REMOTE STORAGE PREVENTION OF OCCUPATIONAL DISEASES WITH SPECIAL REFERENCE TO LEAD POISONING. Of all industrial poisons which now cause unnumbered cases of those peculiar maladies known as diseases of occupation, the most important is lead. Its use in approximately 150 industries exposes thousands of American workers daily to the risk of lead poisoning. NATURE OF THE EVIL. Industrial lead poisoning (saturnine poisoning, plumbism or “leading”) is usually the cumulative result of the daily entry of minute quantities of lead into the system. These may be breathed in the form of fume or dust, swallowed in the saliva, or eaten in food contaminated by dusty or paint- smeared hands. Day by day the organs of the body strive to eliminate the lead through the channels of excretion; but when the system has been impregnated then comes a convulsive effort to get rid of the poison, and agonizing colic or acute brain symptoms develop, or a general physical breakdown ensues. The usual warning of chronic lead poisoning is a blue line on the gums; the first symptoms are loss of appetite, indigestion, head- ache, constipation, extraordinary pallor (for lead reduces the red blood corpuscles from 30 to 50 per cent), loss of weight and muscular force, and gouty or rheumatic pains. With the slow starvation of liver, kidneys and heart, abnormal blood pressure develops, and frequently there is paralysis of wrists and ankles, or of the whole body. When the brain is affected, epileptic attacks, violent insanity and fatal convulsions may occur. Lead also affects the reproductive organs; and its influence is peculiarly disastrous to adolescence and to women. EXTENT OF THE EVIL IN THE UNITED STATES. While foreign records of lead poisoning are based on an accurate system of compulsory reports, our investigators must rely on hospital and dispen- sary records (which commonly cover not more than one case out of every four); on physicians' incomplete memoranda; and on the personal statement of a shifting, often foreign-speaking class of employees. But in the Unted States Bureau of Labor Bulletin, No. 95, Dr. Hamilton reports 398 specific cases of lead poisoning among the workers (some 1,400) in 22 of our 25 white lead plants, with 16 fatal cases between January 1, 1910, and April 30, 1911. In the same Bulletin, Dr. Andrews gives a list of 60 fatal cases of lead poisoning reported by physicians for the state of New York during 1909 and 1910. A hasty study of plumbism in New York City showed 376 cases during 1909, 1910, 1911. The Illinois Commission on Occupational Diseases credits 578 cases to that state during 1908, 1909, 1910. The United States Bureau of Labor, in Bulletin 104, reports for 1910- 1911, Dr. Hamilton’s discovery of 60 cases of lead poisoning among 796 men employed in 40 white ware potteries,, and 43 cases among 150 women in the same works; 63 cases among 304 men employed in 18 yellow ware, art and utility ware and tile works, and 35 cases among 243 women in the same works; and 309 cases among the 1,012 men employed in the porcelain enameled iron sanitary ware factories. Out of 148 enamelers and mill- hands, specifically examined, 36 per cent were found to be suffering from chronic lead poisoning. SATISFACTORY RESULTS OF FOREIGN SANITARY CONTROL OF THE LEAD TRADES. The increasing elimination of dust and fume from the English and Continental lead trades, together with the legal enforcing of habits of personal cleanliness among the lead workers, is reducing plumbism in a marked degree An Austrian smelter record of 73 per cent of all employees “leaded” (under old conditions) measured against 3/10 of one per cent of all em- ployees under sanitary control; or a white lead factory record of 31 per cent of all employees “leaded” measured against o per cent of all employees under sanitary control; or a potteries’ report of 28 per cent of all employees “leaded” measured against 8/10 of one per cent under the present system, are stated as typical examples of what can be achieved. While individual carelessness must always remain a factor in the prevalence of poisoning while lead is used, it is now believed that the employer can so protect his workers as almost to neutralize the danger of the materials handled. This is being demonstrated in Illinois by the same methods as those in vogue abroad; and the satisfactory results which have followed the enactment of laws for the protection of those exposed to lead dust and lead fume are a conclusive argument in favor of uniform laws for the control of these industries in the United States. RELATION OF LEGISLATION TO PLUMBISM. EUROPEAN. AMERICAN. White lead factories in Dussel- dorf employ 150 men; examining physician reports 2 cases in 1910. English white and red lead fac- tory employs 90 men; no case of poisoning in five successive years. At the Hart Accumulator Works in London (storage batteries) 80 to 100 men are employed; no case for over a year. Government factory inspection in Staffordshire potteries reports 13 cases among 786 male dippers in one year. Poisoning in all potteries, Great Britain, 1910: Males employed (1907) 4,504 Cases (1910) 4C Females employed (1907) .... 