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*
#. * ,
O tº 4 0 * * * > '...' ' ‘. .
American Association for Labor Legislation . . .
131 EAST 23d St., NEw'York city . . .
President, Henry R. SEAGER, Columbia University.
Vice-Presidents * . • 4.
JANE ADDAMS, Chicago MoRTON D. HULL, Chicago.
Louis D. BRANDEIS, Boston, Mass. J. W. Jenks, Ithaca, N. Y.
Robert W. DeForest, New York FREDErick N. JUpson, St. Louis
RICHARD T. ELY, Madison, Wis. PAUL M. WARBURG, New York
SAMUEL GoMPERS, Washington, D. C. WooDRow WILson, Trenton, N. J.
Qº. Secretary, JoHN B. ANDREws, 131 East 23d St., New York.
Assistant Secretary, IRENE OsgooD ANDREws, New York City.
Treasurer, V. EveRIt Macy, New York City.
EXECUTIVE COMMITTEE
t
CHARLEs M. CABor, Boston FREDERICK L. HoFFMAN, Newark
JoBIN CALDER, Detroit, Mich. PAUL U. KELLOGG, New York City
JoHN R. Commons, Madison, Wis. SAMUEL McC. LINDsay, New York
HENRY W. FARNAM, New Haven John MITCHELL, New York City
ERNST FREUND, Chicago CHARLEs P. NEILL, Washington
The President and the Secretary.
MEMBERSHIP AND DUES
Minimum individual membership fee, $3 a year.
Associate members contribute annually $5 to $25.
Contributing members contribute annually $25 to $100.
Sustaining members contribute annually $100 or more.
In addition to the American Labor Legislation Review, which is sent pre-
paid to all members, the quarterly Bulletin of the International Labor Office
will be sent to members paying $5 or more, if specially requested.
Societies and institutions pay $5 or more a year and receive all publications.
Letters of inquiry and membership contributions should be sent to THE
AMERICAN ASSOCIATION FOR LABOR LEGISLATION, JOHN B. ANDREws, Secretary,
I31 East 23d St., New York City.
International Association for Labor Legislation
BASEL, SWITZERLAND.
Serves as a bond of union to all who believe in the necessity for Labor
Legislation.
Facilitates the study of Labor Legislation in all countries and provides in-
formation on the subject.
The International Labor Office publishes a periodical Bulletin in English,
German and French—which contains the text of recent Labor Laws in all
countries, notes on action taken in the various Legislatures, resolutions of
Congresses, and an International Bibliography on Labor Legislation.
NATIONAL SECTIONS
ARGENTINA FINLAND ITALY
AUSTRIA FRANCE NORWAY
BELGIUM GERMANY SPAIN
DENMARK HOLLAND SWEDEN
ENGLAND HUNGARY SWITZERLAND
UNITED STATES
Public Halth
AMERICAN LABOR LEGISLATION REVIEW
Vol. II, No. 2
ILLUSTRATIONS
Dry Sandpapering. Wet Sanding with Pumice Stone. Facing Page 181
Arsenic Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . & Gº ** 188.
Cross Section of Caisson in Full Operation . . . . . . . . “ ** 193
Occupational Skin Diseases ......... p e º e s e e o e e s e 6 & ** 208.
Making Lead Colors. Lead Casting, Showing Lead
Pot in a Smelter . . . . . . . . . . . . . . . . . . . . . . . . . . & & “ 273.
Dust Collectors in a Lead Plant. Emptying a Red-
Lead Furnace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . & & “ 276.
Lead Used as a Hardening Agent. Heading up
Barrels of Dry Red Lead . . . . . . . . . . . . . . . . . . . & & ** 284
Chaser Room in White-Lead Factory . . . . . . . . . . . . & & ** 288
Air-Lock on Top of Caisson . . . . . . . . . . . . . . . . . . . . & & “ 353
Separating Screens in White-Lead Factory ........ & & ** 360
Workers in White-Lead Factory . . . . . . . . . . . . . . . . . & & “ 368.
AMERICAN LABOR LEGISLATION
REVIEW
Vol. II JUNE, 1912 - No. 2
C O N T E N T S -
I. SYMposium on INDUSTRIAL DISEASEs. PAGE
Classification of Occupational Diseases...... W. G. Thompson... 185
Compressed-Air Illness. . . . . . . . . . . . . . . . . . . . FREDERICK L. KEAYs 192
Occupational Skin Diseases. . . . . . . . . . . . . . . . JoBIN A. FoEDYCE. . 206
Occupational Nervous and Mental Diseases...CHARLEs L. DANA... 217
Occupational Eye Diseases. . . . . . . . . . . . . . . . . ELLICE M. ALGER. . 223
Industrial Poisoning. . . . . . . . . . © tº e o e s e s a s s a s DAVID L. EDSALL. . . 231
Cooperation in Promoting Industrial
Hygiene . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HENRY R. SEAGER... 235
GENERAL DISCUSSION . . . . . . . . . . . . . . . . . . . . . . . . . 242
II. INVESTIGATION OF INDUSTRIAL DISEASEs.
Intensive Investigations in Industrial
Hygiene . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F. L. HoFFMAN. . . . 255
Compulsory Reporting by Physicians ...... LEONARD W. HATCH 264
Lead Poisoning in New York City.......... EDWARD E. PRATT. . 273
GENERAL DISCUSSION . . . . . . . . . . . . . . . . . . . . . . . . . 281
III. HEALTH PROBLEMs IN MoDERN INDUSTRY.
- The Function of Hospitals and Clinics in the
Prevention of Industrial Disease. . . . . . . RICHARD CABOT...... 293
Temperature and Humidity in Factories....C.-E. A. WINSLow. . .297
Air Impurities—Dusts, Fumes, and Gases...CHARLEs BASKERVILLE 305
Effects of Confined Air Upon the Health of
Workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . GEORGE M. PRICE. ... 312
GENERAL DISCUSSION . . . . . . . . . . . . . . . . . . . . . . . . . 317
IV. STATE PROMOTION of INDUSTRIAL HYGIENE.
Education for the Prevention of Industrial
Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . M. G. Overlock.... 329
Notification of Occupational Diseases...... CRESSY L. WILBUR. . .339
Medical Inspection of Factories in Illinois. . HARo1.D. K. GIBSON.. 346
Compressed-Air Illness in Caisson Work. ... L. M. RYAN. . . . . . . . 350
Legal Protection for Workers in Unhealthful
Trades . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . John B. ANDREws... 356
GENERAL DISCUSSION . . . . . . . . . . . . . . . . . . . . . . . . . 363
V. BIBLIOGRAPHY on INDUSTRIAL HyGIENE. -
American Titles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369
Titles Other Than American . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 397
The American Labor Legislation Review is published quarterly by the Ameriean Asso-
ciation for Labor Legislation, 131 East 23d St., New York, N. Y. The price is one dollar
per single copy, or three dollars per year in advance. Annual subscription includes indi-
vidual membership in the Association.
z
Public Health
Princeton University Press
Princeton, N. J.
<sº
Ét s *~ --- ** g
/2.4% A4%f
*
84% A Zºm e4a/
7 - 22.3%
DRY SANDPAPERING
DRY SANDING of PAINT is A FREQUENT CAUSE of LEAD Poison ING, THE
OPERATION FILLs THE AIR WITH TINY PARTICLEs of LEAD DUST
WET SANDING WITH PUMICE STONE
Dust is Avoided WHEN SANDING is Doxe witH Wet PUMIce Stone


INTRODUCTION
When the American Association for Labor Legislation called
the First National Conference on Industrial Diseases, in Chicago
in June, 1910, it was possible only to mention the appointment of
the first state commission on occupational diseases and to note the
completion of an investigation of one industrial poison. That
practically marked the extent of serious public interest in disº
eases of occupation, and the first conference attracted attention
to this as to a new problem. Since then there has been a re-
markable development of interest in the subject.
The Memorial on Occupational Diseases, prepared by a com-
mittee of the first conference, laid the foundation for and strongly
urged national investigation of industrial hygiene. One after
another eight states have since then passed the Association for
Labor Legislation’s standard bill requiring physicians to report
all cases of certain diseases of occupation. The work of the one
state commission, in Illinois, led to the enactment of a special
occupational disease law requiring monthly medical examinations
of workmen in a few of the most hazardous employments. In
April, 1912, the United States Congress agreed, by passing the
Association’s bill placing a prohibitive tax on poisonous phos-
phorus matches, to abolish “phossy jaw”, the occupational disease
due to the one industrial poison which had then been thoroughly
studied. In the meantime, the List of Industrial Poisons, pre-
pared by the International Association for Labor Legislation and
translated by the United States Bureau of Labor, gave definite
direction to further investigations. Reports on industrial pois-
oning from lead and mercury have already been published, and
medical inspection of factories has increased in importance.
The Second National Conference on Industrial Diseases, in At-
lantic City, June, 1912, was attended by practicing physicians,
state and federal public health officials, medical inspectors of
factories, physiologists, investigators and statisticians, manu-
facturers, efficiency engineers, insurance experts, labor leaders,
economists, and social workers. Through an industrial hygiene
exhibit, the first extensive display of the kind in America, in-
dustrial processes dangerous to health and the effects of these
peculiar work hazards, including such diseases as “phossy jaw”,
lead poisoning, arsenic poisoning, compressed-air illness and nu-
merous occupational eye and skin diseases, were graphically
placed before the audience. These photographs, charts, . and
drawings were realistically and effectively supplemented by
stereopticon illustrations, made by the new process in color
photography. Finally, through the medium of a joint session
with the American Medical Association, that organization, for the
first time in the sixty-six years of its existence, gave a place to the
industrial disease problem on its annual program.
. There is now scarcely a public meeting of importance for
the discussion of any phase of the labor problem that does not
include at least some mention of occupational diseases. Three
federal bureaus are now making investigations in their own re-
spective fields, and several state commissions, bureaus of factory
inspection, and boards of health are at work upon the problem.
The American Association for Labor Legislation has now pub-
lished and distributed no less than forty papers and reports on
Occupational diseases and industrial hygiene. The publication at
this time, through the cooperation of the Association for Labor
Legislation, the Library of Congress, and the United States
Bureau of Labor, of a special Bibliography on Industrial Hy-
giene, will make further researches less difficult.
The proceedings of the Second National Conference on Indus-
trial Diseases, here made available in permanent form, should give
a new impetus to the nation-wide campaign for the promotion of
industrial hygiene. The members of the Association for Labor
Legislation may well feel that by intelligent cooperation along
definite lines they have made a promising beginning in the im-
portant work of conserving the health and lives of industrial
workers.
JoHN B. ANDREws, Secretary,
American Association for Labor Legislation.
I
SYMPOSIUM ON INDUSTRIAL DISEASES
JOINT SESSION witH THE AMERICAN MEDICAL ASSOCIATION
Presiding Officer: RUPERT BLUE
Surgeon General, United States Public Health
and Marine Hospital Service
WASHINGTON, D. C.
CLASSIFICATION OF OCCUPATIONAL DISEASES
W. GILMAN THoMPSON
Cornell University Medical College.
In order to establish a satisfactory classification of the occupa-
tional diseases and the industrial hazards which give origin to them,
it is necessary to agree upon a standard nomenclature which may
prove not only of scientific value, but constitute a working basis for
such remedial legislation as may prove desirable. The authority
for such nomenclature and classification is properly vested in the
United States Bureau of the Census which, being a national insti-
tution, is better fitted for this work than the local municipal or
state boards of health or labor bureaus. Agreement as to uniform-
ity among the latter would obviously involve much time and dis-
*Cussion, with probably less satisfactory ultimate results. -
The Bureau of the Census already furnishes a generally accepted
classification of the causes of death from ordinary diseases and
includes a number of causes of death from occupational diseases,
about one hundred of which are enumerated in the Mortality
Statistics Bulletin No. 108, 1909, p. 33. But this list is obviously
merely tentative, else why should the making of neckties be included
as hazardous and the caisson disease be omitted, of which, in the
admirable report of Dr. F. L. Keays, twenty fatal cases are re-
corded as occurring within a few years in New York City alone?
Fortunately, the Bureau of the Census is at present cooperating
with the Committee of the American Medical Association on the
Nomenclature and Classification of Diseases, and it is to be hoped
that they will find time to include in this work the formulaton of a
complete classification of the disease hazards and deleterious sub-
stances which are causatively related to the industrial diseases,
irrespective of mortality statistics. As far as these diseases are
themselves concerned, they are fairly well named and classified
already, but not in connection with their causation. For example,
arteriosclerosis or chronic nephritis due to chronic lead poisoning
do not differ materially from the same diseases originating from
I86 American Labor Legislation Review
syphilis, chronic alcoholism, gout and other etiological factors. Nor
does a bronchitis due to inhaling dust in a cotton mill differ essen-
tially from that acquired in other ways. In fact, apart from the
lesions of the caisson disease, and a few of the bone lesions, occupa-
tional tics and palsies, there is little that is new in those of the
diseases of hazardous industries, and little which cannot be included
in existing medical nomenclature as applied to disease in general.
A. HARMFUL SUBSTANCES
The injurious substances employed, however, present a somewhat
more complex problem, mainly because their number is rapidly
increasing, and any system of classification should be an elastic one,
permitting of extension and providing for a large miscellaneous
group. For example, the great majority of injurious substances
may be comprised under the six general headings: (1) Metal
poisons, including the metallic salts; (2) toxic gases, vapors and
fumes; (3) toxic fluids (such as acids and alkalies, petroleum
products, etc.); (4) toxic or irritant dusts, subdivided into:
(a) insoluble inorganic dusts (irritating the respiratory passages),
(b) soluble inorganic dusts (liable to be swallowed and absorbed),
(c) organic dusts and fibers; (5) organic germs (such as those of
glanders and anthrax); and (6) miscellaneous irritants.
Under these major headings may be grouped practically all of
the irritant substances, yet certain difficulties arise even in this
elementary arrangement. For example, lead, which of course would
be classed as a simple metal poison, is also, when heated, to be
ranked among the toxic fumes, and again, in the form of filings, as
a soluble inorganic dust. As this applies to many of the other
metals, to repeat them all under each subheading would be cumber-
some. Phosphorus, for instance, is a metal, yet it is as a toxic
fume that it works such havoc, and it had better be classed with the
latter.
Furthermore, the names of many substances may convey no inti-
mation of their special hazards. For example, whether ferrosili-
con be classed among the metals as containing iron and traces of
arsenic, or as a liquid, since by itself it is non-toxic, neither of these
groups would suggest its real hazard, which consists in the acci-
dental access of water, producing the combination arseniuretted
hydrogen gas that has cost many lives, especially on ships in which
the ferrosilicon was being transported.
Classification of Occupational Diseases 187
For such reasons, it would seem best to class each substance
primarily in the major group which its most common form and use
suggest, and, when its common name conveys no idea of the hazard,
to indicate the latter in parenthesis. Thus ferrosilicon would be
grouped under toxic liquids, and a parenthesis should follow,
reading “(arseniuretted hydrogen gas, on hydration)”.
B. HARMFUL ConDITIONS OF PHYSICAL ENVIRONMENT
The above general classification refers only to the material haz-
ards, so to speak, and does not provide for the injuries arising from
environmental or physical conditions, such as the air compression
affecting tunnel and caisson workers and divers, the rarefied air af-
fecting aviators, or the tunnel injuries to the ears. Nor does it pro-
vide for the injuries arising from excessive temperature changes as
affecting smelter employees, stokers, workers in cold-storage, etc. A
group, therefore, of hazardous occupations due to physical environ-
ment should be established, including hazards from excessive varia-
tions in (a) air pressure, (b) humidity, (c) air temperature, and
(d) light (including electric light, the X-ray, etc.).
C. INJURIES (MEDICAL) To NERVES, MUSCLES, AND BONES
Another general group of occupational hazards is necessary to
comprise disease injuries to nerves, muscles, and bones, arising from
such conditions às occupational strain, fatigue, repeated blows and
vibrations, excessive pressure, repeated muscular contractions, and
faulty positions assumed in working at benches, handling many
forms of tools, etc. The large group of “occupational neuroses”,
with cramps, palsy, tremors, tics, neuralgia, neuritis, and vaso-motor
disorders, should be included as subdivisions of this group. To this
also may be added a subclass comprising insomnia, headache, general
nervousness as from “speeding up”, etc.
D. INJURIES OF SPECIAL ORGANs
Other primary groups of occupational diseases should include
injuries of special organs: namely, (I) injuries to the skin; (2)
injuries to the eyes; (3) injuries to the ears; and (4) injuries to
the nose and throat.
Under the foregoing general classification, with appropriate sub-
divisions, may be included all the specific causes of occupational
diseases, namely, the (a) material, (b) chemical, (c) physical,
and (d) physiological causes.
I88 American Labor Legislation Review
CLASSIFICATION OF HAZARDOUs OCCUPATIONS
There remains to be dealt with the classification of hazardous
occupations, which is, from every point of view, a far more difficult
task. While it is true that some few definite occupations, like that
of the caisson and tunnel workers, each produce a single definite
disease from a single definite cause, very many industries are SO.
complex as to give rise to many different hazards and as many dif-
ferent diseases. A classification which fails to make this clear fails
of its primary object, and is not alone useless but may prove unfair
as a basis for remedial legislation or scientific deductions. But to
specify all the subdivisions of labor in a complex industry is to
accumulate a catalogue of many thousands of technical terms and
easily to become lost in a maze of phraseology. It is precisely in
this understanding of technical work that physicians as a body
need education, for upon them must devolve the collection of
disease data, if such data are to be confirmed by accurate diagnoses.
It is not customary, as yet, to give systematic instruction in medical
colleges upon occupational diseases. Most of the standard text-
books on medicine refer to scarcely a half dozen of the industrial
poisons, such as lead or arsenic, and the literature of this topic
adapted for use in this country is scattered mainly in isolated
monographs and a few brief journal articles. º
One or two illustrations will serve to emphasize the difficulties of
properly classifying the occupations involving disease hazards. If
a workman be classed merely as a “potter” he may be employed in
glazing or polishing and acquire lead poisoning; or, as in the Limoge
works in France, he may be a grinder subject to inhalation of silica
dust, and may acquire fibroid phthisis and subsequently tuberculosis;
or as a molder he may be exposed to constant humidity and may
suffer from rheumatism or chronic bronchitis. Obviously, to class
him solely as a potter supplies information so incomplete as to be
almost useless. Other terms are still more ambiguous. For example,
a “hatter” may be engaged in the non-hazardous occupation of selling
hats, may be a maker of straw hats, associated either with no hazardſ
or with the minor one of using some bleaching substance or inhaling
straw dust, or may be a man who is employed in making felt hats.
This latter industry is so subdivided that the man may rank as a
blocker, blower, pouncer, flanger, curler, shearer, stiffener, singer,
trimmer, coner, dyer, dryer, feeder, hardener, mixer, welter, or
2.
ARSENIC POISONING
1. PUTTING PARIS GREEN INTo A Bolter. AN OLD AND DANGErous Method
2. A CoMPARAtively Dustless Bolter. REspirators Worx. As AN ADDITIONAL
Protection

Classification of Occupational Diseases 189
finisher. In about half of these labors he would be subject to no
Mazard whatever, as for instance if he be a curler or finisher; but
if he be a fur-cutter, “maker” or sizer he is very susceptible to bron-
chial irritation and liable to add to the tuberculosis mortality. If,
on the other hand, he be a pouncer he is almost certain to acquire
chronic mercurial poisoning and sooner or later to become wholly
incapacitated for work, and he may possibly die as a result of his
labor.
In confirmation of the lack of information among manufacturers,
or of their much worse willful neglect of the humanitarian interest
which they ought to exercise, is the common observation of all who
have made special investigations in lead poisoning that the manu-
facturers almost universally profess ignorance as to its existence, at
least in their own establishments. Yet in New York State, Dr. John
B. Andrews has compiled data of sixty cases of death from this
cause occurring within the two years IQ09 and 1910, and I have
personally collected data from only two hospitals and one dispensary
in New York City of over three hundred cases of lead poisoning so
serious as to demand hospital treatment, and sometimes to produce
permanent disability.
Before a standard classification of occupational diseases is adopted,
attention should be given to the educational needs of the situation.
A classification which is too elaborate may fail of its chief purpose,
which is to interest physicians in this important humanitarian,
scientific, and legislative work, i. e. the control and mitigation of
the Occupational disease hazards. It is desirable, therefore, to
furnish physicians and employers with a simple general classifica-
tion, after the form outlined in this article, and to supplement it
with a more elaborate classification to be supplied to special investi-
gators in hospitals and dispensaries, or to those who have access to
the study of large groups of cases. It is clearly undesirable that
hasty or unfair legislation, based on insufficient data, should be
enacted, and it is therefore of the greatest importance that physi-
cians everywhere enter into hearty cooperation with the state
authorities in the collection of accurate statistics which shall be of
true scientific value.
A beginning has been made in eight states by the enactment of
laws requiring physicians to report six of the occupational diseases,
namely, those due to four metals, lead, arsenic, mercury, and phos-
I90 American Labor Legislation Review
phorus, to one germ, the anthrax bacillus, and the caisson disease.
This list will doubtless be extended considerably in the near future,
and among the first additions should be wood-alchohol poisoning.
This substance is used to dissolve the shellac for varnish which is
often applied in confined spaces, such as the linings of brewery vats,
where the alcohol fumes accumulate. There were two deaths and
a case of permanent blindness from this cause in Buffalo recently,
and three other deaths, the last one of which was diagnosed by the
physician who was summoned as a case of “epilepsy”, occurred in
a brewer’s vat in New York.
As an aid to meet the educational requirements of classification
in New York State, I have furnished the state labor bureau with
a brief general classification of occupational hazards and harmful
substances, which is printed on the backs of the notification blanks
required by law to be sent to each physician. I also furnished a
more elaborate classification which is printed in small booklet form
and is designed for distribution to hospitals and dispensaries, social
service workers, and all physicians who will take interest enough to
gather special data. As far as possible this classification is arranged
in four parallel columns, headed respectively “Industry”, “Harmful
Substance”, “Mode of Entrance”, “Symptoms and Diagnosis.”
For my own use and that of my assistants in hospital and dispen-
sary work, I have designed history cards with headings calling for
classified data, one set for the metal poisons, another for the dust
and fiber irritants, etc. From such uniformly classified cards it is
easy to compile Scientific data for any particular group of diseases.
CoNCLUSION
In conclusion, I would recommend (I) that the Bureau of the
Census establish a uniform nomenclature and classification as com-
plete as possible, to be used as a mational standard; and (2) that
the state labor bureaus or health boards issue a standard notification
blank like the one in use in New York State, which is modeled after
the national death certificate blank of the Bureau of the Census. On
the back of this blank should be printed a brief working classifica-
tion of the commoner occupational hazards and harmful substances,
emphasizing in black letters the most important ones. And I would
also recommend (3) that there should similarly be issued to all who
will make use of it, a more comprehensive classification in booklet
Classification of Occupational Diseases I9I
form, detailing the symptoms in parallel columns with the injurious
substances liable to produce them.
GENERAL CLASSIFICATION OF OCCUPATIONAL DISEASES
AND HARMFUL SUBSTANCES
A. Harmful Substances:
I. Metallic poisons.
2. Toxic gases, vapors, and fumes.
3. Toxic fluids (acids, alkalies, dyes, etc.).
4. Irritant dusts and fibers. •
(a) Insoluble inorganic dusts.
(b) Soluble inorganic dusts.
(c) Organic dusts and fibers.
5. Organic germs (anthrax, glanders, etc.).
6. Miscellaneous irritants.
B. Harmful Conditions of Environment:
I. Air compression and rarefaction.
2. Excessive humidity.
3. Extreme heat and cold.
4. Excessive light (electric, X-ray, etc.).
C. Occupational Injuries:
(Medical)
I. Injuries to nerves, muscles and bones.
(Strain, fatigue, cramp, faulty positions, “occupational
neuroses”, blows, vibrations, pressure, etc.]
2. Injuries to the eyes.
3. Injuries to the ears.
4. Injuries to the nose and throat.
5. Injuries to the skin.
OCCUPATIONAL DISEASEs of THE
. Blood.
. Circulatory system.
. Respiratory system.
Nervous system.
Digestive system.
. Muscular system.
Cutaneous system.
. Urinary system.
. Special sense organs.
I
COMPRESSED-AIR ILLNESS
FREDERICK L. KEAYS
Cornell University Medical College.
This paper is based largely upon a report, made by the writer in
I909*, of 3692 cases of compressed-air illness which resulted at the
Pennsylvania East River Tunnels during the time that he was medi-
cal director. It will present a brief general description of the subject
of compressed-air illness, special attention being paid to its cause
and to its prevention.
Triger,” a French engineer, who designed the first practical caisson
in 1839, mentioned the occurrence of pains in the extremities of
workmen employed. In 1868, Le Roy de Méricourt” published
the first medical report of illness among sponge-divers. Since
Triger's report many contributions have been made to the subject
of compressed-air illness. A full review of the literature of the
subject may be found in Caisson Sickness by Leonard Hill, a book
published this year. z
ETIOLOGY--CAUSEs
Various theories have been advanced to explain the symptoms
occurring among compressed-air workers. The earliest theory to
receive general recognition was that advocated by Pol and Wattelle"
in 1854, the so-called mechanical-congestion theory. In 1878
Paul Bert" proposed the theory, supporting it by logical reason-
ing and by experiments, which is now universally accepted. It is
* Keays, “Compressed-Air Illness, With a Report of 3692 Cases,” Researches
from the Department of Medicine, Publications of Cornell University Medi-
cal College, Vol. II, pp. I-55.
* Triger, “Compte rendus,” Acad. des Sciences, 1841, tome XIII, p. 884
* De Méricourt, Bull. de l'Académie de Méd., 1868, XXXIII. Ann. d’Hygiene
Publ. et de Méd. Légale, 1869, second series, XXXI.
* Pol and Wattelle, “Memoire sur les Effets de la Compression de l'Air.”
Annal. d’Hyg. Publique et de Méd. Légale. Paris, 1854.
* Bert, La Pression Barométrique. Paris, 1878.
d
*--------
CROSS SECTION OF CAISSON IN FULL OPERATION
WoRKERs (“SAND Hogs") At Bottom of CAIsson WoRK UNDER AT Mospheric
Pressure SUFFICIENT to PREVENT WATER FROM Flowing
IN. As SAND is SHovelled UP
Too RAPID DEcoMPREssion, As IN GoING SUDDENLY out INTo THE Norm AL
At MospherE, CAUSEs CoMPREssen-AIR ILLNEss




Compressed-Air Illness I93
a surprising fact that Bert's explanation was practically disregarded
for several years, while the mechanical-congestion theory continued
to be accepted, especially by the early American writers.
Briefly stated, Bert's theory is as follows: The blood of a man or
of an animal, when in compressed air, takes into solution an in-
creased quantity of oxygen and nitrogen from the air, the quantity
of the gases absorbed being in direct proportion to the increase of
pressure. The gases taken up by the blood are gradually distributed
to the fluids of the various tissues. With rapid decompression the
nitrogen gas bubbles off in the blood. These bubbles act as emboli,
block up the capillaries in one or another part of the body and, by
cutting off the blood supply or by direct mechanical violence, cause
the symptoms of compressed-air illness. Symptoms of illness may
be prevented by making decompression slow enough to allow the
absorbed nitrogen to escape from the lungs. Further experimenta-
tion by Von Schrötter,” Hill and his associates," and others, have
confirmed his theory. Post-mortem findings, moreover, in many fatal
cases of compressed-air illness, both in men and in animals, give
conclusive proof that this theory is correct.
From this theory, as well as from practical experience, the chief
etiological factors have been deduced as follows: (1) In general,
the higher the pressure, the greater the chances of illness; (2)
the longer the time of pressure, the greater the chances of illness;
and (3) the more rapid the decompression, the greater the chances
of illness.
Let us now consider these three factors in brief detail.
I. The degree of pressure.—Practical experience has shown that
cases of compressed-air illness seldom happen at pressures up to
fifteen pounds per square inch above normal.” Fatal cases seldom
result from pressures below thirty pounds. The lowest pressure
from which death has been reported is twenty-one pounds, and there
seems to be some doubt as to the authenticity of this report. Among
“Heller, Mager and von Schrötter, Die Luftdruckerkrankungen, Vienna,
I900.
"Hill and Macleod, “Caisson Disease and Diver's Palsy,” Journal of Hy-
giene, 1903, p. 401; Hill and Greenwood, Proceedings Royal Society, B. Vol.
77, p. 442, 1906; Vol. 79, p. 21 and p. 284, 1907.
*The figures in regard to pressure given in this paper all refer to the
number of pounds per square inch above normal atmospheric pressure, which
is a little less than 15 pounds.
I94 American Labor Legislation Review
twenty fatal cases of compressed-air illness resulting at the Pennsyl-
vania East River Tunnels, only two were caused by pressures below
thirty pounds, one at twenty-eight pounds, the other at twenty-nine
pounds. The following table, taken at random from the records of
the Pennsylvania East River Tunnels, illustrates the influence of
only slight additions of pressure upon the percentage of cases of
illness, when pressures in the neighborhood of thirty pounds were
being used.
TUNNEL A. MANHATTAN SITE.

Average Pres- No. Cases of
Number of Length & Per
* * sure Above | Comp.-Air
Month Man-shifts of Shifts Normal Illness Cent
Jan. *07 3751 8 hours 28.5 lbs. 7 .18–H
y 6 hours
Feb. '07 4141 (2-3 hr. periods) 31 lbs. 25 .60+
Mar. 07 4902 . {{ 31.5 lbs. 33 .67–H
Apr. '07 4018 {{ 32 lbs. 39 .97+
It may be stated that, with other conditions the same, the number
of cases of illness will depend directly upon the degree of pressure.
2. The time under pressure.—When pressures of one atmos-
phere or more are being used, the time spent under pressure is an
important etiological factor. It is obvious that if less time is spent
in compressed air than is necessary for complete saturation of the
body fluids, the chances of symptoms developing upon decompres-
sion will be less than if that time is equalled or exceeded. The
exact time in which complete body saturation takes place has never
been determined. No doubt it varies in different individuals. It is
certainly hastened by work and exercise. Some parts of the body
saturate quickly and others slowly. Fat especially saturates slowly,
both on account of its poor blood supply and because it has the
property of absorbing about six times as much nitrogen as the other
body fluids. Haldane and Boycott” estimated that half saturation
of the body occurs in about twenty-five minutes, and almost full
saturation in about ninety minutes.
* Boycott, Damant and Haldane, “The Prevention of Compressed-Air Ill-
ness,” Journal of Hygiene, Vol. VIII, No. 3, June, 1908.
Compressed-Air Illness I95
In the Pennsylvania East River Tunnels, when pressures of
30 lbs. and more were being used, all new men, before being allowed
to work, were given a preliminary test at the prevailing tunnel pres-
sure which lasted 90 minutes, decompression being at the rate of
two pounds per minute. In 2719 preliminary tests only three cases
of compressed-air illness were encountered. Two of these were
mild cases of pain, and the third was a case of paralysis of the lower
extremities. After the preliminary test, those who took it satis-
factorily were allowed to work 90 minutes when six-hour shifts
were in progress. In 2000 men who worked for 90 minutes in
pressures averaging 32 lbs., seven cases of compressed-air ill-
ness resulted, all being mild cases. The small number of cases in
the former group would indicate that complete Saturation had not
taken place in 90 minutes. The influence of work in hastening .
absorption would account for the increased number of cases in the
latter group.
The following table, made up from the records of the Pennsyl-
vania East River Tunnels, throws some practical light upon the
question of the time of nearly complete body saturation and of the
effect of work, and also indicates the effect of fatigue, as shown by
a comparison of the number of cases following the first and the
second three-hour periods of six-hour daily shifts:

Cases of
Average Cºir
Pressure | Time under | Number of In eS
(estimated) Pressure Men No. Per cent. Remarks
2719
Preliminary 2 cases ordinary pain.
31 lbs. 1% hours test, not 8 0.18+ || case paralysis legs.
working
2000 (estim- All ordi
32 lbs. 1% hours ated) 7 || 0.35–H ordinary cases
"Working (pain, vertigo, etc.)
6000 (estim- 1 case pain and prostra-
29 lbs. 2 hours ated) 13 0.21+ tion, not severe.
Working Rest, ordinary cases.
3 hours #. §k : fatal. d
orking B. pain and prostration.
88 lbs. 1st *. 6-hr. D. Tunnels, 152 0.85+ || partial paralysis.
Shift Manhattan Rest, ordinary cases.
3 hours ; *** prostration
33 lbs. 2nd ; 6-hr. {{ 317 | 0.72–H 1 partial paralysis.
shift Rest, ordinary cases.
196 American Labor Legislation Review
The decreased percentage of cases of illness from two hours
work, as compared with that from one and one-half hours work,
is accounted for by the lower pressures in the former case. At
the same pressure, other factors being equal, two hours work
would probably be followed by more cases than one and one-half
hours work. In comparing results from three-hour shifts with
those from one and one-half and two-hour shifts, it should be noted
that in the former case the percentages were based chiefly upon
old workmen; but in the latter the percentages were based entirely
upon new men.
3. The time of decompression.—All authorities agree that the
rate of decompression is a most important factor in determining
the number of cases of compressed-air illness, as well as in de-
termining their severity. During decompression the absorbed gases
are liberated from the body fluids and blood in the form of bubbles,
and are excreted through the lungs. The rapidity with which these
gases are set free, and the size of the gas bubbles, depend directly
upon the rate at which the pressure is removed. Consequently
rapid decompression increases the chances of illness and slow decom-
pression diminishes them. It is not known how long it takes for
complete desaturation; like saturation it probably differs in indi-
viduals. The practical problem is to find, if possible, a safe rate
of decompression. From practical experience it has been learned
that with pressures up to I5 or 20 lbs. rapid decompression seldom
gives rise to any symptoms, and probably never, even after long
exposures of six to eight hours, to those due to large quantities of
free gas in the circulatory system. An explanation of this, which
appears logical, is that at these pressures not enough gases can be
absorbed to embarrass the circulation even when suddenly liberated.
That rapid decompression from pressures of four or more atmos-
pheres is more dangerous than slow decompression has been re-
peatedly demonstrated in animal experimentation.
Bert concluded, from experiments with animals, that all trouble
could be avoided by allowing thirty minutes for decompression from
pressures between two and three atmospheres and sixty minutes for
decompression from pressures between three and four atmospheres.
Von Schrötter considers an allowance of twenty minutes per atmos-
phere safe; and Hill and his associates found twenty minutes per
atmosphere safe for a large number of animals exposed to satur-
Compressed-Air Illness I97
ation. Haldane,” on the other hand, advocates the interrupted or
stage method of decompression. Starting from the fact that rapid
decompression from 19 lbs. to normal atmospheric pressure is com-
paratively safe, he argued that it would be correspondingly safe to
decompress rapidly from four to two atmospheres, or from six
to three atmospheres, and he found this true in a series of experi-
ments with animals. He proposes the following rate of decompres-
sion for caisson and tunnel work:

Number of Minutes for each Pound of Decompression
Working Pressure after the First Rapid Stage.
in Pounds per After second or
s f
Square Inch After first 8 hours' third 3 hours' ex- m:*...*.
exposure posure following an 8XOOSULTO
interval for a meal. p
18–20 2 3 5
21-24 3 5 7
25–29 5 7 8
30–34 6 7 9
35–39 7 8 9 .
40–45 7 8 9
His first rapid stage of decompression reduces the pressure in
about three minutes to a point equal to one-half the actual pressure.
To illustrate, if the working pressure is 40 lbs., the actual pressure
equals 55 lbs. One-half of 55 or 27.5 equals the actual pressure, or
I2.5 lbs. equals the gage pressure. Applying this table to decom-
pression from 40 lbs., one would reduce the pressure in about three
minutes to I2.5 lbs. and then allow 87.5 minutes for decompression
after the first three hours’ exposure.
Haldane presents strong theoretical reasons in proof of the advan-
tages of the stage method of decompression. In his own experiments
with goats, however, the beneficial results of stage decompression, as
compared with the uniform decompression of equal time, are less ap-
parent than the theory would lead one to expect. Hill and Green-
wood” tested the effects of uniform and stage decompression on pigs
without showing any decided advantage for the latter method. Hill
says: “The conclusion to be drawn, then, from experiments on ani-
mals is that there is evidence in favor of stage decompression after
* Haldane, “The Hygiene of Work in Compressed Air,” Journal of the
Society of Arts. Vol. XVI, p. 214. Jan. 1908.
* Hill, Caisson Sickness, Longmans, N. Y., 1912,
198 American Labor Legislation Review
short exposures, but no decisive evidence of its superiority after long
exposures. The theory is a captivating one, but experiment has not
brought that conclusive support which was to be expected.” In this
statement by short exposures is meant periods of one hundred and
twenty minutes or less. -
Bornstein compared the effects of stage and uniform methods at
the Elbe Tunnel Works, Hamburg, (two atmospheres), with the
following results:

Days Workers Cases of Illness
20 stage 526 15
16 uniform 528 17
18 stage 529 12
16 uniform 529 14
14 stage 536 12
The percentage on the basis of man-shifts for the stage method
is o.15; and for the uniform method o.19. These results show only
a slight advantage for stage decompression, but they are not con-
clusive.
It would seem, then, that in the case of men working long periods
in compressed air in pressures above 20 lbs., the question of the time
taken for decompression is of more importance than the question
of the method of decompression. Hill claims that exercise and the
breathing of oxygen, both of which aid in the elimination of nitrogen
gas, during decompression will safely permit of the reduction by
at least one-half of the times of decompression advocated by Hal-
dane.
In the Pennsylvania East River Tunnels, during a period of five
hundred and fifty-seven days, with about one thousand men a day
working in compressed air at pressures varying from 15 lbs. to 36
lbs., and a decompression period at the rate of one minute for each
two pounds of pressure, there were reported to the medical depart-
ment 3692 cases of compressed-air illness with twenty deaths. About
ten thousand different men in all worked during this time. On the
basis of the number of men working, the percentage of illness was
36.92 and the percentage of fatal cases O.2. On the basis of man-
shifts, estimating one thousand men a day for five hundred and
fifty-seven days, or 557,000 man-shifts, the percentage of illness was
o.66 and the percentage of death ooo35. The substitution of the
C ompressed-Air Illness I99
rate of decompression now required by the New York State law
for tunnel work, of three pounds every two minutes up to 36 lbs.
and of one pound per minute for pressure above 36 lbs., would no
doubt have reduced the number of cases of illness, as well as the
number of serious and fatal cases, but it seems highly improbable
that it would have prevented all illness and death.
In considering the etiology of compressed-air illness it must be re-
membered that, beside the questions of pressure, time of compression,
and rate of decompression, there are many other factors to be reck-
oned with, which might be called predisposing causes. Briefly stated
these are as follows: -
Age.—Boys, on account of underdevelopment, and men past forty
are generally acknowledged to be bad subjects for compressed-air
work.
Build.—Fat individuals are bad risks in compressed-air work and
should be avoided.
Organic disease.—Persons with organic disease should not be sub-
jected to work in compressed air because, even if they are not more
susceptible to compressed-air illness, they are certainly less able than
those with normal organs to stand the effects of such illness.
Alcoholism.—Alcoholics are bad risks for the same reason that
those with organic disease are bad risks. -
Newness to work.-‘‘Green” men are more likely to have symptoms
of compressed-air illness than old workmen.
Fatigue.—This appears to play a decided part in the causation of
compressed-air illness.
Ventilation.—CO, within reasonable limits probably has no effect.
Poisonous gases, such as CO and H2S, may play a part in etiology.
The personal element.—This is a factor which I believe plays a
large part in the causation of compressed-air illness. I have used
this term for want of something more definite. Just what conditions
may exist to make certain individuals susceptible to compressed-air
illness or to cause those who have apparently been immune suddenly
to develop symptoms, sometimes serious, I cannot say. It has seemed
to me probable that certain individuals may lack the ability to ex-
crete the gases from the blood at the physiological rate during decom-
pression and that such a condition may arise at any time in men who
have been free from it. In my experience I have found that certain
men, who from careful examination appeared especially fit subjects,
2OO American Labor Legislation Review
fell easy victims to the effects of compressed air. In the work on the
Pennsylvania East River Tunnels several old workmen had fatal ill-
nesses while working under apparently the same conditions under
which they had worked safely for months.
SYMPTOMS
The time is too short to allow of a detailed report in this paper
of the symptoms of compressed-air illness. They are various in
form and depend first upon the amount of gas set free in the blood,
and second upon what organs are affected by the gas emboli. In
many cases, as when soft tissues or unimportant organs are in-
volved, gas emboli will give no symptoms. A small gas bubble
causes pain when present in some unyielding tissue, such as nerve
sheath or periosteum; it causes vertigo when in the semicircular
canal; paralysis when in a motor area of the spinal cord; and Sud-
den death when in a vital center of the medulla, or possibly in the
coronary artery. Large accumulations of gas in the blood stream
cause general pains and prostration, and in extreme cases collapse,
coma, and sudden death.
In my study of 3692 cases I made the following classification,
giving the number and percentage of cases falling under each
group, as follows:
No. Per cent
A.—Cases showing pain in various parts of the
body, “bends” . . . . . . . . . . . . . . . . . . . . . . 3278 88.78–H
Cases with pain also having local manifes-
tations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 .26–H
B.—Cases showing pain and prostration...... 47 I.26–H
C.—Cases showing symptoms referable to the
central nervous system:
I. Brain (hemiplegia)........ . . . . . . . 4 .II+
2. Spinal cord:
(a) Sensory disturbance . . . . . . . . . . . 36
(b) Motor disturbances . . . . . . . . . . . 34
(c) Sensory and motor disturbance .. IO
Total (Spinal cord) . . . . . . . . . . . . . 8O 2.I6+
D.—Cases showing vertigo, “staggers” . . . . . . . I97 5.33+
E.—Cases showing dyspnoea and sense of con-
striction of the chest, “chokes” . . . . . . . . 60 I.62
Compressed-Air Illness 2OI
F.—Cases showing partial or complete uncon-
sciousness with collapse . . . . . . . . . . . . . . 17 .46–H
Grand total . . . . . . . . . . . . . . . . . . . . 3692 99.98–H
Group B. . . . . . . . . . . . . . 6
Fatal e- Group C. . . . . . . . . . . . . . 5
Group F. . . . . . . . . . . . . . 9
2O or .54+ per cent.
PATHOLOGY
The results of autopsy in fatal cases have fallen largely under
two classes: first, those which died after long illnesses and showed
lesions of the spinal cord, such as disseminated and transverse
myelitis and hemorrhage, with consequent complications, such as
pneumonia, cystitis, pyonephritis, bed Sores, etc.; and second, those
which died soon after decompression, many of which showed the
presence in greater or less degree of free gas in the circulatory sys-
tem. Von Schrötter, in an analysis of one hundred and thirty-seven
fatal cases reported between the years 1854 and 1897, found twenty
reported autopsies showing lesions of the spinal cord and their
complications, and eighteen reported autopsies in rapidly fatal cases
of which eleven showed the presence of free gas in the circulatory
system. In the twenty fatal cases reported by me, five fell within
the first group, and of these two came to autopsy and showed lesions
of the cord and complications; fourteen fell within the second group
and of these, in twelve autopsies reported, eight showed the presence
of free gas in greater or less degree in the circulatory system. In
cases of sudden death, when no discoverable lesions have been
found, it seems fair to suppose that death has been due to the in-
volvement of vital centers by emboli too small to be detected. In
several of our fatal cases no sign of organic disease could be found.
TREATMENT
Recompression is the most efficient means of treatment. This was
recommended by Pol and Wattelle in 1854; Bert demonstrated its
value in animal experimentation about 1871; and Mr. E. W. Moir
made the first practical use of the medical lock at the old Hudson
2O2 American Labor Legislation Review
River Tunnel. He there proved its efficiency, thus making it a
necessary equipment in caisson and tunnel work.
The medical air-lock, as used on the Pennsylvania East River Tun-
nels, consisted of an air-tight steel cylinder about six feet in diameter
and twelve feet in length, closed at one end. At the other end was
an entrance by means of an air-tight door which opened inwards.
The cylinder was divided into two compartments by means of a
transverse partition, which had a door opening toward the inner
compartment. Compressed-air pipes and outlet valves supplied both
chambers, so that the pressure could be raised or lowered from either
chamber. This arrangement enabled the physician or attendant to
enter or leave the chamber in which the patient was being treated
without disturbing the pressure of that chamber. Valves were also
placed outside the lock so that the pressure could be regulated from
without. The inner chamber was fitted with two bunks, one on either
side, upon which patients could lie, and with electric lights, telephone,
clock, pressure gage, thermometer, and electric heater. A means of
ventilating the inner chamber was also supplied. Heavy glass win-
dows were placed on a line in both doors so that one could watch
from outside the patient, pressure gage, and thermometer.
Recompression should be instituted as soon as possible after the
appearance of symptoms, the pressure being raised quickly to the
working pressure. Relief of symptoms, when afforded, usually
occurs before this point is reached. Soon after reaching full tunnel
pressure decompression should be begun at a rate not less than one
pound per minute, and in severe cases much more slowly. At the
Pennsylvania East River Tunnels we thought our results were best
when decompression was made rather quickly down to IO or 15 lbs.,
and then continued very slowly. During decompression the patient,
if able to do so, should move about and exercise the affected part.
In severe cases massage and passive movements should be admin-
istered by an attendant, and in unconscious cases artificial respira-
tion should also be performed. If symptoms return after one recom-
pression, a second recompression should be made. We sometimes
had to recompress three or four times before permanent relief was
obtained. In cases of simple pain, where there is a return of symp-
toms after recompression, relief, frequently permanent, may be
obtained by the use of counter-irritation with linaments, the vibrator,
or the Faradic current, or by hot applications. A hot bath for the
Compressed-Air Illness 2O3
return of pain after recompression is beneficial, but would hardly be
indicated in cases where there is prostration.
The results of treatment in 3692 cases in the Pennsylvania East
River Tunnels were as follows:
In 3278 cases of pain in various parts of the body about 90 per
cent got relief from one or more recompressions. Recompression
failed to give any relief in only about .5 per cent of the cases of
this class, and in some of these the failure was undoubtedly due to
improper recompression or to failure of the patient to exercise while
decompressing.
In forty-seven cases of pain and prostration, thirty-eight were re-
lieved or cured by recompression, all ultimately recovering, but six
had only temporary improvement and died. The other three refused
the medical lock, and recovered after illnesses of about a week.
In eighty cases with symptoms referable to the central nervous
system the results were as follows:—
Four cases of hemiplegia were all cleared up permanently by re-
compression; of thirty-six cases of sensory disturbance, thirty-four
were relieved by recompression, two refused the medical lock
and were improved by medical treatment; of thirty-four cases of
motor disturbance, partial or complete paralysis of the legs, twenty-
three were benefited by recompression and either cleared up at once
or recovered later, in eleven recompression caused no improvement
and of these five ultimately died, three had permanent spastic
paraplegia, and three were lost sight of; of ten cases of sensory
and motor disturbance, nine were permanently relieved, and one was
improved, but the final result was not learned.
In one hundred and ninety-seven cases showing vertigo, with or
without vomiting, pain, prostration and dyspnoea, one hundred and
eight had complete relief from recompression, eighty-two had par-
tial relief from recompression, and seven refused the medical lock.
In sixty cases of dyspnoea and sense of constriction of the chest,
all cleared up with one recompression except two which required a
second recompression.
In seventeen cases of partial or complete unconsciousness and
collapse eight were cured or relieved by one or more recompressions,
but nine had little or no relief and died. Oxygen given to several
of these severe cases during decompression afforded no appreciable
benefit.
2O4 American Labor Legislation Review
PREVENTION of CoMPRESSED-AIR ILLNESS
How to prevent compressed-air illness is a most important ques-
tion. Modern demands in engineering require the use of compressed
air. Recompression, while an efficient means of treatment in mild
cases, often fails to prevent disability and death in severe ones. If
high pressures are to be used, all means should be employed to
prevent illness. These should consist of thorough medical examin-
ations of workmen and especially of new candidates. In cases
where “green” men must work in high pressures, 25 lbs. or over,
preliminary tests should be given and, if satisfactorily passed, a short
working shift should first be tried. Careful supervision of the
workmen should be exercised, and occasional reexaminations made,
especially after any absence from work. The men should be instruct-
ed as to the dangers of rapid decompression, should be made to
move about during and after decompression, and should be warned
that neglect to seek medical advice at once upon the appearance of
any symptoms may result disastrously. They should also be in-
formed of the bad effects of excesses of all kinds, of improper hy-
giene, and of intercurrent illness.
The following table indicates briefly what can be done by medical
examination and proper supervision to eliminate the predisposing
causes mentioned under the subject of etiology:
Predisposing factors Can be prevented
Age (improper) Yes
Build (fat) Yes
Organic disease To a large extent
Alcoholism To a large extent
Newness to work Partly -
Fatigue No
Ventilation (bad) To a large extent
Personal element - No, not with our present knowl-
edge.
The chief means of preventing illness must be found in the ar-
rangement of shifts and decompression periods to suit the pressures.
In this connection we find the old conflict between labor and capital.
The workman is willing to reduce the shift but rebels at what seems
to him an unnecessary time for decompression. The contractor, on
the other hand, desires to offset long shifts by long decompressions.
Laws have already been passed in different countries regulating
Compressed-Air Illness 2O5
the length of shifts and decompression periods. Such a law has
been passed, however, in but one state (New York) in this country.
As time goes on further legislation will no doubt be needed and
this could be made much more efficient if full information in regard
to all cases of compressed-air illness could be reported to the state
and reviewed by some competent person or board, who should recom-
mend the necessary changes in the laws. What is now most needed
is an exhaustive study of the practical application of theories which
have been well worked out. In studying the causes of compressed-
air illness, one should not forget that many factors play a part, and
that, since the human organism is concerned, it is not a purely phy-
sical question. The results of comparatively few experiments with
animals should not be looked upon as final. In the same way, the
results, under certain conditions, with a comparatively few men
should not be considered conclusive. While much may be done by
proper regulations to diminish cases of illness and death in com-
pressed-air work, I believe that, when pressures of two or more at-
mospheres are being used, it should be classed as a dangerous occu-
pation on account of individual conditions, not now understood,
which I have called the personal element.
OCCUPATIONAL SKIN DISEASES
John A. FordyCE
University and Bellevue Hospital Medical College.
With the exception of certain well-defined types, occupational der-
matoses as a class have not, in this country at least, received the
attention they merit. While every dermatological clinic numbers
among its applicants each year many patients in whom occupation
has a direct or indirect bearing on the causation of their eruption,
it is difficult, owing to lack of systematic investigation, to give a
definite idea as to the prevalence of skin affections in the various
trades. At my own clinic at the University and Bellevue Hospital
Medical College about 2 per cent of the total number of new cases
for 1911 constituted occupational dermatoses. The great majority
of these were of the type known as trade eczemas and, while many
cases yield readily to treatment and proper preventive measures,
others constitute a serious inconvenience from an economic stand-
point, sometimes necessitating a complete cessation from work or a
change of occupation.
Cutaneous vulnerability is more or less an individual peculiarity,
for while persons are met with who are so sensitive to an irritant,
physical, chemical, thermal, or actinic, that they react after a short
exposure or contact by an acute dermatitis, other people remain en-
tirely unaffected. Occasionally such individuals exhibit so high a
degree of sensitiveness that, instead of acquiring an immunity, an
increasing susceptibility is established. Fortunately these cases are
not very common and it is more usual to see workers, though sub-
jected to continuous injury, only after a considerable time develop
lesions, either from the summation effects of the irritant or because
the resistance of the skin has been gradually undermined. After
such a cutaneous outbreak there is frequently a tendency to acute
exacerbations at regular intervals or when the occupation is resumed.
These eruptions may then persist for years.
While the skin, both anatomically and physiologically, is en-
dowed with a relative amount of protection against the action of irri-
Occupational Skin Diseases 2O7
tant substances, by reason of its exposure it is subjected to injuries
of every description and these may lay the foundation for a subse-
quent eruption. In addition there are other contributing factors,
such as a special susceptibility, a delicate skin or one presenting
some congenital anomaly, as excessive dryness or ichthyosis, impaired
gastro-intestinal, hepatic or renal function, a depressed state of
health, neglected hygiene of the skin, or its lowered resistance due
to a preexisting eruption.
We often find the same etiologic factor operative in both allied
and unrelated trades, owing to similar conditions under which the
work is done; for example, where men or women are exposed to ex-
cessively dry or moist heat. Such an atmosphere leads to congestion
and interference with the normal activity of the skin, which is fol-
lowed by various inflammatory processes and sweat eruptions like
prickly heat. These affections are met with in cooks, stokers, fire-
men, foundry workers, etc. A warm, moist medium, such as laun-
dresses work in, sometimes produces a cystic condition of the sweat
ducts of the middle third of the face, known as hydrocystoma. Cold,
by favoring the development of chilblains, causes much suffering
among people who are obliged to carry on their work outdoors or
in poorly heated places. In factories where drastic measures are
employed for the removal of dirt or stains, cleansing agents like
chlorid of lime or benzine used on the hands, by divesting the skin
of its natural secretions, supply the base for an eczema. Oil, which
is used wherever machinery is installed, is the causative agent of
acneiform and eczematous lesions in employees who operate or are
otherwise engaged about such apparatus.
In occupations which necessitate standing, people who have a
tendency to varicose veins not infrequently exhibit this condition,
with a secondary eczema and ulceration. Slight traumatisms lead to
erosions of the skin, which often become infected in patients who,
owing to venous congestion, have slight resistance. Young women
who are obliged to stand at their work sometimes develop erythema
induratum or Bazin's disease, which is characterized by nodules be-
neath the skin that may break down and produce ulcers. Some of
these forms of Bazin's disease have been proved to be tuberculous.
The infection is usually of benign type and readily yields to rest in
bed, improved nutrition, and a change to better hygienic surround-
1ngS.
208 American Labor Legislation Review
Many occupations, without being pathological in the strict sense of
the word, bring about changes in the skin which are so characteristic
that Blaschko" has given them the name of trade stigmata. These
include localized thickenings of the horny layer in shoemakers, tai-
lors, musicians, etc.; bronzing of the skin in gardeners, farmers, and
other people who follow outdoor occupations; staining of the hands
in dyers, chimney-sweeps, etc.; pigmentation in workers in silver
from a deposit of the latter metal and in millers from iron par-
ticles, etc.
The skin responds to the most diverse irritants, on the one hand
by the production of a catarrhal inflammation, and on the other by
the development of different types of eruption from the action of
the same agent. Of the former we have an example in the trade
eczemas and of the latter in the effects of working with tar, where
eczema, acne, warty and epitheliomatous lesions may exist alone or
intermingled.
The commonest type of occupational disease is an eczematoid
dermatitis. In a recent article Herxheimer” enumerates seventy-
four trades provocative of this form of disease. It may vary in
grade and intensity from an erythematous and scaling dermatitis to
a vesicular and bullous eruption. As the condition becomes chronic,
infiltration of the skin takes place, with desguamation and fissuring.
With the cutaneous defenses lowered, pus infection is frequently
superadded.
The excessive use of soap and water, by extracting the fat and
macerating the horny cells, reduces the resistance of the skin. These
agents may then act as direct excitants or prepare the way for some
other irritant, as washing powders, etc. Severe eczemas of the
hands and forearms are seen in those whose occupations require
them to have their hands continually in water, as in the case of
washerwomen, housemaids, barkeepers, etc. In my clinic nearly
one-third of the occupational diseases during the past year were
seen in persons whose vocations necessitated the frequent employ-
ment of soap and water, and in some cases of the various cleansing
alkalis.
* Blaschko, “Gewerblichen Hautkrankheiten.” Handbuch der Arbeiter-
krankheiten, Th. Weyl-Gustav Fischer, 1908.
* Herxheimer, “Ueber die gewerblichen Erkrankungen der Haut.” Deutsch.
Med. Wochenschr., 1912, Nr. I.
2.
OCCUPATIONAL SKIN DISEASES
1. Papilloma of PALM of the HAND of AN IRoN-Worker.
Lesion is due to Friction from the tools of the TRADE
Three YEARs'
Duration.
2. Common Type of Chronic Eczema of HANds AND ForeARMs. Following
Prolonged Contact with IRRITANTs. IN THIS CASE THE IRRITANT
WAS WOOD-ALCOHOL USED IN THE PREPARATION OF WARNISH

