very thin layer of tin, often largely mixed with lead, and sometimes zinc, is applied to sheet iron, or black plate, or castings. (In some places it was said no lead was used.) Terne plate may contain up to as high as 75% lead. The process varies in different places. 157 The following is the usual method. Sheets from the "white pickle" are dipped (by hand or machinery) into a flux of sal ammoniac, hydrochloric acid and zinc, then into 70% lead (sometimes omitted), then into pure molten tin from which they emerge under a layer of palm oil or other oil. They are next polished and cleaned by hand or in rollers with middlings (bran), ground peanut shells, or sawdust and rags. The hand dipping is done by skilled men who use tongs to hold the sheets. Tinning was investigated in 13 plants, located in 9 cities, and employed a total of 583 wage-earners (exclusive of "pickling", etc.), of whom 508 were males and 75 were females. The females were employed as sorters (and occasionally as polishers) to pick out the "wasters" after the tinning process was completed. The vast majority of workers were employed at the process in connection with Iron and Steel Rolling Mills, where the black plate was also made in preparation for tinning. A union organization existed in 1 place investigated. The interest which employers took in the welfare of workers appeared to be very good in 6 places, fair in 5 more, and practically lacking in the remaining place, which also was a big employer. In 8 places an intelligent class of workers was employed, in 2 others fairly so, while in the remaining 2 they were largely ignorant foreigners. The workers appeared to remain steadily in 7 places, fairly so in 3 more, and not so in the remaining 2. Health appliances, consisting of hoods, with vents and sometimes exhausts to draw the fumes off from the tinning vats, were good in 3 places, fair in 3 more, but absent in the remaining 6. In 1 place organized instruction along health conservation lines was given : but very little attention was paid to this in the remaining 11. In 2 places sick benefit associa- tions existed. The tinning quarters were hygienically well constructed in 5 places, fairly so in 3 more, and not so in the remaining 4. In 2 places other processes, such as pickling and polishing were carried on in the same quarters. The vast majority of workers were between 20 and 40 years of age, while a few were under 20. Dust, dirt and disorderly surroundings, dampness (water, steam and humidity), heat (from the process itself), exposure to cold (by drafts and hav- ing to go to outside closets), and poor lighting arrangements — all of these constituted from fair to bad hazards in from J to J of the places investigated. General ventilation was good in 3 places, fair in 5 more, btit poor in the remain- ing 4, due to contamination with the fumes of oils and greases used, and metals, as well as to deoxidation through the presence of furnaces in confined work quarters, and to the lack of means of keeping the air in circulation. In 2 places steam was excessive. Fatigue seemed to be a fair hazard in 5 places and considerable in the remaining 7, the chief reasons being hurrying piece-work in monotonous and straining manipulations, and less often long hours, noise, con- stant awkward positions, and occasionally jarring work. The workday was found to be 8 hours in 1 place, 8 to 9 hours in 3 places, 9 to 10 hours in 1 place, 10 to 11 hours in 4 places, and 11 to 12 hours in the remaining 3 places. Xight shifts were the rule in several of the large places. The noon recess was 1 hour in 3 places, about f hour in 6 places, and \ hour in the remaining 3. Constant standing in the case of females while inspecting, polishing and sort- ing sheets of tin was also noted. Eyestrain, due to glancing of light on the polished sheets of tin, as the females turned them over, was present. The liability to the contraction of comi>iunicable diseases seemed a fair hazard in 158 8 places and considerable in the remaining 4, due to such factors as promiscuous spitting about the floors, the absence of cuspidors, the great inadequacy of washing facilities, and the little attention paid to toilet arrangements in several places, and occasionally to crowding. There was great liability to cuts and burns of all grades of severity with consequent pus infections, blood poisoning, erysipelas, etc. There was a risk of infection from rags used for polishing purposes. Furthermore, but few of the workers were under medical super- vision. Practically the only females found employed in Iron and Steel Mills were in this division of the work. They were very largely immigrant girls. The poisons used in the tinning process were found to be lead, zinc, tin (there is a question as to this last metal's being a poison), hydrochloric acid, and sal-ammoniac fumes, in addition to the escape of fumes and gases from furnaces in some places. Some risk of poisoning existed in all places, and particularly so in 6. Those who- handled lead directly, or terne plate, very rich in lead, were the most exposed, but there was some risk around the pots from the breathing of lead vapors, created by the constant stirring up of the tin-lead alloy, near which the workers were necessarily closely stationed. The risk of "zinc chills" was also present. The ignorance of the workers, the practice of using palm oil to wash the hands (thus greatly favoring lead absorption through the skin), the lack of instructions concerning the danger of lead poisoning, the lack of medical supervision, and, in several places, the great inadequacy of washing facilities, were other important factors in the risk of poisoning. The industrial inducement to stimnlantism seemed present in practically all places and was influenced chiefly by the exposure to the poison factor, as well as heat, long hours, poor washing facilities, and fatigue, while the character of the drinking water supply was bad in some places. In others, bubbling fountains were the rule. In all large places some workers were seen who were decidedly under par physically, but the general average was good. The complaints of the workers were not numerous, but consisted of poor ventilation, breathing of fumes, work- ing in steam, lack of heat in the winter time, the loss of time from various forms of sickness, metal burns, zinc chloride burns, etc. Our investigators re- ported the following occupational disease cases : lead poisoning, 4 positive, 1 tentative; lead and zinc poisoning, 3 tentative. There were also some hearsay cases of lead poisoning. In 1 place employing only a few men, but 1 worker had remained for two years, and he stated that because of the lack of ventila- tion he had seen 200 men come and go in that time. Undoubtedly his state- ment was considerably overdrawn, but there was considerable exposure at the place. Comments. — Greater precautions should be taken in tining than in galvanizing because of the large percentage of lead which is customarily used. By all means should all alloy pots be well hooded and vented. Washing facili- ties should include shower baths for those at the hot work. We are confident that for a physician to see each worker for three to five minutes once a month, the gradual progress of slow lead poisoning, which is certainly present in a good percentage of the workers, could be prevented. ACID DIPPING. Acid dipping is a process preliminary to electroplating, in which metal pieces are dipped into jars or vats of acids (usually a strong mixture of the inorganic acids, HCl, HNCi, and H^SOj), in order to cleanse the surfaces from 159 oxides and corrosive deposits, and other accumulations. The process differs from "pickling", chiefly in that acid dipping is done in cold, strong acid solu- tions, and smaller objects are usually so treated, while in "pickling", hot solu- tions of weak acidic character, sometimes with alkaline treatments as well, are used. Acid dipping is usually done by hand or some form of holder; pickling, by mechanical means. Acid dipping is a very rapid process, requiring but a moment for a dip, while pickling takes from five to twenty minutes or more in each solution. We here report upon this process as investigated in 5 establishments, in 3 ,^cities where it was found to employ a total of 32 workers, all males. There was a tendency to employ youths at the process, although there were 4 persons Fig. 44. Acid Dipping in Plating Room. Slot ventilator along wall connected with powerful exhaust. Note slatted floor treads. Aprons and gloves furnished. observed who were over 40 y^ars of age. Even in the largest establishments the process requires but very few workers. It is also more or less discontinuous, as a rule. In the places investigated workers appeared to remain well in most instances. There were good health appliances in 3 plants, but these were absent in the remaining 2 where a total of 8 men were employed. In 1 place the 8 or 10 employes so engaged had the privilege of a sick benefit association, and their general care was .well supervised. The work required very little skill and in 3 places a very ignorant type of workers was so employed. The work quarters were hygienically well constructed in all except 1 place. In large places the process was by itself, while in others it was usually found in a corner of the plating room, or polishing and buffing rooms. The chief hazard is the breathing of strong, mineral acid vapors, which are created by dipping metals into such acids. In a number of instances the i6o vapors were clearly visible as the very poisonous brown vapors of nitroso- nitric acid. In neutralizing, vapors were also created from alkaline bath^ (NaOH). In plating rooms there was also the risk of potassium cyanid and other poisons used. The liability to poisoning, particularly from acid vapors, was considerable in 1 place, and fairly so in 3 others, due either to the absence of a ventilating hood having good draft, or to the carelessness of the workers in creating and distributing vapors, particularly where such were not plainly visible. In one place the work was done in front of an open window where the breeze drove the vapors directly towards the worker. Other hazards to acid dippers were the dampness of quarters, due to the vats of rinsing water, often splashed upon the floors, and the humidity from steam arising from hot water cleansing baths. All workers were found to be engaged from 9 to 10 hours, while in 3 places the noon recess was only J hour. Comments. — Acid dippers should be protected by a good hood and local exhausts, or other very efficient means of confining the vapors ; also with rubber gloves, rubber aprons, and perhaps rubber boots, if the work is of a splashing character at all., It must not be forgotten that a single exposure of only a few moments to breathing nitroso-nitric acid vapors, may result in pneumonia within 24 hours, or, later, to a permanent nervous affliction, char- acterized by constant tremors. The situation is similar to exposures which firemen suffer when carboys of acids are broken in storage rooms and other places during fires. In the recent New York disaster, in which a hundred persons or more were exposed to breathing nitric acid vapors in a sub-way accident, the subsequent death rate was over 25%, all of which followed be- tween a few hours to a week afterwards. ■ — See also, comment on arsenic poisoning tmder "Soldering" wherever acids are allowed to act on metals. ELECTROPLATING. The process of electroplating consists in placing the metals to be plated in a solution of an electrolyte through which an electric current is passed. The electrolytic solution is usually contained in rectangular shaped tubs or vats which stand about waist high, and the objects are hung in the solution for a period of hours. The electrolyte varies in composition according to the metal to be deposited. The process was investigated in 43 firms in 7 cities and engaged 532 wage-earners, of whom 510 were males and 22 were females, (the latter all employed in one place where plating, buffing and coloring lead composition ornaments was done). Comparatively few employes are required for the process even in large stablishments. The industries covered were Art Glass; Automobiles; Bolts and Nuts; Brass and Bronze Products; Cash Registers; Coffins; Copper; Tin, and Sheet Iron ; Electrical Apparatus; Electroplating; Foundry and Machine Shop Products; Furniture; Instruments; Regalia; Signs and Advertising Novelties; Stereo — and Electrotyping'; Stoves; Safes and Vaults ; and Wire Manufacturing. In 2 of the places investigated unions existed. The employers' attitude toward welfare of workers appeared very good in 26 places, fair in 12 more, and not good in 4 places. The general type of workers was an intelligent class in 29 places, and fairly so in 10 more (not reported upon in 3). Practically all of the workers were skilled in 8 places, and a majority of them in 15 more, but in 20 plants a large percentage of unskilled workers were employed. In all lOl but 4 places, workers appeared to be retained fairly steadily at the process. Health appliances, consisting of hoods and vents, particularly over hot cyanide solutions, and over steaming rinsing tubs, and occasionally room exhaust fans were found present in 23 places, in 18 of which they were very efficient. They were absent in the remaining 20, in a few of which they were not needed. In 8 places some instructions were given in health precautions, but the workers were very ignorant of the exposure to poisons in most of the balance. In a like number of places sick benefit associations existed. The general construc- tion of workrooms was hygienically good in 19 places, fairly so in 6 more, and not so in 15 (the remaining 3 not reported upon). In 21 establishments other processes were carried on in the same quarters, such as Polishing and Buffing, Lacquering and Shellacing, Acid Dipping, Enameling, Electrotype manufacture. Fig. 4.V Aci;)-Dippix(; jx Plating Room. Xutc xentilatur over acid jars. Ruljber gloves and apron funiislied. Xote also health placard (overhead to the right). storage, etc. The age-group estimations summed up as follows : over 4n years, 70; under forty, 462, of whom about 10 per cent were under 20 years. In 9 places, dust, which was due to the presence of other work, con- stituted a hazard to the electroplaters. Quarters were kept orderly and fairly well clca)icd in all but 2 places. WhWe water and steam are necessary features, these constituted no hazard in 20 places, and were a bad feature in only 7, where enough provision was not made for drainage from the floors, or the removal of steam from the air, or the workers were not supplied with proper clothing. Some quarters were very humid and were not supplied with foot treads or grates to keep the feet off the wet floors. Quarters were well lighted in 33 places, fairly so in 4 more, and not so in the remaining 6. The character of thv wnrkronm I'ciihhtluni was fair to gcind in I'l places. l)ut this 11 O. D. l62 could not be said for the remaining 22. Usuallj^, contamination with steam, vapors from the tanks, fumes from acid dipping in the same quarters and from other processes were the reasons for vitiated atmosphere. In 6 places it was somewhat warm, but this was not much of a hazard any place. Going home without changing the clothing from the wet and steamy rooms was more of a hazard than heat while at work. Fatigue was not found to be much of a feature in electroplating, but prolonged faulty postures, monotony, and constant standing were some feature. As a rule electroplating was diversified work. The workday was 8 hours in 9 places, 8 to 9 hours in 12 places, 9 to 10 hours in 23 places, and 10 to 11 hours in 2 places (three not reported upon). The noon recess was 1 hour in 27 places, about f hour in 9, and J hour in the remaining 6. The risk of contracting cominunicahle diseases was graded as fairly negligible in 27 places, but more or less bad in the remaining, the chief reasons -being the use of common drinking cups and towels, poor closets, in- adequate washing facilities, and the absence of cuspidors. In some places workers at small work were crowded together, while a large percentage of the workers were under no medical supervision. On account of wet floors and the absence of dust in most places, the risk of spreading disease through spitting was not great. The liability to poisoning was considered to be neg- ligible in 10 places, fairly so in 19 more, but a quite evident hazard in the remaining 14. The types of poisons were potassium cyanide in hot solutions, acid fumes, alkali vapors, copper sulphate, and working with lead (in a few places), while fumes from other processes such as lacquering and acid dipping were frequently present. The industrial inducement to alcoholism or other' forms of stiimilantisin was considered as negligible in 16 places, and fairly so in 22 more, but the breathing of fumes and vapor, the hot steamy atmos- phere in some places, and the rather long hours, especially for young persons, were conducive to this where they existed. The general appearance of the workers was on the average good in 20 places, fair in 17 more, and not good in the remaining, including one or two where large numbers of employes were engaged. Complaints from employes were quite numerous and were as follows : breathing acid fumes, dampness, cyanide ulcers, coughs, colds, throat trouble, nasal irritation, dizziness and headache. In some instances our investigators suffered from difficult breathing and severe headache for several hours after these inspections in plating rooms. Investigators reported a total of 8 occupational afflictions which they came across as follows : cyanide ulcers, 4 ; chronic eczema, 2 ; lung disease, 2. Comments. — On the whole, work in electroplating is not as dangerous as might be expected from the nature of the poisons which are used. An at- tempt should be made to keep the atmosphere in workrooms as nearly normal as possible by providing hoods and vents over hot solutions, acid dipping places, for the escape of steam, etc. While females are rarely employed at this process, in many places they were engaged in lacquering and otlier processes in the same quarters where plating fumes were quite noticeable. Where the processes are necessarily wet and sloppy workers should be provided with the usual means to protect themselves, such as rubber aprons, boots and raised floor tread. Gloves should be supplied for protecting the hands from cyanide solutions, especially where alkalis are also used. Personal carelessness on the part of the workers and lack of instruction are other reasons for dangers to health. i63 In ELECTROTYPING, the design is impressed into wax, this dusted over with graphite powder, then electroplated (usually a copper or nickel deposit is made upon the graphite), then the wax is removed and the thin metallic impression mounted on a lead back, and this fastened to a block of wood. Besides the hazards of electroplating there are those of graphite dust and lead (the latter melted in a pot, ladled out into moulds, cooled and handled). MIXING CHEMICALS. There is a distinction to be made between the mixing (or compounding) of chemicals and the actual manufacture of chemical ingredients. While new substances, of course, result from the mixing of chemicals, such processes are not done with the object in view of making new chemicals as products for sale. In a large number of industries certain chemicals are mixed together, or articles are subjected to chemical action, usually by a few workers, ior use throug'hout the plant, or to make up the principal ingredients worked upon. These chemicals may be in the shape of various dry preparations or of liquids or of volatile substances. The best example of this process is the mixing of paint ingredients with various solvents and vehicles, but this par- ticular branch, as well as some others, are so important that we take them up under separate heads. We cite here only a few of the instances in which chemicals are mixed on the grounds of the various establishments : the mak- ing of drugs, photography and photo-engraving, the preparation of inks, the grinding of dry colors, cleaning processes by chemical means, the mixing of ingredients for rubber, for enamel, paper goods, railway signals, roofing materials, glass, in the refining of oil, the making of perfumes, etc. The chief exposure to which these workers are liable are poisons, which affect primarily the respiratory and digestive systems, the skin, the eyes, and the eliminative organs. The exposures are largely the result of similar environment and methods, and may all be avoided, more or less, by the same measures. Compounding or mixing chemicals is here summed up for 20 firms, located in 11 cities, and employing a total of 138 wage-earners, of whom 127 were males and 11 were females. In 14 of these places the methods used were modern from a mechanical point of view. In the remaining 6 they were more or less crude and obsolete. The vast majority of workers were unskilled labor of changing type, often non-English speaking, while the interest man- ifested in their welfare was usually as nominal as anywhere in the plants concerned. However, in this respect the general attitude toward them seemed good in a total of 13 of the 20 places. In 5 places health appliances were pro- vided and were quite efficient. In 2 places instructions in the care of health were definitely given, while the workers had the benefits of sickness insurance associations in 3 places. The construction of the workplace, as it had a bearing upon the health of the employes engaged in the mixing of chemicals, was good in 14 instances, fair in 2 others, but bad in the remaining 4. In 7 places workers at other processes were exposed to the hazards of this as were these workers exposed to other processes. The age-group estimations for the chemical mixers summed up as follows : over 50 years, 2 : between 40 and 50 years, 7; and under 40 years, 129, while probably 5 per cent of the latter were under 20 years. Dust from the process wasi a negligible hazard in 7 places, fairly so in 4 more, but bad in the remaining 9. In most instances it was poisonous in 164 character as well as being mechanically irritating. In 11 places .quarters should have been kept considerably cleaner in order to insure freedom from dust and fumes arising from this source. In 4 instances water, steam, daiiifness, and oils were also features, while in 2 places the light w^as very poor. There was a tendency to relegate this work to basement rooms or out-of-the-way quarters which were often quite uninhabitable when one considers that workers were supposed to spend 8 to 12 hours a day in them. In this respect some 16 places were deficient in ventilating arrangements so that the air was more or less continuously vitiated. by one or more of the usual causes (deoxidation, con- tamination, pollution, stagnation, and faulty temperature-humidity relations). In 4 places workers were subject to an undue amount of heat while there was the often present risk of catching cold throu;5h going from hot to cold quarters. Fatigue was not a usual feature of this process, although in 2 places it was considered as a hazard. On the other hand, inactiziity from the sedentary character of the work was a feature in 1 place. The workday for this class of workers was 8 hours in 2 plants, 8f to 9 hours in 4 plants, and from QJ to 13 hours in the remaining 14 places. The noon recess was 1 hour in 1 place, i hour in 6 places, ^ hour in 10 places, while in the remaining plant, in which there were two shifts working 11 hours a day and 13 hours at night, workers were not allowed to leave the plant during the entire shift. The liability to contracting communicable diseases was considered negligible in 4 places only. For various places the whole list of sub-factors were present. As these processes were conducted, the risk of poisoning seemed negligible with ordinary care on the part of employes in 4 places, and fairly so in 4 more, while, in the remaining 12, the risk was great and depended very largely upon the surroundings and methods used. It is true that in a number of these in- stances working conditions were satisfactory enough if employes had been informed correctly of the risks of poisoning at hand, and instructed in the avoidance of the same. This responsibility, however, was too often not as- sumed by the employer. Oftentimes the latter acknowledged he was not posted. The industrial inducement to stimulant^ism (principalh" alcoholism) was present in 16 places and especially so in 5, with the poison hazard as the chief cause and the other hazards of dust, vitiated air, heat, cold, etc., coming in thereafter. The general appearance of chemical mixers was good on the whole in 9 places, but below par in the remaining 11, in which a total of 55 workers were concerned. The health complaints and complaints of working conditions by employes were, where English-speaking persons could be interviewed, varied and numerous, and usually checked up very closely with the hazards which our investigators found to be present. A number of cases of Chronic poisoning were discovered by our investigators among these W'Orkers. It is from this class that a considerable percentage of cases which physicians encounter in their practice are also drawn. Comments. — Unquestionably the risk of lead poisoning is the chief one of all the poisons concerned, as lead and its various compounds are so univers- ally used. It may be said that there are practically no lead compounds which are harmless-, since it has been proven that any and all of them, commonly used in industry, are soluble in the stomach juices and hence only have to be swallowed to become a menace. After lead, benzine or naphtha was probably the next in frequency, and thereafter all manners of poisons both organic and i65 inorganic. Very seldom, of course, did workers suffer from acute or sudden attacks, but the characteristic of most industrial poisons is their slow and progressive action, so that it is only after we look over sickness records and death statistics for numbers of years^ that the appalling amount of preventable diseases, and deaths from degenerative diseases, become evident. Since 74 per cent of all trades-persons (as shown in Part II) die unnecessary deaths, it is very probable that 90 per cent of the sicknesses as well as deaths among chemical mixers are preventable. Placards, drawn up by qualified health authorities, explaining the slowly acting poisonous nature of these substances and adapted to each trade process, and explaining to foremen and employes how to avoid poisoning, should be posted up in all of these work quarters. WOOD WORKING. The various carpenter shop, cabinet making, pattern making, cooperage, and veneering processes, which are all that are intended to be included under the term "wood working", were investigated in a total of 50 establishments employing 2,497 wage-earners, of whom 6 were females. The analysis here given is based upon the various wood working processes in" connection with the following industries : Agricultural Implements, Automobiles, Boxes, Carriages, Wagons, Cars, Cash Registers, Cooperage, Coffins, Cutlery, Electrical Ap- paratus, Foundries and Machine Shops, Furniture and Refrigerators, Iron and Steel Works, Oil Rejining, Ship Building, Signs and Advertising Novelties, and Wood Carving. According to the Ohio Vital Statistics report, there were 852 deaths among Workers in Lumber and its remanufacture during the years 1910, 1911, and 1!>12. Of this number 93 or 10.91% died of pulmonary tuberculosis. Among Carpenters and Joiners there were 2,358 deaths, of which number 221 died of pulmonary tuberculosis or 9.37%. These rates compare very favorably with that for all occupations combined for the same years which was 13.3%, and even for those engaged in Agricultural Pursuits (7.13%). The methods observed appeared to be modern in 26 places, fairly so in 18 more, and poor in the remaining 6. The attitude toward employes appeared good in 31 places, and at least fair in the remaining, with the possible excep- tion of one or two where large numbers of foreigners were employed. The general type of workers was fair to good in all except 2 places, while their steadiness in the plants where they were employed was generally good in 36 plants, fair in 6 more, poor in 3 (and not reported upon in the remaining 5). Health appliances, consisting of various blower systems and methods of con- fining dust, were good in 18 places, fair in 4 more, and absent or very in- adequate in 25. In 6 of the places instructions along health lines were found. Benefit organizations covering sickness, and, in some cases, deaths, and pen- sions were present in 13 places. Most of the workers were skilled hands, but still a large number employed at various auxiliary processes "were unskilled labor. Figures on age-groups summed up to show that about ] of the total employes were over 40 years of age, while only a few were under 2<'. Car- penter shops were hygienically well constructed in 13 places, fairl_\- so in 14 more, not so in 17 (and not reported upon in the remaining 6). In about 1/10 of the places other processes were carried on in the same quarters, such as Painting, Machine Shopping, and various factory processes. i66 Dust, derived from wood, sandpaper, sanding belts, and various machines, was negligible in 6 places, a fair hazard in 15, a bad hazard in 25 (and not reported upon in 2). The floors were kept excellently clean and orderly in 5 places, fairly so in 23 miOTe, and not so in the remaining 22. Damp quiarters were a health-hazard in 3 places. Light was good in 38 places, fair in 8 more, and poor in 3. Workroom ventilation was good in 15 places, fair in 21, .^nd poor in 12 places, usually due to an interior or confined location of the carpen- ter shop. Three places were unduly hot, and 2 others fairly so, due to the proximity to other heating processes, the presence of steam chambers, etc. Nine places were not sufficiently heated for winter purposes. Except for the "carpenter's stoop" and certain monotonous piece-work operations, usually requiring constant standing still, the element of fatigue was not found to be Fig. 46. Woodworking Shop. Light, spacious. All dust-producing machines have a powerful exhaust system. much of a factor in the processes. The most striking factor was the ear- splitting noises from certain ripping and planing machines. The workday was fotmd to vary between 8 and 10 hours, the usual rule being a 10-hour day, J hour noons, and Saturday afternoons off. The liability to the contraction of communicable diseases was a considerable hazard in 39 places, the chief reasons being the absence of cuspidors, spitting upon the dusty floors, inadequate wash- ing facilities, poor closets, the use of common drinking cups and towels, and occasionally the crowding together of workers, and dry sweeping during work hours. Medical supervision obtained in 4 plants; first-aid equipments (par- ticularly for small cuts and bruises) were found present in most all places. Poisoning from the woods worked upon was found to be a complaint in 3 plants, but no alkaloidal woods were met with. Complaints were made of 167 "dust bronchitis" and, less often, of the irritating effects of dust from coco- bola wood, rarely from walnut and birch. In some instances gas fumes, steam, and oak fumes from drying ovens were complained of. The presence of other processes rendered some workers liable to poisoning from ammonia, gasoline, and wood alcohol, — these in addition to Painting and Sanding. The industrial inducement to alcoholism was a matter of dust exposure largely, but in some 16 plants drinking water facilities were quite inadequate. The physical appearances of workers were found to be good for practically all persons in 33 establishments, fairly so in 9 more, and not so in 3. A number of industrially maimed workers were seen. The chief com- plaints of the workers were the necessity of blower systems where such were not provided, and the inadequacy of some which were present; occasionally, also, the poor ventilation of quarters, inefficient heating in the winter, and the presence of fumes and vapors from other processes. In several plants all dust producing processes were found to be excellently well taken care of, the more difficult ones sometimes through the ingenuity of the workers them- selves. Comments. — Most of the hazards above mentioned define their own preventions. As with other processes investigated, it would appear that there is great need for an engineering bureau to collect the variovis successful con- trivances which have been made to confine dust and to make them available to all. The fact that wood dust is organic and usually non-irritating, except a few of the rarely used woods, probably accounts for the longevity of car- .penters and their relative freedom from consumption. However, from one large furniture plant employing many foreign laborers, there were 9 cases of consumption reported during the last six months of the survey when an ac- count was kept of the cases of tuberculosis among workers in that vicinity. GLUING, PASTING AND LABELING. The processes indicated in the title are reported upon as investigated in 8 plants, including the following industries : Manufacture of Fancy and Paper Boxes, Patent Medicines and Drugs, Printing and Publishing, Musical In- struments, Paper, Cigar and Tobacco, Regalia and Paint and Varnish Man- ufacture. In these 8 plants there were a total of 194 wage-earners so em- ployed, of whom 56 were males and 138 were females.. Occasionally machine methods were used, but the vast majority of the workers were doing hand work. There were no unions. The general attitude of the employers, the type of the workers, and the steadiness at work places appeared good 'n\ all except 1 or 2 places. In two places heated clothes-lockers were provided to enable employes to dry their outer garments in case of rain. In the same number of places some instructions were given along the subject of health conservation. In 1 place the workers had the privileges of an employes' ben- efit association. In 4 places workers were at least semi-skilled. Workrooms were hygienically constructed in 4 places, fairly so in 3 more, and not so in the remaining 1, while in the case of Cigar Making, especially, other processes were done in the same quarters. There were 18 workers over 40 years, and a considerable number, especially females, under 20 years. The chief hazard was the licking of labels by a certain number of the employes in different industries, although they were all provided with other means of moistening them. Steaming ketlles of glues and pastes produce4 i68 • considerable humidity m some places. A number of samples of paste and glues were examined chemically, but no poisons (metallic) were found. Some workers, however, were associated with art work (see Printing) . Instances were cited where workers were found unable to tolerate the odors of hot glue, particularly fish glue. In a number of places fatigue was some factor, due to hurrying piece-work, with monotonous and often sedentary application, faulty postures, and, in the case of machine work, jarring processes, and occasionally loud noises. In 1 place the workday was 8 hours ; in 1 place, 8J ; and in the remainder from 9 to 10 hours. The noon recess was 1 hour in 4 places, f hour in 1 place, and J hour in the remaining 3. General sanitary ar- rangements and workroom h3'-giene ranged from fair to bad in half of the places investigated; they were good in the remaining. Coiiments. — (See also General Factory Processes.) Labelers run the risk of lead poisoning in paint factories where the filled and sealed cans come to them often finger-marked with fresh paint. The lahefers handle the cans (some of them carelessly) and • moisten their thumbs in their lips to expedite the handling of the labels. — Likewise, in the tobacco and cigar industrj^, it is the materials handled (usually b}^ females) which tend to nauseate and produce digestive troubles. PAINTING AND VARNISHING. These two processes are usually carried on by the same workers and the terms stand for a varietj' of sub-processes, which include the brushing on of paint and varnish, filling, rubbing, sandpapering, staining, priming, oiling, dip- ping b}^ hand or machinery, spraying, stenciling, hand decorating, striping, and polishing. Sometimes the work is associated with shellacing, lacquering, enameling and japanning, but it is not intended to include these here. The indoor painting shops (these only are considered here) were investigated in 127 establishments, located in 15 cities, and emplo}-ing a total of ■2,.382, of whom 2,328 were males, and 54 were females. The industries in which painting was investigated were Agricultural Implements, 8; Art Glass, 5; Automobiles, 23; Bicycles and Sewing Machines, 1 ; Brass and Bronze Products, 2 ; Carriages and Wagons, 47 ; Cars, 8 ; Coffins, 3 ; Electrical Apparatus, 4 ; Enameling and Japanning, 1 ; Foundry and Machine Shop Products, 4 ; Furniture, 1 ; Iron and Steel Mill Products, 2; Photo Art Work, 1; Safes and Vaults, 3; Shipbuild- ing, 2; Signs and Advertising Novelties, 6; Regalia, 1; Toys and Games, 2; Wire Manufacturing, 1. ■Ohio Vital Statistics Reports for the years 1910, 1911 and 1912 show a total of 1,025 deaths among "painters, glaziers, varnishers, and paperhangers". of which number 185, or 18.05 per cent died of pulmonary tuberculosis. The figures upon tuberculosis must be regarded as quite conservative, or too low for the class of painters and varnishers (indoor workers) which we are con- sidering here. Also the hazards for glaziers and paperhangers (these workers could not be separated) are much less than for indoor shop painters. The above rates should be compared with the pulmonary death rate for all occupa- tions combined during the same years, which was 13.3 per cent, and also to that for Agriculturists which was 7.13 per cent. Also with Carpenters. Union organizations existed in 9 of the places investigated. Interest in employes' health and welfare was very manifest in 65 places, fairly so in 30 niore, and only questionably so in the remaining 32. An intelligent type of J workers were einpIo3'ed in 93 places, fairly so in 25 more, while in 9 the}' were practical^ all an ignorant type of foreigners. Apparent endeavors were made 10 keep the same workers in 9U of the plants, fairly so in 17 more, while little thought appeared to be given to the personnel in the remaining 20. In a total of 17 places, various forms of health appliances were found, consisting of hoods and vents to remove fumes, vapors and dust, and to promote better ventilation in work quarters. These appeared to be efficient in 7 places, fairly so in 4 others, and not so in the remaining 6. In 110 places there was nothing present which could be so designated. In many of these, of course, the work was done in very spacious quarters so that some hazards were correspondingly less. Instructions concerning the dangers of poisoning were well given in 10 places, and fairly so in 7 more, but in the remaining 110 but little attention was given to this, and in some places very crude ideas existed concerning the methods of preventing poisoning. Sick benefit associations existed in 12 places. The general construction of work quarters was hygienically good in 39 places, fairly so in 46 more, and not so in the remaining 42. Other processes - were present in about i of the places, such as wood-working, machine shopping, and general factory work. Age-group estimations summed up as follows : No. of Age Groups. Wage-earners Over 50 years 82 45 to 50 years 88 40 to 45 years .200 20 to 40 years 1,957 Under 20 years 55 Total 2,382 The work was done without the creation of dust and dust was a negligible hazard in 53 places but it constituted some hazard in 23 more, and a bad hazard in the remaining 51. Its danger consisted especially in its lead content. The chief source of dust was the sanding, sandpapering, or dry "rubbing down" of painted surfaces, or surfaces which had been previously lead filled. In the case of some fine work a great many coats of paint were applied on a lead priming coat, and each coat "rubbed down", or sanded by hand. Oftentimes the worker was in a confined space and unable to avoid the dust created. Very often it was impossible to control the dust and keep the worker from breathing- it by any other means than the constant wearing of a respirator, to which the workers usually had violent objection. In 31 places premises were kept clean and orderly, and fairly so in 54 more, but not so in the remaining 42, so that the paint and dust which was allowed to accumulate constituted a hazard in these proportions. A few places kept floors clean by laying papers down be- fore beginning work. In a total of 16 places dampness, due, sometimes, to location of the workroom, constituted a hazard. This was bad in 4 places. Also the process of. water rubbing added to it in a number of places. Quarters were naturally well lighted in 104 places, only fairly so in 18 more, and not so in the remaining 5. \^ery often the use of naked electric lamps was depended upon for artificial lighting. Quarters were well ventilated in 41 places, fairly so in 45 more, but not so in the remaining 41. The reasons for poor air con- 170 ditions were contamination with various paint and varnish fumes, chiefly, but also the absence of air-agitators, or room exhaust fans in a large percentage of such places, or a fresh supply of air to workers in confined places (ships, cars, cabinets, vaults, etc.). Quarters were warm enough to be of some hazard to health in about 20 places, especially since they were constantly so. Usually, the heat was due to maintaining warm quarters to promote drying of painted and varnished surfaces. On the other hand, quarters were inefficiently heated for winter work in many places. (This does not include the painting of cars which is often practical}- out-door work.) Fatigue was some factor in about 3 of the places investigated. The reasons for this were, in descending order : hurrying piece-work, monotonous application at the selfsame movements, pro- longed standing -in one place, and, in a number of instances where workers were seated, no backs to the chairs or stools furnished. The workday was 8 hours in 7 places, 8 to 9 hours in 33 places, 9 to 10 hours in 62 places (and not determined in the remaining 25). The noon recess was 1 hour in 39 places, about f hour in 17 places, ^ hour in 61 (and not determined in the remaining 10). The liabilitj' to the contraction of communicable diseases was graded in 122 places as follows : negligible, 12 ; fair risk, 42 ; bad risk, 68. The chief causes were promiscuous spitting where more or less dust existed, the ab- sence of cuspidors, absence or great inadequacy of wash-places, poor closets, common drinking cups, and towels. Occasionally workers were closely crowded. Also wiping rags from unknown sources and unsterilized were almost universally used. The greatest hazard to health in the process is that of poisoning. The principal poisons found were lead (both as dust and in solution in oil and water, or spraj-, also "kicked up" from dust accumulations), tur- pentine, benzine, benzol, wood alcohol, creosote and asphaltum. In a number of the industries investigated it was claimed that no lead was used. In others lead was only used at intervals. It is well to mention that drying oils (boiled oil, etc.) often contain lead oxide as the principal drier. A physician called our attention to three cases of severe lead poisoning which he had in a father and two sons who drank some "boiled" oil to relieve constipation. Often- times it "was impossible to determine all the poisons that might be present, in which case the investigators simply reported "paint", "varnish fumes", "paint removers", etc. However, paint removers were not very much used. Hand rubbing with oil containing a lead drier, and hand polishing with a solution containing wood alcohol (about two quarts to five gallons of mixture) were also noted. There were many predisposing causes to poisoning, the chief being the breathing of dust and sprays containing lead, and of fumes of the various volatile substances used. "No place to wash up before eating", was a common complaint. In one place six men used an old paint can to wash in. Lack of correct information on the prevention of lead poisoning, the idea, held by many, that they bore charmed lives and could not be poisoned, carelessness in eating, eating in the workroom, failure to connect up minor sickness com- plaints with the existence of slow poisoning, and personal carelessness — these constituted the chief hazards. The industrial inducement to stimulantism is con- siderable for practically all workers engaged in this process, due to the poison elements present, to dust, to nauseating fumes and odors, and the like. Many of these workers go without breakfast because they have no appetite for the same — a sign of lead poisoning (particularly). The general appearance of indoor or shop painters was in the majority of instances below par. In this respect the investigators reported the general 171 average of workers not healthy appearing in a total of 68 plants. In 45 dif- ferent establishments workmen were found who made various complaints con- cerning the health aspects of the processes in which they were engaged. Ar- ranged in as nearly descending order of frequency as possible, these were: breathing of dust, breathing of fumes, lack of good room ventilation, digestive troubles, attacks of dizziness, personal carelessness, kidney and bladder troubles, and general sanitary inadequacies. Investigators reported 167 cases of occu- pational diseases as follows : Lead poisoning, positive 90 Lead poisoning, tentative 27 Lead poisoning, partially recovered from 26 Lead poisoning, authentic hearsay cases 10 Lead poisoning, ocular 1 Benzine and Naphtha poisoning 3 Turpentine poisoning 2 Varnish poisoning 2 Wood Alcohol poisoning 1 Bleeding fingers from sanding 1 Dermatitis 2 Tubercular Bronchitis 2 Total ' 167 In addition to the above, there were large numbers of hearsay cases and other evidence which the Survey did not have the time to investigate further. In some old established places, foremen said that practically all workers ever em- ployed got lead poisoning. In one large place it was said that at times there were "epidemics" of bladder and kidnej- troubles due to the turpentine and other solvents used. The health officer of Cincinnati, Dr. Landis, called our attention to the harmful effects of certain new paint solvents which were producing a new train of symptoms among painters. Comments. — Dry rubbing or sanding of painted surfaces should be sub- stituted by wet methods, or with mineral oil, to keep down the dust. Occasion- ally, local exhausts can be used. Where these are unfeasible, the worker should wear a tight respirator, perhaps supplied with air under pressure, while frequent change from this process to another is essential. Almost the same precautions should be taken in regard to spraying. As much needed as any- thing are placards informing workers how to prevent lead poisoning, and other health educational measures. Great precaution should be taken to keep quarters clean so- as to prevent the "kicking up" of dust. Good washing facilities and insistence upon their use are absolutely necessary. Street clothes and lunch boxes should be kept out of painting quarters. — For vapors, fumes and gases, spacious quarters, air-agitators, local exhaust hoods, blowers and short inter- vals at such work are suggestions variously adaptable to various places. Finally, there is no other class of workers, from the large numbers employed to the poison factors concerned, which is more in need of a frequent medical examination than indoor (shop) painters. In a number of instances, as for instance, STENCILING, marking, etc., harmless substitutes could be used for lead and other poison-containing paints, 1/2 and in a number of instances it was found that lead paints were being used less and less. In a paper entitled, "The Composition of Paint Vapors" (Jour. Indust. & Engrg. Chem. Vol. VI., No. 2, Feb., 1914) H. A. Gardner, Assistant Di- rector Institute of Industrial Research, Washington, D. C, calls attention to carbon dioxide, carbon monoxide, benzol, formic acid, and aldehydic sub- stances, which may be evolved from surfaces covered by drying oil paints. All of these, of course, are toxic substances, and the author's contention that the carbon monoxide may be responsible for the peculiar type of anemia from which painters sometimes sufifer is certainly a possibility. The newer forms of quick drying paints are the most likelj^ to \deld these substances. (See also Bulletin No. 41, Paint Manufacturers' Association of the U. S.) Ventilation of painting quarters, or quarters being painted, is the only means of avoiding the effects of these substances. SHELLACING AND LACQUERING. A shellac is a gum resin produced by an insect on several East Indian trees. The resin is dissolved in ordinary alcohol, denatured alcohol, or wood alcohol, according to its purpose. A lacquer is a thin, highly transparent varnish used to produce a thin, lustrous film on metals, etc., to preserve them against gases and vapors. The process of Shellacing and Lacquering is closely associated with Painting, Varnishing and Staining, and in many instances it is quite impossible to separate them, since the same workers may be concerned with each process. Shellac and lacquer may be brushed or sprayed on, or articles may be dipped into the solutions. In 32 establishments, in 9 cities, employing. a total of 894 wage-earners, of whom 868 were males and 26 were females, the processes of shellacing and lacquering were fairly well separated from the other processes mentioned. General conditions respecting the types of workers, health appliances, con- struction of workrooms and presence of other processes were practically the same as for Painting and Varnishing. The hazards of dust, dirt, dampness, darkness, heat and cold, Vv^ere all less than for Painting (warm, light rooms free from dust being a necessity). The condition of the atmosphere in workrooms was good in 14, fair in 19, and bad in the remaining 6 places, due chiefly to contamination with the fumes and vapors emitted from the process, combined with stagnation and temperature-humidity abnormalities. Fatigue was usually a negligible factor, except that in a few places piecework, monotony, constant standing and faulty postures were observed. The workday was 8 hours in 1 place, 8 to 9 hours in 11 places, 9 to 10 hours in 25 places, and 10 to 11 hours in 2 places. The noon recess was 1 hour in 9 places, about f hour in 7 places, \ hour in the remain- ing 23. Age-group estimations summed up as follows : over 40 years, 195 ; 20 to 40 years, 671 ; under 20 years, 28. There was a tendency to employ youths of both sexes. The liability to communicable diseases was not quite as great as among painters because dust was not so frequent. Various poisons to which workers were subjected were lead (in boiled oil), turpentine, amyl acetate, wood alcohol, benzine (naphtha), benzol, toluene, acetone (?), "banana oil" and other varnish and lacquer solvents (and varnish removers). 