2,361 Cases (1910) 37 Total employees (1907) ... .6,865 Total cases (1910) 77 Ratio of cases to employees, 1 to 89. American white lead factory employs 170 men; 60 cases in 1911. American white and red lead fac- tory employs 85 men ; doctors’ rec- ords for six months show 35 men “leaded.” Storage battery plant in Chi- cago employs 15 men; two cases of poisoning in nine months. An American Local Dippers’ Union reports that 13 men out of a local of 85 dippers, had 16 at- tacks of lead poisoning in one year. Poisoning in only part of pot- teries in United States for 1911: Males employed 1,100 Cases 87 Females employed 393 Cases 57 Total employees 1.493 Total cases 144 Ratio of cases to employees, 1 to 10. (s> l . oX't OBJECT OF THE STANDARD BILL. The purpose of the standard bill for uniform state legislation (see last five pages of this leaflet) is to lessen the prevalence of occupational diseases, and especially to protect certain workers from the dangers of lead poison- ing. While all uncontrolled lead trades offer risk to the employees, exposure to dust and fume from the important lead salts mentioned in the bill is recognized as extra-hazardous., and their manufacture and handling is under strict governmental regulations in Great Britain, Germany, the Netherlands, Belgium, Switzerland, Denmark and France. The French government has even prohibited theT production or trade use after 1914. While general legislation is required in the United States to cover approximately 150 trades in which lead poisoning may occur, it has been deemed best to ask this year for legislation regarding only those industries concerning which we have specific American data The remedies proposed for the dangers arising from the manufacture and handling of lead sab 5 are based on approved European measures, and those already in force in Illinois, and voluntarily adopted in several American factories. They are the result of months of careful study of the subject, and have the endorsement, of practical lead men, engineers, and scientific and medical experts. NECESSITY FOR THE PROVISIONS OF THIS BILL. Since it has been proved that cleanliness in the lead trades must be absolute, not relative, a type of factory construction is called for which shall provide airy, well lighted rooms; the separation of dusty and non- dusty processes, and flooring which permits the sanitary removal of all dust. Since lead may enter the System by means of contamination by dusty cloth- ing or soiled hands, clean working clothing must be furnished the employee, and proper dressing rooms and ample lavatory and shower bath facilities for use at the noon hour and on leaving the work. Since food exposed in workrooms offers special danger, eating rooms must be provided, and their use enforced. Since respirators are essential to protect those directly exposed to fume or dust, they should be furnished and worn. Since early detection of symptoms of lead poisoning may prevent a serious attack, X ^e'jff odical medical examinations, with a report of all cases to the employer and to the proper state officials, are imperatively called for. Since mechani- cal dust-control is possible by means of enclosed machmery and its con- nection with air-exhaust; and fume-control by means of hoods with exhaust • ventilation; these specific regulations, based on practical experience, are > demanded. Ultimately all these provisions will benefit the employer also in increased efficiency and in economy of material and time. A With the example before us of other nations’ efforts to banish from their lead trades one of the most serious and far-reaching of occupational diseases, and the encouragement of the good already accomplished in one of our own states, the passage of the b’ll is demanded alike by the dictates of sound business judgment, and every instinct of common justice and humanity. For additional information address American Association for Labor Legislation 131 East 23d Street, New York City. STANDARD BILL FOR THE PREVENTION OF OCCUPATIONAL DISEASES WITH SPECIAL REFERENCE TO LEAD POISONING AN ACT to prevent occupational diseases. Be it enacted, etc., as follows : Section i. General Duties of Employers. Every employer shall, without cost to the employees, provide reason- ably effective devices, means and methods to prevent the contraction by 'his employees of any illness or disease incident to the work or process in which such employees are engaged. Section 2. Especially Dangerous Works or Processes. Every work or process in the manufacture of white lead, red lead, litharge, sugar of lead, arsenate of lead, lead chromate, lead sulphate, lead nitrate or fluo-silicate, or in the manufacture of pottery, tiles or porcelain enameled sanitary ware-, is hereby declared to be especially dangerous to the health of the employees, who, while engaged in such work or process, are exposed to lead dusts, lead fumes or lead solutions. Section 3. Duties of Employers to Provide Safety Appliances for the Protection of Employees in Especially Dangerous Works or Processes. Every employer shall, without cost to the employees, provide the fol- lowing devices, means and methods for the protection of his employees who, while engaged in any work or process included in Section 2, are exposed to lead dusts, lead fumes or lead solutions : (a) Working Rooms , Hoods and Air Exhausts for the Protection of Employees Engaged in Any Work or Process Which Produces Lead Dusts or Lead Fumes. The employer shall provide and maintain work rooms adequately lighted and ventilated, and so arranged that there is a continuous and sufficient change of air, and all such rooms shall be fully separated by partition walls from all departments in which the work or process is of a non-dusty character; and all such rooms shall be provided with a floor permitting an easy removal of dust by wet methods or vacuum cleaning, and all such floors shall be so cleaned daily. Every work or process referred to in Section 2, including the corrod- ing or oxidizing of lead, and the crushing, mixing, sifting, grinding and packing of all lead salts or other compounds referred to in Sec- tion 2, shall be so conducted and such adequate devices provided and maintained by the employer as to protect the employee, as far as possi- ble, from contact with lead dust or lead fumes. Every kettle, vessel, receptacle or furnace in which lead in any form referred to in Sec- tion 2 is being melted or treated, and any place where the contents of such kettles, receptacles or furnaces are discharged, shall be provided with a hood connected with an efficient air exhaust ; all vessels or con- tainers