Occupational Skin Diseases 209
In bakers a form of dermatitis of the hands and forearms is
known as baker's itch. The exciting causes are the heat, the moist
dough, and the saccharine solutions. A mite said to live in flour
has also been incriminated. Candy-makers suffer from a similar
eruption, as well as from impetiginous lesions. Confectioners, bak-
ers, and preservers of fruit frequently show an eczema of the fingers
and peri-ungual tissues from the action of fruit acids.
In a personal communication, Winfield describes a dermatitis in
sugar-refiners, which involves the hands, forearms, and legs, and re-
sembles an impetiginous scabies. It has been claimed that a mite
found in raw sugar is responsible, but this lacks verification. Oliver”
states that in sugar factories a condition known as “lymphangitis of
sugar-makers” is sometimes found among the sugar-refiners and
molasses stirrers. It is accompanied by a slight constitutional dis-
turbance and a crop of boils is not an unusual sequel. According to
Gaillot the lymphangitis is a Staphylococcus pyogenes aureus infec-
tion. This organism is said to be found, not in the freshly made
molasses, but in the residue, and the temperature of the factory and
the condition of the skin favor its development.
Builders and masons develop an eczematous affection of the ex-
posed parts of the body from the irritating effects of lime and
cement. In stonecutters an analogous condition is caused by the
stone dust. A palmar dermatitis is also seen in brickmakers. Metal
workers, whether from the constant irritation of the dust or filings,
their direct cauterant action, or that of acids or turpentine used in
the various processes, suffer from all grades of inflammation to in-
tractable ulceration. Printers and machinists, from contact with
chemicals and oil, often develop a chronic eczema of hands and fore-
arms. Electroplaters are also liable to an inflammation of the hands
and forearms from the use of a mixture of lime dust and olive oil in
“finishing” and of sour beer in the process known as “scratch brush-
ing.”
Workers who handle the chromates in the arts and trades suffer
from an eczematoid eruption, as well as from ulceration of the skin
and mucous membrane, which shows little tendency to heal. Hydro-
fluoric acid, employed in the manufacture of glass, the bleaching of
cane, the washing of manure, etc., produces Sores of the nasal ori-
fice and gums and painful blisters and ulcers of the skin.
* Oliver, Diseases of Occupation. E. P. Dutton & Co., 1908.
2IO American Labor Legislation Review
The irritant action of arsenic on the skin is well known. In the
arts and manufactures where its compounds are employed, workers
are attacked with eczema or ulcerative or gangrenous lesions, which
may be present on the face, neck and extremities, but more especially
the genitals. In color works ulcers of the hands are designated
“arsenic pock.” The sulfid of arsenic which, with lime, is used in
curing fur, sets up a very severe dermatitis in furriers, not infre-
quently with persistent ulceration.
Chemists are prone to inflammation of the hands and sometimes
of the face from handling various drugs and chemicals. Their skin
often develops so marked a susceptibility that minute quantities or
even fumes will call forth an outbreak. I have several times noted
a similar anaphylactic condition from formalin in laboratory work-
ers. Another familiar example of an eczema due to chemical action
is that of the hands of physicians and nurses from the use of antisep-
tics, notably bichlorid of mercury and carbolic acid. These forms
of dermatitis are very rebellious to treatment.
Among miners, smelter workers, and photographers an eruption
of erythematous and pustular type is sometimes encountered from
the irritant effects of mercury. Photographers are also subject to
an eczema, more especially of the terminal phalanges and nails, from
other reducing agents, particularly pyrogallic acid.
In hat factories eczema of the hands is said to result from the
manipulation of hot water acidulated with sulfuric acid. The
eczema in tobacco workers is believed to be due to the caustic solu-
tions used in separating the tobacco leaves. Calico-printers suffer
from eczema, fissures and wounds, which often become infected.
The cause here is referred to the bleaching and cauterizing substan-
ces handled.
In flax and linen workers various skin affections are reported,
among them a follicular eruption due to the oils and irritating
materials met with in this occupation. In Belgium many of the flax
workers show a peculiar abrasion and ulceration of the palmar sur-
face of the hands. Fissures form, exfoliation takes place, and
when the deeper structures are involved the condition stimulates a
syphilitic lesion. An eruption resembling smallpox has also been de-
scribed on the forearms, arms, and faces of workers who remove
the bobbins from spinning-frames. From the pressure and friction
Occupational Skin Diseases 2II
caused by pulling threads the people who engage in this part of the
work present callosities on their index fingers.
Callosities of the palms are also met with in laborers, engine
drivers, etc. Among miners they form a special dermatosis called
“beat hand.” Painful thickenings develop over the regions where
the handle of the pick makes greatest pressure, along the bases of
the fingers, over the ball of the thumb, and on the outer side of the
hand. The subjacent tissue becomes inflamed, and not infrequently
is further complicated by suppuration. To this condition the term
“keens” is applied.
Warts sometimes form very troublesome lesions on the palms of
people engaged in manual work. In some cases they are purely epi-
dermic growths; in others, where the epidermis has been removed,
the underlying tissue, as the result of irritation, becomes the seat of
exuberant granulations with papillomatous formation.
Dyers and workers in anilin colors are apt to develop eczematoid
and pustular eruptions on different portions of the body. The bad
effects are not limited to those in this trade, but the wearers of
clothing prepared with certain of the dyes may ultimately be the
victims of a severe dermatitis. The black, red, and orange-yellow
pigments are particularly irritating, marked inflammatory reactions
having been caused by Socks, gloves, underwear, and shoes so colored.
I have also seen unusually severe forms of eczematoid dermatitis in
barbers who had employed proprietary anilin hair dyes on their
patrons. It is not an uncommon experience in dermatological prac-
tice to be consulted for a dermatitis of the face, neck, and ears which
had followed the application of various of these hair dyes. In sus-
ceptible subjects the use of hair tonics may produce similar trouble.
Another dermatological condition met with in anilin workers is a
hyperidrosis of the palms due to washing the hands with chlorid of
lime for the removal of dyes. According to Blaschko it may be so
intense as to amount to a flux. The affection is also seen in chlorid
of lime and soda workers. -
The manufacture of chlorid of calcium and chlorid of sodium
and potassium by electrolysis is sometimes attended by an erythema-
tous and edematous inflammation of the face of the workmen resem-
bling erysipelas. This is attributed to the hypochlorite of soda that
is formed. With the subsidence of the acute process an acneiform
eruption is left behind, the so-called chloracne. This is the com-
2I2 American Labor Legislation Review
monest cutaneous malady met with in this occupation and is char-
acterized by the early development of blackheads on the face, trunk,
and extremities, followed by a grayish discoloration of the face.
With inflammation and suppuration of the follicular glands, nodules,
pustules, boils, and disfiguring scars are a not uncommon sequel.
Tar and paraffin workers develop a similar eruption which may last
several months and then change to the so-called “tar itch.” This is
accompanied by hyperkeratosis and increased activity of the seba-
ceous glands, forming plaques and crusts, with the further develop-
ment of multiple warts, one or more of which degenerate into
malignant growths. The disease affects chiefly the hands, forearms,
and scrotum. It progresses slowly and in many instances no recur-
rence takes place after removal of the epithelioma. Oliver cites the
case of a man aged 58 who had worked among coal-oil and tar
products for thirty years. He presented numerous indurated patches,
Some of which had ulcerated, as well as multiple black warts and
Scars, the remains of old ulcers. On the other hand, his son, 27
years old, following the same employment, developed a malignant
growth of the forearm which necessitated amputation. Metastases
of the axillary and cervical lymph nodes took place and the patient
succumbed to secondary carcinosis.
Cancer in chimney-sweeps has been reported chiefly from England.
The soot produces a chronic irritation of the skin, and when retained
in such regions as the folds of the scrotum causes warty growths
which become epitheliomatous. In some instances the hands, arms,
and thighs have been involved. With the advent of machinery for
cleaning chimneys the incidence of scrotal cancer has been markedly
reduced. It is reported that gardeners who employ soot for the pro-
tection of plants from slugs show in a like manner the effects of this
irritant in the development of malignant growths of the hands.
Gardeners and florists frequently suffer from some form of in-
flammation of the hands and arms occasioned by contact with certain
plants. It is estimated that some sixty or seventy plants possess
this irritant action and the power to induce a dermatitis. The more
familiar ones are poison-ivy, poison-Sumac, primrose, chrysanthe-
mum, and eucalyptus, the eruption varying from a simple erythema to
marked swelling, with the formation of vesicles and bullae. Not only
are the exposed parts involved, but the affection may be carried by the
hands or clothing to other portions of the body. It is probable that
Occupational Skin Diseases 2I3
the active principle in the majority of these plants, as in the case of
Rhus towicodendron, is an essential oil. Lacquer which is obtained
from a tree belonging to the genus Rhus produces a dermatitis
either by direct contact or through the fumes from evaporation.*
The symptoms appear in a few hours, and consist of fever and
edema of the skin of the face, limbs, and generative organs, nasal
and conjunctival catarrh, and a papular eruption of the legs and fore-
3.1111S. -
The resinous dust of certain hardwoods, like teak, ebony, satin-
wood, rosewood and others, will occasionally set up a dermatitis in
carpenters and joiners. In teak the exciting agent is believed to be an
essential oil derived from the central part of the tree and present
in the dust. The symptoms are sometimes very severe, the eruption
becoming generalized and accompanied by vomiting. It may last
for Several months and is quite apt to recur on resumption of work.
The so-called “polisher's itch” of the forearms and hands, met with
in furniture polishers, is attributed to the methyl or impure alcohols
present in varnishes and polishes. Impure benzine and turpentine
used for cleansing purposes likewise provoke an eczema of the hands.
In individuals who follow an outdoor occupation the uncovered
portions of the skin sometimes undergo peculiar degenerative
changes. Under the name of “sailor's skin.” Unna has described an
affection which he observed chiefly in seafaring men. A diffuse
cyanotic redness not unlike chilblain develops at first on the ears, on
adjacent parts of the cheeks and temples, on the backs of the hands,
and on the fingers. The skin then becomes mottled, pigmented,
rough, and hard, and in places papillomatous. These warts may
last for years and slowly undergo a malignant change. A similar
condition is met with on the face, neck, and hands of people who
follow agricultural pursuits. The cause is sought in the actinic rays.
The effect of light on the skin is illustrated in X-ray workers, in
whom, unless protected, the hands become the seat of a mild erythem-
ato-squamous eruption, more or less persisent, which is succeeded
by pigmentation, telangiectases, and atrophic wrinkling. This con-
dition may remain unchanged, or keratoses may be added, which
develop into epitheliomata.
Drivers and coachmen exposed to the rigors of the weather are
* Castellani and Chambers, “Lacquer Poisoning.” Manual of Tropical Med-
icine, 1910, p. 118.
2I4 American Labor Legislation Review
often the subjects of the severer forms of rosacea. The use of
alcohol, however, to which many of these people are addicted, cannot
be wholly ignored as a contributing etiological factor.
Certain callings, notably those dealing with dead or live animals
or their products, favor the development of infectious diseases.
Owing to the prevalence of pyogenic organisms, local pus infections,
as boils, carbuncles, impetigo contagiosa, or cellulitis are not infre-
quently met with in butchers, slaughter-house men, and other indi-
viduals who handle dead animal matter. A generalized bullous
dermatitis, with severe constitutional symptoms and a high mortality,
has also been observed. The starting point is usually an infected
wound. Several years ago Bowen” pointed to a possible relationship
between these cases of so-called “acute infectious pemphigus” and
foot and mouth disease of cattle, as he had observed such instances
during an epizootic of the latter disease in New England. Foot and
mouth disease takes place by inoculation of the skin or mucous mem-
brane in butchers, dairymen, stableboys, and drivers. Herxheimer
records having seen a case in a horsedealer.
The parasitic diseases which are more definitely identified with
particular avocations are tuberculosis, anthrax, glanders and actin-
omycosis. Inoculation tuberculosis occurs in its simplest form as
verruca necrogenica or anatomical tubercle. It is encountered
chiefly among medical students, physicians, hospital ward attendants,
and butchers as a localized papillomatous formation usually about
the knuckles or other parts of the hand or forearm.
Anthrax is very uncommon in this country, but it is very preva-
lent in animals, especially cattle and sheep, in certain parts of Europe
and Asia. In man the disease occurs as the result of direct infection
from such animals or their products, via the skin, the intestines, or
more rarely the lungs. It is met with in the wool-sorting, wool-
combing and spinning industries, in horse-hair and brush factories,
in stevedores, wharf-laborers, carters, farmers, shepherds, butchers,
meat inspectors, and cattle salesmen. The internal form is known as
“wool-sorter's disease.” Of the external, which is also the more
usual, there are two varieties, the malignant pustule and malignant
anthrax edema, the latter of which is the more fatal of the two.
* Bowen, “Acute Infectious Pemphigus in a Butcher During an Epizootic
of Foot and Mouth Disease with a Consideration of the Possible Relation-
ship of the Two Affections.” Journ. Cutaneous Diseases, 1904, vol. xxii, p.
253.
Occupational Skin Diseases 2I5
Glanders, usually contracted from horses, is seen almost exclu-
sively in hostlers or those who have to do with these animals. It
is rare in this country. The bacillus may gain entrance through
the mucous membrane of the eye, nose, mouth, or respiratory tract,
or the site of inoculation may be a lesion of the skin. Clinically the
disease is divided into glanders and farcy, according to whether the
lesions of the mucous membrane or skin predominate. Both types
present an acute and a chronic form.
Actinomycosis is endemic in cattle and more rarely affects horses,
hogs, and other animals. In man the disease is seen in those who
come in contact with such animals or who handle fodder or grain, as
farmers, coachmen, dairymen, millers, etc. Infection in man takes
place through a carious tooth or a lesion in the mouth, and less often
through the skin. The ray fungus is believed to flourish on corn,
hay, and cereal grains, as the latter has frequently formed the
nucleus of an actinomycotic lesion.
Erysipeloid, an infection of the skin caused by poisoning from
meats, fish, poultry, cheese, and similar animal products, is seen
chiefly in butchers, fishmongers, poultry dealers, cooks and scullions.
From Gilchrist's" observations, crab bites and injury by crabs are a
frequent cause. The disease is believed by Rosenbach to be due to
a micro-organism of the order Cladothrix. It is characterized by
one or more areas of slowly spreading inflammation, clearing up at
the part originally affected and progressing slowly to new areas, the
advancing border being festooned or Scalloped. Burning, pricking,
or itching sensations accompany the affection, which involves chiefly
the fingers and hands.
Among the minor infections may be mentioned ringworm trans-
mitted from horses, dogs, and other domestic animals to men and
boys employed about stables or engaged in the care of such diseased
animals. Ringworm of equine origin is characterized by the forma-
tion of irregular and projecting nodular lesions studded with pus-
tules involving the beard region, neck, wrist, or hands.
In certain grain regions infested by a mite, Pediculoides ventri-
cosus, an intensely itching urticarioid eruption is epidemic among the
farmers and laborers who handle sacks of wheat, barley, and other
* Gilchrist, “Erysipeloid, with a Record of 329 Cases, of Which 323 were
Caused by Crab Bites or Lesions Produced by Crabs.” Journ. Cutaneous
Diseases, Vol. xxii, 1904, p. 507.
216 - American Labor Legislation Review
grains or straw harboring this parasite. Small epidemics have also
appeared at different times from the use of mattresses made from
straw on which the organism had made its habitat. To Dr. Jay F.
Schamberg’ belongs the credit of priority in describing the affection
in this country. w
In conclusion, while many of the industrial dermatoses lead to
little inconvenience, some forms of dermatitis may become so severe
that they absolutely prevent a man from carrying on his occupation.
In certain susceptible individuals the action of the irritant is not con-
fined to the parts exposed, but may spread over the entire body.
Where patients develop such an idiosyncrasy they should be guarded
against these forms of dermatitis becoming permanent, and should
be advised as to the best means of prevention. Such measures cannot
be discussed at length in a paper of this scope, as they must neces-
sarily fit individual cases. If the nature of the work permits, the
wearing of masks and gloves to protect the exposed parts, as prac-
tised by Chinese lacquerers, is advisable, but obviously this is not
feasible in all forms of occupation. The use of soap and water is to
be recommended in some trades in order to remove the noxious sub-
stances; while in those instances where they prove the irritants they
are positively injurious and should be sparingly used. In any case,
after washing, the hands should always be very carefully dried and,
if practicable, covered with a protective ointment, or a salve or cold
cream should be thoroughly rubbed into the skin at night. People
whose vocations bring them in contact with live or dead animals or
their products should be instructed as to the mode of inoculation of
infections from these sources, and all wounds or breaks in the con-
tinuity of the skin should be sealed with collodion, plaster, or some
other protective dressing.
‘Schamberg, “Grain Itch (Acaro-Dermatitis Urticarioides): A Study of a
New Disease in this Country.” Journ. Cutaneous Diseases, 1910, Vol. xxviii,
p. 67, -
OCCUPATIONAL NERVOUS AND MENTAL DISEASES
CHARLES L. DANA
Cornell University Medical College.
The nervous and mental diseases which may be called occupa-
tional are brought about by one or more of three agencies: (1)
The occupation itself may be such as directly to cause damage
to the nervous tissues, as when a cigarmaker gets a cramp or
neuritis, or a painter or worker in a lead factory gets an arm paraly-
sis. This is a direct occupational disease. (2) The occupation
may be such that exposure and the mode of work or life almost
necessarily involve risks, temptations, or accidents which lead to
disease. Thus cab-drivers suffer from occupational alcoholism, and
soldiers in time of war and millworkers on very long hours suffer
from occupational insanities of various kinds. These may be
called indirect occupational neuroses or psychoses. (3) Nervous
diseases may develop when work is carried on under such depressing
conditions of meager wages or insanitary and unwholesome fac-
tory and home life that ill health necessarily follows. These may
be called industrial neuroses and psychoses. With this broad view
of the nervous diseases of occupations one can see that the subject
is not easily exhausted.
DIRECT OCCUPATIONAL NERVoUs DISEASEs
The direct occupational nervous diseases are quite numerous.
They take the form of paralysis, atrophy, inflammation of the
nerves of the arm or leg, neuralgia, paresthesia, and dysesthesia
(disagreeable numbness, prickling, tingling, etc.). In most skilled
workers, and in all kinds of workers who do one skilful act over and
over again for long periods of time, we have the occupational
cramps; writer's, telegrapher's, musician's, pianist's, etc. Though
about ninety per cent of these troubles affect the arms and hands, the
legs are also affected, and we have paralysis and pains in tailors,
gardeners, and potato diggers, besides the more serious paralysis of
the legs in caisson disease. The occupations which involve long
218 American Labor Legislation Review
periods of standing also cause various foot-pains, due usually more
strictly to mechanical disturbances of the ligaments, bones, and mus-
cles than to nerves. Policemen, soldiers, and letter-carriers have
podalgia, sciatica, and other painful troubles. The nerves of the
head are least often involved, but miners suffer from nystagmus,
boilermakers and rivetters from deafness, and workers with strong
arc-lights from paralysis of the accommodation or light reflex
muscles. -
The general facts about these troubles were set forth by Dr. Starr
and myself in papers read before the Academy of Medicine and
published in the Medical Record of February 3, 1912. It was
shown that among occupational nervous diseases, the most serious
and frequent were those due to lead poisoning; and it has been
shown by Dr. Alice Hamilton that lead is used and lead poisoning
may occur in one hundred and eleven different trades. Arsenic,
which is used in the furrier's trade and twenty-six others, is much
less often a cause of nervous disease, but it has been in the past an
important source of danger in the manufacture of wall-papers and in
beer making. Mercury and brass occasionally cause symptoms of
nervousness, tremors, and asthenic and anemic states.
The number of occupations in which, by reason of mistake or
overuse of the hands and arms, we find neuritis, neuralgia, and
cramps, is very large. I gave a list of twenty such occupations
in my previous paper. In a Paris thesis, 1901, under the title
Occupational Neuritis, Dr. Helene R. Baraks gives a list of one
hundred and nineteen different occupations in which inflammation
of some nerves, mainly those of the arm and shoulder, was due to
the work in which the persons were employed. She reports over
two hundred cases illustrating the different conditions. Bruising
and pressure on the parts and overwork are the immediate causes.
In New York the occupations which contribute most often to these
troubles are those of tailors, cutters, ironers, pressers, laundry
workers, musicians (pianists and violinists), porters and other car-
riers of heavy weights, stenographers, telegraphers, and bookkeep-
€1’S.
The occupational nervous troubles, aside from those due to the
caisson disease and to lead, and aside from the cramps, are not very
serious. They are curable as a rule in a few months. In rare cases,
however, they pass on to serious and progressive organic disease
Occupational Nervous and Mental Diseases 2I9
(atrophy or sclerosis). These troubles are caused partly by care-
lessness and uncleanliness and perhaps more often by prolonged and
excessive work.
If I were to single out any one point for special attention and
action, I should advise that short pamphlets be written to be cir-
culated among ironers, pressers, tailors and especially cutters, cigar-
makers, masons, and boilermakers, whose work involves heavy, reg-
ular manual movements; and also among workers in compressed
air and those who have to handle arc-lights, cautioning them
against the dangers and showing how they may be avoided. The
dangers of lead, mercury, arsenic, phosphorus and caisson work
have already been fully explained. The remedies have only to be
applied.
Summing up, one may say that the principal occupational ner-
vous diseases are:
1. Toxic: Lead palsies, neuralgias, psychoses.
Arsenical palsies.
Mercurial tremors, etc.
2. Mechanical: Paralyses, neuritic and atrophic.
Atrophies.
Parasthesias.
Neuralgias.
Spasmodic disorders.
Caisson paraplegia (the “bends”).
3. Environmental: Exhaustion (auto-toxaemia).
(Neurasthenia, psychasthenia, insanity).
. MENTAL DISTURBANCES DUE TO OCCUPATIONS
The occupational psychoses, or mental disturbances due to occupa-
tions, furnish practically an unexplored field and perhaps not a
fruitful one. That is to say, occupation is essentially a healthful
thing, much more so than recreation or rest; and I would urge that
the aim of the Social and industrial reformer be not to lessen oc-
cupation, but to make it easier and more agreeable, or at least more
interesting. There is nothing so mentally healthful as work.
There are, consequently, very few occupations which directly, by
22O American Labor Legislation Review
reason of the kind of work, cause insanity. Nevertheless, there is a
lead insanity, an alcoholic insanity, and an insanity caused by sulfid
of carbon and by sulfureted hydrogen; also perhaps a mental deteri-
oration, especially of memory, in those exposed to CO2. Then
there are certain occupations which are in their nature exciting or
one-sided in their demands on the mental life, and Dr. T. H. Kel-
logg enumerates soldiers (and sailors), poets, prostitutes, and poli-
ticians as being especially liable to insanity. To this list others
have added the occupations of cab-driver, stoker, and bartender.
Millworkers who tend machines for long hours are said by Spoult-
ing to contribute unduly to the state hospitals for the insane.
The insanities due indirectly to occupation and industrial condi-
tions are, moreover, very numerous and important. Forel says:
“Other causes, such as the herding together of the proletariat in
great cities, in bad rooms or tenements with insufficient food and
unhealthy employment, undoubtedly weaken the nervous system.”
And Dr. Kaplan, in enumerating the causes of that devastating
form of mental degeneration, dementia praecox, says:
Most, if not all, of my patients came from the congested districts of
Greater New York; they lived in tenement houses; they were deprived of
light, proper sanitation, fresh air, and good food; they worked in Sweatshops
for means of getting their livelihood; they were in constant struggle and
strife for the maintenance of their existence. Some of the married women
were compelled to work in shops, in addition to their housework, in order to
support the family. Seventy-two patients did housework; thirty-three were
employed in shops; three had positions in stores; eight were dressmakers;
two were bookkeepers; three stenographers; one a governess; one an attend-
ant in a hospital for the insane; two clerks; one a student; four had no oc-
cupation.
INFLUENCE of GENERAL INDUSTRIAL CONDITIONS
All this, however, is in a way only incident to industrial progress
and more intense social activity. The occupation of becoming high-
ly civilized leads to increase of insanity. In the north of Italy,
among the active industrial population, says Tanzi, the percentage
of insanity is 25.3 per Io,000. In southern Italy it is 1.3 to 6.6
per cent. Crowd people together and there surely will be more
insane. Occupations compelling life to be lived under congested
conditions are thus indirectly the cause of insanity. If we wish
to improve industrial conditions with a view to improving mental
Occupational Nervous and Mental Diseases 22I
health, we should discourage urban industries, especially urban fac-
tories.
This is not because of the industries or the factories, so much
as it is because of the mode of living. What is the use of high
wages and short hours if life away from work is unhealthful? The
occupation of making shirtwaists may keep one well or drive one
insane, according to the nature of the home and the kind of rest
and amusements which are taken. But we should also discourage
industrial isolation. Man needs social life as much as he does
fresh air and good food. Men are like certain trees which do
best when they are planted just so far apart; not too close, for then
the roots encroach and rob each other of nourishment; and not so
far apart that there is no support and protection from the sun and
winds.
The active money-earning occupations of life, then, have really
little in themselves to do with causing the great mass of nervous
and mental disorders. It is what is done between times, what
kind of rest is taken, and what kind of home life is lived. It is
this which does the harm. Women have many more nervous
troubles than men, but they have fewer occupations and the
fewer they have the more they get nervous. It is, then, I repeat,
not occupations themselves, but the industrial and domestic con-
ditions to which working people are subjected which cause the
mass of nervous and mental diseases.
Take a man or a woman and make him or her do a dexterous
piece of work over and over again during long hours and under
a nervous strain. Underfeed a little, shorten or disturb the sleep,
and you can produce neuralgia or neuritis or a cramp within from
two to three months. Take a person who has not a very stable
nervous system and put him at work for long hours, at tasks of
concentration or skill. Let him have no real recreation and not
quite enough restful sleep and you can produce a mental trouble
of at least a minor type.
Those who work on a certain tension, like mill operatives in
charge of machinery, engineers, etc., and those who work always
with a strain and effort to finish a certain fixed amount in a fixed
time, get nervous or mental troubles unless they have periods of
real recreation. Real play is needed for hard, tense work. For
the ordinary worker it is not so important. Scientific manage-
222 American Labor Legislation Review
ment, therefore, which speeds up the human machine, must give
it longer rest and an absolute change of nervous and mental in-
terest. - - *
The direct occupational causes of mental diseases are, then, of
small importance. The industrial causes, however, which lead to
bad home conditions, bad forms of recreation and rest, bad social
and moral conditions, are of immense and fundamental impor-
tance. We could lessen insanity more by razing tenement-houses
than by shortening hours of labor. Occupation is mentally health-
ful; play may be exhausting and dangerous. Give the hard-
working man knowledge and opportunity to spend his leisure well,
just as seriously and just as quickly as you give him more leisure.
Some legislation, but much more ordinary good sense and sanitary
rules should be preached. I would say, then, in conclusion, that
occupational and industrial nervous diseases call for special atten-
tion on the part of the sanitarian and of the legislator.
OCCUPATIONAL EYE DISEASEs
ELLICE M. ALGER
New York Postgraduate Medical School.
If we are to judge from the relative space assigned to them in
our books, the importance of occupational diseases of the eyes has
not been properly estimated. There are many industries which
regularly cause serious organic diseases of the eyes while, in the
wider sense, there are few skilled occupations in which the eyes are
not used far beyond nature's intentions, with corresponding discom-
fort and disability. I have no intention of giving you a catalogue
of the rare diseases which have been observed from time to time
in connection with our modern highly specialized industries, but I
do wish to call your attention to several distinct types of occupa-
tional disease and to assure you that of each variety there are
numerous subvarieties.
ExPOSURE TO INJURIOUS SUBSTANCES
Trade accidents should not, of course, be classed as trade dis-
eases, whether of the eye or of other organs. It is very difficult,
however, to draw any hard and fast line between the occasional
injuries which must be classed as accidents, and those which, like
injuries from dust, are due to constant exposure to injurious sub-
stances and must, therefore, be assumed as conditions of the in-
dustry. To lose an eye from the impact of a popping cork is
doubtless an accident, though not by any means so rare a one as
you might suppose. But, in the bottling industries, accidents of this
sort happen so regularly that they have to be considered as inci-
dents of the trade and guarded against accordingly. The same
may be said of the bursting of unprotected water gages and of
other similar accidents which so often destroy the eyes of engi-
neers and machinists. The daily total of more or less dangerous
injuries to the eyes of workmen is something enormous.
224 American Labor Legislation Review
Consider the men employed in the various grinding trades. In
working over an emery wheel, for instance, there is a constant
stream of small particles thrown off at great speed. The experi-
enced man has learned to save his eyes as much as possible, but the
beginner is always in trouble. When these particles are small they
are removed from the eye by a fellow workman with the corner of
a dirty handkerchief, the soft end of a chewed toothpick, or the
point of a penknife. Every large shop has some man who is par-
ticularly expert at removing these foreign bodies, and it is only
when they are too deeply embedded for the amateur operator's skill
that they are referred to the physician. The writer often sees half
a dozen or more cases in a single afternoon in his dispensary ser-
vice, most of them showing signs of previous manipulation.
Considering the chances for infection, bad results are astonishingly
rare. Nevertheless, there are many cases in which infection does
occur, resulting in extreme pain, loss of time, more or less perma-
nent disability, and most infrequently in the loss of the eye itself.
It must not be forgotten that every one of these foreign bodies,
except the most superficial, produces a minute but permanent opac-
ity of the cornea, which if rightly situated interferes seriously with
sight. I have seen many men with numerous scars in each eye as
the result of repeated injuries of this kind, and yet they seem to
learn nothing, the same ones coming back time after time in spite
of warning and advice. The various safeguards that have been
devised do not seem to be practical, for opposition to their use
seems to come from the men rather than from their employers.
Then there is the less frequent but much more serious list of
injuries caused by the larger bits of metal and stone in foundries,
quarries, and mines. These chips fly through the air with tremen-
dous velocity and not infrequently pass clear through an eye. These
are, of course, accidents and are therefore rather outside the limits
of this paper, but they are for the most part preventable and they
should be prevented.
There are many other trades each of which has its own peculiar
type of injury, like the lime burn and the solder burn. Practically
all the so-called dusty trades cause chronic inflammation of the eyes,
which not only makes trouble in itself but predisposes to various
infections. Masons and plasterers not only suffer from lime
burns but commonly have chronic conjunctivitis, as do flour-mill
Occupational Eye Diseases 225
employees. Hop pickers suffer from an acute inflammation of the
conjunctiva during the season, and farmers and other outdoor la-
borers who are exposed to wind and dust very often develop ptery-
gium.
TRADE POISONING
There are also many trades in which the workmen suffer more
or less permanent loss of sight through the absorption of drugs of
one sort or another, and the number of these is constantly increas-
ing as the complexity of our manufacturing processes increases. I
have no intention of giving you a list of all the chemicals which
are on record as having produced blindness. The list is a long One
and many of them are important simply as suggesting profitable di-
rections for future investigation. Among them are tobacco; alcohol;
lead, used in so many different industries; bisulfid of carbon, used
in the manufacture of rubber; nitrobenzol, used in the manufacture
of explosives; and some of the anilin dyes. -
The one to which I wish particularly to draw attention is methyl
or wood-alcohol. Owing to its low price it has very largely displaced
grain alcohol in manufacturing processes. It was never intended
for internal use, but has long been consumed by the ignorant and
benighted as furnishing a cheap and very potent source of intoxica-
tion. Such sprees often end in death and more often in a specific
type of blindness. Since attention has been devoted to this subject,
it has been found that in susceptible individuals a very small dose
of wood-alcohol may produce permanent total blindness. Ten drops
have produced this effect in one case. Furthermore, instances are
accumulating in which the same result has followed its use as a sub-
stitute for grain alcohol in bathing and rubbing.
But the fact that compels us to class wood-alcohol blindness with
the occupational diseases is the increasing number of cases in which
it has followed mere inhalation of the vapor for a comparatively
short period. It is used in many of the trades as a solvent of shel-
lac, as, for instance, by painters and hat makers. Many typical cases
are now on record of blindness in painters, who have used it in re-
moving varnish in close rooms or in applying shellac to the inside
of beer vats and the like.
There are probably many cases of wood-alcohol poisoning which
are entirely unrecognized. Tyson reports a whole room of girls in
226 American Labor Legislation Review
a pencil factory who suffered from ill-defined disturbances of vision,
among other symptoms. It was finally discovered, almost by acci-
dent, that the pencils were varnished with wood-alcohol, and with
suitable ventilation the trouble disappeared.
Apparently there is no valid excuse for the manufacture of wood-
alcohol. Its actual cost is much greater than that of grain alcohol,
and its manufacture results in the denudation of mile after mile of
growing timber. To facilitate the use of grain alcohol in the arts
the government permits the sale of the so-called denatured alcohol
tax free; but unfortunately one of the processes of denaturing con-
sists of adding ten per cent of wood-alcohol, which is sufficient to
make even denatured alcohol dangerous to the susceptible. It is,
perhaps, beyond the scope of this paper, but Holden has recently
called attention to the fact that many retail druggists sell wood-alco-
hol over the counter under various names, not only without any
indication of its poisonous nature, but with the phrase on the label
“guaranteed under the food and drug act”, which many people
understand, not as a guarantee of purity, but of harmlessness.
We have much to learn about the subject before we can legislate
intelligently. The manufacturers claim that the pure wood-alcohol
is harmless, the poisonous brands being those incompletely refined,
while even the latter are safe enough if sufficient ventilation is se-
cured. - -
DISABILITIES DUE TO ExPOSURE TO LIGHT
There is another long list of more or less serious disabilities which
result from exposure of the eyes to artificial light, made necessary
by our modern factory conditions. Electricians are dazzled and
sometimes blinded by sudden exposure to the intense light caused
by blow-outs and short circuits. Too intense light, like that of the
arc lamp, decomposes the visual purple faster than it can be regen-
erated and causes a condition of retinal exhaustion. It also causes,
in the effort to exclude the light, a constant extreme contraction of
the pupil, which is both painful and fatiguing. This accounts for
the asthenopia which is so common in many trades which, like
those of gilders, metal polishers, and glass workers, compel a close
attention to polished surfaces which reflect light.
The modern methods of industrial lighting have made the com-
position as well as the intensity of light a subject of great practical
Occupational Eye Diseases 227
importance. Incandescent gas and electric lights contain many of the
violet and ultra-violet rays, which are not only useless for illumina-
ting purposes, but are capable of causing effects on the eye not un-
like a modified snow-blindness. The worker who is exposed to
them day after day often develops annoying inflammations of the
lids and conjunctiva, and also often suffers from asthenopic symp-
toms which vastly diminish his efficiency. Furthermore, their ef-
fect on the deeper structures of the eye is suspected of being still
more serious. The refractive media of the eye absorb most, if not
all, of these ultra-violet rays, so that the retina suffers little harm,
but it is quite possible that the continued process of absorption
may be one of the causes of cataract. It is certain that stokers,
bottle makers, glass-blowers, and others who are continually ex-
posed to very intense light and heat have an enormously increased
liability to cataract. One foreign observer found that as many
as 40 per cent of the bottle makers in one establishment showed
evidences of cataract, though the great majority of them were
under forty years of age. The left eye, which is nearest the fire,
was invariably affected more than the right.
DISEASEs DUE TO OCCUPATIONAL STRAIN
There is also a very large group of diseases, organic or functional,
which are due to prolonged use or excessive strain of the eyes. The
eye is one of the most complicated organs in the body. Perfect
single vision requires not only two good eyes but their complete co-
ordination, which is accomplished by the joint action of fourteen
separate muscles. Four of the twelve great cranial nerves are de-
voted exclusively to vision. When one stops to think that most
people use their eyes almost constantly and that many tasks involve
a continuous strain for hours at a time, one begins to understand
why vision necessitates expenditures of "nerve and muscle energy
beyond almost any other function.
There are at least three distinct types of eye fatigue which show
themselves in different trades. We have already alluded to the
retinal fatigue resulting from the constant watching of polished
or reflecting surfaces, resulting in the asthenopia of gilders and
polishers. Next comes the muscular fatigue which we see in the
trades that compel the constant use of the eyes for close, fine work.
The perfectly normal eye sees things close at hand only by a process
228 American Labor Legislation Review
of accommodation or focusing, which is a muscular effort and
which produces a normal fatigue. It is, therefore, perfectly possi-
ble to strain healthy, normal eyes by overwork. In most of the so-
called errors of refraction, hyperopia, astigmatism, and the like,
distinct vision is only possible by overaccommodation, and the
individual who has to accommodate too much naturally becomes
tired sooner than he otherwise would. Holden, in a very interest-
ing paper, calls attention to the fact that one of the first occupa-
tional diseases of which we have any record was the scholar's dis-
ease; his headache, his eye pains, his indigestion, and his pessimism
were ascribed to his sedentary life and his brain work. Many of .
the ills which the scholar endured were due to overuse of his eyes
and are to-day relieved by the use of suitable glasses. But
the scholar no longer has any monopoly of either the symptoms or
the life. To-day there are many trades in which the workman sits
hour after hour chiefly engaged in watching intently—a task which
eventually tires even the normal, healthy eye. And among the
factory workers, badly housed, ill fed for generations, diseased,
refractive errors, which are for the most part congenital, are not
only practically universal, but often so great that they cannot be
compensated for by any amount of strain.
Consider the garment workers, for instance. They all suffer from
errors of refraction, large or small. They have less than the nor-
mal compensatory powers because their muscles are overworked
and badly fed. They work long hours in close, badly ventilated,
badly lighted rooms, driven to the utmost. The least muscular re-
laxation means indistinct vision and mistakes in their work,
and for every mistake there is a regular tariff of fines and
deductions. The constant strain to see distinctly results in a whole
series of eye symptoms. The muscular fatigue causes headache,
which most operatives seem to consider an inevitable incident of
life. The eye, like the hand, has its muscle cramps from over-
stimulation, and its pareses from exhaustion, but, while the cramp
of writers and telegraphers is regularly included in the list of oc-
cupational diseases, nothing is said of the far more common ciliary
spasm or the convergence insufficiency of the eye worker. The
nervous exhaustion which follows the effort to stimulate tired ocu-
lar muscles day after day is certainly one at least of the causes
of lowered vitality and depression. Neurasthenia and the other
Occupational Eye Diseases 229
fatigue and attention neuroses are said to be practically universal
among the garment workers, and no small part of it can be ascribed
to eyestrain.
Miner's nystagmus has always been described as the type of oc-
cupational disease resulting from eyestrain of a definite sort. Pro-
gressive myopia is no less so. Practically unknown in infancy, it
first appears occasionally in the early years of school, and be-
comes more and more common as the children advance from grade
to grade. In the various social classes it is found to be in direct
proportion to the amount of close work which they have to do.
Among the German lithographers Cohn found that 45 per cent
were myopic and among the typesetters 51 per cent. The same
practical conclusions are true the world over. The myopic eye is
a diseased eye and progressive myopia means a gradual failure of
vision, constant liability to ocular inflammation, and in many cases
final blindness. It is a true occupational disease which in Germany
accounts for approximately ten per cent of blindness.
CoNCLUSION
I have given a very brief resumé of certain types of disability
which may affect the eyes as the result of certain occupations. Be-
fore we can possibly have wise legislation we must have far more
exact knowledge of many of them. Accidents and injuries are,
even to-day, passably taken care of. They are interesting to the
physician, and their cause, their treatment, and their prevention
are often so obvious that much progress has already been made
in reducing their frequency. -
The study of the trade poisonings which affect the eyes is still,
however, in its infancy in this country, and is not likely to progress
much till a change is made in the method of investigation. The
hospital physician is in no position to study them. They come to
him as isolated cases, often in patients who speak little or no Eng-
lish and who work at trades the details of which are unknown to
him. Most of them have no pathognomonic symptoms to distin-
guish them from similar conditions which are not occupational. I
am sceptical of the scientific value of the compulsory reporting of
such cases. It will doubtless reveal occasional extreme typical
cases and be worth while from an educational standpoint and from
the standpoint of punishing legal infractions, but that it will add
23O American Labor Legislation Review
much of scientific value to the specialist's knowledge of occupa-
tional diseases I doubt. The place to study these conditions is
not in the hospital or the clinic but in the factory. What we need
is an intensive study, once for all, of each of the important trades
by a group of trained observers.
Personally I believe that the eye diseases due to fatigue are far
more important than we commonly suppose. More people are
blind from malignant myopia and retinal detachment than from all
the trade poisonings. More inefficiency and more misery are caused
by defective eyes than by diseased ones. There is no field in which
it would be easier to enlist the enlightened self-interest of employers.
Any intelligent shop management must consider the eyes of em-
ployees. There may be a place in our modern factory system for
the lame and the halt, but not for the blind or the partly blind. Pro-
fessor Munsterberg can tell by psychological tests whether it will
be worth while to train a girl as a telephone operator. The oculist,
in his turn, can not only do a good deal to convert unprofitable
into profitable employees; he can pick out employee after employee
whom no intelligent man could afford to hire. More than this
he can form a pretty good estimate of those who are fit to-day but
will be unfit to-morrow. There has been so much exaggeration
on the subject of eyestrain that the medical profession has dis-
gustedly refused its attention, and yet I know of no one factor
that affects the earning capacity of the laboring classes to such
an extent. I know of no medical field to-day in which the poor
and the ignorant have been so entirely abandoned to the care of
the incompetent and the dishonest. Here again intensive study
is needed.
INDUSTRIAL POISONING
DAVID L. EDSALL
Harvard Medical School.
There has been a great deal said in the past few years about the
general problem of industrial hygiene, but until very recently there
has been a deplorable lack in this country of precise information in
regard to industrial intoxication. Even yet, in spite of the investiga-
tions made by Dr. Alice Hamilton, Dr. John B. Andrews, and others
for the Labor Bureau, the Illinois Industrial Disease Commission,
and the American Association for Labor Legislation, we do not have
anything like the detailed information which is available in Europe.
I have been able to get more information in two or three days from
an official introduction in a foreign country than I can get in this
country in two or three months. The only difficulty there is that
the manufacturers are often afraid you are looking into trade se-
crets; they don't care how much you look into trade health.
Yet we know that conditions in this country are certainly as bad
as conditions abroad. There used to be claims that, owing to our
great national ingenuity and inventiveness, or to other causes, there
was not so much industrial disease here and that, therefore, we did
not need the rigid legal control which they exercise in other coun-
tries. But the recent investigations of phosphorus and lead and
mercury poisoning show that we are dealing with conditions that
need attention here just as much as abroad. Dr. Thompson has
mentioned his experience in New York with regard to lead poison-
ing, and I have had some experience in Philadelphia. From my
own records I could produce more cases of lead poisoning from each
of two white-lead works there than from any similar works in Great
Britain. I have gone over the records of some of the latter and
know what they are.
The work I have done, however, has been purely individual.
Official information and investigation is much better. The expe-
rience we gain from unofficial investigations is very vague and frag-
mentary and brings to light only a fraction of what exists. As good
232 --. American Labor Legislation Review
evidence as I have ever had of this fact was in connection with two
large plants, both of which used carbon bisulfid and lead. One manu-
facturer told me they had so little trouble they did not pay any
attention to it at all. The other plant, carrying on the same processes,
told me with the greatest openness that they had considerable
trouble with carbon bisulfid and lead in spite of great precautions.
It is essential to get precise and definite studies on the subject from
an official standpoint.
Such studies are particularly necessary, I believe, by reason of
the fact that a great many processes in this country differ from the
processes abroad. It is an interesting fact that Great Britain has
had a different problem to deal with from that in Germany. As
we know, Germany's vast commercial importance is the development
of the last half century or less and it has been possible, therefore, to
put into effect there almost any law affecting the health of employees
without greatly disturbing the manufacturer. In England many per-
Sons carried on trades in very old localities and old shops and if they
had enacted drastic laws immediately they would have destroyed
their industries. They had different conditions. We are only mak-
ing a beginning at regulation and are far behind both Germany and
Great Britain. But we must know our own conditions, and not go
too much on observations in other countries, if we are going to deal
justly with our industries. From the United States Bureau of Labor
and other such sources we must get the information we need. No
one need feel, because we have acquired some valuable knowledge of
conditions in the last two or three years, that we have approached a
fraction of what is really important.
In getting this information and in drawing up regulations based
upon it, the first thing we need is uniformity, uniformity between
investigating agencies and between states. If we cannot have uni-
formity in the first place we will have trouble in classification. More-
over, it is extremely important in legislation, for any regulation
of these things in one state, when there is no regulation in surround-
ing states, may do such harm to industries that they will move to an-
other state or new industries will not develop there. Uniformity
is the first step in regulation.
The reporting of industrial diseases, and the reporting of a larger
number than now required in the eight states that demand such
reports, furnishes the most important source of information, The
Industrial Poisoning 233
importance of this is at once recognizable by anyone who knows even
vaguely the effect of the reporting of infectious diseases, though very
few except those interested know the profound effect of the report-
ing of industrial diseases. As a striking example of this, I was talk-
ing with Dr. Legge, the head of the medical inspection of factories
in England, in regard to their regulations concerning industrial in-
toxication. His long experience under the British reporting law
has made him familiar with almost all the plants in Great Britain,
and particularly with all the different operations of these plants.
He told me, if I wanted to see a curious difficulty which they had
not been able to remedy, to go to a certain pottery. Then he pointed
out various plants elsewhere that exhibited simple or more complex
means of overcoming particular dangers. This detailed information
gave him precise knowledge as to where any company needed
to be corrected and where they did not need to be corrected. There
is other important information that cannot be gained in any way
except by the reporting of diseases. In particular it gives a definite
idea as to whether or not regulations are doing the right amount of
good.
Another fact that the reporting of industrial diseases opens out is
the occasional necessity for rather drastic special regulations in re-
gard to matters of this kind, such as the French laws concerning
the use of lead paint. In England they have had little improvement,
owing to their regulations, in lead poisoning among painters. It
may be that they will be forced into drastic prohibitory laws like
those in France.
The medical inspection of working people exposed to conditions
of this kind will unquestionably, I am sure, lead to improvements
of conditions equal to those from reporting diseases. The manufac-
turers abroad that I have talked with about this, and I talked with
a number in England, were actually enthusiastic then, though they
opposed it at first. Some told me that, although required by law to
have an inspection once a month, they had voluntarily introduced
it once a week because it had the value of detecting any trouble at
once. The manufacturer has been rather condemned this morning by
one or two speakers. My experience has been that very frequently
he is quite as willing to cooperate as anyone else. Manufacturers
may be divided into three classes: those who are educated as to the
value of these matters, those who are willing to be educated, and
234 American Labor Legislation Review
those who are uneducated and unwilling. But many of them are
willing to do what they can if the matter is once made clear to them.
An essential thing that, it seems to me, needs to be done in over-
coming the conditions we are facing is to establish some definite
standards. That is true of anything relating to industrial condi-
tions or anything else. You cannot make improvements unless you
know the standard of improvements. Most of our laws in regard
to industrial hygiene throw the whole burden on the medical
inspector. If he is an honest and capable man he may do it well.
If he tends to be a grafter, he can use his position for that purpose.
If he is uninstructed he does nothing. In England the regulations
in regard to potteries fill a large pamphlet, going precisely into every
detail. This is fair to the manufacturer, because he knows what he
must do; but it holds him up if he does not do it. Standards should
be given in every instance when possible, so that the manufacturer
may come up to the standard and not just vaguely try to do the
right thing. Even then inspectors should be trained.
Another important thing is that the regulations shall not be de-
pendent upon the occasional meeting of a state legislature, that there
shall be some provision similar to that in the English law, which
practically gives the Secretary of State power to modify these regu-
lations as may seem to him wise if he submits the changes to the
action of Parliament as soon as possible; but in the meantime he can
protect working people from changes in processes, or other things
that might be dangerous, and not wait for indefinite periods.
There is only one thing more I should like to say, and that is that
I think we have been and still are altogether too prone to consider
occupational poisoning of various kinds merely as showing certain
picturesque results. We tend to look on colic, palsy, and encephalo-
pathy, for example, as being all of the important effects of lead
poisoning, but the main effects of lead poisoning are other things;
much more ill health is caused by the general effects on the health,
the arteries, the kidneys, and digestion. I think we have no more
right to speak of lead colic and such things as the main effects of
lead poisoning than we have to speak of drowsiness as the main
effect of the morphine habit. Any statistics that we can get only
show a minor fraction of the results of these intoxications. They
undoubtedly cause many times the bad results that appear from
these definite, discoverable consequences.
COOPERATION IN PROMOTING INDUSTRIAL HYGIENE
HENRY R. SEAGER
President, American Association for Labor Legislation.
Nothing could better illustrate the advantages of cooperation in
our efforts to promote industrial hygiene than the papers that have
been presented at this Conference, or indeed than this Conference
itself. The greatest present need in this field in the United States
is undoubtedly fuller knowledge. We need to know more accurately
what are the occupational diseases to which American wage-earners
are exposed. We need to know the conditions which give rise to
these diseases in the occupations in which they are found. Finally,
we need to know the easiest and most effective means of changing
conditions so that these diseases may be prevented. The fact that
this is only the Second National Conference on Industrial Diseases
is evidence of the tardy attention we are giving to occupational dis-
eases in this country. For some time to come careful, intensive
studies, like that described by Mr. Hoffman, must precede the intro-
duction of remedial measures.”
If fuller knowledge is what we most need, the group to which
we must look for light is obviously that of the trained physicians
who have taken to heart the old adage that an ounce of prevention
is worth a pound of cure, and who are deliberately turning aside
from the work of curing the sick to the more important, if less
appreciated, work of searching out the causes of sickness and
devising measures that will narrow the field over which these causes
operate. But in connection with occupational diseases physicians
require, perhaps more than in any other department of preventive
medicine, the cooperation of other groups. This is because occu-
pational diseases must be studied not merely in the symptoms of
* The results of one such study have been published in a monograph by Mrs.
Lindon Bates on Mercury Poisoning in the Industries of New York City and
Vicinity, by the Women's Welfare Department of the National Civic Feder-
ation. Copies may be secured by application to the American Association for
Labor Legislation, Metropolitan Tower, New York City.
236 American Labor Legislation Review
their victims, but in direct connection with the occupations that
give rise to them. It is not enough that employees who have con-
tracted occupational diseases submit themselves to examination and
treatment; other employees in the same trades who have not yet
contracted the diseases must be examined, and all must be induced
to furnish full information, not only in regard to the places and
conditions under which they work, but also in regard to their
homes and habits of life. It is not enough for employers to send
employees who require treatment to company physicians; they must
also grant free access to their plants and permit periodical phy-
sical examinations to be made of all their employees, both well and
ill. Finally, to bring physicians, employees, and employers together
in a united effort to lessen the ravages of occupational diseases,
the zeal and enthusiasm of social workers are required. As in the
case of tuberculosis, itself to some extent an occupational disease,
so for occupational diseases generally, the road to reform lies
through a vigorous campaign of public education. Social workers
must be counted upon to organize this campaign and to press it
on to a successful issue.
A comparison of conditions in the United States with conditions
in Germany and in the United Kingdom indicates how far we are
behind those countries from the point of view of public appreciation
of the importance of industrial hygiene. In introducing the sys-
tem of obligatory illness insurance for wage-earners in 1883 and
requiring employers to contribute one-third of the necessary prem-
iums, Germany made industrial hygiene thenceforth a matter of
supreme concern to her industrial classes. Preventing occupational
diseases was changed from the interest of a few unusually humane
or unusually far-sighted employers to a pursuit in which the most
mercenary and penny-wise were almost equally zealous. Reducing
the number of employees to fall ill and the number of days of
illness for those who could not be kept well, now meant reducing
sick-insurance premiums and thus adding directly to the year's
profits. Whatever may be thought of incidental effects of the
compulsory insurance system, there can be no doubt that the won-
derful progress that Germany has made in the last thirty years in
the field of preventive medicine has been largely due to this bold
policy of the Iron Chancellor.
The United Kingdom, in adding in 1906 to industrial accidents
Cooperation in Promoting Industrial Hygiene 237
certain specified industrial diseases as grounds on which wage-
earners suffering a loss of earning power might demand compen-
sation from their employers, went even further than Germany.
Under this plan the employer had to pay, not merely one-third of
the premiums out of which indemnities should go to wage-earners,
but the whole indemnity prescribed by the law. The list of occu-
pational diseases has been steadily expanded since the law was first
passed, until now more than a score are included; and as regards
these diseases, it will readily be believed, the British employer has
become the eager coworker with the sanitarian in trying to lessen
in every possible way the risk to which his employees are exposed.
The National Illness and Unemployment Insurance Law, which
comes into operation next month, gives the British employer an
interest equal to that of his German colleague in reducing all
forms of illness. It is no doubt unfair, as well as unkind, to
British physicians to ascribe their opposition to certain features of
this law to a fear that it will put them out of business; but it is
certain that in England, as in Germany, the new policy will give
a tremendous impetus to preventive medicine.
In the United States illness insurance, even through sick-benefit
societies, is as yet little developed. Even without it, it is probably
true that on strict financial grounds it is worth while for the
American employer to give greater attention than is customary
to keeping his employees well and strong; but for employers in our
big cities, with large reserve forces of labor to draw on, the
proposition is debatable. It is, therefore, essential that social work-
ers cooperate with physicians in trying to induce employers, on
grounds of humanity, or self-interest, or both, to do their indis-
pensable part in furthering the cause of industrial hygiene. Social
workers must also rouse employees to an appreciation of the risks
they run in unhealthful occupations and induce them, not only to
demand safer conditions, but to give the attention to personal
hygiene that is now so commonly lacking.
In preference to elaborating further on the subject in general
terms, I prefer to illustrate the need of cooperation in promoting
industrial hygiene by describing some of the work in which the
American Association for Labor Legislation has been concerned
since its organization six years ago. Its founders early recognized
that industrial hygiene was one of our great national needs. How
238 American Labor Legislation Review
to impress this view on a busy and indifferent public was the prob-
Iem. It happened that the European sections of the Association
had recently been giving much attention to the prohibition of the
use of poisonous phosphorus in the manufacture of matches, and
that European governments had even made treaties for their mutual
protection on this subject. Poisonous phosphorus thus seemed
a promising industrial poison with which to begin our campaign.
When Dr. Andrews, the secretary of the Association, began his
investigation of the match industry for the federal Bureau of
Labor, phosphorus necrosis, “phossy-jaw”, was a disease of which
it is safe to say few laymen in the United States outside of match
factories had ever heard, and which few physicians had ever had
occasion to diagnose. His first task was to satisfy himself that this
disease was one of the necessary by-products of the manufacture
of poisonous matches in the United States, as it was acknowledged
to be in Europe; his second, to convince an influential body of pub-
lic opinion that such a dangerous, loathsome, and unnecessary dis-
ease ought to be stamped out here by prohibitive legislation, as it
had been stamped out by the other civilized nations of the world.
Without the cooperation of employers, employees, and physicians,
his investigation must have proved a failure. I need not now detail
the steps by which it was made a success, nor the two years' cam-
paign waged by the American Association for Labor Legislation
which culminated last April in the enactment of the Hughes-Esch
Law imposing a prohibitive tax on poisonous phosphorus matches
manufactured in the United States after July 1, 1913. Suffice to say
that but for the cooperation of the majority of the match manu-
facturers in agreeing not to oppose the bill, on condition that it
should apply to all of them alike and that it should include the
prohibition of the importation of poisonous phosphorus matches,
the act probably would not have been passed. Further, but for the
cooperation of physicians and hospital authorities in supplying evi-
dence of cases of phosphorus necrosis and of the ineffectiveness of
preventive measures falling short of outright prohibition, the public
could not have been aroused as it was against this evil. Finally,
but for the aid of match workers, one of whom went to Washing-
ton to display his cruelly disfigured face to the members of the Ways
and Means Committee for the sake of his fellow workers exposed
to a similar fate, those gentlemen would not have reported out the
bill, which had so long been held in committee.
Cooperation in Promoting Industrial Hygiene 239
The issue presented by the use of poisonous phosphorus in the
American match industry was simpler and more clear-cut than that
found in connection with any other industrial poison. Usually pre-
ventive measures, not outright prohibition, are the remedies to be
sought, and usually there is great difference of opinion as to what
preventive measures are best and how they may best be made
effective. º
Appreciating the need of further information about occupational
diseases, the Association has been responsible for the introduction
and enactment by eight states in the last two years of bills requiring
physicians to report certain specified industrial diseases to desig-
nated state authorities, usually the state commissioner of labor.
Legislatures are only too ready to pass bills imposing duties upon
physicians ! It was another matter to devise machinery to insure that
reports of value would be sent in and that the statistics so secured
would be turned to useful account.
Partly for this purpose and partly to promote industrial hygiene
in other ways, the New York Association for Labor Legislation,
on the initiative of its secretary, Mr. Paul Kennaday, organized last
October, in conjunction with the New York Academy of Medicine,
a joint committee on industrial diseases. Dr. W. Gilman Thomp-
son has been from the first the guiding spirit of this committee, and
its frequent evening meetings at his house have already resulted in
achievements which promise much for its future usefulness. It
was felt by all that the first work of the committee should be to
try to make the law requiring the reporting of industrial diseases
more effective. Dr. Hatch, statistician of the department of labor,
was asked to be a member of the committee. He gladly accepted
the offer of the committee to cooperate with him in drawing up a
more satisfactory form for the reporting of occupational diseases
than the department had been using. A much improved reporting
blank was finally agreed upon, and this blank is now not only in
use in New York, but is likely to be adopted by other states which
require occupational disease reports. To impress upon physicians
the importance of cooperating with the state authorities in the
efforts to collect adequate statistics of occupational diseases, the
committee next undertook the compilation of a pamphlet on the
nomenclature of occupational diseases, which is to be printed and
circulated by the department of labor to all of the physicians in
the state.
24O American Labor Legislation Review
The services of Dr. E. E. Pratt were then secured to make a re-
port on all the investigations of occupational diseases that had up
to that time been undertaken in New York State. With this report
as a guide, the committee advised the special Factory Investigating
Commission of this state as to the occupational diseases most likely
to repay further investigation. The other work undertaken by
the commission is so broad that the attention it can devote to occu-
pational diseases has proved to be disappointingly slight, but it has
asked the cooperation of the committee in framing recommendations
to the state legislature for the creation of a permanent bureau for
the study of occupational diseases, and with the constantly growing
interest in the subject there is strong likelihood that such a recom-
mendation will be acted upon favorably.
Besides these more important activities, the committee has served
as a clearing-house of information for numerous other groups in-
terested from other points of view in the general subject of in-
dustrial hygiene. For example, it has met with the committee on in-
dustrial poisons of the Chemists’ Club of New York City and dis-
cussed possible lines of cooperation during the coming winter. It is
the purpose of this committee, so soon as the necessary funds are se-
cured, to prosecute investigations of the numerous occupational dis-
eases that have not thus far received adequate attention. Its mem-
bers, through articles and addresses to all sorts of audiences, are
constantly urging the importance of greater attention to industrial
hygiene. Also through its members it hopes to induce some em-
ployers voluntarily to introduce the precautionary measures that
its investigations and the investigations of others prove to be de-
sirable. So soon as the practicability and efficacy of these measures
shall have been demonstrated, the Association for Labor Legislation
will seek to have their introduction made mandatory through labor
laws, so that the lives and health of all employees may be protected.
Our experience in New York has convinced us that the organiza-
tion of a committee of physicians, sanitarians, and interested lay-
men, such as I have described, is an important, if not a necessary, aid
to effective work for industrial hygiene. Physicians and sanitari-
ans must supply the expert knowledge, but for the most part they are
too busy to direct the work of educating public opinion or of shaping
the legislation which this knowledge proves to be necessary. This
Cooperation in Promoting Industrial Hygiene 24I
part of the task must devolve mainly on social workers. In addition,
industrial chemists, representatives of life insurance companies, and
officials of the appropriate departments of the city and state govern-
ments, may be drawn in to form a group which is representative of
enlightened and progressive public opinion touching this problem.
Through such a group tasks can easily be accomplished that would
be impossible for men working in isolation, or even for the associated
members of any single profession.
We recommend the organization of similar committees in other
states as an efficient means of advancing the cause which we all
have at heart.
GENERAL DISCUSSION
DR. WARREN COLEMAN, Bellevue Hospital, New York City: In
view of the importance of the subject of industrial diseases, may I
be permitted to suggest that a petition be presented from this section
to the House of Delegates of the American Medical Association re-
questing the appointment of a committee to cooperate with the
American Association for Labor Legislation to promote the study of
industrial diseases.
This motion was duly seconded and unanimously carried.
DR. ROSALIE SLAUGHTER MoRTON, New York City: I have been
especially interested in this joint session. It seems a great evidence
of progress that the laity and the profession of medicine should get
together to work for the public good. The work done by the Asso-
ciation for Labor Legislation has gone so far that I, as vice-president
of the Medical Section, feel it an honor to cooperate with you.
DR. C. F. STOKES, Surgeon General, United States Navy, Wash-
ington, D. C.: We have been looking after occupational diseases in
the Navy, but entirely on the basis of military efficiency. There is
no humanitarian factor in it. Sanitation generally has reached a
satisfactory condition. But in a battleship we find grouped together
a more varied set of activities than will be found elsewhere in the
Same Space.
Respecting the eye troubles, the men who adjust arc-lights have
severe troubles caused by the sudden glare. In our turrets, too,
we have our gun pointer, the man who points the guns; the range
is so long that he must use a telescope, and we have found that these
men, who started in with normal vision, have dropped down to eight
and ten below. That is something which is very important to the
Navy.
Then there are the toxic gases. We find in almost all these great
ships a type of gas which has caused death in many instances, hap-
pily in foreign navies. The element at work seems to be a diminu-
tion of oxygen. After two or three rounds at battle practice, the
carbon dioxid runs up to forty. We have powder gas at work there
which gives us a carbon monoxid poison. Men who have at the
General Discussion 243
beginning of firing a pulse rate of seventy-two, have at the end of
ten minutes a pulse rate of one hundred and twenty. And in the fire
rooms the heat prostrations are due largely to gas contamination,
carbon monoxid. The same thing applies to submarines. We have
been working at this gas problem.
I was interested in what Dr. Dana had to say. It is now known
that there were some two thousand men at Port Arthur during the
Russian-Japanese War who were invalided home by reason of insan-
ity. In other words, they were not temperamentally fit for that
hazardous work. We find that some men get along very well during
peace times but, when it comes to battle practice, or possibly to
Some great hazard, they break down. They are temperamentally
unfit. These are all military considerations bearing on occupational
hygiene. - !
DR. MARK D. STEVENSON, Akron, Ohio: Occupational eye dis-
eases may be caused by exposure to excessive light or heat, to poison-
ous gases or fumes, and by prolonged and peculiar strain.
First are diseases due to excessive light or heat, e. g., in electric
welders, steel smelters, and in those who melt or anneal glass. Metal
polishers and buffers, brightening surfaces which they must closely
watch, often suffer with hyperesthesia of the retina. This can be
relieved by proper lenses or colored glasses. Excessive heat and
light are met with in iron and steel works. Men can watch a fur-
nace until the temperature is up to 2000° F., but before it gets to
3000° colored glasses should be worn. If some of these hot furnaces
are looked into without lenses it is several minutes before the eye can
see ordinary objects again. Some men seem to have surprising
immunity from bad results in dealing with these white-hot furnaces;
others cannot endure them and must change their work. Herbert
Parsons and Marcus Gunn, who visited some of the important
glass works in England in 1908 to gather statistics of industrial
diseases for the framing of the Workmen's Compensation Act, state
that bottle workers have a characteristic form of cataract, typi-
cally, a dense, well-defined disk of opacity in the center of the poste-
rior cortex. Excessive heat and bright light are said to be the causes,
but the Germans claim that heat is the most important cause. Weyl
mentions, besides glass-blowers, fire workers, puddlers, blacksmiths,
bakers, and cooks. Great care is required to avoid very strong light
244 American Labor Legislation Review
flashes before the eyes, as in short circuits and electric welding. In
the latter large shields are worn, in the center of which are four al-
ternate layers of blue and red glass. Helmets and screens, with four
or six layers of red and green glass, are often used. The tempera-
ture in electric welding goes as high as 7000° F., but the question
of whether it is the heat or the chemical rays that act so harm-
fully has not been settled. If the eyes catch the light they are affected
at once, but usually the effect appears some hours afterwards. The
eyes feel swollen as if filled with burning sand and the pain is
usually severe; the lids are swollen and there is much lacrimation.
Other diseases are due to working in certain poisonous gases,
fumes, dusts, or substances, such as bisulfids of carbon, lead, etc.
Dinitrobenzol is largely employed in making explosives. During
the various processes of its manufacture fumes are given off which
affect vision. These can be lessened by properly covering the mix-
tures and by the use of fans and exhaust apparatus. Respira-
tors and glasses should be used. Bisulfid of carbon, formerly much
used in vulcanizing rubber, caused impaired eyesight, but this pro-
cess has been so greatly modified that it is now of little impor-
tance in causing ocular lesions. Toxic amblyopias, due to tobacco,
ethyl alcohol and wood-alcohol, are too well known to require
consideration. The eye affections formerly attending the manu-
facture of iodoform have by care been eliminated. A few cases of
eye involvement have been reported in dye factories from handling
the various coal-tar preparations. Arsenic and paris green from
wall-paper, artificial flowers, paper hangings and paintings, have
caused various visual disturbances. Painters, plumbers, electro-
typers, file-cutters and many others, through handling lead, are like-
ly to get chronic lead poisoning, causing central and peripheral
affections of sight, various paralyses, retrobulbar neuritis, etc.
Poisonous gases and fumes are also formed in certain lead processes,
and in shoe cement, japanned or patent leather, and rubber manu-
facturing, where the mixtures containing naphtha are sometimes al-
lowed to remain in uncovered containers and proper ventilation
is not insisted upon.
Eye diseases may also be due to occupations requiring prolonged
and peculiar use of the eyes, e. g., nystagmus in miners, which is
due to their peculiar way of looking at their work. Treatment
consists in changing the kind of work. After relief the miner can
General Discussion 245
return to his work if the head can be kept straight and the eyes are
not often turned upward. Snell mentions several other, occupations
which he has thought might cause nystagmus, because the eyes were
turned directly or obliquely upward.
DR. WALTER F. DUTTON, Carnegie, Pa.; The occupational dis-
ease which results from the manufacture of vanadium is not as yet
well known. There are two reduction plants in the United States, in
which there are a number of employees. The products are being
used more and more in the manufacture of steel, in photography,
and in manufacturing plants where mordants are used. The mon-
Oxid is used in photography; the dioxid in printing calicoes, and the
trioxids in the manufacture of steel. This disease will become
more and more well known as the use of vanadium products in-
creases. I should like to call your attention to an article in the
Journal of the American Medical Association of June 3, 1911.
MR. E. C. CURTIs, New York City: Speaking for the men who
work in compressed air, I think we need very much the cooperation
of physicians and of the American Association for Labor Legislation
to better our condition. Up to the present time the doctors have not
attended to this industry as they should. There were 3692 cases of
compressed-air illness in one small job, the East River Tunnel. I
have known personally of men who have entered these air-locks
without the doctor ever looking at them; there were small boys who
acted as doctors and passed the men to go into the caissons. We
had one case in particular where we ought to get a conviction; we
went before the doctor proving that the man was sent down with
an abscess on his neck, and was dead before he got half way down.
That is one of the conditions under which the men I represent are
compelled to suffer, and I claim there is carelessness among the doc-
tors. We had another case only recently, where a man was put into
the medical air-lock while a new invention was being tried on him.
They put him into cold air. The man was frozen to death in the
medical air, taken out of there and laid for three solid hours on a
plank, and then brought home dead. The physicians do not seem to
value human life at all. Here was a man with six children brought
home dead for experimental purposes. But if the physicians are
going to be sincere in this matter, and the American Association
for Labor Legislation and the American Medical Association will
246 American Labor Legislation Review
work together, it is going to be a great help to the men in the industry
I represent.
MRS, HENSON: With regard to the point just brought out,
the workmen ought to know, and they do know if they stop to think
about it, that physicians are better paid by the corporations. They
should take this point close to heart and get after the remedy. Until
the workmen own the industries, and therefore are the employers of
the physicians, they will never be certain of the best service. Lest
Some may not have read enough of Socialism to know what I mean,
they must establish the cooperative commonwealth.
DR. ALLEN STARR, New York City: I wish to say a word about
a matter which does not seem to have been brought out in the dis-
cussion,-the necessity for informing the individual laborer of his
dangers and of the means for their avoidance. It seems to me that
the American Federation of Labor can do a great work by insist-
ing in its labor unions upon certain definite information being given
to each laborer, in his own department, as to the methods of avoid-
ing these dangers, and so preserving his health. If a painter, for
example, will take an ordinary piece of newspaper and place it be-
tween his sandwich and his fingers, he will not get the lead from
his fingers into his mouth. Yet in a large clinic in New York last
year I questioned thirty individuals suffering from lead poisoning
in regard to whether any instructions had been given them, by their
employers through notices posted in the factories, or in their labor
unions, as to methods of avoiding lead poisoning, and found that
they had never heard even of a simple device of that kind.
Many of these cases of disease, too, are the result of careless-
ness. I have had some experience with the caisson disease, which the
gentleman from New York has alluded to. One of the most compe-
tent engineers in the employ of the Pennsylvania Railroad Com-
pany insisted on disregarding the precautions he should have known
and was careless enough to come out from a tunnel without spend-
ing enough time in the various compartments. I should like to
know if these men are not instructed about the necessity of remaining
in the compartments a certain length of time, and whether their in-
juries have not resulted from carelessness.
I should also like to make one other point in defense of the manu-
General Discussion 247
facturer. I have a large acquaintance with important manufactur-
ers in New York State, but I have yet to find one, of a reasonable
degree of intelligence, who is not as much interested, from his stand-
point, as the laborer is from his. I will cite one company in Jersey
City which put up a factory in which incidentally there is a large
amount of dust discharged into the air. This company spent
$40,000, under the direction of an incompetent engineer or archi-
tect, for a system of ventilation by which the dust was taken up to the
top of the room, passing on its way the mouths of the operatives.
One intelligent operative came to the head of the firm, a personal
friend of mine, and said: “That is a defect; if you would put your
exhaust apparatus in the side of the floor, gravitation would take the
dust down and we would not breathe it in.” That gentleman had the
good sense and the philanthropic instinct developed, and he changed
the whole system and spent $20,000 more in installing a new
apparatus.
I believe there is great hope along these lines of disseminating in-
formation,-first, information to the employer as to what is the
necessary thing for him to do, and secondly information to the em-
ployee as to personal methods of protection. And that, it seems
to me, devolves more upon the Association for Labor Legislation
than it does upon us physicians.
DR. GEIER, Cincinnati: I wish to disagree with the last speaker
when he states that you must approach the employer from the hu-
manitarian standpoint. I have had some experience with employers
in Cincinnati in the tuberculosis problem. You don’t need to use
the cry of humanity at all. They prefer to have you come in with a
business proposition. It is perfectly possible to go to them and
say: “You are doing this and that and the other thing and you are
losing this and that, so many hours loss and so much inefficiency;
put in this device for sanitation and ventilation and you will make
from one to twenty per cent in the increased efficiency of your em-
ployees.” That is the thing that is bound to appeal to the business
man. As a trimming on the side we may speak of the humanitarian
work; but we must approach the business man with a business
proposition.
In Cincinnati there is a factory which is ready to pay $2500 to
$3000 a year to a physician to come in and advise them and examine
248 American Labor Legislation Review
their operatives, etc. I have been asked to find such a man. As
a matter of fact I do not know one man in Cincinnati, who is not
earning $5,000, $6,000, or $10,000, who has the proper socio-
logical view to fill that position.
DR. CHARLEs E. BREST, Waterford, N. Y.: For some twelve years
I pointed my practice to preventive medicine. It naturally brought .
me into the shops and into contact with employers, and I barked
up the humanitarian tree for four or five years. I looked up sta-
tistics in regard to the mortality among employees in certain rooms
where the air was the same air as when the walls of the building were
put up, and presented them to the employers. But up to the good
times of a few years ago, when it was difficult to get trained em-
ployees, they derided me, and there is nothing more difficult to
stand than ridicule. At that time, however, I demonstrated that it
is an expensive proposition to develop skilled employees and then
lose them absolutely, and that it is good policy to care for them.
Employers close down for a week every year to fix up the machin-
ery; they never think of doing that for the employee. But when
I put it as a business proposition the employers were willing to see
the point, and they came to me, not only in cotton mills, but in
laundries. I thoroughly agree with the gentleman from Cincinnati.
If you present the proposition to any manufacturer who is trying to
make good with his work he will cooperate with you.
PROFESSOR HENRY R. SEAGER, President, American Association
for Labor Legislation, New York City: Some one has said that the
first work of science is classification. From that point of view it
would be impossible to exaggerate the importance of Dr. Thomp-
son's paper. The other papers give point to the suggestions which
he has made, since they deal, most of them, with specific occupa-
tional diseases. We are especially glad to have evidence from the
men who must know what the occupational hazards really are.
As a business proposition to employers, as a line of least resist-
ance, I am afraid, when we consider the employer in a large city and
his mass of unskilled labor, that those of us who are conscientious
would not have the face to go before an employer and tell him that
it would be profitable to look after the health of this man who is .
taken ill and turned off, for some one else can be taken on in his
General Discussion 249
place without much expense and with little trouble. But by all
means let us, wherever possible, approach the problem from the
point of view of business. I do not regard that as optimistic. It
seems to me those who approach the problem from the humanitarian
point of view are the more optimistic.
DR. A. M. HARVEY, Chicago: As one of the chief duties of the
physician is to prevent disease and preserve health, it is indeed
gratifying to attend a joint meeting of physicians and members of an
Association which is interested in proposing legislation for the pro-
tection of the health of workers. We need a great deal more knowl-
edge of the subject of occupational diseases before proper laws can
be proposed and enacted. Nothing should be done hastily, for we
undoubtedly have too many laws now on our books that are not
enforced.
I believe that one of the chief things that can be done to prevent
occupational disease is to limit the age at which children may go
to work, and another is to limit the hours of work so that the worker
may recover from the fatigue incident to his labor. My experience
with workers during the past sixteen years has shown me that
many diseases may be prevented by proper elimination of dusts and
noxious gases and by proper ventilation and lighting of workshops.
As all speakers have said, a great deal can be done by cooperation,
but I think we have left out one class of organizations with which
we should cooperate, the manufacturers' associations of the various
states. In Illinois we have an influential manufacturers' associa-
tion, and I think it would be very easy to induce it and other similar
associations to take up the work as outlined in this symposium. I
know that many of the larger manufacturers in Illinois have main-
tained health departments for years, have a great deal of data for
which you have been asking, and would do a good deal toward pre-
venting disease. Many of our manufacturers have taken an interest
both from the humanitarian standpoint and from the economic
standpoint, because they know it is hard to get skilled workers and
that it is cheaper to prevent than to cure.
Mrs. Florence KELLEY, National Consumers' League, New York
City: As a layman I have listened to the papers of the morning with
the very greatest interest and I should not venture to criticize the
25O American Labor Legislation Review
medical statements. But Dr. Edsall ventured into my own field
when he suggested that we should not be hasty or drastic in drafting
bills for the protection of working people lest the manufacturer move
from one state to another. Manufacturers do not move from one
state to another to escape legislation for the protection of working
people. Our legislation is very halting and faulty compared with
that of Europe, and its enactment is always accompanied by threats
of removal from manufacturers.
Since May, 1889, I have been looking for the manufacturer who
actually moves to escape such laws. For four years I was head of
the state factory inspection of Illinois. The Illinois Glass Company
of Alton made the most ominous threats in order to escape the en-
forcement of the child labor law enacted in 1893. We found two
hundred and ninety-six violations of that law and made it clear that
children under fourteen must be dismissed, that children under six-
teen must not work at night, and that all children must have the
certificates required by law. The threat has been renewed by that
company at every amendment to the statute. But the company has
not moved. It has stayed where it was and has multiplied its staff
and plant by three in the intervening years.
I did once appear to have come upon a case in which a textile
mill had moved from Massachusetts to Rhode Island in consequence
of an amendment which made the laws for the protection of women
and children more drastic. When I hunted it up I found that the
company was desirous of establishing new and entirely modern,
up-to-date plants simultaneously in one of the southern states and
in New England. It received from the village to which it went in
Rhode Island the gift of right to the land and valuable concessions
in regard to water power. Its removal has been used as an argument
against improved legislation in Rhode Island and Massachusetts;
but no one, not even the manufacturers themselves, could clearly
disentangle the influence of a slightly increased rigidity in the laws
regulating the employment of children from the gift of land and
lasting concessions of water power.
We want uniformity, but we don't want to let uniformity become
such a bugaboo that we are afraid to do anything for fear a state
may cease to be uniformly bad with the other states. I challenge
anyone here, and I have been challenging anyone from whom I had
any hopes of enlightenment for twenty-three years, to produce an
General Discussion 25I
authentic case of the removal of a manufacturer from one state
to another because of the protection of the workingman.
MR. MILEs M. DAwson, New York City: I feel as if I were
taking the position Scipio Africanus is said to have taken before the
Roman Senate, “Carthage must be destroyed”, when I arise to speak
concerning the intimate and necessary relations between the various
branches of the work we are unfolding and starting in the United
States. We can never accomplish what we wish in the matter of
industrial hygiene and the prevention of industrial diseases until we
have throughout the United States a system of compulsory sick
insurance. The statement made by the lady who spoke of the neces-
sity for the workman being interested in the employment of the
physician, whatever we may think about her general conclusion, is
justifiable. The physicians have not given the caisson sickness
proper attention. We need in the United States something which
will take care of our people and we shall not be able to do it effec-
tively until they are obliged to have sickness insurance.
PROFESSOR SAMUEL McCUNE LINDSAY, Columbia University,
New York City: In view of the fact that every speaker has con-
fessed that our ignorance of occupational diseases is so great that
any legislation at present would be hasty, we are likely to have
hasty and ill-considered legislation. But there are some kinds of
legislation we are now ready for, and it is important that, at this
joint meeting of the Medical and Labor Legislation Associations,
we should turn our thought to the kind of legislation for which
we are ready. -
I shall pass over the sort of legislation that has resulted so satis-
factorily in the prevention of phosphorus poisoning, where our
knowledge was a little further advanced than in regard to other
kinds of industrial poisoning. We need authoritative information
and, as has been suggested by several speakers, we are all agreed that
such information can be had, in the last analysis, only with the co-
operation and support of the state. In other words, we must se–
cure legislation in several states that will set to work the machinery
we need to get that information. I have just returned from Wash-
ington, where I have been in connection with the work of the com-
mittee which has undertaken to urge the passage of a bill providing
252 American Labor Legislation Review
for an impartial national commission to inquire into all the relations
between employers and employees. Such a commission, I take it,
would properly bring within the scope of its inquiry the subject we
are discussing. That measure should have the support of all here
present. -
Reference was made by one of the speakers to the disagreeable
feature of reporting cases of industrial disease, the burden on the
physician. I think the gentleman suggested that he had a little doubt
about the advantage of these laws. But it ought to be pointed out
that the use of such a schedule as that of the bureau of labor of
New York will have a good effect. It will call the physician's atten-
tion to the industrial side of the health problem and will have a
value in his work which will make the burden not without its re-
ward. At any rate, it seems to me that this is a type of legislation
for which we are ready, and that the American Association for
Labor Legislation is justified in pushing its campaign to have re-
porting laws passed in all the great states.
II
INVESTIGATION OF INDUSTRIAL DISEASES
Presiding Officer: HENRY R. SEAGER
President, American Association for Labor Legislation
NEW YORK CITY
INTENSIVE INVESTIGATIONS IN INDUSTRIAL
HYGIENE
FREDERICK L. HoFFMAN
Statistician, Prudential Insurance Company.
Industrial hygiene is gradually assuming the position of an applied
science in its relation to government and the public at large. The
nation-wide agitation for effective workmen's compensation legisla-
tion and the establishment of state insurance for this purpose in
Washington, Ohio, and Massachusetts, emphasizes the necessity for
trustworthy information, statistical or otherwise, with regard to the
whole question of health and safety in American industry. It is not
going too far to say that most of the published information on the
subject of industrial hygiene and industrial accidents is of very
limited practical value, and much of it is decidedly misleading.
There have been very few intensive studies of the actual condi-
tions under which American industry is carried on at the present
time. In the memorial to the President on the appointment of a
national commission for the investigation of industrial diseases,
practically all the conclusive evidence was derived from foreign
sources or intensive and more or less conclusive investigations made
in foreign countries. It is most encouraging, however, that within
recent years the necessity for such investigations should have been
recognized, and mention only requires to be made of what has been
done in this respect by the states of Massachusetts, New York, Illi-
nois, etc. The honor belongs to the state of Illinois for having been
the first to appoint a special commission to investigate and report
upon the subject of industrial diseases, and the report of that com-
mission constitutes a valuable contribution to the literature of
industrial hygiene. The publications of the Massachusetts State
Board of Health, and of the New York State Department of Labor
require also to be mentioned as helpful indications of the direction
which in years to come investigations of this kind are bound to take
to an increasing extent. The monograph by Dr. Andrews on phos-
phorus poisoning and the reports by Dr. Hamilton on lead poisoning
256 American Labor Legislation Review
are epoch-making documents which separate precisely the field of
guesswork opinion from the field of impartially ascertained facts.
The principles which underlie all investigations of this kind are
not as yet fully defined. It may be said at the outset, however, that
every industry should be inquired into with reference to the health
and safety of persons employed therein, but with a due regard to
the essential conditions under which such industries can be econom-
ically, profitably, and efficiently carried on. It is important in all
investigations of this kind that the investigator first make him-
self thoroughly familiar with the technique of the industry or
trade about to be investigated, since whatsoever conclusions may be
arrived at, they must be more or less conditioned by the elements of
the industry itself. A clear understanding of the technical details
of any given industry or trade often requires much patient study and
research, but without such an understanding of the methods by
which a particular industry or trade is carried on most of the
conclusions as to health and safety must be more or less wanting in
the essential requirements of absolute accuracy and impartiality.
It is unfortunate for research in the field of American industrial
hygiene that most of the textbooks descriptive of industrial or
manufacturing processes should be by foreign authorities, just as is
the case with regard to textbooks on Occupational diseases and the
prevention of accidents. Some notable exceptions are the standard
works of reference on metallurgical processes and industrial chem-
istry. The treatise on Industrial Organic Chemistry by Sadtler, and
the Outlines of Industrial Chemistry by Thorp, are indispensable to
research work in a large number of industries chiefly or partly in-
clusive of chemical processes of manufacture. The earlier Diction-
ary of Arts, Manufactures, and Mines by Ure, in three volumes, and
the still earlier Cyclopedia of Useful Arts by Tomlinson, and Cham-
bers' Information for the People, published in 1847, are useful for
the purpose of illustrating the methods and processes of manufacture
in the past. Some of the descriptive accounts of industrial processes
published by the Census Office from time to time since 1880 are of
considerable practical value in investigations of this kind, but it is
much to be regretted that there should not be a popular treatise on
the technology of trades and industries giving, at least in brief out-
line, an intelligent account of modern methods of manufacture, with
particular reference to the safety and health of the employees, and
including the smaller, but frequently more important trades.
Intensive Investigations in Industrial Hygiene 257
As illustrations of the textbooks useful for the purpose of obtain-
ing a sound preliminary understanding of the essential factors in
industry, I may refer to the treatise on The Manufacture and Prop-
erties of Iron and Steel, by Campbell; Modern Copper Smelting, by
Peters; The Textbook of Ore-Dressing, by Richards; and Lead and
Zinc Pigments, by Holley. For many of the industries excellent
monographs have been published by corporations which, by their
illustrations alone, render substantial aid to the students of industrial
processes in their relation to health and life. I may refer to a short
treatise on The Destructive Distillation of Bituminous Coal, with ref-
erence to the United-Otto system of by-product coke ovens, which
practically constitutes a guide to that rather intricate process which
has made the utilization of valuable waste products a commercial
possibility. The federal and state geological surveys publish reports
which frequently contain interesting observations and suggestive
illustrations, but I can only refer to the report of the geological
survey of the State of New York on the lime and cement industries
of that state, and to the report on the manufacture of roofing tiles,
published by the geological survey of Ohio.
Next to a sound technical foundation it is of some importance that
the historical facts of any given industry be taken into account, and
while the history of American manufactures has not been brought
down to date, Bishop's classical work is still of value, mono-
graphs are occasionally printed by institutions of learning, and
the report on manufacturing industries by the Census Office also
contains much useful information. I can only refer to the excellent
monograph on The Printers, by Professor Barnett, published by the
American Economic Association, and to the historical account of the
English tin miners, by Lewis, published in the series of Harvard
Economic Studies.
The most useful sources of information with regard to industrial
processes are the technical trade journals, which for practically all
of the industries extend over a considerable period of time. These
publications, to an increasing extent, take into account the economic
and social conditions of labor, and with special regard to wages,
hours of labor, etc. The reports and bulletins of the federal Bureau
of Labor and of the state departments of labor, moreover, make an
immense amount of more or less trustworthy information conven-
iently available. Such reports of the federal Bureau of Labor as
258 American Labor Legislation Review
have recently been published on the steel industry, and the series of
reports on the condition of women and children, emphasize im-
portant elements of inquiry which require to be taken into account.
It is the disregard of this necessity for preliminary education
which usually accounts for failure to secure the best possible results.
Intensive industrial investigations are a burden upon industry and
they should be made only by those qualified for the task, and by
men or women thoroughly trained in advance with regard to all the
facts and conditions which they can ascertain from existing sources
of information. Industry does not exist for the purpose of providing
material for the writing of books or descriptive monographs, but
solely for purposes of production at a rate of profit consistent with
safe and economical management. The large majority of manufac-
turers throughout the United States are deserving of unstinted
praise for the manner in which their establishments are conducted
and made to conform to legal and moral requirements with regard
to the safety, health, and comfort of employees. The difficulty is
not so much in what is obvious as in what is not obvious. Immense
progress has been made and the tendency practically everywhere is
decidedly toward betterment consistent with the conditions under
which industry can be profitably carried on.
The problem is one of ignorance rather than of neglect. Most of
the factors which condition health and safety in industry are as yet
very imperfectly understood, at least in the United States. It is
true that within the last quarter of a century immense progress has
been made in Germany, but largely because of the requirements of
compulsory accident insurance institutions established to replace an
antiquated system of employers' liability law. We have not as yet
developed in this country the function of the safety engineer, who
has attained to such high professional standing throughout the
German Empire because of the practical utility of his services.
Manufacturers or employers of labor generally are not blamable for
their reluctance to install expensive safety devices, or ventilating
devices, or other methods or means by which health, safety, and
comfort can be improved, unless the evidence is conclusive that the
investment will be productive of the desired results. The function
of the ventilating engineer in his relation to industrial requirements
is practically new, and almost the same may be said of the function
of the illuminating engineer. All of these questions require to be
Intensive Investigations in Industrial Hygiene 259
taken into account by the critic of industrial conditions in so far
as they have relation to the safety, health, and comfort of the
employees. --
A manufacturing plant is private property and admission thereto
obtained by visitors or investigators is a matter of courtesy on the
part of the corporation or firm. All manufacturing establishments
are subject to the visitorial powers and duties of state labor bureaus,
or state factory inspection bureaus, and to a certain extent of state
boards of health. The inspectors of these respective governmental
departments are free to make their investigations without let or
hindrance, and their conclusions, so far as practicable, should be
made public as a matter of record. Until, however, the status of the
factory inspector, or the health inspector, is raised to the dignity
and far-reaching responsibility inherent in the position, it is self-
evident that radical conclusions must be accepted with caution, and
exceedingly favorable reports must be looked upon with more or
less distrust. It is not going too far to say that most of the published
reports of factory inspectors in this country are of very limited
practical utility for research work in the field of industrial hygiene;
while, in marked contrast, the annual reports of the chief factory
inspectors of England, Germany, Austria, France, Switzerland, Bel-
gium, etc., are models of their kind and trustworthy sources of
information with regard to conditions more or less detrimental to
health and life in industry.
The investigator, having obtained permission, as a matter of
courtesy, to visit an industrial establishment, should refrain from
any conversation with the employees except by the specific permis-
sion of the employer. A labor force, under the best conditions, is
easily disturbed by the visits of strangers, and most of all by men or
women who are supposed to be in search of information or facts
more or less detrimental to the industry investigated. There are
everywhere employees with grievances, whose evidence may be given
in good faith, but who cannot be relied upon in matters of fact. The
investigator should be a trained observer and should take notes at
the time of inspection of everything seen or heard which has any
possible bearing upon the purpose of the investigation—that is,
whether conditions exist which are a menace to the safety and health
of the employee.
The investigator must keep in mind that employers of labor who
26o American Labor Legislation Review
have given years to the operation of a particular plant, possibly
representative of extremely complex methods of manufacture, are
not likely to be indifferent to the desirability that the best possible
conditions of work be maintained. At the same time it quite fre-
quently happens that the most obvious need escapes attention,
since the mind of the employer is preoccupied with matters of
more immediate personal concern. Every manufacturer or em-
ployer of labor welcomes intelligent, concrete suggestions as to
methods and means by which the conditions affecting the health and
safety of his employees can be materially improved. The investi-
gator may safely take it for granted that, broadly speaking, the man-
ufacturer or employer is as much interested in the ascertainment of
the truth regarding actual conditions as the outside public or the
investigator himself. He is fully assured of the most hearty co-
operation in the large majority of cases in which intensive investiga-
tions are made under proper conditions and by thoroughly qualified
persons fit to go into delicate matters of this kind. -
The information obtained may be considered confidential or not,
according to the previous understanding with the manufacturer or
employer whose particular plant has been made the subject of an
inquiry. As a rule, there should be a precise agreement on this
point, and if a written report is made a copy thereof should be sent
to the manufacturer or employer for verification or for such com-
ments as misstatements or errors in matters of fact may require.
It is hardly possible, on an occasion of this kind, to enumerate all
of the factors which should be taken into account. It requires no
discussion to prove that such problems as air conditioning in textile
mills, the mechanical properties of industrial dust or the effective
removal of such dust by ventilating devices, the alleged pathogenic
properties of mine air, or the injurious effect of intense light in
electro-metallurgical processes, all demand special and highly techni-
cal qualifications for the rendering of a judgment or opinion that
may be relied upon as sound. But with regard to most of the con-
ditions which injuriously affect the health of employees, or which
have a relation to the employees’ safety as conditioned by Safety
devices, ordinary intelligence, plus the power of intelligent observa-
tion, is sufficient. But granting this, an intensive industrial investi-
gation is a difficult task, than which perhaps no public function
requires to be approached with more genuine humility and diffidence.
Intensive Investigations in Industrial Hygiene 26I
It is not a difficult matter to conceive of ideal conditions of work,
and most of all is it easy to condemn the employer and relieve the
employee of all responsibility. But it requires a trained mind to
ascertain the necessary facts and to draw conclusions which can be
practically applied to the more or less apparent needs for drastic
reform. Investigations of this kind are laborious and should not be
undertaken by those who are easily fatigued or confused.
The sole object in view is to ascertain the truth and to ameliorate,
as far as possible, the conditions of labor, so that those who are the
real producers of the nation may not pay the price of industry in an
excessive amount of disease or premature invalidity and death. There
is no more useful function in society than that of the earnest seeker
after truth in matters of this kind, and there is nothing more credit-
able to any nation than actual progress in industrial hygiene and the
prevention of needless industrial accidents. On a very conservative
basis, twenty-five thousand lives are annually lost in the United
States as the result of industrial accidents, which is the tribute paid
in lives by some thirty million toilers who carry on the nation’s work.
What the tribute is in ill health and invalidity no one is at present in
a position to estimate even with approximate accuracy upon the
slender basis of data available. But granting that the relative occur-
rence of industrial disease is greater in Germany than in this country,
and taking only half the calculated amount of sickness on the German
basis, the figures are as startling as they are suggestive of the im-
perative need for the most patient, the most disinterested, but at the
same time the best qualified methods of research in industrial
hygiene. | -
It requires no argument, therefore, to emphasize the need for a
thorough understanding of the essential facts of industrial hygiene
as a preliminary requisite for intensive investigations into the con-
ditions inimical to health and life in industry. The historical method
has obvious advantages in that it brings out with reasonable accuracy
the progress which has been made by the complete elimination of
some of the worst conditions injurious to the health of wage-earners
in the past. The treatise by Ramazzini, published for the first time
in English in 1705, is a textbook which may still be consulted to
practical advantage, and it is to be hoped that some time this exceed-
ingly rare work will be reprinted. Tissot's Essay on the Disorders
of the People of Fashion, and the Diseases Incident to Literary and
262 American Labor Legislation Review
Sedentary Persons, published in 1772, is also quite suggestive; and
the same may be said of Thackrah's treatise on The Effects of Arts
and Professions on Longevity, published in 1832. There is much
valuable information in Gaskell's book on Artisans and Machinery,
and the Moral and Physical Condition of the Manufacturing Popula-
tion; but one of the most suggestive works on occupational diseases
is The Vital Statistics of Sheffield, by Holland, published in 1843.
There could be no more serious error than to assume that the health-
injurious consequences of occupations are limited to the mechanical
industries, and it only requires to be pointed out that the propor-
tionate mortality from tuberculosis of the lungs at ages from twenty-
five to thirty-four among salesmen is 46.7 per cent. In 1884 Thomas
Sutherst, a barrister-at-law, published a very suggestive work, with
numerous cases, on Death and Disease Behind the Counter, intended
as a protest against the more or less unnatural conditions of shop
labor.
These are the earlier works of reference, which have since been
partly replaced by the Handbook on Occupational Diseases, by Ar-
lidge, followed by the standard work of reference on Dangerous
Trades, prepared under the editorial supervision of Sir Thomas
Oliver, who about two years ago published a compact textbook on
Diseases of Occupation, which can be consulted to great practical
advantage on the group of occupations to which the work is limited.
There are a number of German and French textbooks on industrial
hygiene which have not their counterpart in English. Foremost
among these is the great work prepared under the editorial super-
vision of Weyl, including observations on the “General Principles of
Industrial Hygiene and Factory Legislation” which have for their
specific object improvements in conditions affecting safety and health
in industry. An excellent manual in German is a treatise on Indus-
trial Hygiene, by Holitscher, and there is a book by the same title
published in 1906 by Dr. Bender, a medical factory inspector of large
experience. Special reference should be made to two small manuals
of advice to German boys and girls about to enter a trade, which
have particular regard to the physical requirements and the mental
adaptation to particular industrial processes. Manuals of this kind,
obtainable at a cost of a few cents, convey the required information
in the most effective manner, but the suggestions contained therein
are also of practical value to the student of industrial hygiene.
Intensive Investigations in Industrial Hygiene 263
Research work on a larger scale is much facilitated by the Index
Catalogue of the Army Medical Museum and Library, for some of
the most useful and instructive discussions of special phases of
industrial hygiene and the medical consequences of industrial acci-
dents are the occasional contributions by practicing physicians to
the medical periodical press. A thorough study of the available
medical literature relating to occupational diseases and occupational
neuroses is imperative, for even the most earnest seeker after in-
formation may fail of his or her purpose on account of lack of the
required preliminary training. As has been previously pointed out,
the recent legislation on workmen's compensation and the tendency
in the direction of drastic and far-reaching laws make investigations
into the field of industrial hygiene and accidents of great practical
importance. Those who have had to do with the settlement of
Claims Arising from the Results of Personal Injuries appreciate the
value of a work with this title by Magruder, and of the larger treatise
on the Causes of Disability, by Harbaugh. A most useful handbook
in this connection is Saunders' Medical Hand Atlas of Diseases
Caused by Accidents.
In brief, the present plea is for scientific methods in intensive
investigations in the field of industrial hygiene as a first requirement
for the attainment of really useful and conclusive results. Probably
no other field of systematic research offers such exceptional oppor-
tunities to the earnest seeker after truth, and certainly none is more
likely to prove of great benefit to the mass of mankind. In justice
to employers, whose every effort to improve conditions inimical to
health deserves encouragement, and in equal justice to employees,
whose health and well-being are menaced at the present time by
conditions more or less unsatisfactory, it is of the utmost importance
that so difficult a task should be approached with a due consideration
of the seriousness of the problem, the need of a scientific method,
and the duty of absolute impartiality. The object of all investiga-
tions of this kind is not to prove or sustain any particular conclusion
arrived at in advance, but to determine the truth and the facts as
they actually exist and as they condition at the present time the
health and well-being of the men, women, and young persons em-
ployed in productive industries,
COMPULSORY REPORTING BY PHYSICIANS
LEONARD W. HATCH
New York State Department of Labor.
Compulsory reporting of industrial diseases by physicians consti-
tutes the first step in the campaign for prevention, if the latter is to
be comprehensive and scientific. It is a case of an extensive evil
known to exist in various forms, in divers places, and from a variety
of causes, but also known to be in large measure eradicable if only
we can discover its various forms, their location, and their causes.
If, therefore, preventive efforts are to be directed so that they may
be at once comprehensive in scope and intelligently effective in
detail, knowledge of the frequency, incidence, and sources of the
evil are of prime importance.
Furthermore, it is safe to say that the prevention campaign only
awaits the necessary knowledge of the evil to be assured of success.
The propriety of the exercise of the police power of the govern-
ment in the interests of public health, which means the health, not
only of all the public, but of any particular portion which may be
subject to peculiar health hazards, has long been recognized, and
public sentiment was never more quick than now to back laws for
such a purpose, while private initiative, stimulated by public senti-
ment or moved by humanitarian motives, has never inspired greater
activity than now along these lines.
If, then, prevention waits only for adequate information, where
shall this information be secured? Obviously for information con-
cerning diseases the principal Source technically equipped to serve
as a reliable informant is the medical profession. Further, it is
not essentially a case of calling upon physicians to go out of their
particular field of work, because practically all cases of occupa-
tional disease, serious enough to be important, come to physicians
automatically, so to speak, in the course of their regular professional
practise. In this aspect, compulsory reporting of occupational
diseases is precisely like compulsory registration of deaths. It is
simply the necessary requirement for bringing together by registra-
Compulsory Reporting by Physicians 265
tion at one place scattered data which come under the eye of dif-
ferent physicians in their regular work. That this registration of
industrial diseases is usually to be made with a different depart-
ment of government than registration of deaths, is due simply to
the fact that special government agencies, in the shape of labor
departments, have been developed for the safeguarding of the
health of workers, just as health boards or departments have been
developed for the conservation of the general health of the com-
munity. Registration of deaths, being significant for all phases of
the public health, goes naturally to the department of government
with the broader function. Registration of the diseases of industry
goes, likewise naturally, to the department whose special field is
health in industry.
But more important than analysis of the fundamental reason for
laying upon physicians the obligation of registration of industrial
diseases, is consideration of just what kind of information should
be asked of them in connection with such registration.
It almost goes without saying, of course, that the first thing to be
required in a registration certificate is the strictly professional
matter of the physician's diagnosis of the disease. But if registra-
tion is to furnish all that is necessary, the physician must be asked
to go beyond the narrowly professional function of diagnosis to
consideration of antecedent causes of the patient's condition. The
importance of the physician's taking this point of view can hardly
be overemphasized. It is necessary because, to a large extent, it is
the only means by which the physician can discover that diseases
are occupational. When we speak of industrial diseases we are not
dealing with a class all of which are clearly distinguished from
other diseases by peculiarities of their own, so that identification
alone affords, or necessarily suggests, their occupational character.
On the contrary, we are dealing in large measure—probably when
the full truth is known it will be found to be in largest measure—
with ordinary diseases found elsewhere but which may be due to
occupation and which can be identified as occupational only by
inquiry as to the circumstances of the patient's calling. In a word,
many occupational diseases are distinguished from others primarily
by their causes, so that only by their causes can they be identified.
To put this matter in the concrete, there is one industrial disease,
compressed-air illness or caisson disease, which is practically always
266 American Labor Legislation Review
due to circumstances of occupation. And there are a few poison-
ings, the most notable example of which is—or rather we may now
say, fortunately, has been—phosphorus necrosis, which are known
to be due so frequently to occupation that they have acquired the
name of industrial poisonings. There are also one or two infectious
diseases, the leading example of which is anthrax, which likewise
are so commonly associated with an occupation that they imme-
diately suggest occupational causes. Even in these fairly well-
recognized industrial diseases, however, the physician must go
back of diagnosis to identify them as occupational in character, as
witness instances lately reported in New York State of lead poison-
ing in the case of a schoolboy, of phosphorus and mercury poison-
ings in cases of children, and of anthrax in the case of a stock
broker.
A more striking illustration of this point is another New York
case in which only the accidental discovery of occupational causes
prevented an absolutely incorrect diagnosis of a case of industrial
poisoning. In a brewery in the state two men were employed last
year in varnishing the inside of closed wooden vats with alcohol
and shellac. After a day of such work one of them became
violently ill and died during the night without medical attendance.
The coroner's physician, on examination, found the cause of death
obscure, but, on the strength of what he could discover by inquiry
concerning the patient's illness, certified the cause of death as
apoplexy. On the day of the funeral the physician heard that the
other workman had become blind, and for the first time learned
what kind of work the two men had been doing. Thereupon he
procured a sample of the alcohol and shellac, had it analyzed, and
found that the alcohol was wood-alcohol, with the result that both
the nature of the disease and its occupational cause were revealed,
and his certificate as medical examiner was accordingly altered to
make the cause of death wood-alcohol poisoning. This is, of course,
an extreme case, but experience in connection with the registration
of deaths affords evidence that such errors are frequent enough to
sustain the point here emphasized, namely, that even in the case of
the more exclusively occupational diseases the physician must probe
for causes back of his diagnosis if registration is to realize what is
needed.
This extra-professional information which the physician must
Compulsory Reporting by Physicians 267
be asked for, in order that the identity of the disease as occupational
in character may be evident, at least presumably, comprises two
items. First, and rather obviously, but none the less of most im-
portance, is a careful statement of the patient’s occupation and the
industry in which it is pursued. Upon this, of course, all accurate
statistical study of the whole subject depends. It is, likewise, the
first necessary inquiry of the physician in determining the occupa-
tional character of the disease. Had the physician, in the case of
wood-alcohol poisoning above referred to, looked at once for this
item, which he accidently noticed later, doubtless his first certificate
of the cause of death would not have gone so wide of the mark.
But, as already noted, comparatively few industrial diseases are
caused exclusively by occupation. Many may, or may not, be
occupational in character. Furthermore, even in the case of an
exclusively occupational disease, other factors may also be present.
Hence, in the second place, if we are to read correctly the responsi-
bility of circumstances of occupation for disease, the physician must
be asked to look for the other possible causes, and to report any
factors other than occupation, such as complicating diseases or
personal circumstances, which may be contributing or accompanying
Call SCS.
Now it is precisely in connection with this extra-professional
information that the principal difficulties arise with physicians’
reports, that is, of course, after the primary task of bringing and
keeping before physicians the necessity of reporting at all is accom-
plished. The reasons for this are natural enough, since all the neces-
sary information as to occupational or other causes lies beyond the
strictly professional interest and point of view of the average physi-
cian, and he must secure it by special inquiry outside of his purely
technical duties. For example, when the New York law requires
that all cases of occupational lead poisoning shall be reported, it
means that every physician who may treat a case of the disease,
after his professional work of diagnosis and prescription is attended
to, must first of all remember that lead poisoning is to be reported,
and that then he must make inquiry as to the patient’s occupation,
must ascertain whether any other factors enter into the case as
causes, and must record this information with the necessary details,
along with a number of other items as to sex, age, etc., all outside of
his natural professional interest except as general obligation toward
the public welfare may appeal to him, -
268 American Labor Legislation Review
To a large extent the difficulties referred to are those long
familiar in connection with the registration of deaths by physi-
cians, and simply argue that without doubt a long period of educa-
tion will be necessary to secure general and accurate observance of
a reporting law for industrial diseases. Indeed, so far as the report
of diagnosis and the statement of occupation alone are concerned,
the problem is precisely the same in both forms of registration.
But when we come to that element in the reporting of diseases
which virtually requires the physician specially to weigh the
causative influence of occupation, as compared with other possible
causes, there is a fundamental difference between the two. Regis-
tration of deaths requires a statement of occupation only as a
simple addendum to diagnosis, and requires no consideration what-
ever of occupation as the cause of death. But such consideration
is essential, as pointed out above, in the registration of industrial
diseases. It is specifically implied, moreover, by the very terms of
the New York reporting law which, like all but one of those in
other states having such a law, follows the British act, and which
requires a report from the physician for each patient “whom he
believes to be suffering from (the specified diseases) contracted as
the result of the nature of the patient’s employment.”
The most significant aspect of this peculiar source of difficulty
connected with the reporting of industrial diseases is that it in-
creases in importance as compulsory reporting may be extended
from diseases known to be exclusively or mainly occupational to
those whose sources may be either in occupation or in other circum-
stances, or in both combined. For, as we proceed in this direction,
the causes of the disease become more and more uncertain and com-
plex, with consequently increased difficulty for the physician who
is called upon to determine, or at least to express his belief as to,
the influence of occupation. Compare, for example, caisson
disease and tuberculosis as to the relative difficulty of determining
whether occupation or other factors were responsible for the
disease. -
This aspect of the reporting problem naturally suggests the
question of how general the reporting should be made. As a
matter of fact, reporting laws enacted in this country so far, here
again in accordance with the British act, have limited compulsory
reporting to a small number of easily identifiable industrial dis-
Compulsory Reporting by Physicians 269
eases, namely, as in the New York law, poisoning by lead, phos-
phorus, arsenic or mercury or their compounds, anthrax, and com-
pressed-air illness. All of the American laws are of very recent
date and the wisdom, at the outset, of such limitation of reporting
would seem to be clear from what has here been said. Neverthe-
less, if the problem of industrial diseases is to be treated broadly,
and if the prevention campaign is to be planned on comprehensive
lines, nothing less than an extension of registration to all recogniz-
able industrial diseases must be considered as the ultimate goal.
This may appear, at first sight, to be only an ideal whose con-
sideration may well be postponed for the present. But a rather
interesting experience in New York State has brought it forward
for immediate consideration. The New York reporting law took
effect in September of last year. Prior to that time notices of the
law were sent to medical journals, and shortly thereafter a circular
notice and sample forms for reports were mailed to each of the
I3,700 physicians, hospitals, and dispensaries in the state. The
form adopted for reports was patterned after that used in Great
Britain, was kept as simple as possible, and was limited to the few
items specifically mentioned in the law, without taking advantage of
a blanket clause permitting the inclusion of other items of informa-
tion. The form was made thus simple with the express idea of
encouraging reporting by making it as easy for the physician as
possible. (It may be remarked, parenthetically, that the nine months’
experience so far makes it very evident that something besides
making it easy will be required to make reporting general, even with
a very limited list of diseases). But the law had not been in force
three months before we were met by the suggestion, from members
of the medical profession itself, that we were not calling for
enough information in our report form and that reporting ought
not to be confined to the diseases mentioned in the act, some of
which were not so common or serious as others not included. This
was, indeed, far from being a general clamor from the profession
as a whole, but it was an earnest expression of opinion from a few
prominent members in New York City, who are interested in the
subject.
The question of the extension of reporting to all industrial diseases
thus raised, it must be confessed, in an unexpected quarter, but in
the very one to make it the more to be regarded, became then an
27o American Labor Legislation Review
immediately practical one in New York. To come at once to the
result of the matter, the New York Department of Labor proposes
to ask the cooperation of physicians to the extent of reporting all
industrial diseases, and is just completing the work of inaugurating
such extension. The reporting law has not been amended for this
purpose, but it is proposed, for the field outside of that specified in
the law, to rely for the present, at least, upon the voluntary
cooperation of physicians.
While New York, relying upon a cue from members of the
medical profession itself, thus proposes to start at once definitely
toward the ultimate goal, it will be evident from what has been said
in this paper that the difficulties of this larger program cannot be
overlooked, and a word or two as to practical means of meeting
these difficulties is in order.
Government offices to which reports are to be made have two
chief means of overcoming the difficulties referred to. The first of
these is a carefully prepared form for reports, which shall clearly
indicate the information needed. For this there may be commended
one worked out by the committee on industrial diseases of the New
York Association for Labor Legislation, and recently adopted with
some modification by the New York Department of Labor in con-
nection with the extension of reporting above alluded to. This
form is indorsed by the committee on uniform schedules of the
national Association for Labor Legislation, which recommends it
as a standard schedule for use in all states. But, as repeatedly
suggested in the foregoing analysis of the reporting problem, ulti-
mate success must finally rest to a large extent upon the active
interest of physicians. A second aid to reporting, therefore, may be
found in the circulation among physicians, for their assistance and
to stimulate their interest, of information concerning industrial
diseases. For an example of this, reference may be made to a book-
let recently issued by the New York department, containing brief
descriptive matter and a general classification of industrial-disease
hazards, with a list of the more important harmful substances and
their effect upon workers. Reference to this may be made by the
writer with all modesty because, for the material, the department is
largely indebted to representatives of the New York Academy of
Medicine, especially to Dr. W. Gilman Thompson of the Cornell
University Medical College.
Compulsory Reporting by Physicians 27t
In the foregoing, compulsory reporting of industrial diseases by
physicians has been considered only in its general aspects and
chiefly from the statistical point of view. From that point of view
the problem of accuracy and completeness of reporting are matters
of foremost importance. It has been made clear, perhaps, that the
solution of these problems will be a matter of considerable time and
education, a conclusion which is supported, not only by analysis of
the problems, but by consideration of the number and character of
the reports produced by nine months’ experience in New York.
But, lest a wrong impression as to the value of reporting should be
given by this technical view of the matter, two practical results,
already clear in New York experience, may be mentioned in con-
clusion.
In the first place may be noted the very active interest among a
number of influential members of the medical profession which the
reporting law almost immediately aroused, or at least crystallized
into activity. This has already been alluded to in connection with
the assistance it has lent the department of labor with reference
to reporting. The most significant fruit of it, however, has been the
formation of a permanent committee on industrial diseases under
the auspices of the New York branch of the Association for Labor
Legislation, six members of which committee are physicians con-
nected with medical colleges and leading hospitals in New York
City. The value of such active cooperation of the medical pro-
fession in the campaign for industrial hygiene, going far beyond
mere reporting of diseases, can hardly, of course, be overestimated.
If the reporting laws of the seven other states in which such laws
have been enacted, have revealed possibilities of this kind such as
have appeared in New York within the first few months under its
law, the work of the American Association for Labor Legislation,
in securing the enactment of these laws during 1911 and 1912, must
be regarded as marking the beginning of a very important forward
imOvement.
In the second place is to be noted the practical value of reports
of industrial diseases as indices of points of danger, for the guid-
ance of factory or medical inspectors. This is a value which may
be realized practically from the very moment that reports begin to
come in, without regard to the statistical problems of reporting.
Each individual report at once invites attention to an establish-
272 American Labor Legislation Review
ment or an industry for investigation with a view to preventive
measures, and as reports multiply the field demanding attention
becomes more and more clearly indicated for the inspector. To
illustrate, the medical inspector of factories in New York State is
just beginning a special investigation of lead poisoning. As a
result of only six months’ returns under the reporting law, the
medical inspector may begin his work with definite knowledge at
the very outset of fourteen different manufacturing industries and
of one or more particular establishments in each of those industries,
in which conditions positively known to have caused lead poisoning
are offered for immediate application, or study, of preventive
measures. Here again, therefore, the enactment of reporting laws
in eight states must be regarded as marking a very important step
forward in the practical preventive work of the factory and medical
inspector, and prevention is, of course, the ultimate goal in the
whole matter.
MAKING LEAD COLORS
PouriNg Pig MENts INTo GRINDING MACHINE AND SPRINKLING Color SoLU-
tion. With LEAD LITHARGE
LEAD CASTING, SHOWING LEAD POT IN A SMELTER
DANGER of Poisoning is from BREATHING LEAD Oxide, FUMEs AND DUst.
THE Worker in this Picture Now Loses on AN Average ONE
DAy A WEEK on Account of CHRONic LEAD POISONING