173 The average appearance of workers was generally good in 16 places, fair in 12 more, while pallor, anemia (but sometimes very flushed faces and red- dened eyes), and emaciation characterized the remaining 11 places. The chief complaints of workers were the effects of turpentine fumes and "varnish" causing (besides dizziness) digestive, respiratory, skin, kidney and bladder troubles. Our investigators found the following occupational diseases among workers : Lead poisoning, positive 4 Turpentine poisoning, tentative 8 Benzine poisoning, tentative 2 Occupational dermatitis, positive 6 Occupational rhinitis 1 Occupational anemia 1 Occupational tuberculosis 1 Occupational nephritis 1 Comments. — See under Painting and Varnishing. It is also questionable whether females should be employed in any processes exposing them to shellac, lacquer, varnish, or polishing fumes. The same may be said of j^ouths. ENAMELING. As commonly understood, an enamel is an air-drying or baking varnish to which color and opacity have been imparted by the addition of pigments (in some instances, also, of dyes). The process consists in applying enamel to steel, iron, soft metal alloys, wood, and glass in a moist or oil form with brushes, or by pouring, dipping, blowing, or spraying with compressed air, and in a dry form by sieving, dusting, or blowing the powdered enamel upon the ware. The objects are then dried and baked in a special oven, furnace or kiln to harden the enamel. Japanning was a frequently associated process. While in 3 of the places reported here, porcelain enameling of iron was done, this process itself is considered elsewhere. Enameling was investigated in 25 establishments, in 8 cities, and employed a total of 716 wage-earners, of whom 377 were males, and 139 were females. The females were employed, chiefly, at spraying enamel. The following in- dustries were included : Agricultural Implements, Automobiles, Bicycles and Sewing Machines, Brass and Bronze Products, Copper, Tin and Sheet Iron Goods, Cutlery and Tools, Electrical Apparatus, Enameling and Japanning, Foundry and Machine Shop Products, Furniture, Safes and Vaults, Signs and Advertising Novelties, Stoves and Furnaces, and Toys and Games. In two or thjee small places very crude processes appeared to be used. There were no union organizations. The general interest of employers in the welfare of their workers was good in 19 places, fair in 5 more, and poor in 1 small place. An intelligent type of workers was employed in 16 places, fairly so in 7 more, and an ignorant class of foreigners in the remaining 2. Every attempt seemed to be made to retain the employes in 19 places, fairly so in 4 more, while in the remaining 2, little attention appeared to be given to the personnel. Health appliances consisting of hoods and vents, or work within boxes for spraying, or respirators for sanding or brushing, as well as arrange- ments to protect against the heaf from baking ovens, were present in 13 places. 1/4 in 8 of which they appeared efficient, 4 fairly so, and 1, not so. In the remain- ing 12 they were absent. In 2 places, some instructions were given along the line of health conservation. In 1 place a sick benefit association existed. The work was very largely unskilled. Work quarters were hj'gienically constructed in 11 places, fairly so in 4 more, and not so in the remaining 10. Other pro- cesses were present in 8 places, such as the baking of the ware, japanning, decorating, electroplating, painting and factory processes. The age-group estimations summed up as follows : over 40 years, 28 ; under 40 years, 451, of whom about 5% were under 20 (mostly girls). In 11 places dust appeared to be a negligible hazard ; in 4 places there was a fair amount in the atmosphere, while in the remaining 10 it was bad. It consisted, variously, of lead compounds, fillers, sand, dried spray, and paint. It was chiefly produced by dry sanding. It was "kicked up" considerably from the floors. In many places no attempts whatever were made to control it, although here and there respirators were supplied. Especially in the dry grinding and mixing of enamels was it very dusty. Two places had these processes well hooded. Quarters were kept clean and orderly in 6 places, fairly, so in 12 more, and not so in the remaining 7. This was especially hazardous where lead was a content* of the enamels used. Dry sweeping and cleaning, sometimes during work hours, were also noted. In 3 places the work was of a damp character from. water and sprays used, but the employes wore rubber boots, and were quite well protected. Natural light was very poor in 4 places. General room ventilation was good in 7 places, fair in 9, and poor in the remaining 9. The unhealthiness of the atmosphere was due chiefly to contamination with fumes and vapors, especially where ovens were in the same room, while stagnation of the air was a feature in several places. Heat was no factor in 18 places, but it was a fair hazard in the remaining 7, and especially so in 1, due to the close proximity of the baking oven. In some places cold, due to drafts, and having to go to outside closets or privies, and in 1 place, inefficient heating, was noted. Fatigue was a considerable hazard in some places and negligible in others, the former constituting, however, 16 of the total places investigated. The factors, arranged in descending order were: hurrying piece-work, constant standing (still), and, much less fre- quently, laborious work, long hours for the character of the work, jarring processes, pressure against the body, and loud noises. The workday was 8 hours in 2 places, 8 to 9 hours in 8 places, 9 to 10 hours in 14 places (and not repotted upon in the remaining 1). The noon recess was 1 hour in 2 places, f hour in 2 places, and \ hour in 21. The risk of contracting com- municable diseases was determined as negligible in 2 places, a fair hazard in 13 more, and bad in the remaining 10. The principal reasons for this were promiscuous spitting upon dusty floors, absence of cuspidors, inadequate washing facilities, poor closets, the use of common drinking cups and towels, wiping rags (unsterilized) from unknown sources, while in some places fre- quent trivial injuries, flying particles, and the short-intervaled handling of objects by different workers were factors. Among the poisons used in the industry, lead was not as frequently encountered as might be surmised. In only 5 places was it certainly used (red or white lead as a rule). The enamel in most places appeared to be of the newer preparations, characterized by quick drying, and free of lead. Other poisons necessarily present were turpentine and benzine (naphtha), while amyl acetate, pickling fumes, anti- 175 mony (?), sulphur, smoke and gas fumes were all noted. The risk of poisoning from one or another of these appeared negligible in 4 places, a fair hazard in 9, and considerable in the remaining 12. A monthly medical examination was in vogue in 1 place. The methods of doing the work, in which a large amount of dust or nebulous spray was produced were important factors in poisoning. The industrial inducement to stimiilantism was con- sidered bad in 3 places, and fairly so in most of the remaining, due, chiefly, to the poison factor, after which the question of dust, poor ventilation and fatigue entered. The general appearance of enamelers rated good in 11 places, fair in 12 more, and poor in the remaining 2, the latter including a total of 30 persons. In a number of instances, pale and anemic looking workers were seen. The health complaints of workers were the breathing of fumes, sprays and dust, the frequent failing of the special ventilation systems used, and subjective symptoms of the effects of the above hazards. In a number of places dizziness was a frequent complaint. Investigators reported the following instances of occupational disease: lead poisoning, 4 positive, and 1 tentative; dermatitis from naphtha, 1 .positive ; while there was considerable additional evidence of the effects of turpentine and benzine fumes, as well as further instances of lead poisoning. Comments. — Where lead is used, a monthly examination of all exposed employes should be made by a physician. Installation of hoods and vents, or the performing of the work within enclosed cupboards or boxes, through which the hands may be inserted, and, where these are impractical, the insist- ence upon the wearing of respirators, and a frequent interchange of workers should be instituted. Every case of sickness among enamelers should be in- vestigated by a factory physician, with a view to eliminating the cause (not the worker). JAPANNING. .A japan is a lustre-giving substance containing resins or gum-resins, metallic salts, drying oils, and volatile liquids ; or (decorative japan) asphaltum, etc., and lies between a spirit varnish and an enamel. Japanning is a process closely associated with enameling, the substances being applied in much the same way and baked. , The process was investigated in 10 establishments, in 6 cities, and employ- ed a total of 146 wage-earners, 89 of whom were males and 57 were females. General working conditions, type of workers, retention, health appliances, con- struction or workrooms and the presence of other processes did not differ materially from those described under Enameling. The following hazards were considered bad in the number of places men- tioned: dust, 1; dirt and disorderliness, 2; darkness, 1; poor ventilation, 3 (and in 5 others cuily fair) ; heat, 1 ; fatigue, 5 (due to hurrying piece-work, constant standing and monotony) ; liability to communicable diseases, 6 (the same factors as under Enameling) ; and industrial inducement to stimulantism, a fair extent in most places. Age-group estimations showed 86 over 40, and 5 under 20, the remaining 105 being between 20 and 40 years. The poisons used in the process, so far as could be learned, were turpentine, benzine (naphtha), "japan," and bronze. There were in places also the escape of gas fumes from the baking ovens. The liability to poisoning was considered negligible in 2 places, fairly so in 5 more, 176 but considerable in the remaining 3. In places the workers dipped their arms up to the elbows in the solutions. The general appearance of workers averaged good in 6 places and fair in the remaining 4. There were some pale, anemic looking individuals, and others who seemed below par in health. Complaints were not frequent, but the effects of fumes and urinary trouble were brought to the attention of in- vestigators. At one place one man had quit because of this urinary trouble. Comments. — (See Enameling) The tendency of many workers to wash their hands in benzine was noted in both this process and that of Enameling. BRONZING AND GILDING. — These two processes were frequently seen in connection with other' decorative work in many industries. Usually females were employed. Very thin sheets of bronze aluminum, and other gilding materials were applied or stamped on with a "size", consisting of thin varnish or a similar solvent, while, other times, these gilds were brushed on from a mixture of them in benzol, acetone, pyroxylin, wood alcohol, amyl acetate or gasoline, and occasionally ammonia, or were sprayed oh (in which case a hood and exhaust were used). Again, bronzing or gilding machines, equipped with large gas burners, were usually unvented, and a source of deoxidation and contamination of the quarters in which they were located. None of these "bronzes" were analyzed for lead or arsenic (which they sometimes contain), but no case's of metallic poisoning were discovered among the few workers seen. LITHOGRAPHING. This process was investigated in 10 establishments, in 5 cities, and in connection with the following industries : Printing and Publishing, Copper, Tin and Sheet Iron Goods, and Signs and Advertising Novelties. Different methods of designing, photographing, etc., upon stone, zinc, aluminum and other surfaces, as well as press work, are here included. There were a total of 539 employes so engaged, of whom all but 14 were males. One plant was exclusively a union shop. The work was very largely skilled, the type of workers good, and they appeared to remain at the same places of work to a large extent. There were no benefit organizations, al- though in 1 place instructions along health lines were given. There were no special health appliances in any place. The general construction of work quarters was good in 5 places, fair in 2, and poor in the remaining 3, while other processes were present in 6 places, such as printing, stenciling, engraving, embossing, and the like. There were a total of 50 workers over 40 years of age, 483 between 20 and 40, and 6 under 20 years. Environmental conditions were graded as follows : a fair amount of dust in 6 places; disorder and dirt in 1; in 2, light only fair; in 2, quarters overly warm; and in 8, risk of contracting communicable diseases from the promiscuous spitting upon floors, absence of cuspidors, inadequate washing facilities, and the use of common drinking cups and towels. Fatigue was a fair hazard in 5 places, due to constant standing, monotony, piece-work, eye- strain and loud noises (from presses). Litho-engravers, designers and artists had the same hazards as elsewhere described. The workday was from 81- to 9 hours in 3 places, and from 9^ to 10 hours in 7 places, while the noon recess was 1 hour in 4 places, |- hour in 1, and J hour in the remaining 5. In 1 place a night shift of 12 hours was maintained, while overtime work was some feature in other places. The general ventilation of workrooms was good in 3 177 places, but fair to bad in the remaining 7, due, somewhat, to contamination from gas, fumes and vapors, but, mostly, to stagnation of the air. Occasionall}- pollution from city smoke in the quarters of upper floors was frequent. The chief poisons in connection with the process were found to be the various colors, inks and greases used (but, except for skin affections, the risk from these sources did not appear to be great, especially for the class of workers employed), turpentine fumes, benzine and, occasionally, anilin vised in cleaning, and nitric acid in spray "cutting" of plates, which in one place turned that part of the worker's hair, which was exposed, red-brown in color. The risk to the workers from poisoning appeared to be negligible in 6 places, but a fair hazard in the remaining 4. Nauseating odors from rosin, inks, and fumes were marked in some places. The industrial inducement to stiniulantism was principally a question of the depressing influences of the air in the workrooms, to which the poison factor should be added. The general appearance of workers was good in all places, while there were no special complaints made, except as related to ventilation, and occasion- ally to sanitary inconveniences. Comments. — (See Printing — Art Work, Press Rooms). In some instances it would seem advisable to put a hood and vent over the lithographing presses. UPHOLSTERING. This process is an auxiliary one in certain industries. We here report upon it as performed in 3 automobile plants, 6 carriage plants, and in 5 furniture plants. In these 14 plants there were found to be employed at upholstering a total of 304 wage-earners, of whom 219 were males and 85 were females. Apparently modern methods were the rule in 12 places. There were no labor organizations. An intelligent type of workers was employed in 12 places, fairly so in 1, and largely non-English speaking foreigners in the remaining 1. The attitude towards employes seemed excellent in 10 places, fairly so in 2, and not so in 2. Health appliances to remove or confine dust were absent in all places, but occasionally respirators were furnished. In but 1 plant were the workers protected by a sick benefit organization. All workers were skilled in 2 places, a fair percentage were so in 3 places, and the majority unskilled in 9 places. There were 33 of the total number who were over 40 years of age, and who were under 20 years. Work quarters were hygienically constructed in 4 places, fairly so in 5 more, and not so in the remaining 5. In half of the places other processes were carried on in the same room, such as painting and varnishing, packing, and various factory procedures. Also these workers were apt to be doing other things than upholstering at times. Retention of workers was good in 10 places, fair in 3, and not so in 1. The work was so performed that dust was a negligible, factor in 4 places, a fair hazard in 3, and more so in the remaining 7. Its composition was prin- cipally excelsior, hair, hay, flax, tow, moss and vegetable fiber. Quarters were clean in 4 places, fairly so in 6, and not so in 4. Humidity was no factor. On the other hand, the dust tended to keep the air excessively dry in numbers of places. Light was good in 12 places, fair in 1, and poor in 1. General room ventilation was good in 4 places, fair in 7, and poor in 3. Often this was influenced by paint and varnish fumes from other processes, and faulty heating appliances. Heat is not a feature of the process, but inefficient heating was 12 O. D. 178 found to exist in' 4 places. Fatigue was no hazard in 5 places, a fair hazard in 8 places, and considerable in 1, due to hurrying piece-work, monotony, con- stant standing, and occasionally some eye strain. The work day was between 8J and 9 hours in 7 plac^es, and 9 to 10 hours in 7 places; the noon recess was 1 houi^ in 6 places, f of an hour in 5, and ^ hour in 4 places. The risk of con- tracting communicable diseases was fair in 5 places and bad in the remaining 9, due to such factors as crowded quarters, promiscuous spitting, absence of cuspidors, dry sweeping, common cups, inadequate wash-places and closets, lack of physical examination and medical supervision. Animal infections from the materials handled were not found. Poisons are not used in the process properly, but in some places workers were exposed to paint, varnish and wood alcohol, needlessly. Inducement to alcoholism and stimulants was negligible in 6 places, fair in 5, and bad in 3, due to inadequate drinking water facilities, lack of interest in employes' welfare, the irritating effects of dusts inhaled and swallowed, and other depressing influences as mentioned. Appearances of the workers were generally good in 12 places, but in the remaining 2 several were observed who seemed out of health. The complaints of workers were the irritating effects of the fine dusts breathed, more pro- nounced in the case of certain mosses and hairs. Cominents. — This being a dusty occupation of difficult control, all persons entering it should be physically examined first, and medically supervised at intervals thereafter, and should use some form of a light respirator whenever the work produces sneezing or coughing. According to the U. S. Mortality Statistics Report (1909) there were 327 deaths among Upholsters, of which number 65, or 19.8%, died of consumption. SEWING. The process considered is that of sewing machine operations, although some few hand workers are included in the totals of employes mentioned. The process was investigated in 26 establishments, in 7 cities, and employed a total of 4,206 wage-earners, of whom 793 were males, and 3,412 were females. The different industries covered were : Clothing (including men's and women's garments, mittens, and underwear). Regalia, Hats, Mattresses, Shoes (cloth processes only). Mittens, Fur Goods, Bags, Coffins, and Automobiles (trim- mings). Mortality Statistics including pulmonary tuberculosis for this class of workers have been considered under the subject of Clothing and Textile Man- ufacturing (Part IV.). The general methods pursued were about the same everywhere, irre- spective of the nature of the goods worked upon. Unions existed in 3 estab- lishments. The employers' interest in workers' welfare seemed very good in 18 establishments,; fair in 6 more, and poor in 2 places (employing a total of 150 females). The general type of workers consisted of an intelligent class in 20 places, fairly so in 3 more, while ■ a large percentage of non-English speaking foreigners (girls) j'were employed in the remaining three. • Every endeavor seemed to be made to keep the same employes in 22 establishments, fairly so in 3 others, while 1 establishment, employing a total of about 350, paid very little attention to the personnel, who seemed to be constantly chang- ing. Health appliances, consisting of mechanical means to promote ventilation, 1/9 were good in 5 places, but practically absent in the remaining 21. Some es- tablishments, in addition, had excellent rest rooms, change rooms, restaurants, lockers, nurses in charge, and physicians in easy call, etc. In 5 places organized instructions in health conservation were being given. In 3 places sick benefit organizations existed. About half of the total workers were skilled help. The construction of work quarters was hygienically good in 17 places, fair in 3 more, and not good in the remaining 6. In 8 places other processes were carried on in the same quarters with sewing machine processes, such as press- ing, cutting and hand-work. Age estimations summed up to show that there were 514 over 40 years of age, and 3,691 under that age, of whom probably 25% were under 20 years. fe -^^ 1 Ei Fig. 47. Model Sewing Room in an Underwear Factory. Note air-agitators of the draftless type over the workers' heads to prevent stagnation, — the chief hazard in ventilation. Also swing windows for use in fair weather. Also the excellent lighting system, arrangement of workers side- wise to light, chairs with backs, etc. Such conditions increase production be- cause they insure health and happiness. A certain amount of fiber and textile dust is created by the running of cloth through sewing machines, but in 17 places this appeared to 'be very small in amount, while in the remaining the character of the goods handled seemed to create a good deal of dust, enough to make it a considerable hazard in at least 6 places, employing a total of about 775 workers. It was composed of hemp, cotton, wool, leather, polish, hair from furs, etc., according to tlie nature of the goods worked upon. In some places the workers were covered with this lint and dust and coughed almost constantly. General cleanliness of quarters^, which included the frequent cleaning of floors to collect up dust and lint, was i8o good in 17 places, fair in 6 more, and bad in the remaining 3. Dry sweeping or brushing up during work hours was a fairlj- common observance. Natural light was good in 18 places, fair in 5 more, and bad in the remaining 3, one of which emploj-ed about 225 workers. In a considerable number of places, artificial lighting was b}- naked electric lamps, so placed that they were ver}' damaging to the eyesight of the workers because of the direct light into the eyes. In numbers of places, workers were seated facing windows and other sources of light, while attention was given to seeing that light arrangements were perfect in other places. Light window shades helped materially. The general ventilation of working quarters was good in 15 places, due either to general spaciousness of quarters, or to mechanical means of promoting the circulation of the air ; it was fair in 6 more, and bad in the remaining 5 (where a total of atout 500 workers were employed). Heating arrangements were usually good, although there was a general tendency to keeping room tem- peratures too high in the winter seasons, which, combined with the excessive dryness of the air (see discussion upon Humidity in Part III.) was depressing and predisposing to lung troubles. One place, employing 120 girls up next to the roof, was very warm and close. The chief hazard in this work is fatigue. Practically the whole gamut of fatigue factors were found to be active, different ones varj-ing in prevalence in different places. In descending order of im- portance they were : "bowed over" postures ; hurrying piece-work ; evidences of speeding up; monotonous application and concentration; eye-strain (in one large place 51% of girls wore glasses; probably many more needed them); loud noises ; long hours ; chairs and stools without backs ; prolonged straining movements; jarring and jiggling of certain forms of machines; and here and there laborious work, constant standing, and using the body to press constantly against objects. The workday was found to 'be 8 hours in 1 place, 8 to 9 hours in 6 places, and from 9 to 10 hours in the remaining 19. The noon recess was 1 hour in 12 places, f hour in 1 place, and \ hour in the remaining 13. Overtime was very seldom resorted to (laws governing the workda}^ for females prevent this beyond the 10-hour limit). As the work is very sedentary, most of the muscles and nervous mechanisms of the body are out of function a great part of the time, so that autotoxemia, due to sluggish circulation, is an added factor to the fatigue toxins produced in the parts used. In other words inactivity is a very potent principle in the diseases of this class of workers. In a number of places this was recognized, and work variation such as the re- quiring of employes to get up from their seats and secure their own working materials and to deliver the finished goods were resorted to. (A short recess twice a day would help immensely). Furthermore, in some places gymnasium and outdoor recreative features were supported. The liabilit}^ to the contrac- tion of communicable diseases was something of a hazard in all places, although pretty well guarded against, in at least 6 establishments. In one place the whole building (5 floors) was fumigated twice a month with sulphur — a pipe system distributing the fumes. In 7 others, also, no more than the usual risks of indoor workers appeared to prevail. In the remaining 13 the hazards seemed considerable. The principal factors were the presence of a large number of persons more or less crowded together in the same rooms, the use of common drinking cups, roller towels, dressing rooms without individual hooks or lockers, and in numbers of instances inadequate washing facilities, as well as other sanitary inconveniences. In a number of places where men were em- ployed in large numbers there was considerable spitting upon the floors, and a general absence of cuspidors. The short intervalled handling of objects by different persons was also a feature. In but 3 or 4 of the larger places were physical examinations required of new employes, while, as our case records show elsewhere, numbers of consumptive workers were at work in the midst of the others without any provisions for meeting the situation. The only poison to which workers were found subjected was the use of benzine or naphtha in association with other processes (cleaning, cementing) carried on in the same quarters. The industrial inducement to stimulantism existed in the prevalence of two causes chiefly — fatigue and inactivity. The general appearance of the workers was contented, happy, and on the whole fairly healthy in 14 establishments, but somewhat less so in all these respects in the remaining 12, in which about a half of the total employed were found. Employes, as a rule, made but few complaints. Those heard consisted of eye-strain, headache, backache, lack of recess intervals, dust (especially in mattress and sack or bag factories), poor ventilation, "killing pace" at which it was necessary to work to make a living, coughs, colds, and the like. It is necessary to say that only a very few workers were interviewed personally. Coimncnts. — As the consumption rate is high among this class of em- ployes, managements should give special attention to the hazards mentioned above, and make arrangements for a medical supervision which will provide, early enough, for the removal and proper care of consumptive persons, and a general protection of the -balance. Physical examination of new employes should be insisted upon, including the eyes. Nystagmus, or dancing pupils, is said to affect one-fourth of all sewing machine operators, due to strain of the eyes in following the stitch through the cloth., IRONING AND PRESSING. This hand process requires no special description. It was investigated in 21 establishments, representing such industries as Dry Cleaning and Dyeing, Regalia, Hats. Textiles, and Clothing Manufacture. (The process in laundries is considered elsewhere.) There were 570 employes so engaged, of whom 396 were males and 174 females. In all but 3 places modern methods were used. No union organizations existed. The attitude toward employes appeared good in 18 places, fair in 2 and not so in 1. Although a large percentage of foreign- ers were employed, they were of an intelligent type in 18 places, and remained well at the work in the same number of places. Health appliances, in the nature of room exhaust fans, air agitators, and hoods over large work, were good in 1 place, fair in o, and absent in the remaining. In but 1 plant did a sick benefit association exist. The work is semi-skilled. There were 120 workers over 40 years of age, 433 between 20 and 40, and 17 under 20. The construction of work rooms was hygienic in 14 places, fairly so in 5, and not so in the re- maining 2. Other processes were present in 5 places, such as sewings, cutting, printing, and factory work. Dust was no feature of the process. Quarters were well lighted in 17 places, fairly so in 1, and not so in 3. General room ventilation was good in 8 places, fair in 9, and bad in the remaining 4, due principally to still, "dead" air, incomplete oxidation of gas burners for heating, and absence of. methods to renew the air. Heat was a negligible factor in 13 places, fairly so in 5, and l82 bad in the remaining 3. It is difficult to find a more fatiguing procedure than hand ironing or pressing when such is the operation constantly pursued day after day. The number of persons with fatigue neuroses, particularly affecting the arm used, which appear at dispensaries and hospitals attest to this. Often- times there is added neuritis and partial paralysis. In the plants investigated fatigue was a bad hazard in 6, fair in 8, and about negligible in the remaining 7. The chief factors were hurrying piecework, monotony, constant standing, constant strain, stools '(where used) without backs, continued faulty postures, jarring processes, and constant pressure against the body. The workday was 8 hour.s in 1 place, 8|- to 9 in 11 places, and 9^ to 10 in 9 places ; the noon recess was 1 hour in 9 places, f hour in 2 places, and J hour in 10 places. The liability to communicable diseases was bad in 6 places, fair in 12 and negligible in 3, due principally to overcrowding (irrespective of room space), absence of lockers or clothes rooms, common towels and cups, poor washing facilities and closets, promiscuous spitting, absence of cuspidors, and the handling of articles which, in some places, might carry infection. There seemed to be a rather doubtful moral tone in some places employing both sexes together. Medical supervision was good in 3 places, but absent in the balance. The liability to poisoming was a negligible factor in 17 places, but in the remaining 4 it was fair to considerable. The dangers were escape of unburned gas fumes, the use of gasoline or naphtha in the same quarters (unventilated), and, in 1 place, of wood alcohol which workers used, even, to wash their hands. The inducement to stimulantism' was in direct proportion to the extent of the hazards above mentioned. The general appearance of workers was fair to good in 15 places, and not so in the remaining 6. The chief complaints of workers were hot work- rooms, gas odors, steam and dampness, fatigue effects, rheumatism, and "nervous breakdowns". Comments. — Outside of the usual ventilation and sanitary requirements, considerable thought should be given to varying this process and limiting piecework, speeding up, and constant standing. JUNK. The workers in junk sheds and warehouses are engaged in the sorting of waste, rags, paper and metal. Occasionally non-ferrous metals (especially lead) are melted down, much as in brass founding, and cast into ingots or pigs to be sold. Our investigations covered 25 establishments (exclusive of paper man- ufacturers) located in 5 cities employing 350 wage-earners divided as follows: No. Estab- Process. lishments. Males. Females. Total. Paper and Rag Sorting 20 203 71 274 Refining Metals 4 33 33 Waste Mfg 1 158 10 168 25 394 81 475 Age-group estimations summed up 50 males and 26 females over 40 years of age. There were a few tmdcr 20. There were 2 places, including the waste i83 Works, which had impfoved methods for handling materials. There were no unions. The attitude toward employes seemed bad in 6 places, and but fair in 7 more. A class of ignorant foreigners were employed in 17 places, while reten- tion at the work seemed poor except in 4 places. Health appliances, consisting of dust removal systems locally applied and hoods with exhausts over metal pots, were present in 2 places, but in 1 of these very inefficient. There were no in- structions or health placards in any of the establishments including those which brought the workers in contact with poisonous metals and fumes. None of the workers were industrially insured against ill health. There was no skill re- quired in the processes. Work places were hygienically constructed in 2 instances only, while there was little attempt anywhere to separate various sub-processes. The exposure to dust was a bad hazard in 17 places, its source being the rags, paper and metals handled. Quarters were very dirty and disordered in 19 places, while a fourth of the places were practically unprotected from the weather. The light was very poor where the workers ■^ere engaged in 8 places. Confined quarters giving poor opportunity for ventilation constituted a bad hazard in 13 places, and fairly so in 3 more. Heat was a bad hazard in 1 place employing 10 men. Chilling from winter cold was a hazard to the workers in J of the places. In one place employing 17 men and women the only heat was from unhooded salamanders, the gas from which filled the quarters. Fatigue was a considerable hazard in at least 3 places employing girls, due to absence of seats,' piece-work, faulty postures, and the like. In 1 place 3 females were seen seated upon the floor, there being no chairs nor stools provided. The workday was found to be 8 hours in 1 place employing 12 persons, of whom 9 were females, but was 10 hours or longer in all the rest where reports could be ob- tained. The noon recess was 1 hour in 5 places, f hour in 1, J hour in 10 places, and no regular time taken in the balance. How much overtime was put in could not be ascertained. The liability to the contraction of communicable diseases was great in 18 places, fairly so in 2 others, negligible in 1 more, and was not definitely reported upon in the remaining 5 places. The chief hazards, besides the handling of the materials, were inadequate or absent wash-places and closets (occasionally the same closet was used by both sexes), promiscuous spitting, absence of cuspidors, and lack of any medical supervision. Poisoning was a great hazard to 85 workmen in 10 places where lead and soft metal alloys were handled and smelted. In 1 place 5 tons of lead were melted at a time. The likelihood of "brass chills" was slightly less than in brass foundries. The work was done by ignorant workers who received no instructions as to dangers, were generally without washing facilities, and ate their lunches while at work. Hoods to remove fumes from melting pots were absent in all except 1 place, but a few of the places had the melting pots outdoors. The industrial inducement to stimulantism was of course great in all places where dust, de- pressing surroundings, poor heating arrangements and poisons existed along with the absence or inadequacy of drinking water facilities. There is a ques- tion also of the propriety of employing both males and females together in the sorting of old rags, etc. The general appearance of workers was fair to good in 10 of the plants (none, however, engaged in handling metals). The workers, as a rule, were very reticent about making complaints, but the ill effects of dust, insanitary quarters and long hours were complained of by them. Our investigators dis- covered 4 cases of lead poisoning in 2 smelting plants, 2 cases of tuberculosis. 184 and the report that several cases of lockjaw had come from 1 of the large plants. Comments. — Where metal melting pots are placed indoors they should be properly hooded and vented. The grinding and beating of rags and paper should have dust confining or collecting systems. (These were observed in 1 place.) We were unable to make an intensive study of the possibility of in- fectious and contagious diseases among the workers who were handling rags and materials collected from all sorts of places, but in this connection an out- break of smallpox in a manufacturing establishment was laid to the use of old rags bought for cleaning machinery. Of all workers these should have the best of sanitary conveniences as well as first-aid remedies for cuts, punctured wounds, burns and the like. SPECIAL PROCESSES. PRINTING.- — COMPOSING ROOMS AND GENERAL JOB WORK. This was invesitgated in 26 establishments, in 12 of which it was more or less of an auxiliary feature. The lines of business were printing and publish- ing, manufacture of boxes, art, glass, painting and varnishing, paper goods, matches and electrotyping. In these places there were employed a total of 513 wage-earners of whom 385 were males and 128 were females. Methods Fig. 48. Proper Arr.^ngement of Workman to Light. Xote shaded lamps, eyeshield, also convenient cuspidor. Many less skilled workers do just as tedious eyework under exactly opposite conditions. were considered modern in It; places, fairly so in 5 and crude in ■">. Labor organization existed in !) places. The attitude toward employes was good in 20, fair in 4. and Ijad in 2 places. The employes were an intelligent type in 20 places and the majority only fairly so in the remaining (i. Employes were well retained in 21, fairly so in 1 and not so in 4 places. Instructions along health lines in the form of placards were found posted al)out, in 4 places. In 185 i86 none of the places were benefit organizations existing (union printers ex- cepted). The workers were all skilled in 13 places, fairly so in 7 more and largely unskilled in the remaining 6. There were a total of 67 employes over 40 years of age, 424 between 20 and 40 and 22 under 20. Work rooms were hygienically constructed in 13 places, fairly so in 4 and bad in 9. Other processes in the job printing room were numerous and found to exist in about s of the places. Dust was a fair hazard in 10 places, bad in 1 and negligible in the re- maining. Quarters were kept clean in 14, fairly so in 9 and not so in 3. Dry sweeping and dusting of fonts with an air blast are pernicious. Cold and dampness, due to inefficient heating, were found to exist in 4 places. Light was good in 17 places, fair in 4 and poor in the remaining 5. General room ventilaiion was only fair in 10 places and bad in 7 more. Fatigue seemed ai negligible factor in 8 places, fair in 10 and bad in the remaining 8, due, prin- cipally, to hurrying piece-work, monotony, constant standing, strain, chairs and stools without backs, faulty postures and in some cases jarring processes and loud noises. Eyestrain and myopia are special hazards of the printer and every such worker should be assured of the condition of his eyes for such work. The workday was found to be 8 hours in 13 places, 8J to 9 in 5 places, and 9 to 10 in 8 places. The noon recess was 1 hour in 3 places, 45 minutes in 7 and ^ hour in 16. Overtime was rarely done.. The risk of contracting communicable diseases was negligible in 10 places, fair in 6 and considerable in the re- maining 10, due, principally, to promiscuous spitting, absence of cuspidors, inadequate washing facilities and closets, common cups and towels and less often to crowding, common handling of objects, and trivial injuries. Adequate medical supervision was universally absent. While the risk of poisoning was largely a question of personal hygiene (avoiding dust and holding the type in the mouth), still in § of the places certain conditions favored poisoning; such as, lack of instruction, workers' ignorance, inadequate washing places, eating while at work and in the workroom, absence of lockers, dry sweeping, and lack of ventilation for fume-producing processes. The poisons noted wert lead, analin oil, benzine, carbon dioxide, fuel gas, type dust (which also contains antimony), bronze powders and paraffin fumes. An industrial inducement to alcoholism and stimulants was a fair hazard in 18 places, especially so in 5, due to inadequate drinking water facilities combined with the depressing influences above mentioned. The general appearances of employes were good in 19 places, while in 7 a certain number of pale, sickly and presenile persons were seen. The chief complaints of workers were poor room ventilation, fumes, type-dust, risk of lead poisoning, and working along with supposedly tuberculous fellow-workers. One case of lead poisoning was seen,, and another case of the same complaint which was tentative. Lead poisoning which occurs in this process is usually of very slow progressive character, producing hardened arteries, 'enlarged heart and apoplectic strokes. Comments. — While 6 plants visited were models in sanitation and ventilation, the majority need attention given to still, "dead" air, especially in which free gas flames are present. Especially, is a vacuum cleaner to be used in type-font rooms. The hazards mentioned above suggest other features to be remediedt i87 PRINTING. TYPE MACHINES. This class of procedure includes all processes in which type metal is melted and used, such as linotyping, monotyping, and stereotyping. (Electro- typing is practically identical with electroplating, q.v.) These are here re- ported upon as the results of our investigation in 15 plants. The total wage- earners so employed was 361, of whom 348 were males and 13 were females. Seven of the places were union shops. The general attitude toward employes was good in 12 places, and at least fair in the remaining. The workers were Fig. 49. Linotype Room. Showing System Witn Connections to Each Metal Pot and Bukner. The Whole System is Connected to a Tall Chimney Stack. In Addition the Room Has Two Large Exhaust Fans -TO Promote Air Circulation. of intelligent type in all places, except here and there a few non-English speaking laborers. Retention of workers was good in 12 places, fair in 1, and not so in 2. Health appliances, such as hoods and stacks over metal pots, furnaces and burners, were good in 5 places, fair in 2, and absent in the balance. In 3 places there were sick benefit associations. In 12 places the mass of the workers were skilled, and in the remaining, unskilled. There were 52 employes over 40 years of age, 295 between 20 and 40, and 14 under 20'. The workrooms were hj'gienically constructed in 6 places, fairly so in 4, and not so in 5. In 4 places, other processes were carried on in the same quarters, such as press work, hand type-setting, etc. Except in electrotyping, dust is not a feature of the process, although in several places there was some dust in the air. Dirt and waste accumulations were well taken care of in but 2 places, and were not a bad hazard at any place. Inasmuch as lead is in high percentage in the tj'pe metal used, greater cleanliness should have been the rule in 13 places. Dampness is not a feature of the process. Light was good in all but 2 places, where it was poor. General room ventilation was good in onl}- 1 place (which had all machines piped and exhaust fans in the windows, while in 6 places it was decidedly bad. The chief features were the escape of gases and fumes from the hot processes, absence of air-agitators and means of renewing the air. Heat was a negligible Fig. 50. Recoverixg Type Metal. This melting process should always be done in a separate room. — Type metal pot covered and fairly well flued. factor in 7 places, a fair hazard in 7, and bad in 1. Fatigne was not found to be any particular hazard any place. The work day was 8 hours in 11 places, and from 8;} to 10 hours in the other 4. The noon recess was 1 hour in 4 places, f hour in 5 places, and h; hour in 6. The risk of contracting com- iniinicable diseases was negligible in 2 places, fair in G, and considerable in 7, due, principally, to promiscuous spitting, absence of cuspidors, inadequate wash- places and closets, common towels and cups, occasionally crowding of workers together, with lack of medical supervision. Industrial poisoning was quite negligible in 4 places, a fair hazard in 4, and a considerable hazard in 7, due, chiefly to the absence of hoods and vent pipes over metal pots, and especialh' over gas burners and furnaces; also to absence of proper washing facilities. A chief feature was the habit which some workers had of continuallj' stirring up the surface of the molten metal by dropping in slugs and waste metal at i89 frequent intervals, thus permitting the fine sub-oxide of lead dust, as well as antimony vapors, to .escape. Industrial inducement to alcoholism and stimulants was a fair hazard in 10 places, due, principally, to the depressing" mfluences cited above, rather than drinking water facilities. In 9 places, including most of the larger ones, workers were healthy looking. In 4 the majority were only fairly so, and in 2 quite a number were seen who did not appear well. Their chief complaints were the fumes, ab- sence of hoods and poor room ventilation. One case of chronic iplumbism was seen, and 1 case of antimony poisoning, causing dermatitis as well as bron- chitis. Comments. — The better places have melting pots for scrap metals in a room separated from other workers. Also, over the type-metal pot, heating apparatus and gas flame is a hood and stack passing to the exterior. In some places the stack was found to extend only a few feet above the machine, whence its fumes were given ofif to the air of the room. PRINTING. — PRESS ROOM WORK. This process is here reported upon as investigated in 13 plants, all print- ing and publishing establishments, 'employing a total of 392, of whom 360 were males, and 32 were females. Four plants were unionized. The general attitude towards employes seemed good in 12, and at least fair in the 1 remaining place. The workers were uniformly of an intelligent type. Retention seemed good in all places. Health appliances, consisting of hoods and flues for drawing ofif escaping gas fumes in drying freshly printed work were present and efficient in 2 places. A sick benefit association existed in 1 place. The majority of the workers were skilled in 3 places, and largely unskilled in 1 only. There were 35 employes over 40 years of age, 327 between 20 and 40, and 38 tinder 20. The press-room was hygienically constructed in 7 places, fairly so in 3, and not so in 3. Other processes were usually absent in the press-room. A slight amount' of dtist was in the air in the majority of places. Cleanliness was excellent in 3 and fair in the remaining 10. Dampne^ss, 'be- cause of poor location, was a fair hazard in 4 places. Light was good in 8 places, fair in 3, and poor in 2 places. General room ventilation was excellent in 2 places, fair to good in 7, and poor in the remaining 4, due to lack of means to keep the air in motion, ingress of city smoke, ink odors, and gas fumes from driers. Heat was negligible in 5, fair in 7, and bad in 1 place, due to unflued gas-burners. Fatigue was not much of a feature, although con- stant standing, awkward postures, and a good deal of noise were common. The workday was 8 hours in 9 places, and from 8-] to 10 hours in the remain- ing 4. Some overtime was the feature of several places, while night work and night shifts, in the case of large dailies, were, of course, the rule. The noon recess was 1 hour in 1 place, f hour in 5, and J hour in 7. The risk of con- tracting communicable diseases was negligible in 5, fair in 5, and bad in 3 places, due, chiefly, to promiscuous spitting, absence of cuspidors, inadequate wash-places and closets, and common drinking cups. Industrial poisoning was negligible in most places ; the chief danger was in cleaning ofif rolls with com- pounds rich in anilin oil, to which our attention has been called several times. The workmen concerned were found unconscious with the features very dark colored, and only revived after hours of resuscitating efforts. P'ree-flame gas burners and benzine fumes were other air-contaminators. Industrial stimulajit- \ 190 ism was more or less incited in half of the places, chiefly because of the de- pressing influences of poor room ventilation. In 10 places all workers looked healthy, while in the remaining 