in which dry lead in any chemical form or combination referred to in Section 2 is being conveyed from one place to another within the factory shall be equipped, at the places where the same are filled or dis- charged, with hoods having connection with an efficient air-exhaust; and all hoppers, chutes, conveyors, elevators, separators, vents from separators, dumps, pulverizers, chasers, dry-pans or other apparatus for drving pulp lead, dry-pans dump, and all barrel packers and cars or other receptacles into which corrosions are at the time being emptied shall be connected with an efficient dust-collecting system ; such system to be regulated by the discharge of air from a fan, pump or other apparatus, either through a cloth dust-collector having an area of not less than one-half square foot of cloth to every cubic foot of air passing through it per minute, the dust-collector to be placed in a separate room which no employee shall be required or allowed to enter, except for es- sential repairs, while the works are in operation ; or such other appar- atus as will efficiently remove the lead dusts from the air before it is discharged into the outer air. ( b ) Washing Facilities. The employer shall provide a wash room or rooms which shall be separate from the work rooms, be kept clean, and be equipped with : (1) Lavatory basins fitted with waste pipes and two spigots con- veying hot and cold water, or (2) Basins placed in troughs fitted with waste pipes and for each basin two spigots conveying hot and cold water, or (3) Troughs of enamel or similar smooth impervious material fitted with waste pipes, and for every two feet of trough length two spigots conveying hot and cold water. Where basins are provided there shall be at least one basin for every five such employees, and where troughs are provided, at least two feet of trough length for every five such employees. The employer shall also furnish nail brushes and soap, and shall provide at least three clean towels per week for each such employee. A time allowance of not less than ten minutes, at the employer’s expense, shall be made to each such employee for the use of said wash room before the lunch hour and at the close of the day’s work. The employer shall also provide at least one shower bath for every five such employees. The baths shall be approached by wooden run- ways, be provided with movable wooden floor gratings, be supplied with controlled hot and cold water, and be kept clean. The employer shall furnish soap, and shall provide at least two clean bath towels per week for each such employee. An additional time allowance of not less than ten minutes, at the employer’s expense, shall be made to each such employee for the use of said baths at least twice a week at the close of the day’s work. The employer shall keep a record of each time that such baths are used by each employee, which record shall be open to inspection at all reasonable times by the (state department of factory inspection) and also by the (state board of health). (r) Dressing Rooms. The employer shall provide a dressing room or rooms which shall be separate from the work rooms, be furnished with a double sanitary locker or two single sanitary lockers for each such employee, and be kept clean. ( d ) Eating Rooms. The employer shall provide an eating room or eating rooms which shall be separate from the work rooms, be fur- nished with a sufficient number of tables and seats, and be kept clean. No employee shall take or be allowed to take any food or drink of any kind into any work room, nor shall any employee remain or be allowed to remain in any work room during the time allowed for his meals. ( e ) Drinking Fountains. The employer shall provide and main- tain a sufficient number of sanitary drinking fountains readily accessible for the use of the employees. (/) Clothing. The employer shall provide at least two pairs of overalls and two jumpers for each such employee, and repair or renew such clothing when necessary, and wash the same weekly. Such cloth- ing shall be kept exclusively for the use of that employee. (g) Respirators. The employer shall provide, and renew when necessary, at least two reasonably effective respirators for each em- ployee who is engaged in any work or process which produces lead dusts. Section 4. Duties of Employees in Especially Dangerous Works or Processes to Use the Safety Appliances Provided by the Employers. Every employee who, while engaged in any work or process included in Section 2, is exposed to lead dusts, lead fumes or lead solutions, shall : (a) Use the washing -facilities provided by the employer in accord with Section 3 (b) and wash himself at least as often as a time allow- ance is therein granted for such use ; (b) Use the eating room provided by the employer in accord with Section 3 (d), unless the employee goes off the premises for his meals; (c) Remove his ordinary street clothing before commencing work, and put on, and wear at all times while engaged in such work or process, a suit of the clothing provided by the employer in accord with Section 3 (f), and remove the same before leaving at the close of the day’s work ; and keep his street clothes and his working clothes, when not in use, in separate lockers or separate parts of the locker provided by the employer in accord with Section 3 (c) ; (d) Keep clean the respirators provided by the employer in accord with Section 3 (g), and use one at all times while he is engaged in any work or process which produces lead dusts. Section 5. Notices. The employer shall post in a conspicuous place in every work room where any work or process included in Section 2 is carried on, room where washing facilities are provided, dressing room and eating room, a notice of the known dangers arising from such work or process, and simple instructions for avoiding, as far as possible, such dangers. The (chief state factory