LEAD POISONING IN NEW YORK CITY,
EDWARD EWING PRATT
New York State Factory Investigating Commission.
It has often been said that, compared with foreign countries,
there has been and is very little lead poisoning in the United States.
Recent investigations, however, throw considerable doubt upon
these conclusions. The Illinois commission, during the years 1908,
I909, and I9IO, found five hundred and seventy-eight cases of
lead poisoning in that state alone. Last fall a hasty study of lead
poisoning in New York City revealed three hundred and seventy-
six cases which had occurred during the years 1909, 1910, and 1911.
And during the year 191 I alone there were found one hundred and
twenty-one cases. This study was based largely upon hospital
records, and therefore includes only the more serious cases; a vast
number of less serious ones must have been treated in dispensaries
and by private physicians. These facts are startling when we
think that in England during 191o there were only five hundred and
five cases. In a single year New York City had one hundred and
twenty-one cases, all England five hundred and five,
These cases of lead poisoning were not confined to any one trade
or industry, but were scattered through a considerable number. The
industries represented, in which the victims had been employed,
were the following; white-lead, lead-acetate, lead-oxid, dry colors,
use of lead as a hardening agent, scaling paint on battleships, ship-
calking, diamond-polishing, printing, carpentering, plumbing, tin-
Smithing, and painting. -
A canvass of the hospitals in New York City was made, and all the
cases of lead poisoning or plumbism which they had treated during
the last three years were selected. Names and addresses of the per-
sons and any other available facts were taken from the hospital rec-
ords. These records were lamentably lacking in everything that
* The facts given herewith are taken from a study made last fall and win-
ter, by the writer, with the cooperation of a number of his students, and
submitted to the N. Y. State Factory Investigating Commission.
274 American Labor Legislation Review
would interest anyone who wished to make a study of lead poison-
ing and its causes. In only two hospitals in Greater New York were
occupations specified more accurately than “laborer”, or “painter”,
and in these two exceptional instances the information was not more
detailed than the statement, “lead worker”, “molder”, “carriage
painter”, etc. No hospital recorded where the victims had worked,
or under what conditions. However, with these names and addres-
ses, and a few which were furnished by the New York State Depart-
ment of Labor, the labor unions, the board of health, and several
employers, the men themselves who had been leaded were visited.
It was not always easy to find the people we wanted, for, in addi-
tion to the difficulties due to false addresses, which are habitually
given at hospitals, we found it difficult to locate Poles, Slavs, Rus-
sians, Lithuanians, Italians, and others of our recent immigrants.
I remember searching for a man named John Sichosk, whose name
had been sent in by the department of labor. At the address given,
only the blankest faces answered my inquiry for John Sichosk. In
broken English one of the men explained that he knew no one by
that name. As a last resort I showed the record card with the
typewritten name. The man’s face lighted up at once, “Oh ! John
Sichoskyl Sure, he live upstairs.” He was there all right, and
before the afternoon was over John had taken me to five others
who had been leaded in the same factory.
A careful study was made of each case. The facts, not only
about the man's last job, but concerning others as far back as he
could remember, were ascertained. As far as possible the maternal
history of the wife was obtained, the personal habits of the work-
er, and the precautions or lack of precautions in the factory. One
hundred and nine cases, in all, were intensively studied in this way.
The results are interesting, even if the Small number of cases some-
what detracts from their value. In general, these results are similar
to the results of studies made abroad.
Practically all the various forms of lead poisoning were found,
ranging from light attacks of colic to death. Among these cases
were several of wrist-drop and paralysis. Many of the workers
had had recurring attacks and had been disabled for considerable
periods, varying from a few days to almost a year. About half of
the men were comparatively young; in fact, fifty of the one hun-
dred and nine were actually less than thirty-five years of age, and
Lead Poisoning in New York City 275
almost one hundred were less than fifty-five years of age when they
became leaded. - .
Economists of the old school have always held that men's wages
increase with the dangers and risks of their employment. This is
certainly not true of lead workers. Over half of the workers
studied (fifty-eight) were earning less than $16.00 per week; a quar-
ter (twenty-three) were earning less than $12.OO; and over a tenth
(thirteen) were actually earning less than $10.OO. Strangely
enough, the most dangerous of all the industries paid the lowest
wages. In the white-lead industry not a single man was earning
over $14.OO per week, and many of them were earning less than
$IO.OO. At these low rates one would imagine that the total loss
of wages due to lead poisoning would be comparatively small. It
is not surprising, therefore, that most of the losses were of small
amounts, and that fifty-nine of the one hundred and nine men lost
less than $150 each. But it is a surprising fact that some of these
workers lost larger sums, seven men actually losing over $1,000
each.
Some very interesting facts were brought out in the analysis of
conditions in the factories and workshops. Sixty-two of the one
hundred and nine workers ate in the same room where they worked;
twenty-two never washed before eating and forty-five washed only in
cold water; seventy-three, or almost three-fourths, were never given
oral instructions of any kind as to the dangers of their work or as to
methods of preventing lead poisoning; seventy-six men never saw
any posted instructions where they worked. It is usually admitted
that men addicted to alcohol are more liable to contract lead poison-
ing, as they are to succumb to most other diseases. Employers
delight to say that it is only the “hard drinkers” who are ever
troubled by lead. But only six of the one hundred and nine men
were found to use alcohol to excess; sixty-five were moderate drink-
ers; and thirty-one were teetotalers. These facts point out and
emphasize the importance of the problem, right here and now in
this country, and the need of prevention, the first steps in which
have evidently not been taken by the majority of employers.
Of the one hundred and nine cases studied, seventy-nine persons
were married, among them forty men whose wives had been preg-
nant while their husbands were employed at lead work. In all there
had been one hundred and fifty-seven conceptions among these forty
276 American Labor Legislation Review
wives. There were born to the persons one hundred and forty-four
children, thirty-nine of whom died in the first year, and two in the
second. The cause of death in many cases was malnutrition and
convulsions. In addition, there were four still-births and eight
miscarriages; and the latter figures understate the facts, as our in-
formation on this point is not full nor very accurate.
The effect upon reproduction has long been noted. Some in-
teresting cases have come to my attention:
I. A young Hungarian came to this country in 1904. He worked in a
wire mill, where the wire is tempered and hardened by being passed through
a bath of molten lead. The lead is uncovered, and vapors and oxids fill
the air. He married in 1909. In the same year his wife miscarried at the
end of seven months. Early in 191o a second child was born but died of con-
vulsions within two weeks. About this time the husband had a severe at-
tack of lead poisoning and was given another job. In January of this year
the wife gave birth at full term to a normal child.
2. A Barbadoes negro came to the United States in 1908. He was
married and had a little daughter, at that time two years of age. He found
work in a lead factory handling and packing sugar of lead, or lead acetate.
The following year his wife miscarried at the end of seven months. A year
later a child was born at full term, but died in convulsions when six months
old. The curious part of this case is that the worker himself was unaffected
until a few months ago and until after the birth last referred to.
3. James Scott was a printer for over forty years and died of lead poison-
ing. He was married in 1868. Of twelve births six children survived, four
died from various causes during their first year, there was one still-birth
and one miscarriage.
4. Alexander Joronsky, a Pole, came to this country in 1891. After hav-
ing various unskilled jobs, he found employment as a stripper in a big
white-lead factory. During his period of employment as a stripper his wife
gave birth to four children; one of these was still-born, and the others lived
four days, three days, and one day respectively.
5. A Hungarian painter, who came to this country in 1893, presents an
interesting case. Five of his ten children died within a year of their birth
and his wife has had two miscarriages. The man himself, however, had his
first attack very recently.
The investigation of hospital cases at once opened up numerous
others, and also gave us clues to factories where there were lead
processes of which we did not know. The next step in the investi-
gation, therefore, was the inspection of factories.
One of the first cases which came to our attention was a pathetic
case of double wrist-drop. The victim, a man of middle age, had
worked in a magneto factory. It was a big place, with many hun-
DUST COLLECTORS IN A LEAD PLANT
Cloth BAGs PERMIt Air From Exhausts to Pass THrough WHILE RETAIN-
ING LEAD. Dust WHICH FALLs INto BINs AND is SAVED. IN UP-To-
DATE PLANT's THE BAGs ARE SHAKEN by A MECHANICAL
DEVICE OPERATED FROM OUTSIDE of DUST House
. -
EMPTYING A RED-LEAD FURNACE
WHEN Oxidized IN FURNAces the LEAD Is RAKED OUT INto CARs, IN
SPITE of Powerful ExhAUsts AND Hoods SoME Dust Floats IN THE
AIR AND Is BREATHED BY THE Workers