3, several appeared to be sickly. No complaints were made by workmen, with the ex- ception of the odors of gas and of inks occasionally. Comments. — - Outside of the general features above mentioned, the escape of fumes and gases should be prevented by good suction flues at certain points, and precautions used in regard to substances employed in the cleaning of rolls. PRINTING. — BINDING ROOM PROCESSES. These were investigated in 6 establishments. The total persons so en- gaged was 214, of whom 129 were males and 85 were females. There were no labor unions. The workers were of an intelligent class in all places and retention seemed good ever3'where. There were no unions in the places in- vestigated. There were no sick benefit associations. The work did not re- quire much skill. There were a total of 20 persons over 40' years of age, 150 between 20 and 40, and 33 below 20. Work rooms were hygienically arranged in 5 places, and not so in 1. Other processes of minor health significance were also carried on in most of the binding rooms visited. Dust was present enough to constitute a fair hazard in 4 places. One place was poorly lighted. Room ventilation was excellent in 1 place, fair in 8, and bad in 2. Heat was considerable in 1 place, and a fair hazard in 2 others. Inefficient heating with alternating heat and cold exposures were present in 1 place. Fatigue was only a nominal hazard, although heat, work, monotony and constant standing were' features in some places. However, 'the hours were good. The work day was 8 hours in 3 places, 8i' in 1, and 9 in 2. The noon recess was J hour in 3 places, % hour in 2 places, and 1 hour in 1. . The risk of contracting communicable diseases was excellently provided against in 3 places, but fair to bad in the remaining 3, due, principally, to promiscuous spitting, absence of cuspidors, inadequate washing facilities and closets, the use of common towfels and cups, the same toilets for both sexes, and the lack of medical supervision. The use of poisons was no factor in the process, although occasionally shellacs dissolved in wood alcohol were reported. The inducement to industrial alcoholism and stimulants constituted only a fair hazard in some of the places, due to the combination of some of the depress- ing influences above cited. The general appearances of workers in this process were good in all places, although in 1 place a worker was said to be at home on account of consumption. Coviments. — This part of the printing business is practically a general factory process with no hazard peculiar to it. The location upon upper floors where city smoke invaded the quarters was a complaint in 3 places, making it necessary to keep windows closed. Fans or air agitators in the rooms would help considerably to invigorate the workers. PRINTING. — -ART WORK, HALF TONES, ZINC ETCHING, ETC. The processes included here are designing, artist's work, aerographing, photo-engraving, etching, vignetting, transfer work (decalcomania), graining, stippling and sketching. These processes were investigated in 6 plants mak- ing such work their sole specialties, and employing a total of 157 workers, of 191 whom 2 were females. Also one electrotype plant had 37 workers (all males) engaged in the process here named. Similar lines of work are also reported under special industries (see Pottery, etc.). The workers were of necessity of good intelligence, yet the attitude toward them in 2 places seemed rather bad. There were no health instructions, placards, or special appliances, although precautions were ordinarily good. There were 32 over 40 years of age, 128 between 20 and 40, and 2 under 20. The construction of work rooms was excellent in 5 places, and bad in 1. Other processes, such as litho-transferring and stone work, were also carried on in the same quarters in 3 places. Dust, dirt, and dampnesSj were fair hazards in 1 place. In 2 places the room ventila- tion was bad and the air pungent with turpentine, electroplating, and various chemical fumes. Fatigue was no factor, except that eyestrain might ensue from the arc -lamp reflections in long exposures^ in the photography branch. Inactivity was a hazard, however, to all the sedentary workers (artists, de- signers, wood and steel engravers). The liability to communicahle diseases was usually slight, but in 1 place there was promiscuous spitting, the absence of cuspidors, inadequate washing facilities and closets, which, with the use of common towels and dry sweeping, constituted considerable hazard. Many poisons were used in the various sub-processes named. The artists were liable to lead, arsenic and chrome poisoning from the habit of tipping the brushes in the lips and especially from the aerographing work. Often their faces were within 8 to 14 inches of their work and in the field of the spray. In some instances one could distinguish the artists from the designers by the pallor -on the faces of the former (lead poisoning (?)). The photographers) handled potassium cyanid in concentrated solutions (both in and out of the dark rooms), also corrosive sublimate, iodine, silver nitrate, copper sulphate, and metol, from all of which they complained of skin eruptions, ulcers, pig- mentations and dermatitis. Precautions were usually well observed. Lots of running water was usually depended upon to prevent skin effects. The photo- engravers came in contact with benzol in dissolving rubber films, alcohol and ether in collodion films, strong acetic acid in removing films, ammonium dichromate and gas fumes in sensitizing the copper plates, and ferric chloride in etching; also nitric acid fumes from the open rocking trays, as well as fusion products in zinc etching. There were no risks in routing and blocking, except in the case of electrotypes which are mounted on lead backs. Vignetters used fefric chloride as the etcher which, in bulk form, contained enough free hydrochloric acid to produce some skin irritation if used carelessly. Proving is the same as Printing Press Work (q. v.) Skin eruptions, nose and throat irritations and bronchitis were the chief complaints. Comments. — Placards concerning the poisons used, labels on all poisonous materials, and ventilation in small rooms, would do away with all poisoning dangers, providing personal care (also in aerographing) were well observed. The use of rubber gloves is said to be impractical. Cases of appreciated poisoning in the industry are rare as is shown in the Report of the 15th Annual Convention of the International Photo- engravers Union, 1914. Out of 42 locals (about half of the total in the union and probably representing the great majority of the workers) which responded to a request on the part of the officers for information upon -"Members in- capacitated for work by accidents from machinery, chemicals, gradual pojson- 192 ing, loss of weight, or other disabilities incurred in the pursuit of photo- engraving", 34 locals, reported no cases, while 8 reported as follows ; Bichromate poisoning 5 cases Cyanide poisoning 1 case Accidents (routers and blockers) 9 cases Blood poisoning (laid to zinc in a cut) 1 case Gradual loss of eyesight (Finishing) 1 case Nervous Breakdown 1 case Total 18 cases On the other hand, that some malignant factor (chronic poisoning ? ) is at work among photo-engravers is shown by the enormous death rate from tuber- culosis and degenerative diseases : of 23 deaths in the fiscal year ending June 30, 1914, 9 were from tuberculosis, 7 from degenerative diseases, 1 from accidental poisoning, 1 from erysipelas, 1 from intestinal obstruction, and 4 from accidents and injuries. ■ — Furthermore (p. 45, of above mentioned Report), "A review of our records since 1903 discloses the fact that there have been 217 deaths. Out of these 217 deaths, 88 were due to tuberculosis — very nearly 41 per cent" (Italics are ours.) LAUNDRY, LISTING, SORTING AND MARKING. This process was investigated in 7 places employing a total of 142 employes, 14 of whom were males and 128 females. Of the total number, 134 were between 20 and 40 years of age. The health-hazards were exposure to hiiinidky and dampness (due to other processes) in 4 places; dark, close and unzrutilated quarters in 3 places; standing and monotonous character of the work, and nauseating odors from soiled clothing. The liability to the contraction of com- municable diseases from the handling of soiled clothing and linen is of course present, but is a much disputed point in actual fact. In this connection it will first be necessary to have sick records kept of at least several hundred of such employes over at least a j^ear's time before conclusions can be reached. On the other hand, eating in the work room, meagre washing facilities, the use of com- mon towels and common drinking cups, were features in 3 of the 7 places. The general character of the work also would appear to make it inadvisable to em- ploy both males and females at it together. The appearance of the workers was generally good in 2 places, and fair only in the remaining 5 places. The workers made no complaints. LAUNDRY. WASHING. This process was investigated in 19 laundries, all of the character using machinery to a large extent. It was also investigated in such places as dry cleaning establishments, and in some large firms who performed their^own laun- dry work — the general feattires being similar to what is here described. It is recognized that some work must necessarily be done by hand. The total number of employes was 241, of whom 118 were males and 123 were females. For the work undertaken the methods were modern in 12 places, fairly so in 3, and not so in the remaining 4. No imion organizations existed. The general attitude to- wards employes was good in 11 places, fair in 6, and poor in 2. Employes were of an intelligent type in 13 places, fairly so in 4 nioi'e, and ignorant foreigners in 193 the remain Jig 2. Retention seemed good in 13 places, fairly so in 3, and not so in the remaining 3. Health appliances, consisting of exhaust apparatus over operations, and, when needed, special room ventilation apparatus, were fair to good in 11 places, and absent in the remaining 8. In 4 places health placards, etc., were found present. In no places were there sick benefit organizations. The construction of work quarters was hygienically good in 10 places, fair in 2, and not so in the remaining 7. Other processes than washing were present in 8 places. The work was unskilled. There were found to be 2 employes over 40 years of age, 214 between 20 and 40, and 25 under 20. Uncleanly quarters were noted in 5 places, and especially so in 2. General room humidity, wet floors, and steam, were negligible factors in 4 places, fairly so in 3, and bad in the 12 remaining. In some of these, attempts made to better the conditions were quite inefficient. Light was good in 14 and bad in 5 places. The workroom ventilation was good in 5 places, and not so in the remaining 14. Several depended solely upon windows for ventilation. Heat was no hazard in 9 places, fairly so in 9 others, and bad in the remaining 1. In some .places it ranged from 80 to 90 degrees, which, combined with humidity, rendered it especially deleterious. Washing facilities, such as shower baths, were absent in all but 2 places, although other types were good in 7 places, fair in 7, and poor in the remaining. Fatigue was some factor and due principally to monotony, hurrying, constant standing, faulty postures and constant rapid move- ments. In some places were excellent rest rooms and lunch rooms where coffee was furnished at the noon hour. The workday was 8-2- hours in 1 place, and from 9 to 10 in the balance. The noon recess was 1 hour in 5 places and ^ hour in the remaining 14. The liability to the contraction of communicable diseases was negligible in 7 places, fairly so in 8 others, and considerable in 4, due to such features as promiscuous spitting, absence of cuspidors, the use of common towels and drinking cups, inadequate wash places, poor toilets, work clothes hanging in the same room, and the absence of medical supervision to keep out frail and diseased workers. Poisoning, due to the effects of bleaching powder and of sodium carbonate, appeared some risk in a very few places, although no cases were found. Bleaching by electricity (a harmless process) was in vogue in some places. On the other hand nauseating odors, due both to piles of dirty clothes and washing odors, were fairly frequent. Escaping unburned gas fumes, usually from other processes, were present in some places. The inducement to stiinulantisiii was a fair hazard in the majority of places, due to the depressing influences of various combinations of the hazards above men- tioned. The general appearance of workers was good in 13 places, and fair to bad in the remaining 6, where many were in need of physical examinations to determine their health status. Complaints on the part of the workers were sur- prisingly few and pertained to heat principally, and fatigue secondarily. Com- ments. — Air conditioning systems to supply cool air in summer and warm air in winter, with means of removing humidity, as by suction fans or hoods, are urgently needed in many places. In addition, good floor drains, impervious aprons or clothing, proper shoes or boots, variations at process so that females in particular need not stand constantly, adequate wash facilities (even to shower baths), a proper place to hang street clothing outside of the wash room, and the separation of the washing process from other processes, are chief correc- 13 O. D. J 194 tive features. Again, a careful record should be kept of all sickness and its character. LAUNDRY, MANGLING. This process consists in taking flat work, as a rule, which has just come from the washing machines and extractors and passing it through cylinders which are heated by steam pipes or electricity. While the central cylinder ex- poses an iron surface the others are usually covered with felt. The workers stand on raised platforms at the large mangles, while they may sit down at the smaller ones. Feeders introduce the goods into the rolls while folders on the opposne side of the machine remove them. The process was investigated in 15 plants employing a total of 362 wagfe- earners of whom 22 were males and 340 were females. The work, although unskilled, engaged a fairly intelligent type of workers in two-thirds of the places. There were no union organizations. The retention of the workers was good in 12 places and at least fair in the remaining. The attitude towards workers seemed excellent in 9 places, good in 4 more, and not so in the remain- ing 2. Some instructions along health lines were found in 2 places. There were no sick benefit organizations. Health appliances (see below) were good in 9 places, fair in 2, and absent or inefficient in the remaining 4. The general construction of work quarters was good in 6 places, fair in 6 more, and poor in the remaining 3. Other processes, such as washing, ironing, marking and sorting, were present in the same room in 9 places. There were 16 persons over 40 years of age, and about 25 under 20 years of age. Steam, humidity and dampness were negligible in 6 places, fairly so in 4 more, and bad in the remaining 5. In some places this was as much due to the washing processes present as escape of steam from the mangles them- selves. In 3 places quarters were unduly dark. General room ventilation was good in 5 places, fair in 5 more, and poor in the remaining 5, due to the lack of air exchange and the contaminations from the processes present. The room temperature was good in 3 places, fairly hot in 8 more, and unduly so in the remaining 4. In about the same proportion washup facilities were meagre, while here and there toilets were located at a distance and were only reached through cold passage ways. Fatigue was a bad feature in 1 place, fairly so in 8 more, and negligible in the remaining 6. The chief features were constant standing and monotonous work, particularly in the case of young girls. Piece- work was noted in but 1 place. The awkward postures assumed by many, and the self-same rapid movements, were also features. The workday was 8 hours in 1 place, and from 9 to 9^^ in 7 places, and 10 hours in the remaining 7. In a few places it was shortened on certain days of the week. Saturday after- noon oflf was the rule at all places. The noon recess was 1 hour at 1 place, and J hour at the remaining 14. The risk of contracting communicable dis- eases was negligible in 5 places, but a fair hazard in the remaining 10, due to such features as common cups and towels, inadequate wash places, poor toilets, absence of lockers, crowding of workers side by side, and lack of medical super- vision. In only a few places were men and women working side by side. Medical supervision is quite important since the large machines require a number of persons to work close together. Poisoning is no feature of the process, but escaped and incompletely oxidized gas fumes were noticeable in 195 2 places. The industrial inducement to stimulantism was in direct proportion to the extent of heat, moisture and fatigue factors. The appearance of the workers was generally good in 9 places, and no more than fair in the remaining 6. Here and there were some who were plainly affected by the heat. Comments. — For the escape of steam there should be provided exhaust hoods as closely suspended over mangles as possible, room exhaust fans, air-agitators and perhaps air-conditioning systems such as a number of places have already installed. In 1 place cool air blasts were pro- vided. Changing about between feeders and folders would do much to vary the monotony of the work, as the folders can usually sit down. LAUNDRY. IRONING. This process was either machine ironing or hand ironing. In the former, goods are passed through cylinders resembling mangles and arranged to suit the classes of goods to be ironed. They are usually operated by the use of a foot lever which is several inches above the floor. The machines operate very fast, as a rule, and have different names, such as body- ironers, cuff ironers, etc. In the processes here described, dampening, drying and starching, which are closely associated, are included .with ironing. This was investigated in 21 establishments employing at this process a total of 774 wage-earners, of whom 34 were males and 740 were females. The use of modern methods prevailed in 10 places, fairly so in 6, and not so in the remaining 5. Health appliances, consisting of exhaust fans and air-agitators for room ventilation (and in a few instances of compressed air to operate the rolls, instead of a foot le\er), were good in 9 places and absent in the remaining 12. Definite instructions along health lines were being given in 5 places. There were no union organizations. The general type of workers was good in 13 places, fair in 6 more, and largely ignorant foreigners in the remaining. The attitude toward employes appeared excellent in 14 places, fair in 6, and not so in the remaining 1. Retention seemed good in 161 places, fair in 3, and not so in the remaining 2. There were no sick benefit organizations. Work rooms were hygienically constructed in 9 places, fairly so in 3 more, and not so in the remaining 9. Other processes than those mentioned were present in 4 places. There were 14 persons over 40 years of age, and about 80 under 20. The work is unskilled, although a little experience develops a high degree of dex- terity. General cleanliness was good in 18 of the places, and at least fair in 2 of the remaining. Humidity was a bad hazard in 4 places, fairly so in 6 more, and negligible in the remaining 11, the cause being escaped steam, and, in some places, wet floors. Seventeen places were well lighted, 1 fairly so, and 3 not so. General room ventilation was excellent in 5 places, and fair to good in 14 more, but bad in the remaining 2. This was due to motionless air, contamination by imburned gas fumes from heating appliances and somewhat by odors arising from solutions and goods. Heat was a bad feature in 2 places, and fairly So in 10 more. Fatigue was a factor in practically all places, due to the nature of the work which seems to require (?) constant standing for the majority of the workers, and in a rather unnatural posture, with monotonous movements rapidly performed. The constant use of the foot lever is the most fatiguing feature. In 9 places there was evidence of hurrying piecework. There was 196 also considerable eye strain, due to the constant looking do^vnward upon white and other glazed starcHed goods. This is more pronounced among hand ironers. The workday was, 8 hours in 1 place, 8^ to 9 hours in 4 places, and 9 to 10 hours in the remaining 16, with some variations on certain days. The noon recess was 1 hour in 2 places, and l4 hour in the remaining 19. Overtime was rarely resorted to. The liability to the contraction of communicable diseases was negligible in 9 places, a fair ; hazard in 9 more, and bad in 3, due prin- cipally to inadequate wash facilities and closets, the use of common drinking cups and towels, and to the lack of medical supervision, especially for the large number of young females employed. Liability to poisoning is no feature of the process itself, provided gas connections are good; otherwise, there is considerable danger of chronic gassing. This is the same for hand ironers, as elsewhere described. The industrial inducement to stiiiiulantism was found to be a fair hazard in at least 13 places, due to the depressing influences above described. The general appearance of workers was good in 12 places, and only fair in the remaining 9. Complaints by workers themselves were not numerous, although in many instances they appeared either too busy or too timid to answer questions. Their statements consisted chiefly of fatigue symptoms, heat effects, especially in warm weather, and the frequency of headaches and indispositions. Comments. — Work variation appears to be the most feasible means of meeting the question of fatigue in this process. This should be in- sisted upon irrespective of the wishes of employes. Standing upon cement or other hard floors should be prevented by the use of mats, low platforms, etc. Instructions should be given in how to stand, and in the avoidance of awkward postures. The leaning upon hand irons with the breast or stomach is apt to be productive of digestive troubles, chief among which ulcer of the stomach and gall bladder troubles are to be feared. Frail girls should not be permitted to manipulate heavy hand irons nor foot treadle machines. This question of fraility and qualifications for such work cannot be judged by the mere appearance of a worker. All of these employes should be under proper medical supervision. The frequency of lower limb complaints, under par con- ditions, female disturbances, and neurasthenia among laundresses, is well known. Much headache can be prevented by arranging the workers properly in respect to light, and in the use of eye shades; darkened glasses for workers on white goods would prove very restful. Other features are suggested in health hazards above mentioned. DRY CLEANING. Dry cleaning involves various chemical and mechanical processes for the cleaning and removing of spots and stains upon clothing and various textiles. While naphtha (benzine, gasoline), is the chief chemical used, and that which the vast majority of workers are concerned with, a considerable list of other fat, resin, and color solvents are used by a few skilled workers who understand th'eir solvent powers, and are usually well informed as to their poisonous properties. The process in many places is closely associated with dyeing, so that the workers at one process were subjected to the hazards of the other. Dry cleaning was the chief process concerned in 25 establishments here reported. These were found to employ a total of 142 wage-earners, 73 of whom were males and 69 females. Thoroughly modem methods and equip- 197 ments were the rule in 20 places, fairly so in 2 other, and not so in the remain- ing- 3, the largest of which employed 5 persons. Health appliances (see below) to protect tlic workers from breathing the naphtha fumes were of good efficiency in T places, fairly so in 2 others, and not so in the remaining 16. Health placards and definite health instructions were present in 2 places. There were no union organizations, nor were there sick benefit societies. The attitude toward workers, retention of workers, and the type of workers were good in 21 places, fairly so in 3 more, and not so in the remaining 1. The work Fig. 51. Dry Cleaning. A revolving naphtha cleaning tub, completely enclosed and having an excellent exhaust system to remove fumes. itself required no particular skill. Work quarters were hygienically constructed in 14 places, fairly so in 5 others, and not so in the remaining 6. Other pro- cesses (other than dyeing) were found occasionally. In all places great care was taken to avoid fires and explosions in the storage and use of naphtha. In dry cleaning itself there were but 3 wage-earners over the age of 40 while very few, if any, appeared to l)c under the age of 20. Quarters were kept clean in 22 places and fairly so in the other 3. In 7 places dampness and humidity were fair hazards, while in the balance they were negligible. Quarters were well lighted in 'lO places, fairly so in 2 others. 198 and not so in the remaining 3. The air of the workrooms was satisfactory in 4 places, fairly so in 16 others and not so in the remaining 6, due to the con- tamination of escaping naphtha fumes. In 2 places quarters were kept unduly warm. Workers also had a tendency to dress very lightly, and to expose them- selves outdoors, or to drafts, rather frequently while so clothed. In some places the isolated dry cleaning building was entirely devoid of heating methods. Fatigue was a negligible factor in 22 places, but in at least 3 establishments there was constant standing even where females were employed. The work- FiG. 52. Dry Cleaning. Showing method of hot drying of articles so that workers do not need to enter the drying room, which is filled with hot naphtha fumes. day was 8 hours in 1 place, from 8^ to 9 hours in 15, and from 9 to 10 in the remaining 9. The noon recess was 1 hour in 13 places, and ^ hour in the remaining 12. Outside of the disputed risk of handling used garments, there was no particular liability toward contracting commtmicable diseases in 21 of the places, while in 4 there was promiscuous spitting about the floors, and the absence of cuspidors. As a rule there were very few employes doing this work in any one place, although in the cleaning of gloves, and similar small pieces, there were as high as 25 females employed. The absence of lockers 199 and the use of common towels and common drinking cups were frequent obser- vations. In 4 places the escape of naphtha fumes was sufficient to cause chronic poisoning. Fortunately these were all small places, employing 1 or 2 men at the process. In 19 other places the odor of naphtha was definitely present, but in rather too small amount to affect the health of workers, pro- viding undue individual susceptibility were guarded against. Many workers appeared to expose their hands more than necessary to naphtha. The use of other dangerous substances, such as ether, chloroform, acetone, wood alcohol, benzol, turpentine and carbon bisulphide was always limited in amount, and looked after by a skilled worker. Industrial inducement to stimulantism had for its chief factor the depressing influence of the inhalation of the fumes. The general appearance of the workers was good in 19 places, fair in 4 others (including 1 establishment employing 14 help, of whom 8 were females), and poor in the 2 remaining (both ^mall places'). In 5 places workers com- plained of poor ventilation and the insufficiency of methods used to remove the fumes. Their symptoms were the usuat ones of acute and repeated benzine poisoning. Investigators saw 2 cases of mild, acute benzine poisoning, and 2 whose symptoms were evidently due to chronic benzine poisoning. In several instances workers were remarkably pale as well. Comments. — The complete enclosure of naphtha tubs, or the complete confinement of the fumes within the tub, except during brief intervals of opening and closing, were the methods usually taken. In addition, for table work and open vats, room-exhaust fans and hoods locally applied, with down-draft fans, should be used. Floors should be impervious and easily drained. The subsequent DRYING of the cleaned articles should be done in cabinets or cupboards which do not have to be entered. This can be effected quite easily by the use of sliding racks, upon which the articles are hung, and so arranged that when the rack is within the cupboard, or is in the room out- side, the cupboard is entirely closed. There should be. also, a slight suction in this cupboard to prevent leakage into the outside room. It was further claimed that agitating the air in this cupboard greatly facilitated the drying. CARPET CLEANING. — Carpet cleaning is sometimes also done by dry cleaning establishments. This was investigated in 3 places employing a total of 24 wage-earners, all males. In all places dust from the carpets was a bad hazard. In 1 place the people in the neighborhood complained very much on this ac- count. In all places there seemed to be great liability to the contraction of communicable diseases, due not only to the dust coming from the carpets but to carelessness in spitting upon the floors and in the inadequacy of wash- places and proper toilets. Cleaning of quarters was usually done by dry methods. Windows were depended upon for ventilation. Quarters were very dirty in 1 place. After removing the dust from the carpets, they were next scrubbed either by hand or in a tumbling machine, without any material hazard to health. Again, some rugs, and, even, carpets were cleaned in naphtha baths, without practically any protection from the fumes. Fortunately, this latter process was not a continuous one. DYEING. The process of dyeing clothes was investigated in 1^^. places, and of hats in 1 place. The dyeing of textiles (not an extensive industry in Ohio) was 200 investigated in several places as well. The total workers so engaged numbered 422, all males. The type of workers and their retention was good in all but 1 place. The attitude toward workers was good in 10 places, fair in 3, and not so in the remaining 1. There were no unions ; also no sick benefit associa- tions. The amount of skill necessary, so far as the workers were concerned, appeared to be very limited, this probably being due, in a large extent, to the use of anilin dyes in modern methods. In 5 places, health appliances con- sisting of hoods over certain vats and tubs, and room-exhaust fans were good; in the balance they were absent. The construction of the work room was good in 6 places, fair in 3, and poor in the remaining 5. Usually the dyeing room was by itself, but in 2 places washing, steaming and pressing were being done — in 1 place' engaging 10 females. There were 6 persons over 40 years of age, and none, aparently, under 20. Dust is not a feature of the process, although the careless handling of some of the dye ingredients might easily cause poisoning in such form. Quarters were cleanly in 10 places, fairly so in 2, and not so in the remaining 2. There was unnecessary exposure to dampness, steam and wet floors in 1 place, and a fair exposure in 11 more. Quarters were poorly lighted in 4 places, but good in the remaining 10. General room ventilation Avas good in 3 places, fair in 8, and bad in the remaining 3, the hazard of quiet, still air being accentuated in several places by the presence of gasoline fumes and steam. While heat is a necessary feature of dyeing, it constituted no health-hazard in 13 places, the remaining 1 being unduly hot. On the other hand, 2 places were very poorly heated for winter work (both small). The process was not fatiguing, although there was considerable standing-still. The workday was found to be from 9 to 10 hours in all places ; the noon recess 1 hour in 8 places, and ^ hour in 6 places. The liability to the contraction of conMunnicahle diseases was negligible in 1 place, a fair hazard in 8 others, and considerable in 5 others, due, principally, to promiscuous spitting, absence of cuspidors, inadequate wash places, poor toilets and the use of common cups and towels. (The question of handling used garments is discussed under Dry Cleaning and in Laundry Processes.) The liability to poisoning was some hazard in all places, and particularly so in 4, the risk being largely one of personal carelessness. For- tunately, the large majority of anilin dyes are non-poisonous. However, the manufacturers' agents for such dyes claim that it is almost impossible to rid most of them from traces of arsenic. The non-labeling of poisonous dye materials is a serious factor, for it was found that practical^ none of the workers had any information as to which were poisonous and which were non-poisonous. In addition to the dyes, various cleaning substances, especially naphtha, used in auxiliary processes, were encountered in several places. The industrial inducement to stimulantism was chiefly influenced by the unhealthy character of the air breathed. The general appearance of the workers was good in 12 places and* fair in the remaining 2. The chief complaints were the effects of steam and escaped gas fumes, while 1 employe mentioned, particularly, dermatitis. Com- ments. — Good workroom ventilation, and the use of hoods over steam and hot processes are the essential features. Beyond this, workmen should be pro- tected by the requiring of a label upon all poisonous dye ingredients. The almost exclusive use of anilin and vegetable dyes in weak solutions seems to have done away with the danger of poisoning after the solutions are made up. 20I As STEAM CLEANING is more apt to be done in connection with tlie dyeing quarters than elsewhere, it is mentione'd here. Heat, humidity, ahernate exposure to drafts, absence of lockers and dry places for street clothes, and of proper wash-up facilities, were the main hazards, and the mention of them suggests the remedies. STORAGE BATTERIES. In the making of storage batteries (electric accumulators) lead plates are cast, usually in machine molds, dressed up, polished, brushed, and lead oxide pastes rubbed into them. The plates or elements are then connected together by soldering and lead-burning processes, using blow pipes as a rule, after which they are placed in lead-lined boxes or glass, or other impervious jars, dilute sulphuric acid added or other electrolyte, and then charged. The process was investigated in 9 different establishments of which 4 employed but 1 to 3 men ; also in connection with 1 automobile factory, 1 auto- mobile repair plant, and 1 railroad, shop. One shop employed no workers outside of the owners themselves, the total employes engaged in the remain- ing 8 plants numbering 529, all males. In no places could methods be regarded as modern, from the point of view of preventing lead poisoning. There were no unions. The attiture towards workers seemed good in 4 places, while interest in their welfare seemed to lag in the remaining. In the 2 largest plants workers were very largely ignorant foreigners, most of whom were unable to speak English. This would include fully 80% of all the workers so engaged. The steadiness of workers in the various processes was con- siderably interfered with by sickness in the form of lead poisoning. Health protective appliances to remove fumes and dust were quite universally absent or were installed with more or less makeshift attempts, and greatly lacking in efficiency, particularly for the protection of the type of workers so employed. In the 2 large plants medical supervision was being developed at the time of our in.spection, while instructions were being published for the workers upon the subject of lead poisoning and its prevention. How far such were in- telligible to the workers we were unable to ascertain. Apparently too much was being expected of the physician and too little thought and money devoted to the correction of conditions. In 1 plant employing 6 men at this process the privilege of a sick benefit association was at hand, but the balance of wage- earners enjoyed no such insurance. The work was practically all unskilled. The hygienic construction of work rooms was good in 5 places employing a total of 57 workers, and bad in the remaining 3. Other work than that apper- taining to the making of storage batteries was present in the same quarters in 4 small places, thus needlessly exposing such workers to the hazards of the storage battery business. In practically all work rooms where lead dusts or pastes were used, the hazard to health was bad. Methods of generally doubtful efficiency were adopted here and there to prevent it. Employes were supplied with respirators which seemed to be the chief means depended upon to avoid the inhaling of dust. These were indififerently worn. Much of the dust came from the drying down of the pastes upon the work bench and the floor, where moving about stirred it up. There was also great risk from the fine lead dust deposited from fumes in the founding and casting quarters. General cleanliness of quarters, an extremely important feature in this line of work, was good in 4 small places. 202 fair in 1, and bad in the remaining 3, which included the vast majority of the total number of workers. Impervious floors capable of flushing with a hose were a chief absent feature. There was some dampness and permanent wetting of floors in some places (as the charging rooms), but this constituted only a nominal hazard and employed few persons. In some places, quarters for a considerable number of the workers were poorly lighted. General room ven- tilation was good in 1 small plant, fair in 2 others, and bad in the remaining 5. In the melting and casting processes, heat was a fair hazard, although most (not all) of the melting pots and furnaces were fairly well hooded and drafted. Adequate washing facilities for most employes were very meagre, and for hot process-workers no shower baths were provided. Fatigue was a considerable factor in 1 place, fairly so in 1 other, and negligible in the remain- ing 6, the latter employing a total of only a few men, however. The chief factors were hurrying piecework, speeding up, monotony, prolonged standing, and faulty postures. The workday was 9 hours in 2 small places and 10 hours in the remaining 6 places. The noon recess was ^ hour in 6 places, ^ hour in 1, and 1 hour in the remaining 1, the last 2 employing a total of 11 persons. Occasionally overtime was necessary. Lead poisoning is the great hazard in this industry. There is some risk also from the careless handling of acids in pasting, soldering, lead burning, and charging. The chief factors inducing lead poisoning are the use of lead and lead compounds in dust, molten and fumy forms without proper mechanical confinement or removal of the same from the atmosphere which the workers breathed. The next feature is the employing of an ignorant type of laborer in a most poison-hazardous process, — ipersons whom it is most difficult to instruct in personal hygiene. To ac- complish anything here it is necessary to supply workers with special outer garments and keep them clean and in repair, to insist that workers do not eat in the workrooms (by all means proper eating quarters should be pro- vided), that they carefully wash their hands, faces and lips, before eating or putting anything in the mouth, that they do not carry tobacco about in their work clothes so that lead dusts and fumes can contaminate the same, that they keep their finger nails trimmed short, their mustaches trimmed short, and that time be given them at least twice a day to attend to these matters, — preferably just before the noon recess and before quitting time, and that foremen be especially drilled to superintend the carrying out of such measures. A third feature is extreme cleanliness of floors, tables, benches, walls and ledges, by wet processes and vacuum cleaners, and the maintenance of the purity of the air by preventing its contamination in any way with lead in any form. Finally, the frequent physical examination of each worker by a com- petent physician. The industrial inducement to alcoholism is greatly favored in this industry by the presence of the poison element — lead — one of the eflfects of which is to create a craving for stimulants. The frequency of the associa- tion between alcoholism and lead poisoning is well known. In two small places employing a total of 9 men, all were healthy appearing. In the remaining establishments, a few to many occupationally diseased work- men were seen. Most of these had prominent signs and symptoms of lead poisoning, sometimes of acute form with manifestations just beginning. In addition, numbers of persons reported attacks of colic, and disabilities lasting from a few days to several weeks which were unquestionably due to lead poisoning. Hospitals, dispensaries and physicians, in the vicinity of such works. 203 gave many statistics of lead poisoning cases. The chief features of these are summarized in Part VI of this report. Comments. — Outside of the actual manufacture of the oxides and salts of lead, there is no industry covered in our survey which requires greater precautions against lead poisoning than the manufacture of storage batteries. The means necessary to prevent lead poison- ing are summarized above. This is an industry in which conditions are much more to blame for sickness than to workers. These conditions have been success- fully coped with elsewhere. It is only fair to say that the seriousness of these things is being more and more appreciated by manufacturers and that many improvements in these same plants have been under way since our inspections were- first made, with the result that there has been a noticeable dropping off in the number of reported cases of lead poisoning, when the year 1914 is com- pared to the year 1913. The reader is referred to the rules and precautions for the prevention of lead poisoning formulated by the Committee on Storage Batteries; Asso- ciation of Edison Illuminating Companies, adopted September 15-17, 1914, and approved by the American Museum of Safety (see ''Safety," Vol. 2, No. 9, Oct. 1914, p.. 219, — 29 West 39th St., New York.) Furthermore, the Ohio State B9ard of Health has a large placard upon "Instructions to Employes — How to Pre- vent Lead Poisoning," intended for posting up in workrooms. These instruc- tions were published in the Bulletin of the State Board of Health for June, 1914, p. 845, and are given in Part VII of this report. DRY BATTERIES. The manufacture of dry batteries was investigated in 3 establishments, in 3 cities, in which a total of 978 wage-earners were engaged at this process, of whom 761 were males and 117 were females. There were no union organiza- tions in any of the places. The general welfare attitude towards the workers, the type of the workers, and their retention at work seemed good, fair and bad in each of the places respectively. There were no adequate health ap- pliances, no instructions or placards along health lines, nor sick benefit asso- ciations. The work was almost entirely unskilled labor. Dust was a bad hazard in 2 of the places, and to a fair extent in the third, due to the large amount of carbon and "battery dust" used. In one place the men kept faces covered with talcum to prevent "skin from peeling off" in handling hot pitch. One plant was also quite dark, and not kept clean. General ventilation seemed good in all three places. Fatigue was not much of a factor. General sanitary arrangements were usually good, but on account of the dust \ and the usual absence' of cuspidors there was considerable risk of spreading communicable diseases, particularly as no medical supervision obtained. Creo- sote, pitch, benzol, hydrochloric acid, zinc chloride, lead (soldering), mercury (amalgamizing), and the organic bodies found in carbon constituted the poisons present; the hazards from all were considerable. In 1 place a large percentage of the workers were pale and anemic looking, in the other 2 places their appearances were somewhat better. Our investigators found several cases of skin trouble, with redness, fissuring and itching; also cases of unquestioned con- sumption; and in some instances of acid burns and zinc chloride burns. Com- plaints were frequent of fumes, dusts, acids, etc. A prominent surgeon in Cleveland claims to have had several cases of epitheliomata (cancer of the 204 skin) from these workers and thinks they resemble in origin the same class of neoplasms which affect chimnej'-sweeps. An officer of a companj- in another city stated that he knew of 3 of their employes who had worked, subject to carbon dust, and who were said to have died of cancer which began in the mouth. Coiniiients. — It would require an intensive study to determine how best to protect this class of workers. It is well enough to sa}^ "local exhausts, hoods, gloves, etc.", 'but the exposure to the dust is unusual, and very difficult to con- trol. Probably chemists, engineers and sanitarians could suggest some changes in methods which would suffice. It must be remembered that most of these employes probably do not have the cancers develop until years after leaving the emploj' of the firms. INCANDESCENT LAMP MANUFACTURING. As the processes in this industry, with the exception of glass blowing, are quite different from those elsewhere described, it is considered best to take them up separatelj' at this place. The industry was investigated in 7 plants located in 5 cities and employing a total of 1995, of whom 447 were males and 1548 were females. Of this number 82 males and 577 females were engaged in the particular processes discussed here below. The general type of workers was good in all places. Verj- good effort was made to retain them. There were no union organizations. Considerable attention has been given to health ap- pliances, especially in 5 places. There were no sick benefit organizations re- ported, though in 1 place a beginning was being made for such. None of. the work was of a skilled character. Premises were of fair to good hygienic con- struction and arrangement in 6 places and not so in 1. Efficiency auxiliaries such as organized welfare promotion, pleasant surroundings, instructions in personal hygiene, and disease prevention, were advantages enjoyed by the work- ers. Age groups ran very largely to j'ounger persons, there being but 18 over 40 years of age, 455 between 20 and 40, and 174 under 20. In some departments in 5 places glass dust from broken fragments was a moderate hazard, although frequent cleansing by wet methods existed. Respira- tors were furnished in sand-blast-departments but were little used by the work- ers. Much of the work was of necessity done in darkened rooms and in rooms in which green window-panes obscured the natural light. In 6 places the general room ventilation was of no more than fair character, while heat was a fair hazard in the same number of places. A considerable amount of hurrying piecework was noted in 5 places, much of it of monotonous character, and especially trying upon the eyes, due to flashing of lights, to brightness of lights and to working with fine filaments. The workday was between 8 and 9 hours in 6 places and 10 hours in 1 place, the noon recess being 1 hour in 4 places and I hour in the remaining 3. All places had good rest rooms, employed a factory nurse, required their employes to leave the workrooms at the noon hour, and to eat in the lunch rooms provided for the purpose. At this time the windows of workrooms w^ere widely opened. Considerable study had been given to the subject of eyestrain, and in practically all places seats were provided for stationary work. The liability to the contraction of commumcahle diseases was a fair hazard in parts of places, due to such factors as the use of common towels, crowding (irrespective of room space), flying particles, frequent trivial 205 injuries and short-intervaled common handling of objects. On the other hand these conditions were found to have been anticipated by first-aid equip- nienis. surgical rooms, good wash places and closets, the keeping of sick records, the supplying of goggles, asbestos finger cots, and in some plants individual lockers and individual towels. Mercury, wood alcohol, phosphorus, escaped gas fumes, and solder, were the chief poisons concerned. None were exposed to mercury, which was used in closed containers to produce a vacuum. The red phosphorus was used free of the white or yellow variety in painting, and the risk of lead poisoning from the grade of solder used and its manner of use seemed negligible. On the other hand in many places the air was con- siderably devitalized by numerous gas flames and contaminated by the escape of fumes from the same. In other places exhaust flues locally applied seemed ample. In certain processes wood alcohol fumes were unduly strong, due to lack of prompt air exchange. In at least 1 place the girls' fingers and hands were moistened through sponging with wood alcohol. The industrial induce- ment toward the taking of stimulants was some factor, due to the effects of eye-strain, fumes and fatigue. Good drinking water facilities were present in all places. In all places a few or more workers were seen who were not healthy looking. Their chief complaints were eye trouble, causing a considerable amount of headache among a goodly number of employes. While this was laid to strain, we are not certain that some of it was not due to wood alcohol. Less often were mentioned foreign bodies in the eyes, trivial cuts and burns, and, here and there, one stated that wood alcohol fumes caused headache, and solder fumes caused sore throats. A summary of the chief hazards in each department of the process is here given. Filament Making. — Wood alcohol, inadequate room ventilation, gas fumes, heat, presence of other processes, hurrying piecework and monotony. Tubulating, Sealing and Painting. — Gas fumes, heat, wood alcohol, some con- stant standing, broken glass dust, monotony and hurrying piecework, presence of other processes, sometime^ crowding, small cuts and burns, foreign bodies in the eyes. Filament Mounting, Spidering and Winding. — Eye-strain from fine work, wood alcohol, gas fumes, warm quarters, the presence of other proc- esses, inadequate room ventilation, some crowding, hurrying piecework and monotony, foreign bodies in the eyes, small cuts and burns. Vacuum Produc- tion. — Eye strain from bright and flashing lights, presence of other processes, heat, some crowding, some escape of gas fumes, hurrying piece-work and monotony. Photometry and Aging. — Eye-strain, due to bright flashing lights, some constant standing, heat from lamps, presence of other processes, some crowding, hurrying piece-work and monotony, inadequate room ventilation. Finishing Processes. — Some escape of gas fumes and solder fumes, a little eye-strain, wood alcohol, troublesome calluses produced by the use of wire cutters, some hurrying piece-work and monotony, inadequate room ventilation. Comments. — In all places most of the hazards above enumerated had evidence of being given considerable thought by the managements. However, contrast conditions were frequent ; for instance, little attention was paid to heat in some places while cool air blasts were found installed in others, for similar work. Lack of co-operation on the part of some of the employes was unques- tionably a troublesome factor at times. For general room ventilation exhaust fans in the walls were installed in many places, in some, rather too high up, we 2o6 believed, to be of good service. The addition of air-agitators, preferably the large paddle, slowly revolving type, would help greatly in quarters where many gas burners and methyl alcohol are used. Atmospheric determination instru- ments, such as the room thermometer and hygrometer are called attention to, especially for warm quarters where youths and females predominate. The examination of employes for physical fitness, already inaugurated, should be greatly extended. RUBBER. — WASHING. - This process consists in the cleansing and preparing of crude rubber by "cracking" it up in mills, both warm and cold, with running water, after which the rubber is further steeped in large tanks of water. The process was investigated in 11 establishments. There was a total of 279 wage-earners, all males. The employes were very largely foreigners, many of whom spoke very little English. Outside of their own shifting tendencies they were found to be well retained by their employers. The work is unskilled. Health appliances, such as floor drains, elevated floor treads, the supplying of rubber aprons, boots and gloves were found to be sufficient in 5 places, while 4 others made little attempts along these lines. Work hours were 8 per day in 1 place, 10 hours in 9 places, and llj- to 12 hours in 1 place. The noon recess was 30 minutes in all except 1 place. Ninety-five per gent of the workers were under 40 years of age. The general construction of the workroom was found to be hygienic in 7 places and fair to bad in 4 others. The process was usually by itself, but in 2 places the mixing and calendering mills were in the same room. Some soapstone dust was used in 5 places, and in 1 place contaminated the air badly. The quarters were kept clean and orderly in 8 places, while, in 3, waste-products were allowed to accumulate and dr}' out ; furthermore, dry cleaning during work hours was done. The process is necessarily damp and steamy, and because of the absence of ventilators for steam, the humidity was- excessive in 6 places, and fairly so in 5 more. Wet floors were common. Light was good in 7 of the rooms, fair in 3, and poor in 1. Outside of the humidity, the air was good in 5, fair in 5, and bad in 1, due to faulty general ventilation of quarters. Rubber odors were pronounced in some confined quarters. The temperature was satisfactory in 7, and rather uncomfortably warm in 4 places. Washing facilities were poor in 6 places, while but 1 pro- vided a shower bath. Lockers were present in 5 places and change rooms in but 2. Day work was the rule. Fatigue was hardly a factor. The contraction of communicable diseases was very possible in 2 places, fairly so in 6, and practically nil in 3. The hazards were common cups, inadequate washing places, poor closets, spitting about the floors, absence of cuspidors, and the lack of medical supervision. Poisoning was not a hazard in this process of itself. In 3 plants, lead and antimony were being used in dust form in the some room, with, considerable liability to poisoning all the workers. Alcoholism was favored in 8 places by the lack of good drinking water facilities, the depressing effects of humidity, and absence of change-rooms for removing wet work-clothes and drying them out before the next day's work. The workers were found to be healthy in appearance in 8 places, while in 5 others 1 or more sickly looking men were observed. 