inspector) shall prepare a notice containing the pro- visions of this Act, and shall furnish, free of cost, a reasonable number of copies thereof to every employer included in Section 2, and the employer shall post copies thereof in the manner hereinabove stated. The notices required in this Section shall be printed in plain type on cardboard, and shall be in English and in such other languages as the circumstances may reasonably require. The contents of such notices shall be explained to every employee by the employer when the said employee enters employment in such work or process, and in addition shall be read to all employees at least once a month, interpreters being provided by the employer when necessary to carry out the above requirements. Section 6. Medical Examination . The employer shall cause every employee who, while engaged in any work or process included in Section 2, is exposed to lead dusts, lead fumes or lead solutions, to be examined at least once a week for the purpose of ascertaining if symptoms of lead poisoning appear in any employee. The employee shall submit himself to the weekly examina- tion and to examination at such other times and places as he may rea- sonably be requested by the employer, and he shall fully and truly answer all questions bearing on lead poisoning asked him by the exam- ining physician. The examinations shall be made by a licensed physician, designated and paid by the employer, and shall be made during the working hours, a time allowance therefor, at the employer’s expense, being made to each employee so examined. Section 7. Record and Reports of Medical Examination . Every physician making any examination under Section 6 and find- ing what he believes to be symptoms of lead poisoning shall enter, in a book to be kept for that purpose in the office of the employer, a record of such examination containing the name and address of the employee so examined, the particular work or process in which he is engaged, the date, place and finding of such examination, and the directions given in each case by the physician. The record shall be open to inspection at all reasonable times by the (state department of factory inspection) and by the (state board of health). Within forty-eight hours after such examination and finding, the examining physician shall send a report thereof in duplicate, one copy to the (state department of factory inspection) and one to the (state board of health). The report shall be on or in conformity with blanks to be prepared and furnished by the (state board of health), free of cost, to every employer included in Section 2, and shall state : (a) Name, occupation and address of employee. (b) Name, business and address of employer. (c) Nature and probable extent of disease. (d) Such other information as may be reasonably required by the (state board of health.) The examining physician shall also, within the said forty-eight hours, report such examination and finding to the employer, and °after five days from such report the employer shall not continue the said em- ployee in any work or process where he will be exposed to lead dusts, lead fumes or lead solutions, nor return the said employee to such work or process without a written permit from a licensed physician. Section 8. Enforcement. The (state department of factory inspection) shall enforce this act and prosecute all violations of the same. The officers, or their agents, of the said (department) shall be allowed at all reasonable times to in- spect any place of employment included in this act. Section 9. Penalties. Every employer who, either personally or through any agent, violates or fails to comply with any provision of Section 1 or Section 3 shall be guilty of a misdemeanor, and on conviction for the first offense shall be fined not less than one hundred dollars nor more than two hundred dollars, and on conviction for the second offense, not less than two hundred dollars nor more than five hundred dollars, and on conviction for each subsequent offense, not less than three hundred dollars nor more than one thousand dollars, and in each case he shall stand com- mitted until such fine and the costs are paid, or until he is otherwise discharged by due process of law. Every employee who violates or fails to comply with any provision of Section 4 shall be guilty of a misdemeanor, and on conviction for the first offense shall be fined not less than ten dollars nor more than twenty dollars, and on conviction for the second offense, not less than twenty dollars nor more than fifty dollars, and on conviction for each subsequent offense not less than thirty dollars nor more than one hun- dred dollars, and in each case he shall stand committed until such fine and the costs are paid, or until he is otherwise discharged by due process of law. Every employer who, either personally or through any agent, violates or fails to comply with any provision of Sections 5, 6 or 7, relating to him, and every employee who violates or fails to comply with the pro- vision of Section 6 relating to him shall be guilty of a misdemeanor, and on conviction thereof shall be fined not less than ten dollars nor more than one hundred dollars. Section 10. Definition. In this act, unless the context otherwise requires, '“employer” includes persons, partnerships and corporations. Section ii. Constitutionality. For the purpose of determining the constitutionality of any provision of this act, Section 1 hereof is declared to be independent of and separable from the remaining sections. Section 12. Time of Taking Effect. This act shall take effect on the first day of October, 1913, except as to subdivisions (a), ( b ), (c) and ( d ) of Section 3 which subdivisions shall take effect as follows : Subdivisions ( b ), (c) and ( d ) of Section 3 on the first day of October, 1914. Subdivision (a) of Section 3 on the first day of October, 1915.