Lead Poisoning in New York City 277
dreds of employees, but the lead process was carried on exclusive-
ly in one small room, a sort of lean-to at the rear of the factory
and a little below the level of the ground. Here were located five
lead pots, the temperature of which varied from 800 to 1500 de-
grees. These pots, when inspected, were covered by hoods
leading to a chimney, but were not provided with any blower at-
tachment. The roof was raised slightly and a fan at one end gave
a fairly good air circulation. In the process preceding the so-called
“hardening”, bars of steel are bent into the horseshoe shape of a
magnet. They are then brought into the hardening room and im-
mersed in a bath of molten lead. There they remain for a specified
length of time, when they are removed and suddenly immersed in
water. After cooling they are stacked up, one above the
other, and are rubbed down with sandpaper to remove any particles
of lead that remain. This process, at the time when the inspection
was made, had been in operation for less than a year and nine men
were employed at it. I found seven cases of lead poisoning; one
had resulted in death, and one in double wrist-drop; others had
necessitated long periods of unemployment.
A wire mill carried on a similar process. Here the tempering
and hardening is done by passing the wire slowly through a bath
of molten lead. The wire is wound on huge spools revolving slowly,
and is then wound onto another reel. The room is habitually full
of Smoke, gas, and fumes, and the men work intolerable hours,
two shifts of twelve hours each, with no time for meals. They have
to snatch what they eat, because the lead positively cannot be
cooled off.
In both of these processes the danger comes, I believe, not from
the fumes of molten lead, but rather from the particles of lead oxid
which probably fill the air. In both cases the skimmings from the
lead pots are brushed carelessly aside and allowed to fall upon the
floor, or to accumulate in piles beside the pots.
Some of you will wonder how a girl working in an embroidery
factory can be poisoned by lead. You will doubtless scoff at the
possibility of a worker on embroidery contracting lead poisoning.
But I have found two such cases. The designs to be embroider-
ed are stenciled on cloth. This is usually done with a mixture of
chalk and talcum powder. One resourceful employer, however, ob-
serving the way in which the chalk rubbed off, substituted dry
278 American Labor Legislation Review
white lead, which clings more tenaciously. The girls who used it
were ignorant of its poisonous character and handled it as care-
lessly as they had handled the chalk. They pounded it into the
stencils and the dust rose in their faces and the lead covered their
hands. Little wonder they got lead poisoning. The use of lead for
this purpose is common.
Another case, which is individually the most pathetic I have seen,
is that of William O'Connell. O'Connell has now been out of
work for about eleven months and is likely to remain so, as he is to—
tally incapacitated. The interesting and exasperating thing about it is
that he is Our employee,_speaking collectively,–because O'Con-
nell was in the employ of the United States government, immediate-
ly under the Navy Department and a worker in the Brooklyn Navy
Yard, where his job was that of “scaling” in the double bottoms.
Battleships are provided nowadays with double bottoms, a shell
which envelops the entire keel of the ship; between these
bottoms is a space of about two and one-half feet, which is divided
into compartments of from four to six feet square. In order to
prevent rust these double bottoms are painted with red oxid of
lead, sometimes to a thickness of one-fourth of an inch. The pro-
cess of scaling consists of scraping off the red oxid paint with an
automatic compressed-air chisel called a “hammer”. When in op-
eration this hammer throws a spurt of dust up into the faces of the
workmen, who wear goggles but no respirators. Sometimes several
men work in one small compartment, and they tell me that it is al-
most impossible to see the electric bulbs at their elbows. “And
then when the air hose breaks, you ought to see the place l” one of
the men remarked. Think of working in such a place for eight
hours a day! It is any wonder that, out of a Squad which averaged
about fifty men, we found twenty cases of severe lead poisoning, in-
cluding two deaths and O’Connell, who is totally incapacitated P
And these men have no washing facilities, they wear no respirators,
there is no exhaust, there are no accessible eating facilities, there is no
medical inspection, and they get no compensation. The government
gives no compensation for lead poisoning because, technically, it
is not an accident, which is true, for under the circumstances it
is a dead certainty. Yet the surgeon of the post asked me, a lay-
man,—“Why I is that work dangerous?”
Other industries contributed their quotas of lead poisoning cases.
Lead Poisoning in New York City 279
One firm, manufacturing white and red lead, reported through its
physicians twenty-four cases from October, 1910, to October, 1911.
We dug around a bit and found a dozen more. About two hundred
men were exposed. In another white-lead works, where the factory
had been running with about two dozen men, we found eight cases
diagnosed by the factory physician. In another white-lead fac-
tory the Superintendent claimed that no case of lead poisoning
had ever occurred during his ten or a dozen years there; for, said
he, “We send a man off when he shows the first signs of being
leaded.” The next Sunday I saw five men who had been leaded in
that plant, and who had been out of work for periods varying from
a week to almost a year. One poor fellow had had four separate
attacks and had gone doggedly back to the same job. Just the
week before, when he was suffering severely from colic, this same
superintendent had on two occasions sent a messenger to him asking
him to come back to work.
Of all the industries which I have studied, painting, especially
interior decorating, yields more lead poisoning than any other, not
proportionately but in the total number of victims. Man after man
had the same tale to tell,—a long job, close interior work, sand-
papering, stipple, painting, more sandpapering and more painting, a
sudden overpowering attack, and a period of sickness and idleness,
leaving him just at the end of the busy season when it is impossible
to find work. -
It does not occur to many of us that in New York, at any rate, a
building in course of construction is absolutely (with one or two
possible exceptions) without the pale of the law. And yet any new
building in course of construction in New York City has constantly
working in it from two hundred to six hundred, or even more, men.
These men are usually working under almost intolerable conditions,
with a complete lack of sanitary conveniences, no washing facilities,
no provision for eating, and no attention to health or hygiene.
Many a painter has related to me how impossible it is for him to
wash his hands for lunch, and how he is forced to hold his sand-
wich between two pieces of paper in order to keep his lead-covered
hands from coming in contact with his food. It is not a difficult
matter for a builder to safeguard his painters. He can use zinc white,
which is better in some ways than white lead and is but slightly more
expensive. In fact, one of the biggest so-called speculative builders
in New York City now specifies white zinc and wet sandpapering.
28O American Labor Legislation Review
We have now acquired in this country, I believe, a body of evi-
dence which demonstrates the prevalence of lead poisoning and
other industrial diseases. They may not be as prevalent as abroad,
but I doubt it. The industries in which these diseases are found
employ unskilled, non-English speaking workers, who pass quickly
from one industry to another, and who seldom come under the ob-
servation of the authorities.
In preventing industrial disease, especially lead poisoning, an ed-
ucational campaign is, it seems to me, the thing of prime impor-
tance,—education of the worker and education of the employer.
The first step in the education of the employee is a knowledge of
the rudiments of English, then the simple rules for the care of
health and self which are so effective in preventing lead poisoning.
The employer, on the other hand, should be told that there is such
a thing as lead poisoning, and then how to prevent it and how to
treat it. There are many employers who are willing and anxious to
safeguard their workers. One white-lead manufacturer is spending
$20,000 on prevention. He may not be doing it in the right way, but
he has got the right spirit and will doubtless do more, more in fact
than he could be forced to do. Then, let us bring on the legislation
and force the recalcitrant employers into line.
GENERAL DISCUSSION
I. LEAD POISONING
MR. F. V. HAMMAR, President of Hammar Brothers White-Lead
Co., East St. Louis, Illinois: I think the pictures shown by Mr.
Pratt demonstrate one fact, and that is that all lead poisoning comes
from lead dust. Factories can be made sanitary by the elimination
of dust. This statement relates, not to industrial poisoning as a
whole, but to white lead, and is based on experience in my own fac-
tory. We are not appalled by the lead menace. Our record of
twelve years is not one death, either in our lead smelter or in our
white-lead works, and in the past eleven months we have had but
four reportable cases under the Illinois law, and the loss of labor
was not to exceed fifteen to twenty days. The experience of those
who have been reasonably successful in controlling lead poisoning,
with a view to minimizing the laborer's loss of wages and preventing
any danger to his future health, should be of interest.
No consideration of the sanitation of lead works is valuable until .
the avenue of entrance of various poisons, dusts, fumes, or gases
into the human body is satisfactorily settled. If you do not know
how toxins get into the body, you have little hope of knowing how
to keep them out. Lead poisoning seems to be particularly pro-
ductive of theories as to causes of inoculation. But, as a practical
fact, lead is non-poisonous until brought into contact with the fluids
of the alimentary tract, chiefly hydrochloric acid in the stomach.
Undissolved lead is no menace, and only when dissolved by the or-
ganic fluids is it absorbed into the vascular system. Such solvents
are lacking in all organs except the alimentary tract. Therefore
the skin, abrasions of the skin, the scalp, under the finger nails, and
even the lungs, are not avenues of entrance of toxins. If they
were, they have little if any power of converting sufficient lead salt
into soluble poisons and absorbable solutions to be a serious menace
to health. There is no doubt but that mild plumbism may result
from lead hair dyes and lead face powders, and that lethal quantities
may be forced into the pulmonary organs of a cat, but the menace of
282 American Labor Legislation Review
such special conditions is so rare and so slight that, for general pur-
poses of sanitation, we may assume that the only avenues of entrance
are the nose and the mouth, and that the only place of conversion
into absorbable liquids is the alimentary canal.
The cardinal principle of lead-works hygiene, therefore, is to pre-
vent the lead salt, in any form, from entering the nose or mouth. The
first necessity is to inform all workmen of the danger of lead poison-
ing-that it comes from working in lead dusts; that the first symp-
toms of intoxication are constipation and colic; and, of great im-
portance, that as soon as they notice alimentary disturbances, they
are to report at once to the foreman and to the factory physician
for treatment.
That men may work in a minimum of dust, forced drafts, hoods,
and artificial ventilation are necessary. It is generally recommended
by authorities that floors should be of such material that they may
be flushed daily, and this is most desirable. If all lead works could
be rebuilt, for this and other economical reasons, they would have
concrete floors. But we believe forced drafts are more efficacious
than flushed floors because, while it is most desirable that floors
should be clean, the first truck or barrel that passes over them drops
some lead salts, and the quantity on the previously clean floor ac-
cumulates in proportion to the work done during the day. Lead
salt is, as a rule, of high specific gravity and only a small proportion
of the siftings are carried into the air. As a result, while the floors
may not be immaculate, the ventilators soon remove floating parti-
cles, and leave the air cleaner and more sanitary than where the
floors are flushed daily without the forced draft and ventilation.
There is no doubt in our minds that under all circumstances and
conditions, no matter how perfect the ventilation and cleanliness,
wherever lead dust is in the air the workman must wear a protec-
tion over the nose and mouth. We have to some satisfactory extent
perfected a “mask” that is inexpensive, affords a maximum area
for air filtration, and, once it becomes damp from the laborer's
breath, is an excellent protection against dust. The workmen wear
these masks without objection, and the results are very encouraging.
There are places in all American factories where fans, drafts, or
flushed floors are impossible. In these departments the workmen are
forced to wear masks, the circulation of air is as free as possible,
the hours of labor are reduced to a minimum, and the physician
General Discussion 283
gives his especial attention to the men employed. Our records show
that, by these means, the menace is reduced to a minimum. We find
it essential to separate the dusty departments from those where no
dust originates, for the men who handle lead in oil never suffer
from plumbism, and in the latter department the liberal use of ordi-
nary floor oil is quite satisfactory. It fixes in place such dust as may
blow in and assists in sanitation.
All of these suggestions are only coordinate with shower-baths,
washing facilities, places for eating outside the factory, frequent
Sweeping, and above all constant vigilance to see that the laborer
realizes the danger and uses the precautions furnished. But all
these items are precautionary. The active and effective agency
in the conservation of our workmen's health is an excellent phy-
sician. No system of prevention can be devised that will be so
perfect as entirely to prevent plumbism among men of the small
intelligence of the average day-laborer. The tendency is always
to minimize the danger and to disregard positive orders regard-
ing wearing the mask and proper cleanliness in eating. There-
fore men do get lead colic, and they often neglect to report it
until it becomes severe. In fact, such serious cases as we have had
have almost invariably arisen among strong, vigorous young white
men who, in the egotistical belief that nothing can hurt them, neg-
lect, as far as they dare, our regulations for their protection, espe-
cially in emergencies. That we may treat cases in their incipiency,
our physician personally sees all the workmen every Friday. The
men whom he suspects of intoxication are held for personal exami-
nation. His experience enables him to spot a suspect at sight and a
few words completes the diagnosis. There is a great advantage in
reaching the case in its incipiency, when a spoonful of Epsom Salts
will effect a cure.
There is no doubt that white lead is a menace. But there is also
no doubt that this menace can be controlled. For such control regu-
lation and law are necessary. We believe in legislation for danger-
ous trades. The necessity for it comes, however, from ignorance
rather than from essential danger. We believe that every man
working in lead should realize how and why he may become intoxi-
cated and, equally important, how he can avoid serious results. Legis-
lation is necessary that this information shall be disseminated; and
legislation helps the manufacturer by assisting him to enforce regu-
284 American Labor Legislation Review
lations. That plumbism can be controlled to a satisfactory degree
I know beyond a question of doubt, and if your Association can
suggest any practical methods or regulations that will assist in re-
moving the menace to labor, all white-lead makers will give you
hearty cooperation.
DR. JAMES P. WARBASSE, New York City: I have listened with
interest to this apology for the lead industries. But I think there is
one point to bring out, that the lead industry is practised for the
profit there is in it. There are satisfactory measures for protecting
the lead worker, but I do not agree with the previous speaker that
adequate means of protection are now used in any factory in the
United States. The question of profit is the important side and it
behooves us, as students of industrial diseases, to bear this fact
in mind.
DR. J. W. Foss, Arizona: The statement has been made that the
only way a person can become poisoned from lead is through the
intestines, and not through the skin. Only last evening Dr. Ander-
son of the Navy told me they had been making investigations of the
poisoning of the men who chip off paint scales in the Brooklyn
Navy Yard. They made tests and it was thoroughly demonstrated
that in seven days you could get poisoning by rubbing lead on the
skin. The investigations made by the Navy show that it is a great
error to believe that you cannot be poisoned except through the
intestinal tract, and that we ought not to allow this idea to go out.
MR. HAMMAR: The men who work in the Navy wear goggles
instead of respirators. I contend, very reasonably, that if they keep
the dust out of their mouths they will keep it out of their systems.
But I was speaking of white-lead works, and ninety per cent of lead
poisoning comes from sandpapering and not from lead works.
DR. C. T. GRAHAM-Rogers, Medical Inspector of Factories, New
York: The fact that lead is absorbed through the skin and pro-
duces toxic effects is brought out by Rambousek of Austria and
Roth of Germany, in works published within a year. The method
of poisoning indicated by Mr. Hammar is the more usual, but most
of the cases of lead poisoning occur among painters who are work-
LEAD USED AS A HARDENING AGENT
STEEL MAGNets ARE DIPPED INTo MoLTEN LEAD UNTIL RED Hot, THEN
PLUNGED INTo WATER, AND WHEN CoolED, Polished witH SAND
Paper. WoRKERs ENDANGERED by FUMEs ANd Dust
DEATH's Due to Lead Poisoning from BREATHING Dust in this Work
HAVE Sometimes BEEN REPorted by Physicians with the Occupa-
tion. Given MEREly as “Cooper”. A MoRE Specific State-
MENt of Occupation is NEEDED to Reveal True
Cause of DEATH


General Discussion 285
ing with lead paints. When they are employed in sandpapering
paint and the application of oil is neglected, the poison is absorbed
through the skin.
MR. JoHN Vogt, New York Department of Labor: I had the good
fortune to accompany Mr. Pratt during his investigation, and from
the many tests I made of the various oxids came to the conclusion
that, where the dust was eliminated as much as practicable, the num-
ber of cases of lead poisoning was reduced.
PROFESSOR C.-E. A. WINSLow, New York City: The great pos-
sibility of lead poisoning is getting lead into the mouth. It is an
ordinary problem of sanitation.
DR. HAROLD K. GIBSON, Illinois Factory Inspection Department:
Mr. Hammar's remarks are interesting. I believe he is, like others,
making an effort to eliminate lead poisoning from his plant. It
can be eliminated, but all the dust collectors and improved methods
of sanitation and exhaust devices and washing facilities will not
do it by themselves. After all, I think the decisive factors are strict
personal supervision by foremen and the education of the men in
personal hygiene. We have what we call two classes of manu-
facturers, those who comply with the letter of the law and those
who comply with the letter and with the spirit. Mr. Hammar I
know to be one of the latter class. All these measures, including
sanitation, will not avail unless the manufacturer complies with the
spirit of the law.
DR. John B. ANDREws, Secretary, American Association for
Labor Legislation, New York City: A year and a half ago Mr.
Hammar treated this subject at our annual meeting in St. Louis. I
have often cited his work as an illustration of what can be done.
There is need of labor legislation to bring other manufacturers up
to his standard. -
Mr. Hammar is also correct in his contention that the amount of
industrial lead poisoning due to absorption through the skin is
comparatively insignificant. Practically all industrial lead poison-
ing, leading authorities agree, is caused by the inhalation or the
swallowing of lead vapor or dust.
286 American Labor Legislation Review
MRS. FLORENCE KELLEY, National Consumers’ League, New York
City: What is the use of teaching a man to shovel lead and then
telling him it is harmful, yet paying him to keep it up. Is there any
apparatus on the market to prevent that phase of the business?
MR. THOMPSON, Chemist, National Lead Company, New York: I
came here on account of our interest in this work. I want to say
a word or two in supplement to what Mr. Hammar has said about
dust. In our experience the dust is the dangerous element. In re-
gard to mechanical handling, not much has been done on that ques-
tion, but we are making progress. There is a phase in the manu-
facture of white lead not yet touched on, however, which illustrates
One direction in which a saving of dust can be accomplished. From
the time when you put the white lead in the factory, it may be
handled in enclosed machinery and no dry lead dust produced until
it is put in pans; and even that can be avoided by mixing it with oil.
However, the trade requirements are such that this cannot always be
done. Some painters will not accept such paint.
We need an educational movement, to be followed by such legis-
lation as is necessary, and I am almost inclined to think, by the
time the legislation is accomplished, the manufacturers will have done
everything that will be required of them. We sympathize heartily
with this work and want to help it along in every way possible. We
are spending a great deal of money, from an economic standpoint,
in washrooms and in new machinery. The policy of our company,
and I speak authoritatively, is not to hold back the expenditure
of money in any way which will assist in the prevention of lead
poisoning.
II. InvESTIGATION AND REPORTING OF INDUSTRIAL DISEASES
DR. GEORGE M. KOBER, Georgetown University, Washington, D.
C.: The papers presented this morning are particularly valuable.
Very naturally we inquire why there is such a paucity in American
literature upon this subject. The reason we have so little litera-
ture is that we have had few original investigations, and I think it
is exceedingly encouraging that the United States Labor Bureau
is recently paying more attention to the question of industrial dis-
eases. I consider that one of the most important duties the bureau
can perform is to have expert investigations made into the conditions
General Discussion 287
affecting the workers' health. This example should be followed by
our states. More money should be spent on original investigation,
so that we may come into possession of facts to form a literature on
the subject. Then we need the training of men and women to this
work.
I believe the reason the Germans lead in literature of that kind is
that they have a large number of medical officers connected with in-
dustrial insurance companies, whose business it is to prevent dis-
ease and who naturally give special attention to the investigation of
factors which affect the welfare of workers. We may benefit the
American laborer to a great extent by encouraging the employment
of men whose business it is to give their entire attention to the
health of the laborer. The ordinary workman often hesitates until
he is really compelled to give up work before asking for medical
advice. If he were in the hands of a physician whose duty it was to
give attention at any hour of the day, he would ask advice at the
earliest possible and most opportune moment.
I wish to make a strong plea for the reporting of all industrial
diseases in every state in the union. Until we do this many dis-
eases may be due to industrial causes but not be recognized as such.
We should also train up medical men to be perfectly conversant with
what constitutes industrial disease.
DR. J. W. Foss, Arizona: I have had some experience in the re-
porting of diseases, and the question of what should be reported
and what compensation should be paid. It would seem right to ask
the labor organizations to cooperate, as they have recently done in
Arizona in regard to the union label. They sent out letters to all the
people who use printed matter asking them to use that label. If
the physician is receiving his living from these people he will pay
attention to their request.
DR. WILLIAM F. SNow, California State Board of Health: The
California legislature of 1911 passed a law, recommended by this
Association, requiring the reporting of six occupational diseases. The
bill was essentially that formulated by this Association but with one
minor change, that reports should be made to the state board of
health instead of to the bureau of labor statistics. The state board
of health then makes a transcript of the report and immediately
forwards it to the bureau of labor statistics.
288 American Labor Legislation Review
I think it possible that, when a careful survey has been made, we
shall find that California does not have, under present industrial
and limited manufacturing conditions, a large problem of industrial
disease. We are doing some things, however, which may interest
you. The labor bureau is in touch with the labor associations of the
state and I have given them a list of all the occupations which we
thought might be productive of industrial diseases. We have tried
to get the names of the secretaries of all the painters' unions and of
all the printers' unions. We are also trying, in the principal cities,
to obtain information in regard to diseases which are not reported.
That is joint work of the health and statistical boards.
The physicians are the biggest factor in reporting. If we could
get all the physicians to be active and interested and to study the
problem and see the importance of reporting, it would be a great
assistance.
PROFESSOR HENRY R. SEAGER, Chairman: I am sure we have all
listened with the greatest interest to Mr. Hoffman's stimulating and
salutary paper. It is just the sort of doctrine we need as social
workers to keep us alive and aware of our weakness. But I think
most of us would wish to put in a caveat against his description of
the manufacturer. He has had in mind the large-scale, high-minded,
far-seeing employer. There are many of that type, but I think we
must not forget that there are manufacturers of the other type and
that the presence of such manufacturers in the community is the
justification for public interference, by legislation or otherwise, to
remind them that, while tariff protection is to them the all-important
thing, to the community at large protection of the lives and health
of their employees is even more important.
Mr. Hoffman has called attention to the paucity of literature on
the subject of industrial hygiene and the difficulty of obtaining
readily the literature that is available. We hope our bibliography
of industrial hygiene will serve a useful purpose by giving access
to this literature.
One of the achievements of this Association has been the enact-
ment by some eight states of a law requiring the reporting of certain
industrial diseases. Dr. Hatch's paper brings out very clearly the
fact that in this work we have passed the stage of talking about what
we ought to do and are really beginning to do things of value. I wish
“CHASER ROOM.” IN WHITE-LEAD FACTORY
MECHANICAL MIXING OF DRY LEAD AND OIL
DRY WHITE LEAD Is SHovelled From THE TRUcks INTo the OPENINGs UNDER
the Exhaust Pipes. Which CARRY Away Much of THE
DANGERous Dust
IN ONE MoDERN FActory THE CHAsers ARE ENTIRELY ENclosed, FILLED BY
MACHINERY LIGHTED BY ELECTRICITY, AND INspected THROUGH
Glass WINDows