207 RUBBER. — COMPOUNDING. The mixing together of various ingredients, usually metallic oxides and salts to be mixed with the rubber later, is termed "compounding". According to the various formulas, the dry powders are scooped out of bins and weighed by hand, placed in opentop tin boxes, and carried direct to the mixing mills, or delivered close thereto through pipes, by gravity. Occasionally, the in- gredients are first bolted in shakers in a room above, to break up lumps. Unless the shaker is well enclosed, this is exceedingly dusty work. Sometimes anilin oil is poured directly upon the weighed powders from an ordinary cup. This process was investigated in 16 establishments, employing a total of 151 wage-earners, all males. Methods were considered fairly modern in 6, and as clumsy and antiquated in 10 places. The attitude toward workers ap- peared to be good in 12 places, fair in 3, and poor in 1 place. The workers were intelligent laborers in 7 places and ignorant foreigners in 9 places. The firms made an apparently serious endeavor to retain workers in 6 places, fairly so in 7 others, while in 3 the attitude toward the workers in this process ap- peared to be that of "If you don't like the work, quit". Adequate health appliances were not found in any place, but the use of closed hoppers, conveying pipes and receptacles, kept down dust considerably in 5 places. In no places were complete dust exhaust systems found, while in 11 places very little at- tempt was made to limit dust in the air. This fact was surprising, inasmuch as in all other departments of most of these plants, considerable attention was given to health appliances. In but 1 plant were the workers given instructions by a competent person on the avoidance of lead poisoning. The work day was 10 hours in 14 places, 9i- hours in 1 place, and 8 hours in the remaining 1. The noon recess was v hour in 11 places, 1 hour in 4 places, and not ascer- tained in the remaining 1. There were usualh^ but 1 or 2 men considered skilled in each place. The vast majority of the men were between 20 and 40 years of age. The workrooms were hygienically constructed in 8 places, fairly so in 3, while in o, poorly so. The process was found in all places to be done in a room or space by itself, although, in many, wide doors and window-ways gave free air access to adjoining processes. Metallic and poisonous dusts contaminated the air badly in 6 places, and fairly so in all the balance. Dust and waste-product accumulations upon walls, windows, ledges and floors was bad in 4 places, and present to a fair extent in the balance. Dry sweeping during work hours was frequently noted. Damp- ness is not a feature of the process. Light was found to be good in 12 places and only fair in 4 others. Room ventilation was excellent in 1 place, good in 11 others, and poor in 4 places, the latter due, principally, to confined quarters and the presence of fumes. There were no artificial ventilating systems found. Temperature is not a factor in the process. The work is not fatiguing to any extent. The contraction of communicable diseases was highly possible in 4 places, fairly so in 8 and practically nil in 4 others, the chief hazards being the use of common cups, improper or absent wash places and closets, spitting upon dust laden floors, the absence of cuspidors, and the lack of physical examination of employes. Poisoning by lead and antimony in the shape of dust, and occasionally, anilin in the shape of oil or fumes, was easily possible in 11 places and fairly so in the remaining 5. The chief factors were the dustiness of the work, the ignorance o^ the workmen, lack of instructions, the 208 wearing of mustaches and even beards, the eating and chewing at work and in the workrooms, the non-observance of personal care, lack of medical super- vision, of proper gloves, the invariable lack of respirators, also clothing supervision, lockers, washing facilities, and, as mentioned above, mechanical protection from the dusts. The industrial inducement to alcoholism was decided in 3 places, and fairly so in 8 others, due to the lack of good drinking water facilities, the subjection to the dust and poisons above cited, and the belief among the workers that alcohol prevents metal poisoning ! In no place were all the workers perfectly healthy appearing, while in 5, some very sickly looking men were seen. The chief complaints of the work- ing men, where they could speak English, were dust and, occasionally, fumes. Occupational diseases were encountered as follows in 8 -places: Lead poisoning, positive 22 cases. Lead poisoning, tentative 5 cases. Several of these cases had partial paralysis. There were, in addition, 2 cases of acute anilin poisoning reported, but not seen by the investigators, and numbers of hearsay cases of lead poisoning. Comments. — Much greater supervision of workmen is necessary in this process, including at least monthly examination of all the workers for signs of lead poisoning, while we feel certain that the ventilating engineer could render the work practically dustless. The hazards named above indicate other precautions. RUBBER. MIXING MILLS. In this process, the previously washed and dried rubber is macerated be- tween steel rolls, while, at intervals, the workman pours upon the rolls a scoop- ful or cupfull of the ingredients, delivered^to him from the compounding room. Our findings covered this process in 21 establishments, employing a total of 525 wage-earners, all males. The attitude toward the workers was good in 15 places, and at least fair in the balance. The workers were English-speaking in 6 places, but in the remaining the large majority were ignorant foreigners. An endeavor to retain the workers at the process was evident in 20 places and not so in 1. Health appliances, consisting of hoods and ventilating ducts, some- times with partial curtains, or aprons, placed over the mixing rolls, and with exhaust fans, were found in 3 places ; 7 other places had exhaust fans in the upper parts of the room, the value of which, however, was questionable, since, without hoods and vents over the mills, these only tended to suck up the dust into the air. In the balance of the places (11) there were no health appliances of any sort. The noon hour was a 30 minute recess in 5 places, 45 minutes in 2 places, and 5 allowed 1 hour. Overtime was also frequent in 7 places. The work is not a skilled process. Three boys under 20 were observed, and less than half a dozen of the total workers were over 45. The work rooms were constructed hygienically in 10 places, fairly so in 7, and not so in 4. The process was practically by itself in 14 places, and, in the balance, was in the same room with Rubber Washing, Calendering, or other processes. Dust in the atmosphere was observed in all places. In 10 it was present to only a fair degree, while in 11 places it was bad. The dust consisted of the dry ingredients (Al, Fe, Ca, Zn, Pb, Sb, Soapstone, etc.), which go into rubber, — 209 lead ranging, according to one analysis of the finished product, as high as 25%. Dirt and waste-product accumulations were evident upon the floors, machinery, lodges, etc., in all places, though to only limited extent in § of them. Dry sweeping and considerable negligence obtained in 7 places. Dampness is not a feature of the process. Light was good in 16 places, fair in 4, and poor in 1 (located in basement). Room ventilation was good in 2, fair in 15, and poor in 4 places, the latter due to bad location, presence of burnt rubber odors, the biting fumes of antimony, and the absence of a room ventilation scheme. Heat was not a great hazard, although the warming mills rendered the temperature, fairly hot in 8 places, and badly so in 1 confined place. Washing facilities were meagre as a rule. The work is not overly fatiguing. The work day was found ■H^*^ X i ' ~~ -^ S^ >):■ ;. '^^^ Sf^-'-'- — - — . -— T— ~___..^ffl^B ,.^' i i ^HH^;^^ ^_ mM 1 ■ i » X ^^|;.r <;.r4^, "S^^H 1 ipi ..... ^ 'r .' " ;%,, lifer .. ^ ah^&S?""*"': r^'^^*^.''"'";^''':^ ,^^^^^M r jj EM SiHWil^^^ m^'m *^j t^^""^^ jiMS. h 1 S^ — ^^^P^ * ■'■^'^ssiisssr'" ^^ ■"■'*'^"^'^*-^.^ m^ i "■^'^'.-"^^y-... SkkSte-. > . ^^1^:2^ ^ i I ^^:^- gt "'^'^WB^] Fig. 53. Rubber Manufacture — Mill and Calender Room. From right to left are two mixing mills, a refiner with a conveyor belt, a warming mill and another mixing mill. The 3-cylinder-high calender is shown at rear. to be 8 hours in 1 place, 9 to 10 hours in 20 places, while in 5 places night shifts worked for as long as 11 to 12^ hours. Piece-work was the rule, limited by certain restrictions to safe-guard quality of output. Noise was ^Iso something of a factor. The contraction of communicable diseases was very possible in 9 places, fairly so in 10 others, and practically nil in 1. The hazards were the use of common cups, promiscuous spitting upon the dusty floors, absence of cus- pidors, and lack of physical examination : in some places first-aid provisions were lacking. Poisoning was about as great a hazard as in the compounding room, due to the same ingredients, which, in dust form, were here scooped out of conveyance boxes and poured upon the rolls. Here and there anilin oil was similarly handled. The risks of poisoning were considered bad in 13 14 O. D. 2IO places and fair in the balance, due, principally, to the ignorance of the workers, lack of instructions, wearing of mustaches, eating and chewing while at work and in the work room, lack of personal care, interval medical examinations, adequate washing facilities, and, in most places, lack of process-ventilation ap- pliances to remove dusts and fumes. The odors of anilin and antimony fumes were plainly detectable in several places. Industrial alcoholism was greatly favored in 4 places, and fairly so in 15 others, due to improper drinking facilities and the various hazards above cited. Appearances of the workers were good in 4 places, but in the balance some sickly lookly individuals were observed. Their chief complaints were found to be the breathing of dust and fumes, nausea due to odors, the closeness Fig. 54. Rubber Mixing Mills. There is a row of these mills on the left with exhaust hoods to remove poisonous dusts and fumes. Xote air-conditioning pipes running full length of room, protected machinery and batch tables within easy reach. and stuffiness of the workrooms, and the symptoms of poisoning — usually lead Our investigators discovered 30 cases of occupational diseases as follows: Lead poisoning, positive 22 cases Lead poisoning, tentative 4 cases Dermatitis, positive 1 case Anilin poisoning, positive 3 cases Comments. — While means of confining or drawing off the dusts and fumes from each milling machine are necessary precautions, personal care, ■ properly taught and supervised, with a monthly examination of the workers, would obviate all of the cases of lead poisoning. 211 RUBBER. CALENDERING (INCLUDING WARMING MILLS). This process follows that of the mixing mills. Compounded rubber is introduced into the rolls of the warming mills and of the calenders which further perfect the material and grade it down into, sheets of required thick- ness. Oftentimes also the calenders are used to press the rubber into cloth fabric, which is called "frictioning". In 12 places in which this process was investigated there were 793 wage- earners, all males. The welfare attitude of the employers towards the workers was considered to be good in 9 places, fair in 2 others, and not so in one. In 5 places the workers were of an intelligent type, while in 7 they were very Fig. 55. Rubber Calender. Note hood above 'which draws off heated air, odors and fumes. Completely equipped with safety devices, including rubber floor mat "X". largely ignorant foreigners. Retention of w^orkers was good in 7 places and at least fair in the balance. Health appliances consisting of hoods and stacks with exhaust fans, covering the calenders and mills, were excellent in 2 places. While these were absent from the balance, other health appliances such as room exhaust fans and ventilation schemes were present in 5 places. In 5 others no attempts were made to remove dusts or fumes arising from the process. The day averaged from 10 to 11 hours in 8 plants, with 30 minutes for noon in 10 plants. In the others the day period was 8 to 10 hours, and the noon recess 1 hour. Some overtime was the rule in 3 places. A certain per cent, of men at this process were at least semi-skilled, but about 80 % were unskilled. Rarely were men over 40 years of age seen. There were, however, very few youths 212 under 20. Working quarters were modern and of hygienic construction in 9 places, fairly so in 1 other, and bad in the remaining 2, due to low ceilings, crowded machinery and the presence of ulterior processes. The process was in the same room as the mixing mills in 5 places, though, in some, well separated. A fair amount of soapstone dust was present in the atmosphere in all places. In most of the places it could 'be considered almost negligible as a health-hazard. Dust accumulations about the floors and ledges were present in all places, although daily cleaning, usually by wet methods, was the rule. Dampness was no factor. Nine of the places were well-lighted, and 3 only fairly so. Room ventilation was good in 3 places, but only fair in 9 others, due to poor location and inadequate or absent ventilating appliances. Heat from the rolls was found bad in 2 places, fairly so in 5 others, and a negligible factor in the remaining 5. Fatigue factors were moderate and in the shape of limited piece-work, monotonous hum of machinery, with evident speeding up in at least 1 place. The process is also fairly noisy. The danger of contracting communicable diseases was considered bad in 2 places, fairly so in 7 others and practically nil in the 3 remaining. The hazards here were the use of common drinking cups, improper washing places and toilets, spitting on the dusty floors, the absence of cuspidors, the lack of physical examinations and of first-aid provisions. Occupational poisoning is hardly a hazard in this process, but dermatitis or eczema, due to the dust and to the handling of rubber, may aflflict the more susceptible. On the other hand benzine fumes were fairly strong in 2 places. Industrial alcoholism was favored in 8 places because of in- efficient drinking water facilities, and the influence of the factors above men- tioned. In only 3 places were all workers healthy appearing. Complaints of the workmen were the benzine fumes, a considerable part of which came from open- top cement cans. These fumes, because of the heat, volatilized greatly. In most places benzine was little used in the process. No cases of occupational poison- ing were found. RUBBER. TIRE-BUILDING. This process consists in the making of casings for automobile and bicycle tires by the applying of layers of rubber fabric upon wheel-shaped molds; to these are cemented the beads, cover layers, etc. It may be all hand work, the operator sitting or standing before the mold, mounted upright on a pedestal, and carefully stretching the fabric as he revolves the "wheel". In some places more than half of the work was being done by mechanical application of the fabric to the molds, called "machine building". This process was investigated in 13 places employing 4,135 wage-earners, all males. The workers are among the most skilled in the rubber industry, while the attitude of employers toward them seemed to be excellent in 12 places and at least fair in the other, so that the retention of the men seemed to be good every place. Health appliances consist of means of ridding the atmosphere of benzine fumes and of reducing the laborious character of the work. In 3 plants, only, were attempts made to limit -the fumes by so much as using covered containers. Privileges of sick benefits were available to part of the workers in 2 plants. The work day consisted of 8 hours in 2 places and 9 to 10 hour shifts in 8 places and 10 to 13 hours in 3 places, with a noon recess of 1 hour in 2 places and 30 minutes in 10 places. In 3 places, overtime was an 213 occasional requirement. Full}- 95% of the workers were between 20 and 40 years of age ; there were some youths under 20, while older men were usually found working in small plants. The work rooms were hygienically constructed in 11 places, but not so in two. Many half-auxiliary processes, such as bead- making, buffing, book-making, and inner tube making, were, as a rule, carried on in the same room. This helped to add to the benzine content of the air. Dust in the shape of soap-stone was present to a fair extent in all places. The quarters were kept well cleaned m 11 of the places, while dust and rubber scraps were allowed to collect in the other two. Dampness was no factor. Light was invariably good. In all places the odor of benzine was detectable and in 5 its concentration was bad. Invariably open windows were depended upon largely for ventilation. Fans and air- agitators were uniformly absent as were also room air-exhaust schemes. Two places were equipped with air-conditioning systems for use in winter for sup- plying tempered air, but these did not remove contaminated air. Heat was no factor. On the other hand the effects of cold draughts from open windows were a hazard in practically all places. Fatigue was more than a fair hazard in most places due to hurrying piecework and, in some places, constant standing in strained positions, faulty postures, jarring processes, pressures against the body, and the lifting and carrying of heavy molds. The contraction of coni- )nunicable diseases was favored in 3 places, fairly -so in 5 others, and could be considered negligible in the remaining '5. The chief reasons were the use of common drinking cups, inadequate washing facilities and closets, spitting upon the floors, the absence of cuspidors, and, to some extent, the crowding together of large numbers of workmen without medical supervision. In some places adequate fist-aid arrangements were absent, though bruises and sprains are frequent in the process. There is some likelihood of the direct spreading of venereal disease through the common handling of the same article. The poisons CO be feared are benzine, antimony and perhaps lead (the last two from handlin-? rubberized fabric). In no place was benzine odor absent, while in 9 of the 13 it was strong enough to cause symptoms. The process necessitates using it with sponges in an open manner, and it is also a solvent for the cements which are applied, usually, by the bare hand, occasionally also with brushes, hence its con- trol is difficult. Continual changing of the air in the room by mechanical means, air-agitators and the keeping of the artificial temperature down in the winter months would help greatly; also the substitution of closed containers witli a pressure-valve benzine emitter in place of the open cups now used. 'Antimony dermatitis was an occasional complaint. Industrial alcoholism was favored in most of the plants through inadequate drinking water facilities, particularly, when combined with the depressing effects of benzine fumes and hard work. In this large body of workmen it was of course possible to find some anemic or sickly looking workers in practically all the places. The chief com- plaints were headache, dizziness and stupefaction, due to breathing benzine fumes. Many claim that this bothered them only at first. We have commented upon this toleration to poisons in a previous Part as decidedly unphysiological. Many cases of anemia were seen which were undoubtedly due to the chronic effects of benzine. The workers' disregard of the fumes and the tendency of many of them to scoff at their effects is unfortunate and can only be met by enlightment, particularly upon degenerative diseases. 214 RUBBER. STEAM VULCANIZING. This process is also called "curing", and in many plants the rubber tires were subjected to two steam cures, the first, when the tire was partly built, called "semi-curing", and the second, when the tire was completely built, "final curing". Inasmuch as the curing used to be done in cylinders sunk in pits in the ground (usually in the basement), the "semi-cure" process room retains its name, "the pit". Tire casings are placed in iron molds within the steam cylinders, steam admitted for a proper length of time, then shut off and the cured tires mechanically removed. The process was investigated in 15 places, engaging 733 wage-earners, all males. The welfare attitude towards workers seemed good in 10 places and at least fair in the balance. The workers were of an intelligent American type in 6 smaller places, while the balance (mostly large places) employed a good grade of foreign labor. The retention of workers seemed good in 6 places, fair in 8 more, and in 1 not so. " Health appliances consisting of a hood and vent stack over the openings of the cylinders, air conditioning system for the work room, or air agitators and floor treads or drains to remove water, were good in 3 places, fair in 4 places, and all entirely absent in 8 places. In some of the better places, boots, aprons, and gloves were provided, while others used a pro- cedure which permitted a very little escape of steam, water and excessive heat. The work day was 8 hours in 2 places, 9-10 hours in 13 places ; the noon recess was 1 hour in 8 places, and I hour in 11 places. Overtime was frequent in 5 places. The work is not skilled beyond the immediate supervision of the foreman. Very few workers were seen over 40 years of age, and practically none under 20. The work quarters were of hygienic construction in 7 places, fairly so in 2 others, and poorly so in the remaining 6, due, principally, to low ceilings and crowded floor or basement, while in 2 places 1 or more additional kinds of work were being carried on. Dust, due to soapstone, was a bad factor in 8 places, and fairly so in. 4 others, while in the remaining 8 there was none, due to a difference in procedure. In 1 place a laudable measure was the wetting down of the soapstone used. Dust and waste-product accunmlations were bad in 3 places, fairly so in 4 others and absent in the balance. Water, steam and humidity were bad in 3 places, fairly so in 8 places, but practically absent in the remaining 4. Light was good in 9 places, fair in 5, and poor in 1. Room ventilation was -good in 5, fair in 4, and poor in 4 places, the latter due largely to location, resulting in closeness, stuffiness, and still air; also to the absence of artificial ventilation schemes. Heat was determined as bad in 4 places, fair in 7, and satisfactory in 4. In only 1 place was a shower bath at hand. Cold and draughts were bad in 2 places, fairly so in 2 others, and but little factors in the remaining 9. The work is rather laborious and on this account big powerful workmen were usually seen. In three places the piecework was promoting exhaustion, while in 1 large plant the men, though working in 8-hour shifts, were hurrying along, many of them, half stripped, and dashing from steam heated to draughty areas in what appeared to be a killing pace. Some places were very noisy. The con- traction of communicable diseases was highly possible in 5 places and fairly so in 8 others, and practically nil in 2 others. The hazards were common drinking cups, improper washing places and closets, promiscuous spitting, absence of cuspidors, lack of first-aid provisions and of the physical examination of 215 workers. Venereal diseases have a slight chance for spreading due to the com- mon handhng of the same objects. Poisoning is not a real factor in the process, except the escape of fuel gas fumes, which seemed bad in 5 places, fair in 5, and no factor in 5 others. Industrial alcoholism was much favored in 2 places, and fairly so in 7 others, due, not so much to faulty drinking water facilities, as, to the depressing influences of humidity, dust and fatigue. In 6 places no sickly looking workers were observed, but in the remaining 9, one or more of such should at least have had a physical examination. In several places complaints were made of the heat, or cases of heat-prostration, and of heat colic and cramps. Comments. — In certain places the escape of water and steam should be better controlled, and, where locations have 'been unfortunate, high temperature should be contravened by air blasts, electric fans, etc., as is done in steel mills and elsewhere. Other corrections are suggested in the hazards above mentioned. RUBBER. DIPPING. In this process, molds of gloves, finger cots, etc., are dipped, usually mechanically, into vats containing rubber dissolved in benzine, Whereby, when the o'bjects are raised from the vats, a thin coating of rubber adheres to the mold. This process is repeated several times, according to the thickness of objects required. Great precautions are necessary to avoid fire and explosions. This process was investigated in 11 establishments in which 49 wage- earners, all males, were found so engaged. The workers were either Ameri- cans or foreigners of fair intelligence in all places. Retention at the process was fair in 6 places and good in 4. Health appliances, which consist in the provision of hoods with exhaust pipes, curtains, air forced into the rooms under pressure and slatted floors with exhausts beneath were found good in 5 places, fair in 5 more and absent in the remaining 1. The workday was 10 hours in 10 places and 9i in 1 place ; the noon recess was J/2 hour in 9 places and 1 hour in 2 places. In addition, the work is of such a nature that an employe is required to be within the room only a few minutes at a time. Probably from 1/3 to ^ of the workday is spent witljin the dipping room. Overtime was resorted to in 3 places. The work requires no par- ticular skill. All workers were under 40 years of age. The rooms were of hygienic construction in 4 places, fairly so in 3 places and not so in the remain- ing 4. The quarters were always spacious in proportion to the num'ber of workers employed. In 5 places cement mixing, . vapor cures and some other processes were carried on in the same room. These were all small places. Dust is foreign to the process and was not noted in 9 places, but in 2 others a considerable amount of soapstone dust was observed from other pro- cesses. The quarters were clean in 7 places, fairly so in 2 others and not so in the remaining 2. Dampness was no factor. Light was good in 7 places and only fair in the remaining. In all places benzine odor was plainly detectable. This amounted to a fair health-hazard in 8 places and a bad risk in 3. Its concentration was in proportion to the absence of health, appliances to remove or confine the vapors. Although the process requires warmth, this was not enough to be an unhealthy factor in but 1 place. The rooms were usually close and still in order to keep out dust. Fatigue was no factor. The con- traction of communicable diseases was a fair hazard in 8 places and especially 2l6 so in 1, due to the use of common drinking cups, improper wash-places and closets, promiscuous spitting, absence of cuspidors, some common handling of articles and the lack of medical supervision. In the remaining 2 places such factors were nil. Benzine was the only poisonous substance used. It con- stituted a bad hazard in 7 places and fairly so in the remaining 4, especially if an employe were required to remain more than 15 minutes or so in the immediate vicinity of the uncovered dipping vats and the dripping frames above. The process rarely required this. When not in use each separate vat was hooded to prevent waste by evaporation. Industrial alcoholism was somewhat favored in 7 places and very much so in 3 others, by the lack of Fig. 56. Rubber "Dipping Room." Gloves are made by dipping molds into solutions of rubber dissolved in benzine. The benzine tanks are covered when not in use. The floor is latticed with an exhaust system beneath to draw off the heavy benzine fumes. adequate drinking water facilities and the depressing influences of the heat and vapors above described. In practically all places some pale and unhealthy looking workers were seen, especially among the older employes. The chief complaints of the workers were dizziness, loss of appetite, tiredness and, occasionally, "benzine jags," due to breathing the fumes. One positive and 2 tentative cases of chronic benzine poisoning were seen. Comments. — Heahh appliances (see above) should be provided in all places where dipping is done on any scale. While in the dipping room, and for a few minutes before, the exhaust ventila- tion system should be set in motion. 217 RUBBER. BUFFING. In this process rubber tire casings partly built are roughened up by re- volving them on a wheel and holding a coarse file against them. Other semi- hard rubber objects are also buffed, usually by pressing them against a revolving emery wheel. The object of roughing up the rubber is to give surface for the cement which is later applied in order to put on further coats or covers. The process was investigated in 6 establishments employing a total of 168 males and 6 females. The workers were largely foreigners. The work seemed uninviting and retention of workers at the process was not good. But 10 of the entire number of workers, including the 6 females, had any mechanical protection from rubber dust. The workday varied from 10 to 12|- hours ; the noon recess being Yz hour in 5 places and 1 hour in 1. The work was unskilled. But 4 workers were observed over 40 years of age, while a considerable number were under 20. The work-place was hygienically constructed in 4 places and only fairly so in 2 others. It was in the same room with tirebuilding in half of the places. Opportunities for inhaling rubber dust were bad in 4 places and fair in the 2 remaining. But 1 place supplied respirators and these were unwillingly used. Many of the workers were as black as coal heavers, due to the dust. In all places except 1, the dust accumulations on the floor and vicinity were considerable. Here and there persons were constantly sweeping up and using only a dry method. In some places the rubber was buffed in a semi-moistened condition so that dust was very much reduced. Dampness was no factor. Light was good in all places. Temperature was no factor. The general char- acter of the air in the room, outside of the dust factor, was good in only 1/3 of the places. Fatigue was a fair factor in all places, due to the arduous character of the work, piecework, speeding up, monotony, constant standing (except for a very few, including the 6 females), constant strain, the very faulty postures of leaning over with a file pressed across the thigh, the jarring character of the work and the steady application. The contraction of covi- municable diseases was a fair to bad risk in 2/3 of the places, due to the use of common drinking cups, improper wash-places and closets, spitting upon the dusty floors, absence of cuspidors, lack of physical examinations, medical supervision, goggles, gloves and first-aid provisions. Poisoning from lead which is in the compounded rubber is a possibility, while benzine fumes were present to a fair extent in most places. The risk of lead poisoning may be considered as in about direct proportion to the dust inhaled and ingested. The workers could be very little blamed for personal carelessness where the dust flew all over them. Proper washing facilities, lockers and eating quarters were present in but 1 place. Industrial alcoholism was favored by such factors as fatigue, dust, and perhaps poisoning. Many of the workers appeared very tired. They complained bitterly in some instances of 'rubber dust, "friction" smoke and long hours. In most places the process was acknowledged health-hazardous by the management, while several places were arranging for dust control systems. One questionable act of the workers was the holding of a bare handful of cement dissolved in l)cnzine, and in at least one instance, benzol while applxin.!.; it to the revolving surface of the tire. 2l8 RUBBER. INNER TUBES FOR TIRES. Inner tubes are made, generally, of almost pure rubber by lapping long strips of rubber around an iron rod of the proper size, or 'by butting the edges together on a table top. The rubber is made to adhere to itself by moistening with benzine or benzine cement (rarely benzol). The long tube is next wrapped or 'bandaged with a wet strip of cloth and then steam cured (hazard somewhat less than steam vulcanizing, described elsewhere), after which the ends are spliced together, as a rule, by a cold cure process. Although a difficult procedure, steam cure for splicing is sometimes used. Only the first process, viz., lapping (?r edge butting, is considered here. This was investigated in 8 plants and engaged 389 males and 201 females, usually only the one or the other sex being employed in a given plant. The work requires a little skill and a fairly intelligent type of workers was the rule, the females in particular being largely so. The workers appeared to stay at the process fairly well in but 3 places. Health appliances to remove or confine benzine fumes were absent in all places. The work day was 8 hours in 1 place, and between 9 and 10 hours in all the balance, with a half hour noon recess. Overtime was frequent in 3 places. A vast majority of the workers were youths, and men and women under 40 years of age ; not more than 10 were above this age. The work rooms were constructed hygienically in 6 places and fairly so in the 2 others. In 3 places several other processes were in vogue in the same room. Soapstone dust was a fair hazard in 6 of the 8 places. The cleanliness of the quarters was good in 5 and fain in the other 3 places. Dampness w,as no factor. Light was good in all places. The general character of the atmo- sphere was good in 1 place, .fair in 3, and bad in the remaining 4, due to the closing of windows to keep out dusts and drafts, and to the absence of any artificial ventilating systems, fans, etc. Heat is not a factor of the process itself, but in 1 place the quarters were unusually warm, due to their location over the vulcanizing room below. Fatigue is a fair hazard, due to piece-work, constant standing, or stools (for females only) without backs, and monotony. The contraction of communicable diseases was a bad risk in at least 2 places and fairly so in 4 others, due to the use of common drinking cups, improper wash-places and closets, spitting upon the floors, absence of cuspidors and lack of medical supervision. Poisoning, due to benzine and occasionally to benzol, was a 'bad hazard in 6 places and fairly so in the other 2. Benzine and benzine cement sat about in open cups into which brushes or sponges were dipped. Workers, as a rule, ate in the workrooms. It was claimed in most places that drafts could not be allowed, but in other places the windows were wide open. Industrial alcoholism and coffeeism were incited in proportion to the extent of poor drinking water facilities, the dust, fumes and fatigue. In but 2 small places were all the workers of health3r appearance. In the larger places a few to a considerable num'ber of pale looking workers were seen. The workers complained variously of the efifects of the fumes, of the stuff^y and close character of the workrooms and occasionally of the dust. Benzine stupor and fainting spells were common, especially among the females and those new at the work. It was said that many girls and sometimes men never came back after the first day or two. In 1 large place each girl averaged 1 day a week off on account of sickness. Sore throat, frequent headaches, 219 dizziness and tiredness, and other symptoms of acute or chronic benzine poisoning were common complaints. Benzine dermatitis was occasionally en- countered. A typical form of complaint was that in which the workers said that physicians appeared unable to better their ills. In 1 place a fainting girl was being rushed to the windows during the time of our inspection. Comments. Beyond question, benzol should not be permitted in the way in which it is used (fortunately rarely) in this process. All benzine and benzine cements should be kept in closed containers with some sort of automatic-valve emitter. The room temperature should be kept not over 68°. Some means of changing the air in the workrooms should be provided and everything done to keep down the concentration of benzine fumes. Finally, sickly and tuberculously inclined persons should be kept out of the process through medical super- vision. RUBBER. SPECIALTY MAKING. (Including Mechanical Goods, Drug Sundries, Accessories, Etc.) As "almost anything can be made out of rubber," a vast number of em- ployes are engaged in more or less factory types of processes included i:nder the general heading above. As a rule, their health risks were of a genera', type plus the breathing of benzine fumes and soapstone dust. The articles made concern all manner of soft and hard rubber, and rubber fabric materials, from tiny rubber bands and washers, finishing-up processes on gloves, toy balloons, etc., the assembling of boots and shoes, rain coats, etc., to the fabricat- ing of fire hose and enormous belts for power transmission purposes. In the small work many females were employed, while in the rougher and larger work, males were engaged. This class of processes was investigated in 22 establishments in which 2,912 males and 1,668 females were so engaged. A good attitude seemed to exist between employers and enfiployes in 15 of these places. While a large number of more or less ignorant foreigners were employed, still the usual type of fairly intelligent people, particularly females, was the rule. In some processes workers did not appear to remain long because of various objec- tionable features. Where health appliances were plainly needed, but 2 places were adequately equipped, 6 others fairly so, while 14 had given practically no attention to such features. The work day varied considerably : in 20 places it was from 9 to 10 hours, and in 2 between 10 and 12 hours; the noon recess was 1/2 hour in 15 places, 54 hour in 1 place, and 1 hour in 4 places. Practically all of the workers were unskilled labor. A considerable number of youths between 16 and 20 were employed, probably more than the number of workers who exceeded 40 years of age. Considering these processes grouped by plants, our summaries show the following : Dust was a negligible hazard in 4 plants, a fair hazard in 12 and a bad hazard (at least for some processes) in the remaining 6. Invariably this was due to soapstone ; occasionally, to rubber ingredients. Quarters were kept cleanly in 10 places, fairly so in 8 more and not so in the remaining 4. Damp- ness was no factbr in 18 places, but constituted a fair hazard in 3 others and was especially bad in 1. It was due to the escape of water and steam. In 17 plants light was good, in 8 only fair and in 2 bad. The air condition of the work rooms was satisfactory in 1 place, fairly so in 15 others, and bad in 220 the remaining 6. The reasons for this were poor location, closeness and stuffiness, lack of room ventilating systems, and of local exhausts in many places where they should have been provided. Heat was no factor in 17 places, but was a fair to bad ha:^ard in some processes in the balance. Cold, due to the opening of windows for ventilation, inadequate heating facilities, sedentary work in drafty places, and going in- and out of hot quarters was a factor in some places. Fatigue was a considerable factor in 6 places, and Fig. 57. Making Rubber Specialties. This room is well lighted, has an air-conditioner which changes the air continually, thus removing benzine fumes. (Some of the girls are not faced well as respects light). more or less so in a number of others, due, principally, to the unlimited hurry of piece-work, constant standing, use of stools without backs, faulty postures, jarring processes and, occasionally, loud noises. The liability to the contrac- tion of commimicahlc diseases was a bad risk in parts of 5 places, fairly so in 10 others, but well controlled in the remaining 7. The factors were : the crowding together of employes, sometimes in large numbers in rather limited spaces, often quite filled with work benches, shelvings, machinery and stock; the use of common towels and drinking cups ; improper wash-places and closets ; 221 spitting upon the floors; absence of cuspidors; frequent trivial injuries without lirs,t aid provisions ; and the absence of gloves. Occasionally, goggles were needed, and, more especially, medical supervision to keep out persons having communicable diseases. The more or less common handling of articles, and the working together of both sexes were factors, although in no place was any- thing suggestive of an immoral atmosphere observed. The chief poison to which vast numbers of these employes were exposed was benzine. Occa- sionally, also, benzol, sulphur chloride, carbon bisulphide, ammonia, anilin dyes, wood alcohol, and other less commonly used substances. In but one plant were all employes satisfactorily protected from all forms of poisoning. In 7 others risks were not bad, while in the 14 remaining, acute poisoning, especially from benzine, was very possible. Practically all contributable factors discussed under poisons in Part III. upon principles of industrial hygiene were encountered, sometimes one and sometimes another, and sometimes many in the same establishment. Industrial alcoholism was favored in 19 places, 2 especially so, due to inadequate drinking water facilities, added to which the depressing effects of the hazards above cited should be taken into account. In this vast number of .people, it was natural that some unhealthy looking persons should be encountered, particularly where large numbers were em- ployed. In 6 plants, however, all appeared well, but in the remaining 16, one or in some cases, many were seen who were unquestionably in the need of a physical examination to determine their health status, and, indeed, their safety towards fellow employes. A summary of the complaints encountered by talking to work people constitutes the following : dust and fumes causing nausea, dizziness, fainting, headaches, loss of appetite, loss of weigh,t, tired- ness, "benzine jags," eczema, coughs and colds, and "can't work long at this until I am sick and have to lay off for a few days." In some places workers were hard to retain if other work was obtainable. Females were naturally worse afifected. Ten cases of chronic benzine (and perhaps benzol) poisoning were seen in 4 plants. Comments. — Where so many health-hazards are involved, it is well to aim at a principal one if such a one exists, and endeavor to control it. Usually such a . principle results in reducing other bad features. In this class of processes the chief aim should be directed first at a better control of benzine fumes. While these are not a deadly poison and produce no more than a temporary "drunk," and, perhaps, uncon- sciousness, they are, when inhaled or absorbed, destructive to the blood cor- puscles and fat-absorbent in their effects upon the system. Again, it must be said that toleration to such a hazard is beyond the limits of physiology. Inef- ficient hoods and exhaust systems, absence of such systems, failure to keep the atmosphere in motion and prevent dead air saturated with fumes, failure to provide gloves where needed, escape of fumes to neighboring departments or processes, and the practically universal use of 'benzine and benzine cements in open cups placed before the workers were the chief features. A feasible closed container for benzine has been mentioned under "Tire Building." After benzine, the next chief hazard was soapstone dust. While much of this in the air was due to carelessness on the "part of the employes, the processes are bound to produce it. Much of it can be curtailed by local exhausts, slatted table tops and floors, wet methods, improved methods, substitutes, and the wearing of light respirators. Particularly, should workers in the dusty proc- esses be limited to those who give no personal or family history of tuber- 222 culosis. While the dust itself is non-poisonous and free from harshness, it excites coughing, which is all that is. required to awaken tuberculosis in many persons with whom it would otherwise remain latent. RUBBER. COLD VULCANIZING. This process is also called "cold cure" and "acid cure." It consists in dippinj the articles to be vulcanized into various solutions carrying sulphur, or of applying the solutions to the rubber with a brush or sponge. Usually only a high grade of thin rubber articles unmixed with fabric are vulcanized in this way, such as gloves, cots, bags, etc., which are dipped into the solu- tions. We have also inclucjed here "splicing" of inner tubes for tires, in Fig. 58. Rubber "Cold Cure" Process. This room has slatted floor with exhaust beneath to draw off heavy poisonous fumes (carbon bisulphide, sulphur chloride, etc.) which the solution is applied with a brush in the presence of a brief air suction blast, the worker standing before a small stand. The process was investigated in 15 establishments, engaging 200 males and 3 females at this work. A welfare attitude seemed to prevail between employer and employe in 9 places and fairly so in the other 6. The workers were of an intelligent type in 10 places, and a fair type of foreigners in the remaining 5 (usually the larger places). It appeared difficult to retain workers at the process, especially in 5 places and fairly so in 9 others. Health ap- pliances, consisting of exhaust systems locally applied, of confinement of the process within cupboards and good room ventilation were adequate in but 1 place, altho in 14 of the 15 places some attempts were made to control the 223 escape or concentration of the vapors. In all places workers were given gloves to protect their hands. Instruction concerning the poisonous solutions was good in 3 places only. The work day was between 9 and 10 hours in all places, with a noon recess of 1 hour in 3 places, ^ hour in 1 place, and ^ hour in 9 others. In 5 places some overtime was the rule. The work required very little skill. There was a tendency to employ youthful persons. It was found to be a type of process in which persons were first introduced to the rubber business. Only 2 persons were seen over 40 years of age. Construction of the work quarters was hygienic in 8 places, fairly so in 4 others and bad in the remaining 3. In 8 places the work-room was only partially partitioned off from other processes, so that vapors and odors were interchangeable. Fig. 5!l). Rubber Works. A carbon bisulphide dipping cupboard to the right, showing mechanical means of operating and dipping (carried on- within cupboard) and the door to cupboard. Also slatted drying bench in center of room. Both this and the dipping cupboard are connected with a powerful exhaust system beneath the floor. In 10 places soapstone and sulphur dusts were a fair hazard, due both to carelessness in their use and the absence of a removal system. In the remain- ing 5, dust was negligible. Quarters were clean in 7 places, fairly so in 7 others and not so in 1. Dampness was no factor. Light was good in 12 places and fair in 3. The room air was good in 1 place, fair in 8 and bad in 6, due to the escape of fumes and the absence of means for promoting ventilation. Heat was no factor, but cold, due to ineflficient heating and to the wide- opening of windows in order to dilute the vapors and fumes was a bad factor in several places. Fatigue was a fair factor, due to the hurry of piecework, constant standing, faulty postures, and the youthfulness of many of the workers. 