General Discussion 289
to reenforce what he has said in regard to the cordial cooperation
that this Association has had, in connection with its efforts to make
the reporting law a success, from leading physicians in New York
City. It must be admitted that, at the outset, most of the physicians
we communicated with were not enthusiastic about this additional
burden. But as soon as it was explained to them, their attitude
changed and we have had their cordial cooperation. I hope that
the plan worked out in New York State may serve as a model for
the other seven states which have laws requiring the reporting of
industrial diseases.
III
FIEALTH PROBLEMS IN MODERN INDUSTRY
Presiding Officer: WARREN ColeMAN
Bellevue and Allied Hospitals
NEW YORK CITY
THE FUNCTION OF HOSPITALS AND CLINICS IN
THE PREVENTION OF INDUSTRIAL DISEASE
RICHARD C. CABOT
Massachusetts General Hospital, Boston.
What are the hospitals doing to prevent industrial disease? Little
or nothing. What ought they to be doing? Much. Why? Were
hospitals organized to do preventive work and to follow back into
the community all the medical problems that the community shoots
into the clinics? No; the charters and constitutions of hospitals
contain no distinct evidence of any such provision. But public
sentiment is beginning to demand that the hospital shall advance, as
the country has advanced, beyond the thought of its founders.
Public opinion is beginning to demand that hospitals and doctors
alike shall do something to abolish the need of their own existence—
shall make, at any rate, a sincere and strenuous effort in that direc-
tion. There are those of us who doubt the success of that effort
and are inclined to believe that the prevention of industrial disease
is largely a moral problem with which the hospital is not organized
or temperamentally fitted to deal. But there can be no doubt that
the public is putting it up to the hospitals to deal in some way with
the many-spreading branches and with the single deep root of
industrial disease.
Industrial diseases, such as lead poisoning and “heat cramps”, pass
through the hospital and out again like threads in a loom. They
represent but one of many such threads of human suffering which,
from the hospital point of view, suddenly appear out of the wild
jungle of the modern industrial world, are visible for a moment in
the cleared and lighted space which science has established in the
clinic, and disappear again into the tangled outside world.
It is precisely because there are so many such threads, besides
that leading to industry, that no one notices or follows up any one
of them. The doctor's mind is distraught with a dim awareness,
“out of the corner of his mind's eye”, of this mesh of threads. He
sees not only occupational diseases but recreational diseases (poi-
294 American Labor Legislation Review
soned recreations) and educational maladies due, like caisson
disease, to the crushing pressure of many atmospheres on sensitive
minds, or to rarefication of the educational atmosphere, or to poi-
sonous elements introduced in education. He cannot be altogether
oblivious of the strands which bad housing, bad cooking, alcohol,
morphine, racial misadaptation, and disillusionment weave into the
many-colored fabric of misery as it passes through his clinic.
If he had been challenged only by the disgrace of industrial
disease, he might have long since picked up the gauntlet and gone
into the fight. But he is dimly aware that industrial disease is now
in the limelight chiefly because Mr. John B. Andrews and a few
other intelligent people have recognized the horror and shame that
it is and are focusing public opinion upon it. He knows that poi-
soned recreation and poisoned education are disease-breeding
factors as serious as poisoned air, and that the housing problem,
the immigration problem, and the drink problem do as much as
industrial risks to keep the public sick and the hospitals busy. But
he also knows that he cannot fight all of the giants at once and
unaided, and that to recognize them clearly and do nothing about
them would render his medical right arm powerless. Hence, with
a judicious instinct of self-protective adaptation, he turns his
attention elsewhere.
This explains why our hospitals, though called upon to do so
much, are actually doing so little to prevent industrial disease.
Hospital doctors see no advantage and no heroism in biting off.
more than they can chew. -
But the reorganization of the hospital has begun. Its forces will
Soon be arranged so that the doctor can call for the help he needs
with some confidence that an answer will come. As soon as
doctors realize this, they will begin calling for the following:
I. Trained investigators.--The human results of industrial
disease should be followed up to their source. Was it the patient's
ignorance, the employer's negligence, the law's delay, or the predis-
posing influence of heredity and other conditions outside the field of
industry? Whenever one case of industrial disease appears at a
hospital there must be many more that didn't. These others must
be found.
The investigator should represent the hospital and not an outside
agency, because the hospital occupies a position of judicial fairness
Hospitals and Clinics in Industrial Disease 295
and impartiality. It is quite unconcerned with the special viewpoint
or class consciousness of the employer or of the employed. It
cannot justly incur the suspicion of either, for the hospital doesn’t
care a button whose fault is represented in industrial sickness.
2. Educational weapons.—As a result of the efforts of these
investigators, excellent illustrative material will be amassed for the
prosecution of campaigns of education among employers, employed,
members of legislative bodies, and the general public.
The recent success of the campaign against phosphorus in industry
would have been impossible if the agitation had not had some excel-
lent pictures of the effects of phosphorus necrosis on the jaw. The
hospitals are very promising fields in which to search for awful
examples of this kind, and the examples will be all the more telling
and persuasive if they are found by the hospitals' own agents and
not by outside agencies exposed to suspicion of prejudice.
Pictures illustrating the effects of diseases and the devices for
preventing them should be on the walls and screens of every clinic.
They accomplish little by themselves, but if you lead a patient up
to one of them and explain the picture and your advice, each by
means of the other, you produce a far deeper effect on the patient's
mind than you can by talk alone. A clinic thus furnished is a
permanent exhibit of industrial hygiene and one likely to produce
all the more effect because of its connection with the hospital.
Hospitals will probably be slow to set up such exhibits by them-
selves, but they might be given sets of pictures on trial by an
organization interested in industrial hygiene.
3. Research in industrial hygiene.—Such research will naturally
become a part of any hospital associated with a medical school which
maintains an active department of preventive medicine. It will
concern the modes by which industrial disease is produced and those
by which it may be prevented.
At the beginning of this article I indicated my conviction that it
is the hospital’s business to look into education, recreation, housing,
and alcoholism as causes of disease for the same reason that it is its
business to look into industry. Each of the factors just mentioned
is as important as industry in causing illness and disability. In
closing I wish to say that just because the hospital physician sees the
interweaving and interlocking of all these factors as no one else
296 - American Labor Legislation Review
does, he is pointed out by the finger of common sense as the man
most responsible for the difficult task of disentangling them and de-
ciding which is dominant and most deserving of remedial effort. Tu-
berculosis, for example, is sometimes referred to as an industrial
disease and doubtless in occasional cases it is so, but in the vast
majority of cases the influence of other factors, such as nutrition,
contagion, and housing, is, I believe, more important. The hospital
physician, with his eye on all these factors, can take a more impar-
tial and discriminating view of the tangled problem than anyone
else. He is therefore the king-pin in the whole situation. Let us
try to make him realize the honor and responsibility thus thrust upon
him! -
TEMPERATURE AND HUMIDITY IN FACTORIES
w C.-E. A. WINSLOw
College of the City of New York.
Discussion of certain moot points in the theory and practice of ven-
tilation has become so general and sometimes so disputatious that
we are in danger of losing sight of the underlying facts upon which
experts are in substantial agreement. Yet there is a solid basis of
accepted principles and efficient methods; and this basis is amply
sufficient for practical application on the part of individual factory
owners, even if it is not yet so concretely defined as to be easily em-
bodied in the form of legislative enactments.
In the first place, it is quite clear that the principal thing which
makes the air of confined spaces harmful, aside from the special
problems presented by dust and fumes, is overheating, especially
when combined with excessive moisture. Any temperature over 70°
F. puts a strain upon the heat-regulating mechanism of the body,
keeps the blood in the skin away from the vital organs, and produces
far-reaching impairments of the efficiency of the nervous system, the
digestive system, and the body as a whole. Changes in metabolism
and blood pressure, to which attention has recently been called by
Dr. Gilman Thompson, are similar well-known physiological reac-
tions to temperature change. This general effect of heat and
humidity is familiar to everyone who contrasts his own ability to
do either brain work or muscular work in the dog-days and in brisk
autumn weather. It is established by the exhaustive studies of
physiologists in Germany, in England, and in the United States;
while the same studies have as yet failed to reveal any definite bad
effects due to the chemical constituents of the air. Other atmos-
pheric conditions are still in doubt. The best lower limit of tem-
perature is uncertain. The action of hot, dry air is debatable. The
physiological effect of odors in air has not been demonstrated. It
is beyond question, however, that the workers in a factory where
the temperature is over 70° are injured by a lowering of their
vitality that may lead to tuberculosis and other serious diseases; and
298 American Labor Legislation Review
that they are working below their normal standard of efficiency,
so that both they and their employer are the losers.
The New York State Department of Labor is the only official
body in this country, so far as I am aware, which regularly carries
out examinations of factory air and publishes the results. From
the reports of this department for 1908, 1909, and 1910, it ap-
pears that two hundred and fifteen workrooms were examined
at seasons when the outdoor temperature was 70° or less. Of
these workrooms one hundred and fifty-six, or 73 per cent, had tem-
peratures of 73° or over and sixty-three, or 29 per cent, had temper-
atures of 80° or more. In a recent study of a mill village carried out
by the Rhode Island Anti-Tuberculosis Society, temperature and hu-
midity readings were taken three times a day inside and outside of a
weaving room. The outdoor temperature for the month (Septem-
ber) averaged 65.5°. The temperature in the weaving room aver-
aged 75.8°, Io° higher. Is it not clear that, aside from all debatable
questions, there is a simple and obvious condition here which di-
rectly menaces the health of the workers and impairs the efficiency
of industry?
The first clear problem of air conditioning in the factory is the
prevention of overheating. The practical method of attaining
this end is air change or ventilation. With only a few people in
a room, heat may be transferred through cracks and through
the substance of walls and ceiling with sufficient rapidity, without
any special provision for the purpose. Where many workers
are crowded together, however, this is impossible. The average
human being at work produces about two hundred and fifty calories
of heat per hour, equivalent to the heat liberated by the burn-
ing of two candles. In many factories this heating effect is sup-
plemented by the friction of machinery and the combustion of
illuminants, and often by furnaces, mangles, steam jackets, press-
ing irons, solder pots, and other direct sources of heat. The most
convenient method of removing this excess heat is by air change;
and the primary need in factory ventilation is to provide for the
removal of the heated air and its replacement by cooler air from
without. The latter must usually be first tempered by raising it
to a point a little below that which is normally felt to be com-
fortable. Whatever may be the case in hospitals and schools, it
is fairly certain that incoming air much below 60° would not be
Temperature and Humidity in Factories 299
endured by factory operatives; and it would certainly not be
compatible with efficiency in the majority of trades which call
for manual dexterity.
I am speaking in this connection of the maintenance of ordinary
normal atmospheric conditions in the factory. The possibility of
occasional variations from this normal is a separate question. It
is maintained by many sanitarians that changes in temperature are
stimulating and beneficial. There is little exact evidence for this
view, but it is in harmony with general experience and is probably
correct. In many schools it is the practice to open windows and
flush out the room with cold air every two hours or so, and the
effect upon the spirit and efficiency of the pupils is said to be
excellent. Such a procedure might be well worth the temporary
interruption of work in many industrial processes. It is merely
a modification of a general system of air conditioning, however,
not a separate system by itself. The fundamental problem is
the exhaustion of the hot air of the workroom and the supply
of cool but tempered air to take its place. I shall not dwell upon
the methods by which this end can be attained, since they differ
in each individual case. In general, I believe the hot air should
be taken out near the top of the room and the cool air admitted
near the bottom. The hot air may escape by its own tendency
to rise or may be sucked out by fans. The cool air may be ad-
mitted at window openings in the room, equipped with tempering
coils; or it may be forced from a central point through special
ducts. The system of ventilation may or may not be supplemented
by a direct system of heating. The essential principle remains
unchanged.
When we pass, however, to the question of embodying desirable
conditions in statutory form, which is the primary object of
your Association, the matter is not so simple. At present there
are only two types of laws on the statute books of American states,
with the exception of the 1909 law of Illinois. Eight or ten states
provide for a minimum cubic space per occupant, usually two
hundred and fifty or four hundred cubic feet. Some twenty
states require that factories shall be “ventilated” or “well venti-
lated” or “sufficiently ventilated”. The cubic space requirement
by no means insures good air conditions. It merely prohibits
such a state of overcrowding that proper air conditions are im–
3OO American Labor Legislation Review
possible. Whether a factory with ample air space is comfortable
or not depends on the further provision for air change. In the
studies made by the English departmental committees it was
found that the air was no better on the average in factories with
over five thousand cubic feet of air space per occupant than in those
with an air space under three hundred cubic feet. As to the provisions
that factories must be “ventilated” or “well ventilated”, they are
unenforceable and meaningless in the hands of the present de-
partments charged with factory inspection in this country. The
Illinois law is the only real ventilation law in the United States.
It provides that a definite amount of air, 1500 to 1800 cubic feet
per occupant, according to specified conditions, shall be supplied,
unless the cubic space in the workroom be over 2000 cubic feet
per occupant and the outside window and door space be equal to
one-eighth of the floor space.
In formulating a standard for factory ventilation one is met
at the outset by the question whether the standard should be a
mechanical or an analytical one. Ventilating engineers prefer to
have the amount of air supply fixed as in the Illinois law. Sani-
tarians argue that the proper standard is the actual condition
maintained in the workroom, however it may be reached. In a
proposed law drafted in conference with members of this Asso-
ciation in New York a year ago and introduced in the state leg-
islature as Senate Bill No. IoI9, on March 31, 1911, an attempt
was made to combine these two viewpoints on an alternative basis.
This bill provided that “a workroom shall be deemed to be prop-
erly and sufficiently ventilated if the air in the working parts
thereof does not contain more than nine parts of carbon dioxid
in Io,000 volumes of air in excess of the number of parts of car-
bon dioxid in Io,000 volumes of the exterior air, or if there is
constantly supplied throughout the interior of the room at least
1200 cubic feet of air per hour for each person therein present
and employed and in addition thereto at least IOOO cubic feet of
air per hour for each cubic foot of gas burned per hour”. Such a
law, which demands a reasonable rate of air change, to be demon-
strated either by analysis or on a mechanical basis, seems eminently
fair to the manufacturer and probably safeguards sufficiently the
health of the worker so far as the extent of air change is concerned.
Any ventilation standard must, however, deal with the quality as
Temperature and Humidity in Factories 3OI
well as with the quantity of the air. The most important things
are the temperature and humidity of the air. These qualities are
measured very simply by the use of an instrument known as the
sling-psychrometer, which consists of a pair of thermometers, one
of the ordinary type and the other having its bulb covered by a wet
cloth. Moisture evaporates from the wet cloth at a rate determined
by the amount of moisture in the air and this evaporation cools the
wet-bulb thermometer and lowers the temperature recorded. From
the temperature of the dry-bulb thermometer and the difference
between the dry and wet bulb, the moisture in the air may be readily
calculated. A high wet-bulb reading means a combination of tem-
perature and humidity, precisely the condition most harmful to the
human organism, and Haldane has shown that in general a given
wet-bulb reading has about the same physiological effect, whether
it be the result of a very high temperature with low humidity or of
a moderately high temperature combined with high humidity. The
proposed New York law, to which reference has been made, pro-
vided that “the temperature in any factory workroom except a
boiler room, shall not exceed 72° F. as determined by the wet-bulb
thermometer, unless the temperature of the exterior air exceeds 70°
F. as determined by the same process, in which case the wet-bulb
temperature shall not exceed that of the exterior air by more than
5°.” A wet-bulb temperature of 72° would correspond to a dry-
bulb temperature ranging from 72° with completely saturated air
to 93° with air containing only 30 per cent relative humidity.
It is just here that the difficulty comes in formulating a standard
for factory ventilation. Either the Illinois law or the proposed
New York law would serve pretty well to regulate the amount of
air to be supplied. I do not believe, however, that we have ade-
quate data for fixing a maximum figure for temperature and hu-
midity. The limit of 72° wet bulb written into the proposed New
York law was taken as a maximum which would probably not be
onerous to the manufacturer, but it is possible that even this limit
might be difficult of attainment in certain industries, while in most
factories it is probable that a much more stringent regulation
could well be adopted. Industrial processes are very diverse and
any rigid statutory standard is likely to work hardship on the one
hand and to give inadequate protection to the worker on the other.
As Socrates long ago taught his ardent pupil Glauco in the Mem-
3O2 American Labor Legislation Review
orabilia, it is no light matter to make laws governing industrial
conditions. Standards for factories can only be wisely formulated
after a careful study of existing conditions in the light of physio-
logical ideals and by striking a fair balance between what we
should like and what the factory owner can reasonably provide.
In our own homes we maintain, not a wet-bulb maximum of 72°,
but a dry-bulb maximum of 70°, a very different thing. How near
this desirable ideal the legal limit should be placed can only be de-
termined by a careful study of present conditions and practical
possibilities in specific trades.
The old English law governing conditions in cotton-weaving
sheds provided that in sheds in which there was artificial humidi-
fication the limit for carbon dioxid should be nine parts per Io,
OOO, and fixed a definite relation between wet and dry-bulb tem-
peratures for each dry-bulb temperature over a wide range, but
set practically no upper limit for either. With the advance of
modern ideas as to the supreme importance of temperature in air
conditioning the whole question was reopened by the creation of a
departmental committee which heard ninety-six witnesses, including
physiologists, factory inspectors, mill owners and operatives, made
seventy-six inspections and numerous air examinations, published
the results in two hundred and fifty closely printed pages and
formulated a new standard raising the carbon dioxid limit to eight
parts in excess of that in the outside air and adding a temperature
limit of 75° wet bulb. All this was done for one branch of one
industry; precisely this sort of investigation is urgently needed in
the United States.
In view of the difficulty of formulating legal standards, Wis-
consin has adopted an entirely different plan, abandoning entirely
the attempt to fix the details of factory regulation in the form of
law and creating instead an industrial commission with power to
fix specific standards whose reasonableness can be reviewed only
by the supreme court of the state. The regulations of such a com-
mission could be made far more responsive to the varied and chang-
ing conditions of science and industry, and would offer the most
promising method of securing a maximum of protection for the
worker with a minimum burden on the business itself.
It is quite as essential, however, for the work of such a commis-
sion as for the formulation of specific laws, if that method of pro-
©
Temperature and Humidity in Factories 303
cedure be preferred, that a thorough study of existing factory con-
ditions by properly qualified experts should be made. There have
recently been valuable studies of certain industrial poisonings in
this country, notably by the Illinois Commission on Occupational
Diseases and by Dr. Andrews, the secretary of this Association.
General sanitary conditions, and particularly air conditioning, are
far more important in the aggregate than these specific poisonings.
The latter are obvious and spectacular, but they only affect a com-
paratively small fraction of the working class. Even in the pottery
industry, one of the trades most subject to lead poisoning, it was
shown in England by the departmental committee on this industry
that the excess death rate due to plumbism was only .8 per Iooo
while the excess death rate due to tuberculosis was 7.o. Industrial
tuberculosis pervades not only the dusty trades, but in less degree
every industry from the largest to the smallest. Yet as to air con-
ditioning in our factories we know pitiably nothing and we have no
machinery for finding out anything. New York has a good medical
and laboratory expert in Dr. Graham-Rogers. Illinois has recently
appointed a medical expert from whom we are to hear to-morrow.
Massachusetts has a force of fifteen medical inspectors devoting
some or all of their time to the work. This is all that we have in
the way of scientific factory inspection in the whole United States.
For progress in air conditioning it is essential to have air exami-
nations and intelligent inspection of ventilating appliances in fac-
tories of various types. Only on the basis of such studies can legal
standards be enacted or specific rules laid down by a factory com-
mission. Yet we have in the whole United States, except for Dr.
Graham-Rogers in New York, not one single chemist or engineer
regularly employed by any state to study factory air conditioning.
Would it not be well for this Association to take up seriously at
this time the problem of expert organization of the state bureaus
which are supposed to deal with industrial hygiene and sanitation?
It is less standards that we need than experts to formulate new
standards and enforce the old ones. There should be medical
experts and chemical experts and engineering experts, not just
doctors and engineers, but doctors and engineers who have spe-
cialized in public health, on the staff of the body which enforces
health laws in factories in every large industrial state; and we
shall not get much farther with the problems on hand until this
comes to pass. * --
3O4 American Labor Legislation Review
Meanwhile, however, there is an excellent opportunity for the
individual factory owner to benefit his employees and increase their
output by attention to the problem of air conditioning as regards
temperature and humidity. There should be a thermometer in
every workroom and the foreman should be made to understand
that every time the temperature passes 70° he is failing to secure
the best work from his hands. In any large factory, observations
of ordinary temperatures should be supplemented by the use of the
sling-psychrometer. Only by such observations can window venti-
lation in small shops and ventilation systems in large factories be
intelligently controlled. Direct practical results in diminishing ab-
sences and decreasing damaged and imperfect work have been
obtained in many a factory by improved air conditioning. Efficien-
cy methods have been applied to a hundred mechanical details of
shop administration. That delicate mechanism the human body is,
however, the underlying factor which is after all of most impor-
tance. Yet in many a workshop, perhaps in most workshops, the
human body is being operated under conditions which preclude its
maximum effectiveness, and the work suffers while the sanitariums
fill up with cases of industrial tuberculosis.
AIR IMPURITIES-DUSTS, FUMES, AND GASES
CHARLES BASKERVILLE
College of the City of New York.
The nature and extent of air impurities discussed in this paper are
dependent upon local conditions. For our purposes these air im-
purities may be classified under three heads: namely, (I) dusts, (2)
fumes, and (3) gases. These divisions are not exclusive, as fumes
in abundance may become dusts; for example, a sudden escape of
white arsenic fumes results in a cloud of dust. Again, smelter
fumes (mainly sulfur dioxid), much diluted, may be classed as
gaseous. The classification, therefore, is neither specific nor de-
pendent upon inherent properties of the materials. It is merely a
convenience and must admit of a broad and liberal interpretation. A
technical discussion as to proper lines of differentiation would be of
little profit and less interest.
INDUSTRIAL DUSTS
It is well known that various industrial dusts cause irritation of
the respiratory passages and of the eyes and skin of workmen. Such
dusts may be considered in three classes: namely,–
I. Insoluble inorganic dusts.--This class includes metals (anti-
mony, arsenic, type-metal, brass, bronze, copper, aluminum, iron,
steel, lead, manganese, vanadium and ferro-vanadium, silver, tin,
zinc, and solder) in a state of fine division (dusts, atomized metals,
metallic powders); flue dusts; various ore dusts (iron ore, etc.);
silica, sand, emery, flint, glass powder; carbon, graphite, diamond,
coal, soot; brick dust, marble, granite, cement, terra-cotta; lime,
gypsum, plaster, meerschaum; phosphates, guano, etc.
Fibrosis of the lungs may result from the inhalation of silicious
or metallic particles; for example, we have “potter's asthma” and
“grinder's phthisis” (chronic catarrhal bronchitis among knife-
grinders). Pneumonia has been reported as frequent among work-
men in blast-furnaces, in part owing, directly or indirectly, to the
306 American Labor Legislation Review
inhalation of slag dust; cardiac dilation is said to occur among work-
men in slate quarries; ankylostomiasis among brickmakers, miners,
etc.; and recurrent inflammation of bone with hypertrophy among
pearl-dust workers.
Hellthaler" has shown the high rate of death among various classes
of metal workers in America who are apparently in ignorance of
the peculiar dangers of their occupations; and Prinzing” has demon-
strated the high death rate from phthisis among steel grinders and
other workmen at Solingen, Germany, for the years 1885 to 1895. It
is certain that the inhalation of iron dust may diminish in time the
respiratory efficiency of the lungs through a loss in their elastic
property; or may reduce the resistance of the organs to invasion by
harmful bacteria; or may infect the lungs through a transportation
of disease germs to places favorable for their inoculation. The
disease known as siderosis exists commonly among metal polishers,
knife-grinders, and others engaged in metal working. The earliest
symptoms of this disease are, according to Soper,” catarrh and bron-
chitis, but shortness of breath is pronounced by all authorities to be
the most characteristic symptom. Eventually there follows what
appears to be phthisis without the presence of tubercle bacilli, yet
genuine infective phthisis is the most common cause of death. The
effects may be delayed for years, but metal working is indeed a dan-
gerous occupation; undoubtedly many die from infectious pulmo-
nary diseases who do not know that the breathing of dusty air has
led to their infection.
With the development of rapid transit systems in modern cities,
it may be well to direct attention to a new and specific form of city
dust investigated by Dr. Soper,” who found that the average weight
of dust in subway air was 61.6 mg. per I,000 cubic feet of air, or
2.25 mg. per cubic meter. The figures for the streets were 1.83 mg.
per cubic meter. The subway dust was found to consist chiefly of
angular particles of iron, but no case of siderosis seemed to have been
reported. .
2. Soluble inorganic dusts.-This class comprises such substances
* Hellthaler, “The Death Claims.” The Independent, December 27, 1906, v.
61 :1560. •
* Prinzing, Handbuch der Medizinischen Statistik, 1906, p. 489.
* Soper, The Air and Ventilation of Subways, 1908, p. 205.
“Ibid., p. 200.
Air Impurities—Dusts, Fumes, and Gases 307
as are likely to be swallowed and absorbed, and includes: metal
particles (lead, brass, copper, zinc, arsenic, mercury, and silver)
and soluble inorganic salts. Many dusts of this class are dangerous,
not only because of their irritating or poisonous properties, but also
because of their inflammability,+e. g., potassium chlorate.
3. Organic dusts.-This class comprises sawdust, fur, skins,
feathers, broom and straw, grain and flour, jute, flax, hemp, cotton,
wool, carpet dust, street sweepings, tobacco and tobacco-box dust,
hides and leather, felts, rags, paper, horsehair, etc.
As representative diseases caused by organic dusts we have: “flax-
dresser's disease”, a kind of pneumonia due to the inhalation of par-
ticles of flax; pneumokoniosis due to the inhalation of dust by gannis-
ter workers; alkaloidal poisoning from African boxwood by workmen
engaged in shuttle making; and malignant pustule and a febrile
disease among rag-sorters. As in the other classes, the components
of this class of dusts are all irritating to the respiratory tract and to
the eyes, and especially are they capable of forming inflammable,
and even explosive mixtures with air. In addition, there are various
trade eczemas, and anthrax has been frequently reported among
wool-sorters.
The solution of the industrial dust problem presents many diffi-
culties. Undoubtedly, however, disease from dust may be much re-
duced by the following procedures:
(a) Those engaged in the following occupations should wear
“workmen-respirators”: sorting rags in paper factories; workmen on
threshing machines; millers; batch-mixers in glass factories; stone-
cutters and sculptors; and all those working in factories where the
air is contaminated with irritating or poisonous dust.
(b) Those employed in the manufacture of oxidizing agents and
lead workers should be compelled to change their clothes before
leaving the factory. This is done now in some works in this country.
(c) Glasses for the protection of the eyes of workmen should be
looked upon as necessary in plants where irritating dusts are
unavoidable.
(d) The dust on the floors of printing, type-casting, metal-
working, and other establishments may be laid by means of certain
useful preparations. Heise" considers those consisting entirely of
non-drying (mineral) oils to be the best for the purpose.
* Heise, Arb. Kais. Gesundh-Amt, 1909, v. 30: 93.
308 American Labor Legislation Review
Where vapors are likely to occasion industrial poisoning, ventila-
tion will serve to prevent their accumulation; but in the case of dusts,
economic considerations often render such a procedure difficult
except, of course, as the maintenance of normal ventilation assists
in their elimination.
NOXIOUS FUMES, GASES, AND VAPORS
The air of cities and towns where chemical manufactories exist
is often contaminated with noxious gases of industrial origin which
are dangerous to the health of the workmen employed in the in-
dustries. The usual gases which give rise to complaint in manu-
facturing localities are the following: chlorin, which is emitted
by pottery kilns and ceramic-products manufactories, and from
plants for the electrolysis of halides; hydrogen chlorid, which is
produced by the combustion of coal, and by pottery kilns, ceramic-
products manufactories (partly from the coal and partly from the
clay), nickel and cobalt smelting, platinum refining, glass manufac-
tories, fertilizer manufactories, the chlorid of lime industry, and
alkali manufactories; sulfur dioxid and sulfuric acid, which result
from the combustion of coal, coke, petroleum, and gas, copper smelt-
ing, bleaching operations, etc.; fluorides and hydrofluoric acid, which
are emitted from acid phosphate and heavy chemical plants; hydro-
gen sulfid, from chemical works, especially those which produce
ammonia; carbon monoxid, which is emitted from iron furnaces
and from copper smelters; organic vapors, from, for example, glue
refineries, bone burners, slaughter and packing houses; zinc fumes
from zinc smelters and from brass foundries; arsenical fumes from
copper smelters; phosphoric fumes from match manufactories; and
carbon disulfid and sulfur chlorid from some rubber works.
Lehmann" compiled the accompanying table from the reports of
many investigators, to show at what concentrations the various com-
mon industrial gases are capable of producing immediate and observ-
able effects upon health. The destructive action of fumes in the
vicinity of chemical plants is generally due, however, to the presence
of sulfurous acid, sulfuric acid, or hydrochloric acid; and this table
is given on account of the occupational hazards on the part of work-
men employed in chemical manufactories and smelters.
* Lehmann, Methoden der Praktisch en Hygiene, 1901, p. 174.
Air Impurities—Dusts, Fumes, and Gases 309
º Bearable for
Rapid and 30 to 60 min. Trifling symp-
NAME OF GAS dangerous without grave toms after action
1njury effects for some hours
Hydrochloric acid. ... per Iooo I.5–2 O.O5 O.OI
Sulfurous acid ....... “ IOOO O.4–5 O.05
Carbonic acid . . . . . . . “ IOOO About 30 6 to 8 I to 2
Ammonia ........... “ IOOO 2.5–4.5 O.3 O.I
Chlorin; Bromin..... “ IOOO O.O4—O.06 O.OO4 O.OOI
Iodine . . . . . . ... . . . . . . “ IOOO O.OO3 O.005—O.OOI
Hydrogen sulfid .... “ Iooo O.5—O.7 O.2—O.3 O.I.-O. I5
Carbon disulfid ...... “ IOOO O.OI O.OO2 O.OOI
Carbon monoxid .... “ IOoo 2 to 3 O.5—I.O O.2
Of the gases which affect the respiratory passages and eyes the
most important are the following: illuminating gas, gases from coke
and coal; carbon monoxid; carbon dioxid (in brewing, baking, and
the manufacture of aerated waters); chromic acid; chlorin; sulfuric,
hydrochloric and nitric acids, and nitrogen oxids (in acid factories,
heavy chemical works, engraving, etching, lithographing, etc.); mer-
cury cyanid; heated lead; ammonia; naphtha and benzine (petroleum
refineries and dry-cleaning establishments); arseniuretted hydrogen
(copper refineries); sulfur, hydrogen sulfid, sulfur dioxid, and car-
bon disulfid, sulfur chlorid, nitrous gases, hydrocyanic acid; Smoke
(fire extinguishing); and the vapors of various organic compounds
and substances (tar, creosote, carbolic acid, petroleum and its pro-
ducts, methyl alcohol, fusel-oil, varnish solvents, dinitrobenzol, nitro-
glycerine, formaldehyde and formic acid, pyridin, etc.). In addition
to irritating the respiratory tract and eyes, such substances as the
halogens, mineral acids, formic acid, alkalies, creosote and carbolie
acid, various dyes, etc., cause injuries to the skin, giving rise to
burns, eczema, fissures, ulcers, etc. It has been said that workmen
in by-product coke plants, coal-tar color works, and in the roofing
and paving industries are troubled with epitheliomatous cancer or
ulceration of the skin or of the corneal surface of the eye, owing
to constant exposure to pitch and tar compounds; that workers with
chromates, tanners, and dyers have “chrome ulceration” of the skin;
and that there are various trade eczemas, often of a troublesome
nature. !
Virtually no accidents have been recorded with hydrogen chlorid
gas, and accidents with hydrocyanic acid gas and arseniuretted
3IO American Labor Legislation Review
hydrogen are not of frequent occurrence in American plants. Car-
bon monoxid occurs in colliery workings after explosions, in gas
producers, blast-furnace gases, and in the manufacture of calcium
carbid and phosphorus; hydrogen sulfid occurs in gas-liquor storage
tanks, gas purifiers, sulfate stills and saturators, and in sewers;
chlorin is found in and about bleaching-powder chambers, mangan-
ese stills, and Deacon and other chlorid plants; and nitrous and
nitric acid fumes, which are very insidious in their action, are met
with in vitriol chambers, especially in Gay-Lussac towers, during
repacking and cleaning, in the manufacture of nitrate of iron and
nitric acid, and in all breakages of vessels containing nitric acid.
The prevention of accidents and diseases among workmen in
chemical and metallurgical plants is a subject which has received
much consideration in England and Germany. From the experience
in those countries we may conclude that the following preventive
measures may be taken:- -
I. In petroleum refineries, extraction rooms, ether manufactories,
plants where inflammable liquids and vapors are likely to be present
in the air, flour mills, and all other mills where inflammable dusts
are likely to be wafted about or suspended in the air, the belts on
all machinery should be treated with a suitable compound to pre-
vent or minimize the possibility of static discharges. The other
measures necessary for minimizing the fire risks are well known.
2. Workmen in plants wherein the air is contaminated with halo-
gen, mineral acid, metal or other irritating vapor, should be re-
quired to wear “workmen-respirators”. -
3. Instructions should be given as to the use of oxygen and the
methods of effecting artificial respiration. A very good description
of such procedures is given in the Chemical Trade Journal, 1896, v.
I9: 260.
4. Glasses for the protection of the eyes of workmen should be
required in plants where acids or caustic liquids are used or made.
5. The plants should be well ventilated, in order to prevent the
accumulation of gases and vapors.
A number of safety devices have been invented in Europe for
workmen in chemical plants, and many of them have been found to
be of great value. These cannot be considered here. It has also
been statistically shown that a great many of the accidents in chemi-
cal plants happen on Mondays. -
Air Impurities—Dusts, Fumes, and Gases 3II
While we have not given as much attention in this country as we
might to the subject of dusts, fumes, and gases in industrial establish-
ments, the writer knows of earnest efforts on the part of certain
large corporations to provide every precaution. One of the most
difficult phases of the problem here is to secure the cooperation of
the non-English speaking laborers. The American's appraisal of the
value of a Dago's life, however, is associated not only with questions
of financial economy, but also with the problem of how best to pre-
serve the economic efficiency (health) of the individual. Preven-
tion, reduction, and recovery are, therefore, of great importance as
public health problems. Legislation is needed, but laws do not
either enact or execute themselves and we must have sufficient ap-
propriations for the determination of facts and the enlightenment of
the public mind as to the effects of noxious industrial emanations.
EFFECTS OF CONFINED AIR UPON THE
HEALTH OF WORKERS
GEORGE M. PRICE
New York State Factory Investigating Commission.
The air conditions in industrial establishments, which have an
effect upon the health of the workers, may be classified in three
divisions: (1) extreme variations in pressure, humidity and tempera-
ture; (2) dusts, poisons, gases, fumes, and infective bacteria; and
(3) ordinary confined air. Of these three divisions the first two
may be regarded as accidental to industries. The third division, or-
dinary confined air, is practically incidental to all indoor industries.
The relative number of industries in which there is considerable
variation in pressure, humidity, and temperature, or in which there
is considerable danger from dust, poisons, gases, and fumes, is small
in comparison with the industries in the establishments of which
confined air prevails. -
By the term “confined air” is meant air which is confined and
vitiated by many impurities due to respiration, combustion, illumi-
nation, and overcrowding. In an examination of 4,850 establish-
ments in New York State no means of ventilation, except by win-
dows, was found in 88 per cent of the shops. The air in all these
shops was confined and vitiated.
There is as yet a difference of opinion as to the exact nature of
the toxicity of confined air. There is, however, no difference of opin-
ion as to the dangers to health of a continuous and constant inhala-
tion of such air.
It is not difficult to study the effects of extreme variations of
pressure, temperature, and humidity of the air upon the health of
workers in factories. Nor is it very difficult to trace the effects of
specific poisons, gases, or fumes in the air, or to study the results
of constant inhalation of certain kinds of dusts. The etiological re-
lations between the accidental air impurities and the health of
workers may be studied experimentally as well as clinically. The
pathological lesions produced by most of these accidental impurities
Effects of Confined Air Upon Health of Workers 3I3
are distinct and certain, and the diseases produced by them are either
acute or chronic.
Not so with the effect of ordinary air impurities, which are under-
stood by the term “confined air”. The effects of confined air are
less distinct, more difficult to prove, less direct, and more insidious,
although not less deadly. Mortality statistics show that the death
rate of workers in indoor occupations is much higher than that of
workers in outdoor occupations. There is no doubt that the chief
cause of this higher rate of mortality among indoor workers is the
confined air of shops and factories. Aside from this, however, we
have hardly any evidence in mortality statistics as to the effects of
confined air upon workers. Confined air does not produce distinct
pathological lesions, nor does it directly cause any diseased condi-
tions; and therefore its influence on the death rate is difficult to
prove. The best method for studying the effects of confined air
upon the health of workers is to study the comparative morbidity
rates of workers in different occupations who habitually breathe
stale air in the course of their several employments.
The effects of constant and continuous inhalation by workers of
the vitiated atmosphere of shop or factory will undoubtedly manifest
themselves upon the general health of the workers, but more imme-
diately and directly in the organs of respiration and digestion.
Lassitude, fatigue, headaches, anorexia, anemia, indigestion, defec-
tive oxygenation, lack of vital resistance, and a predisposition to
catarrhal affections of the air passages, are the inevitable results of
a chronic intoxication by vitiated air.
The diseases, therefore, which we would expect to find among
workers in vitiated atmospheres are bronchitis, anemia, and indi-
gestion. Pulmonary tuberculosis and diseases of metabolism would
probably be the sequelae.
In the effort to determine the effects of confined air upon workers
it would be valuable to have a comparative table of the prevalence
of anemia, bronchitis, and digestive diseases among workers in vari-
ous indoor occupations. Unfortunately such data are unavailable in
this country. The only way by which the facts may be gathered is
by a physical examination of a large number of workers in different
trades. It has, therefore, occurred to me that it may be of value
to present some results of a physical examination of workers in
3I4 American Labor Legislation Review
two different industries, which it was my privilege to conduct
during the last year.
The medical examination of eight hundred bakers was made dur-
ing last October by the New York State Factory Investigating Com-
mission. The medical examination of six hundred cloak and suit
makers was made by the Joint Board of Sanitary Control in the
Cloak, Suit and Skirt Industry during the month of March. The
bakers examined were those found in cellar bakeries in New York
City; the tailors examined were those found in some of the best
shops in the same city. We have also examined six hundred tailors
in the worst shops in the East Side of New York City, but data for
these are still unavailable. The accompanying table is very incom-
plete and no classification has been made according to age and sex.
The nativity and personnel of the bakers and tailors examined
differed very little; their hours of labor were but slightly different
though somewhat to the advantage of the tailors; night work is, of
course, customary in bread making although a negligible factor in
tailoring.
Dust was found in bakeries as well as in tailor shops. With the
present methods of baking, however, the effect of the flour dust is
unimportant as very little is allowed to escape. The vegetable and
animal dust found in cloak shops was not sufficient in quantity to
cause serious injuries. In the bakeries the temperatures near the
ovens were rather high, but this affected only a comparatively small
number of workers. The amount of CO2 in bakeries and cloak
shops does not differ very much. According to Dr. C. T. Graham-
Rogers, who has made examinations in the shops of both industries,
the amount of CO2 in the air ranges from 6 to 25 per Io,000 vol-
umes, and does not differ very much in the two industries.
The sanitary conditions of the cloak shops in which workers
have been examined were exceptionally good, as these belonged to
certificated shops in the industry. All the cloak shops examined
were ventilated, however, by means of ordinary windows and,
although not overcrowded, the ventilation of all the rooms was de-
fective because the windows were closed and no special provision
was made for introducing fresh air. The bakeries examined were
all underground with no provision for ventilation except through
small windows or gratings, but owing to the heated ovens the change
of air was probably not less than in the tailor shops.
Effects of Confined Air Upon Health of Workers 315
RESULTS OF THE PHYSICAL EXAMINATION OF 1413 workERS IN
CELLAR BAKERIES AND IN SOME OF THE BEST TAILOR
SHOPS IN NEW YORK CITY
BAKERS TAILORS
No. Per cent No. Per cent
Total examined 8OO IOO.O 613 IOO.O
Free from disease 347 43.4 II5 I8.8
Had the following diseases: -
Anemia 183 22.9 1581 25.8
Asthma w 2I 2.6 9° I.5
* - ſº 2. 3 , Tº -
Bronchitis | tº: 177 22. I . :
Laryngitis - 5* O.8
Pleurisy 2 O.3 4° O.7
Tuberculosis | Positive I9 2.4 4 O.7
Suspected 77 I.2
Diseases of the digestive system 76 9.5 186 30.3
* Of the 158 who had anemia only 31 had no other disease; of the 186
who had diseases of the digestive system only 36 had no other disease;
the others had one, or more than one, other disease.
* Five of these had chronic bronchitis and are included in that list.
* One of these had tonsilitis and is included under diseases of the diges-
tive system.
“One of these had pharyngitis and is included under diseases of the
digestive system. - -
* One of these had chronic bronchitis and is included in that list.
* Two of these had chronic bronchitis and are included in that list.
* All of these had chronic bronchitis and are included in that list.
Total number of diseases among the tailors, about 950.
Total number of tailors, 613.
Ratio of diseases to tailors, I5.5:10,
316 American Labor Legislation Review
We have no statistics in this country with which to compare the
results obtained by our physical examination. We thus have no
standard by which to judge the variations in the morbidity rate.
Nor can a comparison be made with the morbidity statistics of
Sommerfeld and others gathered from the German sick funds
(Krankenkassen), for the reason that these morbidity rates are giv-
en mostly for those members of the sick-fund societies who are
unable to work. Dr. Sidney I. Schwab's figures of the preval-
ence of neurasthenia among tailors,” and Dr. Waters’ claim of the
large percentage of tuberculosis among tailors, may be referred to
here as the only figures available on the morbidity of tailors.
The standard mentioned by Hoffman of the incidence of I5.5 dis-
eases to ten persons, being the German rate, can be compared to
the 950 diseases for the 613 tailors examined, which makes a
ratio of 15.5 to Io.
The large number of bakers suffering from bronchitis, in com-
parison with the number of tailors suffering from that disease,
seems to indicate the better sanitary conditions of the tailor shops,
which, as has been noted above, belong to those that have received
sanitary certificates from the Joint Board of Sanitary Control.
On the other hand, the comparatively large number of digestive
diseases among tailors may perhaps be due to their stooping pos-
ture and to their lesser muscular activity as compared with bakers,
who are always on their feet and who change the character of
their work a number of times during the day, while tailors sit at
a machine for nine hours a day with only a single interval for
relaxation.
It seems to me that the comparatively high percentage of anemia,
bronchitis, and digestive diseases noted among both the bakers
and the tailors is at least suggestive of the defective ventilation
of the shops in these industries, and that the confined air which bak-
ers and tailors are compelled to breathe habitually has a strong etio-
logical relation to these diseases. Much more intensive and exten-
sive study of the subject is necessary, however, before the relation
of confined air to the health of the workers can be definitely deter-
mined. -
"Publication No. 12, American Association for Labor Legislation.
GENERAL DISCUSSION
MR. J. T. AINSLIE WALKER, New York City: I have listened with
great interest to the papers read this afternoon. Speaking as an
Englishman, having been in this country but a few months, there
is one phase of this problem which you do not consider as fully as
I had hoped. We have heard of the precautions to secure proper
ventilation, but the last speaker has dashed our hopes by stating
that in many instances among tailors and bakers confined air is al-
most essential. To consider ventilation alone is not enough; we
must deal with the presence of dust on all workroom floors. This
problem has received attention at home and I hope soon to see it
properly handled in this country. I know of no finer institution
to take up such work than this Association. - -
I think we all agree, also, that if this problem is to receive proper
attention we must have the assistance of the manufacturers. There
is no use in trying to force them to do what we want, but we must
try to persuade them. If the moral argument is not sufficient,
the best inducement is the one that appeals to the pocketbook. The
best that a man can do in a day is one hundred units of work. Sup-
pose a manufacturer is employing one hundred workmen. If you
represent to him that, by neglecting certain precautions which you
can show him how to handle successfully and economically, the loss
of work and fall in efficiency is ten per cent, you have a direct ar-
gument to place before him. He sees that among one hundred
workers a lowering of ten per cent in efficiency means that he is
losing the work of ten able-bodied men every day. If this argu-
ment is put before the American manufacturer, as it has been suc-
cessfully put before the English manufacturer, I think he will
listen to you. You are more likely to achieve success this way than
if you appeal from a moral point of view.
A year or two ago an English doctor, bearing the famous name
of Lister, called attention to the high death rate among printers.
The attention of the federation of printers and allied trades was
called to it by myself, and they decided to investigate the question
first-hand. A certain area of floor space in one of the largest es-
tablishments in London was chalked off. One-half was sprinkled
with a disinfection solution; the other half was sprinkled with
318 American Labor Legislation Review
water. Swabs were taken over each of these spaces and the con-
tents examined. On the plate which was from the section sprinkled
with water only there were crowds of bacteria; the other plate
showed no colony of bacteria. Thus the disinfection was shown to
be satisfactory. The publication of this result in the textile papers
and trade journals had a marked effect on the minds of manufac-
turers in England.
MR. MEHREN, New York City: We are engaged in efficiency en-
gineering work, the improvement of factory conditions in order that
the output may be the maximum and that the manufacturer may
have the least possible cost and the worker the highest wage. From
that standpoint the efficiency of the men is a very important con-
sideration. We go to the manufacturer and say, “Betterment works,
of all sorts are not philanthropies; they are profitable investments.”
We have not gone into chemical factories and consequently much
said this morning about the lead industry went over my head, but
we have been able to make valuable use of efficiency tests. We found
a short time ago a large establishment with fifteen hundred em-
ployees in which the manufacturers knew they had not full effi-
ciency, although they had not been able to put their finger on the
cause. We found that the ventilation was bad and that the common
drinking cup had propagated colds in winter. Why not call in to
aid the campaign for industrial hygiene the efficiency engineer, who
is directly studying factory conditions with the idea of improving
them? Legislation, strict enforcement of law, will produce much
good. But the greatest result will be accomplished when you take
advantage of all possible methods, one of which is to enlist the
cooperation of the consultant in the engineering world.
DR. LEONARD W. HATCH, New York Department of Labor: This
point has come to my attention as bearing out what was said of the
value to the manufacturer of medical care of his employees. A
certain small New York plant employing two hundred and fifty
people is quite a model establishment so far as ventilation goes.
The firm established a benefit system and in connection with that
a plan for giving the employees medical attention. It was arranged
that a physician, employed by the firm, should be at the plant every
day at five o'clock, and anyone who was employed there could con-
General Discussion 3I9
sult the physician by making his desire known to the watchman or
porter. At five o'clock all who could be attended to that day were
notified by the watchman. After a year's experience the head of the
firm stated that, though they had never kept records of the time lost
in previous years, he was sure that, even in that period, without any
special hazards, they had saved enough of the workers' time to more
than pay the cost. -
MR. PAUL KENNADAY, Secretary, New York Association for
Labor Legislation, New York City: We have heard that it pays to
keep the workmen well. In this Association we want to take the
view that it is just to keep the workmen well. We should go to the
labor unions, get out on the stump, use the newspapers, and teach
the industrial population that they should keep themselves well for
their own benefit and not to increase any dividends. And then,
having aroused that feeling among them and a certain amount of
enthusiasm, we should get after our state labor departments and get
them to do their duty. Many are doing excellent work and many
are not doing anything at all. They should make investigations
into continuous processes, and give us the facts in regard to the
number of men who are working seven days a week and the effect
of such work on their health. At present we have no such facts. As
one member of the Association I say, let us emphasize a little
more strongly the fact that it is justice we are after and not the
payment of higher dividends.
DR. LEE K. FRANKEL, New York City: I have been reminded
of an old story about barking dogs that never bite. I suppose you
know the story of the man who was running away from a dog.
His friends told him, “Barking dogs never bite.” But the man re-
plied, “You know it and I know it, but the dog doesn’t know it.”
The discussion here has centered largely around what might be
done in the direction of preventing disease through efficient legis-
lation and by the employer of labor, but nothing has been said about
what can be done by the workman toward safeguarding his own
health. I want to mention what has been done in the city of Vienna,
where there is a federation of sick clubs, under the Austrian govern-
ment, which records every disease that occurs among its members,
and these clubs practically comprise every workman earning a cer-
320 American Labor Legislation Review
tain income. Every member realizes that it is for his distinct ad-
vantage to report the conditions that exist in the factory where he
works, particularly with reference to accidents. The result is that
in the central bureau there is a careful record of every industrial
establishment in the city of Vienna reported under the very best .
form of factory inspection known, namely by the employee himself,
and by moral suasion without the necessity of legislation. These
clubs have gone to the employer who has not introduced proper
safeguards against accidents, or who has not put his mill or factory
in good Sanitary order, and have shown him that his establishment
is below the standard, or proved to him that more accidents occur
in his establishment than in those of his competitors. By this method
they have been able to raise the standard exceedingly. Lacking
compulsory industrial insurance it seems to me that, if this problem
were taken up by our labor organizations, they could institute a sys-
tem similar to that in vogue in Vienna and bring home to their
employers the need for putting their factories in proper condition.
MR. MILES M. DAwson, New York City: There is no question in
my mind but that wherever there is a system of insurance, con-
tributed to by both employer and employee, in addition to the col-
lection of reliable information, there is the further result that at-
tention is given to the subject by both sides. The benefits of sick-
ness insurance in guarding the health of employees in Germany are
doubtless great. This has reference quite as much to accidents
as to illness. It is, therefore, unfortunate that so far, during the
brief development we have had of workmen's compensation in this
country, there has been no extension of such insurance. We would
not only have done better work in connection with workmen's com-
pensation, but would have indirectly had means of determining what
the facts are concerning industrial diseases and industrial accidents,
if we had adopted the plan in force in many countries of sickness
insurance societies.
MR. JoHN MARTIN, New York City: Professor Winslow said,
and so far as I have been able to read the literature on the subject
it seems to be agreed, that practically the only factor in ventilation
about which we are positive is that overheating is detrimental to
health and vigor. He went on to argue that that was a sufficient
General Discussion 32I
reason for declaring in favor of an artificial system of ventilation;
because, he said, if your factory or schoolroom is overheated, evi-
dently the thing to do is to force in air, but it must not be below
60° F. when it enters. That logic, which I think is commonly enun-
ciated by ventilating engineers, seems to me defective. If the fac-
tory or schoolroom is overheated, the common-sense, obvious
remedy is to turn off the steam and reduce the heating surfaces.
As a matter of fact in this country we have for some years been
convinced of the desirability of having rooms occupied by human
beings, particularly hotels, trains, factories, and schools, kept at
something above the outside temperature in winter and, with a na-
tional tendency to overemphasis and exaggeration, we have gone to
the length of making about 75° or 80° F. the standard indoor tem-
perature in wintertime. Manufacturers and school authorities are
literally killing with kindness. We have installed elaborate heating
apparatus, and we use up coal in the most lavish manner, with the
result that we are creating greater loss than we are avoiding. Now
the remedy for that, it would appear, is not to discard heating
apparatus but to install another apparatus to offset the one you
have already installed. Surely the manufacturer might more rea-
sonably be told, “You can save your earlier expense; you need not
install so many radiators; you are damaging your employees, as we
are damaging our school children, by this mistaken kindness.” To
my mind, the thing to do is to teach the employees to throw the
windows open.
MRS. IRENE OSGOOD ANDREws, New York City: I want to say
a word as to the relative value of protection from bad ventilation
and protection from disease. Ventilation is a much bigger problem
and covers a larger number of persons, and we should be delighted
to know what to do about it. We knew, after some study, what
was an effective remedy for phosphorus poisoning; we knew after
a while about compressed-air illness, about lead poisoning, and some-
thing about blindness from wood-alcohol; but we don’t know what
to do about ventilation. Illinois passed in 1909 perhaps the most
effective law, yet I am told that it is only indifferently enforced.
The occupational disease law passed last year has met with greater
success. Massachusetts has had medical inspection of factories for
six years, but Massachusetts has no standard for ventilation. New
322 American Labor Legislation Review
York has had medical inspection for four years, but has no standard
for ventilation. Those of you who are familiar with New York
conditions know that for three years we have been having confer-
ences on ventilation. Last year a bill was proposed and this year
the experts disagreed entirely and the bill was cast out. Anyone
who can give us information on how to handle effectively and en-
forcibly this subject of ventilation awaits a place in the hall of
fame. We hoped that might be one outcome of the meeting here.
Dr. Frankel has told us what the workman can do. Austria has
been behind other foreign countries. But, as an illustration of its
recent progress, although fourteen countries have prohibited the
night work of women, the period of rest being between ten at night
and five in the morning, Austria has now taken the advanced stand
that the rest period is to come between eight at night and five in the
morning. Before we can expect much of the workman we must
have a strong body of labor law back of what we expect him to do.
I see no reason why the conditions which Mr. Pratt showed us this
morning in his pictures of lead poisoning should not be removed
before we ask the workman to protect himself. I think that must be
the line of progress in this country.
DR. C. T. GRAHAM-RogERs, Medical Inspector of Factories, New
York: I think the subject of ventilation has been pretty well covered
by those who have discussed it, and I do not feel that I can add
much. It is true that experts on ventilation, instead of agreeing,
have disagreed, and that the whole subject is in rather a chaotic state,
probably because there has not been strong enough cooperation on
the part of engineers, physiologists, medical men, and factory work-
ers to get results. There are so many factors entering into the
question that I doubt if six months or a year will give us much of a
clue to its solution. It will take several years of intensive investiga-
tion. But we cannot have any standard ventilation for all indus-
tries; each industry stands by itself and in each intensive research
must be pursued. We shall get results, not now, but in the future.
PROFESSORC.-E. A. WINSLow, New York City: I hope very much
that this Association will take up specifically the problem of venti-
lation. If the Association could get experts, men qualified to take
up these problems, it would mean a great deal of work and time, but
the results would be of great value.
General Discussion 323
I face the logical conclusion: If the only problem is overheating
we can do without ventilation. But aside from the heat question we
have to change the air in order to remove the odors, the dust, and
the fumes. Whether they hurt or not they have to be removed.
And we have to have tempered air. In a hospital you can do what
you want with patients, but in a factory you cannot have the people
making complaints, so the windows have to be shut, and I doubt if it
would conduce to the efficiency of the industrial worker to do other-
W1Se.
MRS. FLORENCE KELLEY, National Consumers’ League, New York
City: One point has not been clearly brought out in the discus-
sion of poisonous trades and occupations. We were shown this
morning pictures of common laborers shoveling lead, filling the air
with dust in its most poisonous forms, for themselves and for every-
body else to breathe, and to my lay mind it was a most horrifying
spectacle. I do not know much about it, but I had not had a con-
ception that there were men who would do such work, especially
when it is not necessary in this or any other country. Would it
not be possible to have the officials of a state where the lead industry
is carried on publish the pictures and an explanation of apparatus
in use by standard concerns, which eliminates the poisonous process,
so the workman could be intelligent in his choice of occupations?
Could not that knowledge be spread among the people so that where
there is in actual use a successful mechanical method for the elim-
ination of poison there need no longer be any excuse for the primi-
tive process?
DR. DAVID L. EDSALL, Harvard Medical School, Cambridge:
There is one thing I should like to say in relation to a subject of
which Dr. Cabot spoke. It is important that hospitals keep records
and that physicians be trained. The hospital records, if available,
would be the best thing we could have. At present it is impossible
to get any satisfactory facts which are precise enough to amount to
anything. Except a careless name like “laborer” to describe a dozen
different occupations, we find nothing to indicate what a man is
doing. Hospital physicians need to be urged to contribute their
share to the solution of the problem of industrial diseases.
Hospitals should also have exhibits which they could use to teach
324 American Labor Legislation Review
the patients themselves what they should do. Undoubtedly one of
the best effects of the German insurance laws has been their effect
on health, and one of the most important ways in which they have
affected health has been through the graphic education they have
given. The education that has spread among the people as to right
methods of living has been one of the most advantageous things the
country has had.
The hospital must be looked upon as one of the centers for spread-
ing information in regard to hygiene. I do not see any reason why
our hospitals should not spread a great deal more information than
they do on health matters.
DR. WARREN COLEMAN, Chairman: In Bellevue and no doubt in
the larger hospitals of the country, the physicians themselves take
little or no part in acquiring sociological data concerning the patient.
At Bellevue we have our bedside card, one side giving the sociolog-
ical data and the other the bedside data. The sociological data is
filled out in the lower office by an untrained person. That could be
corrected, but they are not disposed to pay salaries to trained per-
sons for that character of work.
Again, there is no nomenclature to which we can turn to deter-
mine what a man's occupation is. A committee has been appointed
for the purpose of getting up such a nomenclature. It will be a
heavy task, but in the course of perhaps a year of two years we
shall probably have some such thing. Not long ago a young man
came into my ward as a patient. He was sixteen and gave his occu-
pation as lithographer. I thought I would cross-question him and
find out just what he did. I found he swept the floor in the litho-
graphing room and in winter swept the snow off the sidewalk; yet
he had gone down on our records as a lithographer. There are many
other similar points to which I could refer.
DR. John B. ANDREws, Secretary, American Association for
Labor Legislation, New York City: The medical profession can
furnish us with information which we can spread broadcast in the
form of leaflets among the workers and employers. Professor
Thompson of New York has prepared a leaflet on lead poisoning
which he has been using in his hospital work and from which he is
getting interesting results. Why cannot that plan be worked out in
every hospital?
General Discussion 325
There was a second point that I hoped Dr. Cabot would empha-
size,_the establishment of special clinics for the prevention and
cure of occupational diseases. We have such a splendid illustration
in Milan, where they have three buildings with hospital wards, lab-
oratories, clinics, etc., especially devoted to this subject. I hope that
within the next ten years we shall have in this country half a dozen
of these institutions. It may be necessary to begin the work with
general hospitals and I think Dr. Cabot and Dr. Edsall will be among
the first men to superintend such plans. We must have medical men
with the tools at hand working all the time supplying information
for the prevention of these industrial diseases.
IV
STATE PROMOTION OF INDUSTRIAL HYCIENE
Presiding Officer: HENRY W. FARNAM
Yale University
NEW HAVEN, CoNNECTICUT
EDUCATION FOR THE PREVENTION OF INDUSTRIAL
DISEASES
M. G. OverLOCK
State Inspector of Health, Massachusetts.
Standing to-day at the very portals of a vast field of opportunity,
I can see stretched before me a decade of achievement in human
efficiency unparalleled in the history of the world. Your organiza-
tion has tilled the bare edges of this field, and the fruits of its
labor has attracted the attention of every student of human events.
The mighty stride of our industrial and commercial America is the
wonder of all the nations of the earth. And the superior skill of
our American workmen is attested by the fact that, although the
machines of the American Shoe and Machinery Company are scat-
tered throughout Europe, shoes made upon the same machines by
American workmen are still eagerly sought, because of their supe-
rior finish and workmanship, by Europeans.
The maintenance of human efficiency at its highest standard must
be the watchword in the next decade. And, if kept at high-water
mark, it will rebound to the credit, satisfaction, and glory of those
who have to do with and who bring about the application of tried
and found-true principles of personal hygiene for the avoidance of
industrial accident and industrial disease. The prevention of
such diseases must be brought about by a systematic course of edu-
cation, with the cooperation of the numerous agencies at our com-
mand. These agencies, taken in the order in which in my judg-
ment they belong, should be: first, medical colleges; second,
industrial clinics; third, industrial hygiene exhibits, both traveling
exhibits and museums; and fourth, publicity by means of lectures,
leaflets, and posted warnings. Laws drawn up for the protection
of working people from disease are themselves, moreover, educa-
tional, and employers can do much to assist the movement,
33O American Labor Legislation Review
I. MEDICAL Colleges
At the present time an opportunity presents itself to the medical
colleges of this country which is most opportune. If these institu-
tions of learning will add to their curriculum a department for the
diagnosis and treatment of industrial diseases, they may be, by their
cooperation with boards of health and bureaus of factory inspection
in the various states in which they are located, a potent factor in
impressing upon the different legislative bodies the need for proper
health legislation and for proper appropriations to carry out this
work. Medical men thus trained, reporting all industrial diseases
to the central body and keeping in close touch with the boards of
health and bureaus of factory inspection in different states, may
by this cooperation be of immense value to that great army of work-
ers whose occupations make them susceptible to industrial diseases.
What is the legislation necessary to bring this about? To my
mind the system under which we are working in the state of
Massachusetts should be in vogue in every state in the union. Every
state should have medical men as state inspectors of health, working
under the direction of a state board of health or bureau of factory
inspection, and reporting their findings to the central health author-
ity. It is my candid opinion, and I feel that it is also the opinion
of the physicians generally throughout Massachusetts, that the act
creating the state inspectors of health and setting forth their duties
was a most important legislative action. For it is well to remember
that they are the only large body of physicians on this continent who,
acting in the capacity of state health officials, study the health, in-
cluding the moral, social, and physical habits of the people, within
and without the factory. Their investigations include, among
other things, an inquiry into cleanliness, ventilation, the condition of
the air, eyestrain, temperature, artificial moisture, the proper
removal of dust, a proper system of lighting to avoid injury to the
eye, pure drinking water, receptacles for expectoration, excessive
humidity in textile industries, exposure to extreme heat in laundries
and foundries, and exposure to lead and other industrial poisons,—
in fact, a scientific study with a view to the elimination of all
causes which lead to industrial disease. Those of us in the field
feel that we are working under the direction and careful scrutiny
of those who have made the prevention of disease their life study
and who are ever willing and anxious, so far as the means at their
Education for the Prevention of Industrial Diseases 331
command will allow, to make scientific application of every health
principle.
I believe that the emulation by every state in the union of the
methods now in vogue in the state of Massachusetts will, within a
decade, produce results of which this nation may be justly proud.
Then, as I said in the beginning, the medical colleges, by their co-
operation with the state boards of health and bureaus of factory
inspection, could with profit to themselves and to the community
and the state, turn out men whose training would aid greatly in the
reduction of industrial diseases. Because it is plain that these
colleges, using the deductions made from the experience of the state
health officers in the field, would be working on facts and not on
theories.
II. INDUSTRIAL CLINICs
The results and experience at Milan, Italy, and the opinion of
medical men who have followed this clinic and its workings show,
I believe, that we should have an industrial clinic in each of the
large industrial centers of the United States. This seems to me an
excellent opportunity for our philanthropists, but it could also, in
my judgment, be taken up with benefit and propriety by the United
States government. The money thus spent would make for effi-
ciency in our industrial life, would be conducive to a greater de-
gree of health among the industrial classes, and would be of ines-
timable value to the millions yet unborn. I therefore suggest that
the Association for Labor Legislation, by the appointment of a
proper committee, take this matter under advisement.
III. INDUSTRIAL HYGIENE ExFIIBITS
As I said in the beginning, this campaign for the betterment of
the condition of the man or woman who works, to be efficient and
far-reaching, must necessarily be a campaign of education. I feel
sure that you will agree with me that the traveling exhibits, particu-
larly those which have been sent out by the Boston Association for
the Prevention of Tuberculosis, as well as those from other cities
and states, have been of immense educational value and have left a
strong impression upon the lay mind, as well as upon the minds of
members of the medical profession and of social workers, in fact
of all who visited these different exhibits. It would seem to me that
we might establish an industrial hygiene exhibit which could be
332 American Labor Legislation Review
sent from city to city and which would have a stimulating influence
upon those at the head of industrial establishments, who have an
Cpportunity to provide sanitary conditions in modern up-to-date
factories. It would also bring to the laboring man the realization
that, after all, the scientific application of the principles of sanitation
and hygiene are being worked out for the betterment of the working
class.
Such an exhibit would have another effect. It would ask a
question of the landlord who is renting insanitary and ill-kept dwell-
ings to the working classes. This question in substance is: If the
manufacturer furnishes excellent sanitary surroundings for working
men and women ten hours a day, why should I not furnish tene-
ments with equally healthful conditions and surroundings for these
people during the remainder of the twenty-four hours? In fact, in
Massachusetts, with its rigid enforcement of factory laws calling for
proper light, cleanliness, removal of dust, pure drinking water, re-
ceptacles for expectoration, and numerous other health measures,
the question is often asked: “Why have we not a tenement-house law
that will place the conditions of the home on a par with those of
the factory and shop?”
Such industrial hygiene exhibits might be brought together at
some central place, thereby forming a museum which could be
visited by those anxious to learn just what is being done for the
man and for the woman who works.
IV. PUBLICITY THROUGH LECTURES, LEAFLETs, AND POSTED
WARNINGS
In 1908, in the eleventh health district in my state, I began a
series of noon-day talks in the different large manufacturing estab-
lishments, particularly those located in the city of Worcester. If I
may speak without egotism, I believe that these talks were of im-
mense educational value. They were given in lay language on ques-
tions of personal hygiene and sanitation, including the use of pure
air and the importance of proper exercise, diet, and rest. These
lectures were largely attended. I have in mind at this moment one
establishment employing at that time twelve hundred women where,
when a notice was posted a few days in advance that this talk was to
be given, nine hundred remained at the factory during the noon hour
to listen to what they must have considered a question pertinent to
Education for the Prevention of Industrial Diseases 333
their welfare and well-being. In a number of instances manufac-
turers shut down at half past eleven o’clock to allow their employees
to attend my lecture without its interfering with their noon hour.
During these lectures I usually distributed a little circular on
“Don’t”, setting forth briefly, and recommending the avoidance of
certain habits detrimental to health. These little leaflets were eager-
ly sought for; I believe they were carried home; and perhaps the
suggestions were followed. At any rate, I had the satisfaction of
knowing that I had set the people to thinking. Since that time I
have been pleased to learn that these lectures have been delivered in
several other states.
It is my opinion that the posting of warnings, whenever this can
be brought about in large industrial establishments, will be prolific of
much good, as they readily attract the attention of all the employees
and at least set them to thinking as to their meaning. I also feel
that an excellent means of educating the industrial worker is by the
distribution of leaflets through the different trade-union organiza-
tions. A great deal of good can be brought about in this way, and
especially effective work may be done by calling the attention of the
employee to the ordinary care needed in the handling of articles or
chemicals which might in numerous instances be conducive to the
production of poisoning. For example, attention may be called
to the need of ordinary care in preventing lead poisoning. These
leaflets, gotten up in a plain, readable manner, and printed in the
several languages used by the employees in the different industries,
might be made of great educational value.
V. VENTILATION AND EYESTRAIN LAWS
In Massachusetts the law covering the ventilation of factories and
the installation of mechanical ventilating apparatus (Chapter 106,
Secs. 51 and 52) has, I believe, brought into play factors which
tend in many instances to the maintenance of bodily resistance, as
well as to the prevention of many industrial diseases. This law
provides that “a factory in which five or more persons and a work-
shop in which five or more women or young persons are employed
shall, while work is carried on therein, be so ventilated that the air
shall not become so impure as to be injurious to the health of the
persons employed therein and so that all gases, vapors, dust or other
impurities, injurious to health, which are generated in the course of
the manufacturing process or handicraft carried on therein shall, so
334 American Labor Legislation Review
far as practicable, be rendered harmless.” Should elements detrimen-
tal to the health of the employees be found in any of these factories
or workshops, the state inspector of health may require the installa-
tion of mechanical ventilating apparatus. In any instance where
much dust is generated, if it appears to the state inspector of health
that the inhalation of such dust would be substantially diminished
without unreasonable expense by the use of a fan or other mechani-
cal means, such fan, if he so directs, must be provided, maintained,
and used. In all of the dusty trades, as well as in rooms which are
close and poorly ventilated, the installation of fans and blowers has
had its effect upon the health of the employees. The enforcement of
this statute does away with vitiated and foul air, to which otherwise
the employees must be subject.
Numerous examples of the practical working of the law might be
given if space permitted, but in passing I will mention two. In the
basement of a large manufacturing establishment, where about forty
men were employed, the air, which appeared damp, was heavy and
charged with carbon dioxid, and the men were continually suffer-
ing from colds. The installation of two small fans and the covering
of several emery wheels, which were provided with suction pipes,
clarified the atmosphere to such an extent that the men told me they
felt as if they were working in the open air as compared with the
conditions under which they had worked before this apparatus was
installed. They said that they had fewer colds, that they felt more
like working, and that they could do better work without getting
tired. In other words their physical condition underwent a change
almost immediately after the installment of the apparatus mentioned
and the removal of the foul and heavy air.
In another instance, in the weave room of a large cotton mill
where about forty girls were employed, the air was close and heavy,
the girls went about their work in a listless manner, and hardly a
day elapsed during certain seasons of the year but several of them
were out on account of not feeling well. After the installation of a
large fan, which removed the dust as well as the overheated atmos-
phere and allowed fresh air to take its place, a change was immedi-
ately brought about which was at once noticeable to the eye of the
inspector. There was less absence from work, denoting, of course,
less sickness among the employees, and the manner in which they
applied themselves to their work showed that a higher degree of
Education for the Prevention of Industrial Diseases 335
efficiency was being maintained, and that their general health was
much better.
Massachusetts, I believe, is the only state in the union which has
passed any act relative to injuries to the eyes of those employed in
industrial establishments. This, I believe, is an excellent law and
will do away with many cases of eyestrain, of headache, and of
nervousness, which arise from improper lighting of the rooms in
which people are employed. In going into this question, we look
first to the natural light and attempt to bring about, by a careful
study of the different establishments, the best condition obtainable
from natural light. The question of artificial lighting, the kind of
light and its effect upon the eyes, is next gone over, and the best
light which our experience and judgment dictates is ordered in-
stalled. In many instances simple washing of windows and orders as
to their care have wrought a wonderful change. In others, the
placing of more windows in such a position as to give the best pos-
sible light has proved beneficial. Then again, the whitewashing or
painting white of the walls and ceilings of many rooms has made a
change in the condition of the eyes of the employees. On entering
one of these establishments, we first determine the kind of work,
whether it needs close application of the eyes or not, whether many
of the employees are wearing glasses and, if so, why they are worn,
and then we determine the effect of the artificial light or the rays
of light admitted to the room upon the eyes of the employees. Ques-
tions are asked as to the length of time employed in the present
occupation, the condition of the eyes previous to this employment,
and the difficulties, if any, under which the employees are working.
As this law is new, and as many changes in the lighting of estab-
lishments are being made throughout the state, we are as yet unable
to judge of the beneficial results which we hope to obtain. From
my personal observation, however, I believe this to be an important
step which the state has taken, and I believe that eyestrain and
kindred industrial diseases, which heretofore were caused by inade-
quate and improperly lighted rooms, will be done away with to a
large extent. There is no doubt in my mind that many internal dis-
turbances, particularly what is known as dyspepsia or nervous indi-
gestion, which is in many instances the result of eyestrain and
which has become distinctly an industrial disease, will be done away
with. If this be true, it is plain that the general condition of the
336 American Labor Legislation Review
worker must be bettered. Physicians, of course, have for a long
while realized that much malnutrition and consequent general weak-
ness has been brought about by eyestrain. And no one whose occu-
pation requires close application to fine work can escape its deleterious
effects and its consequent influence over the general nervous system.
This, of course, leads up to the whole question of industrial disease
as related to the eye. In comparing notes with the several inspectors
of health throughout the state, we can arrive at but one conclusion
and that is, that the judicious application of this statute will be rich
in beneficial results to the industrial worker.
VI. EMPLOYERS’ TUBERCULOSIS AGREEMENT
It is said that all medical men have hobbies. I believe once in a
while, however, the laity credit us with entertaining practical ideas.
Appointed state inspector of health in 1907, with instructions to
inspect and examine minors in various industries throughout my
district, I knew I should find tuberculosis. I reasoned that in the
vast majority of cases, when I found this disease in a boy or girl, I
should also find that they did not have the four dollars a week re-
quired of all who would enter a sanitarium, even if such opportunity
was open to them. I have since found it to be a fact that more than
ninety per cent of the workers, when stricken with this disease, have
not saved for the so-called rainy day. After one of my noon-day
talks a young girl approached me saying that she had listened to
the hope which I held out to those having tuberculosis that they
might be cured if sent early to a sanitarium. She told me that she
had tuberculosis but that she had an invalid mother whom she must
support, and that she had no money. I took up this case with the
president of the company for whom she worked, and he not only
assured me that he would pay for this girl, but that he would pay for
any other of his employees who might be so stricken. I asked him
if he would give me a letter to this effect. He did, and I then saw
a vast field opened before me. I went to other manufacturers, ask-
ing for the same pledge, and in a short time I obtained more than a
hundred similar pledges.
This was the starting of what the Survey, in April, 1910, saw fit to
call the “Overlock Tuberculosis Agreement”. This movement
quickly spread throughout the city of Worcester and the surrounding
towns. It attracted the attention of the Boston Chamber of Com-
merce, which body, by accepting a year later a recommendation of
Education for the Prevention of Industrial Diseases 337
their committee on the prevention of disease, adopted it without a
dissenting voice. Boards of trade and merchants' associations
throughout New England took up the matter as bodies. The move-
ment has spread from city to city and from state to state, until I
find, by conferring with my coworkers in different states, that this
agreement at the present time protects more than a million people.
In a year's time, moreover, the work which I had done began to
bear fruit in a different direction, which I had not anticipated in the
beginning. Young men and women were sent to sanitariums, into the
country, and to their homes across the sea, and were then sent back
as arrested cases to become teachers in sanitation and health mat-
ters. At the present moment I think I can say that there are in
different parts of New England and the eastern states more than five
hundred cases under treatment, the expenses of which are paid by
their employers. My hope now is that this movement may spread
throughout the United States.
This movement, outside of its humanitarian and economic fea-
tures, has set the manufacturers to thinking. They began at once to
reason, first, as to why they should have tuberculosis among their
employees; second, as to whether, if it did occur, it was because of
the surroundings under which they were working; and third, what
were the steps necessary to place their different establishments under
a sanitary regime and to remove as fast as possible all causes which
lead up to the lowering of vitality and resistance in their employees.
They soon learned, also, that by placing their establishments in the
best possible hygienic condition the efficiency of their employees was
increased. I have been much gratified in the past three years by the
whole-souled cooperation of the manufacturers in this movement.
They at once began to extend the welfare work, in their several
establishments, so that at the present time not only do many of the
large establishments provide recreation halls, but they are serving
the noon-day meal at its bare cost. This sentiment existing among
the business men of a community must necessarily have its effect
upon the whole community. The local health authorities, who in
too many instances in the past have been sadly remiss and dilatory
in the manner in which they enforced laws, have had it pointed out
to them that they must cooperate in matters pertinent to the health
of the community.
The steps taken for the eradication of tuberculosis from industry
338 American Labor Legislation Review
are the very steps which must be taken for the prevention of indus-
trial diseases in general. This movement, in the localities in which
it has been applied, unites, we find, all sects, all creeds, all schools of
medicine, in one common brotherhood. Your organization, acting in
conjunction with the organized forces which I have mentioned, may
be a most potent factor in bringing about the cooperation of the
various agencies needed in the campaign of education for the pre-
vention of industrial diseases. - -
NOTIFICATION OF OCCUPATIONAL DISEASES
CRESSY L. WILBUR
United States Bureau of the Census.
The notification of occupational diseases has a somewhat similar
relation to the registration of deaths from occupational diseases
that the notification of births has to the registration of births.
Notification in each case—and to be entitled to be considered real
notification it must be immediate—is for the purpose of giving the
earliest possible information to the authorities charged with the
supervision or control of the class of events. Immediate notifica-
tion of births is chiefly for the purpose of enabling the sanitary au-
thorities to insist upon the necessary precautions for the preven-
tion of ophthalmia neonatorum and of infant sickness and mortal-
ity. It is not intended to replace the registration of births, for
which a reasonable interval must be allowed, at least in rural dis-
tricts; but it may serve as an important aid in securing complete
registration, while the birth registration law may in return help to
secure the thorough enforcement of notification. The purposes of
such laws may be combined, as in the recent Massachusetts statute,
which provides that physicians and midwives shall, within forty-
eight hours after the birth of a child, mail a notice thereof to
the local registrar (notification), and within fifteen days file a cer-
tificate of birth (registration), but that the notification shall not
be required if the birth is registered within forty-eight hours.
In like manner the notification of sickness from occupational dis-
ease will be followed, in a certain proportion of cases, by the regis-
tration of death. The notification of all cases of occupational or
industrial diseases ought to be a most valuable aid for the com-
plete and satisfactory registration of all deaths from such diseases;
and likewise the registration of the deaths should be a most im-
portant check on the completeness and promptness of the notifica-
tion. It is, therefore, desirable that the notification and registra-
tion of occupational sickness and mortality should be thoroughly
340 American Labor Legislation Review
correlated, and for this reason it will probably be found necessary
to administer them under the same general direction.
The notification of occupational diseases may properly be con-
sidered a part of the general subject of the notification or regis-
tration of sickness in general. The reporting of sickness is a very
difficult matter to deal with, and morbidity statistics are, as a rule,
far less complete than statistics of mortality. Even with respect
to some of the most important infectious diseases, such as typhoid
fever, diphtheria, and tuberculosis, it will be found that in some
localities many cases fail to be reported. This is readily shown
by comparison of the reported cases of sickness with the deaths
registered, according to which a most absurd ratio of fatality will
not infrequently be shown. Such indications prove that physicians
fail to a considerable extent to report the occurrence of notifiable
diseases; and knowledge of this fact by the sanitary authorities
should lead to rigorous enforcement of the law, with prosecution
and the collection of fines when it is disregarded. It is likely that
the same condition will be found to exist in the administration of
laws requiring the notification of occupational diseases; and the
whole experience of general registration points to the necessity of
rigid and thorough enforcement of law from the very beginning,
if fully dependable results are to be obtained and the true value of
such legislation is to be demonstrated. It is far easier to enforce
a reasonable law from the start than to restore the efficiency of
a law that has become more or less of a dead letter.
The registration of sickness does not come in the scope of the
Bureau of the Census, which receives and compiles the returns of
deaths from the registration area of the United States. I shall,
therefore, deal chiefly with the relation of the notification of oc-
cupational diseases to the registration of deaths from occupational
diseases. It may be proper to point out, however, that the re-
ported mortality from occupational diseases is as yet relatively
insignificant, and the true measure of the loss of health and ef-
fective working power can only be learned from well-kept mor-
bidity returns. For example, during the year 1910 there were,
in the registration area of the United States, comprising an esti-
mated population of 53,843,896, or 58.3 per cent of the total
population of continental United States, and including practically
all of the chief industrial states of the north and west, only one
Notification of Occupational Diseases 34I
hundred and thirty-six deaths reported from chronic lead poison-
ing and six deaths from other chronic occupational poisonings out
of a total of 805,412 deaths from all causes. All the deaths from
chronic lead poisoning were not occupational in character. The
very small number of deaths (six) from other chronic occupa-
tional poisonings includes all deaths reported from phosphorus
necrosis (whether specified as industrial or not), from chronic
industrial arsenical and mercurial poisonings, etc. It is likely,
however, that some deaths that should have been classified under
this title were omitted because the certificates of death bore no
evidence as to the industrial character of the poisonings, and some
may have been reported under terms relating to mere symptoms or
conditions, such as “paralysis,” “necrosis,” etc., that afforded no
clue to the true nature of the cause of death. The returns were
compiled in strict accordance with the international classification;
and it is impracticable for the Bureau of the Census to investigate
all doubtful statements of cause of death, although this is done to
a certain limited extent. The responsibility for indefinite reports
rests, primarily, upon the recording physician, and, secondarily, upon
the local registrar of vital statistics who accepts a doubtful certi-
ficate and issues a burial permit thereon.
It may be noted in the above statement in regard to “occupational
diseases” that the term is used in the very limited sense of occupa-
tional poisonings, and not in the broader sense of all diseases af-
fected by occupations. Thus the draft of the “Certificate of Indus-
trial Diseases” issued by the New York State Department of Labor
provides for the reporting of “poison by lead, phosphorus, arsenic,
or mercury or their compounds, or from anthrax, or from com-
pressed-air illness.” The schedules of California, Wisconsin, Con-
necticut, New Jersey, Maryland, and Michigan are the same as
that of New York, while Illinois requires the reporting of “disease
or illness due or incident to” a few specified dangerous occupa-
tions. The very recent introduction of such legislation is indicated
by the fact that these eight states are the only ones having such
laws. The report of the Illinois Commission on Occupational Dis-
eases (January, 1911) related chiefly to industrial poisonings, al-
though the scope of a more comprehensive investigation was fully
pointed out. It may be asked, for example, whether the reporting
of tuberculosis caused by, or aggravated by, occupation is contem-
342 American Labor Legislation Review
plated as a regular procedure by means of any of the special noti-
fication blanks?
It is difficult to define those diseases that may or may not be
affected, to some extent, by conditions incident to employment.
The general study of occupational mortality is dependent upon
comparison of the deaths from various causes of persons engaged
in specified occupations with the corresponding populations or lives
at risk, and it is hardly necessary to say that regard must be had
to the age and sex distribution, as well as to the factors of race and
color, in order to obtain comparable results. It is absolutely neces-
sary that there should be a uniform classification of causes of death,
that physicians should report the causes of death by means of pre-
cise and definite terms that can be readily compiled thereunder, and
also that there should be an identical classification of occupations in
use for both the population and mortality returns. In order to make
the latter of the greatest service, physicians and others must be in-
structed in regard to the correct statement of occupations.
It is, therefore, very gratifying that a standard form of certifi-
cate of death has come into general use in the United States dur-
ing the last ten years, prior to which time there was very little uni-
formity in this respect. This blank was originally prepared in 1902
and was revised in 1909 by the organized registration officials of the
country (Section on Vital Statistics of the American Public Health
Association). I desire to call attention especially to the form of
statement of occupation on the present blank, with specification of
the “(a) Trade, profession, or particular kind of work”, and “(b)
General nature of industry, business or establishment in which em-
ployed”, and to the instructions on the back of the certificate rela-
tive to the statement of occupation and cause of death. Although
not as detailed as the information sought on the New York certifi-
cate of industrial diseases, it was the general consensus of opinion
among registration officials that the statement was as complete as
it would be practicable to require in the general mortality returns.
The necessity for full information in regard to the length of time
employed, the previous employment, previous illnesses due to occu-
pation, etc., can best be met by including such inquiries on the no-
tification blank, thus avoiding incumbering the death certifi-
cate with many questions in addition to those already required for
the general purposes of vital statistics. Thus the two blanks to a
Notification of Occupational Diseases 343
large extent supplement each other, and may be used together as a
basis for many important statistical purposes and intensive investi-
gations. It would seriously interfere with the conduct of death
registration, the extension of which to cover the entire United
States is one of the most important tasks in which the Bureau of
the Census is cooperating with state authorities and national asso-
ciations, to add a single additional question to the schedules, which
are already regarded as cumbrous by legislatures and those not fa-
miliar with the requirements of registration laws. But a state of
high industrial development can readily obtain, by means of such
blanks as are provided for notification of industrial diseases, all
supplemental data required to make its occupational statistics of
the greatest practical value. -
A very beneficial means of building up complete and correct
statistics of occupational mortality for the United States lies in the
education of physicians, undertakers, and others in regard to the
proper statement of occupation upon certificates of death, and in
training physicians to report the causes of death under precise
designations. For the latter purpose a booklet entitled the Phy-
sicians' Pocket Reference to the International List of Causes of
Death has been distributed by the Bureau of the Census to all the
physicians of the United States. It contains lists of indefinite and
unsatisfactory terms, and also points out the importance of examin-
ing the statement of occupation (not usually filled in by the phy-
sician) so that full data may be available concerning the occupa-
tional influences affecting causes of death. Similar instructions are
used by state and local authorities; and it is only necessary, with
the growing knowledge of the importance of the statement of occu-
pational diseases, to make such instructions just as precise as may
be necessary. I believe that it might be useful for a committee of
this Association to consider the subject and to cooperate with the
registration officials and with the Bureau of the Census in obtain-
ing more complete returns. Objections not infrequently arise when
a local or state registrar questions the completeness of a return of
death, that would be removed if a great national organization had
pronounced clearly in regard to the necessity for full details.
In this connection I may say that the reporting of the causes of
occupational mortality has suffered, in common with all reports of
causes of death, from the entire absence in this country of an ac-
344 American Labor Legislation Review
cepted nomenclature of diseases. I do not mean by this that we
do not have a standard classification, or preferably statistical list,
of causes of death and illness. The latter necessity was met by
the general adoption of the International List in 1900, since revised
at Paris in 1909. But this list is solely for statistical purposes and
does not answer the purpose of a nomenclature, or authoritative
guide for the selection of medical terms for the designation of dis-
eases and conditions, such, for example, as the “Nomenclature of
Diseases of the Royal College of Physicians of London”, which has
been the accepted authority in England for the past forty years.
I am glad to say that the American Medical Association has un-
dertaken to supply this deficiency, and that its Committee on the
Nomenclature and Classification of Diseases has held several ses-
sions during the present meeting of that association and will sub-
mit a report calling for the publication of a nomenclature for im-
mediate practical use. In this nomenclature, which must neces-
sarily be regarded as somewhat provisional or tentative in charac-
ter—although the committee has labored upon the subject for sev-
eral years—precise directions will be given for the reporting of
industrial poisonings, and the importance of such reports will be
emphasized as earnestly as possible. It is hoped that any sugges-
tions on the subject from members of this Association, and also
any action which may be taken by the Association on the basis of
the papers presented by Dr. Thompson and others, may be
promptly sent in to the committee, a statement and report by which
may be found in recent issues of the Journal of the American
Medical Association. .
The nomenclature will be arranged in the order of the Interna-
tional List, in accordance with the original resolution of the House
of Delegates adopted in 1907. This is for the purpose of compara-
bility with the statistical lists employed for the compilation of mor-
bidity and mortality statistics. For the essential use of the nomencla-
ture the question of classification is of minor importance. One ar-
rangement may be as good as another for the presentation of indus-
trial diseases, but as a matter of convenience it is desirable that tables
should present causes of death as far as possible in the interna-
tional order. Of course, the titles of the International List can be
subdivided to any extent found necessary, but when this is done
the aggregates should be comparable with the causes shown under
Notification of Occupational Diseases 345
the corresponding titles in general morbidity and mortality statis-
tics. The Bureau of the Census and the Registrar-General of Eng-
land have recently published manuals for the assignment of terms
to the International List, so that a convenient guide will be available
for all offices compiling statistics of occupational causes of death.
Thus the general comparability of all classes of mortality and
morbidity statistics will be assured.
MEDICAL INSPECTION OF FACTORIES IN ILLINOIS
HAROLD K. GIBSON
Medical Inspector of Factories in Illinois.
Is the Occupational Disease Act of Illinois in its application
practical? To this question, although appreciating the fact that our
experience is all too brief, I must answer most emphatically in the
affirmative. There have been reported, in the period from August
I, I9 II, to April 1, 1912, two hundred and forty-seven cases of occu-
pational or industrial disease, which were divided as follows:
Lead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24O
Arsenic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Phosphorus necrosis . . . . . . . . . . . . . . . . . . . . I
Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
When it is taken into consideration that in this period not to
exceed thirty-one manufacturing establishments were reporting,
the importance of this legislation, particularly as it concerns the
reporting of occupational disease, may be grasped.
Personal experience has taught me that the Occupational Disease
Act, as applied in our state, must fall far short of its mission unless
we keep continually before us the idea of education, not only of
employee, but of employer. I have with me now, indeed, the mental
picture of two large manufacturers of paints whom we will desig-
nate as X and Z. Both plants are new and well equipped with
modern devices for collecting dust; both have shower-baths, abun-
dant facilities for washing, dining rooms, compartment lockers,
working clothes, and regular medical examinations by well-qualified
physicians. X reported eight cases of industrial lead poisoning for
the month of October. Z reported seven. From this period until
April 1, the monthly reports of X have failed to show a single
case of lead poisoning; while Z, on the contrary, has reported on
an average of four cases monthly since October. Why this great
discrepancy in two large industrial concerns using a practically identi-
Medical Inspection of Factories in Illinois 347
cal process, having the same number of employees, both of modern
building construction and sanitation, and both complying with our
occupational disease law P Because X is complying with the spirit
as well as the letter of the law, while Z is complying only with the
letter. Being present in X’s plant recently when the noon whistle
blew for lunch, I was surprised to find that X not only allowed
sufficient time for thorough scrubbing of the hands and face, but
that the firm provided a man whose duty it was to see that all
hands were clean before the food was taken from the locker.
It is merely a difference in superintendents, foremen, and shop
discipline. An employee in the plant of X knows that the creation
of an unnecessary amount of dust, as, for example, in opening
a container of white lead, or the failure to wear his respirator
where there is dry grinding, means a reprimand from the foreman
or, if he is a chronic offender, dismissal. On the other hand, the
superintendent at Z plant is a lead man of thirty years’ experience,
who boasts he has never been leaded, and who believes that chewing
tobacco is the greatest of all prophylactic measures in the prevention
of lead poisoning. It was interesting to note, however, that this
man, although not a user of alcohol, had a blood pressure of one
hundred and sixty and peripheral blood-vessels of the consistency of
whipcords. Z will not get results in his plant, with all of his
modern sanitary apparatus, fans, and dust collectors, until he gets
foremen who will personally supervise the hygiene of his men. I
grant you that this is not a simple matter. -
Quite recently, in the inspection of the linotyping room of one
of our largest dailies, equipped with a splendid exhaust system,
the men complained bitterly that the exhaust and fans caused colds
and sore throats. These are purely matters of education. Then
there is the employer who tells you that the men prefer the saloon
to the dining room and will not use a shower-bath, and that the
men will not wear respirators; he is as badly in need of education as
his employees. Demonstrate to him what an intelligent foreman can
accomplish. -
Will you allow me to tell you of our experience with the Pullman
Car Company which, by the way, was the first corporation to comply
with the occupational disease law in Illinois? Their first report
made after our preliminary inspection showed seventy-three cases
of lead poisoning. Bear in mind that they employ between three
348 American Labor Legislation Review
hundred and six hundred painters and interior finishers, and that
these people are engaged in an occupation, peculiar to the finishing
of Pullman cars, which is, I believe from personal experience, the
most fraught with danger of any of the occupations in which lead
is handled. I refer to the dry sander of lead inside the Pullman
car. Here a group of men is confined in a relatively small place
devoid of artificial ventilation, rubbing down dry lead paint with
emery paper. They told us in the beginning that men could not be
made to wear respirators in such a case; that they would want to
temporize with a strip of gauze or a handkerchief tied over nose and
mouth. I wish to emphasize the point that in this, the most dan-
gerous of the lead trades, the gauze or handkerchief will not do.
Only an approved respirator, constantly worn when at work, and the
most scrupulous personal hygiene, will save the dry sander of lead.
His work admits of no compromise. - -
To recapitulate, the Pullman company had seventy-three cases in
August; they have not had a case for the past four months. They
have a perfect equipment of baths, washing facilities, lockers, clothes,
and dining rooms; but more than that they have a safety department
with a man at its head who is an enthusiast in his work and who
believes that lead poisoning in employees can be practically elimi-
nated by personal supervision. Remember, too, that these men, of
all classes of lead workers, are doing the character of work which
furnishes the greatest number of cases of lead poisoning. That is
to say, they are painters and sanders.
Permit me, also, to say a few words upon the importance of what
our German colleagues call the symptom complex in making a diag-
nosis of industrial disease. I will refer to lead, as it is easily the
most frequent and has the most disastrous final results of any of
our industrial poisons. The blue line is by no means pathognomonic
of lead poison, nor is a basophilic degeneration unless a previous
malaria can be excluded, and it must be borne in mind that many of
our lead workers, at least in Illinois, come from the malarial belt of
southern Europe. Muscular weakness in any group of muscles with
anemia I regard as most suggestive, even without colic or blue line.
You must not ask a man if he has abdominal pain, but if he has pain
and where, giving importance to the group of symptoms rather than
to any one symptom, unless, of course, it be a wrist-drop or a typi-
cal colic. I have found what I considered a well-marked case of
Medical Inspection of Factories in Illinois 349
lead poisoning where there was no history of pain, muscular weak-
ness or paralysis, and no blue line, but a moderate anemia, albumin-
uria, and a blood pressure of one hundred and eighty, with a baso-
philic degeneration. Of course, in estimating the value of blood pres-
sure, one must exclude alcoholism and evidence of venerial disease.
Just a word in regard to the importance of basophilic degeneration as
a sign of lead poisoning. In a series of twenty-six cases, all of which
presented a certain degree of anemia, I found this sign present in
twenty-one cases.
If I have dwelt upon lead to the seeming exclusion of other
poisons, it is because of its commercial importance. I am sure
that we in Illinois owe a debt of everlasting gratitude to this Asso-
ciation and to your honorable secretary, in particular, for his efforts
in the matter of white phosphorus legislation. The Esch-Hughes
Act will eliminate one plague spot from our industrial disease map in
Illinois, and one which was particularly offensive, as 70 per cent of
the employees exposed to the fumes of phosphorus were girls under
the age of twenty. But consider, I beg of you, that while phosphorus
necrosis is a loathsome disease, yet it is strictly a local disease, and
where it numbers its victims in tens, lead numbers its victims in
thousands. I wonder how many lead workers of all grades could
obtain a standard life insurance policy at the age of thirty-five. Re-
member, too, that the atheromatous changes produced in the vessel
walls by lead, as also the kidney changes, are permanent.
* * * * . . . * *
L. M. RYAN
Medical Eraminer, New York Foundation Company.
Under conditions as they exist in New York at present employ-
ment in compressed air is not such a dangerous occupation as it
was a few years ago. As improvements have been made in equip-
ment for lessening the laborious part of the work and for over-
coming the difficult problems of engineering, so has there been a
great advance toward bettering the conditions under which the men
are working. Chief among the altered conditions which have less-
ened the dangers of loss of life from caisson disease are: (1) phy-
sical examination of all employees; (2) shortening the hours of
labor; (3) hospital locks, in charge of qualified attendants, where
victims of the “bends” can be immediately recompressed; (4)
lengthening the time of decompression in coming from work; (5)
substitution of electricity for candlelight; and (6) a greater ten-
dency on the part of the men to sobriety.
I am speaking now with reference to the work of sinking cais-
sons for foundations of buildings, and particularly of the compressed-
air work during the last five years in connection with many of
the large buildings in lower Manhattan. Caissons or large vertical
boxes are sunk to rock or hardpan, as necessity may demand. As
the earth is excavated from underneath and inside the boxes the
caisson settles, so that when rock or hardpan is reached we have
a hollow vertical cylinder, or a miniature tunnel, leading from the
surface of the ground to a solid support. For a building which
extends over a large area a great many of these caissons have to
be sunk. In the case of the municipal building of New York, for
example, one hundred and six caissons were sunk to a depth of one
hundred and twelve feet below water level and one hundred and
thirty-five feet below the street level. These boxes or caissons are
sunk in groups of three, four, five, or six, so that a force of from
one hundred to one hundred and fifty men, or even as many as
five hundred men, are employed at one time. The air is pumped
from air compressors to the caissons and the pressure varies ac-
Compressed-Air Illness in Caisson Work 35i
cording to the depth of sinking, so that at the same moment we
may have one caisson, which is nearing its destination, having a
pressure of as much as forty-five or forty-six pounds and another
one, just being begun, having a pressure of only two or three pounds.
In caisson work we have a few difficulties to be dealt with that
are not met in tunnel work, but in the main the problem is the
same. The percentage of cases of compressed-air disease in my
experience has been lower on foundation work than in tunnel work,
in spite of the fact that under most circumstances employees in
caissons are working under more disadvantageous conditions than
tunnel workers. The reason for this is, I think, that in tunnel
work, up to the present time, for the same pressure the men have
worked longer hours. In caisson work our main difficulty in the
past has been in lengthening the time of decompression on exit from
work. One reason for this is that, on account of the comparatively
Small size of the lock used in this work and through which all em-
ployees must pass, it is a much greater mechanical problem to di-
minish the pressure gradually. I mean that, comparing two locks,
one large and the other small, with an equal pressure of air on them,
if you release the same amount of air from each through the
same sized valve, the pressure in the small lock will drop much
more quickly than in the large one. Another reason is that the
lock used on the caisson, in contrast with tunnel work, is not
permanently placed, as it must be lowered with the caisson. The
necessity for the frequent removal of locks leaves a greater mar-
gin of chances for leaks to occur from time to time, and from a
leaky lock it is almost impossible to release the air slowly. In
addition, the cramped position that the air worker must assume
while sitting in the bucket during decompression differs from the
comparative comfort with which he issues from a tunnel lock.
Another feature of caisson work that has to be reckoned with is
the environment of a busy city, as compared with the location of
a tunnel plant which is usually in a more secluded section. In the
former case the force of men, like the pressure of the air, is con-
stantly changing; in the latter the tendency is more for the force
to be a steady one, for the men have a pressure to work in that
is pretty nearly constant and is not accompanied with the same
degree of uncertainty. *
In considering the problem of how to care for the men, the
352 American Labor Legislation Review
two factors that are of the utmost importance are: (1) the rejec-
tion for work of all physically unfit; and (2) slow decompression
in coming from work. The only death that has occurred in any of
the work of which I have had charge during the last five years
was due to a pressure of only twelve pounds of air where a man
had gone to work without having been examined. Post-mortem
examination showed that he had had a dilated heart which ruptured
from the strain of a fairly rapid decompression. Very few cases
of caisson disease occur in a pressure less than twenty pounds.
In the examination of the men it should be borne in mind that it
is an extraordinary occupation in an extraordinary atmosphere,
and only extraordinary men should be employed. They should
be physically above the average, between the ages of twenty-one
and forty, of slender build, non-alcoholic, and with absolutely
Sound heart and lungs. Any variation from normal, even in rate or
regularity of the heart, should be enough to reject a man. No man
with symptoms of any organic disease should be passed.
The fight for slower decompression has not been with the con-
tractors so much as with the employees themselves, and I do
not believe that the reason is so much the desire on the part
of the men to get away from their work quickly as it is a spirit
of bravado that prevails with nearly all. There is a certain con-
tempt developed for the air, the result of familiarity. As
they say, they can “eat air”. Reason and a few painful lessons,
however, have diminished this spirit to a great extent and, by
the placing of responsible men in the position of lock-tender,
we have been able to regulate the time to much better advantage.
Nearly all cases are caused by too rapid decompression, and my
experience has been that where the decompression has been slow
no serious case has ever resulted. It is my belief that if a suffi-
ciently long time were taken for decompression we would never
have a fatal case in an otherwise healthy man.
The time that should be taken for proper and scientific de-
compression depends directly on the amount of air that is dis-
solved by the blood under pressure. And the amount of air dis-
solved by the blood is determined by (1) the length of time spent
in the air, (2) the number of pounds of pressure, and (3) the
amount of exercise undertaken in the air. . A lock-tender may
go rapidly in and out of very high pressure with no ill effects,
AIR-LOCK ON TOP OF CAISSON
IN. SINKING Foundations For Skyscraping BUILDINGs MEN Go Down
BENEATH the WATER LEvel AND Work IN CoMPREssed-
AIR CHAMBERs Or Caissons
THE AIR PREssure Is FREQUENTLY MoRE THAN THREE TIMEs THE NorMAL
FIFTEEN Pounds PER SQUARE INCH. WoRKERs, IF RELEASED GRAD-
UALLY DURING DEcoMPREssion IN THE AIR Lock, Avoid THE
“BENDs", or CoMPREssed-Air Illness

Compressed-Air Illness in Caisson Work 353
as his stay in the air is short. Superintendents and engineers,
whose stay is shorter than that of a regular shift and who do no
manual labor in the air, do not suffer from the “bends” as fre-
quently as do the diggers.
In addition to the purely mechanical problem as a causative fac-
tor, we have to take into account the individual susceptibility to
caisson disease. Five men of apparently the same physical condition
come out of a caisson under absolutely the same conditions. One
of the five is attacked by the affliction and the other four are unaf-
fected. What determines this susceptibility? The blood of each
undoubtedly dissolves the same amount of air under pressure, and
when the pressure is reduced the air comes out of solution in pre-
cisely the same length of time. Authorities differ as to the change
in pressure in the vessels, but to my mind this is a real and impor-
tant factor. If the pressure within the vessels were not increased,
the blood could not dissolve the air or hold it in solution. Conse-
quently, in rapid decompression we have not only to deal with air in
the form of small emboli in the blood stream, but we have exerted
against the vessel walls an abnormal pressure which has not had
time to diminish at the same rate as the air in the air-lock. The ves-
sel walls of the man in good condition, or rather the man who is the
good risk, are able to counteract this pressure and carry the air to
the lungs where it is expelled. The man whose vessel walls dilate
under this pressure is not able to get rid of his air so quickly, and the
small emboli collect in sacculations at the weaker points and remain
until recompression is carried out so that the air is again taken up
in solution in the blood.
For my own convenience I have classified the different types of
the disease as follows: (1) spinal type; (2) cerebral type; and
(3) pulmonary type. Each of these is again subdivided into (A)
mild variety, and (B) severe variety. Of the spinal type the mild
variety is characterized by aching pains in the extremities; and the
severe variety by paraplegia and general weakness but no pain. Of
the cerebral type the mild variety is characterized by vertigo, nausea
and some prostration; and the severe variety by coma, usually hemi-
plegia, and great prostration, with pulse and respiration barely per-
ceptible. The main Symptom of the pulmonary type, which is seen
less frequently, is dyspnoea. The mild variety of the spinal type
never results fatally, but in rare cases it causes a wasting of the
354 American Labor Legislation Review
muscles of the thigh by a gradual process which involves the hip-
joint as well. The severe variety, with paralysis of the legs, never
terminates fatally except from the secondary results of a myelitis,
where treatment has been of no avail. The milder variety of the
cerebral type is due probably to a disturbance of the internal ear and
terminates favorably; but the severe variety of the cerebral type,
characterized by coma, is fatal in many cases in spite of any treat-
ment that may be instituted.
In regard to the treatment of the severe cases, everything de-
pends on proper and skilful recompression in the hospital lock.
The greatest mistake in the past has been in recompression to the
number of pounds in which the patient was working. This is abso-
lutely unnecessary and is highly dangerous. Uniformly good
results are obtained by recompressing to two-thirds what the pres–
sure was in the working chamber. This corresponds in some meas-
ure to Dr. Haldane's theory of rapid decompression for the first
stage. When the desired pressure is attained it is wise to leave it
stationary for some time, according to the merits of the case and the
improvement of the patient. In all cases of the severe type the
medical attendant should be recompressed with the patient and it is
his duty to use artificial respiration if necessary, to massage over
the heart with movements of the extremities, and in many cases to
force the mouth open and promote respiration. When consciousness
returns it is wise to encourage the patient to execute voluntary
movements and to get up and walk in the lock, allowing him to rest
at intervals. Decompression in patients afflicted with the milder va-
riety of the disease can be carried out at the rate of about one pound
in four minutes, taking one hour where the recompression has been
to 15 lbs. In the severe cases, decompression should be much
slower, at the rate of ten to twelve minutes for a single pound,+
that is, where the recompression has been to I5 lbs. taking as long
as two and one-half or three hours, and where the recompression
has been to 20 lbs. taking as long as three and one-half or four
hours. :
The following is the history of an interesting case followed by
recovery:
Name, J M Age 28. Ht. 5 ft. 6 in. Wt. 160 lbs.
History:—On December Ioth, 1909, started to work in 37 lbs. pressure
without ever having been examined. He had been quite ill for about two
Compressed-Air Illness in Caisson Work 355
weeks previously, suffering from a severe cold. Worked for two hours, al-
though he had never been employed in compressed air before. On coming
out of the lock was decompressed very rapidly, in about one minute's time,
with the rest of the gang. He fell unconscious and was carried to the lock
for recompression.
Treatment:-Was at once recompressed with an attendant to 20 lbs., and
after the air had been maintained at this level for about ten minutes re-
covered consciousness and was able to get up and walk about in the lock.
He was gradually decompressed, taking a period of two hours. On exit
from the lock he felt pretty well, but at the end of fifteen minutes again
fell over unconscious and seemed to be quite lifeless. He was again recom-
pressed with myself to 20 lbs. and under the same treatment recovered con-
sciousness in the air. His pulse was weak and rapid, pupils dilated, and
body covered with a profuse perspiration. I encouraged him to sit up, after
administering strychnine to him hypodermically. Passive movements were
carried out with massage and two and one-half hours were taken for de-
compression. When he made his exit from the lock he felt fairly well, but
was noticeably weaker than he was on coming out the first time. He was
allowed to rest in the recovery room and restoratives were administered to
him. Five hours later he said he felt well enough to get up and walk
around, but complained of some dizziness. He was standing up near the
hospital lock and was speaking to me when he was seized with a violent
convulsion and fell over in my arms. He was again recompressed with me
to a pressure of 22 lbs. and the pressure was maintained at that level for an
hour before he fully regained consciousness. During that time I was using
artificial respiration on him, his jaws held open with a mouth gag and his
tongue drawn forward. It was almost a quarter of an hour before he
breathed at all satisfactorily. At the end of an hour he could answer ques-
tions but only in an indefinite way, and he had a well-marked paresis of his
left side. This gradually improved, but he was so very weak that he was in
clined to lie down. He wanted to sleep continually. We released him very
slowly until at the end of five hours decompression was complete. This was
at the rate of one pound in fourteen minutes. He was carried to the re-
covery room and by that time had recovered entirely from the coma and
paresis. He was given some broth and was allowed to sleep for three hours.
He rested for two hours more and at the end of that time was so improved
that I allowed him to go home.
He never had any recurrence and was able to come around for his pay
three days later. Two weeks later he was in apparently good health, but I
advised him never to enter even the slightest pressure again. Neverthe-
less, within three weeks of his illness, he did go to work in light pressure
in another part of the city, but only worked a few days. About four months
later he had an attack of pneumonia and died.
LEGAL PROTECTION FOR WORKERS IN UNHEALTHFUL
TRADES
JOHN B. ANDREws
Secretary, American Association for Labor Legislation.
The need of labor legislation for the protection of workers in
unhealthful trades is so apparent to anyone at all familiar with the
facts that argument upon the subject is unnecessary. “Factory
legislation”, to use the earlier English term, has aimed particularly
at the protection of workers from insanitary conditions of employ-
ment. Long before any considerable number of people admitted that
legal regulation of working hours and of wages was justifiable,
there was very general recognition of the fact that the worker was
entitled to a decently safe place in which to labor. The reasonable-
ness of Sanitary regulations as a legitimate interference with work
conditions prescribed by the employer and suffered by the employee,
has also been more uniformly upheld by the courts than any other
kind of labor legislation.
In general, certain trades are unhealthful and require regulation
principally because the workrooms under ordinary conditions are
likely to be poorly ventilated. More specifically, the harmful condi-
tions of employment are frequently due to the presence of dusts,
gases, vapors, and fumes; to extremes of temperature, humidity, or
density of the atmosphere; and to improper lighting and overstrain.
The evil results of unhealthful conditions have long been recog-
nized, and in every industry there are humane and intelligent em-
ployers who devote much time and money to the elimination of un-
necessary hazards. Whether prompted by humanitarian or commer-
cial considerations, these advanced employers frequently provide
model establishments. By their commendable efforts they also help
to establish reasonable standards of comfort and safety which, when
drafted into labor law, constitute uniform minimum requirements
for all employers in the same industry. But only through the uni-
formity of regulation which legal enactments alone can secure, can
these more progressive and humane employers be themselves pro-
Legal Protection for Workers in Unhealthful Trades 357
tected from less scrupulous competitors who would otherwise often
fail to go to the expense of providing adequate safeguards, and
only through such compulsory uniformity can the health of the em-
ployees of these competitors be protected.
It frequently happens, moreover, that even a vast majority of the
manufacturers in a given industry claim that they are unable to
bring about reforms, which they freely admit are desirable, without
the aid of uniform legal regulations to force the recalcitrant mi-
nority into line. A striking example of this, the condition which
culminated successfully in the poisonous phosphorus match pro-
hibition act, is still fresh in the public mind. Match manufacturers,
representing ninety-five per cent of the total product, testified before
Congress that they could not substitute a harmless compound for
the slightly cheaper poison without a uniform law compelling all
manufacturers in that industry simultaneously to abandon the poi-
son. Match manufacturers representing the remaining five per
, cent of the product stood out stoutly until the last, declaring that
they would close their factories before they would submit to this
sanitary regulation already in compulsory operation in practically
all the civilized countries of the world. It required labor legislation
to prohibit the use of this unnecessary deadly poison before “phossy
jaw”, the most loathsome of all industrial diseases, could be abol-
ished.
For other industrial poisons there are harmless but more ex-
pensive substitutes. Automatic mechanical processes can be sub-
stituted for dangerous methods still conducted by hand labor. Scores
of operations in the present list of particularly insanitary trades
can be made safe by the use of scientific apparatus for the removal
of dangerous dusts and fumes.
The unhealthful trades demanding legal regulation may be con-
veniently classified according to the nature of the principal hazards:
(I) Trades menaced by specific industrial dusts, fumes, gases,
vapors and acids (poisonous and non-poisonous);
(2) Trades menaced by compressed or rarified atmospheres;
(3) Trades menaced by improper light;
(4) Trades menaced by extremes of temperature and humidity;
(5) Trades menaced by excessive strain.
Hundreds of peculiar injuries, caused by these unhealthful con-
ditions of employment, are now beginning to receive serious atten-
358 American Labor Legislation Review
tion in America as special diseases of occupation. This new line
of study is most encouraging to those interested in securing effective
legal regulation of unhealthful trades, because it has long been recog-
nized by the people most familiar with the facts that specific studies,
leading to the establishment of more definite standards of safety, are
necessary before much even of the now existing legislation can be
effectively enforced.
While such researches are under way, we should emphasize at
every opportunity the following considerations: (1) All preventable
Occupational diseases must be prevented; (2) those occupational
diseases which we do not yet know how to prevent must be reduced
to a minimum; and (3) the victims of occupational disease must be
compensated for their injuries by some just system of insurance.
Efforts to carry out this program lead naturally to three principal
methods:
(I) Absolute prohibition.—Through the successful outcome of
the efforts to secure a prohibitory tax upon matches made
with poisonous phosphorus, an avenue of tremendous possi-
bilities, if carefully followed and not abused, is opened up
for the further conservation of human life.
(2) Regulation.—There may be specific or general regulations:
A.—Specific regulation.—For the sake of clearness we may
recall, as an illustration of specific regulation, the earlier his-
tory of the match industry, when several countries, before
harmless substitutes for poisonous phosphorus were dis-
covered, attempted to prevent “phossy jaw” by requiring, (a)
that match paste should contain not more than seven per cent
of the deadly poison; (b) that no one should be permitted
to work in the poisoned atmosphere of a match factory more
than eight hours in any one day, and (c) that children should
not be so exposed. There were, then, in this intermediary pe-
riod of specific regulation, three definite limitations, (I) upon
the hazardous material, (2) upon the period of exposure, and
(3) upon the persons exposed. By this method of specific
regulation also there are extensive possibilities for legal regu-
lation in the interest of human health.
B.—General regulation.—This method is, unfortunately, the
most common. If, again, for the sake of clearness, we make
final use of the match-factory illustration, we recall that be-
Legal Protection for Workers in Unhealthful Trades 359
fore prohibition was thought of and before specific regulation
had been tested, most countries had made vague efforts,
through general regulations, to provide education, ventilation,
and cleanliness for the promotion of the comfort and health
of workers in match factories. This general method lends
itself most readily to that large group of trades in which the
Occupational causes of industrial maladies are least clearly
defined. It marks the earliest stage of regulation where, on
account of complex conditions of employment, we are still
feeling our way in partial darkness without definite standards
for our guidance.
(3) Insurance.—It is now recognized that the campaign for work-
men's compensation or insurance for industrial accidents, both
in Europe and in America, has been the greatest practical
force in the prevention of such injuries. No intelligent per-
son can go far in the study of insurance against industrial
accidents without realizing that a logical consideration of the
facts must lead likewise to insurance against industrial dis-
eases. A workman, incapacitated by disease contracted in
his trade and due to his employment, is as much entitled to
compensation as if he had been disabled by an accident. In
many European countries this principle is already established.
In all attempts to control dangerous trades, the method of general
regulation has naturally preceded specific regulation and absolute
prohibition as well as insurance. On paper it is by far the easiest,
and unfortunately it creates a temporary impression of accomplish-
ment which is quite fascinating to the occasional-day reformer. It is
probably a necessary first step in most industries where definite, en-
forceable, scientific standards must wait upon investigation and prac-
tical experiment.
In attempting to deal intelligently with these problems, our bill
drafters are hopelessly baffled by the lack of scientific standards.
And nothing is more clear to serious students of the subject than
the unavoidable conclusion that effective laws for the regulation of
unhealthful trades cannot be properly drafted by busy and harassed
legislators in the midst of legislative sessions. In the field of in-
dustrial hygiene, no greater contribution could be made at the present
time than the establishment, by a commission of experts, of such
standards.
360 American Labor Legislation Review
The existing laws in this country for the regulation of factory
labor in the interest of the comfort and health of the workers are
for the most part formulated on general lines, confused, indefinite,
and full of loopholes. In the fifteen states which even pretend to
protect workers from the effects of poisonous gases, fumes, and
vapors, the laws seldom give more definite directions than that such
dangerous gases, fumes, and vapors must be removed or rendered
harmless “when injurious to the health of employees”, or “so far as
practicable”, or “if necessary”. In one state the law sweepingly
provides for all health protection by stating that the factory inspect-
or “shall also examine into the sanitary conditions of factories,
workshops, mines and quarries, and when any condition or thing is
found that in his opinion endangers the health or lives of the em-
ployees, he shall notify and direct the employer to rectify the same.”
This class of statute law, which is quite common, places no duty
upon the employer to provide proper protection until he is ordered
to do so by the inspector. When one considers the area to be covered
in our large industrial states, and the number of workplaces to be
inspected, it can easily be seen that workers depending for their
safety upon the specific orders of a limited number of inspectors are
likely to receive entirely insufficient protection from laws of this
character.
Although work in compressed air has become an important element
in the building trades of this country, New York is still the only
state which has a scientific law relating to work of this character.
There are only twelve states that make any mention of the sub-
ject of light in their general factory or labor laws. And “in not
one of these”, says a well-known efficiency engineer, “are the pro-
visions sufficiently specific to render them of practical value.”
Laws intended to protect the workers from injurious dusts in fac-
tories have been enacted in twenty states, but they are generally very
crude and in practice more or less ineffective. “Drastic legal re-
quirements alone”, says the leading American authority on this sub-
ject, “are certain to bring about the required degree of comfort
and health.”
One reason that many safe methods are not in operation at the
present time is simply that many employers, busy with the making of
profits, have had no sufficient incentive to turn their attention to
factory sanitation; and another reason is that state factory inspect-
“SEPARATING SCREENS” IN WEHITE-LEAD FACTORY
A. ONCE Dusty Process Is HERE MADE PRActically FREE From LEAD. Dust
By the Use of ENclosed CHURN-LIKE MACHINEs WHICH SIFT
the METAL FROM THE Corroded WHITE LEAD

Legal Protection for Workers in Unhealthful Trades 361
ors have not always been fully aware of their opportunities and
responsibilities. The motive which leads some intelligent employers
properly to equip their plants with safeguards is undoubtedly the
conviction that it increases the efficiency of their workmen. There
is abundant testimony to that effect from the rapidly rising profes-
sion of efficiency engineers and from their patrons. But even the
most enthusiastic “boosters for safety” among the thoughtful effi-
ciency experts recognize the absolute necessity for the establishment
of uniform legal standards of safety if the health of the great
majority of factory workers is to be conserved.
Recently a few of the less thoughful enthusiasts in the popular
agitation for efficiency have failed to get the true perspective and
have clamored for protection for the workers solely upon the ground
that “it pays” the employer. Let us congratulate ourselves that
those who are in danger of losing their health and their lives in their
daily toil have in some instances at least that incidental advantage.
But let us have less of this everlasting dinning in our ears that, be-
fore we ask for decent protection for the workers, we must first
demonstrate that each advance toward health and safety will actually
put additional dollars in the pockets of employers. Let no one for-
get, meanwhile, that the philosophy of mercenary profit, when carried
to its logical conclusion, may result in some instances, where it is
not clear that profits will respond immediately to the expense of
safety, in less than decent protection. No man in this Republic
should be permitted for a moment to forget that, no matter how
urgent is the duty to protect the property of citizens, society has a
much higher responsibility, the protection of human life.
In our efforts to secure the necessary information upon which to
base intelligent legislation, we must draw more and more upon the
expert service of the physician. Eight states have already enacted
laws requiring medical reports on the most easily recognizable dis-
eases of occupation. These reports will indicate special danger
points for intensive study within industrial establishments.
Periodical physical examination of workers in particularly hazard-
ous trades is now required in one state, and the regular medical in-
spection of factories, now unhappily limited to three states, will
undoubtedly be extended rapidly within the near future. Medical
colleges might well include regular courses on industrial hygiene;
hospitals, too, will be expected to improve their system of records;
362 American Labor Legislation Review
and in the leading industrial centers we shall eventually have special
clinics and wards for the study and prevention of industrial dis-
eases. Recent developments indicate that the medical profession will
not evade its opportunity and responsibility.
For many years it has been our shame that in this field we have
lagged far behind some of the countries of Europe. Our scandalous
disregard for the safety and health of workers is widely known.
But in this country true reform waits not so much upon sentiment
as upon facts. We are just beginning to utilize the materials at
hand, and our machinery for scientific cooperation in promoting in-
dustrial hygiene is but fairly set in motion. We move rapidly when
once under way. Let us press on in the hope that another generation
may see America leading the nations of the world.
GENERAL DISCUSSION
DR. C. T. GRAHAM-ROGERS, Medical Inspector of Factories, New
York: Any discussion of the question of state promotion of indus-
trial hygiene would comprise four points, first the reporting of
industrial diseases, second the recording of the reports, third in-
tensive study of the means of prevention, and fourth education.
The departments of state which would naturally be responsible
would be the health department, the labor department, and the educa-
tional department.
Dr. Wilbur has spoken of how the question of reporting corre-
sponds to the registration of births. The notification of industrial
diseases gives us some idea of how to make an investigation and then
of how to prevent further trouble. The morbidity returns are more
important than the mortality returns. Last year I went over the
reports of New York State and I noticed that the mortality from
pulmonary tuberculosis in a locality known for steel grinding ap-
peared to be low, while in an essentially country district it appeared
to be very high. I have visited every factory in the state and, from
the known facts that I have of the steel district, these statistics are
no indication whatever of the real conditions. In foreign coun-
tries the records are more complete.
In New York State the reports of occupational diseases are sent
to the bureau of labor statistics. Dr. Hatch of that bureau
then sends me a copy of every report that is made. These cases are
followed up and when they run up to a certain number in an indus-
try we start an intensive investigation. We try to find the cause
of the occupational disease, whether it is due to dust, to fumes, to
gases, or to atmospheric conditions. We try to find the exact
point in the industry that is to blame. We have in New York an
engineering inspector who takes up the matter with the medical in-
spector whenever it is a question of mechanical means for the re-
moval of dust, fumes, and gases.
The state labor department can also take up the question of the
home worker and of the child worker. In the promotion of indus-
trial hygiene it is an important thing to know whether or not a
child is fit to go into an industry. If a child is not fit to go into
364 American Labor Legislation Review
a certain industry we should keep him out. The educational de-
partment can help in this work by vocational schools, by finding out
what the children are fit for, and by teaching them that there are
certain means to protect their health and lives and how to use these
11163.11S.
Dr. Overlock, in taking up the question of education, has em-
phasized the instruction of physicians in medical colleges to under-
stand and know industrial diseases when they see them. I think
that is most important. I myself had an example of the need for
such instruction. I went into a factory where they made storage
batteries and one of the workers there had a typical case of lead
poisoning and wrist-drop. I asked the foreman if he had known
anything of lead poisoning. He said no, that the individual just
hung around there, suffering from rheumatism and one thing and
another, and that it was a matter of charity to let him do little jobs.
I asked the worker if he had been to a physician and found that
he was being treated for rheumatism. He was in the vicinity of the
Vanderbilt Clinic, so I gave him a card and sent him over there. It
was a well-marked case of lead poisoning and not rheumatism. So
the statement made by Dr. Overlock is true. Some of the medical
men are not instructed and do not see enough cases to be able to
recognize these diseases.
MR. PAUL KENNADAY, Secretary, New York Association for
Labor Legislation, New York City: I liked particularly Dr. Over-
lock's suggestion with regard to tuberculosis. A tuberculosis cam-
paign furnishes us with a standard for the whole question of indus-
trial disease. What the people who are fighting tuberculosis have
done it seems to me we should do with industrial diseases in general.
The exhibition, the lecture, the printed leaflet, and the newspaper
have all been used with great success in that campaign, and we
should use the same means in the matter of industrial diseases.
We must get this thing over to the public. We must make them
realize that there is a relation between occupation and disease, and
we must not be overnice in the way we go about it. In Massachu-
setts they say that at one time there was a sign in Boston which
stated that the public was requested not to deposit sputum upon the
pavements. We said in New York, a more vulgar lot, “Don’t spit”,
and I think the message carried over rather better,
General Discussion 365
It is the same with regard to industrial diseases. We are dealing
with people many of whom are not very intelligent, who are rushed
with their occupations, and who have no time for study, and we must
make this message to them just as brief and just as vivid as possible.
We must use the picture to a large extent and we must use the ex-
hibition. We ought to have in every large city in this country a
permanent industrial exhibition open day and night, especially on
Sundays and holidays, for the education of the worker as well as
the manufacturer. Then we should make *ise, it seems to me, of
the motion picture. There are infinite possibilities there for driving
home this lesson of prevention.
We must remember, too, that we must educate not only the indus-
trial worker but the physician. If we are to believe the physicians
themselves, this latter job is probably more difficult than the former.
The physician looks rather askance on anything new and he is fear-
ful of reformers. We must gain his confidence and we must not
be overstrenuous in our desire to force this registration law. In
New York City the law compelling registration of tuberculosis was
first put on the books, then physicians were notified of it, then lec-
tures were given; and the thing was worked up gradually among the
people until it came finally to actual enforcement. By that time
the law had the good-will of the majority of the medical profession.
The same method should be applied to the reporting of occupa-
tional diseases in general. But, finally, the whole thing is up to the
state labor departments and not to reformers or welfare workers or
employees. Our public officials are put there to do the job for us.
They are our representatives, the representatives of the great body
of the public, of the trade unionists and also of the men who are not
organized but who are still part of the people. It is up to all of us to
see that our public officials do their work honestly and with a cer-
tain amount of vision, that they do not just stick to the strict letter of
the law but go out and do the thing in a whole-hearted, splendid way.
In order that they may do that, it is up to us to see that they get suf-
ficient appropriations, that they are able to pay sufficient salaries so
that they can get and retain the right sort of men, and that they in-
sist upon efficiency and do not countenance the retention in office
of men who simply want to hang on to good political jobs.
PROFESSOR HENRY W. FARNAM, Chairman: I think that the form
366 American Labor Legislation Review
in which the topic “State Promotion of Industrial Hygiene”, is put,
is calculated to awaken in the minds of many people a certain pre-
sumption against the proposition. When we talk of the state I
think we are very apt to have in mind the old police state. “The
state, I’m the state.” We sometimes forget that we are the state, that
the state is all of us in a democracy. The only question is whether
this matter of industrial hygiene is sufficiently important for all of us
to get together to try and put something through or whether it
is a matter which can be safely left to the individual.
We have in our country a very good precedent for the action of
the government in these matters. In the first decade after the adop-
tion of the Constitution the government established a sick insurance
and benefit fund for seamen. It was one of the first systems of
the kind in the world. Here was a case where the government
singled out a single profession or occupation, known to be particu-
larly hazardous, and took extraordinary measures to provide for
sickness. The remarkable thing is that in those early and simpler
days apparently no one ever thought to contest the constitutionality
of that measure, and the consequence was that it went on and we
have developed a great medical system, the United States Public
Health and Marine-Hospital Service, out of that small beginning
which was an effort by the government to provide for the health of
one particular occupation.
In connection with the very valuable suggestion thrown out by
Dr. Overlock with reference to the establishment of hospitals for
industrial diseases, it may be well to state that Dr. Devoto of Milan
is expected to be in this country in September in attendance at the
International Congress on Hygiene and Demography and I am sure
I voice the sentiments of the Association in saying that we second
heartily Dr. Overlock's suggestion and hope that someone who has
money to give away wisely will establish such a hospital.
V
BIBLIOGRAPHY ON INDUSTRIAL HYGIENE
TRIAL LIST OF REFERENCES
ON
OCCUPATIONAL DISEASES AND INDUSTRIAL HYGIENE
Prepared by the
AMERICAN ASSOCIATION FOR LABOR LEGISLATION
UNITED STATES BUREAU of LABOR
LIBRARY OF CONGRESS
WORKERS IN WHITE-LEAD FACTORY
REMOVING CoRRoDED WHITE LEAD FROM JARs IN WHICH IT HAs BEEN TRANs-
formed From METAllic Plates by THE Action of ACEtic Acid.
IMPRovised RAG Muzzles THE only PROTECTION FROM
DEATH DEALING DUst