224 The contraction of communicable diseases Avas a bad risk in 3 places, fairly so in 10 more and negligible in the remaining 2. The hazards were common drinking cups, improper wash-places and closets, promiscuous spitting, absence of cuspidors, and lack of medical supervision. Poisons are the chief hazards in this industry. They vary in tj^pe and number, but include benzine, benzol, wood alcohol, carbon tetrachloride, sulphur chloride, and carbon bisulphide. The risk of poisoning was bad in 8 places, fair in 6, whale in but 1 were we satisfied the workers were amply protected. In some places the work was done on table tops with brushes, the solutions being kept in open-top jars. In many places the drippings accumulated on the w^ork stand and floors whence evaporation took place. Eating in the same quarters was the rule. A very few workers had been at the process more tJhan a few weeks or months. In- dustrial alcoholism was favored in 3 places, partly so in 9 others, and was negligible in the remaining 3, the factors being inadequate drinking facilities, and the depressing influences' of poisons inhaled, ingested and skin-absorbed. In all places some workers were observed who were unhealthy looking, while in o. decidedly pale and anemic persons were seen. The chief complaints of the workers were the breathing of the fumes and vapors and dust. In 9 plants the following cases of occupational poisoning were diagnosed : carbon bisulphide poisoning, 4 positive, 2 tentative and a number of suspicious ones; sulphur, chloride and tetrachloride poisoning, 4 positive; benzol, 1 positive. In addition dermatitis, dyspepsia, and neurasthenia were frequent observations. Comments. — Out side of the use of mechanisms to confine fumes and to re- move them, the workers should be examined weekly and rapidly promoted or rotated to other work. Females and youths under 21 should not be so employed. The liability among workers in carbon bisulphide to great physical and mental deterioration, including paralysis and insanity, the latter of both suicidal and homicidal characteristics, should be kept in mind. RUBBER. VAPOR CURE. «> This process consists in exposing rubber articles, such as gloves, finger cots and drug sundries, to the vapors of sulphur chloride arising from a little of the substance placed upon a tin in a warming cupboard; also, largely used in some places in the splicing of the ends of inner tubes for tires, in which case carbon tetrachloride, and perhaps carbon bisulphide were additional sub- stances used. (As this method- of splicing tubes is done at room temperature, it has been considered under "Cold Vulcanizing.") The goods, except inner tubes, are exposed within the cupboards for the proper length of time and then removed, usually by hand. In most cases the workmen entered the cupboards for this purpose. The process was investigated in 8 establishments in which 43 males were found to be so engaged. Foreigners constituted the main type of workers in 3 plants (all large places), while the balance were usually American-born. The men appeared to stay at the work well in 2 places, but only fairly so in the remaining 6. Health appliances consisted in confining the fumes within warming cupboards, having a hood and exhaust-pipe placed over the entrance thereto. In addition, the cupboards were, in some places, located within sepa- rate rooms, and had local exhaust systems provided to draw off vapors when the process was finished. The work day was 10 hours in all places, with J^ hour for noon recess in 6 places, and 1 hour in the 2 remaining. The workers 225 were only engaged at intervals in the process. The work required no skill on the part of the employes. All workers were between 20 and 40^ years of age. Rooms containing cupboards were hygienically constructed in 7 of the 8 places. In 5 places the roorhs were not well partitioned off, or were in the same quarters with other processes, such as dipping, specialty making and finishing. Dust in the shape of soapstone and sulphur was a considerable hazard in 2 places, and fairly so in 3 more, the remaining 3 being satisfactory. Cleanli- ness of quar'ters was good in 1 place, fair in 5 and poor in 2. Light was not good in 2, places. The process required some heat, but in only 3 places could this be considered in a fair way detrimental. Fatigue was no factor. The contraction of communicable diseases was a bad risk in 4 places, fairly so in 2 others, and negligible in the remaining 2. The hazards were the use of common towels and cups, inadequate wash-places and closets, promiscuous spitting on the dusty floors, absence of cuspidors and lack of medical super- vision. The poisons used by these workers were benzine, benzol, sulphur chloride, and carbon bisulphide. Sulphur chloride, however, was the only one usually concerned. Sulphur chloride itself is practically non-poisonous as used, since moisture is usually kept away from it. Otherwise the effects of chlorine and sulphur dioxide fumes would be noticeable. Industrial alcoholism was favored in 2 places, due, principally, to inadequate drinking water facilities. In 3 places no unhealthy appearing workers were seen, while in the re- maining 5, 1 or more were so. In 1 place workers complained of the effects of the fumes which caused coughing, sore throats and red eyes. Comments. — Arrangements should be made to withdraw the fumes before opening the cup- boards and entering them ; or, to counteract their effects, ammonia gas has been recommended. RUBBER. PRESS-ROOMS. In these rooms, steam vulcanizing is done by means of steel presses, having hollow chambers through which the steam passes. The molds con- taining the rubber objects to be vulcanized (as water bags and drug sundries), are placed within the vulcanizers for the proper length of time. Such a vulcanizer occupies about 4 to 8 square feet of floor space, and stands about as high as the head. They are usually arranged in rows. The process was investigated in 13 establishments, and engaged a total of 468 males and 64 females. The attitude of employer toward workers appeared excellent in 8 places, and fairly good in the balance. The workers were intelligent persons in 7 plants and a fair type of foreigners in the balance. In spite of endeavors on the part of the employers, retention of the workers at the process was only fair in 9 of the 13 places. Health appliances, con- sisting of asbestos coverings to limit "the heat given off by the presses, cool air blasts and ventilating schemes were good in 3 places, fair in 3 others, and absent or inadequate in the balance. The work day varied from 9 to 10 hours in all places, with a noon recess of 1 hour in 4 places and ^ hour in 8. Over- time was sometimes resorted to in 4 places. The work requires compara- tively little skill, except that practice engenders speed. The workers were pre- eminently between 20 and 40 years of age, with some under 20. The general construction of the workrooms was hygienic in 6, fairly so in 2, and bad in the remaining' 5 places. Other processes were carried on in the same quarters in 5 places, and consisted of specialty work, trimming, cement mixing, packing, etc. 15 O. D. 226 Soapstone dust, while present in all places, was a bad hazard in no more than 2. Much of this was due to the personal carelessness of the workers. Waste accumulations were bad in 2 places, and fairly so in 5, with the remain- ing, good. Dampness and humidity, due to escaping steam and water, was bad in 1 place, fairly so in 6 more, but was well controlled in the remaining 6. Light was good in 9 places, fair in 2, and bad in 2. The ventilation of the rooms was good in 3 places, only fair in 8 others, and poor in the remaining 2. Heat was a bad factor in 5 places, and more or less so in the remaining 8. Cold drafts from open windows, sendentary work, and heat or cold alternation was another common hazard. Fatigue was a fair hazard as the work was con- ducted in 9 places, due to piece-work, monotony, hurr}', and the frequent lifting of heavy steel molds. The contraction of communicable diseases was a bad risk in 3 places, a fair risk in 8 others, and well controlled in the remaining 2. The risks were the use of common cups, improper wash-places and closets,, promiscuous spitting, absence of cuspidors, lack of first aid provisions and medical supervision. Poisoning may be due in this process to benzine, benzol and, occasionally, antimony fumes from the rubber. In 9' places it was minimal, in 1 a fair risk, and in 3 a very bad risk. Open cups of benzine and of benzine and benzol cement were chief factors. Industrial alcoholism and coffeeism were decidedly favored in 5 places, and fairly so in 6 others, due to inadequate drinking water facilities, and the depression due to humidity, heat, fatigue and the fumes mentioned. In but 2 places were all workers healthy appearing. In the remaining 11, one or more fpersons were at least in need of a physical examination to establish their health status. Pallor, anemia and exhaustion were the physical signs. The workers complained, principally, of the excessive heat in 5 places, which was increased in warm weather. Also the smell of burnt rubber and the benzine fumes. In 1 room the temperature was 120°. Comments. — The generous use of asbestos coverings to presses seems to be very efficient in pre- venting heat loss in the process as well as promoting a healthier atmosphere. Room ventilation schemes, local air blasts and aid-agitators are necessary ap- pliances in most of the places. While some places were kept comparatively dry, and escaping steam was limited, others were at the opposite extreme. Plenty of room space should also be given. RUBBER. CEMENT MANUFACTURING. This process, called "cement mixing", consists in the admixture of pow- dered rubber with benzine, benzol and canbon bisulphide. Sometimes one and sometimes all constitute the solvent for the rubber, with some other ingredients. The process, because of the risk of fire and explosions, is usually conducted at a distance from the other buildings in a small brick and stone outbuilding. In some places, however, no such precautions were observed. The mixing may be done by hand in open containers, using a wooden paddle, or by machinery. After the mixing, the cement is drawn off and usually filled by hand into com- pressible tubes and cans to be sold, except that to be used at the plant itself, which is placed in five-gallon open or closed cans, and distributed to the various departments. The process was investigated in 9 places, where it engaged 50 wage- earners, all males. Mechanical methods of good protective character were present in 5 places, while, in the other 4, antiquated methods were in vogue. 227 The attitude of employers toward workers seemed good in all places. The workers were very largely foreigners and appeared to remain but a short time in most of the places. Health appliances, consisting o'f mixing machines, which confined the fumes -by local down draft exhaust systems at the places of drawing ofif the cement, and of room exhaust fans, were adequate in 2 places, fairly so in 4 others, and absent in the balance. The foreman seemed well informed on the danger of poisoning in only 3 of the 9 places. Usually the danger was considered as a matter of course. The work day consisted of 9 to 10 hours in all places, with 1 hour for noon recess in 1 place, and ^ hour in the other 8 places. No particular skill was required in the process. But 2 workers were observed over 40 years of age. On the other hand, a con- FiG. 60. Mixing Rubber Cement. Poisonous solutions and fumes are confined within rotary mixers. The room, has exhaust floor vents along the edges, and fresh air is forced in con- tinually from pipe openings along walls overhead. siderable number of boys were employed, this being their first introduction to the rubber business in some places. The construction of the workplace was hygienic in 7 places, fairly so in 1, and bad in the remaining. The process was carried on in an open, hand method in the same room with other processes in 2 places. Dust was hardly a factor in the process. Quarters were dean in all but 1 place. Dampness was no factor except that in outdoor buildings adequate heating was absent. In only 2 places was the air safely freed of the fumes and vapors. The balance were badly in need of local exhaust ventilation schemes, particularly in the filling of tubes and cans, which was usually dniu- by boys, working around a table. Cold, from the outdoor character of the 228 work, was a bad feature in 1 place. .Fatigue was no factor. The liability to contracting communicable diseases was a factor in most places, due to the use of common drinking cups, improper wash-places and closets, promiscuous spitting and absence of cuspidors. The risk of poisoning, depending some- what upon the carelessness of the operator himself, was present in all places. In 4, however, protection was by no means adequate. The chief poisons were benzine or naphtha, benzol and carbon bisulphide. Industrial alcoholism was well controlled in 3 places by providing adequate drinking facilities, and taking care of the fumes as v^^ell as giving personal instructions. No sick workers were observed in 3 places ; in another, all were new employes, while in the remaining 5, several persons, as a rule, were in need of a medical examination. The complaints of the workers were dizziness, nervous- ness, loss of appetite, easy fatigue, coughs, sore eyes and other symptoms of the fumes named. Many workers refused to remain more than a day or 2. Some were seen who had been so employed for_a number of years, but, of these, few were healthy appearing. Comments. — Every mechanical effort should be made to confine and remove fumes. In addition, workers should have a frequent medical examination, and they should be rapidly promoted, or frequently rotated to other positions. The liability to paralysis and insanity among workers exposed to carbon bisulphide has been mentioned under "Cold Vulcanizing." RUBBER. RECLAIMING. By various chemical and mechanical processes old rubber is reclaimed from waste products about the rubber works and from vast quantities of old rubber goods which are shipped in. It is. a special industry by itself. The process consists in grinding, milling, chemical treatments and drying. The finished product is called "shoddy". The process was investigated in 6 plants employing a total of 582 wage- earners, all males. The plants varied from 18 to 350 wage-earners. A vast majority of the workers were foreign-laborers who had a tendency to come and go. Adequate health appliances were found in 3 places, fairly so in 1 more, and not so in the remaining 2. The work day varied from 10 to 12 hours ; the noon recess was i hour in all places. Most of the workers were pretty steadily engaged at their various applications. Very few workers were under 20 or over 40 years of age. The plants were hygienically constructed in 2 places and not so in 3. A general jumbling of processes, usually to the detriment of health, was observed in 8 places. Dust, consisting of lint, shoddy and rubber, was a bad factor in 1 place, fairly so in 2 others and no hazard in the remaining 3. Cleanliness was good in 3 places, fair in 1 and bad in 2. Protection from water, steam and humidity. which are essential features of the process, was good in 1 place, fair in 3 others, and bad in the remaining 2. Half of the places were poorly lighted.— large numbers of men worked in basement-like rooms barely lit with flaming gas jets. In 2 plants, how^ever, light was excellent throughout. The general aerial condition of the work rooms was good in 3 plants, fair in another and poor in the remaining 2, due to the lack of control of vapors and fumes and the absence of ventilating arrangements. Heat was no particular factor in 3 places, but was bad in 2. Exposure to cold and drafts were frequently bad for men who went in and out of hot quarters. Fatigue was not much of a factor . since the workers were usually well selected to laborious processes. 229 The contraction of communicable diseases was a bad risk in 1 place, fairly so in 2 others and neghgible in the remaining 3, due to inadequate washing places and closets, common drinking cups, promiscuous spitting, absence of cuspidors and lack of medical supervision. The poisonous substances used, mineral acids and alkalis, were well enough confined in 3 plants to constitute no hazard and fairly so in the remaining 3. Industrial alcoholism was rather favored in all plants, and especially in 2, through the lack of adequate drinking water facilities. The appearance of the workers was good in 3 plants, while in the re- maining 3 some workers were seen who were not healthy appearing. No health complaints were obtained from any of the employes, altho the inability of large numbers to spea.k English considerably hindered such inquiries. Com- ments.— The grinding up of old rubber should be hooded and exhausted to limit the dust, which, it must be remembered, is oftentimes rich in lead. Also more attention should be given to providing the workers with rubber boots and aprons who are employed at the watery and steamy processes. Those in hot, damp work should be given the privileges of shower baths, with change rooms and lockers in which to dry work clothes and keep their street clothes separate. POTTERY. SLIP MAKING. Processes in the so-called slip houses are, in general, as follows : remov- ing the clays in the form of dust and lumps from the stock bins, grinding, water-washing and sifting processes, the preparation of the "slip" (as the liquid form of the clay is known), in blunging mills, pug mills, agitators, com- pressing machines and drying kilns. In the larger and better arranged plants, several of these sub-processes were in rooms or quarters by themselves, or ar- ranged on different floors, but in the majority of instances all were carried on usually in a basement or first floor room. The process was investigated in 38 plants (24 Whiteware, 7 Stoneware, 4 Artware, and 3 Tile plants) employing a total of 214 wage-earners, all males. Even in large plants but a comparatively few persons are employed in this part of the industry. Modern methods appeared to exist in 16 places, fairly so in 20 others, and not so in the remaining 2. Twenty-three were union plants and 15 non-union. Evident interest in workmen's welfare was excellent in 10 places, fair to good in 24 more and not so in the remaining 4. The type of workers was good in 30 places and fair in the remaining 8. The work was unskilled, or, at the most, semi-skilled labor. The majority of the workers appeared to be fairly steady employes in 20 places, and not so in the remaining 18. Special health appliances were good in 1 place, fair in 2 others, and practically absent in the remaining 35. Placards and organized instructions along health lines were absent in all places, as were also sick benefit, death and pension features, except such as were maintained by the unions. Work quarters were hygienically constructed in 4 places, fairly so in 5 others, and not so in the remaining 29. In 7 plants other processes, such as clay molding, finishing and glaze-mixing were carried on in the same quarters with slip making. Of the total number of workers, 20 were over 40 years of age and the balance between 20 and 40. The work was so conducted that in 9 places dust, composed of a small percentage of flint and the various clay earths used (and non-poisonous), was no hazard; in 6 others it constituted a fair hazard, and in the remaining 23 it 230 was bad. The chief causes for dust in the atmosphere were the more or less constant shoveling of the clays in a dry form, its escape from grinding machines, and from "kicking up" from the floors. In 3 places quarters were maintained excellently clean and orderly, especially for a class of work such as this ; in 9 other places general cleanliness was from fair to good ; in the remaining 26 the word "cleanliness" could hardly be said to apply, inasmuch as many of them were located in basement and cellar quarters, with clays in both wet and dry form covering the floors. In many places it seemed difficult even to move about because of the uneveness of floors and platforms, the piles of clay, the crowding of machinery, vats, partitions, posts, low ceilings and the like. Water and dampness were well enough controlled to constitute no hazard to health in 8 places, and fairly so in 10 more, but not so in the remaiing 20. This seemed to be due to faulty floor drainage, leaky vats and slip-containing ?»s'"""^'^gS%-f^ Fig. 61. The Slip House. Showing presses where water is squeezed out of the "slip". machines, and the presence of the wet clays under foot, as well as quarters which it would be hard to keep from dampness under any circumstances. Light was good in 14 places, fair in 3 more and bad in the remaining 21, due, chiefly, to the confined location within basement or ground floor rooms, many times practically shut off from daylight. In such quarters flaring gas flames burning at the end of a pipe and without vents to remove fumes were fre- quently the main source of light. General room ventilation, was excellent in 2 places, fair in 17 more, and bad in the remaining 19, due, chiefly, to inside, basement, or cellar locations, the presence of dry kilns, of heating and lighting processes without adequate vents for gases and fumes, and to the absence of ventilating machinery or appliances in places where doors and windows could not be counted upon for proper ventilation. Hot, still, humid air was a com- mon observance in many places, and cold, still moist air in others. Workers often passed from the one to the other. Heat was a negligible hazard in 21 231 places, fairly so in 10 others, and bad in the remaining 7. The chief causes of heat were hot processes, particularly the exposed location of drying kilns. While cold is not a feature of the process, the work quarters, although in- spected in the summer time, were hazardous in this respect in 5 places and fairly so in 3 others. The proportion would unquestionably be higher in the winter season. In the majority of places, however, heating arrangements were extended to the slip houses, or the processes themselves insured the same. A considerable part of the work is of a heavy, arduous character, and for this reason the more powerfully built types of laborers were usually found present. However, fatigue, to the extent of exhaustion, was a hazard in 27 places, the I chief factors being the continual lifting of heavy clays'and "slips", piece-work in some places and constant straining postures. The workday v^^as 8 hours in 3 places, from 8^- to 9 hours in 4 places, and from 9 to 10 hours in the re- maining 31. The noon recess was 1 hour in 6 places, h hour in 17 others, and less than a half hour in the remaining 1-5. Sometimes the men apparently worked without observing any particular noon recess. Overtime was an infrequent occurrence. A morning lunch recess at 9 o'clock was a common observance. The liability to contracting communicable diseases was a bad hazard in 29 places and fairly so in 8 more, due, chiefly, to promiscuous spit- ting, absence of cuspidors, use of common drinking cups, inadequate washing facilities, poor closets, lack of lockers and of medical supervision. In many places first-aid provisions were inadequate or lacking. Poisons were no feature of the process, but in many places these workers w^ere more or less exposed to the dusts from the glaze-mixing machines in the vicinity where lead com- pounds were being group up and mixed. The inducement to alcoholism was considerable in 26 places and fair in at least 6 more, due to inadequate drinking water facilities and the depressing influences of dampness, laborious work, disorderly surroundings, devitalized air and the like. The general appearance of workers was good in 8 places ,while it was generally no more than fair in the remaining 30. Many prematurely aged, pale and under-w^eight men were seen among those longest employed. The chief complaints of the workers were the breathing of dust, damp quarters, heat, fatigue, poor washing facilities and general insanitary quarters. Comments. — • Except the breathing of dust, there is nothing about this process which is inherently hazardous to health. All features dangerous to health come under the head of general sanitation, ventilation, light, heat, water and dampness control. The various figures above given show the proportion in which these features were not up to a standard sufficient to conserve the health of the workers. FLINT DUST MAKING is the most hazardous dust process in the pottery industry. Only a few large firms did this for themselves, but our attention was called to two firms employing foreign laborers who were engaged in making this product. Crushing, grinding, conveying, and packing all created an unusual amount of fine, hard flint dust which pervaded the air of the "houses" and even coated the openings of windows, doors, and roof vents with a white flour-like powder. Comments. — Dust-confining machinery, short hours, and respirators are needed in all such places, 232 POTTERY.— SAGGER MAKING. This process consists in the making, shaping, baking, finishing and repair- ing of the clay containers in which the pottery ware itself is later baked. It was investigated in 10 plants where 1 or more men were practically steadily so employed, the total number of wage-earners heing 106. From this it, will be seen that a comparatively few potters are engaged in sagger making. The plants investigated were white-ware, tile and art potteries. Fifteen were union plants and 4 non-union. The type of workers was generally good, the work requiring some skill. Retention at the trade appeared good in 13 places and fair in at least 5 more. Health appliances and instructions along health lines were given some consideration in 1 place. The construction of the work place was good in 4 places, fair in 2 others, and hygienically bad in the remaining 13. The process was usually carried on in close proximity to the slip making quarters. There were 8 workers over 40 years of age, the balance being between 20 and 40. Fig. 62. Saggei^-Making Room. Saggers hold the ware while being fired in the kilns. The work was done so as to keep dust at a neglibible minimum in 4 places, fairly so in 5 more and not so in the remaining 10. The chief cause of dust was the careless handhng and dumping of clays and the "kicking up" of it from the floors and benches. Quarters were in clean condition in 2 places, fairly so in 6 others, and not so in the remaining 11. Dampness was negligible in 8 places, fairly so in 3 more, but constituted a hazard to health in the re- maining 8, due to water, steam, humidity, and in some places, basement or cellar locations. Others hazards of light, ventilation, heat, fatigue, and the liability to communicable diseases, were about the same as those described in "slip" making. One other great hazard was noted, viz., "sagger washing", which consists in the painting of the inside of the saggers with a red lead solution. Among the 20 men found so employed were 3 cases of chronic lead poisoning and 1 other who had had acute lead poisoning. The appearance of the sagger makers in general was good in 5 places, while 1 or more sickly appearing workers were seen in the remaining places. General complaints were breathing of dust, dampness, rheumatism, and poor Sfinitation. Comments. — Tht lead poison hazard of sagger washers is largely 233 one of personal hygiene, plus the fact that in numbers of places there were no washing facilities, that workers did not know that red lead was poisonous and that periodic medical examination for the slow onset of lead poisoning were lacking. The improvement of general working conditions was needed in from J to I of the places to insure the health of the workers, particularly, along the lines of dampness prevention, cold drafts alternating with heat exposures, poor closets and the like. POTTERY.- — MOLD MAKING. The making of plaster-of-Paris molds for forms for china ware, art ware, etc., is a feature employing 1 or more men in each pottery. The process was investigated in 16 plants where 37 men were more or less constantly employed at mold making. Health appliances to handle and confine the dust mechanically were absent in all places. The men were old employes in 9 places, and re- mained fairly steadily at the work in the remaining 7. The work place was hygienically good in 2 plants, fairly so in 6 more, and not so in the remaining 8. The work was usually carried on in quarters by itself. There were 9 of the 37 workmen who were over 40 vears of age. FiG: Go. Mold Making.i A process resembling sculpturing. The dusts were so handled in 6 places as to constitute a fairly negligible hazard, but in the remaining 10 this was not so. The chief factors were the emptying of barrels of plaster-of-Paris and the handwork with the same. Piece-work caused too much hurrying and too little care in the amount of dust created. Quarters were kept clean and orderly in 4 places, fairly so in 7 more and not so in the remaining 5. Da/mpness, darkness, heat, cold, and fatigue were negligible features in all but 1 or 2 places. General room ventilation wSs good in 5, fair in 8, and poor in 3 places. The liability to the contraction of communicable diseases was a considerable hazard in 13 places, due to pro- miscuous spitting, absence of cuspidors, common drinking cups, inadequate washing facilities, poor closets, and lack of medical supervision. Poisons were not used. The general appearance of workers was good in 6 places, while 1 or more in the remaining 10 appeared under par. The complaints of the work- ers were the breathing of dust and general features of sanitation. Comments. — It would appear that mechanical means could be contrived to convey and weigh 234 the dusts used, particularly, where piecework obtains. Being a dusty occupa- tion and an injurious type of dust, workers should be under medical super- vision. In addition, respirators should be furnished and worn while perform- ing unavoidably dust}' operations in the work. POTTERY. CLAY OR BISQUE MAKING. The clays which are prepared in the "slip" houses are conveyed to the clay or bisque making rooms where they are shaped on plaster-of-Paris molds or otherwise by various groups, of workers and with the aid in some instances of simple machinery. In tile and porcelain factories the work is done by machines in what are known as the pressrooms. The workers include batters- out, pressers, jiggermen, jollymen, turners, handlers, stickers-up, dish specialty makers, finishers, machine pressers, mold boys (called also mold runners and dog trotters), and helpers. Of these classes females were employed par- FiG. 64. A Line of Jiggermen in the Clay House. Here plates are formed. ticularly as finishers and in the making and putting together of small parts. After the ware is shaped it is placed on board trays and carried into drying ovens located usually a few feet to the backs of the workmen. The mold boys do the carrying of the ware and the filling and emptying of the ovens, which they enter and climb up to the upper shelves as required to reach them. The process was investigated in 53 plants, including all branches of the pottery industry. It was skilled work in all except machine processes (tiles and porcelain ware). There were employed a total of 3,048 wage-earners, of whom 2,521 were males and 527 were females. The majority of all potters are en- gaged in the bisque making rooms. Unions existed in 33 of the plants in- vestigated and were absent in the other 20. The general attitude towards em- ployes seemed fair to good in all but 4 places-. The relations between em- ployer and employes are peculiar in this process : while the older and skilled men work for the company, a large percentage of the total employes, com- posed principally of boys and females and some adult male helpers, are em- 235 ployed by the skilled workers. The type of workers was of an intelligent class in practically all places. Non-English speaking persons were rarely en- countered. The question of how well workers remained at the various proc- esses is probably best answered as in direct proportion to their skill. As the unskilled outnum'bered the skilled and as apprentices were selected from among the former, there was considerable rivalry among helpers, — enough to keep most of them intensely busy. In but 3 places were features which could be considered as health appliances present, and these consisted in 1 place of air exhaust fans for the work quarters, of mechanical mold and "green ware" carriers in 2 places, and in cuspidors and garbage cans in some places. Some instructions along health lines were given in 3 places. Outside of the unions v.ery few of the workers had sick, death, or pension benefits. Work quarters were hygienically well constructed in 4 places, fairly so in 11 others, and not so in the remaining 38. The chief features were due largely to the old types of factory construction, with low ceilings, inadequate window space (particu- larly for room interiors), rough floors, half floors, lof/ts, "chopped-up" Fig. 65. Pressing Department in Clay House. quarters, poor heating facilities, and so on. In most places the clay rooms were on several floors, one above another, or scattered about. The mass of workers were at benches before the windows from which boys and helpers transported the ware to the baking ovens which occupied the centers of the rooms, and were usually heated by gas or steam and without vents to remove the motionless heated air from the rest of the room. At about ^f of the places other processes, as the making of "slip" or saggers, and dipping, were done. Age-group estima- tions summed up as follows: 32 persons over 50 years of age, 256 between 40 and 50, 2,482 between 20 and 40, and 278 under 20, the latter, boys, as a rule. In 3 plants the work was performed ind supervised in such a way that dust was a negligible hazard to workers, and in 10 more such was the case to a fair extent. In the remaining 40 places, workers were under considerable hazard from the breathing of fine clay dust in the air. Some machine press- rooms were free from dust ; others were very dusty, apparently because clays were handled drier. In these, each fall of the press was accompanied by a discharge of dust. While the clays are handled in the wet, as the process proceeds they become dry until they are eventually baked. Carelessness and 236 hurrying work at the benches creates some dust, but most of it arises from clap drippings which dry out on the floors, from the carrying trays, from the continual hurrj'ing trips of the mold boys, and particularly, from the finishers. The finishers (largely females) who scrape rapidly revolving articles, ran the greatest dust hazard, while the mold boys and helpers who handled the dried bisques in the ovens suffered next in hazards. In no places were local ex- haust systems found for the protection of finishers. If the dusts were not of an injurious character the risks to the general mass of workers could be over- looked. Quarters were orderly and cleanly in 6 places, fairly so in others, and not so in the remaining 41. General construction was a chief factor in such, rendering it impossible to use a hose for cleaning floors and benches or to use Fig. 66. Pressroom ix ax Art Tile "Works. The machines (on right) press the moist clays into tiles, the workers select and "sagger" them. The workers are not crowded as foreshortening by camera appears to show. vacuum cleaners. While the work is necessarily with wet and moist clays, still, dampness was a negligible hazard in 21 cases, fairly so in 7 more, but not so in the remaining 25, in which latter poor locations and insufficient heating provisions (other than the baking ovens) were the chief causes. Carelessness on the part of the workers was another factor. Light was good in all places for the more skilled workers, but in i of the places, a large percentage of those engaged in sub-processes were in very poorly or improperly lighted quarters. General room ventilation was good in 11 places, fair in 14 more, and poor in the remaining 28, particularly, for the winter season of the year. This was due to the large number of work people assembled together, the presence of the baking ovens, and the lack of air-agitators and air-conditioning systems, and often to the absence of ordinary vents in types of buildings which it was 237 . impossible to ventilate efficifently without mechanical means. Heat constituted no particular hazard to workers in 24 places, while it was some feature in 6 places, and bad in the 23 remaining, particularly, in the warmer seasons of the year. The presence of the baking ovens accounted for this. While the mold boys remained in the ovens for only a few minutes at a time, the investigators found them to be very hot, especially for youths who worked at such a hurrying pace as was commonly observed. Cold, due to the presence of the wet clays and insufficient heating arrangements, was a considerable complaint in 26 es- tablishments during the winter time. Many persons said they worked with hands and arms benumbed and the feet cold at the benches during this season. The alternations between heat and cold for the oven workers was another frequent complaint. Fatigue, especially for youths, constituted a fair to con- siderable hazard in all handwork places. It was chiefly due to hurrying piece- work, monotonous application under constant strain, constant standing (very rarely were females, even, found to be seated), and faulty postures. Less frequent factors were for some of the classes employed : laborious work, long hours, and pressing various portions of the body against objects to facilitate Fig. 67. "Green" Room. Where the ware is dried before firing. the work. Chairs with backs (for females) were rarely observed. Many workers had formed the pernicious habit of leaning over their work which was oftentimes of a dust-producing character. This was explained by some workers as due to the lack of an apprenticeship for the first week or 10 days during which workers could learn their manipulations in a proper and safe manner. The workday averaged 6 hours in 4 places, between 8J and 9 hours in o places, between 9^ and 10 hours in the remaining 44 places. The noon recess was 1 hour in 11 places, f hour in 1 place, J hour in 19 places, and was "as desired" in the remaining 22. In the majority of places a morning recess of 10 or 15 minutes was the custom. The liability to the contraction of com- municable diseases was present in all places, but constituted no more than a fair hazard in 10 places. The chief factors were the crowding together of large numbers of workers whose health status was unknown, and without medical supervision. Added to these were inadequate washing facilities, poor closets (sometimes at great distanc-es and perhaps only privies out in the yards), promiscuous spitting, absence of cuspidors, the use of common drink- ing cups, and the constant presence of dust to help in the conveying of 238 diseases, and in the injuring of the respiratory organs. Poisons were not a feature of the process, but there was considerable complaint from the fumes and gases from the ovens in many places. In very few places was the in- dustrial inducement to alcoholism and various forms of stimulantism absent, because of the depressing influences above stated. In 10 places the general appearance of the workers was good and con- tented. In the balance many fatigued, underweight, and general under-par individuals were seen. The usual complaints of workers were heat, fatigue, dust, poor ventilation, dampness, and cold. This is the chief process (because it employs so many) in the pottery industry from which consumptives come, and many instances of this disease were brought to the attention of the in- vestigators by both workmen and employers, usually with the information that it was unavoidable. Commtents. — Among the shortcomings pointed out in the discussion above are to be emphasized hurrying piece-work in a hot-and- cool atmosphere, especially for youths, and the lack of a physical examination for all employes, in order, especially, to get those who are consumptive out of the workrooms and to forewarn persons so disposed. It must not be for- gotten also that pneumonia is a frequent occupational disease among mineral and clay dust inhalers. In many places hoods and stacks or roof ventilators could be placed over the oven quarters. Smooth floors, frequently wet- cleaned or vacuum-cleaned, are necessities. It would appear to be much better to have the factory management take care of cleaning up the work quarters than to leave it to each worker to attend to his own. — Those who question the presence of fine dust in the breathing atmosphere should expose a shallow pan or dish, colored dark on the inside, at the level of the workers' heads, fill it with water and after an interval evaporate the water to note the presence and amount of deposit. POTTERY. GLAZE MIXING. This process consists in the weighing, mixing together and fritting of materials for glazing the molded ware. While some glazes used contain no oxides and salts of lead, the vast majority of them do. All the forms of lead used are harmful. The glaze mixers handle the lead oxides and salts in their original form, and hence run considerable risk of lead poisoning because of the dustiness and solubility of the lead ingredients. While fritted lead glazes (the lead added before the fritting is done) greatly reduce the solubility, this feature concerns the glaze-dippers who later use it, rather than the glaze mixers who prepare it. The process was investigated in 16 plants where men were more or less constantly so employed, including 12 whiteware, 3 artware, and 1 stoneware plants. There was a total of 24 wage;-ea.rners, all males. From this it will be seen that glaze mixing even in large establishments does not require more than 1 or 2 workers. The general type of workers was good in 13 places, and fairly so in the remaining 3. In 10 places the workers had been at the process for some time, while in the remaining 6 they were recent employes. In no places were special health appliances observed, while in but 2 was any definite instruction apparently given to the workers upon the dangers of lead poisoning. However, each worker had some indefinite idea, as a rule, that the substances he was handling were poisonous, but his knowledge on the avoidance of poison- ing was usually very imperfect. The work requires no particular skill. The 239 glaze mixing quarters were commonly in association with the slip house or sagger quarters. But 3 of the workers were over 40 years of age, while no youths were seen. In 1 place dusi was well enough confined and controlled to constitute practically no hazard, and in 4 more places it was but a fair hazard, while in the remaining 11 it was bad, considering its nature. The same proportions obtain as to the general cleanliness of the quarters or room in which the work was done. The workers were healthy appearing in 2 places, fairly so in 12 others, and not so in the remaining 2. The workers' complaints were the exposure to dust and the general insanitary character of the work quarters (see "Slip" Making). Of the 20 men seen, 2 were suffering from lead poisoning and 3 others tentatively so. Comments. — Where dusts, particularly of poisonous character, cannot be controlled in their handling and manipulation by confine- ment or by exhausts locally applied, the worker should wear a respirator while so exposed, and cleaning of quarters should be done either in the wet or by FiG. 68. Glaze Mixing. vacuum methods. However, general sanitary provisions, instructions on the preventing of lead poisoning and periodic medical supervision are essential for this process. POTTERY. — GLAZE DIPPING. This process consists in taking the bisque ware (occasionally the green ware) and dipping it into a glaze solution, the chief component of concern being lead in some form. For some artware and tiles subsequent glazings are done by brush painting, sponging, and mottling. The colored glazes are the richest in lead compounds. Some of the glazes used contained no lead, es- pecially for certain special ware (porcelain, stoneware, and some tiles). The vast majority of the glazes contained lead in an unfritted form (especially solu- ble in the human gastric juice if swallowed). Water constituted the solvent or medium for the glaze. The dipping was done by hand in all except a few processes in tile factories where small and regular pieces were dipped by ma- chinery. However, it was said that hand dipping was rapidly disappearing in tile factories. After glazing, the ware is placed in saggers and baked in the glost kilns. The dipping process was investigated in 53 plants, employing 329 males and 257 females, or a total of 586 workers. In all except a few instances the dip- 240 ping was done by males, while females acted as helpers in draining, wet finish- ing, and rubbing of the glazed ware. In many instances females or boys acted as "gatherers", and removed the ware from the dipping quarters. Tiles were usually placed in the saggers while still wet (hence, not dusty). Unions existed in 34 of the plants investigated and were absent from the remaining 19. In some cases helpers belonged to the unions.- The helpers were usually hired by the dippers and constituted a fair to good type of unskilled help in practically all places. While the dippers themselves were long-time employes, as a rule, a large percentage of helpers had worked less than a year in nearly all places. This was mostly due to varying social conditions, and sometimes to sickness. They changed about considerably from plant to plant. Special health appliances (outside of mechanical means for dipping in the tile works, and room exhaust fans in one place) were not found, although cuspidors and special methods of cleansing the floors by frequent flushing into floor drains were features in a small percentage of places. A very few places provided lunch Fig. 09. Dipping Room. Here the fired and finished bisque ware is dipped in the glaze. rooms and occasionally these were most uninviting and not kept clean, and consequently were little used. Some instruction in the prevention of lead poisoning was given the workers in 5 plants. A number of plants were under- going remodeling at the time of our investigations. Except for the benefit privileges kept up by some of the union locals, none of the workers were protected by organized sick insurance. The general construction of the work quarters was hygienically very good in 7 places, fair in 11 more, and not so in the remaining 35. Other processes were carried on in the glaze room in 12 places, such as glaze mixing, glost and bisque' kilning, clayshop work, finishing and decorating. At first glance very few dipping quarters appeared dusty, but when one considers that glaze dust usually contains lead, the mere trace of dust, pro- duced even at intervals, becomes a decided health-hazard. As all dipping and finishing is done in the wet, all dust is the result of carelessness and hurry on the part of the workers from splashing upon the floor, upon benches and 241 boards, and upon the clothing, and allowing it to dry, whence it "kicks up" as a fine powder, hardly visible to the eye perhaps, but enough in amount to cause lead poisoning by settling on the lips, and by inhalation. In 4 plants dust ap- peared to be absolutely controlled. In 23 others it was kept down enough to constitute only a fair hazard, but in the remaining 26 the possibility from poisoning from this source was great. The floors and work benches were kept very clean in 10 places and fairly so in 21 more, but not so in the remaining 22. In several places dried glaze was allowed to cake on the floor under foot. Cement or other impervious floors with drains, and capable of frequent flush- ing, were installed in all the clean places. Although dipping was done in a watery solution, water and dampness were no hazard in 27 places, and but fairly so in 12 more. In the remaining 14, workers were engaged in injuriously Fig. 70. Hand Glazing of Art, Floor and Wall Tiles. The men do the glazing or dipping; the girls do, the finishing or fettling in the "wet" over pans of water. damp quarters. Light was good in 27 places, fair in 11 more, and poor in the remaining 15. Occasionally work was done in inside rooms under a flaring gas flame burning at the end of a pipe. The ventilation of quarters was fair to good in 37 places, and poor in the remaining 16, due to confined quarters. Heat is no factor in the /process, but in 9 places it was very warm, due to proximity to kilns. In 4 places strong complaint was made of cold, damp quarters, and in a total of 16 complaint was made about inefficient heating in the winter season. Some dippers claimed that the solutions became so cold that they worked with hands and arms "lialf frozen" in the winter time. Drafts were usually ipurposeij avoided, to keep out street dust ; on the other hand, in some plants, windows were allowed to be open. Fatigue is largely a question of how well the individual worker is adapted for the work he or she is perform- 16 O. D. 242 ing, for although hurrying piecework was the rule in practically all plants except artware, the hours were sufficiently short and recesses frequent enough for most of the workers. The workday was 8 hours in 3 places, and varied between 8^- and 10 hours in fhe remaining, the workers usually leaving when a certain output had been accomplished. Thus, many of them got through as early as two o'clock in the afternoon. The noon recess was 1 hour in 13 places, f hour in 1 place, J hour in 20 places, and "as desired" in the remaining 19. A morning lundi recess at 'about nine o'clock was observed in nearly all places. Outside of piece-work, the chief factors conducive to fatigue were monotonous dupliation of movements and constant standing. This was worse for the dip- pers than for the helpers, who had opportunities to change positions with greater frequency. In practically all places, except machine dipping in tile works, workers, including females, remained standing constantly. In porcelain M^^^H iHiimii ^H^^H^^H^^H^^^ir- '^'' m H ^^^ ' Q ^ o 0) ;-! in > >-. -73 nJ H s c + +++ 3 + + +++4-++^++++- ++ + ++ 1 T— I t— I -^ tM CO .— I 1 he _c 'S o •^ • bo bo a •■.s.s • c c (U 00 ^3-4:: o o ^. 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Anthracosis ; • ■ •_• Antimony poisoning Appendicitis Benzine, benzol poisoning Blind spells (light) Brass chills Brass itch Bronchitis, asthma, catarrh Burns (zinc chloride) Bursitis (olecranon) Byssinosis Calcicosis , Compressed air illness Conjunctivitis, blepharitis Cramps (heat) ., CS2, CI4, S2CI2 poisoning Cyanide ulcers Deafness Derniatitis, eczema, pruritus, ulcers. Dyspnea .• Enamel fume poisoning Epistaxis (nose bleed) Eye-strain (welding) Flat foot Fume poisoning Gas poisoning Glue fume(?) intoxication Heat prostrations Hydroflouric acid poisoning. . . ' Keratitis (wire mill) Lead poisoning Nitroglycerine poisoning Occupational neuritis Occupational neurosis Pharyngitis Pneumonokoniosis Rheumatism Rhinitis, choryza Siderosis Tobacco heart Tobacco poisoning 24 6 1 3 1 1 33 1 117 ,7 16 •2 1 1 1 9 5 9 1 2 39 9 2 1 1 2 12 1 2 1 1 544 2 4 1 2 7 9 12 2 2 2 1 2 3 14 138 3 373 ALPHABETICAL LIST OF OCCUPATIONAL DISEASES AND DISABILITIES SHOWING TYPES AND NUMBER OF CASES. CONCLUDED. Disease or Disability. Number of re- ported cases of disease or disability by type of case. / tive. Posi- tive. Tenta- Tuberculosis 301 2 3 8 21 Turpentine, poisoning 2 Zinc chills ■ 1 Other occupational poisonings Total 1,204 211 OCCUPATIONAL LEAD POISONING BY INDUSTRIES AND TRADE PROCESSES. Industry. Number of re- ported cases of disease or disability by type of case. Posi- tive. Tenta- tive. Agricultural Implements. Automobiles and Parts... Babbittinp- Metals and Solder. Bicycles, Sewing Mach., etc... Brass and Bronze Products... Carriages, Wagons and Parts. Cars and Repairs (by rail- roads) Cars and Repairs (not by roads) Cash Registers and Calc. Mach Chemicals Coffins, Vaults, etc Copper, Tin, etc Cutlery and Tools Elec. Appar., etc Painting, bronzing Carpentering on primed work ; painting, sanding, etc.; tempering; not speci- fied Melting (soft metals) Painting, varnishing Founding, soldering Painting, sanding Carpentering on primed work; painting; varnishing soldering Painting, varnishing ' Tempering I Lead burning, ore crushing. . . I Brass and lead founding; I painting, varnishing; pollsh- I ing, buffing; solderincr I Machine .shopping; soldering. Tempering I Lead burning, storage batter- I ies, soldering 79 1 6 1 I 1 2 1. 3 1 2 42 1 I 13 3 3 6 I 1 2 1 6 i. I ! 13 1 4 3 1. 7 1 1 1 107 1 10 374 OCCUPATIONAL LEAD POISONING BY INDUSTRIES AND TRADE Processes — Continued. Industry. Emery Wheels Enameling- and Japanning Explosives - Files Flags, Regalia, etc Foundry and Mach. Shop Products Furniture and Cabinets Glass Cutting, Staining, Art.. Glass Mfg Trade Processes. Number of re- ported cases of disease or disability by type of case. Instruments (scientific) Junk Iron and Steel Rolling Mills. Lead Bar, Pipes, Sheets, etc. Lead Oxides and Carbonates. Leather, Tanned and Curried. Musical Instruments Oil Refining Paint and Varnish (Mfg.)... P a i n t i n o- and Varnishing (Non-mfg.)* Porcelain Enameled Iron Ware! Pottery ' Printing and Publishing. Rubber Goods. Safes and Vaults Scales and Balances Shipbuilding and Boats... Signs and Adv. Novelties. Smelting and Refining. . . . Stereo and Electroplating. Stoves and Furnaces Toys and Games Wire (Works and Mills) . Miscellaneous Babbitting, moldin Enameling Lead founding File cutting, tempering Painting Die casting, founding, paint ing, soldering, tempering...! ^Painting, varnishing I Painting, assembling I Lead putty making, mixing ! ingredients I Metal grinding, soldering I Smelting I Tinning I Various processes I Various orocesses I Enameling ' Assembling metal parts I Handling lead pipes I Grinding, mixing, filling con- ! tainers, soldering, labeling..! I House oainting I Enameling I Glaze mixing, glaze diooing. ' straining glaze, washin"' I saggers, p-lost kilns, fettling, I decorating and t i n t i n o-. I riig^ times this number of offspring. It is not likely that social conditions alone account for this decrease in progeny in the space of one generation. Diagnosis — Acute lead poisoning should be easily diagnosed, but there seems to be a great hesitancy on the part of physicians to make a positive diagnosis. While intestinal colic is fairly constant, other chief features are breakfast anorexia, extending later to all meals ; metallic taste ; nausea, with or without vomiting; loss of weight; loss of strength; constipation, perhaps alternating with diarrhea; pain in the lumbar region; pains in the joints; headache; drowsiness; insomnia ; confusion ; blind spells and diziness. In a few days to a few weeks such symptoms are followed by a weakness of the hands, arms, or legs, with a tendency to "wrist drop," and less often "footdrop," "shoulder drop," or even "head: drop." The set of muscles most used is apparently the set most affected. Associated with these symptoms is a "blue line" (it may be only a few collections of punctate spots) in the gums in about one-third of the cases only. Invariably there is a peculiar pallor affecting the face, and especially the lips. There may be a slight yellowishness of the conjuctivae, tremor of the tongue, of the hands, and a tremulous voice, while the examining physician may note a weakness in ocular movements and a tendency to "springy pupil" when exposed to the diagnostic lamp. After a short time emaciation may set in, though it is by no means a constant manifesta- tion. Many times the abdominal symptoms are mistaken for obstipa- tion, ileus, hepatic colic, renal colic, vesical colic, tabletic crises and appendicitis. It must not be forgotten that true appendicitis may be present' as an accompaniment of the spastic constipation present. Fever is absent as a rule, but various complication may cause it. When the colic is present there is apt to be present, also, a slow, hard pulse and an increased blood pressure, but these may be counter- acted temporarily by the effects of nausea or collapse. It may also be possible to discover basophilic degeneration, or punctate "stippling", in the red corpuscles in a properly stained blood smear, but unless these are present to about the extent of i in every lOO red cells they should not be given much significance, for it is well known that they occur in other conditions, such as dysentery, cancer, leukemia, cachectic states, septic processes, and, indeed, in secondary anemias. Their importance as a diagnostic feature has been greatly over-estimated. Furthermore, they are often absent in well-marked cases of acute lead poisoning, or only present at intervals. 38i Liebermann's intoxication test- — increase of the resistance quotient of the red blood corpuscles to hypotonic salt solutions (0.45% NaCl) — is much more important than basophilic degeneration, particularly when the intoxication is due to lead. It is necessary to mention that this test may be vitiated in a given case if the individual has been more than usually exposed to benzine, naptha and some other volatile poisons within a period of 48 hours since these cause a decrease in the resistance quotient. The urine in lead poisoning is usually highly acid ; indican may be demonstrated to be present in excess (Lavelle's test), while lead can be demonstrated (the electrolytic process advised,^ — see, also, next article) in many cases. However, as lead is largely excreted by the intestines, the feces prove to be the chief excrement in which to dem- onstrate the presence of lead. Occasionally, severe cases may show no elimination at all. In such cases it is probable that all the lead is being retained in the body. The presence in the urine of albumen and casts is only of secondary importance since these may be due to so many other factors. By way of summary, the following features obtain in diagnosing acute and sub-acute lead poisoning : ( 1 ) Lead poisoning should be sought for in all workers and per- sons exposed to lead in any form, particularly if lead may be inhaled in the form of dust. (All such persons should be considered suspicious cases of plumbism). (2) A "lead line" in the gums means the absorption of lead into the system and its distribution by the blood stream, which, carrying a fraction of the absorbed lead through the capillaries of the gums, per- mits it to be precipitated and held there through the action of the sul- phides in the food. While a true "lead line" shows that the individual is "leaded," still the "lead line" does not mean lead poisoning neces- sarily, for there may not be enough accumulation in the system to pro- duce any symptoms of intoxication. All "lead line" cases, however, are highly suspicious, and undoubtedly will develop signs of intoxication, particularly if not removed at once from exposure. (A "lead line case" warrants a tentative diagnosis of lead poisoning). (3) Lead demonstrated in the urine does not furnish proof - positive evidence of lead poisoning, since the metal is, perchance, being eliminated as fast as it is absorbed, i. e., not enough is accumulating to produce intoxication. {Tentative diagnosis). (4) Lead demonstrated in the feces, also, does not warrant a diagnosis of lead poisoning by itself. It does not even imply lead ab- sorption, for the lead may have been ingested in an insoluble and non- 3^2 absorbable form. In fact, lead may be absorbed through the respir- atory tract and eliminated through the intestinal mucous membrane, but its mere demonstration in the feces does not prove lead poisoning for the same reason as just stated in connection with the urine. (Again, only a tentative diagnosis). (5) Lead poisoning actually exists when evidence of actual in- toxication is added to a history of exposure, or is added to (a) the Fig. 100. Lead Poisoning. The photograph shows the dark lead line in the gum margin, as well as on the teeth. sign of absorption, i. e., the "lead line", or (b) the absolute sign of elimination, i. e., lead in urine. {Positive diagnosis), (6) This necessitates a statement of the early signs and symp- toms of lead intoxication. The chief constant and early physical sign of lead intoxication is pallor of the face, including the lips, which is due more to arterial spasm, (peripheral or centric?) than to anemia. The chief symptoms are, in somewhat descending order, digestive dis- 383 turhances, insomnia and weakness. Unless the pallor is due to tem- porary nausea or collapse, it will usually be found to be accompanied by an increased blood-pressure. The Liebermann test will be found positive in acute cases. (y) The sodium sulphide test (Na^S, 5% solution) applied with an applicator to the hands, arms and face, is very useful in dem- onstrating the exposure to lead in the case of a workman ignorant of the materials to which he is exposed, and where the metal has had a chance to get into the epithelium of the exposed parts. A brown or black line will often result in a painter, even after ten days or two weeks from the time of his last exposure, in spite of many ablutions in the meantime. The test is invaluable in the factory "wash-up" room as a means of determining whether ablution has been thorough enough. In this case the solution may be kept in a pail and the supposedly cleansed hands dipped into it. The fact that the discoloration may be due to other black sulphides, such as mercury, copper, bismuth and nickel is almost negligible since painters are so little liable to exposure to such metals. Chronic lead poisoning — Those workers who do not develop symptoms of acute or sub-acute lead poisoning may be considered as having superior eliminative capabilities. But with these a slowly ac- cumulating set of signs and symptoms throughout years of time ulti- mately ends in premature senility, various degenerative diseases, or the sudden onset of Bright's disease, heart failure, pneumonia, influenza, tuberculosis, pleurisy and the like. In fact, long-period workers appear to go to pieces suddenly in the end. With these there has undoubtedly been progressing, for a long time, fibrosis affecting es- pecially the 'arterioles of the kidneys and of the intestines. Of 100 house-painters recently examined in the city of Chicago'* (these are less exposed to lead than the indoor factory-painters) indications of chronic plumbism were found in 59 instances, or 59%, while 26 gave a clear history of acute lead poisoning at some time in the past. As there is an average of seven painters to every 1,000 of urban population, the State of Ohio has something over 20,000 workers so engaged. The first 100 deaths in a large Painters' Union^ in Chicago re- vealed five chief causes : organic heart disease, pulmonary tuberculosis, nephritis, pneumonia and accident at work. The average age at death from these five causes was from two to seven years less than the cor- responding death rate in the city at large. Besides a history of exposure, chronic lead poisoning has for its chief diagnostic factors the following: (i) A diseased condition of the gums which has usually supplanted a previous "leadline". It is not 384 uncommon to find associated a "lead line," wasted or diseased gums, dental caries with yellowish to blackish discolorations and the absence of many teeth. (2) Atrophy, particularly of the most used sets of muscles, with accompanying signs of tremors, weakness, muscular inco-ordination, decreased or absent muscular reflexes, and perhaps fibrillations should be sought for. (3) Vascular hypertention, association with arterio-sclerosis, cardiac weakness upon not undue exercise, and chronic Bright's dis- ease, are very frequent concomitants. The Johnson-Lavis*' observation that systolic pressure should normally not be over the number of years of age plus 100 for adults is also found to be exceeded in a good pro- portion of all lead-exposed workers. (4) "Rheumatism", of chronic type, particularly of the ankles, feet and back is a common complaint. Lead gout or "poor man's gout" may be present. (5) I would especially call attention again to the weakness of the hand grip in nearly all painters, as demonstrated by the hand dyna- mometer - — ■ this is more apt to be present than signs of weakened dorsi-flexion of the wrist, and is more likely to be found in the hand most used, contrary to the findings in carpenters, blacksmiths, etc. (6) Unquestionably the application of Barach's'^ Cardia Energy Index (the systolic pressure multiplied by the pulse rate per minute plus the dyastolic pressure multiplied by the pulse rate per minute) would show a degree of hyper- normal energy expenditure in most cases of considerably over the 20,000 mm. of Hg. per minute which he considers the highest admissible for the normal person. (7) Basophilic degeneration of the red corpuscles, which signifies acute intoxication of progressive character, is uniformly absent in chronic plumbism. So, also, is Liebermann's test. (8) The urine should be examined for lead, if doubt still exists. Preventive measures — Various authorities state that zinc can be substituted for lead for all interior painting and to a large extent for exterior work. The rubbing down and dry sandpapering of painted surfaces has been practically eliminated in certain foreign countries, as well as hand work, the latter, by dipping and spraying processes. In many industries wet rotten stone or pumice-stone powder applied with a bass-wood block or piece of felt can be used without the creation of any dust. Finally, the dust arising from sandpapering can be entirely checked by the use of mineral oil to take up the dust. This oil is cheap and does not damage the work nor interfere with speed. The wearing 385 of wet sponge respirators is an additional precaution, but these will not in themselves prevent plumbism. Finally, we submit below a table^ showing the preventive measures which have been adopted in Germany, France and Belgium to prevent lead poisoning among painters. It is applicable to many other workers as well. COMPARATIVE ANALYSIS OF LEGISLATION RELATING TO LEAD POISONING IN GERMANY, FRANCE AND BELGIUM FOR INDUSTRIES USING PAINT CONTAINING LEAD. Germany. France. Belgium. Clothes closets. Wash and dressing rooms. Wash water. Soap. Towels. " Nail brushes. Must wash before meals, No food in work room. No alcoholic drink in work room. No tobacco during work. Overalls. Caps. Medical inspection every six months. "Necessary facilities for I Wash water, cleanliness." I Overalls in all moist I Soap, scraping off, and in painting with white lead. Employers must hang Towels, text of law in work places and where men receive wages. Scraoing off of white I Means to rinse mouth, lead paint by the dry method is forbidden. White lead only used in pasty condition. Manipulating with bare hands any material containing white lead forbidden. All .tools kept clean. Wash before meals. Wash before leaving shop. Food brought in to be in tight packages. No alcoholic drink in shop. Work clothing and head covering. Medical inspection every 3 months. 25 o. D. 386 Comparative Analysis, Etc. — Concluded. Germany. France. Belgium. Leaded man removed to occupation where no contact with lead. Men breaking regula- tions after warning to be discharged. Health register. Employers must indi- cate to workmen the dangers. Employers must hand men copy of- the reg- ulations. "The rubbing off of dry paint which cannot be proved to be free of lead must only be done after previous moistening." (1905). Cleaning must not done in dry state. be After July 20, 1914, "the use of white lead, of linseed oil mixed with lead and all specialized products contain ing white lead will be for- bidden by law in all painting no matter of what nature carried on by working painters either on the out or in- s i d e of buildings." (1909.) No men addicted to liquor to be employed. Health register. Dry working, scraping or rubbing of white lead surfaces forbidden. Mixing, grinding, manip- ulation, etc., of white lead or other lead com- pounds forbidden ex- cept when in such way that workers do not come in contact with lead with their hands. (1905). After August 20, 1910, "the sale, transporta- tion, or use of white lead in powder, grains, or cakes, intended for painting is forbidden." For this purpose white lead may only be sold, transported or used in form of paint mixed or ground in oil. (1909). LIEBERMANN'S RED CORPUSCLE RESISTANCE TEST. — Normal blood corpuscles will hemolize (lose their hemoglobin) in "plain water." So also will they in hypotonic salt solutions of less than 0.5% strength. But the blood corpuscles in lead intoxication become resistant, so that in salt solutions as low as 0.4% they may not dissolve. Usually 0.45% is a convenient strength in which to try the test. In contrast to the effects of lead, mercury or phos- phorus, which also affect the blood corpuscles, most toxic, debilitated or anemic states cause a lessened resistance in the red corpuscles. To make this test the patient must not be plainly suffering from signs of intoxication from alcohol, benzine, or benzol. (1). By means of a glass pipette, marked at point where one drop of blood comes, place a drop of fresh blood in 5 cc. of a 0.5% NaCl solution contained in a centrifuge tube. Shake gently for two minutes, then add 5 cc. of 1.5% NaCl, and centrifuge quickly for a moment. The fluid above the compact mass of corpuscles in the bottom of the centrifuge tube will be practically colorless if the blood corpuscles are normal, or if they have been rendered hyper-resistant by the acute toxic effects of lead. (2). To a second centrifuge tube containing 5 cc. of a 0.45% NaCl solu- tion add another fresh drop of blood. Proceed as above. (Both performances 387 may be done at the same time). In this tube normal blood will show a distinct hemolysis (reddening of the supernatant fluid after centrifuging), bat in lead intoxication the solution remains clear, showing that the corpuscles are resistant to the hemolytic action of the hypotonic salt solution. After a little practice the whole test requires less than three minues, and, as explained, only two drops of blood. The various solutions must all be of the same temperature, that of the room, and an atomizer bulb should be used to blow out the drop of blood from the collecting pipette, since the CO2 of the breath decreases the resistance. The above is a qualitative test only, but in the original method, definite quantitative relationships can be determined, and stated by a resistance quotient "R. Q.," which is expressible in figures, so that the amount of intoxication may be shown. THE ELECTROLYTIC TEST FOR LEAD IN THE URINE. — Mate- rials and apparatus (lead-free) — (1) beaker of 200 cc. capacity, (2) evaporating dish of 1 litre capacity, (3) cone. HNO3 c. p., (4) cone. HCl c. p., (5) NaOH sticks, (6) Swedish filter paper 3 and 6 inches in diameter, (7) cover-glass, or glass funnel, to be inverted over beaker. Also two 5 inch lengths of medium sized platinum wire for electrodes. Platinum truncated cones are better. Also 3 ordinary dry-cells connected in series, with several feet of ordinary insulated bell-wire, brass wire-connectors, a miniature rheostat, a small combined volt- ometer and ampere-rneter (the watch-shape type costing about $2.00 is satis- factory) and 1 or 2 single-blade switches to facilitate control of current. Gen- erate H2S gas by placing lumps of FeS in a bottle having a glass delivery tube drawn out to a point, adding half-strength HCl whenever gas is wanted. All the work should be done inside of a laboratory hood, to get rid of odors, acid fumes, etc. The whole apparatus can be set up on one small iron standard, with a few rings and clamps. The platinum electrodes are coiled up in the form of spirals, and each connected to a respective wire from the batteries. The electrodes are let down inside of the beaker, so as to be near the bottom, and not closer than >^ inch from each other. Lead in the solution will deposit on the negative pole as Pb02. To determine the electrode or pole, place a weak solution of NaCl in the beaker containing a drop or two of phenolphthalein indicator; pink color appears at the negative pole when the current is turned on. Procedure. — A 24-hour specimen of urine is evaporated down until all is contained in the evaporating dish. Then add carefully 30 cc. of pure nitric acid, bring to a boil, evaporate down to a total of 60 cc. This changes all lead present into the nitrate, which is in solution, and the carbon from the organic com- pounds appear as black flakes. Filter to remove carbon. The filtrate, together with the washings to 90 cc, are now placed in the beaker fitted with the electrodes and covered to prevent foreign matter accidently dropping in. The electrodes should have been previously boiled in a mixture of HNO3 and HCl to brighten them, then washed in distilled water. The current is thrown on, and adjusted by means of the rheostat, so that about 2 volts is read on the voltometer temporarily attached at the electrodes. This shows the actual delivery current, as there is considerable resistance in the wires at the low voltage used. The amperage will be found to read about 4, but is of variable quantity. The current is continued through the solution for 8 to 10 hours. It is best to immerse the beaker in a water-bath, kept at about 30° to 40°C. by means of an electric lamp, as the current action is better. Qualitative Determination. — At the end of the period, throw off the current, remove the electrodes, and any lead present will be shown by a black 388 or brown discoloration on the negative electrode. To further prove the pres- ence of lead, the electrode is boiled in a test-tube in 2 or 3 cc. of aqua regia, until it has brightened. The electrode is then removed, the solution neutralized with NaOH, and tested to prove lead by the usual qualitative tests. The most delicate of these is that of passing a stream, of H2S bubbles through the neu- tral, or slightly acid solution, and obtaining the brown or black discoloration due to lead sulphide. The method is very delicate, making it possible to show as little as 1 part of lead per million, in the original 24-hour specimen of urine. Quantitative estimations may be made by weighing the electrode before and after the ex- periment, or by comparing the hue of the lead sulphide discoloration in the test above mentioned with a known amount of lead nitrate precipitated by H2S gas in another test-tube. From 0.032 to 0.16 mgm. of lead have beeivfound by the above method. The method is much more delicate than the magnesium wire test of Hill. It must not be forgotten that an acute case of lead poisoning may show no lead in either urine or feces, since all may be withheld in the system, and none eliminated. This is more likely to be so with the urine than the feces. BIBLIOGRAPHY. (1) M. Paul — Cited from Blyth's "Poisons, Their Eflfects and Detection," 4th Ed., 1906, p. 629. (2) Liebermann— L. v. — Deut. Med. Woch., 1912, XXXVIII, No. 10. Also Schaffer, E., ditto, No. 40, and Orban, R., ditto. No. 44. (3) Blyth — .y. J/., p. 636. (4) "Hygiene of the Painters' Trade." — U. S. Labor Bulletin, Whole No. 120, May, 1913, p. 51-58. (5) Special Report of Statistician of Local No. 194, Brotherhood of Painters, Decorators and Paperhangers, Chicago, 1913. (6) Johnson-Lavis, H. G.,— Brit. Med. Jour., No. 2663, p. 72, Jan. 13, 1912. (7) Jour. Amer. Med. Assoc — Vol. LXII, No. 7, p. 525, Feb. 14, 1914. (8) From "Occupational Diseases," E. E. Pratt, in "Preliminary Report of the Factory Investigating Commission," New York, Vol. I, 1912, p. 387. There are several other excellent tables of similar sort in this volume for other industries. THE STANDARDIZATION OF A METHOD FOR THE DETECTION OF LEAD IN URINE.* Chas. R. Parkinson^ M. A., Department of Chemistry, Ohio State University. The object of this research has been to develop and standardize a method that could be employed conveniently by" a physician to deter- mine lead in the urine. It may be said, in brief, that the electrolytic test (this is the method described by Dr. E. R. Hayhurst, in the pre- * Abstracted from Article in Monthly Bulletin, Ohio State Board of Health, October, 1914. 3^9 ceding article) requires very exact conditions and considerable experi- ence. Furthermore, it is not as delicate as the test embodying the precipitation of lead as the sulfide. Procedure One. — After the sample of urine has been evaporated to about 40 c. c, add 20 gms. of potassium chlorate and 10 c. c. of concentrated hydrochloric acid. Boil : add hydrochloric acid in 10 c. c. portions until the odor of escaping chlorine can no longe be detected. If the solution is water-clear, all organic matter has been destroyed. If it is colored brown or yellow, the above procedure should be re- peated. After all organic matter is destroyed, test for lead in accord- ance with directions which follow later. Procedure Two. — Evaporate the sample to a volume of about 20 c. c. Add 20 c. c .of strong nitric acid (sp. gr. 1.42). Evaporate to 10 c. c. keeping the material washed down from the sides of the dish. Flakes of carbon will forrn and tend to persist if this is not observed. Add 20 c. c. of water. If the solution is water-clear the destruction of organic matter may be regarded as complete. If the flakes of carbon are present, or if the solution is a yellow color, transfer it to a small evaporating dish and evaporate until the residue begins to char or spatter. Mix in 5 gms. of sodium car- bonate and heat until the ash is. pure white. All organic matter is thus destroyed. In any case, after the organic matter has been destroyed, make the solution alkaline to litmus by adding ammonium hydroxide. If any iron is present it will appear as a brown flocculent precipitate. If copper is present the solution will assume a bluish hue. If iron is present acidify the solution with HCl. If copper is present add KCNf to the alkaline solution till the blue color disappears. If iron and copper are both present add 0.5 grams tartaric acid, make alkaline and add KCN till the blue color disapears. (The tartaric acid should be examined for lead.) If the test for lead is to be made in acid solu- tion, add 5 c. c. of a saturated solution of H2S in water, or allow the gas to bubble through the solution. If the test is to be made in alka- line solution, instead of HgS in water, a solution of a soluble sulfide, preferably sodium sulfide, NaoS, may be used ; — this does away with having to generate HoS gas. (Ammonium sulfide is not as desirable because of its strong yellow color.) The darkening produced is prac- tically proportional to the quantity of lead present. In some cases where a very small amount of lead is present a brownish color is pro- duced. In order to confirm this as beingf due to lead the following' t Great care must be taken not to add potassium cyanide to a solution which reacts acid to Htmus paper, because of the generation of dangerous hydrocyanic acid fumes. 390 further test may be employed. Boil out all excess of hydrogen sul- fide, add hydrog-en peroxide, full strength U. S. P., and let stand. If the dark color disappears, due to the oxidation of lead sulfide to lead sulfate (which remains soluble in the quantities found here), it sig- nifies that the darkening was due to lead in the form of sulfide. The action of hydrogen peroxide on other black sulfides, as the sulfide of copper, mercury, bismuth, nickel, cobalt and iron, was investigated and in no case is a similar reaction observed. Mercuric sulfide is unattacked, copper, nickel, cobalt and iron give colored solutions. Bis- muth yields a white percipitate, due to the formation of basic salts. In view of the preceding work the following procedure is recom- mended for the examination of urine for traces of lead: (i). Evaporate at least i,ooo c. c. of the suspected urine down to about 20 c. c. • (2). The method for the destruction of organic matter with nitric acid is recommended (Procedure Two). {3). After organic matter has been destroyed dissolve in HCl and make alkaline with ammonium hydroxide. (4) . If copper or iron or both are present make the appropriate additions of KCN and tartaric acid. (5). Dilute to 100 cc. and divide into two parts, use one for com- parison and in the other precipitate the lead with a solution of HgS gas or with sodium sulfide, 10% solution. (6). Shake and let stand. If a black or brown color is observed by looking down on the end of the tube, lead is possibly the cause. (7). To confirm lead, boil out the excess of H2S (if H.S was used to precipitate the lead), cool and add 10 c. c. of HoO, (full strength, U. S. P.), shake and let stand 10 minutes. If the black color disappears, the color was undoubtedly due to the presence of lead sul- fide, which proves the presence of lead in the sample tested. The time required for the detection of lead by this method will not exceed 3^ to 4 hours including the time for evaporating the urine, which may be left to an assistant. The actual chemical tests require less than one-half hour. It does not require the undivided attention of the operator and several tests can be run at the same time. Apparatus Necessary. ] Evaporating dish — 1,000 cc. capacity. 1 Evaporating dish — 50-75 cc. capacity. Dishes glazed with a lead-glaze should not be used. (Royal Bohemia virare is recommended.) 391 2-4 Nessler tubes or test-tubes of uniform size and color. 1 Erlenmeyer flash. A white background to compare colors over. Ring-stand, rings, Bunsen burner, etc. Keep clean so as not to drop iron rust into solutions. Reagents Necessary. (a) To destroy organic matter: (Procedure One) — Hj-drochloric acid (Sp. gr. 1.19). Potassium chlorate. (Procedure Two) — Xitric acid (Sp. gr. 1.42). (b) To remove iron or copper occurring as impurities: Ammonium hydroxide (weak). Litmus paper. Potassium cyanide. Tartaric acid. (c) Test Solutions: Hydrogen sulfide or sodium sulfide solution 10% (filter if necessary). Hydrogen peroxide, U. S. P. The impurities apt to be introduced through the reagents which . have to be considered here are iron in the potassium chlorate. A blank test for lead should be run on all reagents, especially the potassium chlorate and for the control of all operations. This can be done very conveniently by running a sample of lead-free water along with the sample of suspected urine, adding the same reagents and performing the same manipulations. This solution is also very useful as a blank for comparison. Results of Urine Analyses. Nine samples of urine from 5 patients suffering with lead pois- oning were examined for traces of lead.- — Two of these samples came from Cleveland and 7 from Cincinnati.. The collecting bottles were found to yield no detectable amount of lead. In the examination of 8 samples, the organic matter of the urine was destroyed by treating with nitric acid and igniting with sodium carbonate. The organic matter of the remaining sample was destroyed by treating with sul- furic acid and potassium bisulfate. The destruction with nitric acid was a little more convenient and required less time. The result of the analyses are given in the following table: 392 1 H Be'" o 1—1 05 0, c CO oxi lOU cirn ^^-^ u O C u. aj .-H V^ s 0. »-. g (U U V ^ Ti •a a,< " g'S C3 ^^ ^ < cr Q o < J 1200 cc 1. Cincinnati Tulv 21 HN03 Yes 0.5 mgms. 800 cc 2. Cincinnati. . . . Tulv 25 HX03 Yes 0.0 " 900 cc 3. Cincinnati. . . . f\Ug. 5 HN03 H.S04 & Yes 0.0 " 600 cc 4. Cincinnati. . . . Aug. 7 KHS04 .... Yes 0.0 " 900 cc 5. Cincinnati Aug. 9 HN03 Yes 0.1— " 1100 cc 6. Cleveland Aug. 6 HNO, Yes 0.2 " 400 cc 7. Cleveland .... Aug. 6 HNO, Yes 0.2 " 800 cc 8. Cincinnati Sept. 3-4 HNO, Yes 0.0 " 300 cc 9. Cincinnati. . . . Sept. 5-6 HNO3 Yes 0.0 " Samples 1 and 2 were from the same patient, kiln room laborer in white lead works. Samples 3, 4 and 5 were from the same patient, kiln room laborer in white lead works. Sample 6, laborer loading box cars ; 10 months previously "worked in a lead shop for a chemical company. Sample 7, laborer in automobile factor}-; sandpapered old auto-bodies to re- move paint. ' Samples 8 and 9 were from the same patient, kiln room laborer for one month, and just taken sick. In conclusion, I wish to thaiik Dr. Wm. L. Evans, of the De- partment of Chemistry of the Ohio State University, for valuable sug- gestions and advice made during the progress of the work which was done at the request of Dr. E. R. Hayhurst. BIBLIOGRAPHY. Fairchild, J. D. Electrolytic Determination of Lead, New features in, Jour. Met. & Chem. Eng., V. 3, P. 902. Wociechowski, B. Electrolytic Determination of Lead, Met. & Chem. Eng., V. 10, P. 108. List, E. Electrolytic Determination of Lead, Met. & Chem. Eng., V. 10, P. 135. Benner. Electrolytic Determination of Lead, Jour. Met. & Eng. Chem., V. 2, P. 348. Knapp, A. W. Estimation of Lead in Beer, Jour. Soc. Chem. Met., V. 30, P. 165. Harcourt, A. G. V. Method for Approximate Estimate of Lead, Jour. Chem. Soc, V. 97, P. 841. Woudstra, H. W. Uber die Genauigkeit Colorimetrischer Bleibestimmungen. Zeitsch. Anorg. Chem., V. 58, P. 168-9. Vortman, G. Zur. Electrolytischen Bestimmung des Bleis Annallen, V. 351, P. 283. Biol. Zeitschrift ,V. 81. P. 63. (On the Electrolytic Detection of Lead.) 393 Large placards of the form below will be supplied to manufac- turers upon request. NOTICE. INSTRUCTIONS TO EMPLOYES. How TO Prevent Lead Poisoning. (1) All workers exposed to lead dusts, lead fumes, lead solutions and lead com- pounds are liable to poisoning. These poisons get into the body through the nose while breathing, or through the mouth when chewing, or swallow- ing, or wetting the lips. (2) Do all you can to keep down dust. When sweeping or cleaning, always dampen with water, oil or wet sawdust. Where dust can not be kept down, you must wear a respirator. This must be cleaned out at least once a day. (3) Eat breakfast before going to work. Drink milk at meals, and if possible once between meals. Do not eat meals in workroom. Leave work-room at meal times. (4) Keep dirty fingers out of your mouth, and off of your food, and whatever goes into your mouth. Wash hands, arms and face with warm water and soap before eating, going to the toilet, or quitting the work-room. Clean your lips and rinse out your mouth before eating or drinking. (5) A mustache, if worn, must be kept short. Do not wear a beard. Keep fingernails clean and cut short, also loose skin about the nails or hands. (6) Do not chew tobacco or gum while at work. Avoid the use of intoxicants in any form, as they promote lead poisoning. (7) Take a full bath with warm water and soap at least twice a week. (8) You must wear overalls and jumpers while at work. Wear a cap if ex- posed to dust or fumes. Do not wear your working clothes outside of the working place. (9) Keep your bowels moving if possible once a day. Report to your foreman if you notice (1) loss of appetite, (2) poor sleep, (3) indigestion, (4) continual constipation, (5) vomiting, (6) pains in stomach, (7) dizziness, (8) continual headache, or (9) weakness in arms, limbs or body. Note: Lead poisoning brings on Paralysis of the wrists and arms, hardens the arteries, causes chronic diseases, and hastens old age and death. WORK- MAN PROTECT YOURSELF. Your employer and the Board of Health cannot do all for you. OBSERVE THE ABOVE PRECAUTIONS. OHIO STATE BOARD OF HEALTH, Dr. E. F. McCampbell, Columbus, Ohio. Secretary and Executive Officer. instructions to employes in dusty trades. Dangers of Dust. 1. Don't breathe dust of any kind — it causes colds, consumption and pneu- 394 2. Don't sweep during work hours — it spreads germs of all kinds. 3. Don't work in dusty air. Stop the dust or wear a dust protector over your mouth and nose. 4. Dust breathed into your lungs is never breathed out again. 5. If you breathe dust you are bound to cough. 6. Coughing or spitting is nature's warning that your lungs are in danger. 7. If you hem or cough every day see a doctor at once. FOUR CASES OF SUDDEN DEATH IN A SILO. E. R. Hayhurst, M. D., Director, Division of Occupational Diseases, Ohio State Board of Health, AND Ernest Scott^ M. D., Professor of Pathology, Ohio State University, College of Medicine COLUMBUS^ OHIO. (Reprinted from The Journal of the American Medical Association Oct. 31, 1914, Vol. LXIII, pp. 1570-1572.) In view of the constantly increasing importance of the silo for the preservation of fodder on the American farm, it seems proper to draw wide- spread attention to the danger of fatal asphyxia which may occur to workers in filling and emptying silos. There are no reported cases on record of fatali- ties under such circumstances so far as we have been able to learn after a careful search of the literature. Agricultural bulletins^ warn of the danger of carbon dioxid asphyxia unless certain' precautions are taken. A sudden death here and there has unquestionably been laid to heart failure, apoplexy and the like. Since the first American silo was built by Dr. Manly Miles', in 1875, the principle 'has undergone widespread development throughout the country so that the dangers herein cited are liable to beset a large number of persons. The danger from the accumulation of heavy gases in t)he old type of pit-silos dug in the ground can be easily appreciated, but the instances in question took place in a modern upground metal silo, built about 40 feet high, and free from surroundings which might interfere with ventilation. At the Athens (Ohio) State Hospital, at about 7 o'clock on the morn- ing of September 19, 1914, four members of a squad of six men ascended the ladder on the outside of the silo in question to an open door about 12 feet from the top, and jumped in, one after the other, on the silage, the level of wihioh was about 6 feet below the doorway. Within five minutes, as reported. ^ Babcock, S. M., and Russell, H. L. : Causes Operative in the Production of Silage, 17th Ann. Rep., Wisconsin Agric. Expt. Sta., 1900, p. 131. Crisp, H. L., and Patterson, H. J. : Silos and Silage in Maryland, Bull. 129, Maryland Agric. Expt. Sta., July 1908, p. 10. Erf, Oscar : The Silo for the Dairy, Bull. Agric. Coll., Farmers' Reading Course, Vol. 2, No. 4, Ohio State Univ., p. 3. "Year Book, U. S. Dept. Agric, 1899, p. 616. 395 < CQ X m ^ w s fc .2 H 396 the next two men who ascended shouted down that the first four looked as though they were dead. A large force of workers who were at hand im- mediately ascended the silo, and opening a lower door which was just above the level of the silage, 'hurriedly removed the unconscious forms, and, in spite of the immediate arrival of four or five physicians from the institution, all attempts at resuscitation failed. The unfortunate ones, one of whom was 31 years old, and the others 56, 56 and 67, were "trusties" at the institution, and all had been engaged for several years on the institutional farm,, and had helped in filling silos for the past two or three years. During the two weeks previous they had helped to fill two large wooden silos nearby, and during the three days previous had helped with the filling of the metal silo in question. Their work was to tramp down the ensilage as it was delivered from the blowpipe. On this morning the machine had not yet begun operations, and apparently the men sat down or lay down on the silage to wait. To expedite the removal of the victims they had to be let down head first within the 3^-foot chute which surrounds the ladder. In this manner they were passed down from helper to helper to the brickpaved dairy-yard below. All were cyanotic, and respiratory movements had ceased, but it was thought that in three tihe heart action was still present when resuscitation efforts began. In a few minutes, however, all became pallid, and in spite of an hour's efforts on each one with artificial respiration and stimulants none revived. On the evening of the same day we arrived at the institution and necrop- sies were performed on two of the bodies with significant anatomic findings (which were exactly similar in both cases) as follows : A black fluid condi- tion of the blood which flowed persistently from practically all places of in- cision, there being an entire absence of clots ; marked cyanosis of the lungs and mucous membranes of the tracheae and bronchi. The same was true of the livers and kidneys. There was also marked capillary injection of the brains and intestines. Aside from these findings tlie tissues of the bodies showed no recent changes worthy of comment; especially there were no patho- logic conditions of the hearts or vessels to be noted. The next morning about 7 o'clock we visited the silo in question, where conditions had been allowed to remain as on the previous morning, except that before orders could be issued a couple of feet more of silage had been added. This had apparently sunk 1 foot during the night, leaving about 5 feet up to the bottom of the door in question. However, according to the manner in which the gases are generated (see below), about 10 or 12 feet should have been added, more nearly to reproduce the amount of gas to which the workmen had undoubtedly been subjected. The weather on the two days was practically unchanged, being slightly cool at night and warm during the day. The silage consisted of fresh, rather finely cut, immature corn. Light ■within the silo was good, owing to open doorways above and in the roof. The temperature seemed about 10 F. higher than that of the atmosphere with- out. A more peaceful and inviting scene could not be imagined than the warm,, pleasant smelling green silage within. With a few moments to spare, the most natural thing for workmen to do would be to sit down or lie down on the silage. We dropped a guinea-pig within, which, in thirty seconds, toppled over unconscious after a brief exhibit of respiratory difficulty. A rabbit was next 397 dropped down on the silage. It took a few steps, showed some dyspnea and dropped over on its side unconscious at the end of sixty seconds. Next a large, slender collie dog was lowered down and in just two and three-quarter minutes it likewise fell over unconscious. The oncome of unconsciousness in all cases was very sudden. The animals, after unconsciousness, rapidly turned bluish about the nose, lips, tongue (and ears in the case of the rabbit). The guinea-pig was dead in ten minutes, the rabbit at the end of forty-two minutes, while the dog was removed at the end of thirty-three minutes, when abdom- inal and chest movements had ceased, although drawing back of the corners of the cheeks was still present. Within a few minutes on the outside, the dog, which had been let down by its tail, showed signs of reviving; at the end of six minutes it appeared partly conscious, and thereafter rapidly recovered without any efforts at resuscitation having been tried. Necropsies on the guinea-pig and rabbit revealed conditions entirely similar to those described above in the cases of the human subjects. Next a bunch of matches, lowered on a pitchfork tine, snuffed out at a level of about 18 inches above the silage. A lantern behaved similarly, and the level of the gas could be estimated within half an inch by means of the effect on the lantern flame. At this point a gallon bottle of water was lowered, inverted, and a sample of the gas thus collected. Another half-mongrel dog of medium size was dropped in, but unlike the collie, which sniffed around over the surface of the silage, this dog kept its nose well elevated and showed very few symptoms. At this point one of the investigators jumped in and lowered his head to the top of the silage. A most startling, rather pungent, warm and slightly alcoholic smelling gas caused the investigator to retreat hastily to the open door above. The lower door (just above the silage) was then opened, through which the second investigator detected the same gaseous odor, which irritated the mucuous membrances and the throat considerably, and the effects of which could be felt for fifteen or twenty minutes afterward. There was no odor suggestive of bitter almonds, garlic or rotten eggs (hydrocyanic acid, hydrogen arsenid, or hydrogen sul- phid). A few more experiences convinced the investigators, however, that one could rapidly become used to the at-first-unpleasant effects of the gas, and that to wor^ters customarily employed about silos it might not be considered of any moment. Experiments with animals and lights were made in the two neighboring silos, which had been filled with a riper and drier corn fodder, but all resulted negatively. The analyses of the gases collected, which were made by Prof. William L. Evans, of the Department of Chemistry, Ohio State University, showed as follows : A. Sample from the silo in which the deaths occurred : First Second Estimate Estimate Gas. Per Cent. Per Cent. • Carbon dioxid 3S.0 38.3 Oxygen 13.5 14.0 Nitrogen 48.5 47.7 No test could be obtained for carbon monoxid, ammonia, hydrocyanic acid or methane. 