BÍBLIOGRAPHY ON INDUSTRIAL HYGIENE
This preliminary list of titles is here printed in the hope that it may
be found immediately useful to the rapidly growing group of Ameri-
cans intelligently interested in industrial hygiene.
made to this list during the year.
Additions will be
Copies of all publications on the
subject are therefore urgently solicited in order that from this beginning
there may be prepared a comprehensive bibliography, conveniently ar-
ranged and classified and fully annotated, for the guidance of all who
wish to make future work still more effective.
AMERICAN TITLES
Addams, Jane, Hamilton, Alice. The
“piece-work” system as a factor in
the tuberculosis of wage-workers.
(Transactions of the Sixth interna-
tional congress on tuberculosis,
Washington, 1908, v. 3: I39-140.)
The effect of fatigue from “speeding up”.
Adler, L. H., Jr. Report of a case of
chronic mercurial poisoning.
(American lancet, Detroit, 1890, n. . .
s. v. I4: I61.)
General discussion of mercurial tremor
and account of a case in a hatter.
tº e e º 'º - e > A report of five cases of
chronic mercurial poisoning. (Med-
ical news, Philadelphia, 1891, v. 59:
I86-188. Also reprint.)
All in hat factory workers.
Agnew, C. R. A preliminary analysis
of 1,060 cases of asthenopia. New
York, 1877. I2 p
With occupation tables for men and wo.
men afflicted with this eye disease.
Alcohol. Hearings on free alcohol be-
fore the Committee on ways and
means of the House of representa-
tives, February–March, 1906, Ist ses-
sion, 59th Congress. Washington,
government printing office. I906.
9 p.
Testimony upon the effects of wood-alco-
hol on the health of workmen. See Index,
“Health”, p. 436.
Aldrich, Charles J. Trap-drummer's
neurosis: a hitherto undescribed Oc-
cupational disease. (Medical news,
N. Y., Feb. 7, 1903, v. 82: 257–258.)
Single case due to overstrain of certain
muscles.
• . . . . . . . Caisson disease; illustrated
with pen drawings of caisson, tunnel,
shaft and drift, air-locks, etc.
(Cleveland medical gazette, March
1899, v. I4:279-287. Discussion, p.
287-295.) . *
General discussion of symptoms, causes,
theories, etc., with account of cases in Ar-
kansas.
.....: Compressed-air illness, or cais-
son disease. (Medical news, N. Y.,
1904, v. 85: 1020-1024. Illustrated.)
Based on study of 50 cases of caisson
disease occurring in the water tunnel under
Lake Erie at Cleveland, with description, of
a caisson, and review of experience else-
where.
Alger, Ellice M. Occupational eye
diseases. (American labor legisla-
tion review, June 1912, v. 2, no. 2:
223-230.)
Allen, J. W. On the need of a pro-
gressive study of industrial diseases.
(Chicago magazine times, I907, V.
40: 641–649.)
American Association for Labor Leg-
islation. First national conference
on industrial diseases. Chicago,
June 10, 1910. American association
for labor legislation, New York,
1910, 52 p. (Publication no. Io.
American association for labor leg-
islation.) (See Farnam, Favill, An-
drews, Henderson, Hamilton, and
Hoffman.)
... ....Second national conference on
industrial diseases, Atlantic City,
June 3-5, 1912. American Labor leg-
37O American Labor Legislation Review
American museum of safety,
islation review, v. 2, no. 2. p. 179-417.
(See Thompson, Keays, Fordyce,
Dana, Alger, Edsall, Seager, Hoff-
man, Hatch, Pratt, Cabot, Winslow,
Baskerville, Price, Overlock, Wilbur,
Gibson, Ryan, and Andrews.)
tº e º 'º e e º ºs American labor legislation re-
view, v. I, no. I (see Hamilton,
Schwab, Hoffman, and Memorial on
occupational diseases). (Discussion
of reporting of diseases by employ-
ers, medical inspection of factories,
clinic for industrial diseases, mer-
curial poisoning in New York and
New Jersey, etc., p. 73-95.)
& tº º ºs & © tº € gº tº g tº e º v. I, no. 2 (see Hoff-
man, Winslow, Elliott, Graham-
Rogers, and Laws.)
• * * * * * * * * * * * * * * v. I, no. 3 (see Laws).
tº e º e º e º ſº º e º e º a v. I, no. 4 (see An-
drews). (Discussion of occupational
disease reports, p. III-I37.)
tº tº º gº tº º ſº tº ſº º º is ... v. 2, no. 1 (see Hotch-
kiss.)
tº $ tº ſº º e tº e Leaflets, nos. I-6.
New
York. Safety manual no. 3. Foun-
dry practice. Dangers to health in
the molding industry. I912. 44 p.
Ames, Azel, Jr.. Sex in industry: a plea
for the working girl. Boston. Os-
good and company. 1875. I58 p.
A popular treatment of the results of the
investigation into special effects of certain
forms of employment upon female health,
published in the Sixth Annual Report of the
(Mass.) Bureau of Statistics of Labor (q.v.)
by the physician who made the investiga-
tion.
Andrews,. John B. Phosphorus poi-
soning in the match industry in the
United States. (U. S. Bureau of
labor, Bulletin no. 86, Jan. 1910, p.
31-144.) & ſº º & ſº a tº
Based on thorough, original investigation
of 15 out of the 16 match factories in the
Ljnited States. -
tº e º 'º gº tº tº ſº Deaths from industrial lead
poisoning (actually reported) in
New York state in 1909 and 1910.
(U. S. Bureau of labor, Bulletin no.
95, July 1911, p. 260-282.)
A personal investigation of 60 deaths re-
ported by physicians as due to lead poison-
tº e º g º ſº ſº º Phosphorus poisoning in the
manufacture of matches. (American
association for labor legislation,
1910. Publication no. 10: II-I9.)
Brief general discussion based on report
for United States Labor Bureau (q. v.).
& & © tº dº e º gº Beginning of
& © tº e º e º &
Bartlett, Elisha.
e tº ſº & © tº ſº The beginning of occupational
disease reports. (American labor
legislation review, Dec. 1911, v. 1,
no. 4: IO7-II.3. Discussion, p. III-
I37.) tº g tº ſº
Reasons for and main provisions of laws
passed in six states in 1911.
gº º sº e º ſº º Legal protection for workers
in unhealthful trades. (American
labor legislation review, June 1912,
v. 2, no. 2: 356-362.)
is e º ºs e º e º e Industrial diseases and occu-
pational standards. (Proceedings
of the National conference of chari-
ties and corrections, 37th session,
May 1910, p. 440-449. Reprinted as
pamphlet.)
tº e º 'º tº e º ſe Protection against occupation-
(Academy of political
York, v. 2, no. 2: 18-
al diseases.
science, New
23.)
. . . . . . Industrial diseases and physi-
cians. (Journal of American medical
association, April 15, 1911, v. 56:
II32-II34.)
occupational
disease reports. (Journal of Ameri-
can medical association, Dec. 16,
I9II, v. 57: 1984-1986.) *
} Diseases of occupation. (The
physician, Aug. 1911, p. 9-15. Ameri-
can federationist, June 1911, p. 455-
457.)
& e º e º ſº tº e Industrial diseases problem.
(Proceedings of the National con-
ference of charities and corrections,
39th session, June 1912.)
© º 'º e º tº º tº Clinic for industrial diseases,
(Survey, Nov. I2, 1910, v. 25, p. 268-
270. Illustrated.)
A description of the Milan clinic.
match worker. (Survey,
Dec. 2, 1911, v. 27, p. 1275. Illus-
trated.)
Case of phosphorus necrosis.
Bard, C. L. Malignant pustule, and
insanity due to bisulphide of carbon.
(Southern California practitioner,
Los Angeles, 1892, v. 7: 481-485.)
Case of anthrax and discussion of dangers
to which sº. are exposed. Three cases
of insanity from bisulphide of carbon, one in
a manufacturer of the substance, and dis-
cussion of its uses and effects on workmen.
Vindication of the
character and condition of the fe-
males employed in the Lowell mills.
Lowell, 1841, 23 p.
Results of personal investigations of
hº of operatives in 1835 and 1841 (p.
10-14).
Bibliography (American)
37I
Baskerville, Charles. Air impurities—
dust, fumes and gases. (American
labor legislation review, June 1912,
v. 2, no. 2: 305-31I.) - º &
Bassoe, Peter. Compressed-air dis-
ease. (Report of Illinois commis-
sion on occupational diseases, Jan.
I9II, p. 99-150.) - e e
Thorough, up-to-date discussion, . with
table of 161 cases personally investigated,
abstract of work conducted by British Ad-
miralty, abstract of Henry Japp's article
(q. v.), text of the New York law, summary
of laws in other countries, and suggestions
for legislation. º º
Bates, Josephine (White). “Mrs. L.
W. Bates.”. Mercury poisoning in
the industries of New York city
and vicinity, by Mrs. Lindon W.
Bates. . . . . . (New York) National
civic federation, New York and New
Jersey section (Women’s welfare de-
partment), 1911, I32 p. Illustrated.
Results of an investigation made by the
Woman’s Welfare Department of the Na-
tional Civic Federation, with statistics, des-
criptions of processes, and cases.
Bauer, Louis. Pathological effects up-
on the brain and spinal cord of men
exposed to the action of a largely
increased atmospheric pressure. (St.
Louis medical and surgical journal,
May Io, 1870, n. s. v. 7: 234-245.)
Historically interesting experience with
caisson disease among workmen on St.
Louis bridge. © tº
Beard, Geo. M. Our home physician.
New York, I869. “Influence of the
occupation on health,” p. 332–373.
Illustrated.
Bistorically interesting description, pic-
tures and statistics of especially danger-
ous occupations. tº , tº
Bennett, W. H. Dust as an exciting
cause of disease of the air passages.
(Medical record, N. Y., 1872, v. 7:
388-389.) . - º
Brief article on dusty occupations. .
Bergey, D. H. Principles of hygiene.
3rd ed. Philadelphia, 1909, Ch. XI.
“Industrial hygiene”, p. 268-286.
On effects of anilin dyes and nitroben-'
zine, influence of length of working day on
health of laborers, and lighting of industrial
establishments.
Betts, W. W. Chalicosis pulmonum,
or interstitial pneumonia induced by
stone-dust. (Denver medical times,
1899-1900, v. 19: 354-361. Discussion,
p. 361-366.)
Based on practice among workers in a
cyanide mill, showing great mortality from
effects of dust.
Billings, John S. Diseases of occupa-
tion. (Progress of the world, Aug.
1896, v. 2:248-252.)
Good, brief, general treatment in lecture
before Pratt Institute. Based on experi-
ence in the Philadelphia Hospital, with
special description of 9 cases.
Blumer, G., Young, H. H. A case of
anthrax septicaemia in a human be-
ing, associated with acute anthrax
endocarditis and peritonitis. (Johns
Hopkins hospital bulletin, Baltimore,
I895, v. 6: I27-132. Also reprint.)
In a hair factory laborer, resulting in
death, with report of autopsy.
Boston, L. N. Leukocystosis in lead-
workers. (Philadelphia medical
journal, I902, v. Io: 441–443. Also
Proceedings of the Philadelphia
county medical society, 1902-3, v. 23:
246-250.) -
Bowen, John T. Acute infectious pem-
phigus in a butcher, during an epi-
zootic of foot and mouth disease,
with a consideration of the possi- .
ble relationship of the two affec-
tions. (Journal of cutaneous dis-
eases, 1904, v. 22, p. 253-265. Illus-
trated.)
Braymer, O. W. The sanitary inspec-
tion of factories. (Journal of the
American medical association, Chi-
cago, 1896, v. 26: 320-323.)
Urging importance of proper legislation
and factory inspection.
Brigham, Charles H. Influence of oc-
cupations upon health. (Michigan
State board of health report, 1875,
p. 41-54). . .
General descriptions of effects of dust, bad
air, noise, eyestrain, etc., and possible safe-
guards. tº tº
Brooks, Harlow. Caisson disease;
the pathological anatomy and patho-
genesis, with an experimental study,
(Long Island medical journal, April
I907, v. I: I49-158.)
Thorough discussion of the history, theo-
ries, etc., with medical history of cases and
autopsies.
compressed-air workers. (Medical
record, N. Y., 1907, v. 71:855–857.)
Observations in 75 cases occurring in
employees of the Belmont Tunnel.
Brose, L. D. Amaurosis following the
entrance of a well after the use of
dynamite. (Archives of ophthalmol-
ogy. N. Y., 1899, v. 28: 402–406.)
Two cases of prostration, and temporary
blindness in a farmer and his rescuer.
Broughton, M. The “bends.” [Cais-
372
American Labor Legislation Review
son disease.] (Medical tribune, N.
Y., 1882, v. 4: 185-195.)
General discussion based largely on Dr.
Smith’s pamphlet (q.v.) with description of
case in employee of Hudson River Tunnel.
Burr, C. W. Occupation spasms. (In
A text-book on nervous diseases by
American authors. Ed. by Francis
X. Dercum, 1895, p. 276-279.)
Brief discussion of various occupational
cramps.
Burrell, H. L. The report of a case of
anthrax. (Transactions of the
American surgical association, Phila.,
1893, v. II: 309-328. Also Annals of
surgery, Phila., 1893, v. 18; 605-622.
Illustrated. Bibliography.)
Thorough discussion of the disease as
manifested in a longshoreman who had been
handling hides.
Butler, Elizabeth. Women and the
trades: Pittsburgh, 1907-1908. The
Pittsburgh survey. Charities pub-
lication committee, N. Y., 1909.
“Health,” p. 358-367.
Summary of health conditions among
women workers in Pittsburgh.
Cabot, Richard. The function of hos-
pitals and clinics in the prevention
of industrial diseases. (American
labor legislation review, June 1912,
v. 2, no. 2: 293–296.)
Caisson disease and a safety apparatus
for pneumatic caisson locks.
gineering record, N. Y., 1904, v. 49:
II2-II3.)
Brief description of disease, and descrip-
tion and pictures of a device for reducing
pressure gradually, invented by Mr. W. I.
Aims, engineer of the New York Tunnel Co.
Caisson disease, Cases of. (Medical
and surgical reports, Presbyterian
hospital, New York, 1896.) -
Callan, L. W. Double choked discs
associated with compressed-air dis-
ease. (Archives of ophthalmology.
N. Y., July 1907, v. 36:509-512.)
Case in a tunnel worker, and general dis-
cussion of effects of compressed air on the
eyes.
Camac, C. N. Bancker. Chromic acid
poisoning. (Cornell university med-
ical college bulletin, Jan. I905.)
Cancer mortality in the United States,
by occupations. (In Tenth census,
vital statistics, v. 2: 576-577.)
Canfield, W. B. Relation of dusty oc-
cupations to pulmonary phthisis.
(Transactions of the medical and
chirurgical faculty, Maryland. Balti-
more, 1889. Report of the section of
(En-
practice of medicine, p. 106-IIo. Also
reprint.)
Describes case of a slate miner.
Carpenter, J. T. Mining, considered
with regard to its effects upon health
and life. (Transactions, Medical
society of Pennsylvania, Phila., 1869,
5. S. pt. 2:487-49I.) &
General discussion of effect of coal min-
ing on the health of miners.
Chace, D. E. Diseases of shop-girls
in notes of private practice. (Med-
ical society of the County of Kings,
Brooklyn. Proceedings, June 1881,
v. 6:83–89. Discussion, p. 89-91.)
Record of 150 cases, arguing that lack of
seats is not particularly injurious.
Chadbourne, A. P. The gastric and
respiratory symptoms caused by the
dust of curled hair. (Boston medi-
cal and surgical journal, 1894, v. I30:
Case of a man who had worked 20 years
in a mattress factory.
Chancellor, C. W. Impure air and un-
healthy occupations as predisposing
causes of pulmonary consumption.
(American public health association
report, 1885, Concord, N. H., 1886, v.
II: 67–72.)
General discussion of indoor and dusty
occupations.
Chaney, Lubian W. Employment of
women in the metal trades. (Report
on condition of woman and child
wage-earners in the United States.
61st Cong., 2d sess., Senate doc. 645,
v. II. “Legal provisions against
industrial dangers and diseases,” p.
I6-18; “Light and ventilation, dust
and fumes,” etc., p. 22-26.)
General results of extensive, official in-
vestigations.
Chapin, J. B. Insanity following ex-
posure to fumes of mercury. (Amer-
ican journal of insanity, Utica, N. Y.,
1863-4, v. 20:335-338.) tº a tº
. General discussion , and description of a
single case in a blacksmith who had been
engaged for two years in “retorting gold,”
or driving off the mercury by means of high
temperature.
Chenery, Wm. Ludlow. Occupational
diseases. (Independent, Feb. 9, 1911,
v. 70: 306–309.)
Popular article based on Dr. Hamilton's
report for the Illinois Commission on In-
dustrial Diseases and Dr. Andrews’ report
for the U. S. Labor Bureau (q. v.).
Cheney, Horace B., La. Rue, Omer.
Report of factory conditions in Con-
necticut as related to tuberculosis.
Bibliography (American)
373
(Connecticut public document, spe-
cial. Hartford, 1908. 8 p.)
Part of report of special committee to in-
vestigate tuberculosis, with special reference
to the future enactment of laws to prevent
its spread.
Church, John A. Accidents in the
Comstock mines and their relation
to deep mining (Transactions of
the American institute of mining
engineers, 1879-188o. v. 8:84-97.
Abstract in Scientific American,
Nov. 1, 1879, v. 55: 272-273.)
On the effects of excessive heat on min-
ers, fainting, insanity, prostration, and
death.
Clark, E. A. Effects of increased at-
mospheric pressure upon the human
body with a report of thirty-five
cases brought to city hospital from
the caisson of the St. Louis and Il-
linois bridge. (Medical archives, St.
Louis, Sept. 1870, v. 5: I-30.)
Valuable historically, not theoretically.
Clark, J. F. Mercurial tremor. (Med-
ical record, N. Y., 1893, v. 43: I3.)
. Single case in a hatter, with description of
his work.
Clark, L. P. Occupation neurosis or
ironer's cramp. (Medical record,
N. Y., 1896, v. 50:642.)
Single case in a laundress.
Clendening, L. Muscular spasms due
to heat in cooks on Pullman diners.
(Journal of American medical asso-
ciation, Chicago, IQIO, v. 54: I517.)
Brief account of single case.
Clothing, Men’s ready-made. (Report
on condition of woman and child
wage-earners in the United States,
61st Cong., 2d sess., Senate doc. 645.
“Health and hygienic conditions”
(home work), v. 295-298; “Ventila-
tion of workrooms,” v. 2:321-322.)
General results of a thorough official in-
vestigation in New York and other cities.
Coleman, J. W., Jerome, A. T. Some
pathological conditions to which the
miner is peculiarly liable. (Colora-
do medical journal, Denver, 1902, v.
8: 99-IoI. Also Medical dial, Minne-
apolis, 1902, v. 4: 183-184.)
Effects of powder smoke, heat, dust, etc.,
especially on metal miners.
Cook, J. C. Physical effect of child
labor upon the individual. (Illinois
medical journal, Springfield, Igo2-3,
n. s. v. 4:509-51O.)
Brief, general article.
Cooseman, E. The hearing-power of
beetlers; contribution to the study
of occupation deafness. (Archives
of otology, N.Y., . v. 28: 413.)
Linen-workers in Belgium.
Coplin, W. M. L., and others. The ef-
fects of heat as manifested in work-
men in sugar-refineries. (Medical
news, Sept. 3, 1892, v. 61:262-266.)
Experience with over 200 cases in a single
refinery in Philadelphia during period of
eight days.
Corning, J. L. Observations on the
caisson or tunnel disease, with notes
on nine cases which occurred at the
engineering works known as the
Hudson river tunnel. (Medical
record, N. Y., 1890, v. 37: 513-521.
Illustrated. Bibliography.)
Corporations and operatives.
1843, 72 p.
. On health conditions among factory oper-
atives in Lowell, p. 35-40.
Cotton textile industry. (Report on
condition of woman and child wage-
earners in the United States, 61st
Cong., 2d sess., Senate doc. 645. Pre-
pared under the direction of Chas.
P. Neill, commissioner of labor.
“Hygienic conditions of mills,” v.
I: 358-367.) * tº . tº . * e
Results of extensive investigations, in the
North and the South, of lighting, venti-
lation and humidity, dust and lint, and spit-
ting on floors.
Dis-
Cotton and woolen operatives.
eases, and disease tendencies of oc-
cupations. (New Jersey bureau of
statistics of labor and industries,
twenty-fifth annual report, 1902, p.
377–382.) . . . tº a tº gº &
General description and statistics of sick-
ness and death.
Cowgill, J. E. Occupation as affecting
the death rate. (Medical examiner
and practitioner, N. Y., July 1901,
v. II: 339-34I.)
General discussion from actuarial point
of view, with classification of occupations
and census and life insurance company
statistics. * *
... ...... Mortality of the United
States: diagrams of the mortality by
occupation. Indianapolis, 190I.
Crabtree, J. H. The methods of dust
extraction on cotton-carding en-
gines: safeguarding the working-
man’s health. (Scientific American,
Dec. 30, 1911, v. IoS: 592-593. Illus-
trated.)
Practical.
Crawford, H. M. Medical appliances
for health and safety in the weaving
industry. (Cassier, Dec. I910, v.
39: I 17-134. Illustrated.)
Mainly on accidents, but describes and
gives pictures of safe methods of thread-
ing shuttles.
Lowell,
374
American Labor Legislation Review
. . . . . . . . Mechanical appliances for
dust extraction in cotton mills. (Cas-
sier, Nov. 1911, v. 40: 579-596. Illus-
trated.) º -
With 21 illustrations of respirators, dust
extractors and exhaust fans.
Crum, Frederick S. Health and mor-
tality of the cotton mill operatives
of Blackburn, England. 23 p. (Med-
ical record, Aug. II, 1906, v. 70: 207-
213. Also reprint.) . . .
. . . . . . . . Occupation mortality statis-
tics of Sheffield, England. I890-
1907. (Publications of the American
statistical association, Dec. I908, v.
II: 309-318.)
. Two reviews of English reports.
ticS. -
e e º 'º e e ... The mortality from consump-
tion in small cities. (Quarterly pub-
lications American statistical asso-
ciation, Boston, Dec. 1907, v. Io: 448-
Statis-
Íñfluence of occupations, with statistics,
p. 463-466.
Curtis, Josiah. Public hygiene of Mas:
sachusetts; but more particularly of
the cities of Boston and Lowell.
YTransactions of American medical
association, 1849, v. 2:487-554. Sum-
mary quoted in Documentary his-
tory of American industrial society,
v. 8: 187.) º
On lack of ventilation in mills and board-
ing houses of Lowell (p. 513-519).
Dana, Charles Loomis. Text-book of
nervous diseases and psychiatry,
for the use of students and prac-
titioners of medicine. 7th ed. New
York, W. Wood and company, 1908,
xii, 782 p. “Professional neuroses,
occupation neuroses”: p. 609-617.
Excellent treatment of occupational
cramps.
g º e º is ...Occupational nervous and
mental diseases. (American labor
legislation review, June 1912, V. 2,
no. 2:217-222.)
e e o e s e s a Occupational neuroses. (Med-
ical record, Feb. 3, 1912, v. 81, no.
Io: 451–459. Illustrated.)
Elaborate clinical study of 100 cases, giv-
ing occupations of patients.
Darlington, T., The effect of the pro-
ducts of high explosives, dynamite,
and nitro-glycerine, on the human
system. (Medical record, N. Y.,
1890, v. 38: 661-662. Also reprint.)
hased on experience as surgeon of the
Croton Aqueduct and of Arizona mining and
railroad companies.
Darwall, J. Diseases of artisans.
(In Ziemssen’s Cyclopedia of practi-
cal medicine, Phila., 1845, v. I: I70-
182.)
Davis, I. P. Diseases occurring in
manufacture of rubber boots and
shoes. (Tenth annual report of the
board of health of New Jersey, 1886,
Trenton, 1887, p. 195-200.)
Describes processes of manufacture, con-
ditions of work and danger of lead poison-
ing, etc.
Dennis, L. Hatting as affecting the
health of operatives. (Report of the
New Jersey State board of health.
1878, p. 67–85. Also Report of the
Connecticut board of health, 1882,
Hartford, 1883, p. 41-59.)
Description of processes and statistics of
168 cases of mercury poisoning among 1546
hatters.
Detmold, W. The physiological effect
of highly condensed air on the hu-
man body. (New York journal of
'medicine, 1843, v. I: 185-189.)
. Description of the use of compressed air
in mining and its effect on the miners, based
on German article. Interesting as the first
American article on caisson disease.
Dickey, John L. “Nailers' consump-
tion” and other diseases peculiar to
workers in iron and glass. (West
Virginia State board of health re-
ports, 1881-1884. p. 149-154.)
Describes briefly work and its dangers,
with typical case of “nailers’ consumption”.
Diseases of occupation. . (Report, of
the Chicago industrial exhibit,
March, 1908.)
Diseases and disease tendencies of oc-
cupations. (New Jersey bureau, of
! statistics of labor and industries,
twenty-fourth annual report, Igor,
p. 347-354.)
General discussion.
Dock, George, Bass, Charles C. Hook-
worm disease. St. Louis, 1910.
250 p.
Describes briefly St. Gothard Tunnel epi-
demic, the anemia of brick workers, miners,
etc. p. 22:23, 33-37. Hookworm disease in
the United States, p. 37-45, etc. º
Doehring, C. F. W. Factory sanita-
tion and labor protection. (U. S.
Bureau of labor, Bulletin no. 44,
Jan. I903, p. I-131.)
Extended treatise on factory conditions
and industrial processes injurious to health,
with lists of injurious dusts and poisons and
descriptions of the lead manufacturing and
using industries, and of dangerous processes
in the manufacture of oilcloth and linoleum,
linseed oil, tallow, and fertilizers. Describes
Bibliography (American)
375
methods of safeguarding workmen. Based
mainly on European experience and inves-
tigations in a few factories in the United
States.
Donaldson, Frank. The influence of
city life and occupation in devel-
oping pulmonary consumption.
(American public health association.
Reports and papers, v. 2: 95-II.4.
New York, 1876.)
Mainly on general influence of city life,
but shows briefly influence of sedentary and
indoor occupations (p. 106-7).
Drake, Daniel. The principal diseases
of the interior valley of North
America. “Cotton ginning,” v. 2:
799-801.
Draper, Frank W. Arsenic in certain
green colors. (Massachusetts State
board of health report, 1872, p. 18-
Éffects on workmen, with specific in-
stances, p. 52-56.
Dudley, P. The metal worker's occu-
pation and his health. (Report of
the board of health, etc., of Penn-
sylvania, 1888-9, fifth annual. Har-
risburg, 1891, p. 374-377.)
Brief general discussion of the effects of
dust, especially as a cause of consumption.
Dust and its relation to disease. (Iowa
State board of health report, 1906,
p. IOS. Illustrated.)
. Pictures of lungs of coal miners, lead
miners, steel grinders, etc.
Dusty occupations and the dust prob-
lem. (See reports of state factory
inspection departments and of state
labor bureaus.)
Dusty trades, in , Massachusetts.
(Monthly bulletin of the Massachu-
setts State board of health, Aug.
I9IO, v. 5: 316–379. Illustrated.)
Mainly illustrations, with brief descrip-
tions. List of processes declared injurious
to the health of minors b
Health, July 7, 1910, p. 378-9. e
Dutton, Walton Forest. . Vanadium:
ism. . (Journal of American medical
association, June 3, 1911, v. 56: I648.)
Brief description of the poisoning to
which employees are subject in establish-
ments where vanadium is produced.
Eads, James B. Report to the presi-
dent and directors of the Illinois
and St. Louis bridge co., 1870.
On compressed-air illness in employees.
Edsall, David L. Diseases due to
chemical agents. (In Osler's Mod-
ern medicine, 1907, v. I : 83–155.)
Authoritative treatise on chronic poison-
ings, with special reference to occupational
Ca11S6S.
State Board of .
. . . . . . . . Industrial poisoning. (Amer-
ican labor legislation review, June
I912, v. 2, no. 2: 231-234.)
* * * * * * * * Some of the relations of occu-
pations to medicine. (Journal of
American medical association, Dec.
4, 1909, v. 53: I873–81. Wisconsin
medical journal, Jan. 1910, v. 8: 425-
447.) & & g
Good general discussion of the disease
tendencies of occupations.
Elliott, E. Leavenworth. Factory.
lighting: topical criticism of exist-
ing laws. (American labor legisla-
tion review, June 1911, v. I, no. 2:
IIO-II2.)
Brief criticism of existing laws, with sug-
gestions for improvements.
Elliott, W. C. Measures to protect
workers in factories and elsewhere
from noxious dust and fumes.
(Transactions of the Medical society
of Wisconsin, Madison, 1896, v. 30:
360-362.)
Brief plea for the protection of the metal
polisher.
Emerson, Nathaniel B., Tracy, Roger
On the manufacture of cigars in
tenement houses. (New York city
board of health report, 1874-75, p.
649–656.) $ s 3 s & ſº e
Results of personal investigation of air,
light, ventilation, etc., with special reference
to the effects on the health of workers and
their families.
Endemann, H. The operations of
cleansing hair and manufacturing
felt. (New York city board of
health report, 1872, p. 305.)
Brief account of dust conditions, advo-
cating use of respirators by working people.
Erdman, Seward. Aeropathy or com-
pressed-air illness among tunnel
workers. (Journal of American
medical association, Nov. 16, 1907,
v. 49: 1665-1670.)
General review of history, theories, etc.
Exline, J. W. The sanitation of mines.
(Transactions of the Colorado med-
ical Society, Denver, 1896, p. 235-242.
Also Medical age, Detroit, 1897, v.
I5: 99-102.)
General discussion, with special reference
to the prevention of disease in Colorado
1111116S. gº
Fantus, B. The diagnosis and treat-
ment of plumbism. (Illinois medical
journal, Springfield, 1910, v. 17: 616–
62I.) •'
Mainly technical, but names, trades which
are most likely to produce plumbism, and
gives special attention to symptoms.
376
American Labor Legislation Review
Farrar, J. N. Importance of direct
sunlight in the workroom; useful-
ness in art, and its bearing upon
the general health. (In American
dental association. Transactions,
1877. Elgin, 1878, v. 17: 77–85.)
General argument applied mainly to health
of dentists, but using as illustrations Wal-
tham and Elgin watch factories (p. 83-84).
Favill, Henry Baird. Importance of
industrial hygiene. (American asso-
ciation for labor legislation, 1910.
Publication no. IO: 9-II.)
Brief remarks as presiding officer at First
National Conference on Industrial Diseases.
tº º G & © tº gº . Industrial hygiene and the
police power. A reprint of a paper,
prepared for the American associa-
tion for labor legislation, on the
Legitimate exercise of the police
power for the protection of health.
(From the Thirteenth biennial re-
port of the Wisconsin bureau of
labor and industrial statistics. Mad-
ison, Wisconsin, 1908, p. 479–486.
Also in Transactions of the Sixth
international congress on tubercu-
losis, Washington, 1908.)
Shows the necessity for extensive regula-
tion of unhealthful trades, based on Scien-
tific research.
e e º 'º - e º te The toxin of fatigue. (Pro-
ceedings, Thirty-seventh annual ses-
sion of the National conference of
charities and corrections, p. 405-4I4.)
On fatigue as a factor in standardizing
hours of labor.
Female health, Special effects of cer-
tain forms of employment upon.
(Sixth annual report of the Massa-
chusetts bureau of statistics of labor,
1875, part II, p. 67-II2.)
Describes especially the manufacture of
textile fabrics, typesetting, telegraphy, and
sewing machine labor.
Fisher, Irving. Industrial hygiene as
a factor in human conservation.
(Academy of political science, New
York, v. 2, no. 2: I-9.) -
Relates primarily to women and children.
Fitch, John A. The steel workers.
The Pittsburgh survey. Charities
publication committee, N. Y., 1911.
“Health and accidents in steel mak-
ing”, p. 57-75. - - º
Effects of heat, dust, noise, nervous strain,
and long hours.
Foley, J. L. The influence of occupa-
tion in skin diseases. (Journal of
cutaneous and genito-urinary dis-
eases, N. Y., 1889, v. 7: 170–178
General discussion and classification of
occupational skin diseases by a London
(Eng.) physician.
Fordyce, John A. Occupational skin
diseases. (American labor legisla-
tion review, June 1912, v. 2, no. 2:
2O6-216.)
tº e º 'º - e tº e Occupational diseases of the
skin. (Medical record, N. Y., Feb.
3, 1912, v. 81: 207-2IO.)
Practically same as article in American
tº: Legislation Review, v. 2, No. 2 (q.
V. ).
Freeman, J. Addison. Mercurial dis-
eases among hatters. (Transactions
New Jersey state medical society,
1860, p. 61-
. One 㺠cases in Orange and cases
in other New Jersey cities.
French, John Marshall. Occupation
in relation to longevity. (Medical
examiner and practitioner, N. Y.,
Jan. IQ04, v. I4:26-28.)
Statistical study based on Massachusetts
registration report for 1886.
. .......Occupation and ... longevity.
(Annals of hygiene, Phila., 1896, v.
II: 80–82.)
Brief, general discussion. -
Freudenthal, Wolff. In what relation
does occupation stand to, tubercu-
losis? (Medical news, Philadelphia,
Sept. I5, 1900, v. 77:402-404.)
Results of investigation of 1,576 cases,
with statistics of occupations and special
discussion of tuberculosis among tailors.
Furey, G. W. Obesity among loco-
motive engineers. (Medical bulle-
tin, Philadelphia, 1889, v. II: 2II-
212.)
With table showing weight of 19 men, on
becoming engineers. and “present weight.”
Gallivan, J. V. The etiology of cais-
son disease; theories based on clin-
ical observations of the disease.
(Long Island medical journal, April
I907, v. I: 181-183.) -
Account of a case, and theories of causes
of the disease.
Gardner, A. K. Hygiene of the sew-
ing machine. (American medical
times, Dec. 15, 22, 1860, v. I: 420-
421, 435-437. Also Bulletin of the
New York academy of medicine,
1860–62, v. I: Ioo-Io&.)
. Argument that use of sewing machines
is not injurious to health of women.
Garvin, L. C. Sanitary require-
ments in factories: injurious effects
of cotton factories upon the health
of operatives. (Transactions of the
American public health association,
N. Y., 1877, v. 3: 69-78.)
Bibliography (American)
377
sey bureau of statistics of labor and
industries, twenty-fourth annual re-
...; Trenton, 1902, p. 355-363; 373-
391.
Description of unhealthful occupations,
statistics of sickness and death, and sched-
ules from 24 establishments, filled in by
employers.
Goldmark, Josephine. Fatigue and ef-
ficiency; a study in industry. . Char-
ities publication committee for the
Russell Sage foundation, New York,
I912, 890 p.
Thorough, scientific, and authoritative
study based on European and American ex-
periments and experience, and on European
authorities. Part II consists of material
used in four briefs for the regulation of
the hours of women.
Goltman, A. A case of occupation
neurosis. (New York medical jour-
nal, 1898, v. 68: 625-626.)
In a cigarette roller.
Gonley, John W. S. Excision and dis-
articulation of the entire inferior
maxillary bone for phosphorus ne-
crosis. Philadelphia, I877, 6 p.
History of interesting case and operation
in 1864.
Gordon, John A. Tuberculosis among
the granite workers of Quincy. (In
Tuberculosis in Massachusetts, ed.
by Edwin A. Locke, p. 193-200.)
Based on analysis of death records of
Quincy, Mass.
Graham-Rogers, C. T. Protection
from gases, fumes and vapors: top-
ical criticism of existing laws.
(American labor legislation review,
June 1911, v. I, no. 2: IIO-II2.)
An argument, based on several years’ med-
ical practice in a Rhode Island factory vil-
lage, for child labor legislation, regulation
of hours, and medical factory inspection.
George, H. The poisons of the man-
ufactory. (Popular science monthly,
N. Y., 1882, v. 21: 663-667.)
Brief general article on industrial poisons,
lead, mercury, phosphorus, etc.
Getchell, Albert C. The relation of the
industries of Worcester to tuber-
culosis. (In Tuberculosis in Massa-
chusetts, ed. by Edwin A. Locke,
p. 187-192.)
Based on personal observation of 1000
CalSeS.
Gibson, Harold K. Medical inspec-
tion of factories in Illinois. (Amer-
ican labor legislation review, June
1912, v. 2, no. 2: 346-349.)
Gilbert, G. R. Effects of gases and
powder smoke upon coal miners'
eyes, and the treatment to be used.
(Therapeutical gazette, Detroit, Igo3,
3. s. v. Ig:529-532.)
ased on experience as surgeon of a coal
mining company in Wyoming.
Gilchrist, T. C. Erysipeloid, with a
record of 329 cases, of which 323
were caused by crab bites or les-
ions produced by crabs. (Journal
of cutaneous diseases, 1904, v. 22:
50Z-519) . . .
Description of disease and cases, some
of them due to occupational causes.
(Ohio
Gilliam, D. T. Miner’s wrist.
medical recorder, Columbus, 1878, v.
2: 542-543.) -
Based on personal observations.
Glass industry. (Report on condition
of woman and child wage-earners
in the United States, 61st Cong., 2d
sess., Senate doc. 645. Prepared un-
der the direction of Chas. P. Neill,
commissioner of labor. v. 3. “Dif-
ficulty and physical strain of the
work”, p. 47–59; “Dust and fumes”
and “Heat conditions”, p. 65-80;
“Causes of death of glass blowers
and diseases of glass workers”, p.
237–277; “Light, ventilation, and
overcrowding”, p. 341, 342; “Rela-
tion of the work to health”, p. 433-
447; “Special features of the work”
of making incandescent electric
lamps, and “Ventilation”, p. 477-487,
500, 501.) º º - a -
Results of extensive, official investigations.
... ...... Diseases incident to the glass
industry. Diseases and disease ten-
dencies of occupations. (New Jer-
e e s tº 9 - > * Medical inspection of indus-
trial plants. (Proceedings of the
eighth annual conference of sani-
tary officers of the state of New
York, Albany, Dec. I-3, 1908. Twen-
ty-ninth annual report of the N. Y.
state department of health, Albany,
1909, p. 726-736. Discussion, p. 736-
742. Also North American journal
of homoeopathy, 3. s. v. 24: 386–395.)
General description of the work of the
sanitary inspector of factories, with remarks
on physical condition of the working child.
e e s e º e º e Report of medical inspector
of factories, New York. (Eighth
annual report of the commissioner
of labor, for the year ended Sept.
30, 1908. Appendix II, p. 65-94,
Albany, 1909.) -
• e i s e º e < e < e < * * * (Ninth annual report of
the commissioner of labor for the
year ended Sept. 30, 1909. Appendix
378
American Labor Legislation Review
II, p. 68-91. Albany, 1910.)
fatigue. (World’s work, Sept. 1907,
v. I4: 9345-9349. Also in his Mind
and work, N. Y., 1908, p. 89-109.)
Hackley, Chas. E., Walter, Emma E.
Caisson disease. (In Reference
handbook of the medical sciences,
Albert H. Buck, ed., v. 2:547-8.)
Brief general discussion.
Haines, Walter S., Karasek, Mathew,
Apfelbach, George L. Carbon mon-
Oxide poisoning. (Report of Illin-
ois commission on occupational dis-
eases, Jan. I9 II, p. 88-98.)
Based on original investigations in Illinois
steel and illuminating gas industries, with
suggestions for prevention and treatment.
Hall, H. N. Preventive medicine
among the working classes. (Med-
ical news, Philadelphia, 1891, v. 58:
462-465.) & º
Based on experience as physician of the
Crane Company, Chicago, and covering occu-
pational and other diseases.
(Na-
Hall, J. N. Trainman’s back.
tional association of railway sur-
geons. Official report of the fifth
annual meeting. Chicago, 1892, p.
88-91.)
Based on experience among employees of
the Union Pacific Railway.
Hamilton, Alice. White-lead indus-
try in the United States, with an
appendix on the lead-oxide indus-
try. (U. S. Bureau of labor, Bul-
letin no. 95, July 1911, p. 189-259.)
Based on personal investigation of 22 out
Includes special investigation of the calico
print industry, bakeries in Manhattan bor- .
ough, and potteries.
e e e s tº e º e º º 'º it ... (Eleventh annual report
of the commissioner of labor for the
year ended Sept. 30, 1911. Appendix
II, p. 69-133. Albany, IQI2.)
Includes special investigation of ventila-
tion of a department store and of the cloak
and suit industry in New York City.
tº e º e º C º º . . . . . . (Tenth annual report of
the commissioner of labor for the
year ended Sept. 30, 1910. Appendix
II, p. 62-III. Albany, 1911.)
Includes special investigation of the phos-
phorus match industry and the pearl button
industry.
These reports contain valuable data con-
cerning the sanitation and ventilation of fac-
tories, the results of air analyses, etc.
tº & e º 'º º º tº Ventilation of industrial es-
tablishments. (American journal of
public hygiene, Boston, June 1910, v.
20: 245-251.)
Brief description of the work of the Medi-
cal Inspector of Factories of New York,
with special reference to air analyses.
tº tº º tº g tº gº tº Medical inspection of indus-
trial plants. (North American jour-
nal of homoeopathy, N. Y., 1909, v.
57:386--395.) *
Green, Charles Lyman. Medical ex-
amination for life insurance. “Oc-
cupation”, Phila., 1900 ed. p. I47; 2nd
ed., Phila., 1905, p. 155-I57.)
Brief discussion from point of view of
life insurance risks, of occupations involv-
ing injurious exercise. gº tº
Green, J. O. The factory system in its
hygienic relations. (Medical com:
munications, Massachusetts medical
society, Boston, 1842-8, v. 7:217-248.
Also reprint.)
Extended discussion of Lowell factory
system and its effects on the health of opera-
tives, with .#;"; statistics, and brief ac-
count of English factory system, especially
hours and child labor. * e
Griswold, S. Case of poisoning by ar-
senic from working in Scheel’s
green. (New York journal of med-
icine, 1858, 3. s. v. 5:64-77.)
Death of a fourteen year old boy who had
been working in an establishment for the
manufacture of paper hangings, with account
of proceedings of the coroner’s jury.
Guilford, Paul. Will certain occupa-
tions in time affect the cylindrical
curvature of the eyeball? (Ophthal-
mic record, Chicago, Sept. Igo3, n.
s., v. 12:426-428.)
Results of examination of 22 locomotive
engineers over 50 years of age.
Gulick, Luther. The effects of mental
of 25 factories manufacturing white lead in
the United States.
Report on investigations of
the lead troubles in Illinois from the
hygienic standpoint. (Report of
Illinois commission on occupational
diseases, Jan. 1911, p. 21-49.
Covers some fifteen different industries.
Report on arsenic (p. 47-48).
tº gº tº tº e º 'º º Lead poisoning in Illinois.
(American association for labor leg-
islation, 1910. Publication no. Io:
27–35.) tº g
Brief general discussion based on pre-
liminary investigations for her report to
Illinois Commission on Occupational Dis-
eases (q. v.).
Lead poisoning in Illinois.
(American labor legislation review,
Jan. IQII, v. I, no. I: 17-26. Bulle-
tin of the American economic asso-
ciation, fourth series, no. 2: 257-264.)
Lead poisoning in Illinois.
(Journal of the American medical
association, April 29, 1911, v. 56,
I240-1244.)
Bibliography (American) 379
Two general discussions, with comparison
of conditions in Europe and in Illinois.
......Occupational diseases. (Hu-
man engineering, 1911, v. I:I42-149.)
...: ..... Industrial diseases, with spe-
cial reference to the trades in which
women are employed. (Charities
and the commons, Sept. 5, 1908, v.
20:655-659.)
Hamilton, Allan McLane. On manu-
facturing establishments where lead
and arsenic are used. (New York
city board of health report, 1872, p.
312-314.). * , º a tº
Descriptive account of an investigation
of several typefoundries, lead-smelting, and
shot and lead-pipe manufactories.
........ On the liability of car-drivers
to certain forms of disease. (New
York city board of health report,
I873, p. 444-5.)
Diseases of circulatory and nervous sys-
tems due to long hours of labor.
Hamlin, A. C. Consumption as affect-
ed by seafaring pursuits. (Report
supervising surgeon, marine hospital
service, 1875. Washington, 1876, p.
187-190.)
Brief, general discussion.
Hanson, W. C. Attitude of Massa-
chusetts manufacturers toward the
health of their employees. (U. S.
Bureau of labor, Bulletin no. 96,
Sept. 1911, p. 488-500.)
On health and welfare work and Worces-
ter tuberculosis movement.
tº e º 'º e º 'º e The work of the state inspec-
tors of health. (In Tuberculosis in
Massachusetts, ed. by Edwin A.
Locke, Boston, 1908, p. 18–28.)
Brief description of their duties in fac-
tories and workshops. & º:
e e º e s tº º e The effect of industry on
health. Boston, 1907, 12 p. (Bos-
ton medical and surgical journal,
April 4, 1907, v. I56: 421-425. Also
reprinted as pamphlet.)
Brief review of investigation conducted
by Dr. Charles Harrington (q.v.) for the
Massachusetts State Board of Health, into
the sanitary condition of factories, workshops
and other establishments.
tº s e º 'º e º e Protection of factory em-
ployees against dust arising from
certain occupations. (American
journal of public hygiene, Boston,
June 1910, v. 20: 239-244.)
Description of methods used by State
Inspectors of Health in , enforcing the two
Massachusetts laws relating to dust.
a s s s a e º º The health of young persons
in Massachusetts factories. (Bos-
Harrington, Charles.
ton medical and surgical journal,
1910, v. I62: 313-314. Proceedings
Sixth annual conference on child la-
bor, Boston, Jan. I3-16, 1910, p. III-
II.3).
Brief account of duties and opportunities
# ; Massachusetts State Inspectors of
ealth.
Hard, William. Where poison haunts
man's daily work. (Munsey's mag-
azine, Sept. 1907, v. 37: 717-721.)
Popular article on occupational poisons
and caisson disease.
Hare, Hobart Amory. New and al-
tered forms of disease, due to the ad-
vance of civilization in the last half
century. Philadelphia, P. Blakiston,
son & co., 1886, 71 p.
Caisson disease, phosphorus necrosis, lead
poisoning, etc.
A manual of .
practical hygiene for students, phy-
sicians, and medical officers, 4th
ed., revised and enlarged by Mark
Wyman Richardson. Philadelphia
and New York, Lea and Febiger,
1911, 13, 17–760 p. “Hygiene of oc-
cupation”: p. 716–742.
Thorough general treatise on the causes
of industrial diseases, including classifica-
tion and description of unhealthful occupa-
tions, and brief discussion of employment of
women and children in such occupations.
. . . . . . . Report of the Massachusetts
State board of health upon the san-
itary condition of factories, work-
shops and other establishments
where persons are employed. Bos-
ton, Wright & Potter printing co.,
state printers, 1907. I44 p. Run-
ning title: Dangerous occupations.
<Mar. Igo7.> Senate. No. 250.
Continuous report pub. in thirty-
sixth Annual report of the Board,
I903-04, p. xxii-xxxi.
Results of a special investigation of dan-
gerous processes in some 65 different indus-
tries, with special attention to boot and
shoe and textile factories.
Harris, Henry J. Workmen’s insur-
ance in Austria and Germany. (In
Twenty-fourth annual report of the
U. S. commissioner of labor, 1909,
v. I. Also reprints. Statistics of
sickness in Austria, 1890-1895, p. 293–
395. Statistics of sickness in Ger-
many, p. 1243-1251; “Sickness sta-
tistics of the Leipzig local sick
fund”, p. 1255-1354.)
Hatch, Leonard W. Compulsory re-
porting by physicians. (American
38o
American Labor Legislation Review
labor legislation review, June 1912,
v. 2, no. 2: 264-272.)
© tº tº e º 'º º º State control of occupational
diseases. (Medical record, N. Y.,
Feb. 3, 1912, v. 81: 202-205.)
Explanation of need for and purpose of
New York, law requiring the reporting of
occupational diseases.
Hatters, Vital statistics of. (Semi-
annual reports of the United hatters
of North America.)
Hatting industry, Health conditions of
the. Diseases and disease tenden-
cies of occupations. (New Jersey
bureau of statistics of labor and in-
dustries, twenty-fourth annual re-
port, Trenton, 1902, p. 365-37I, 392-
399. Continued in twenty-fifth an-
nual report, I003, p. 361-362.)
Description of processes dangerous to
health. Publishes schedules filled in by em-
ployers for 11 establishments.
Hayes, Denis A. Length of trade life
in the glass bottle industry. (An-
nals of the American academy of
political and social science, May
1906, v. 27, no. 3: 34-41.) tº a tº
General discussion, without statistics,
mainly of child labor.
Hayhurst, Emery R. Report of the
investigation of the brass manufac-
turing industry, Chicago (Cook
county), and the zinc smelters of
La Salle county, Illinois. (Report
of Illinois commission on occupa-
tional diseases, Jan. IQII, p. 49-84.)
Results of original investigation.
e - © e is e º – Brass chills: brass moulder's
(Survey, Sept. 23, 1911, v.
26: 879-82. Illustrated.) te
General discussion based on results of his
investigations for Illinois Commission on Oc-
cupational Diseases (q. v.).
Health and duration of trade life of
workmen, The effect of occupation
on. (New Jersey bureau of statis-
tics of labor and industries, twelfth
annual report, p. 1-303; thirteenth
annual report, p. 357-413; fourteenth
annual report, p. 171-234; fifteenth
annual report, p. 347-432; seven-
teenth annual report, p. 81-135; eigh-
teenth annual report, p. 63-161, 1889–
1895.). . . . © a
Statistics of ages at beginning work, ages
of journeymen beginning to decline, causes
of decline and of incapacity, etc., by occu-
pations, with descriptions of industrial pro-
cesses and conditions.
Health, The relation of occupation to.
(New Jersey bureau of statistics of
labor and industries, thirty-third
annual report, Paterson, 1910, p.
I67–178.)
General discussion with brief description
of health measures in use in certain estab-
lishments.
Health and its relation to occupation.
(Ohio bureau of labor statistics,
tenth annual report, 1886, p. 206.)
Health and morals in their relation to
occupation. (New York bureau of
gº first annual report, 1885, p.
5.
Health in industries. (Montana bu-
reau of agriculture, labor and indus-
try, first annual report, Helena, 1893,
p. 18-132.)
Individual reports of quartz miners, smelt-
er men, engineers, and others, showing
health at beginning work, health “now”, and
sanitary conditions of their work. Analysis
of these reports by occupations.
Health in industry. (Wisconsin bu-
reau of statistics, third biennial re-
port, 1887–88, p. 189–213. Table V.
“Trade statistics, showing peculiar-
ities of occupations, ailments of
workmen,” etc.)
Compiled from reports made by workmen
as to bodily ailments peculiar to their trades.
Health in various industries and causes
of decline. (New Jersey bureau of
statistics of labor and industries,
sixth annual report, Trenton, 1883,
p. 80-109.)
Tables, showing age at which the work-
men begin to decline, age at which they be-
come incapacitated for active work, and dis-
eases peculiar to the trade, for glass, silk,
cotton, woolen, hat, and other industries.
Health of employees in various in-
dustries. (California bureau of la-
bor statistics, fifth biennial report,
Sacramento, 1891-92, p. 245-465.)
Tabulated statements of individual wage
earners showing time lost by reason of
sickness.
Heaton, James P. World-wide fight
against phosphorus poisoning. (Sur-
vey, Dec. 3, 1910, v. 25: 384-388.)
Popular, general article.
Hedger, Caroline. The relation of in-
fant mortality to the occupation and
long hours of work for women.
(Bulletin of the American academy
of medicine, Easton, Pa., 1910, y.
II: 80-89. Discussion, p. 89-91.)
Effect of work on health of women, with
mortality statistics for Fall River, Provi-
dence, Chicago, and York (Eng.).
Heinemann, O. S. Necrosis of the
maxillae by phosphorus poisoning.
(Ohio dental journal, Toledo, 1901,
v. 21:215-219.)
Bibliography (American)
381
General discussion, with special reference
to lucifer-match workers.
Henderson, Charles R. Occupational
diseases in Illinois. (American as-
sociation for labor legislation, 1910.
Publication no. Io: 19-27.
On the origin, plan, and methods of the
Occupational Disease Commission.
Hessler, Robert. Dust; a neglected
factor in ill health. (Transactions
Indiana State medical society, 1904.)
Hill, Leonard. Caisson sickness and
compressed air. (Scientific Ameri-
can supplement, Oct. 21-28, 1911, v.
72: 270–271, 282-283.)
Excellent treatment by leading English
authority on the subject.
Hinsdale, Guy. The occupation neu-
roses. Illustrated. (In Wilson and
Eshner, An American textbook of
applied therapeutics, p. III3-II21.
Philadelphia, 1896.)
On writer’s and telegrapher’s cramp and
their treatment.
Hirt, L. Tobacco dust in the lungs.
The effect of the dust upon the
health of workers in tobacco. (Clin-
ic, Cincinnati, 1872, v. 3: IO2-105.)
Translated from Hirt’s Krankheiten der
Arbeiter, Breslau, 1871.
Hobbs, W. R. Industrial lead poison-
ing. (New York medical journal,
1898, v. 67: 323-325.) -
Results of four years’ experience among
lead workers, with statistics.
Hodgen, J. T. Effects of compressed
air upon the human body. (Medical
archives, St. Louis, 1870-71, v. 5:
219–226.)
A criticism of Dr. Clark’s article (q. v.).
Hoffman, Frederick L. Mortality from
consumption in dusty trades (in-
cluding list of references on occupa-
tion mortality). (U. S. Bureau of la-
bor, Bulletin no. 79, Nov. 1908, p.
633-875.) tº a º º
Thorough, statistical study by classified
occupations.
........ Mortality from consumption
in occupations exposing to munici-
pal and general organic dust. (U. S.
Bureau of labor, Bulletin no. 82,
May 1909, p. 471-638.)
Practically a continuation of the preced-
ing report, taking up a new series of occu-
pations. º
e o 'o e o 'º e e Problem and extent of indus-
trial diseases. (American associa-
tion for labor legislation, 1910. Pub-
lication no. Io:35-52.)
General treatment, with estimate of mone-
tary loss from sickness and accidents. Mor-
tality statistics.
. . . . . . . Industrial diseases in Amer-
ica. (American labor legislation re-
view, Jan. I9II, v. I, no. I : 35-41.
Bulletin of the American economic
association, 4th series, no. 2: 271-
276.
Brief general discussion of needs.
. . . . . . . . Legal protection from injur-
ious dusts: topical criticism of ex-
isting laws. (American labor legis-
lation review, June 1911, v. I, no.
2: IIO-II2.)
. . . . . . . . Intensive investigations in in-
dustrial hygiene. (American labor
legislation review, June 1912, v. 2,
no. 2:255-263.)
tº e º e º ºs º º Physical and medical aspects
of labor and industry. (Annals of
the American academy of political
and social science, May 1906, v. 27,
no. 3: 3-28.)
On efficiency as related to preventable
mortality, trade diseases, industrial acci-
dents, etc., with recommendations for scien-
tific inquiry. -
. . . . . . . Industrial accidents and in-
dustrial diseases. (Quarterly pub-
lications of the American statistical
association, 1908-1909, Boston, v. II:
567-603.)
Plea for legislation, with statistics relat-
ing mainly to accidents.
... Influence of trades on disease.
(North American journal of homoe-
opathy, N. Y., 1910, 3rd ser., v. 25:
234-250; Proceedings of ninth annual
conference of sanitary officers of
state of New York, Nov. 1910, New
York state department of health,
thirtieth annual report, v. I: 421-437.
Discussion, p. 437-439.)
. . Argument for conservation of health, or-
iginal research, medical factory inspection,
and legislation.
. . . . . . . . Relation of occupation to tu-
berculosis. (Medical examiner and
general practitioner, Sept. 1907, v.
17:265-276.)
. . . . . . . . Dust as a factor in occupa-
tion mortality. (Medical examiner
and general practitioner, Dec. 1907,
v. 17:360-375.) . . .
Two papers relating primarily to consump-
tion, with mortality statistics based on ex-
perience of Prudential Insurance Co., simi-
lar to but not as complete or recent as his
reports for the U. S. Labor Bureau (q.v.).
tº e º e e ... Prevention of disease by the
elimination of dust. (American city
magazine, May 1911, v. 4:213–216.
Also in Proceedings of the first an-
© e º 'º º º
382
---,
American Labor Legislation Review
nual conference of mayors of the
cities of New York, June 1910.)
Brief discussion of outdoor public dusts,
household dusts, and industrial dusts.
ge e º e º 'º ... Medical and social aspects of
child labor. (Medical examiner and
practitioner, Aug. I903, v. I3: 470-
£íaborate statistical study based on
measurements of school children.
e e º e º e º a Occupation mortality statis-
tics of England and Wales. (Spec-
tator, N.Y., Qct. 22, 1908) &
• * * * * * * * Tuberculosis as an industrial
disease. (Transactions of the Sixth
international congress on tuberculo-
sis. Washington, 1908, v. 3: I4I-
I75.) . * - -
Extensive statistical treatment of the
dusty trades similar to his reports for the
United States Labor Bureau (q. v.).
e e o e º 'º º º Trade mortality statistics.
(American journal of public hy-
giene, 1910, v. 20: 126-132.)
Brief paper on methods, without figures.
. . . . . . Problems of social statistics
and social research. (Quarterly
publications of American statistical
association, June 1908, v. II: IO5-
I32.)
frief discussion of the problem of prevent-
able diseases, p. 116-117. Table showing mor-
tality from consumption in certain occupa-
tions, p. 128. . • . tº
e e e s - e. ... The vital statistics of the cen:
sus of 1900. (American statistical
association, quarterly publications,
Dec. 1902, v. 8: 127-202).
Theoretical discussion showing what occu-
pation mortality statistics are contained in
the Twelfth Census, p. 170-179, 181-185, 186,
etc. -
Holden, E. Relative mortality of mar-
iners, railroad men, and travellers,
(American journal of medical
science, 1876, v. 141: 102-II3).
Disease treated merely as accounting for
deaths not due to accident, the chief sub-
ject under discussion. -
Homan, George. The leading local
productive industries, and their ef-
fect on the health and lives of their
operatives. (American public health
association. Public health papers
and reports, 1884. Concord, N. H.,
1885, v. Io:327–328.) . .
Outline of proposed inquiry into tobacco
industry of St. Louis, with series of ques-
tions.
Hopkins, G. G. The neural disorders
of writers and artisans. (Brooklyn
medical journal, 1888, v. 2:384-389.)
.*
General discussion with description of
several cases.
Hoppe, H. H. Occupation neurosis.
(Cincinnati lancet-clinic, 1894, n. S. v.
32: I-2.) -
Single case in a type-setter.
Hotchkiss, S. C. Occupational dis-
eases in the mining industry.
(American labor legislation review,
Feb. 1912, v. 2, no. I : I31-I40.)
Based on personal investigations in Color-
ado for the U. S. Bureau of Mines and U. S.
Public Health and Marine-Hospital Service.
Huber, J. B. Occupations with relation
to tuberculosis. (American medi-
cine, Philadelphia, Jan. 21, 1905, v.
9: II2-II4.) -
Based on diagram prepared by Miss
Brandt, statistician of the Charity Qrgani-
zation Society of New York, and considering
53 occupations.
Hughes, C. H. Railway brain strain
of and brain strain regulation of
railway employees. (Alienist and
neurologist, St. Louis, 1906, v. 27:
189-199.) e
Urging sanitary regulations to prevent
railway accidents due to overwork of em-
ployees.
Hunt, Ezra M. The hygiene of occu-
pations. General introduction.
(Tenth annual report of the Board
of health of the state of New Jersey,
1886. p. 157-166.)
Gives long quotations from physicians,
relating especially to diseases due to dust.
s & e º e º e y Relation of trades and occu-
pations to public health. (New Jer-
sey State board of health, fourteenth
annual report, 1890, p. 135-138.)
Abstracts from lectures by Dr. Arlidge of
England.
Hunt, J. Ramsey. Occupation neuri-
tis of the deep palmar branch of
the ulnar nerve. (Cornell university
medical bulletin, Oct. 1911.)
Hunter, Arthur. Mortality among in-
sured lives engaged in certain occu-
pations involving additional hazard.
(Actuarial society of America,
transactions. I907, v. Io: 44-59.)
Hunter, Robert. A plea for the inves-
tigation of the conditions affecting
the length of trade life. (Annals of
the American academy of political
and social science, May 1906, v. 27,
no. 3: 38-45.)
Hutchcroft, L. W. The mortality
from industrial diseases. (American
journal of public hygiene, Boston,
1909, v. 19: Io9-II6. Also in Ameri-
can public health association report,
1908, v. 34, pt. I:356-363.)
Bibliography (American) 383
Industrial hygiene.
Injurious trades.
tion 58 of the labor law. (New York
department of labor, Bulletin no. 50,
March 1912, p. 96.)
(American public
health association report, Concord,
1896, v. 21: 367-372.)
Review of report of Parliamentary Com-
mittee of Great Britain on certain dangerous
trades, bronzing, paper staining, india-rubber
manufacture, etc.
Health and safety
in factories and mercantile estab-
lishments. (U. S. Industrial com-
mission report, v. Ig: 90I-904. Wash-
ington, 1902.)
Brief general discussion of specially in-
jurious trades.
International association for labor
legislation and its publications. (U.
S. Bureau of labor, Bulletin no. 86,
Jan. I9IO, p. 169-184.)
Brief description of the work of the
association and bibliography of its publi-
cations.
tº gº tº tº tº º tº ſº Resolutions of the sixth dele-
gates’ meeting. (U. S. Bureau of
labor. Bulletin no. 92, Jan. I9II, p.
182-193)
On administration of labor laws, child