398 B. Sample from one of the neighboring silos (filled, however, the week before) : First Second ' Estimate Estimate Gas. Per Cent. Per Cent. Carbon dioxid .20 0'.24 Oxygen 20.5 20.7 Nitrogen 79.39 79.06 Likewise no test could be obtained for ammonia, hydrocyanic acid or methane. (Nitrogen was determined by differences in both cases). According to Rambousek,^ 10 per cent, of carbon dioxid in the air causes asphyxia, which is usually sudden. Some peculiar features obain in silos.. The initial heating of silage is described* as due to the direct respiration of plant cells, increased by the cutting of plant tissues, by intramolecular respiration of ensiled material ( the cfiief factor), while (in a tight silo such as this was) the factor of bacterial and mold action is practically negligible. The composition^ of the air at time of filling is of course the same as the normal atmosphere, but immediately after the cut fodder is ensiled, absorp- tion of oxygen by the plant tissues begins and continues until all of the free oxygen in the air spaces is consumed by the respiratory processes of the plant. This direct absorption of oxygen is nearly, but not quite, counterbalanced by the evolution of carbon dioxid, as a portion of the oxygen combines to form other by-products An analysis of the air even within twenty-four hours often shows no free oxygen. The nitrogen of the air is unaffected by these plant processes. Within a short time gas begins to be given off, and continues at an increasing rate for a day or so, then gradually diminishes. The gas so evolved is largely CO2, but is mixed with the residual nitrogen of the contained air. This CO2 is the result of intramolecular rather than direct respiratory proc- esses, and as the oxygen required for this change is derived from the tissues of the plant, the volume of gas in the silo is increased by the amount of GO2 formed. The evolved CO2 is therefore a measure of the intramolecular respira- tion. The evolution of this gas marks an actual and unavoidable loss in the organic matter of silage. This source is operative so long as life exists in the plant cells, but when the cells die, gas from this source is no longer given off. When the gases of a silo are measured, either by volume or by absorption of the CO2, the production of gas is found to be very rapid for the first few days, and then to diminish quickly in a manner somewhat comparable to the evolution of heat previously referred to. It soon reaches (two weeks or so), a rate that continues with slight fluctuations for some months. Such a rate of gas evolution can only be intelligently interpreted by assuming that most, at least, of the OO2 evolved is the result of processes inherent to the plant cell, and not to fermentative action set up by organisms which must have de- veloped subsequent to the ensiling of the fodder. ' Rambousek, J. : Industrial Poisoning, translated by T. M. Legge, 1913, p. 201. * Babcock, S. M., and Russell, H. L. : Causes Operative in the Production of Silage, p. 1.30. 399 In fact, it is the presence" of this carbon dioxid gas which is the prin- cipal perserving agent in the silage. The escape of this gas from the silo will immediately start decay. Usually mold does not affect more than the mere surface of the silage and this acts as a seal to prevent the air from decaying the silage to a greater depth. The amount of carbon dioxid de- veloped° in a silo filled with immature corn may reach 75 per cent, of the total gases present, the chief remaining gas being the nitrogen of the air. "The conditions favorable for a maximum evolution of carbon dioxid is an immature corn cut into fine pieces and placed in the silo at intervals"'^( as the daily filling with nightly interruptions). . Fatal asphyxia from carbon dioxid has been reported under the following somewhat similar conditions : among vintners, distillers, brewers, yeast makers, in the holds of grain vessels and in peat pits. But a very great danger exists also in every silo unless precautions are taken. These consist in keeping the doors immediately above the level of the silage 'open, or in having tinhinged doors which fall in as the silage settles below them, while the absence of a roof (which is said not to be necessary) would permit prevailing winds to draw ofif gases by suction action. The gas can be driven out easily by using an open umbrella, 'bunch of hay, or leafy branch of a tree to promote diffusion. When any doubt exists, the effects on a lantern flame should be noted. In case of accident, the Meltzer apparatus, recommended by the Commit- tee on Resuscitation from Mine 'Gases,* would appear to be the best of the mechanical devices available.* We desire to thank Dr. O. O. Fordyce, superintendent of the Athens State Hospital, his staff, and others for their kindly efforts in facilitating in- vestigations. A complete report of this investigation including necropsy find- ings is given in the Monthly Bulletin of the Ohio State Board of, Health for October, 1914. 'Erf, Oscar: The Silo for the Dairy, pp. 13 and 27. ' King, F. H. : Influence of Close Packing of Corn in the Silo, etc., 18th Ann. Rep., Wisconsin Agric. Sta., 1901, p. 202. ^Quoted from letter under date of Sept. 30, 1914, from R. H. Shaw, chemist, Bureau of Animal Husbandry, Dairy Division, Washington, D. C. * Technical Paper No. 77, U. S. Bureau of Mines, August, 1914. * Resuscitation from Mine Gases, editorial, The Journal A. M. A., Sept. 26, 1914, p. 1117. PART VIII. MEASURES OF PREVENTION. THE GENERAL PRINCIPLES OF THE PREVENTION OF OCCUPATIONAL DISEASES, Plainly, the prevention of occupational diseases lies in the elim- ination of health-hazards from industry. At once it must be understood that occupational diseases are not necessarily extrinsic poisonings, such as lead, benzine, etc., but are just as much the result of intrinsic poisonings and toxins, which have been generated within the system through fatigue, inactivity, temperature variations, dampness and disease. It is, however, well to consider the cases of extrinsic poisoning as specific occupational diseases, and the cases of intrinsic poisonings as non-specific occu- pational diseases, since the health-hazards which produce this latter group are, oftentimes, extant outside of industry, because of various moral delinquencies, domestic habits, etc. ; fbut the moiety which in- dustry causes in these non-specific occupational diseases should not be over-looked, as is now so commonly done and which results in charging all such disasters to factors outside of industry. "In order to improve the hygienic conditions under which people work, and in order to prevent the diseases of occupation, five fundamental conditions are essential: (1) investigations; (2) laws; (3) factory inspection; (4) penalties; (5) education. It is self-evident that before anything may be accom- plished a careful study must be made of the facts. These investigations must include not only scientific studies, but also economic and sociological factors. Suitable laws are necessary, for it has been found in practice that the condi- tions cannot be corrected by an appeal to voluntary reform. To be eflfective the laws must provide ample ways and means for their energetic enforcement. A systematic factory inspection is necessary in prder not only to protect work- people against the preventable diseases of occupation and to correct sanitary defects, but also to enforce the laws concerning hours of occupation, child labor laws, and related subjects. These laws have little force unless they pro- vide a penalty both against the employer and the employees. Either party to the contract should be held legally responsible in case of violation. Finally, education directed to the employer, the employee, and also to the public at large is necessary to obtain the laws and maintain the standards." — (Rosenau. Preventive Medicine and Hygiene, 1913, Page 915.) Principle I. — If it is hazardous to human lives to produce an article of human usefulness, then the cost of production should include the cost of the conservation of health. 400 401 Principle II. — A proper place to work, and safe methods of working, and some knowledge of the dangers to health and life are pre-requisites to conducting any business, or to working, no matter whether one man or a thousand are concerned, and whether the in- dividual is an employer or an employe. Principle III. — The health of the individual is an affair of the State, since his dependency, wilful or otherwise, becomes a burden upon the State, directly or indirectly. It seems at this time impossible to prevent occupational diseases by specific legislation; for, the mass of statutes necessary to enact to cover each particular process, and to keep up with the progress of industries and processes, would seem practically incapable of ac- complishment. On the other hand, we believe that the entire ques- tion can be handled "by means of rules embodying instructions and explanations of reasonable and feasible character, created for all the .industries of the state by the offices of the State Board of Health, and of such a character that though left to the enforcement of the Industrial Commission of Ohio, they will practically enforce them- selves through the common acquiescence of employers and employes, and the extension of the principles of compensation to occupational diseases. The question of how to compensate for non-specific occupa- tional diseases, such, for instance, as tuberculosis which may be due to several factors other than work conditions, has been solved abroad as follows: If the workman at or before the time of disablement was employed in any process mentioned in the schedule (of health-haz- ardous processes) and the disease contracted' is the disease set op- posite to the description of that process (in the schedule), the disease shall be deemed to have been due to the nature of that employment unless the contrary is proved. Attention is called to what is known as the Overlock Tubercu- losis Agreement which is in vogue in the New England States and has been adopted by various chambers of commerce, manufacturers' asso- ciations, and individual establishments. The Agreement provides a simple method by which this scourge of humanity can be driven from the 'factory districts where it now chiefly flourishes. In short, the proposition is that the manufacturer or employer pay for the sanator- ium treatment of any of his employes who are so unfortunate as to be stricken with this disease. In Massachusetts, where the movement began, the Rutland Sanatorium is able to treat such cases for $4.00 a 26 o. D. 402 week. The first manufacturer to make the agreement did so in 1908, in the case of a working girl, whose expenses he offered to pay at the sanatorium "for a period of 3 months or longer if necessary." It is claimed that the Agreement now embraces more than 1,200 mercantile and manufacturing establishments, employing approximately 2,000,000 people in the New England States, where it is driving this plague from industry. Before it could be fully adopted in Ohio, more sana toriums must be provided. As stated before, there are some 35,000 cases of the disease in the state. How many of these are in industry it is impossible to estimate. CORRECTIVE MEASURES RECOMMENDED. Under each general process and special process described in Part V. are given specific suggestions to meet the hazardous conditions described. We will conclude by giving some general statements. The corrective measures to be recommended fall under three heads: (i) Information, education and publicity, (2) correlation of industrial health-hazards and occupational diseases, and (3) co-opera- tive legislation. (i) The supplying of information to the employers of labor in different industries and trade processes upon the forms of health- hazards which have been found to exist in such industries and pro- cesses, and the types of occupational diseases and disabilities, the prevalence of tuberculosis and other chronic diseases — all of th£se are important functions of the state and local health body, and are essen- tial in the elimination of much preventable disease. Along with such information should be supplied an outline of corrective measures which are based upon reasonableness, practicability and economy, and which have been culled from various sources everywhere. The mechanical problems of various installations and devices are, of course, outside of the field of the health officer. The carrying home to the workers themselves of the fundamental principles of hygiene is very important. Our investigation has shown many instances of entirely wrong conceptions of hygiene which seri- ous-minded workers have advocated. It is usually possible to apply these principles of hygiene directly to the industries and trade processes in question. There is no question that much of 'the preventable disease rate among occupied persons, perhaps over half of it, is due to the ignorance or misinformation, or sheer non-interest- edness of the workers themselves. For poisonous trades and the principal dusty occupations, as well as most of the dozen health- hazards commonly met with, placards of instructions on the avoidance 403 of such hazards, such as the two simple forms given in the preceding Part can be posted up in work quarters, and arrangements made for their interpretation into the various foreign languages, and their read- ing at intervals as a definite plan of the factory efficiency. These would help considerably. More important, however, than these is the arrangement for a careful instruction of foremen and overseers in the questions as evolved at each plant. This can be arranged for usually through the local health department, which, if it is not in a posi- tion to devote time to this itself, can recommend properly qualified persons, usually physicians (but at least persons skilled in hygiene), to give brief talks at short meetings, and to co-operate by taking observations throughout the work place. Already, today, this plan has been extended, not only to the skilled, but to the unskilled workers in a number of plants in the state, whereby once or twice a month fifteen minutes or so at noon time is taken for a short crisp talk by a prop- erly qualified person upon the questions of hygiene at hand, and the problems which the workers should meet to increase their own effi- ciency and their own productiveness. The general public itself is, as a rule, quite indefinitely informed on the principles of "preventive medicine" and hygiene, including industrial hygiene. As practically all adults have to work, it is impor- tant that each individual should become acquainted with the health- hazards of his particular calling, for most of which civilization has introduced more or less artificiality, which is not in keeping with the physiological or normal functions of the human being. Publicity through health agents, public health exhibits, lectures, etc., and the preparedness of health agencies to supply the information desired, are the general means of covering this field. (2) There is greatly needed today a real correlation of occupa- tional diseases and disabilities with industrial malhygiene by treat- ing agencies and institutions, which should adopt forms and means of reporting these correlations to local or state health officials. There is unquestionably a great shortcoming in this direction, which is pro- ductive of enormous economic waste. These treating agencies, many of them maintained by the public itself, or by charitable institutions, go through their routine of furnishing aid and succor day after day, without themselves trying to connect up these remnants of social delin- quencies with the causes which produced them, nor is the information which they collect recorded in an available form for utilization by cor- rective agencies. To explain this situation more fully as well as to emphasize corrective measures, the following summary is taken from a recent article by the director of the survey. 404 THE PREVALENCE OF OCCUPATIONAL FACTORS IN DISEASE, AND SUGGESTIONS FOR THEIR ELIMINATION.* / E. R. Hayhurst. The purpose of this paper is, first, to point out the socially wasteful practice of administering daily to person after person for the same types of morbidity, due to the same causes, and, secondly, to emphasize a much neglected sphere of etiology, the proper conception of which is contained in the term "industrial relations." The research summarizes a study of (1) U. S. Census Mortality Statistics of Occupations; (2) 65,000 dispensary records and many hundreds of cases personally seen during a two-year period at Rush Medical College (Central Free Dispensary) ; and (3) the medical portion of 27,887 cases in which the patients received treatment in Cook County Hospital during the year 1913. As a result of considerable study oi hospital and dispensary cases and records, of vital statistics, and of field investigations, we reach the following conclusions : Suggestions for the Solution of the Problem of Occupational Diseases. The health-hazards of industry which cannot be feasibly removed are in- significant in number. The best proof is the fact that certain establishments engaged in the industries and processes in question have circumvented such hazards, and invariably to the improvement of production, as well as labor atti- tude and relations. 1. Occupied persons, other than agriculturists, sufifer an enormous mortality (figures show 74 per cent.) from well-recognized preventable and prematurely degenerative diseases. 2. Occupational diseases exist because industrial health-hazards exist. Responsible employers do not realize the existence of either, while treating agencies take little cognizance of employments. It must not be forgotten that patients themselves are densely ignorant of what constitute health-hazards ; that they calmly accept them as a matter of course, and unworthy of notice; that the competition for work is great; and (one comes to realize) so much greater than everything else is the innate desire in man to work, especially before middle life — a desire which, in the normal man, equals his appetite and seeks to be satisfied in spite of all conditions. 3. From one-fourth to one-third of the medical afflictions of tradespersons are due in whole, or in great part, to industrial health-hazards. 4. In institutions, the vast majority of industrial diseases are lost sight of through failure to recognize properly the industrial relations of the patients, to make etiologic diagnoses, and to classify properly in subsequent filing. A principal feature in all these cases is to determine exactly the occupations. The principal result should be an etiologic diagnosis as far as possible, includ- * Results of a study conducted at the Central Free Dispensary (Rush Medical College) and Cook County Hospital, Chicago, under the Occupational Disease Fellowship of the Otho S'. A. Sprague Memorial Institute for Infec- tious Diseases. — Abstracted from article in Jour. Amer. Med. Asso., Dec. 12, 1914, p. 2093-2097. 405 ing the use of qualifying terms such as "bronchitis, occupational," "neuritis, chiefly occupational," "aortic aneurysm, probably occupational," "nephritis — alcoholic and lead," etc. This is similar to uses elsewhere, as seen in such descriptive terms as puerperal sepsis, tuberculous pneumonia, typhoid fever and diabetes mellitus. During the course of the year 1913, there were in the hospital 2,230 adult cases of tuberculosis (I understand that not over 50 of there were "repeats"), 1,800 males and 430 females. One may safely say that practically none of these had active tuberculosis at the age of 14 years ! The question is. Why and how have they acquired it since? How many of them would have it now had they lived an agrarian existence, for instance? 5. Specific occupational diseases, such as lead poisoning, are not recog- nized in more than one out df three or four instances, more especially the chronic cases. Present-day institutional records are of value only in showing the enormous numbers of representatives of groups of industrial pursuits who are below the physiologic normal, and who seek medical aid for preventable af- flictions. Such records have little value to the student of economics. For instance no cases were recorded of pneumonocondosis, or of its various forms, as siderosis, chalicosis, aluniinosis, etc., although there were a tptal of 184 cases of chronic bronchitis without efforts at etiologic diagnosis. There were recorded 229 cases of arteriosclerosis. Unfortunately an idea of the extent to which fatigue-substances, heat-toxins and extrinsic poisons of industrial origin may have entered into this class of cases can rarely be gained from present-day histories anywhere ; hence any idea of using the information for shutting off the oncome of such cases is at once precluded. . They are all charged apparently to the account of moral hazards, or disease misfortunes. 7. A most important first remedy is a proper nomenclature for industrial relations to take the place of the word "occupation." Such a nomenclature is here propounded. Table ^. — Scheme to Take the Place of the Word "Occupation." Industrial Relations {As stated by the Patient) Previous Present Past {to Past)* 1. Name of employer 2. Address of employer 3. Business of employer 4. Calendar years worked here 5. Department (s) worked in 6. Particular process (es) engaged in 7. Health-hazardsf exposed to The chief feature of this is the introduction of the term "industry-depart- ment-process" for the word "occupation." * For acute afflictions it is not necessary to go back beyond a few days or weeks, perhaps. For recurrent afflictions one should go back months or years. For chronic afflictions it is necessary to go back preferably five years or more. It is not to be expected that the busy entry clerk will fill out this record. It should be the duty of the history taker, oftentimes with the aid of an interpreter, and, if significant, even with outside assistance. t Question "7" should be answered whenever there is any possible relation- ship between the patient's affliction and his industrial relations. 4o6 Table 6. — Examples of the Complete Statemext for •"Occupation." Industry Business Dept. Trade Process Pottery Clay shop Jiggerman Pottery Glaze room Dipper's helper Vehicle Painting Painter and sander Agricultural implements Painting Dipping machine laborer Iron and steel Butt mill Furnaceman Brass Foundry Furnaceman Iron foundry Foundry Laborer General Nondescript Laborer In this way it is possible to classify any one's trade or calling exactly. As in the case of "iron foundry," redundancies seemingly occur, but these are only apparent, for all the information obtained is necessary to exactly identify each worker's industrial application and environment. Adoption of this pro- posed term, furthermore, renders a logical classification of occupations possible. Xo such classification now exists. 8. In spite of the fact that the state in which this study was made (Illinois) has an occupational disease law% workers are still coming into its charitable institutions from the same types of trades, and in some instances, from the same manufacturing establishments, in even greater numbers than at a period three years previous, w-hen the Illinois Commission on Occupational Diseases made its investigation. This, we charge, is most directly due to the non-existence of a correlating body betw^een the hospital and the factory. 9. The powers and functions of the community health-governing body should be extended to the prompt investigation of all industrial complaints, and to the prompt remedying of them without the necessity of preliminary legisla- tion against certain alleged responsible industries. 10. Too much importance is usually given to alcoholism, with a failure to appreciate that subjection to industrial health-hazards in itself induces and promotes stimulantism. (3) As most of the problems concerned have to do with educa- tion and the creation through appeal and psychological means of a receptive and subsequently active state of mind of the masses con- cerned, it does not appear that much legislation is needed. In fact, in this field, legislation is probably more valuable for education than for what it actually accomplishes. On this account it should be very care- fully prepared, of a conservative nature, and flexible in character so as to meet the manv problems, often new ones, which arise. In short, enough legislation is needed to permit health-governing bodies to make investigations of specific complaints, determine the inerits of the complaints, the kind and degree of health-hazards present, and the responsibility which both employers and employes should assume in eradicating any hazards found. In Ohio, the State Board of Health is in a position to handle the vast majority of these situations through board of health regulations. 407 It is believed that two bills to be introduced, (i) "The Model State Law for Morbidity Reports," and (2) a bill "to Divide the State into Health Districts; to Provide for the Appointment of District Health Officers, Deputies and Assistants ; and to Prescribe the Powers and Duties of Such Officers, Deputies and Assistants" will provide such legislation as is necessary. INDEX. Note — The cross reference abbreviations used have the following significances: D. — Dusts reported as hazards. O. C. — Occupational complaints reported. O. D. — Occupational diseases reported. P. — Poisons reported as occupational hazards. * — Consult each industry and process described, especially in Part V., where the subject, if it appertains at all, will be found discussed in its proper place and relationships. Abortion, due to lead poisoning, 379. Abrasives, 136, 141, 268. Absorption, through the skin, (lead), 378. Accidental poisoning, 16, 192. Accident (s) and injuries {see also Violence), 16, 88, 129, 137, 192, 301, 378. Acetone, 172, 176, 199. Acetylene welding, 150. Aches and pains {see also O. C), 35 Acid(s) {see also P.), 42, 69, 74, 160, 161, 203, 282, 349. Acid, acetic, 152, 191. Acid burns, 203. Acid, carbonic, 293. Acids, carboys of, 160, 350. "Acid cure", 222. Acid dipping, fumes of, 144, 155, 158, 161, 162. Acids, fatty, 271. Acid, formic, 172. Acid, hydrochloric, {see also P.), 153, 157. Acid, hydrofiouric, {see also P.), 265. Acid, nitric. See P. Acid, nitrosonitric (nitrous), {see also P.), 343. Acid, oxalic, 266, 267. Acid, phosphates, 347. Acid, stearic, 271. Acid, sulphuric, {see also P.), 153, 201, 317. Acid, sulphurous {see also Sulphur di- oxide), 350. Acid, tartaric, 270. , . Acidulating mixer, 349. Acker, Mr., 4. Acne, 340. Actinic rays, 150. Act. See Law. Advertising novelties, 75. Aerographing, 190, 191. Age, average,* 61, 87, 101, 319, 383. Age, old, (vital statistics), 13, 87. Aging {see also Presenile), 205. Agricultural implements, 59. Agricultural pursuits (vital statistics), 14. Agricultural workers, 89. Air*, 25, 27, 28, 30, 177, 180. Air breathed per hour, 267. Air-emholi, 48. Air-locks, 48, 102. Air vitiators*, 27. Albuminous substances, 356. ALCOHOLISM, 50. Alcohol and alcoholism,* 10, 13, 49, 50, 112, 172, 191, 208, 288, 406. Aldehydic substances, 172. Alkalies {see also P.), 42, 74. 256, 258. Alkaloidal woods, 166. Alloys, 143, 151, 173, 183. Alphabetical list of occupational di- sases, etc., 372. Alternation, 32, 37, 112, 237, 314. " 409 4IO Alum, 144, 336, 337, 339. Aluminosis, 18, 405. Aluminum, 133, 141, 176, 208, 268. Ambition, loss of, 121. American Museum of Safety, 203. Amherst (Ohio), typhoid fever out- break, 99. Ammonia (see also P.), 82, 121, 225, 341. Ammonium chloride (see also Sal am- moniac), 343. Ammonium sulphate and phosphate, 348. Ammunition, 344. Amperage (welding), 150. Amy! acetate. See P. Amyl compounds. See P. Anaesthetics, 289. Andrews, Dr. John B., 343. Anemia (see also O. D.), 13, 29, 36, 97, 285. Anilin dyes (see also P.), 336. Anilin oil (see also P.), 42, 74. Anilin orange, 67. Anilin poisoning, 208, 210. Animal infections, 42, 178, 318, 320, 348. Ankylostomiasis. See Hookworm. Anthracosis, 18. Anthrax, 42, 97, 331, 348. "Anti-example", 353. Antimony (see also P.), 42, 74, 1-3.3, 207, 210, 242. Anxiety, 36. Apoplexy, 126, 186, 300, 318, 393. Apparatus for lead tests, 386, 387, 390. Appearance of workers,* 112. Appendicitis, 87, 98, 120, 380. Appetite, loss of, 49, 153, 216, 221, *228, 25.3, 271, 287, 353. Arsenic (see also P.), 42, 155, 156, 160. Arsenic sulphide, 318. Arsine, 15.3. Artware, 229, 238, 239, 247, 250. Arterial sclerosis, 55, 186, 405. Artificial respiration apparatus (Melt- zer), 42, 47, 48, 399. Artists, art work, 176, 190, 191, 357. Asbestos coverng, 30, 226. Asbestos finger cots, 205. Ashes, 122, 124. Asphaltum, 170, 175, 339. Assembling, 117, 134, 135, 144, 265. Asphyxiation, 293, 298, 315, 393. Asthma. See Bronchitis. Athens (Ohio) State Hospital, 394. Attitude toward workers,* 109. Automobiles, etc., 59, 378, 392. Autotoxemia, 180. Babbit metal and solder, 59, 268, 269. Babcock, S. M., 394, 398. Backache, 181. Bacilltis tuberculosis, 18, 89. Bag-making, 181. Bags (rubber), 222. Bakers (-eries, -ing), 83, 123, 175, 232, 239, 269, 272, 275. Balling (cordage), 331, 3-33. Balloons, 219. "Banana oil," 172, 328. Banders (-ing), 283, 289. Barbers (-ing), 101. Barach's Cardiac Energy Index, 384. Barefooted workers, 337, 338. Basic slag, 347, 349. Bath tubs, 269. Baths (see also Shower baths)*, 344, 345. Battery dust, 203. Batters-out (pottery), 234. Bead-making (rubber), 213. Beards,* 46, 112, 208. Beating rags (see also Rags), 184, 336. Beating machines, 335, 336. Beer, 280, 349. Belief concerning alcohol, 10, 208. Belts (rubber), 219. "Bends," 49. Benzene (see also Benzol), 74. Benzine (see also P.), 42, 74, 135, 170, 172, 215, 219. Benzine and Benzol Poisoning, table of cases of, 376. Benzine emitter, 213, 219. Benzine "jags," 216, 221. Benzol (see also P.), 42, 74. BeFgey (Textbook of Hygiene), 10. Bessemer furnaces, workers, 58, 304, 307, 313. Beveling, 262, 270. Benzine poisoning. See P. Bichromate poisoning, 192. Bicycles, etc., 60. Binders (-eries, -ing), 190, 283. 411 Birch, 167. Bismuth, 133. Bisque kilns, 240, 244. Bisque ware, 239, 247. "Black men," 345. Blacking, blackening, 326, 327. Black pickle, 153. Black plate, 153, 156. Blacksmiths (-smithing), 124, 126, 136, 146, 148. Bladder afifections, 129, 171, 173, 353. Blank forms for reporting, 6, 111, 112. Blankets, 330. Blast furnaces and workers, 58, 85, 121, 301. Blasting powder, 344, 345. Bleaching, 193, 290, 291, 317, 336, 337, 339. Bleaching by electricity, 193. Bleeding fingers, 171. Blepharitis, 67, 299. Blindness, 124, 150, 192. Blistering, 300, 315. Blockers (-ing), 191, 192. Blood (animal), 347. Blood poisoning, 41, 147, 158, 192. Blowers, inefficient, 144, 167. Blowing (enamel), 173. Blow-pipe (s), (-piping), 22, 69, 149, 201, 258, 260. "Blue line," 380. Blunging mills, 229. Board of health regulations, 406. Body-ironers, 195. Boiled oil, 170, 339, 340, 356. Boilermaker's deafness, 147, 301, (315), (316). Boiler making, 147. Boiler rooms, 122. Bolting, 207. Bone dust fever, 349. Bones, 347, 348, 349, 350. Bookkeepers, 89. Bookmaking, 213. Books on occupational diseases, etc., 9, 10. Boots (and shoes), 80, 219, .321. Bosh tanks, 302. Bottlers (-es, -ing), 88, 261, 278, 280, 281. 282. Bottom finishing, bottoming (shoes), 826. Boxes, 60. Boys, 234, 236, 258, 260, 334. Bran, 18, 157. Branchmen, 296. Branding, 289. Brass, brassworkers, {see also P.), 14, 42, 61, 89, 139, 141, 143, 151. Brass and Bronze products, 60, 138. Brassfounders' ague, 2. Brassfounding, 129, 132, 182. Brass poisoning, table of cases of, 377. Bravado, 90. Braiziers' disease, 150. Brazing, 136, 149. Bread, 272. Breaking (cordage), 331. Breathing {see also O. C), 267, 331. Brewers (-eries, -ing), 88, 278, 280, 281, 282, 399. Bricklayers, 58. Brick and tile, 77, 295. Bright's disease (see also Kidney affec- tions), 13, 29, 126, 173, 301, 318. Brilliancy, 22, 150. Brine, 147, 299. Bristles, bristle wheels, 249, 326. Bronchitis {see also O. C. and O. D.), 28, 87, 405. Bronze (s), bronzing, 138, 141, 143, 175. 176, 186. Brooms, broom corn, 77, 290. Brush (-es, -ing), 168, 172, 173, 191, 201, 213, 218, 222, 239. Buffing. See Polishing. Buffing (rubber), 217. Building workers, 58. Bullet (s), 346. Bunch-breaking, 283, 285. Burling, 328, 329. Burns, 129, 139, 156, 158, 205, 265, 343. Burnt rubber, 226. Butcher's wart, 348. Butt welding, 312. By-products, 270, 347. Byssinosis, 18. Cabinets, cabinet making, 165, 199. Casein, 356. Caisson work, 48, 101, 105, 112. 412 Calcium carbonate, 208, 293, 342. Calcium chloride, 340, 342. Calcium oxide (see also Lime), 298. Calculating machines, etc., 62. Calendering (mills), 206, 208, 211, 356. Calluses,* 41, 112, 205, 266, 300, 316. Canal water, use of, 337. Cancer, 13, 22, 87, 88, 151, 203, 340. Candies, 273. Candles, 270. Candy pulling, 274. Cans (tin), 151, 226, 277, 354. Canning, 151, 275, 278. Capping, 278. Capriciousness, of individual, (lead), 378. Caps, 243, 273, 275, 276, 385. Caps, priming, 344, 346. Caramel, 282. Carbon, 203. Carbonated waters, 83, 278, 281. Carbon bisulphide, 42, 74, 199, 221, 224, 225, 226, 228. Carbon dioxid (see also P.), 27. Carbon monoxide. See P. Carbon tetrachloride, 74, 224. Carborundum, 136, 268, 326. Carcasses, 347, 349. "Cardiacs," 18. Carding, 328, 329, 331, 346. Carpet cleaning, 199. Carpenter (s) (-ing), 14, 27, 89, 165, 166. "Carpenter's stoop," 166. Cars, rails, etc., 62, 150, 158, 170. Carriages, etc., 62. Cartridges, 344, 346. Case hardening, 181, 147. Cash registers, etc., 62. Casing (tobacco), 282, 288. Castings, 130, 132, 134, 136, 139, 141, 156. Casual workers,* 343, 379. Cataracts, 22, 124, 150, 260, 300. Catarrh, 29, 135, 156, 260, 266, 349. Catarrhal jaundice, 42. Catsup, 276, 278. Cellars, 281. Cement (-ers, -ing, -mixing), 78, 181, 213, 215, 218, 225, 226, 294, 295, 325, 326, 327. Central Free Dispensary, 404. Ceramic. See Pottery. Certificate of industrial disease, 6. Chairs or stools, 88, 112. Chalcicosis, 18, 405. Chancre, 260. Change rooms,* 110. Charcoal (see also Carbon), 345. Charging, 202. Charitable institutions, 120, 189, 858, 403. Cheeks, dilatation of, 260. Chemicals, 68, 168, 165, 817, 820, 339, 340, 341, 892. . Chest protector, 144. Childhood infection, 90. Children, 108. Chimneysweeps, 204. China clay, 356. Chinaware, 247. Chinese-jute, 881, 882. Chipping, 139, 265. Chlorine, 225, 291, 387, 389. Chloroform, 199. Chocolates, 275. "Chokes," 49. Chrome(s), 191, 242, 818. Cigars (workers, processes), 83, 282, ■ 288, 286, 289. Cincinnati, 18, 80, 171, 360, 391. Cinders (see also Ashes), 180. Circulatory diseases, 18, 86. Classification of occupational diseases, etc., 857, 406. Clay dust, 18, 229, 245, 268, 295, 296, 856. Clay, making, molding, 229, 234, 285, 240. Cleaning, cleanliness,* 112, 168, 181, 186, 196, 198, 201, 202, 264, 270, 288, 288, 296, 327, 828, 852. Cleaning compounds, 270. Clerks, 29, 89. Cleveland, 98, 101, 360, 391. Closets (toilets),* 39, 50, 112, 131, 245, 247, 260, 277, 294, 813. Clothes,* 39, 46, 192, 199. Cloth cutting, 39. Clothing and textiles, 81, 333. Cloth fabric, 211. Cloth windows, 25. Coal, 18, 100, 101, 122, 124, 295, 348. 413 Coating (oilcloth, linoleum), 356. Cobalt, 252. Cocobola wood, 167. Cod-liver oil, 317. Cofifeeism, 10, 218. Coffins, etc., 63, 143. Coke, 121, 130, 339. COLD, 32. Cold*, 104, 112, 237, 238, 241, 260, 275, 337, 338. Colds (see also O. C), 25, 32, 39, 102. Cold cure (rubber), 218, 222. Cold mill processes, 309, 313, 316. Cold room, 340. Cold storage, 278, 280. Cold vulcanizing, 222. Colic, 29, 202, 215, 315, 380. Collodian, 191. "Colonies," 276. Colored ware, 247. Color (s) (-ing), 177, 196, 239, 250. 295, 319, 320, 332, 350. Combs (-ing), 143, 328, 329, 331. Committee on Resuscitation from Mine Gases, 399. Committee on Storage Batteries, 203. Company buildings, 276. Company physician, 358. Compensation, 2, 139, 273, 404. Competition for work, 404. Complaints.* See O. C. Composing. See Printing. Compounding, 163, 207, 278. ''Composition of Paint Vapors, The," 172. COMPRESSED AIR, 48, 101, 266. Concrescence, 36. "Condition of Employment in the Iron and Steel Industry, Report on," 300 Confections (-ers, -eries), 84, 272, 273. Congenital defects, 89. Conjunctivitis (see also Eye affections), 22, 67, 92, 120, 139, 150, 264, 267, 300. Constant standing, 38, 332. Constant strain, 38. Constipation (see also Digestive dis- turbances), 269, 363. Construction, hygienic*, 108. Construction-camp workers, 42. Consumption. See Tuberculosis. "Consumption and Preventable Deaths in American Occupations," 14. "Consumption Mortality from, in Dusty Trades," 9. Contagions, 25, 39. Contamination (of air)*, 26. Contrasts (lights and shadows), 22, 112. Cook County Hospital, 404. Cooking, 275, 288, 350. Cooperage, 'etc., 78, 165, 293. Cooperation, lack of, 205. Cooperative legislation, 402, 406. Copper, etc., 63, 133, 162, 163, 191, 316, 340. Cordage, etc., 78, 331, 333. Core-making, 126, 129, 13'4. Corking, 278, 282. Corneal opacitis, 124. Corning mills, 345. Correlation (hazards vs. diseases), 402, 403, 406. Corrosives, 120, 159, 191, 347. Corrosive sublimate, 191. Corundum, 136, 268. Cosgrave, Judge O. J., 2. Cotton, 18, 81, 143, 179, 329, 330, 333, 334, 346. Cough. See O. C. Council of Social Agencies, 13. Cow-hair, 346. Cow-pox, 42. Cox, James M., Governor, 5. Crackers, 272. Cramps, 131, 215, 300, 308. Creosote, 170, 203. Crimping, 332. Crisp, H. L., 394. Crowding, 39, 112. Crude oil, 331. Crushing, 231, 343. Crystalline dust, 152, 268. Cuff-ironers, 195. Cupboards, 199, 224. Cups, common use of, 39, 112. Cure (-ing,) (rubber), 214, 218. Curriers, 319. Cuspidors,* 39, 112, 120. Cutlery and tools, 64, 123. Cuts, 158, 166, 205, 275. Cutting, 181, 262, 324, 330. 414 Cyanamide, 348, 349. Cyanide fumes, etc., 69, 154, 162, 192, 318. Cyanotic appearance, 319. DAMPNESS,* 23, 112, 162, 182, 231, 232, 238, 264, 267, 281, 296. . Dancing pupils, 181. Dark glasses,* 23. DARKNESS,* 21, 29. Daylight, 21. "Dead" air, 26. "Dead Gas," 293. Deafness {see also O. C. and O. D.), 36. Death. See Age and Vital Statistics. Death of the new-born (due to lead), 379. Deaths, 87, 262, 270, 301, 343, 357, 393. Deaths after 70 years, 14. Deaths, questionable, 13, 153. Debility, general, 300. Decalcomania, 190, 250. Decorating, 174, 175, 240, 250, 265. Definitions, 54, 359, 382. Deformities, 35, 273. Degenerative diseases, 14, 137, 165, 192, 213, 404. Degreasing, 347, 348, 349. Deoxidizing, 340. Deoxidation,* 26. Department (defined), 54. Dermatitis {see also Skin, and O. C. and O. D.), 135, 213. Dermatitis, table of cases of, 375. Descent of deceased, 87. Designing, 176, 190, 265. Desire to work, innate, 404. Desulphurizing, 340. DEVITALIZING AIR, 26. Diagnosis, etiologic, 404. Diagnosis of lead poisoning, 378, 380. Diamond cutting, 69. . Diarrhoea, 131, 300, 315. Digestive disturbances {see also Dys- pepsia and O. C), 49, 154, 163, 196. Dining cars, 291. Diphtheria, 39, 147. Dippers (-ing), 157, 168, 172, 173, 215, 222, 225, 235, 239, 243, 244, 250, 275, 288. DIRT,* 20, 112. Dirt and dirt floors,* 130, 131, 318, 320, 330, 331. Diseases. See O. D. Diseases, circulatory, 13, 36. Diseases and occupational factors, 404. "Diseases of Occupation," 9. Dish-makers, 234. Dispensary (-ies), 96, 120, 139, 182, 202, 358, 404. Dissipated, 320. Disorder,* 20, 112. Distillers (-ing), 339, 340, 399. Division of industries, 51, 103. Dizziness {see also O. C). 219, 349. Dock hands, 58. Doehring, C. F. W., 350. .354, 356. Dogs (test purposes), 397. Dog-trotters, 234. Domestics, tuberculosis rate, 14. Dough, 272. Drafts. See Cold. Drawing, 328, 329, 331. Drawing kilns, 297. Dressing (pottery), 247. Drier (s), 42, 170, 189. Drilling (rock), 262. Drill-pressing, 144. Drinking facilities,* 110. 112. Drivers, deaths' among, 88. Dropsy, 87, 88. Dross, 130. Drugs and sundries, 163, 219, 224. Drugism, 10. Dry batteries, 203. Dry color grinding,* 163. Dry cleaning, 64, 192, 196. Dry grinding {see also Grinding),* 262, ' 263. Drying, 195, 290, 356. Drying oils, 170, 175. Drying ovens (rooms) {see also Kilns), 123, 234, 319. Drying paints, 172. Dryness,* 24, 112, 180. Dry sweeping,* 20. DUST,* 17. "Dust, dangers of," (placard), 393. Dust, every imaginable character, 335. Dusting, 173. Dusts, reported as hazards, Abrasives, 268. 415 Dusts, reported as hazards — continued. Acid phosphates, 347. Alkalies, 271. Alkaloidal Avoods, 166. Alum, 336, 839. Aluminum, 208. Ammonium sulphate and phosphate, 348. Anilin dyes, 344. Antimony, 208, 257. Arsenic, 257. Ashes, 122, 124. Basic slag, 347, 349, 350. "Battery dust," 203. Birch. 167. Bicarbonate (sodium), 342. Blacking, 326. Bleaching powders, 339. Bone, 348, 349. Bran, 157. Brass alloys, 143. Bristles, 326. Bronze alloys, 143. Broom corn, 290. Calcium carbonate, (208), 342. Carbon, 203. Carborundum, 268, 326. Cement, 295. Charcoal, 345. Cinders, 130. Clay. 229, 232, 235, 245, 268, 296, .356. Coal, 122, 294, 295. Cocobola wood, 167. Coloring compounds, 295. Corn meal, 67. Corundum, 268. Corrosive, 347. Cotton, 143, 179, 329, 330, 332, 333. Crystalline, 137, 143, 268. Cyanamide, 348, 349. Dolomite, 307. Dried organic J;ankage, 348. Dried spray, 174. Dross, 130. Dry vegetables, 276. Dye ingredients, 200. Earths, 127, 229, 276, 306, 330, Emery, 143, 298, 319, 326. Enamel. 269. 378. Excelsior, 177. Dusts, reported as hazards — continued. Feathers, 334. Felt, 333. Fettling, 247, 248, 249. Fillers, 174, 378. Flax, 177. Flaxseed meal, 340. Flint, 229, 231, 245. Flour, 273, 316. Font, 186, Forge deposits, 125. Ftir, 179. Furnace, 124. class, 143, 204, 256, 258. 261, 263, 344, 378. Glaze, 239, 240, 245, 248, 255, (378). Glue substances. 143. Graphite, 163. Grinding, dry, 263, 269, 343. Ground laying. 251. Gypsum, 347. Hair, 177, 179, 317, 330, 333. Hay, 177. Hemp, 179, 332. Iron and iron oxides, 130, 143, 208, 306, 316, 340. Lead,* 169, 174, 202, 208, 240, 245, (266), 328, 340, 356, 378. Lead oxides. {See note under Lead), 342. Leather, 179, 320, 325. 326. Lime, 293, 295, 339, 342, 348. Lint, 143, 179, 228, 326, 329, 330, 332, 333. Litharge {see also Lead). 257, 356. Lithopone, 356. Manganese, 257. Machine, 166. Mahogany, 67. Magnesite, 307. Marble, 266. Metal, 125, 144, 183. Metallic and Poisonous,* 207. Middlings, 157. Milling, 280. Mineral, 349, 351. Mold powders, 127. Mold sand, 127, 130, 213. Moss, 177. Oak wood, 67. Organic, 348. 4i6 Dusts, reported as hazards — continued. Oxalic acid, 266. Oxidized iron and steel, 316. Paint, 174, 378. Paper, 183. Paste(s), 201, 266. Peanut shells, 157. Phosphate, 348. Phosphate rock, 347. Plaster-of-Paris, 233. Poisonous.* Potash, 348. Potassium chlorate, 344. Potassium dichromate, 344. Polish, polishing, 179, 263, 298. Polishing powders, 263. Pottery, 239, 378. Powder, 263, 345. Pumice, 266. Rags, 183, 335, 336. ■ ' Red lead (see also Lead), 257. Rosin, 326, 336, 339, 344. Rubber, 217, 219, 228, 378. Rubber scraps, 213. Salt, 290. Sand, 125, 127, 140, 174, 204, 265, 296, 300, 306, 326, 378. Sanding, 169, 249, 378. Sanding belts and paper, 166, 169. Sawdust, 157. Shellac, 268, 326. Shoddy, 228. Silica, 143, 268, 271. Slag, 130. Smoke, 121, 124, 282. Soap, 271. Soapstone, 206, 208, 211, 212, 213, 214, 215, 218, 219, 223, 225, 226. Soda ash, 257, 339. Sodium carbonate, 339, 342. Soft metals (see also under each metal process), 143. Solder, 152. Soot, 121, 125. Sparks, 151. Starch, 272, 274. Steel, 143. Stone, 266, 267, 268, 298. Straw, 256. Street sweeping, 291. Sulphur, 223, 225, 340, 345. Dusts, reported as hazards — concluded. Superphosphates, 347. Tobacco, 284, 286, 288. Talcum, 203. Tan bark, 317. Textile, 179, 330, 331. Tiles, 255. Thomas slag, 350. Tin compounds, 266. Tinting, 251. Tobacco leaves, 283, 284, 286, 289. Tow, 177. Type, 186, 378. Twine, 333. Vegetable fibre, 177. Walnut, 167. Wax, 326. Whiting, 328. Wood, 166, 333. Wool, 179, 330, 332. Zinc and zinc oxide, 208, 265. "Dusty Trades, Mortality from Con- sumption in," 9. Dutch process, 342. Dyes (-ing), 120, 173, 196, 199, 200, 290, 319, 356. Dynamometer (hand) test, 384. Dynamo quarters, 122. Dyspepsia (see also Digestive dis- turbances and O. C), 139, 224,. 287. Ear affections. See Deafness, O. C. and O. D. Earths. See D. East Youngstown, 93 Eat (-ing)*, 46, 110, 112, 170, 202, 204, 257, 275, 353. Eczema. See Skin affections, O. C. and O. D. Edge butting (rubber), 218. Edison Illuminating Companies, 203. Education, lectures, 54, 402, 403, 406. Efficiency,* 112. Electric accumulators, 201. Electric apparatus, etc., 64. Electric cutters, 330. Electric fans*, 31. Electric furnaces, 307. Electric fuses, 344, 346. Electric lamps, manufacture of, "204. Electric lights.* Electric welding, 150. 417 Electrical workers, statistics of, 58. Electrolyte, 160, 201. Electrolytic test (for lead), 387. Electroplating, 61, 64, 143, 144, 154, 158, 160, 174, 191, 263. Electrotypes (-ing), 76, 161, 163, 188, 191. Emaciation, 35, 173. Emanations (human), 27. Embossing, 176, 356. Emergency rooms, 41. Emery, 78, 136, 141, 143, 217, 268, 269, 298, 320, 326. Emitters, benzine, 325. Employer's responsibility, 121, 164. Employes, not appreciative, 323. Empyema, 139. Enamel (-ers, -ing), 65, 123, 161, 163, 168. 173, 175, 265, 319, 350, 378. Engineers (-ing), 21, 122, 123, 167, 204, 293. Engraving, 65, 176. "Epidemics," 135, 171. Epitheliomata, 203. Erf, Oscar, 394, 399. Erysipelas, 42, 147, 158, 192, 348. Establishment (defined), 54. Etch (-ers, -ing), 190, 264, 265. Ether, 191, 199. Etiologic diagnosis, 404. Euphos glass, 151. Evans, Prof. Wm. L., 392, 398. "Everybody's business," 243. Excelsior, 177, 333. Exercise* 39, 112. Exhaust ventilation*, 18, 29, 131. Exhaustion. See Fatigue. Exhibit, Public Health, 3, 403. Explosives, explosions, 65, 197, 215, 226, 301, 308, 344, 345, 346, 350. External causes, vital statistics, 13. Extractors (laundry), 194. Extrinsic poisoning, 50. Eye(s), eyestrain (sec also O. C. and O. D.)*, 38, 55, 69, 93, 96, 112, 154, 163, 350. Eyeshades, 23. Fabric, 219, 356. Faces, flushed, 173, 347. Factory help, 117. 27 0. D. Factory processes,* 52, 117, 152. Fainting, 218, 221, 281. Fancy branding, 46, 379. Fans, ventilation,* 25, 27, 28, 31. Farmers, 13, 14, 357. Fatality. See Deaths. FATIGUE,* 33. Fatigue (see also O. C), 104, 112, 226, 315. "Fatigue and Efficiency," 9. Fatigue anti-toxin, 11, 35. Fatigue toxins or poisons, 11, 33, 34, 38, 39, 180, 405. Faulty postures,* 38, 69, 112. "Fatigue psychosis," 36. Feathers, renovating of, 334. Feeders, 194, 195. "Feet dry, cannot keep," 27!j. Feet (see also O. C), 35. Felt, 82, 333, 346. . Female disturbances. Sec O. C. Fermentation, 280, 316. Ferric chloride, 191, 275. Ferro-silicon poisoning, 301. Fertilizer (s), 65, 271, 347. Fettling, ,247, 249. Fibre (s), 177, 179, 330, 331, 332. Fibrosis, 18, 29, 36. Filament making, mounting, 205. Files (-ing, -cutting). 66, 262. 298. Filing systems and industrial com- plaints, 404. Fillers (-ing), 168, 174, 278, 378, 370. Filling containers, 351, 354. Films, 191. Filtering petroleum, 340. Finger-cots, 215, 222, 224, 213, 254, 255, 266. Fingernails, 202, 250. Finishers (potters), 234, 236. • Finishing,* 117, 134, 205, 229, 234. 240. 247, 327, 333. Finishing (glass), 262. Fire (s, -ing), 197, 215, 226, 297, 319, 350. Fire clay products, 72. Fire hose, 219. Firemen, 122, 123, 128, 160. Firing, 122. First-aid,* 41, 112. 4i8 Fischer (and Summerfeld), 9. Fish-glue, 168, 326. Fish-oil, 331. Fitting (shoes), 325. Flags, regalia, badges, etc., 82. Flames, 121. Flashing lights, 205. Flat foot, 35, 101, 273. Flat work, 194. Flavor (-ing), 282, 288. Flavoring extracts, 66. Flax, flaxseed, 177, 340. Flaying, 348. Fleecing, 328, 329. Fleshing, 317. Flies, 273, 274, 277, 278, 348. Flint, 18, 229, 231, 245. Flour, 78, 254, 273, 316. Flying particles,* 41, 112. Folders, 194, 195. Font dust, 186. Food (dining cars), 292. Foot-and-mouth disease, 42, 348. "Foot-drop," 380. Foot-lever (-treadle), 195, 196. Fordyce, Dr. O. O., 399. Foreign particles (eyes),* 122, 158, 205, 249. Foremen, 109, 110, 403. Forge (s, -ers, -ing, -dust, -gases), 124, 125, 136, 147, 148, 149, 150, 298. Form, blank, for reporting, 6, 111, 112. Foul nature of work, 335. Founding (brass), 129, 132, 135, 182. Founding (iron), 129, 135. Foundry (-ing), 66, 123, 135, 136, 143, 201. "Four Cases of Sudden Death in a -Silo," 393. Friction heat, 298. Friction smoke, 217. Frictioning (rubber), 211. Frit (-ting), 238, 269, 270. Fuller's earth, 340. Fulminate of mercury, 346. Fumes.* Furs and fur goods, 67, 179. Furnace (s, -ing), 50, 76, 123. 130,' 136, 157, 157, 188, 268, 269, 309, 341. Furniture, 67, 167, 378. Furunculosis from oil, 98, (147). Fuses, electric, 344, 346. Galvanizing, 67, 153, 154, 155, 316. Gardner,- H. A., 172. Garbage, 349. Garments, men's, 178. Garme'Uts, women's, 178. Gas (-es) and gas fumes. See O. C* Gas-bacillus infection, 348. Gas (fuel, and illuminating),* 42, 67, 74, 121, 126, 186. Gas helmets, 122, 279, 280. Gas-jets (-flames), 228, 230, 327. Gasoline {see also P.), 42, 74, 196. Gas producers (-ing), 121, 293, 294. Gases, silo, analyses of, 397. "Gassing" {see also P.), 122, 196. Gastritis, gastric catarrh {see also O. G.), 49, 154, 349. Gastro-enteritis, 301. Gatherers (pottery), 240. Gelatine, 347. General processes, 112, 116, 117. Generator gas, 121. German Imperial Regulations, 350. Germs and infections,* 39. "Getting in training," 35. "Get used to," 11, 12, 43, Gild (s, -ers, -ing), 176, 250, 253. Glanders, 42, 348. Glare, 112, 260. Glass {see also D.), 68, 84, 143, 163, 173, 205, 256, 262, 265, 343. Glass, amber, 338. Glasses {see also Goggles),* 196. Glaze dipping, mixing, 229, 238, 239, 240. Glazed ware, 247. Glaziers (-ing), 168. 269, 298, 345. Glost-kilns, 239, 240, 244. Gloves*, -42, 46, 112, 191, 198, 215. 210, 222, 224, 265, 332. Glue (-ing), 167. 168, 347, 348, 349. Glycerine. See P. Goggles,* 42, 112, 266. Goldmark, Josephine, 9. Gold stripes (liners), 250, 253. Gouty, 38. Graining, 190. Grain vessels, 399. Granulated eyelids. 5rr Trachoma. Granulating pits, 302. Graphite, 163, 345. 419 Greases, 157, 177, 318, 320, 339, 340, 347. "Greenware" (pottery), 234, 239, 247. Green window-panes, 204. Grind (-ers, -ing), 163, 174, 184, 229, 231, 269, 270, 294, 295, 298, 334, 335, 342, 343, 344, 345, 349, 350. Grindstone (s), 79, 268, 298. Grippe, 260. Grist mill products, 78, 254. Groins, irritation of, 337. Ground laying, 250, 251. Guinea-pigs (test purposes), 396. Gum drops, 274. Gum resin, 172, 175, 350. Gum tragacanth, 287. Gypsum, 347. Habit (s),* 272, 287. Habituation, 43. Hair (see also D.), 101, 346, 347. Half-tones, 190. Hall (Textbook of Physiology), 10. Hallaner glass, 151. Hammer-man's paralysis, 301. Hammering, 299. , Hand blowing (glass), 262. "Handicapped, Study of the," 13. Hand grip (te^t), 384. Hand ironing, 195. Handlers (pottery), 234. Handling objects (a hazard),* 39, 112, 178, 181, 192, 198, 213, 215, 216, 246, 320, 324, 335, 337. Hand mills, 313, 316. Hand pads, protectors,* 126, 315. Hand-painting, 250. Hangnails, 275. Hanson, Wm. C., M. D., 9. Hardening (metals), 147. Hard rubber, 219. Harrington (Textbook of Hygiene), 10. Hartzell, Josiah, Ph. D., 1. Hats, 68, 199. Hay, 177. Hay fever tendencies, 272. Headache (see also O. C.), 23, 150, 153. "Head drop," 380. Health (complaint of).* Health appliances,* 46, 110. Health department (function of), 403. Health-hazard (defined). ]0, .55, 111, 112. Health instructions,* 110. Health register (see also Sick records), 386. Hearing (see also Deafness), 55, 126. "Hearsay" case (defined), 359. Heart disease (see also O. D.), 13, 37, 55, 61, 87, 88, 126, 128, 129, 142, 378, 393. HEAT,* 29. Heat (-ing) (see also O. C.),* 22, 29, 32, 87, 88, 105, 112, 138, 158, 167, 237, 276, 291. Heating- (of silage), 398. Heat-toxins, 32, 405. Heavy oils, 340. Helmets, gas, 122, 279, 280. Hemorrhages, 800. Hemp, 179, 331, 332. Heredity, 89. Hernia, 55. Hides, 39, 317, 347. Historical Notes, 1. Hoarseness, 260, 332. Hoffman, Frederick L., 9, 332. "Hog machine," 332. Holmes County (hookworm disease), 97. Home gardens, 112. Homicidal characteristics, 224. Hoofs, 347. Hoof-and-mouth disease, 42. Hookworm disease, 42, 96, 97, 268, 296, 298. Horns, 347. Hospitals,* 41, 55, 95, 112, 120, 139, 182, 202, 343, 358. Hospitals and the factory, 406. Hospital Social Service, Cincinnati, 13. Hot mill processes, 309, 313. "House of manslaughter", 358. Housing conditions, 42. Howell (Textbook of Physiology), 10. Humidity, humidifiers (see also Damp- ness), 23, 25, 112, 168,-329, 339, 356. Husking, 276. Hydrogen sulphide (sec also P.), 42. "Hygiene of the Boot and Shoe In- dustry", 328. Hygrometer, 25, 206. Hysteria, 36. Ice manufacture, 84, 278, 420 Ignorance,* 46, 90, 112, 247, 404. Illinois Commission on Occupational Diseases, 406. Illinois, effects of occupational disease law in, 406. Illiterates, 55. Illuminating engineers, 21. Illuminating oils, 339. Immoral surroundings, 50, 112. INACTIVITY,* 38, 112. Impure air*, 112. Incandescent lamps, 204. Indigestion. See O. C. Indisposition, 196. Indoor shop painters, 30, 168, 378. Industrial appendicitis, 98. Industrial Commission (Ohio), 342, 401. Industrial and Communal Typhoid Fe- ver, 99. Industrial health-hazards, 10, 17, 111, 112. '"Industrial Poisons, List of", 9, 42. '■"Industrial Poisoning" (Rambousek- Legge,"9, 350, 398. Industrial relations, 121, 405, 406. Industrial stimulantism,* 10, 50, 406. Industrial tuberculosis,* 42, 89, 91, 120, 360. Industrial tj-phoid fever, 99. Industry (defined), 53, 405. Industries, division of, 51, 103. INFECTIONS,* 39, 41, 56, 90, 112, 143, 287, 348. Influenza, 135. Information, 402. Ingredient mixing {see also Chemicals), 256, 269. Injury, personal, 2, 112, 260. Inks {see also P.), 163, 190, 356. Inner tube making, 213, 218, 224. ■ Innocent bystanders, 291. Insanitary conditions {see also O. C.),* 347. Insanity, See O. D. Insomnia, {see also Sleep), 300. Inspecting, 117. Institutional records, 405. Instructions,* 46, 112, 203, 243, 393, 401. Instruments (professional, scientific), 68. Interest, foremen, 109. International Harvester Machinery Company, 99. Intestinal diseases, 129, 139, 192. Intoxication (test, evidence), lead, 381, 382. Intrinsic poisoning, 50. Invalidism, 35. Investigations (industrial complaints), 399, 406. Investigators, 53, -359. Iodine, 191. Iron dust {see also D.), 18. Iron and steel industry, occupational diseases of, 300. Iron and steel (processes), 69, 82, 85, 128, 155, 157, 300. Ironing (-ers), 2-3, 181, 194, 195, 324, 327, 359. Irregular hours of work,* 260, 339. Irregular hours for sleep, 38, 260. Irritation (s), 24, 50, 120. 141, 150, 154, 156, 178, 191, 287, 290, 318. Japans (-ers, -ing), 168, 174, 175, 319, 350. Jarring processes,* 38, 112, 126. Jaundice, 42, 153. Jellies, 278. .Jewelry, 69, 143. Jiggermen (pottery), 234. Job work (printing), 185. Joiners (-ing), 165, 329. Joint Resolution, establishing the Sur- vey, 3. JoUymen (pottery), 234. Jones, Dr., 1. Junk, 69, 182. Jute, 78, 331. " Keg filling (breweries), 282. Keg-washin? (breweries), 282. Kentucky (hookworm disease), 96. Kettles, 280, 288, 351. Kidney affections {see also O. D.), 36, 87, 88, 129, 253. "Killing pace," 181. Kiln (s, -workers), 123, 173, 2"29, 239, 268, 269, 293, 297. Kiln-room laborers (lead), 392. King.'F. H., 399. Knitting, 3-28, 329. Kober, Geo. M., M. D.. 9, 421 Label (s, -ers, -ing), 167, 191, 200, 278, 281, 282, 289, 350. Labor Bulletin (U. S.) No. 44, - 350. Labor Bulletin (U. S.) Nos. 79, 82, 100, - 9. Labor Bulletin (U. S.), No. 86, - 343. Labor Bulletin (U. S.) No. 95, - 342. Laborers, 58, 378. Laborious work,* 38, 112, 214, 231, 300, 310. Lacquer (-ers, -ing), (see also P.), 143, 161, 168, 350. Lamp black, 319. Landis, Dr., 171. Language, 50. Lapping (rubber), 216. Lap welding, 311. Lard oil, 98. Lasting (shoes), 326. Lathing, 144. Laundering, 86, 192, 194, 195. Law Establishing the Survey, etc., 3. Law, Health Districts, etc., 407. Law, Model, for Morbidity Reports, 407. "Laws of Ohio Relating to Occupational Disease and Industrial Hygiene," 343. Law, Reporting of Occupational Dis- eases, 4, 7, 342, 358. Law, Special Reference to Lead Poi- soning, 7, 341, 342, 343, 358. Layman for health officer, 94. Lead (see also P.),* 42, 74, 133, 141, 169, 176, 317. Lead and appendicitis, 98. Lead, bar, pipe and sheet, 69. Lead burning, 151, 201, 202, 340, 343, 349. Lead colic (see also O. C.J, 2. Lead fumes,* 69, 153, 378. Lead in urine, test for, 387. "Lead line," .381, 383, 384. Lead-lined tanks, 349. Lead ornaments, 160. Leod oxide,* 170, 201, 340, 342, 350. Lead poisoning (see also P.), 70, 139, 153, 171, 173, 175, 205, 210, 213, 253, 258, 378. Lead poisoning, acute, diagosis of, 380. Lead poisoning, chronic, diagnosis of, 383, Lead poisoning — a personal injury, 2. Lead poisoning, belittling danger of, 243. "Lead Poisoning — Diagnosis and Pre- vention," 378, 380. "Lead Poisoning, How to Prevent," (placard), 393. Lead poisoning, table of cases of, 373. Lead sulphide, 345. Lead workers, 357, 392. Leather, 70, 317, 341. Leeching, 317. Leers (glass), 258. Legge, Dr. Thos. M., 9, 398. Legislation for industrial hygiene, 399, 406, 407. Legislation, specific, 401. Lettering, 265. Leucomaines, 34. Licorice, 287, 288. Lieberman's intoxication 'test (lead), 381, 383, 384, 386. Life insurance, 243, 260. Light and lighting,* 21, 22, 112, 126, 150. Lime (workers, processes), 70, 293, 295, 318, 339, 342, 348. Linen, 78, 331. Liners (-ing) (decorative), 250. Linoleum, 71, 355. Linotyping, 187. Linseed oil (see also Boiled oil), 319. Lint. See D. Liquors, malt, 280. "List of Industrial Poisons," 0. Listing (laundry), 192. Litharge (see also Lead), 257, 340,' 356. Litho-engravers, 176. Lithographing, 176, 356. Lithopone, 356. Litho-transf erring, 191. "Liver trouble," 87, 88, 129. Lock-jaw. 13, 41, 42, 98. 147, 184, 332. Lockers,* 46, 110, 112. Lodging-houses, 94, 96. Log-wood, 319. Long hours,* 38, 112, 183, 218, 260. 262. 277, 279, 300, 338, 339. Loud noises,* 36, 38, 112.- Loudonville (Ohio), 97. Lubricating oils, 339, 340, 422 Lucifer matches, 343. Lumbago, 31, 35, 126, 129, 301, 315. Lumber hands, 42, 165. "Luminous Beam, The," 1. Lumpy jaw, 42. Lunch rooms.* Lung diseases (see also O. D. and Tuberculosis), 13, 129, 137, 163, 180, 269, 295, 339. Machine building (tires), 212. Machine ironing, 195. Machine operations, routine, 117. Machine shopping, machinists, 66, 129, 134, 136, 143, 145, 148, 150, 152, 155, 165, 169, 313, 357. Magnesite, 307. Mahoganj^ 67. ^lalignant pustule (anthrax), 348. Malt liquors (see also Brewing), 86, 280. Manganese (see also P.), 133. ^Mangling, 194. Maniacal symptoms, 224, 379. Manilla hemp, 331. Manipulating mixer, 347, 349. Manure, 98, Ml. Marble (see also Stone), 79, 265, 266. Marking (laundry), 192, 194. Marshmallows, 274. Masons, 101. Massachusetts State Board of Health Bulletin, 328. Matches, 70, 343. !Matchworker's disease, 2. Mats, 196. Mattresses, 79, 181, 333. AlcCampbell, E. R, M. D., 8. Measles, 147. Mechanical goods (rubber"), 219. Mechanical protection,* 112. Mechanics (statistics), 58. Median age at death. See Age. Medical school supervision, 267. Medical supervision, 42, 46, 56, 112, 315. 385. Meltzer apparatus, 42, 47, 48, 399. Mending, 328, 330. ?^fenorrhagia. 287. Mental alertness, 55. Mental deterioration, dullness, 122, 222. 800, Merchant (lead poisoning), 358. Mercuric sulphide, 74. Mercury (see also P.), 42, 69, 82. "Metal chills," 156. Metal grinding, 129, 134, 135, 143, 146. 148, 150, 313. "Metal poisoning," 135. Metal polishers. See Polishers. Metals, non-ferrous (or soft), 133, 135, 143, 149, 173, 182, 183, 187, 188. Metals, refining, 182. Methane, 340. 397. Methods, modern,* 109. Metol, 191. Middlings, 157. Migraine, 56. Migration (affecting morbidity rates), 15. Miles, Dr. Manly, 393. Milk (for lead workers), 353. Milk sickness, 42. Millers. 89. Mills (rubber), 206, 208. Mineral dust (see also D.),* 18. Mineral oil, 171, 267,. 385. Miners, 14, 100, 101, 357. Mirrors, 70, 270. Misbranding-, 46, 112. Mittens, 38. Mixing chemicals (see also Chemicals),* . 347. Mixing ingredients (sec also Mixing chemicals).* 256, 269, 344, 356, 379. Mixing mills (rubber), 206. 208. Mixing (tobacco), 288. 289. "Modern Factory, The," 9. Moistening, 282, 331. Moisture particles, 26. Mold (s), 215, 225, 233, 234, 262. Mold boys. 234, 236. Mold runners, 234. JNIolders (sec also Founding), 66. 128, 296. Mold making (pottery). 233. Molders Union, Vital statistics, 128. Monotony (see also O. C.).* 38. 39, 69, 104. 112. Monuments, 79. 26-5. Monotyping. 187. Morals. 21. 50. 112. Morbidity statistics. See Vital statistics. 4^3 Morbidity migration, 15. "Mortality from Consumption in Cer- tain Occupations," 9. "Mortality from Consumption in Dusty Trades," 9. Mortalit}' (occupied males), 14. "Mortality Statistics," General (U. S.), 14. Mosaic effects, 254. Moss, 177. Mottling, 239, 250, 319. Motorcycles, etc., 60. Mouth (-ing, of articles), 41, 112, 260, 287, 288, 289, 320, 355. Muckers, 101. Muck-rolling, 307. Mud guns, 804. - • Mules, 313. Muscular cramps (see also O. C), 29, 35. Medical instruments, etc., 70. Mustaches,* 46, 112, 202, 208, 210, 257. Myopia. See O. D. Nail-files (-brushes), 244, 352, 385. Naphtha (see also P.), 42, 74, 171, 181, 196. Naphthalin, 122. Napping, 328, 329. Nasal irritation. See Nose affections. Nasal septum, perforation of, 258, 290. National Acme Manufacturing Co., Cleveland, 98. Nausea (see also O. C), 49, 128, 154, 170, 177, 192, 271. 275, 320. Necator Americanus, 07. Necropsies (carbon dioxide asphyxia), 396, 397. Nephritis. See Bright's disease. "X^ervous breakdown" (see also O. C), 36, 192. 389. Nervous diseases (see also O. C. and O. D.),* 13, 153. Neuralgia, 35. Neurasthenia, 36, 196, 224. Neuritis, 35, 129, 130, 182, 359. Neurosis (-es). 147, 182, 299, 359. New England States (tuberculosis), 401. New workers, 285. New York Subway (disaster). 160. Nickel, 133, 141, 163. N^ichols, Hugh L., Prcs. of Senate, 4, 5. Nichols, Rov T., 15. Night work,* 37. Nigrisin, 319. Nitric acid. See P. Nitrogen (see also P.), 398. Nitrogenous substances, 347. Nitroglycerine, 344, 346. Noise (s),* 36, 139, 147, 166, 310, 315, 316, 329, 332; 333, 336. Nomenclature (occupational), 405. Non-ferrous metals. See Metals. Noon recess.* Nose affections (see also O. C), 287, 290, 295. Nurse (s), 41, 95. Nut preparation, 273. Nystagmus (see also O. D.), 23. O.ak, 67, 167, 317. Occupational (defined), 405. Occupational complaints, recording of, 120, 357. Occupational complaints reported. (See also Occupational diseases.) Acid (s), exposure to, 144, 153, 162, 203, 264, 265, 267, 270, 318, 349. Alkali (s), 271. Appetite, loss of, 153, 216, 221, 228, 253, 271, 275, 287, 353. Backache, 181. Benzine fumes, "jags," 212, 213, 216, 218, 221, 226. Bladder affections, 171, 173, 353. Bone dust fever, 349. Brass chills, 135. Breathing, difficulty in, 162, 294,334, 349. Breathing of dust, 131, 139, 141, 144, 167, 171, 175, 178, 181, 183, 186, 208, 210, 217, 231, 232, 233, 238, 239, 243, 247, 249, 258,' 264,' 266^ 269, 271, 296, (297), 332, 334, 335, 349, 358, (855). Breathing of gas (-es), fumes, sprays or vapors, 122, (124), 126, 128, 131, 139, 144, 149, 150, 153, 154, 156, 158, 162, (164), 167, 170, 173, 175, 176. 182. 186, 189; 190, 199, 200, 203, 205, 208, 210, 212, 213, 221, 224, 225, 226, 228, 264, 265, 271, 282, 293, 300, 312, 325, 344, 349, 353, (355), 856. 424 Occupational complaints reported — Continued. Breathing smoke, r22, (124). 131, 139, 217, 282, 812. Bronchitis, 131, 139, 167, 191, 260, 300, 302, 345. Burns, 129, 158, 205, 265. Calluses, 205. Catarrhs (various), 135, 260, 266, 349. Closets (various complaints), 128, 131, 247, 260. Cocobola wood, 167. Cold and draft exposure, (123), (124), 129, 149, 237, 238, 241, 260, 262, 282. Colds, 126, 162, 181, 221, 260, 266, 308, 320, 334, 337, 339, 349. Colic, 202, 215, 315. Coughs, coughing, 122, 126, 144, 153, 154, 162, 178, 181, 221, 225, 228, 258, 265, 272, 316, 320, 332, 334, 335, 339, 349. Cramps, 131, 215. Cyanide ulcers, 162. Dampness of work quarters, 129, 182, 231, 232, 238, 262, 267, 281, 282, 296 (297), 339. Danger, 144, 305, 306, 307, 311. Deafness and impaired hearing, 126, 139, 162, 332. Diarrhoeal attacks, 131. Digestive disturbances, 122, 135, 144, 153, 171, 173, 210, 224, 265, 269, 271, 285, 287, 288, 289, 302, 315, 339, 346, 349, 353, (355). Dizziness, 122, 162, 171, 173, 175, 213, 216, 221, 228, 265, 287, 300, 345^ 353, (355). Drinking water (too cold), 131. Dyspepsia. See Digestive disturb- ances. Ear affections, 139, 332. See also Deafness. "Epidemics," 135, 171. Eve affections. 122, 150, 153, 181, (186), 196, 204, 205, 225, 228, 249, 253, 272, 287, 294, 299, 300, 315, 334, 343, 353. Fainting, 218, 221, 273, 285. Occupational complaints reported — Continued. Fatigue (see also Tiredness), 154, (181), 182, 193, 196, 228, 231, 2-38, 287. Feet (various affections), 258, 279, 281, 337. Female complaints, 196, 285, 287, 289. Foreign particles in eyes, 122, 153, 205, 249. Gloves, absence of, 332. Glue odors, 168. Hazards of other processes, 126, 139, 167. Headache, 126, 128, 162, 181, 196, 205, 218, 218, 221, 254, 265, 287, 288, 289, 300, 343, 345, 346, 349, 353 (355). Heat, subjection to, 122, 123, (124), 149, 154, (164), 182, 193, 196, 215, 226, 231, 238, 247, 260, 262, 282, 292, 300, 302, 305, 306, 307, 308, 311, 312, 315, 320. Heating, inefficient, 131, 158, 167, 237. Humidity. S^^ Dampness. Indigestion. See Digestive disturb- ances. Indisposition, 196, (221), 285. Insanitary conditions, 120, (123), (124), (129), 131, 139, 144, 147, (164), 170, 171, 177, 183, 231, 232, 233, 239, 243, 247, 249, 260, ■ 296, (297), 320. Instructions, lack of, 243. Irregular work hours, 260, 338. Jarring processes, 126. Kidney affections (sec also Bladder, Urinary), 171, 173, 253. "Killing Pace," 181. Laborious work, 305, 311. Lead exposure, 153, 186, 270, 264, 343. Life insurance, difficulty in secur- ing, 243, 260. Light, excessive, 126. Long hours, 123, 183, 217. 260, 262, 279, 339. Loss of time, due to sickness, 158. Lower limb affections, 196. '425 "tccupational complaints -eported — Continued. Lumbago, r2G, 130, 315. Lung affections {see also Bron- chitis), 129, 137, 139, 173, 269, 339. "Metal chills," 156. Monotony, 144. Nausea {see also Digestive disturb- ances), 153, 210, 221, 265, 287, 326, 327, 343, 349, 353. "Nervous breakdown," nervousness, 182, 228, 287, 288. Neuritis, 130. Night blindness, 150. Noise, excessive, 126, 131, 147. Nose affections, 135, 139, 153, 154, 162, 191, 258, 271, 287, 335, 337. Nose-bleed, 258. Oak fumes, 167. OdQrs, 128, 168, 182, 190, 210, 226, 275, 326, 346. Oils (s), 149, 332. Pains (various), 130, 153, 265, 269, 334, 349. Paints (new solvents), 171. Palpitation, 287, 288, 353. Personal carelessne'ss, 171. Pigmentations, 191. Pneumonia, 260. Rest intervals, lack of, 181. Rheumatism, 122,- 126, 129, 131, 144, 182, 232, 260, 279, 282, 299, 302, 308, 315, 337, 339. Sciatica, 130. Sickness (not specified)*. Skin affections, 141, 144, 173, 191, 200, 221, 253, 266, 271, 275, 294, 300, 315, 318, 332, 337, 339, 353, (355). Sleeping, 2G0, 338, 353. Span of trade life, 260. Sparks, 150. Standing constantly, 332. Steam, subjection to, 158, 167, 182, 200, 839, 342. Stiffness, 130, 299. Stupor, stupefaction, 213, 218. Sunday work, 279. "Swelling up", 122. 28* 0. D. Occupational Complaints reported — (Concluded). Temperature changes, (123), (124), 129, 237, 303. Throat affections, 129, 135, 139, 153, 154, 162, 191, 205, 218, 225, 260, 267, 271, 316, 318, 332, 335, 337, 343, 349. Tiredness, 216, 221, 253, 273. Trembling, 353. Tuberculosis, 180, 260. Turpentine exposure, 171, 173, 253, 356. "Typhoid fever", 299. Urinary affections, 176. See also Kidney and Bladder. Varnish exposure, 173. Ventilation provisions, faulty, 131, 141, 144, 153, 158, (164), 167, 171, 175, 177, 181, 186, 189, 199. 238, 334. Washing facilities. Sec Insanitary conditions. Weakness, 253. Weight, loss of, 221. Wood alcohol, exposure to, 205, 325, 326, 327. Wry neck, 130. Zinc chills, 156. "Occupational Diseases"', 9. Occupational diseases, non-specific, 50, 400, 401. Occupational Diseases reported {sec also Occupational complaints ; also Part VI.). Acid burns, 203, 265. Alkali dust poisoning, 258, (271). Anemia (various diseases), 122, 147, 152, 172, 173, 175, 176, J86, 191, 199, 203, 213, 216, 218, 224, 226. 231, 253, 273, 288, 289, '291, 294, 300, 315, 318, 320. .Animal infections, (320). Anilin poisoning, 189, 208, 210 . Anthracosis, (100). Antimony poisoning, 189. Anthrax, 97, (381), 348. Apoplexy, 186, 318. Appendicitis, 120, 380. Arsenic poisoning, (153), Arsine poisoning, (153). 426 Occupational Diseases reported^ Continued. Arterial affections, (186). "Beat hand", (100). Benzine dermatitis, 135, 219. Benzine poisoning, 171, 173, 175, 199, •216, 219, 221, 253, 353. Benzol poisoning, 221, 224. Bichromate poisoning, 192. Bladder affections, 171. Bleeding fingers, 171. Blindness, 124, 150, 192. Blood poisoning, 192, 324. Bloody urine, (153). Boiler makers' deafness, 147, 301. Boils, (see furunculosis). Brass chills, 135, 150. Brass itch, 135, 144. Brass poisoning, 139, 144. Brass rash, 147. Brazier's disease, 150. Breathing, difficulty in, 153, 294, 334, 349. Bright's Disease, 318. Bronchitis, 131, 135, 139, 144, 156, 171, 189, 267, 302, 332, 345. Burns, 139, 156, 203, 205, 343. "Butcher's wart", (348). Caisson disease, 101. Calluses, 205, 300, 316, 324. Cancer, (151), 203, (340). Carbon bisulphide poisoning, 224. Carbon dioxide poisoning, 393. Carbon monoxide poisoning, 172. Carbon tetrachloride poisoning, 224. "Carpenter's stoop", 166. Cataract, 124, 150, 260, 300. Chancre, 260. Cheeks, dilatation of, 260. Cirrhosis (lungs), 100. Color sense affections, 150. Compressed air illness. See Cais- son. Conjunctivitis, 120, 139, 150, 264, 267, 300. Consumption. Sec tuberculosis. Cramps, 131. Cyanamide poisoning, .349. Cyanide poisoning, 192. Cyanide ulcers, 162. Dancing pupils, 100, 181. Occupational Diseases reported — Con- tinued. Deafness, 139, 147, 301, 315, 316, 332. Deaths. (See also Vital Statistics), 122, 149, 192, 262, 270. Debility, 300. Deformities, (273). Degenerative diseases, 192. Dermatitis, 120, 149, 171, 173, 175, 189, 210, 212, 219, 224, 258, 267, 292, 328, 340, 356. Diarrhoea, 131, 300. Digestive disturbances. See Occu- pational Complaints. Ear disease, 100. (See also Deaf- ness). Eczema, 135, 162, '212. Emaciation, 173. . Emphysema, (100). Empyema, 139. "Epidemics", 135, 171. Epithelioma. Sec Cancer. Erysipelas, 192, (348). Eye affections, 92, 124, 150, 157, 173, 181, 186, 192, 196, 205, 260, 264, 267, 287, 292, 294, 299, 300, 315, 331, 340, 343. Female disorders, (273), 289. Ferro-silicon poisoning, (301). (Flat-foot), (273). Flushed faces, 173. Foot affections. See Skin affec- tions. Foot-and-mouth disease, (348). Furunculosis, 98. Gall bladder affections. (196). Gas bacillus infection, (348). Gassing, 122, 172, 300, 303, 310. Glanders, (348). Granulated eye-lids. See trachoma. Hair, turning color of, 177. "Hammerman's paralysis", 301. Hay fever, 272. Heart affections, 186, 285, 287, 301, 318. Heat affections. 131. 195, 260, 262, 300, 308, 315. Hoarseness, 332. Homicidal characteristics. 224. 427 Occupational Diseases reported — Con- tiniieil. Hookworm disease, (9G), (1"0), (268), Vim), (298). Hydroflouric acid burns, 2(15. Infections.* Insanity, 224, (228), 300. Jaundice, 1->1 Kidney affections, 171, 173. Lead poisoning, 139, 144, 149, 153, 158, 1U4, 171, 173, 175, 183, 18G, 189, 191, 202, 208, 210, 232, 239, 243, 247, 249, 253, 258, (264), 269, 270, 299, 320, 342, 343, 353, 355, 356, 392. Lock-jaw, (98), 184, (332). Lung diseases (not otherwise spec- ified), KHi, 162, 300, 331. Malignant pustule, (348). Mental deterioration, 122, 224. "Metal chills", 156. "Miner's elbow", (100). Myopia. See Eye affections. Naptha poisoning. See Benzine"' Nephritis. See Kidney affections. Nervous affeqtions, 139, 147, 160, ■ 182, (196), 224, 289, 299, 301. Neurasthenia. See Nervous affec- tions. Night blindness, 150. Nitric acid (inhalation), 160. Nitroso-nitric acid (inhalation). 160. Nose affections, 135, 173, 264, 295, 335, 337. Nystagmus, 100, 181. Ophthalmia electrica, 150. Pallor. See Anemia. Paralysis, 182, 208, 224, (228), 243, 318. Perforated nasal septum, 258, 290. Phthisis, (100^ See also Tuber- culosis. Pleurisy, (100). Pneumonia, (100), 139, 153, 160, (238), (260), (267), 318, (349). Pneumonoconiosis, 332. Poisoning, chronic,* 164, 192. Potassium cyanide, 149. Prematurely aged, 231, 299, 300. Presenility, 186, 231, 299. Occupational Diseases reported — Con- cluded. Pyorrhoea, 154, 156, 299. Rheumatism, 129, 131, 279, 282, 299, 301, 303, 308, 315, 387, 339. Rhinitis. See Nose affections. Salivary disturbances, 260. "Sickly appearing."* Siderosis, 139. Skin affections, 131, 147, 151, 156, 177, 191, 203, 267, (275), 292, 2y3, 294, 300, 315, 318, 328, 33il, 337. Spinal affections, (122). Sterility, ^151). "Striker's arthritis," 301. Suicidal characteristics, 224. Sulphur chloride poisoning, 224. Syphilis, 260. "Sun burning," 150, 300, 315. Teeth, destruction of, 154, 156, 275, 299, 345. Tetanus. See Lock-jaw. Throat affections, 135, 267, 335, 337, 343, 849. Tobacco poisoning, 285, 287, 289. Trachoma, 92, 100. Tuberculosis, 90, 92, 101, 120, 139, 147, 153, 1'54, 171, 173, 183, 186, 190, 192, 203, 238, 256, (260), 267, 273, 278, 285, 287, 291, 300, 318, 828, 329, 332, 834, 8^5, 387. Turpentine poisoning, 171, 173, 175, 356.' Typhoid fever, 99, 100, (268), (299), (348). Ulcers, 156, 162, (196). Urinary affections (see also Blad- der), 153, 176. Varnish poisoning, 171, 253. Venereal diseases, (215), 260. Wood alcohol poisoning, 171. Wool sorter's disease, (331). Yeast dermatitis, (317). Zinc chills, 156, 242. Zinc poisoning, 158, 208. Occupational diseases, reporting of, 7. Occupational diseases, specific, 42, 50, 400, 405. Occupational neuroses, 35. Occupational poisonings,* 43, 46. 428 Occupied males, mortality among, 14, 404. Oculist, 151. Odors,* 49, 50. Offspring (lead-workers), 379. . Ogle, Dr. Wm., 1, 101. Ohio State University, 392, 394. Oil (-ers, -ing, -s) (see also P.), 34, 39, 71, 112, 147, 164, 168, 171, 189, 207, 317, 331, 385. Oil-blast furnaces, 50. Oilcloth, 71, 355. Oil, mineral, 171, 339, 384. Oil refining, 163, 339, 340, 347. . Old age, 29, 36, 87. Old rubber, 228. Oliver, Sir Thomas, 9, 33, 299. Open hearth furnaces, workers, 58, 306, 307, 309. Opening (cordage), 331. Ophthalmia electrica, 150. Ordering (tobacco), 288. Ore (s), 18, 343. Organic dusts,* 18, 348. Organic heart disease (see Heart dis- ease). Other processes (a hazard).* Overcrowding,* 39, 90. Overitis, 120. Ovens. See Kilns, Drying ovens. Overlock Tuberculosis Agreement, 401. Overtime,* 277. Oxygen, 27, 132, 397, 398. ' Oxygen apparatus, 122, 132. Oxyhydrogen blow-pipe. See Blow- pipes. Oxyhydrogen welding, 150. Packing (special forms), 117, 255, 271, 278, 283, 285, 289, 290, 294, 346, 351. Pains. See O. C. Paint (s, -ing) (see also P.), 26, 27, 30, 31, 33, 37, 146, 163, 165, 168, 171, 172, 174, 177, 205, 239, 263, 265, 269, 350, 357, 385. ■Paint and varnish, 71, 350, 354, 378. Paint-dipping, 250. Painters (in shops), 30, 378. Paint Manufacturers' Association Bul- letin, 172. Painters' Union, Chicago (Vital Statis- tics), 383. "Paint Vapors, Composition of," 172. Paint removers, 170. Palm oil, 157, 158. Pale (pallor). See Anemia. Palpitation (see also O. C), 300. Palsy. See Paralysis. Pamphlets on occupational diseases, etc., 3. Paper and paper goods, 80, 163, 182, 183, 336. Paraffin, 144, 186, 339, 340, 346. Paralysis (see also O. D.), 35, 87, 88, 102, 299, 359, 380. "Past cases" (defined), 359. Paste (-ers, -ing, s), 28, 167, 201, 202, 254. Pasteurizing, 282. Pastries, 272. Patent-leather, 319, 328. Patent medicines, etc., 71. Pattern making, 129, 165. Patterson, H. J., 394. Peanut shells, 157. Peat pits, 399. Peeling, 276. Pensions (sickness, old age, death).* Pemphigus, 42. Perforated nasal septum, 258, 290. Perfumes, 163, 270, 271. Periodic examination*, 47. Personal cleanliness*, 46, 110. "Personal injury", 2, 112. Petrol (see also Benzine), 42, 74, 120, 339. Petroleum, 339, 340. Phenol, 144. Phosphatic minerals, 347. Phosphorus (see also P.), 42, 133. Photography, 163, 176, 191. Photo-engravers' Union, 191. Photo-engraving, 72, 163, 190. Photometry, 205. Phthisis, 18, 300. Physical examinations,* 11, 42, 55, 95, 112, 315. Physical exercise, 39. Physician (s)* 41, 54, 106, 110, 202, 219, 343, 358, 403 Picking (textiles), 328, 329. Pickling. 148, 153, 155, 156, 157, 159, 174, 276, 309, 313. 429 Pictures, questionable, 50. Piecing (textiles), 328. Piece-work*, 37, 38, 112. Pieraccini's vicious circle, 353. Pigments, pigmentation, 173, 191. Pipe (drainage, sewer), 296. "Pit,, the", (rubber works), 214. Pitch, 203, 282, 333. Placards of instruction*, 42, 110, 353, 393. "Place" (defined), 54. Plague. 41. , • Planing (metals), 144. "Plant" (defined), 54. Plastei-of-Paris, 233, 234. Plate mill, 311. Platforms, 196. Platinum wire, 346. Plating. See Electro plafing. Pleurisy, 55. Plug tobacco, 288. , Plumbism. See Lead poisoning. Pneumatic riveters, 147. Pneumatic tampers, 131, 132, 301. Pneumatic tools, 139, 266, 301. Pneumonia {see also O. D.), 28, 39, 61, 87, 88, 126, 128, 137, 142, 260, 301, 383. Pneumonoconiosis, 18, 332, 405. POISONS, 42. Poison (-ing, s)*, 12, 16, 36, 38, 46, 59, 103, 112. Poisons, fatigue, 34, 36, 38, 39. Poisons reported as occupational haz- ards {see also Part VI). Acetone, 172, 176, 199. Acids (not specified), 120, 144, 152, 154, 159, 162, 202, 229, 264, 318. Acids, acetic, 152, 191, 265. Acid, carbolic, 144, 265. Acids, fatty, 271. Acid, formic, 172. Acid, hydrochloric, 152, 158, 191, 203, 264, 340, 343, 849, 350. Acid, hydrocyanic, 397. Acid, hydroflouirc, 264, 349, 350. Acid, nitric, 114, 158, 160, 177, 191, 270, 350. Acid, nitroso-nitric (nitrous), 160, 349. Acid, oxalic, 26G. Poisons reported as occupational haz- ards — Continued. Acid, phosphate, 347. Acid, stearic, 271, 320. Acid, sulphuric, 149, 154, 158, 264, 280, 316, 318, 340, 343, 347, 350. Acid, tartaric, 270. Alcohol, 191, 288. Aldehydes, 172. Alkalis (not specified), 120, 154, 160, 162, 229, 271. Alkaloidal woods, 166. ' Alloys (not specified), 143, 151, 183. Alum, 144, 337, 339. Ammonia, 122, 167, 176, 207, 221, 279, 280, 282, 288, 328, 340, 342, 356, 397. Ammonium bichromate, 191. Ammonium chloride. See Sal am- moniac. Ammonium phosphate, 348. Ammonium sulphate, 348. Amyl acetate, 120, 144, 172, 174, 176, 265, 319. Amyl compounds, 328, 353. Anaesthetics, 289. Anilin dyes, 67, 200, 221, 291, 319, 337, 344, 356. Anilin (oil), 177, 186, 189, 207, 200. Antimony, 135, 174, 186, 189, 206, 208, 213, 226, 257. Autotoxins, 180. Arsenic, 153, 176, 191, 200, 242, 252, 257, 318. Asphaltum, 170, 339. Banana oil, 172. Basic slag, 349, 350. Benzine, 120, 144, (104), 171, 173, 174, 175, 176, 177, 181, 186, 189, 196, 199, 212, 213, 216, 217, 218, 221, 224, 225, 226, 228, 253, 265, 319. 320, 353, 356, 376. Benzol, 170, 172, 176, 191, 199, 203, 218, 221, 224, 225, 226, 228, 376. Bichromate, 1!)2. Blacking, 32(i, 327. nicaching powders and solutions, li)3. 291, 317, 339. Boiled oil, 170, 172, 319, .339, 356. . Brass, 147, 377. 430 Poisons reported as occupational haz- ards — Continued. Brass fumes, 127, 131, 134, 135, 138, 144, 150, 183. Bronze, 143, 175, 176, 186. (Calcium carbonate), 293, 342. Calcium chloride, 340, 342. Carbon, 203, 345. Carbon bisulphide, 199, 221, 224, 225, 228. Carbon dioxide, 135, 172, 186, 225, 293, 315, 342, 349, 397. Carbon monoxide, 122, 135, 172, 315, 397. Carbon tetrachloride, 224. Chemicals (not specified),* 320, 339, 340. Chlorine, 225, 291. Chloroform, 199. Chrome compounds (not specified), 191, 242, 318, 337, 839. Cobalt, 252. . Collodion, 191. Colors (not specified), 120, 177, 320, 332, 350. Copper sulphate, 162, 191, 316. Copper sulphide, 340. Corrosives, 120, 191. Corrosive sublimate, 191. Creosote, 170, 203. Cyanide (s), 154, 192, 318. Cyanamide, 348, 349. "Dead gas", 293. Dyes, 120, 200, 319, 356. Enamel, 174, 353, 378. Essences, 271. Ether, 191, 199. Fatigue toxins, 180. Ferric chloride, 191, 275. Ferro-silicon, 301. Fish glue, 326. Fulminate of mercury, 346. Fumes.* Gas(es).* Gasoline, 120, 167, 176, 182, 200, 327, 339, 347, 349. "Gassing," 300, 310. Gild, 176. Glue, 168, 289, 320, 347. (Glycerine), 270, 288. Poisons reported as occupational haz- ards — Continued. Greases, 157, 177, 318, 320, 339, 340, 347. (Gum), 287, 350. Hydrogen sulphide, 318, 340, 342, 344, 349. Inks, 177, 189. Iodine, 191. Japan, 175, 353. - Lacquers, 120, 162, 172, 265, 353. (Lamp black), 319. Lead and its compounds, 60, 120, 126, 131. 135, 138, 144, 147, 149, 151, 152, 156, 158, 162, 163, (164), 168, 170, 172, 174, 183, 186, 189, 191, 202, 203, 206, 207, 208, 217, 229, 231, 232, 239, 242, 246, 249, 252, 254, 257, 264, 265, 266, 269, 270, (277), 278, 281, 289, 298, 299, 318, 319, 320, 328, 340, 341, 342, 343, '345, 346, 349, 353, 355, 356, 357, 373, 389, .393. Lead oxide (see also Lead). 342. (Licorice), 287, 288. Linseed oil, 319, 839, 340, 356. Litharge, 257, 840, 356. See also Lead. (Lithopone), 356. (Logwood), 319. (Dolomite), 307. (Magnesite), 3n7. Manganese, 242, 257, 305, 340. Metal (s) and Metallic fumes (not specified),* 135, 144, 150. 1-57, 183. Mercury, 203, 205, 270, 346. Methane, 840, 397. Metol, 191. Naphtha (sec also Benzine), 120, (164), 172, 174, 175, 182, 199, 200, 228, 819, 320, 825, 826, 827, 339, 353. Naphthaline, 122. "Nigrisn," 319. Nitroglycerine, 846. (Nitrogen), 841, 897. Nitrous oxide, nitrates, 84."), 845. Oil (fumes, etc.,), 125, 126, 149, 157, 170, 172, 817', 819, 882, 889, 810, 847, 856. 431 Poisons reported las occupational haz- ards — Continued. Paint (s), painting, 147, 167, 170, 178, 232, 35S, 356, 378. Paint removers, 170. Paint vapors, 172. Palm oil, 158. Paraffin, 144, 186, 339, 340, 346. Perfume, 271. Petrol, 120. Sec also Gasoline and Naphtha. Petroleum, 339, 340. Phenol. Sec Acid, carbolic. Phosphorus, 135, 205, 344. Pitch, 203, 282, 333. Plating fumes, 144, 191. Poisons, tables of occurrences, 361, 372, 373, 375, 376, 377. Potassium chlorate, 344. Potassium cyanide, 126, 131, 144, 147, 149, 160, 162, 191. Potassium dichromate, 344. Potassium ferrocyanide, 341. Potassium hydroxide, 271, 341, 348. Pyroxylin, 176. (Ptomaines), 301. Realgar, 318. Read Lead, 232, 257, 356. Sec also Lead. Resin, 282, 326, 337, 339, 344, 350. "Rouge," 270. Saffron yellow, 67. Salamander gases, 125, 130, 135, 315. .Sal ammoniac, 156, 158, 343. Salt, 290, (298). Saltpetre, 345. Shellac (s), 120, 190, 265, 281, 325. 326. Silicon flouride, 349. Silver nitrate, 191, 270. Smoke, 121, 124, 125, 127, 180, 138, 152, 175, 177, 189, 190, 282. 292, 300, 325, 339, 342. Soap dust, powders, 271, 272. Soda ash, 257, 339. Sec al-o So- dium hydroxide. Sodium bicarbonate, 341, 342. Sodium carbonate, 193, 339, 342. Sodium hydroxide, 160, 271, 831, 839, 840, 342, 346. Sodium nitrate, 845. Poisons reported as occupational haz- ards — Concluded. Solder, 152, 201, 203, 205, 264, 265, 277, 278, 346, 379. Stains, 120, 252, 291. Substitutes for poisons, 171. Sulphur, 175, 222, 293, 345, 346. Sulphur chloride, 221, 224, 225. Sulphur dioxide, 135, 291, 340, 343, 349. Superphosphates, 347. Tan bark, 317. Tar, 333, 339, 340, 346. Tin and its compounds and alloys, 158, 266, 316. Tobacco, 168, 283, 284, 287, 288, 289, 317. Toluene, 172. Toxins, 180. Turpentine, 120, (164), 171, 172, 174, 175, 177, 191, 199, 251, 265, 353, 356. Vapors.* Varnish and varnish removers, 170, 172, 176, 178, 253, 265, 353, 355, 356, 378. Volatile substances,* 170. White lead, 342. See also Lead. Whiting, 328, 342. Wine, 282. Wood alcohol, 120, 152, (164), 167, 171, 172, 176, 178, 182, 190, 191, 199, 205, 221, 2-24, 266, 281, 319, 325, 326, 327, 353. Zinc, 135, 149, 152, 156, 158, 242, 265. Zinc chloride, 152, 158, 203, 343. Policemen, 58. Polish (-ed, -ers, -ing), {also Buffing), 61, 69, 134, 136, 141, 146, 152, 157, 159, 160, 161, 168, 179, 201, 213, 262, 265, 270, 298, 320, 327. Pollution (of air),* 26. Porcelain, 284, 239, 242* 247. Porcelain enameled iron ware, 72, 173, 26!). Port-holes, 247, 807. "Positive" case (defined, diagnosed), 859, 882. Postures,* 38. Potash. 341, 848. Potassium chlorate. See P. 432 Potassium cyanide (see also P.), 161. Potassium cyanide substitutes, 149. Potassium dichromate. See P. Potassium ferrocyanide. See P. Potassium hydroxide. See P. Potter's asthma, 2. Potters (-eries, -making),, 72, 89, 229, 357, 378. Pouring (enamel), 173. Powder (blasting, sporting), 3-!4. Powder mills, 345. Power production, 122. Predisposition, 89. Premature confinements (due to lead), , 879. Presenile (prematurely aged), 186, 231, 299, 300. Preserving, 83, 275,' 278. Press (-ers, -ing, -rooms, -work), 181, 188, 189, 200, 225, 234, 262, 288, 296, 330, 340, 345, 360. Pressing objects against body,* 38, 112. "Prevalence of Occupational Factors in Disease," 404. Preventable deaths, 14, 137, 165. Preventable diseases, 165. "Prevention of Lead Poisoning,"' 378. Prevention of occupational diseases,* 400. Preventative measures (lead poisoning), 384. "Preventive Medicine and Hygiene," 400. Price, Geo. M., M. D., 9. Priming, 168. Principle(s) I, II, III, 400, 401. Printers (-ing), and publishing, .73, 89, 176, 185, 250, 356, 357. Privies. See Closets. "Process" (defined), 55. Producer gas, 122. Professional men, 16, 89. Proprietors,* 16, 89. Prostration (see also Heat), 29. "Protective Measures," etc., 354, 356. Proving (printing), 191. Psychrometer, 25. Ptomaine poisoning, 34, 301. Public Health Exhibit, 3, 403. Publicity, 3, 378, 402, 403. Publishing. Sec Printing. Puddling furnaces, 307. Pug mills, 229. Pugh, Judge Robert C, 2. Pulmotors, l22. Pulp, 336. Pumice, 266. Punch-pressing, 144. Pustular affections, 97, 147. 158. Putties, 350. Pyorrhea. See O. D. Pyroxylin, 176. Quarry (-ies, -ing, -man), 14, 89, 265, 268, 293. Quartzite, 301. Questionable deaths, 13. Quick drying. See Paints and Enamels. Rabbits (test purposes), 396. Rags (see also D., and Wiping Rags), 40, 157, 158, 182, 184, 334, 336, 338. Railroad employes, 58. Railway signals, 163. Rain coats, 219. Rambotisek, Dr. J., 9, 350, 398. Rattler (-ing) (see also Tumbling), 139, 141. Recapitulation of industries investi- gated, 108, 105. Recarburizing, 307. Reclaiming (rubber), 228. Recommendations*, 95. Recreation, 38, 112, 181. Red lead (see also Lead), 174, 232, 257. 356. Red phosphorus, 205. Reference books, etc., 9, 10. Refining (metals, oils), 182, 340. Refrigerators, 67, 153, 275. Refuse cans, 146. Regalia, etc., 82. Regulations,* 46, 112. Relining of kegs, 282. Rendering works, 347. Resin (rosin) (see also P.), 172, 175, 177, 196. Respirators,* 46, 47, 112. Respiratory affections. See Lung dis- eases. Rest rooms,* 38, 112. Retention (of workers),* 109, Retinitis, acute, 22, 433 Rheumatism {sec also O. C. & O. D.), 13, 29, 31, 87, 88, 275. '"Rheumatism," 380. Rhinitis {see also Nose affections), 173, 264. Riveting (metals), 144, 147. Rock drilling, 267. Rolls, rolling, 189, 194, 208, 211, 283, 320, 337, 356. Roofing materials, 73, 163, 334, 336, 338. Rope making, "rope walk," 332. Rosin. See Resin. Rosenau, (Milton J.), 400. Rotation of workers,* 48. "Rouge" paste, 270. Routers, routing, 191, 192. Routine, 117. Roving, 331. Rubber Company's Report, 55. Rubber ingredients (poisonous), 74. Rubber goods, workers, 65, 73, 74, 89, 163, 191, 206, 265, 357, 378. Rubbing, 168, 247, 249, 319, 378, 379. Rug?, 199. Rum, 288. Rush Medical College, 404. Russell, H. L.. 394, 398. ftusset leather, 320. Rutland Sanatorium (Mass.), 401. Sacking, 295, 342, 347, 349. Sack-making, 181. Safes and vaults, 74, 170. Saffron yellow, 67. Sagger processes, workers, 232, 235, 239, 244. Salamanders, 27, 112, 125, 130, 135, 138, 183, 315. Sal ammoniac {see also O. D.), 154, 157. Salivarj' disturbances, 260. Saloons, 112. Salt, 75, 289, (298). Saltpeter. See P. "Salt rheum", 272. Sanatorium, 401, 402. Sand (-ers, -ing, -papering) (see also D.), 18, 27, 30, 33, 139, 107. 16,^, 173, 247, 2G2, 379, 392. Sandblasting, 136, 139. 204, 265, 269. 298. Sanders-up, 302. .Sanitarians, 2^4. Saponification, 340. Sawduct. See D. Sawgrinder's consumption, 2. Saw-mill hands (hookworm disease), 42. "Scale", 153. Scales and balances, 75. Scalding, 276. Scalp affections, 271. Schereschewsky, J. W. M. D., 92. Sciatica {see also O. C. and O. D.), 129, 130. Scope and methods of inquiry, 106. Scott, Ernest, M. D., 893. Scouring, 249, 265, 327, 330. Screw machines, 147. Scrotum irritation, 337. Scrubbing, 317, 319. Sealing, sealing wax, 205, 278, 350. Seasonal influences*, 110. Section hands, 58. Sedentary work*, 38, 112. Selecting (cigars), 285. Selection of workers*, 42, 112, 315. Self-poisoning, 38. Semi-curing (rubber), 214. Sense (sight and color), 150. "Sensible temperature", 25. Sesquisulphide of phosphorus, 344. Sewer pipe, 295, 296, 297. Sewing, 178, 181, 325, 330, 333. Sewing machines, etc., 60. Shading (pottery), 253. Shadows*, 112, 259. Shaw, R. H., 399. Sheet and Tube Company, Youngstown, Ohio, 92. Sheet iron, 63, 153, 156. Shellac (-ers, ing, s), {see also P. and D), 69, 161, 168, 172. Shells, 346. Shelling, 276. Shields and screens*, 30. Ships (-building), 30, 75. Shoddy (rubber), 228. Shoes, shoemakers, 42, 80. 81, 219. 321. Shop-painters, 30, 168, 378. Short span of years, 260. Shot, 346. Shower bath*, 31, 112, 247. 270, 310. 3] 9. 434 Sick benefit associations, insurance*. Sick, sickly*. Sick records, 53, 55, 56, 192, 194, 358, 386. Siderosis, 18, 139, 405. Sieving, sifting, 173, 229, 250, 288. Signs and advertising novelties, 75. "Silage, Causes Operative in the Pro- duction of", 398. Silica (-ia, -on), (see also D.), 256, 295, 301. Silicon carbide, 268. Silicon flouride. See P. Silicosis, 18. Silo (analyses of gases), 397. "Silo for the Dairy, The", 399. "Silo, Four Cases of Sudden Death in a", 394. Silver nitrate. See P. Silver workers, etc. (union statistics), 61. Sinks, 269. Sisal hemp, 331. Size (-ers, -ing), 176. 250, 276, 288, 336, 339. Sketching, 191. Skilled workers*. Skin affections (see also O. D. and O. C), 13, 29, 35, 41, 101, 112, 154, 163. 203, 265, 266, 271. Skinning, 348. Skip hoists, 302. Skivfeg, 324. Slag, 130, 350. Slate mining, 267. Sleep (-ing), 38, 260, 300, 338, 353. Sling psychrometer, 25. Slip house (s), 229, 239. Slip-making (pottery). 229, 232. 235. "Shoulder drop", 380. Sluggishness, 38. Slushing (enamel), 269. Smallpox. 41. (147. 184. Smelting and refining, 76. Smoke (see also P.), 122. 126, 128. 13!). 269, 310, 841. Sneezing, 27, 178. Soap, 88, 27.0. 271. Soap powder, 272. Soapstone (see also D. ), 17. Social Agencies, Cincinnati. K'. Social delinquencies, 121. Social disgust, 120, 121. Soda ash (see also P.), 258, 346. Soda water, 334. Sodium carbonate. See P. Sodium bicarbonate. See P. Sodium hydroxide. See P. Sodium nitrate. See P. Soft drinks (see also Carbonated waters), 83. Soft metals. Sec metals. Softening boards, 320. Solder (-ers, -ing) (see also P.), 69, 143, 149, 151, 202, 263, 350, 351. Sodium sulphide test (lead), 383. Sole leather, 325. Solvay process, 342. Soot. See D. Soreness, 35. Sorters (-ing), 157, 192, 275, 288. South Amherst (t3'phoid fever out- break), 99.. Sparks, 150, 151. Spasms, 35. Special investigations, 378. Special process (es), 112, 18-5. Specialty making (rubber), 219, 225. Speeding up*, 38, 112. Spinning, 328, 329, 331, 332. Spidering, 205. Spinal trouble, 122. Spirit varnish, 175. Spitting*, 39, 112, 119. Splicing, 222, 224, 32.8, 330. Splitting, 320. Sponge (-ers, -ing), 205, 218, 222, 231). Sporting powder, 344. Spots, removal of, 196. Sprague Memorial Institute, 404. Sprains, 56. Spray (-ers, -ing), 168, 170, 172, 173, 174, 194, 250, 265, 269, 282. Spreading, 331. Springs, 76. "Staggers", 49. Stagnation (of air)*, 26. Stain C-ers, -ing. s). (see also P.). 168, 172, 196. Stampers (-ing), 250, 253, 327. 356. Standino*. 9,8. 112. 435 Starcliy (}', -ing), (sec also D.), 195, 278, 33.H. State Board of Health (Ohio), 401, 406. Stationary engineering, 122. Steam (-ing), (see also O. C.)*, 23, ^, 112, 154, 160, 101, 194, 275, 276, 356. Steam vulcanizing, 214, 218, 225. Stearin, 320. Steel, 473, 300. Steel Company's report, 56. Stemming (tobacco), 283. Stench (see also Odors), 340. Stenciling, 168, 171, 176. Stenographers, 14, 89. Stereotyping, 70, 187. Sterility, 151. Sterihzing, 278. Stewart (Textbook of Physiology), 10, Stickers-up (pottery), 234. Stifif (-ness), (see also O. C), 31. Stiles' method, 97. Stimulantism, 10, 50, 112, 406. Stippling, 190. Stitching (shoes), 325. Stogies, 285. Stokers (-ing), 121, 122. Stomach trouble (see also Digestive dis- turbances), 87, 88, 129, 135, 347. Stone (-processes, -workers), 14, 18, 79, 89, 191, 265. Stoneware, 229, 238, 239, 242, 244, 247, 250. Stools (and chairs)*, 38, 112. Storage (of fertilizers), 349. Storage batteries, 201, 378. Stoves. Sec Furnaces. Stovemen, 302. Stove-mounters, 136, 137. Strain*. 38, 112, 205. Stranding, 332. Straw. 256, 330. Street cleaning, 291. Striker's arthritis, 301. Stringing, 276. Striping, 168. Stripping, 283, 286, 287. "Study of Causes of TuberculDsis", 15. "Study of the 'Handicapped", 13. Stuffiing (leather), 320. Stupor and stupefactinn, 213, 218, Sub-contract system, 243. Substitutes, substitution (poisons), 46, 171. Suction fans*, 28. Sugar, 288. Suicide, 16, 87, 88. Suicidal characteristics, 224. Sulphur (see also P.), 223, 225. Sulphur chloride (see also P.), 74. Sulphur dioxide (see also P.), 225. Sulphurated hydrogen. See Hydrogen sulphide. Suppuration, virulent, 348. Summerfeld and Fischer, 9. Summarized report, 53, 103, 357, 400. "Sunburn (-ing)", 150, 300, 315. Sunday work, 277, 279. Superphosphates. See P. Surgeon*, 41. Surgical emergency room*, 41. Suspicious cases (lead poisoning), 381. Suspicious conjunctivitis, 92. Swain, C. L., Speaker, 4, 5. Sweating (tobacco), 288. Sweating chamber (oil refining), 288,' 340. Sweeping*, 39. Sweetmeats, 273. "Swelling up", 122, "Symposium on Ventilation", 9. Syphilis. 39, 260. Syrups, 275. Tabacosis, 18, 285. Tailors (-esses), 81, 82. "Talc, talcum, 17, 203, 270. Tampers, pneumatic, 131. Tan bark, 317. Tankage. 348. 349. Tanneries (-ing, -s). 317, 347. Tar (ing) (see also P.), 121. Teachers, 80. Teeth. 56, 154, 150, 275, 209, 345. Telephone girls, 89. Temperature-humidity relations, 20, 27. Temperature. See Heat, Cold*. Tempering, 129. 140, 147, 298, 299, "Tentative" case (defined, diagnosed), 359, 381, 382. Tentering, 350. Terne-plate, 77. 15(1. 15S, Terra cotta, 72. 436 Tetanus. See Lock-jaw. Textile (-s, -workers) {see also D.), 81, 89, 199, 328. Thermic fever, 29. Thermometer, wet-and-dry-bulb, 25. Thomas slag, 350. Thompson, W. Oilman, M. D., 9. Threading, 144. Throat affections (see also O. C), 32, 56. Thumb "jibs", 266. Ticks, 333. Tiles (art), 229, 234, 239, 247, 253, 254. Tin (-ners, -ing, -plating), 68, 85, 133, 143, 150, 153, 156, 158, 266, 316, 357. Tin cans. See Cans. Tin foil, 288, 289. Tinting, 250, 251, 252. Tired (-ness) (see also O. C), 217, 219. Tires (rubber), 212, 214, 217, 224. Tobacco (see also P.), 47, 82, 89, 202, 282, 286, 289. "Tobacco heart", 287, 289. Toilets. Sec Closets. Toleration (of health-hazards), 12, 43, 213, 221, 353. Toluene, 172. Tonsillitis, 39. Tools, 64, 123. Top-fillers (blast furnace), 302. Tow, 177. Towels*, 39, 112. Toxins, fatigue, 180, 405. Toys and games, 77. Trachoma, 39, 41, 92. Trade process (es) (defined), 55, 406. Training, 35. Transfer work, 190. "Treers", 324, 327. Tremors, trembling, 35, 160, 353. Trimming, 320, 356. Trivial injuries*, 41. Tubercle bacilli, 18, 147. Tuberculosis (see also O. D.), 28, 36, 39, 61, 87, 88, 126, 128, 129, 137, 142, 167, 276, 301, 348, 383, 405. Tuberculosis Agreement (Overlock), 401. Tuberculosis 'Hospital Report, Cincin- natti, 80. Tube bending, 311. Tubulating, 205. Tumbling (-machines) (see also Rat- tlers), 132, 139, 199, 250, 346. Tunnel (-ers, -ing, -s), 48, 101, 102. Turners (pottery), 234. Turning (metals), 144. Turpentine (see also P.), 42, 74, 170, 173, 250, 253, Twine, 78, 331, 332, 333. Twisting, 328, 329, 331. Type, 73, 186, 187, 188, 378. T3'pe of workers*, 109. Typhoid epidemic (Springfield), 99. Typhoid fever (see also O. D.), 16, 41, 42, 72, 99. T5'phoid fever outbreak (South Am- herst), 99. Ulcers (see also O. D.), 35, 191. Unconsciousness (anilin oil), 189. Under-glazing, 244. Underwear, 178, 328. Unemployable persons, 120. Unfritted glaze, 239. Unglazed ware, 244. Unhairing, 317. Unions*, 109. Unskilled workers*. Upholstering, 177. Urinary affections (see also Bladder), 153, 176, 353. Urine, test for lead in, 387, 388, 391. Utensils, 269. Vacuum cleaning, 20, 21, 186, 202, 236, 238. Vacuum Production (mercury), 205. Vapor cure (rubber), 215, 224. Vapors. See O. C. (Breathing)*. Variation (of work)*, 38, 112. Varicocele, 55. Varicose veins, 35. Varnish (-ers, -ing, s) (sec also P.), 30, 31, 33, 37, 168, 171, 173, 175, 177. Vaults, 74, 170. Vegetables, 278. Vegetable dyes, 200. Vehicles, 378. Veneering, 165. VENEREAL DISEASES*, 50. V'enereal diseases (see also O. D.), 112. 213. 246. 437 Ventilation*, 29, 131, 158, 167, 170, 175, 177, 181, 186, 189, 199, 238, 334. '"Ventilation, Symposium on ", 9. Ventilator, to convert an ordinary sash window into a, 28. Vibrating tools, 147, 304. Vignetting, 190, 191. Vining, 276. Vintners, 399. Violence (statistics), 13, 128, 142. Vital organs, 38, 46. Vital and morbidity statistics (see also Part VI.), Age, 13, 61, 87, 101, 319, 383. Agricultural pursuits, 14, (357). Artists, 357. Barbers, 101. Blacksmiths, 126. Boot and shoe factory operatives, 80. Bottlers, 88. Brass workers, etc., 14, 61, 134, 141. Brewery wagon drivers, 88. Brewers, 88. Bricklayers, 58. Building constructors, 58. Cancer, 13. Carpenters, 14, 27, 89. Cigar factory operatives, 83. Circulatory diseases, 13. Clothing workers, 81. . Coal miners, 101. Degenerative diseases, 14, 57, 137, 142. Dock laborers, 58. Domestics, 14. Electrical workers, 58. Electroplaters, etc., 61. Engineers and firemen, 123. Farmers, planters and overseers (tuberculosis), 14. File-cutters, 800. Foundry w'orkers, 58, 6Q. Glassworkers, etc., 84, 89. Glaziers, etc., 168. Heat exposed workers, 58. Industrial, 9. Injuries, 16, 61, 137, 142. Iron and steel workers, 14, 57, 58, 85. Joiners, 27. Vital and morbidity statistics (see also Part VI.)— Concluded. Laborers, 58, 357. Lead workers, 357. Laundry-workers, 86. Lock-jaw, 13. Machinists, 66, 357. Marble and stone workers, 79. Mechanics, etc., 58. Mechanical and manufacturing pur- suits, 117. Metal grinding, 137. Miners, 14, 89, 101. Molders, 06, 428. Occupied males, 14, 404. Old age, 13. One fault in, 53. Painters, etc., 14, 168, 357, 383. Paper-hangers, etc., 168. Photo-engravers, 192. Pneumonia, 16, 57. Policemen, 58. Polishers, etc., 61, 141. Potters, 72, 358. Preventable diseases, 14, 57, 137, 142. Printers and publishers, 73, 357. Proprietors and professional men, 16, 89. Quarrymen, 14, 89. Railroad employes, 58. Rope-makers, 332. Rubberworkers, 55", 56, 74, d57. Section hands, 58. ■ Shoemakers, 81. Silver workers, etc., 61. Stenographers, 14, 89. Stone-cutters, 14, 89. Stove mounters, 137. Tailors (-esses), 81, 82. Tanners, 318. Tinners, 357. Tobaccoworkers, 83. Tuberculosis*, 13, 14, 15, 16, 57, 89, 126, 383, 405. Upholsterers, 178. Weather exposed workers, 58. Woodworkers, 165. Volatile substances*, 170, 175. Vomiting, 300, 349. Vulvanizing, 214, 222, 225. Voltage (welding), 150. 438 Wad (-ding), 333, 334, 346. Wagons, etc., 62. Walnut, dust, 167. Wall writings, 50. Warming mills (rubber), 211. Warping (textiles), 328, 329. Wash-basins,* 89. Wash houses, 280. Washing processes,* 192, 206, 229, 276, 282, 328, 330. Washing facilities (sec also O. C.),* 46, 110, 112, 299. Waste, 41, 147, 182. Wasters (sheet tin), 157. Water closets,* 46. Water (for drinking purposes).* Water, cold (complaints), 282. Water-cooled doors, 30. Water, hot (complaints), 282. W^ater sprays, 31. Water wall, 253. Wax, 162, 163, 326. Weak, weakness, 253, 384. Weather exposure,* 58, 300. Weaving, 325, 329, 330. Wedemeyer sandblast rooms, 141. Wefting, 328. Weight, loss of,* 231, 238. Weil's disease, 42. Welding, 22, 136, 146, 150, 152. West Virginia (hookworm), 96. Wet-and-dry-bulb thermometer, 25. White coloring (shoes), 328. Whitening (leather), 320. Whiting, 328, 341. White lead (see also Lead), 342. White pickle, 153, 157. Whiteware, 229, 238, 247. Winding, 205, 328, 329. Wine, 282. Wiping rags,* 39, 41, 112, 126, 147, 170. Wire drawing, 316. Wire and wire work. 88, 205, 300. Woltz, Mr., 96. Wood alcohol (see also P.). 42. 74, 170, 265. Wood (t\'pes, processes, workers), 18, 80, 9i, 129, 146, 165, 169, 173, 333, 336. Wooden goods, 78, 165, 293. Wool (types, processes, workers), 39, 179, 329, 330, 340, 347. Woolen goods, 81, 328, 329. 330, 333. Woolsorters' disease, 331. Work, foul nature of, 335. Work shifts,* 110. Work variation,* 38, 112. W'rappers, 283. Wringing, 288. "Wrist drop," 380. Wry neck, 35, 130. X-ray, 151. Yeast dermatitis, 317. Yeast-makers, 399. Young persons,* 36. Youngstown (Ohio) Sheet and Tube Company, 92. Zinc (see also P.), 42, 138, 176, 192. 208. Zinc chills, 156, 158, 242. Zinc chloride. See P. Zinc glaze, 242. Zinc etchings, 190. Zinc oxide, 150. Date Due f) IIA.787 0h3 Ohio» Dept. of health