labor, night work, hours, home work, indus-
trial poisons, work in compressed air, etc.
Ireland, George H. The preventable
causes of disease, injury, and death
in American manufactories and
workshops, and the best means and
appliances for preventing and avoid-
ing them. Concord, N. H., Repub-
lican press association, 1886. IQ p.
(American public health association.
Lomb prize essay, no. 4.) (Issued
also in American public health asso-
ciation. Public health. Concord,
N. H., 1886, p. 137-153.)
General description of how to build and
equip a factory, recommending proper ven-
tilation but giving no consideration to speci-
fic industrial diseases.
Ivy, Robert H. Prevention of indus-
trial phosphorus poisoning. (Amer-
ican medical association journal,
Chicago, IQII, v. 56: IoI8-1019.)
Based on experience in supervision of
health of employees in a large match fac:
tory, arguing that prohibition of use of
poisonous phosphorus is not necessary.
Jacobi, A. The physical cost of wom-
en’s work. (Charities and the com-
mons, 1907, v. 17: 839-844.) g
Overwork of women and its effect on their
health, with brief discussion of legislation.
Jaminet, A. Physical effects of com-
Brief plea for vital statistics that will
show relation of occupation to death and for
state investigation and regulation of con-
ditions of employment.
Hutchinson, Woods. Health of em-
ployees as an investment. (Satur-
day evening post, Philadelphia, Aug.
24, 1907, v. 180, no. 8: I2-13. Illus-
trated.)
Brief, popular discussion of hours, wages,
ventilation, lead poisoning, accidents, etc.
. . . . . The hygienic aspects of the
shirt-waist strike. (Survey, N. Y.,
Jan. 22, 1910, v. 23: 541-550.)
Based on personal investigations of san-
itary conditions in the shirt-waist factories
of New York City. e ©
Hygiene of the sewing machine; a
brief inquiry into the causes of dis-
orders arising from the use of mach-
ines, with suggestions as how [sic]
they may be avoided. By a physi-
cian. Baltimore. Turnbull. I874.
40 p. Illustrated.
Argument to show that “sewing machine
diseases” are due to improper posture of the
body and overstrain of certain muscles, and
that operatives are healthier in factories
where steam power is employed, with ana-
tomical causes.
Hygienic conditions in American em-
ployment. (Consular report 278,
Nov. 1903, p. 456.)
Brief review of findings of the Moseley
commission sent from England to study con-
ditions in the United States.
Illinois commission on occupational
diseases. Report . . . to Governor
Charles S. Deneen. Jan. Igi I. Chi-
Cago, IQII, 2IQ p.
Authoritative treatise based on original in-
vestigations by experts (see Hamilton, Hay-
hurst, Nicholl, Haines, Karasek, Bassoe,
Shambaugh, and Lane), with general des-
cription of the work, discussion of prin-
ciples of effective legislation, text of pro-
posed bills, suggestions for cards of instruc-
tion of employees in dangerous trades, pro-
visions of protective laws in states of the
Union and in European legislation, index of
protective legislation in the United States,
and extracts from Dr. Andrews' report for
the U. S. Labor Bureau on phosphorus poi-
soning (q. v.). e
e g º 'º e º ſº tº Governor’s special message,
transmitting the report of the Com-
mission on occupational diseases to
the Forty-sixth General assembly.
April, 1909. Springfield, Ill., Illin-
ois state journal co., state printers,
1909. 8 p.
e is a e º e º & (Review of report). (U. S.
Labor bureau, Bulletin no. 92, Jan.
1911, 194-202.)
Industrial diseases reported under sec-
pressed air and causes of pathologi-
cal symptoms produced on man by
384
American Labor Legislation Review
increased atmospheric pressure em-
ployed for the sinking of piers in
the construction of the Illinois and
St. Louis bridge over the Mississippi .
river. St. Louis, 1871. I35 p.
Historically, interesting as first extensive
treatise on the subject published in this
country, _ describing 119 cases and 14
deaths. By the physician in charge of the
employees.
Japp, Henry. Caisson disease and its
prevention. (American society of
civil engineers, transactions. N. Y.,
I909, v. 35, no. 4: I-37.)
Comprehensive, practical treatment from
engineering. point of view, by the engineer of
the East River Tunnel, New York. -
Jeffries, B. Joy. Our eyes and our in-
dustries. (Massachusetts State
board of health report, 1882-3. Sup-
plement, p. 89-II?. Also in part in
West Virginia State board of health
reports, 1881–84, p. 178–187.)
Overstrain of the eyes in industries and in
schools.
Jewelry industry, Health conditions of
the. , Diseases and disease ten-
dencies of occupations. (New Jersey
bureau of statistics of labor and in-
dustries, twenty-fifth annual report,
I993, p. 363-369.) ſº
General description of factors producing
ill health, and sickness statistics of 19 firms.
Johnson, An unusual powder
smoke fatality. (Colorado medicine,
April, 1911.) -
Account of death from effects of nitrous
fumes of nine out of a bunch of thirteen
men who inhaled the smoke of a single blast
in the Gunnison Tunnel.
Joint board of sanitary control in the
cloak, suit and skirt industry of
greater New York. First annual re-
port, N. Y., Oct. 1911.
Contains information with regard to pres-
ent conditions.
Jones, J. D. Effect of occupation on
health of individuals. (Ohio State
. "board of health report, 1886-7. Col-
umbus, 1888, v. 2: 311-316. Also Cin-
cinnati lancet-clinic, 1888, n. s. v. 21:
355-358.) . . . . . &
Brief general article discussing workers in
lead, file cutters, etc.
Karasek, Stella, Karasek, Matthew.
Preliminary report on the injurious
effects of metol, platinum, chro-
mates, cyanides, hydrofluoric acid
and of materials used in silvering
mirrors. (Report of Illinois com-
mission on occupational diseases,
Jan. 1911, p. 96-98.)
Results of original investigation.
Keays, Frederick L. Compressed-air
illness, with a report of 3,692 cases.
(Cornell university medical college
bulletin, Oct. Igo9, v. 2: I-55.)
Authoritative article by physician in
charge of the East River Tunnels, New York. .
Compressed-air illness. (Amer-
ican labor legislation review, June
I912, v. 2, no. 2: IQ2-205.)
Kelley, Florence. The sex problems
in industrial hygiene. (American
journal of public hygiene, Boston.
June 1910, v. 20:252-257.)
Brief plea for legal regulation of the
hours of labor of women to prevent exces-
sive fatigue.
Kimball, D. D. Ventilation and pub-
lic health. (Annals of the Ameri-
can academy of political and social
science, March 1911, p. 207-219.)
General article, only incidentally relating
to factory ventilation.
King, William A. Mortality statistics
of the census in relation to occupa-
tions. (American journal of sociol-
ogy, Sept. 1897, v. 3: 216-235.)
Ten tables with discussion.
Klink, Jane S. The health of women
workers. (Academy of political sci-
ence, New York, v. 2, no. 2: 35-40.)
Based on experience as welfare manager
of a Brooklyn laundry.
Knapp, C. P. The caisson disease.
(Lehigh valley medical magazine,
Easton, Pa., 1891-2, v. 3: I-12.)
General discussion and history of 17 cases
that came under his observation as surgeon
during the sinking of two caissons for a
coal mining company.
Knapp, P. C. A case of professional.
neurosis of co-ordination of unus-
ual origin. (Journal of nervous and
mental diseases, N. Y., 1887, n. s.,
v. I2:41-45. Also reprint.)
In a carpet maker, with general discussion
of occupation neuroses.
Kober, George Martin. Industrial
hygiene. A report of the committee
on social betterment of the Presi-
dent's homes commission, 1908.
Washington, D. C., iv, 8-175 p.
(Also in reports of the President’s
homes commission, 60th Cong., 2d
sess., Senate doc. 644, p. 25-107.
Washington, 1909.)
Comprehensive general treatise on con-
ditions in 1907 in a considerable number
of trades, with discussion of measures, legal
and otherwise, which would improve con-
ditions. ©
. . . . . . . . Industrial hygiene. (U. S.
Bureau of labor, Bulletin no. 75,
March 1908, p. 472-591.)
Bibliography (American)
385
Similar to the above, with text of English
laws for the regulation of dangerous and
unhealthful industries.
Korshet, M. Diseases of occupation.
(New York medical journal, IQII, V.
93: II34-II37.) tº a . e. º
On effects of chronic fatigue, occupation
dusts, industrial poisons, compressed air,
woman’s work, child labor, etc.
Lane, Francis, Ellis, John B. Miner's
nystagmus. (Report of Illinois com-
mission on occupational diseases,
Jan. 1911, p. I55.) . . º e tº
Brief report on investigations in Illinois.
Laundries, Employment of women in.
(Report on condition of woman and
child wage-earners in the United
States, 61st Cong., 2d sess., Senate
doc. 645, v. 12. Prepared under the
direction of Chas. P. Neill, commis-
sioner of labor. Effect of laundry
work upon health, p. 25-II8.)
Results of thorough investigation of this
industry in Chicago, New York, Brooklyn,
Philadelphia, and Rockford, Ill.
Law, James. Report on the malig-
nant anthrax in herds, and malig-
nant pustule in men, in Livingston
county, N. Y., in Sept. 1875. (Amer-
ican public health association. Re-
ports and papers, v. 2:465-467.).
Describes three cases of anthrax in the
manager of a farm and two German work-
IIle11,
Laws, G. C. The effects of nitro-gly-
cerine upon those who manufacture
it. (Journal of American medical
association, Chicago, 1898, v. 3I: 793–
794.)
Based on experience among employees of
a large nitro-glycerine factory in New Jersey.
Laws relating to occupational dis-
eases and industrial hygiene. (Twen-
ty-second annual report of the U.
S. commissioner of labor, Igo3.
U. S. Bureau of labor, Bulletins no.
85, 91 and 97.)
. . . . . . . Laws enacted during IQII re-
quiring the report of occupational
diseases. (U. S. Bureau of labor,
Bulletin no. 95, July 1911, p. 283-
288.)
e - © tº º ... Act providing for a tax on
white phosphorus matches and for
prohibiting their import or export.
[Approved April 9, 1912.] (U. S. Bu-
reau of labor, Bulletin no. IOO, May
1912, p. 760-762.)
Comfort, health and safety
Comparative analysis
(American labor
in factories.
of existing laws.
legislation review, June 19II, V. I,
no. 2: I-IOI.) t
e & © e º ºs e e Review of labor legislation of
1911. (American labor legislation
review, Oct. 1911. v. I, no. 3.)
Lea, M. C. On the poisonous effects
resulting from the employment of
arsenical preparations in the arts.
(American journal of medical sci-
ences, Phila., 1860, n. s. v. 40: IIo-
II2.)
Brief, general discussion of effects on em-
ployees and consumers, urging legislation to
stop its use.
Lead. Hearings before the Committee
on interstate and foreign commerce
of the House of representatives, on
H. R. 2190I. Manufacture, sale, etc.,
of adulterated or mislabeled white
1ead and mixed paint. May 31, 1910.
2 D.
s &ntains testimony on lead poisoning. See
111C16-X.
Leather industry, Health conditions of
the. Diseases and disease tenden-
cies of occupations. (New Jersey
bureau of statistics of labor and in-
dustries, twenty-ninth annual re-
port, Camden, IQ06, p. 209-23
4.
General discussion and statistics of health
and accident conditions.
Leupp, Constance D. Phossy jaw.
(Twentieth century magazine, Mar.
I912, v. 5: 28-35.)
Popular article based on Dr. Andrews’ in-
vestigations (q. v.).
Levis, R. J. Phosphor-necrosis. (Med-
ical and surgical reporter, Phila.,
1879, y. 4I: 450-451.).
Brief general description, based on ob-
servation of many cases in Philadelphia and
Wilmington match factories, and description
of a single case in a match factory worker.
Lewis, G. L. The effects of com-
pressed air upon the human system,
as evinced in the sinking of bridge
piers during the construction of the
Atchison bridge over the Missouri
river. (Transactions of the medical
society of Kansas, 1860–77, Law-
rence, 1884, v. I : 279-291.)
History of use of compressed air, de-
Scription of a caisson, and observations on
some fifty cases which he treated as Surgeon
of the American Bridge Company.
Lewis, Morris J. The neural disor-
ders of writers and artisans. (In
Pepper's American system of prac-
tical medicine, Philadelphia, 1886, v.
5: 504-543.) . .
Extended discussion of
cramps.
occupational
386
American Labor Legislation Review
Library of congress. Division of bibli-
ography. Select list of references
on occupational injuries and dis-
eases. Aug. 25, 1910. Typewritten
IO p.
Lincoln, David Francis. School and
industrial hygiene. Philadelphia.
Blakiston, 1880. American health
primers. I44 p.
Part II (p. 107-144) , is an elementary
treatise on industrial hygiene.
Linenthal, Harry. Sanitation of cloth-
ing factories and tenement-house
workrooms. (In Tuberculosis in
Massachusetts, ed. by Edwin A.
Locke, p. 28–36. Illustrated.)
Brief statement of conditions in men's
clothing industry in Boston.
. . . . . . . . The prevention of occupation:
al diseases. (Boston medical and
surgical journal, May 23, 1912, v.
I66: 779-783. Also reprint.)
Based on experience as state inspector of
health in Massachusetts. &
Lloyd, James Hendrie. The diseases
of occupations. (In Stedman, Twen-
tieth century practice. New York,
1895. v. 3:309-496.) .
Thorough treatise covering all the common
occupational diseases, with brief review of
the literature and of the legal restraints on
the employment of women and children in
the United States.
tº tº e º º e º e Occupation neuroses and poi-
sonings in the arts and by foods.
(In Modern treatment, ed. by H. A.
Hare, 1910-1911, v. 2: 583–619.)
Including miner's nystagmus, lead, ar-
senic, phosphorus and mercury poisoning,
etc.
Loeb, H. W. Railroad dust in rail-
roaders' noses. (National associa-
tion of railway surgeons. Official
report of the fifth annual meeting,
Chicago, 1892, p. 208-2II.)
Diseases resulting from such dust.
Loomis, H. . Miners’ phthises.
(Proceedings of the New York
pathological society, 1891. N. Y.,
1892, p. 52.) . g
Brief description of a lung, said to be an
example of “miner’s phthisis.”
Lovejoy, O. R. Age problems in in-
dustrial hygiene. (American jour-
nal of public hygiene, Boston, June
1910, v. 20:233-238.)
An argument for the legal regulation of
child labor.
Maclay, J. W. Prize essay on the re-
lations of the different professions
and vocations to longevity. N. Y.,
1873. 58 p.
Macleod, J. J. R. Cause, treatment
and prevention of the “bends” as
observed in caisson sickness. (As-
sociation of engineering societies
journal, Boston, 1907, v. 39: 283-302.)
An excellent, comprehensive article by
3. former associate of Leonard Hill in ex-
perimental work.
M'Cready, B. W. On the influence of
trades, professions and occupations
in the United States in the produc-
tion of disease. (In the Medical
society of New York. Transac-
tions, 1836-1837. Albany, 1837. v.
3: 9.1-159.). . . . -
Historically interesting as the first gen-
eral treatment of the subject in American
literature. Describes the unhealthful con-
ditions of work of seamen, women and chik
dren in textile factories, tailors, shoemakers,
sewing women, printers, butchers, Smiths,
gold beaters, carpenters, painters, profes-
sional men, etc. “Prize Dissertation for
1837.”
McConnell, J. W. Case of pronator
spasm in a compositor. (Philadel-
phia polyclinic, April 28, 1894, v. 3:
I61–162.)
Description of a single case.
tº e º e º e º e An uncommon case of occu-
pation neurosis. (Philadelphia poly-
clinic, March 20, 1897, v. 6: 123-124.)
In a brick sorter.
McDowell, W.J. Oyster shucker's
corneitis. (Virginia medical month-
ly, 1879, v. 5: 883-885.)
Based on experience with between forty
and fifty cases of this eye disease in oyster
shuckers.
McKay, George A. The effect upon
the health, morals, and mentality of
working people employed in over-
crowded workshops. (Fifth annual
report of the New York state fac-
tory inspector, Albany, 1891, p. 77-
O.
9 &n discussion of results of over-
crowding.
McNeill, George E. Dangerous trades
and occupations. (Insurance press,
N. Y., July 26, 1905, p. 2-4.) -
Industrial diseases from the insurance
point of view (9 columns).
Manning, Caroline. Violations of
health laws in women-employing in-
dustries. (In Labor laws and their
enforcement, with special reference
to Massachusetts. Susan M. Kings-
bury, ed. Boston, 1911. p. 152-155.)
Brief account of personal investigations
in 29 factories, stores and restaurants.
Manning, Wm. J. Health of em-
ployees in the government printing
Bibliography
(American)
387
office, Washington. (U. S. Bureau
of labor, Bulletin no. 75: 497-508.)
Mainly description of methods in use for
the prevention of lead poisoning.
Marriott, W. McKim. The air they
breathe in New York factories.
(Charities and the commons, Nov.
Io, 1906, v. I7: 274–276.)
Results of an examination of air in a
number of factories in New York City.
Table and chart.
Marshall, S. A. [Caisson disease.]
(Long Island medical journal, April,
I907, v. I : 183-184.)
Based on experience among workmen in
the Pennsylvania railroad tunnel. Discus-
sion of Dr. Gallivan’s paper (q. v.).
Martin, John. Factory legislation and
tuberculosis. (Transactions of the
Sixth, international congress on tu-
berculosis. Washington, IQ08. v. 3:
I79-183.) . *
Brief discussion of dusty occupations and
legislation providing for ventilation.
Massachusetts. First annual report of
the work of the state inspectors of
health. (In Thirty-ninth annual re-
port of the State board of health of
Massachusetts. Boston, I907, p.
459–485.)
tº e º e º 'º e e Second annual report. (In
Fortieth annual report of the State
board of health of Massachusetts.
Boston, 1908. p. 653–750. Illus-
trated.)
tº gº tº e º 'º º º Third annual report. (In For-
ty-first annual report of the State
board of health of Massachusetts.
Boston, 1909. p. 763–887.)
tº gº tº gº & e º e Fourth annual report. (In
Forty-second annual report of the
State board of health of Massachu-
setts. Boston, 1910. p. 437-556.)
tº e ∈ E → * * * Fifth annual report. (In For-
ty-third annual report of the State
board of health of Massachusetts.
Boston, 1911.)
These annual reports furnish a valuable
source of information on factory and work-
shop conditions and methods by which they
may be improved, and contain discussions
of specific occupational diseases and danger-
ous processes. But they also cover tene-
ment and schoolhouse hygiene, etc.
......... Massachusetts House docu-
ments no. 50, March, 1845; no. 153,
1850. (Reprinted in Documentary
history of American industrial so-
ciety, Cleveland, 1910, v. 8:133-186.)
Testimony, on effect of long hours of
labor on health of factory *:::::" (o
11t-
Mayo, Earl. Work that kills.
look, Sept. 23, K9II, v. 99: 203-213.
Illustrated.)
Popular, general article covering subject
of industrial diseases.
Mears, J. Ewing. Phosphorus necro-
sis of the jaws. (Philadelphia med-
ical times, Jan. 9, 1886, v. 16:264-
275. Illustrated. Also Transactions
American surgical association, 1885,
v. 3: 357-385. Also reprint.)
Elaborate paper , based on European
sources and on examinations of a large num-
ber of employees in match factories, and the
treatment of sixteen cases in this country.
Meigs, Arthur V. Caisson disease.
A clinical lecture. (Philadelphia
medical news, Nov. 28, 1885, v. 47:
589-592.) .
Based mainly on Jaminet’s, Smith's,
Bauer’s, and Clark’s articles, and on Wood-
zºº, History of the St. Louis Bridge
Memorial on occupational diseases.
Prepared by a committee of ex-
perts appointed by the American
association for labor legislation,
and presented to the President of
the United States. (American labor
legislation review, Jan. 1911, v. 1,
no. I : 125-I43. Also reprint.)
This memorial lays the groundwork for
a federal investigation.
Mercury. Physiological effects of the
mercury arc: its influence upon the
eye. (Scientific American supple-
ment, Oct. 7, 1911, v. 72: 235-236.)
Brief general article on artificial light,
with only incidental reference to working
people.
Merk, Fred. Industrial diseases. (Or-
ation, University of Wisconsin, n. p.
I9II. 5 p.)
Mettler, L. H. Occupation neuroses.
(Clinical review, Chicago, 1904-1905,
v. 21:43-60.) -
General discussion of various types of
nerve disorders due to occupation.
Middleton, P. Harvey. White phos-
phorus horror. (Technical world
magazine, April 1911, v. 15: 146-155.
Illustrated.)
Popular article. -
Miles, Henry A. Lowell as it was and
as it is. Lowell, 1845. 234 p. “Pro-
visions for the comfort and health
of the operatives”, p. II6-127.
e Argues that the factory population, espe-
cially the women, were in good health.
Miller, James A. Pulmonary tuber-
culosis among printers. (Transac-
tions of the Sixth international con-
gress on tuberculosis. Washington,
1908. v. 3: 209-216.)
388
American Labor Legislation Review
Results of thorough physical examinations
of 200 printers in New York City, with des-
cription of working conditions.
Mills, Charles Karsner. Occupation
neuroses; affections of the neuro-
muscular apparatus due to special
occupations. (In Loomis and
Thompson, A system of practical
medicine. v. 4:597-610. New York,
1898.)
Good general discussion of fatigue neu-
roses, occupation cramps and other forms of
nervous disease due to occupation, with
methods of treatment.
tº e º 'º - © tº º Mental overwork and prema-
ture disease among public and pro-
fessional men. (Smithsonian mis-
cellaneous collections, no. 594.
Washington, 1885, 34 p.) -
Moss, R. E. Occupations. (Medical
examiner and practitioner, N. Y.,
1902, v. I2: 7IO-712.)
Occupations as affecting insurance risks,
giving diseases characteristic of a large num-
ber of different occupations. e
Moyer, H. N. A rare occupation
neurosis (shoe salesman's disease).
(Medical news, Philadelphia, 1893, v.
62: 188-189.)
Brief general discussion and description of
a. single case.
Municipal ordinances, rules, and regu-
lations pertaining to public hygiene
adopted from January 1, 1910, to
June 30, 1911, by cities of the United
States having a population of over
25,000 in 1910. Prepared by direc-
tion of the surgeon general. U.S.
Public health, and marine-hospital
service. Washington, Gov't. print.
off, I912, 244 p. e
Murray, F. W. Anthrax maligna.
(New York medical journal, 1889,
v. 49: I44-147. Also reprint.)
General discussion, with a description
of four cases, a porter in a restaurant, a
longshoreman, a clerk, and a groom.
Myers, R. M. Cramps as affecting sto-
kers. (Virginia medical semi-month-
ly, Richmond, 1897-8, v. 2:552-553.)
Observations as ship surgeon on one of
the trans-Atlantic lines.
Nearing, Scott. Social adjustment.
New York, Macmillan co., 1911, 377
p. Ch. xi. “Dangerous trades”, p.
General discussion, and account of three
cases, all occupational in origin.
Nevin, John. Occupational diseases.
(Medical examiner and general prac-
titioner, N. Y., Aug. 1908, v. 19:254-
256.)
As affecting insurance risks.
Newton, W. K. An inquiry into the
causes of disease among workers in
silk, flax, and jute. (Tenth annual
report of the board of health of
New Jersey, 1886, Trenton, 1887, p.
188–194.)
Describes processes and sanitary condi-
tions in workrooms.
2II-22I.
Brief, popular discussion.
Neer, C. S. The value of examination
of the blood in the diagnosis of
chronic lead poisoning. (Interstate
medical journal, St. Louis, 1907, v.
14: 838–843.)
Occupation mortality statistics.
Nicholl, R. H., Flinn, T. E., Hay-
hurst, E. R. Effects of turpentine
upon the health of workmen. (Re-
port of Illinois commission on oc-
cupational diseases, Jan. I911, p.
84–88.).
Results of investigations of 62 men in
Chicago.
Nichols, Arthur H. The effects on
health of the use of sewing machines
moved by foot-power. (Massachu-
setts State board of health report,
I872, p. 180–22I.)
Based on personal investigations and re-
turns from many correspondents.
Norton, H. G. Dangers of the potters’ .
trade from the life insurance stand-
point. (Medical examiner and prac-
titioner, New York, 1906, v. 16:242-
246.)
Description of various branches of the
work and their special dangers, with particu-
lar reference to the Trenton, N.J., potteries:
Obenauer, Marie L. Working hours,
earnings and duration of employ-
ment of women workers in selected
industries of Maryland and of Cali-
fornia. (U. S. Bureau of labor, Bul-
letin 96.) Sanitary conditions in
canneries, p. 359-362, 368, 401–403.
Cen-
sus of 1890. Deaths of males in cer-
tain occupations, in certain cities,
and from certain causes. v. VII, Re-
port on vital statistics, Part II, table
I8, p. II30. Washington, 1896.
º e º e º a ... Census of 1900. Occupations
in relation to deaths. Report on
vital statistics, Part I, sec. xiii, p.
cclvii. Tables, p. 76. Washington,
I902. -
Annual
reports on Mortality statistics, 1900-
date. -
tº e º ºs e º e - Connecticut registration re-
Bibliography (American) 389
ports, 1881-1907. Deaths by occupa- machinery has shortened the life of the
tions in Connecticut for ten years, où.”; ſº is-
in report for IQ06. Oliver, Thomas. Industrial lead pois
tº g tº e º ſº º º Massachusetts registration oning, with descriptions of lead pro-
g cesses in certain industries in Great
reports, 1843-1889. Deaths in Mass- Britain and the western states of
achusetts by occupations for pre- Europe. (U. S. Bureau of labor
ceding 20 years, in report for 1863. º e tºº & 2
e & Bulletin no. 95, July 1911, p. 1-188.
Elliott, E. B. Life tables of Massa- #.:*::::..]"; º; #3
chusetts, 1858. authority on the subject, based on English
... . . . . . Vermont registration reports, and European data.
1857-1889, and health reports, 1900. Oppenheimer, Seymour. Effect of cer-
1906. tain occupations on the pharynx.
e e e º ºs e º e Rhode Island registration re- (Medical record, N. Y., Dec. 16,
ports, 1853-1906. - 1899, v. 56: 891-893.)
tº º ºs e º e º e Rhode Island. Eighteenth an- Results of study of 50 cases, effects of
heat, e. g. a laundress and a tinsmith.
Osgood, Irene. Women workers in
Milwaukee tanneries. (Wisconsin
Bureau of labor and industrial sta-
tistics, thirteenth biennial report,
nual report of the commissioner of
industrial statistics, 1905. Mortal-
ity statistics of workingmen in
Rhode Island, I899-1902. Tables, p.
53-I52. º & & 33 -
.......... New Jersey State board of §. Io29-1172. “Health”, p. 1060
health, annual reports, 1903-1907. #!ed on personal investigations.
& © tº & © º º º Experience of thirty-four life Overlock, Melvin George. The work-
companies upon ninety-eight special ing people; their health and how
classes of risks. Compiled and pub- to protect it. Worcester, Mass.,
lished by the Actuarial society of The Blanchard press, 1910. 293 p.
America. New York, 1903, xiv, 479 Brief, popular discussion of the preven-
p. tion of disease in certain occupations (p.
Experience of leading life insurance com- 89-96); hours and fatigue (p. 106-109);
panies with regard to specially hazardous and the health of factory employees (p.
occupations and groups of persons. 166-169). g e
e tº e º 'º e º º Érudential insurance com- . . . ...... Education for the prevention
pany of America: Industrial occu- of industrial diseases. (American
pation mortality statistics, exhibits labor legislation review, June 1912,
of diagram and charts at Interna- v. 2, no. 2: 329-338.) . º
tional exposition, Paris, 1900; In- Owens, John E. . Caisson disease.
ternational congress on tuberculosis, (Railway surgical journal, Chicago,
London, I901; Pan American expo. Mºjº, º % V.4.” 5:63) erience as
jº 1. *:::::: chief º i the inji and Chi-
- y e 3. 3. - cago an orthwestern railways.
town ter-centennial exposition, Parker, W. W. and others. Report on
I907; International congress on tu- the effect of the use of the sewing
berculosis, Washington, 1908. machine on the health of women.
... • * * * * * ... Mutual life insurance com- (Transactions of the medical society
pany of New York, mortality exper- of Virginia, third annual session,
ience. N. Y., 1877. “Occupations”, Richmond, 1872, p. 146-153.)
V. 2:42-43. Report of a committee, based mainly on
e e e º º e º ºs Connecticut mutual life in- Dr. Nichºls' pape.(q.v.); e
surance company, mortality exper- Parton, Mabel. Women's work in rub-
ience, 1846-1878. Hartford, Conn. ber factories. . The work of women
1884. 54 p. and children in cordage and twine
O’Connell, James. Manhood tribute factories. Plate. (In Labor laws
to the modern machine: influence and their enforcement, with special
determining the length of the trade reference to Massachusetts. Susan
life among machinists. (Annals of M. Kingsbury, ed. Boston, IQII.
the American academy of political D. §º º © . tº f
and social science, May 1906, v. 27, he jºi"...:"...";...”. “...i.
n O. 3 : 29-33.) women workers in these industries are sub-
Brief argument to show that high-speed ject, and methods by which the dangers
390
4merican Labor Legislation Review
could be reduced. Originally published in
pamphlet form.
Peet, Walter. Pressing out “the
bends” (caisson disease). (Harper's
weekly, Feb. 17, 1912, v. 56: I2.)
Brief, popular article on caisson disease
and its treatment.
Peirce, Paul S. Industrial diseases.
(North American review, Oct. I911,
v. 194: 529-540.).
Good general article.
Pelton, Henry H. Treatment of com-
pressed-air (caisson) illness. (Amer-
ican journal of medical sciences,
Philadelphia, 1907, v. 133: 679-685.)
Precautions against, types, and treat-
ment of the disease, with description of a
medical lock.
Perry, S. H. Brass-workers' disease.
(Medical yieſ. St. Louis, Igo7, v.
35: 4I4-4I9.
Description of the disease, with special
reference to its occupational origin, by a
physician of Birmingham, England.
Peterson,. F. Three cases of acute
mania from inhaling, carbon bisul-
phide. (Boston medical and surgi–
cal journal, 1892, v. 127: 325-326.
Also reprint.)
All three in employees of a single rubber
factory near New York City.
Phosphorus matches (white). Hear-
ings before the Committee on ways
and means of the House of repre-
sentatives, 61st Congress, 3d ses-
sion, on R. 2654o and H. R.
29469, December 16, 1910. Wash-
ington, Govt. print. off., 1910. 39 p.
On bill (H. R. 29469) “A bill to
provide for a tax upon white phos-
phorus matches, and for other pur-
poses.” -
© tº & G ſº e º tº Hearings . . . December 16,
1910, and January 20, 1911. Wash-
ington, Govt. print. off., 1911. iii,
277-357 p. On H. R. 26540, H. R.
29469 and H. R. 30022. The Hear-
ing of Dec. 16, 1910, is also pub. sep-
arately.
...... Hearings . .January Io,
ióiz. Washington, Govt. print. off.,
1912, 11o p. On H. R. 2896. .
tº e s tº e º 'º º Hearings on bills relating to
health activities of the general
government, before the Committee
on interstate and foreign commerce
of the House of representatives.
Washington, Govt. print. off., I910,
Part 6, p. 389-496.
These hearings, together with Dr. An-
drews’ report for the U. S. Labor Bureau
(q.v.) contain most of the up-to-date, pri-
mary source material on phosphorus poison-
ing in the United States. *
Poisoning, Industrial. (See Index cat-
alogue of the surgeon general’s li-
brary and Index medicus, under
Lead, Mercury, Arsenic, Phosphor-
us, etc., passim.)
Pietrowicz, S. R. A case of brass
molder’s ague. (Journal of Amer-
ican medical association, Chicago,
1904, v. 43: 465.) . . .
In a brass molder in Chicago.
Polishing and buffing. (Fourteenth
annual report of the New York state
factory inspector, Albany, 1899, p.
32-35.) -
Relates mainly to interpretation of the
law as to the employment of women and
children in polishing and buffing.
ottery industry, Health conditions in
‘the. Diseases and disease tenden-
cies of occupations. (New Jersey
bureau of statistics of labor and
industries, twenty-eighth annual re-
port, Trenton, 1905, p. 177-197.)
Description of processes and statistics.
Pratt, Edward Ewing. Occupational
diseases. Preliminary report on lead
poisoning in the city of New York,
with an appendix on arsenical poi-
soning. (First report of New York
factory investigating commission.
I912. Appendix vi, p. 365-569.)
. . . . . . . . Lead poisoning in New York
city. (American labor legislation
review, June 1912, v. 2, no. 2:273-
28o.)
Price, George M. Hygiene of occupa-
tion. (In Reference handbook of
the medical sciences, ed. by Albert
H. Buck, 1904, v. 6:316-333.)
Comprehensive discussion of the entire
subject.
. . . . . ... Effects of confined air upon
the health of workers. (American
labor legislation review, June 1912,
v. 2, no. 2: 312-315.)
tº tº º & © e º ºs Medical factory inspection.
(Transactions of Sixth international
congress on tuberculosis. Igo3. v.
4, pt. I: 307-310.). º
Brief outline showing the need for medi-
cal inspection of factories. ..
Sanitation, and ventilation of
factories. (Academy of political sci-
ence, New York, v. 2, no. 2:32-34.)
Brief discussion based on experience as
special investigator for Joint Board of San-
itary Control and New York State Factory
Investigating. Commission. Not as complete
. ºisie in Labor Legislation Review
Q. W. J.,
Bibliography (American)
39 I
Pritchard, J. F. Diseases of railway
men caused by their occupations.
(American academy of railway sur-
geons report, 1896. Chicago, I897,
p. 136-144. Also (abstr.) Journal of
American medical association, 1897,
v. 28: II69-II 71.)
Especially nervous and mental diseases
from strain of responsibility over life.
Ramsey, M. E. Practical life insur-
ance examination. Philadelphia,
1908. “Occupation”, p. 20–23. *
Brief treatment of occupations as affecting
insurance risks.
Randolph, R. L. A clinical and exper-
imental study of the so-called oys-
ter shucker's keratitis. (Johns Hop-
kins hospital bulletin, Baltimore,
1895, v. 6: I50-154.) X-
Description, with cases, of eye disease
produced by injuries from oyster shells.
Ravenel, M. P.. Anthrax. (In Osler's
Modern medicine, 1907, v. 3: 42-51.)
Complete technical discussion, with sta-
tistics of occupations of persons affected
with the disease.
Raymond, Rossiter W. Hygiene of
metal mines. (In A treatise on
hygiene' and public health, ed. by
A. H. Buck, v. 2. Ziemssen’s Cyclo-
pedia of medicine, v. Ig: 253-264.)
Discusses ventilation, dust, temperature,
tº º tº dº ſº tº ... The hygiene of mines. (Trans-
actions of the American institute of
mining engineers, 1879–80, v. 8: 97-
I2O.)
Practically same as his Hygiene of Metal
Mines (q.v.), with quotations from Sheafer’s
Hygiene of Coal Mines (q. V.).
Reporting of industrial diseases. New
York State department of labor. Al-
bany, IoI2, 25 p.
Pamphlet for physicians containing the
law, a statement of its purpose, and informa-
tion in regard to the diseases to be reported
and their symptoms.
Reynolds, H. R. . Caisson disease.
(Railway surgical journal, Chicago,
Feb. 1909, v. I5:255-59.)
Rice, M. B. White lead poisoning.
(Alkaloidal clinic, Chicago, 1905, v.
12:460–462.)
In painters and employees of white-lead
factories.
Riggs, C. Eugene. Nervous disorders
and paralyses from excessive use of
the parts affected—vertigo, tremor,
and lead poisoning. (In System of
practical therapeutics, ed. by H. A.
Hare, Philadelphia, 1892, v. 3: 419-
From medical standpoint, without regard
to origin, but including writer’s and tele-
grapher’s cramp and lead poisoning.
Rohé, George H. The hygiene of oc-
cupations. (In American public
health association. Public health
papers and reports, 1884. Concord,
N. H., 1885, v. Io: I65-173.)
Brief, concrete description of causes of
disease in unhealthful trades, with general
summary of American literature and Massa-
chusetts mortality statistics.
Royer, B. F., Holmes, E. B. Fifteen
cases of anthrax treated in the Phil-
adelphia municipal hospital. (The-
rapeutic gazette, etc., Detroit, 1908,
3 s. v. 24:6-17. Also Pennsylvania
medical journal, Athens, 1907-8, v.
II: 937–949. Illustrated.)
Elaborate description of cases, all of which
were occupational in origin, from handling
hair, leather, etc.
Russel, C. P. Table of deaths from
phthisis in New York city, showing
relative mortality of various profes-
sions. (Medical record, N. Y., 1873,
v. 8: 93.
Statistics, without discussion.
Ryan, L. M. Compressed-air illness in
caisson, work. (American labor leg-
islation review, June 1912, v. 2, no. 2:
350-355.)
tº e º º º . . . Compressed-air disease from
a clinical aspect. (New York medi-
cal journal, July 31, 1909, v. 90: 193-
I98. Also reprint.)
Describes the causes, methods of preven-
tion, symptoms, types, and treatment, with
the clinical history of two cases.
Ryland, K. Phosphorus necrosis of
the maxillary bones, peculiar to lu-
cifer-match makers, (St. Louis
medical and surgical journal, 1854, v.
I2:28-34.)
Based mainly on European experience,
but describes conditions of work in a St.
Louis match factory.
Safety and security of American life.
American institute of social service,
New York, 1906.
Sanitary conditions in factories. (See
reports of factory inspection depart-
ments and bureaus of labor of the
various states.)
Sanitary commission of Massachu-
setts. Boston, 1850. Influence of
occupation on health, p. 85-87, I29
and 508–5IO.
Occupation mortality statistics, and mor-
tality and conditions of work of shoemakers
in Lynn. • .
Schamberg, F. J. Grain itch (acaro-
dermatitis urticarioides): a study of
392
American Labor Legislation Review
a new disease in this country. (Jour-
nal of cutaneous diseases, 1910, v.
28: 67–89. Illustrated.)
Scientific description of the disease with-
out special regard to its origin.
Schwab, Sidney I. Neurasthenia in
garment workers. (American labor
legislation review, New York, Jan.
I9II, v. I : 27-33. Bulletin of the
American economic association, 4th
series, no. 2:265-271.
General results of study of 7000 garment
workers in St. Louis dispensary during
ten years.
Schwartz, G. J., Royer, B. F., Keen,
W. W. Anthrax. (Annals of sur-
gery, I905, v. 42: 286-296.)
General discussion of the disease and des-
cription of case in a farmer who had skinned
3. COW.
Schwartz, H. J., Sincard, M. H. Brass
founder’s ague. (Cornell university
medical college bulletin, Jan. 1905.)
Scott, A. L. Report on “hatting”.
(Report of the Board of health of
Connecticut, 1887–8, New Haven,
I889, v. II: 299-300.)
Brief description of processes, arguing that
the making of hats is a healthful occupation.
Scott, W. J. Hygiene of the laboring
classes. (Ohio medical journal, 1881,
v. I : 17-22.)
Brief, general discussion of dangers to
health of lead workers, stonecutters, cigar-
makers, etc.'
tº gº tº tº º ... Hygiene of the working class-
es. (Cleveland medical gazette,
1885-86, v. I : 383-387.)
Plea for public baths as method of pre-
venting occupational diseases.
Seager, Henry R. Cooperation in pro-
moting industrial hygiene. (Amer-
ican labor legislation review, June
I912, v. 2, no. 2: 235-24.I.) '
Sewall, Hannah R. Child labor in the
United States. (U. S. Bureau of la-
bor, Bulletin 52. “Conditions affect-
ing children”, p. 506-516; “Health of
working children”, p. 528–532.)
Sanitary and other conditions in factories,
and facts obtained by questioning the chil-
dren and their parents.
Sexton, Samuel. The ear, and its dis-
eases. “The effect of high atmos-
pheric pressure on the ear in tun-
nels, caissons, , etc. The effects of
submarine diving on the ear.” p.
428-434. . .
With description of a number of cases of
deafness occurring among employees of the
Hudson River Tunnel. In part practically
the same as in Medical Record, 1887 (q. v.).
* the effect of high
atmospheric pressure on the ear.
(Medical record, N. Y., 1887, v. 32:
732-734.)
Based on treatment for ear trouble of
a number of employees working in the Hud-
son River Tunnel.
Shambaugh, Geo. E., Boot, G. W.
Reports on occupation deafness.
(Report of Illinois commission on
occupational diseases, Jan. I9II, p.
I50-155.) tº º
Discussion of occupations which may lead
to deafness and of boilermaker’s deafness,
based mainly on European sources.
Sharples, C. W. A contribution to
the pathology of the spinal cord in
diver’s palsy. (Journal of nervous
and mental diseases, N. Y., 1894, v.
21, n. s. v. 19: 636-640.)
Report of a single case and autopsy.
Sheafer, H. C. Hygiene of coal mines.
(In Treatise on hygiene and public
health, ed. by A. H. Buck, v. 2.
Ziemssen’s Cyclopedia of medicine,
v. Ig: 229-250.)
Describes character of work, danger from
gases, lack of ventilation, etc.
Shoe factory operatives. Diseases and
disease tendencies of occupations.
(New Jersey bureau of statistics of
labor and industries, twenty-fifth an-
nual report, 1903, p. 371-375.) wº
General description and sickness statis-
tics of seven factories employing 1,000
hands.
Silk industry. (Report on condition
of woman and child wage-earners in
the United States, 61st Cong., 2d
sess., Senate doc. 645, v. 4. Pre-
pared under the direction of Chas.
P. Neill, commissioner of labor.
“Light and ventilation”, p. 179-181.)
General results of official investigation in
New Jersey and Pennsylvania.
Skeel, S. Lead colic, or mine sickness.
(St. Louis medical and surgical jour-
nal, 1848, v. 6: 125-129.)
Based on experience with over a hundred
cases among lead miners, with histories of
a number of cases.
Smith, A. H. Effects of high atmos-
pheric pressure, including the cais-
son disease. College of physicians
and surgeons alumni association
prize essay, Brooklyn, 1873, 53 p.
Pub. also by New York and Brook-
lyn bridge co. •
Extensive treatise giving his experience
as surgeon of the New York Bridge Co.,
but based on theory which has now been
abandoned.
Bibliography (American)
393
. . . . . . . . Caisson disease. (Medical
record, N. Y., 1894, v. 45: 130-133.)
Based on experience as physician to the
Presbyterian Hospital, New York City, with
employees of the East River Tunnel.
... .......The caisson disease. (In Pep:
per. American system of practical
medicine, v. 3: 854-860.)
Brief treatment based on his Effects of
PIigh Atmospheric Pressure (q. v.).
© tº tº e º ſº e º Physiologic, pathologic and
therapeutic effects of compressed
air, Detroit, I886.
New edition of his Effects of High Atmos-
pheric Pressure, with addition of a chapter
on therapeutic uses of compressed air.
Snow, Walter B. Dust removal in a
brass foundry. (Heating and venti-
lating magazine, N. Y., Oct. Igo7, v.
4:30-35. Illustrated.)
Scientific, practical. º
Sommerfeld, Th., Oliver, Thomas,
Putzeys, Felix. List of industrial
poisons. Prepared for the Interna-
tional association for labor legisla-
tion. (U. S. Bureau of labor, Bulle-
tin no. 86, Jan. 1910, p. 147-169)
Sommerfeld, Th., Fischer, R. List of
industrial poisons and other sub-
stances injurious to health found in
industrial processes. Prepared un-
der the auspices of the International
association for labor legislation.
(U. S. Bureau of labor, Bulletin
no. 100, May 1912, p. 733–759.) &
This is a revision of the list in Bulletin
86, with an outline of the work along this
line of the International Association for
Labor Legislation and an outline by Dr.
Fischer of measures for the protection of
workers against danger of poison. s'
Soper, George A. The air and yenti-
lation of subways. N. Y. Wiley
and sons, 1909, 244 p. Health of
employees in European subways, p.
77, 98. “Health of New York, sub-
way employees”, p. 195-229. (Also
Technology quarterly, Boston, 1907,
v. 20: 218–245.) -
Results of original investigations into the
effects of metallic dust on health of em-
ployees. Practically identical with report
made in 1907 to the Board of Rapid Transit
Commissioners of the City of New York.
Special regulations for dangerous and
unhealthy industries enforced by the
factory inspectors in England.
(New York State bureau of labor
statistics, twenty-fourth annual re-
port, Albany, 1906, p. 833–879.)
Text of English laws.
Spratling, W. P. Report of , fifty-
seven cases of insanity occurring in
six years among silk-mill employees
in a manufacturing city in New Jer-
sey. (New York medical journal,
1894, v. 59: 614-616.)
Gives cause as “prolonged and excessive
overtax of mind and body” in the course
of their occupation. Tables.
Stainsby, William. Diseases and dis-
ease tendencies of occupation. The
glass industry and the hatting in-
dustry. Trenton, N. J. 1901. 55
p. (From the Twenty-fourth annual
report of the Bureau of statistics
of New Jersey.) -
(See Glass industry and Hatting industry.)
Standen, Wm. T. The effect of occu-
pation and habits on life insurance
risks. Pub. by N. Y. Life insur-
ance co. (Also in his Ideal pro-
tection, N. Y., 1897, p. Ioo-II8.)
Gives classification of occupations, with
number of insurance companies, which re-
ject persons in each, number which discrim-
inate against the specified occupations, and
number which accept persons engaged in
them without restriction.
Starr, M. Allen. Industrial diseases
due to the use of metallic poisons
and the measures needed for their
prevention. (Medical record, N. Y.,
Feb. 3, 1912, v. 81: 205–207.)
Discusses briefly lead, arsenic, mercury
and phosphorus.
Stevens, George A. The health of
printers: a study in industrial hy-
giene. (Twenty-fourth annual re-
port of the New York bureau of la-
bor statistics for the year ended
Sept. 30, 1906. Albany, 1907, p. 71-
I52.
5 * statistics for England and the
United States, and descriptions of health
conditions.
Stewart, D. D. Lead convulsions; a
study of sixteen cases. (American
journal of medical sciences, Philadel- .
phia, 1895, n. s. v. Io9: 288-306.)
Four of these cases were of occupational
origin, in persons who handled dyes and
paints.
Stickler, J. W. Hatters’ consumption.
(New York medical journal, May 29,
1886, v. 43:598–602. Also reprint.)
Description of processes and effects, with
abstracts of letters from hatters’ societies,
records of 17 cases, and mortality statistics.
& & E e º ſº tº º Diseases of hatters. (Report
of the Board of health of New Jer-
sey, 1885-6, Trenton, 1887, v. Io: I66–
188.)
Describes processes and sanitary condi-
tions of workrooms and gives statistics of
physical condition of 240 employees in hat
394
American Labor Legislation Review
factories and mortality statistics of hatters
in Newark and Orange.
Stickler, J. W., Lane, F. B., Stubbart,
J. B. Diseases of workers in textile
goods. (New Jersey board of health,
ºth annual report, 1888, p. I59-
I78.
Describes processes, and gives table show-
ing results of inquiry into diseases acquired
since entering mill.
Sullivan, J. W. The printer's health.
(Typographical journal, 1903, v. 23,
no. 5, p. 425-429; no. 6, p. 527–532.
Reprinted, condensed, in Commons,
Trade unionism and labor prob-
lems, p. 435-454.) . .
Based on mortality statistics of the Inter-
national Typographical Union and of local
union no. 6 (New York Citv), with des-
criptions of unhealthful conditions.
Sumner, Helen L. History of women
in industry in the United States.
(Report on condition of woman and
child wage-earners in the United
States, 61st Cong., 2d sess., Senate
doc. 645, v. 9. Health in textile
factories, p. IOO-Io8.)
Mainly on health of Lowell factory women
before 1880.
Taylor, G. R. The Chicago industrial
exhibit. (Charities and the com-
mons, N. Y., 1907, v. 18:38-45. Il-
lustrations.)
Popular account, with reference to san-
itary conditions in factories.
Thayer, Gordon. Matches or men.
(Everybody’s magazine, April 1912,
v. 26: 490–498.)
. . Popular article on phosphorus poisoning.
Thompson, T. Kennard. Pneumatic
caissons. (Scientific American sup-
plement, Oct. I7, 1908, v. 66: 244-
247.)
Mainly, technical description of caissons,
but contains also brief account of caisson
disease. e {º
Thompson, W. Gilman. Classifica-
tion of occupational diseases.
(American labor legislation review,
June 1912, v. 2, no. 2: 185-191.)
. . . . . . Occupational diseases of mod-
ern life. (Journal of the Maine state
medical association, March 1912.
Also pamphlet.)
. . . . . . . Occupational p o is on in g.
(Journal of industrial and engineer-
ing chemistry, June 1912, v. 4:454-
457.)
On the prevalence, nature, and means of
mitigation of occupational poisoning.
... .... Résumé of the importance
and prevalence of the occupational
diseases. (Medical record, N. Y.,
Feb. 3, 1912, v. 81: 201-202.)
Introductory outline of the subject. . .
... .... Reporting of occupational dis-
eases by physicians. (Academy of
political science, New York, v. 2, no.
2: 24-31.)
Practical article with sample schedules
and history cards.
e tº e º e ... Notes on the caisson disease.
(Medical record, N. Y., 1894, v. 45:
I33-134). . g sº a Q
Brief discussion with description of sev-
eral cases.
Tracy, Roger S. Hygiene of occupa-
tion. (In Ziemssen, Hugo von, ed.
Cyclopaedia of the practice of medi-
cine. New York, 1874-1881. v. 19:
3–78.) g & º
Comprehensive treatise (1879) with clas-
sification of occupations, descriptions of
dangerous processes, effects of poisons, dusts,
constrained attitudes, etc. Bibliography.
g e º 'º º º ... Report on tobacco and cigar
manufactories. (New York city
board of health report, 1872, p. 308-
3II.)
General discussion of results of sanitary
inspection to determine effects on health of
workers.
e º 'º e º ſº. ... Dusty occupations. (New
York State factory inspector, sec-
ond annual report, 1888, Albany,
1889, p. 68-94.)
General discussion of all kinds of dust,
with tuberculosis statistics of dusty occupa-
tions.
Trask, John W. A digest of the laws
and regulations of the various states
relating to the reporting of cases of
sickness. U. S. Public health and
marine-hospital service. Public
health bulletin no. 45. Washington,
Govt. print. off., 1911. IQI p.
Abstracts of laws by states, and tables of
notifiable diseases, including occupational
diseases.
Tuberculosis. American federation of
labor. Movement inaugurated and
plan adopted by the American fed-
eration of labor to war on con-
sumption. 2d ed., 1909. Washing-
ton, American federation of labor,
I909.
e ‘º e º 'º º º e Influence of occupation in tu-
berculosis. (Thirty-seventh annual
report of the Michigan State board
of health, Lansing, 1909, p. 93-IOO.)
Statistics of occupations of 19,642 tuber-
culous, persons in Michigan, 1895-1908, and
mortality statistics of various occupations.
. . . . . Tuberculosis in the industries
of Massachusetts. (Massachusetts
Bibliography (American)
395
Labor bulletin, July 1909, v. I4:81–
IoA. Whole no. 65.)
Brief descriptions of various industries
which produce tuberculosis, and methods of
relief and prevention in use.
e e e º ºs e º 'º Relation of occupation to tu-
berculosis. (Monthly bulletin of the
New York State department of
health, Sept. I908, n. S. v. 3, no. 9:
238-239.). tº a tº º
Occupation statistics of patients at the
Henry Phipps Institute, Philadelphia.
Tyson, James. On chronic interstitial
nephritis. A clinical lecture. (Phil-
adelphia medical times, Jan. 9, 1886,
v. 16:261-264.)
Account of results of lead poisoning in a
house painter.
United States Bureau of labor. Bulle-
tins 44 (see Doehring), 52 (see Se-
wall), 75 (see Kober), 79 (see Hoff-
man), 82 (see Hoffman), 86 (see
Andrews, Sommerfeld, and Interna-
tional association for labor legisla-
tion), 92 (see International associa-
tion for labor legislation), 95 (see
Oliver, Hamilton, Andrews, and
Laws), 96 (see Hanson and Obenau-
er), Ioo (see Laws and Sommerfeld),
85, 91 and 97 (see Laws).
tº e º e º ſº tº e Report on condition of wom-
an and child wage-earners in the
United States, 61st Cong., 2d Sess.,
Senate doc. 645, 1910-1912 (see Cot-
ton textile industry, Clothing, Glass
industry, Silk industry, Laundries,
Chaney, and Sumner).
e ſº º e º ºr ... Report on conditions of em-
ployment in the iron and steel in-
dustry of the United States, IoI2, v.
3. A study of working conditions
in American steel mills.
Treats of the various factors affecting the
health and efficiency of the working force,
e. g. the 7-day week, the 12-hour day, tem-
perature, etc.
Fourth annual
Working women).
& e º º ſº ſº gº º Twenty-second annual report
(see Laws). -
ge º ſº tº tº º ... Twenty-fourth annual report
(see Harris). -
Van Kleeck, Mary. Working hours of
women in factories. (Charities, N.
Y., 1906-7, v. IZ: I3-2I.)
Describes actual conditions, non-enforce-
ment of ten-hour law, and results in physical
condition of working women.
Van Rensselaer, H. The pathology
of the caisson disease. (Medical
record, N. Y., 1891, v. 40: 141-150;
report (see
178-182. Also Transactions of the
medical society of New York, 1891,
p. 408-444. I pl. Bibliography.)
Thorough treatise, with reports of cases
and post-mortem examinations, results of ex-
periments with animals, and history of theor-
ies, upholding the mechanical congestion
theory.
Veasey, C. A. Central amblyopia in a
dye-worker, probably produced by
inhalation of the aniline dyes.
(American journal of ophthalmol-
ogy, St. Louis, 1898, v. I5: I49-152.
Also reprint.)
ingle case.
Wainwright, J. M., Nichols, H. T. Two
phases of anthracite mine hygiene.
(Transactions of the Luzerne county
medical society, Wilkesbarre, 1905,
v. I3: IOO-II6. Discussion, p. II6-
II.7.)
On hookworm disease and the relation
between pulmonary, tuberculosis and anthra-
cosis, with occupation mortality statistics.
Wald, Lillian D. The doctor and the
nurse in industrial establishments.
(Academy of political science, New
York, v. 2, no. 2:41-47.)
Results of experience of various estab-
lishments. .
Walling, William English. The dan-
gerous trades. (Fourteenth annual
convention of the International as-
sociation of factory inspectors of
'America, p. 35-42.)
Walton, G. L., Carter, C. F. Metal-
turners’ paralysis. (American jour-
nal of medical sciences, Phila., 1892,
n. s. v. Ioa: 61-63.)
General discussion and account of two
cases in brass workers.
Warman, D. The diseases of potters,
their causes and prevention. (Elev-
enth annual report of the Board of
health of New Jersey, Trenton, 1887,
p. 97-116.) -
Describes nature of the occupation, its in-
fluence on health, and sanitary conditions
in potteries of New Jersey.
Warthin, A. S. A preliminary report
on some occupational diseases oc-
curring in Michigan. (Public health,
published quarterly by the State de-
partment of health, Michigan, Jan.-
March, 1912, v. 7, no. 1, p. 67-77.)
On miner’s cramp, compressed-air dis-
ease, miner’s nystagmus, etc., with cases.
Washburn, E. Practical studies in oc-
cupational hygiene. (Monthly bul-
letin, State board of health, Massa-
chusetts. Boston, 1911, v. 6: 74-77.)
Weidner, Carl. Occupational diseases.
396
American Labor Legislation Review
(Kentucky medical journal, Feb. 15,
I9II, v. 9: I7I-I75. Discussion, I75-
I77.).
Brief, concrete treatment of a large num-
ber of different diseases.
Wheatley, F. G. Factory inspection.
(Medical communications, Massa-
chusetts medical society, Boston,
I907, v. 20: 50I-506. Discussion, p.
506-509.) .
With special reference to Massachusetts
and to the campaign against tuberculosis.
Wilbur, Cressy L. Notification of oc-
cupational diseases. (American la-
bor legislation review, June 1912, v.
2, no. 2: 339–345.)
& º - e º e º e Better statistics of industrial
mortality for the United States.
(Publications of the American sta-
tistical association, June 1909, v. II:
505–509.)
Plea for more definite statements of oc-
cupations on death certificates.
(Med-
Wile, Ira S. Laundry hygiene.
ical news, N. Y., 1904, v. 85: Io95-
Ioé8.)
- On health of employees, giving results of
investigations in Rochester, N. Y., London,
Paris, and New York City.
Williams, Henry Smith. Poisonous
matches. (The world to-day, Feb.
I912, v. 21: I'798–1800.)
e Brief, popular article. tº , º e tº
Wilson, G. B. Air-conditioning; being
a short treatise on the humidifica-
tion, ventilation, cooling, and the hy-
giene of textile factories, especially
with relation to those in the U. S.
A. New York, 1908. I38 p.
An effort to show how methods used
abroad can be applied to American condi-
tions. Mainly technical, dealing incidentally
with hygiene:
Wilson, James C. Chronic lead poi-
soning. (In Pepper’s System of
practical medicine by American au-
thors. Philadelphia, 1886. v. 5: 678-
692). . . . tº º sº tº e e
Brief history and medical discussion with
reference to origin in trades and arts.
Wilson, J. F. Diseases incident to
some occupations. (“The Transac-
tions”, Youngstown, Ohio, 1879-80,
v. 1: 89-93.)
Winslow, Charles Edward Amory.
Occupational disease and economic
waste. (Atlantic monthly, May 1909,
v. Io9: 679–684.)
General argument for investigation, legis-
lation, factory inspection, etc.
& G - e º e ...Ventilation, air space, humid-
ity and temperature: topical criti-
cism of existing laws. (American
labor legislation review, June 1911,
v. I, no. 2: IIO-II2.)
ºrsing investigations to establish stand-
aſ CIS.
tº º º ºs e º ſº tº Temperature and humidity in
factories. (American labor legisla-
tion review, June 1912, v. 2, no. 2:
297-304) . º
• ‘º e e º 'º e tº Sanitary dangers of certain
occupations. (Journal of the Mass-
achusetts association of boards of
health, May 1904, v. I4: 92-106,
Also reprint.)
© e e s - e. ... Factory sanitation and effi-
ciency. (In Technology and indus-
trial efficiency, a series of papers pre-
sented at the Congress of technol-
ogy. Boston, 1911. McGraw-Hill
book company, N. Y., 1911, p. 442-
448. Also abstract in Journal of in-
dustrial and engineering chemistry,
Easton, Pa., 1911, v. 3:508–5II.) e
On ventilation, with table showing tem-
perature and humidity in New York fac-
tories.
© e º O © tº e º Industrial hygiene. Boston,
I9II. 40 p. (Health-education se-
ries, no. 24.)
& e º e º 'º º is he cash value of factory ven-
tilation. (Transactions of the
Sixth international congress on tu-
berculosis, Washington, 1908. v. 3:
184-189.)
Discussion, tables and chart showing de-
crease in absences from work among tele-
phone and telegraph operators when work-
room was ventilated.
Witmer, A. F. Clinical aspects of the
occupation neuroses. (Proceedings,
Philadelphia county medical society,
Phila., 1898, v. 19: I-5. Also Phila-
delphia polyclinic, 1898, v. 7:44-48.)
ºneral article from physician’s stand-
point. .
Wood, H. B. The influence of factory
inspectors upon public health.
(Pennsylvania medical journal, Ath-
ens, Igo9-IO, v. I3: 17-23. Also Vir-
ginia medical semi-monthly, Rich-
mond, Igo9-IO, v. 14:313–317.)
With special reference to Pennsylvania,
urging additional factory legislation.
Wood, James R. Removal of the en-
tire lower jaw for necrosis caused
by phosphoric acid gas. New York,
1856. Prm. (Also in New York jour-
nal of medicine, 1856, [2] s. v. 16:
301-316.)
History of nine serious cases of phos-
phorus poisoning in match factories in New
York City, during 1855 and 1856,
Bibliography (Other Than American)
397
Woodward, C. M. History of the St.
Louis bridge. St. Louis, 1881. The
physiological effects of compressed
air. (Also in Van Nostrand’s en-
gineering magazine, N. Y., 1882, v.
26:29-42.)
Experience with caisson disease in build-
ing the bridge, with statistics of cases and
deaths.
Working women in large cities.
(Fourth annual report of the United
States commissioner of labor, 1888.
“Condition of health”. Tables xviii,
xix, and xx, p. 369-394.)
Health at age of beginning work during
previous occupations and “now”, by indus-
tries and by cities.
Wright, Carroll D. “Effect of work on
health.” The working girls of Bos-
ton, p. 69-75. (From the Fifteenth,
annual report of the Massachusetts
Bureau of statistics of labor.) Bos-
tön, Wright & Potter printing co.,
I884.
. Brief descriptive treatment based on tes-
Hºy of girls employed in various indus-
. . . . . . . . Effect of factory employments
on health. (Report on the factory
system of the United States. Tenth
census, I882, v. 2:558-562.)
Tables giving amount of air space per
operative in 2,140 rooms in textile factories
in Massachusetts, and occupation mortality
statistics for manufacturing cities in Eng-
land.
Wright, Edward W. Readers’ cramp,
TITLES OTHER THAN AMERICAN 1
an analogy. (New York medical
journal, I897, v. 66:347–349.)
Nerve affection in persons whose occupa-
tions necessitate overstrain of the eyes.
Würdemann, H. V. Economic limi-
tations of the visual acuity in var-
ious trades and professions. (Jour-
nal of American medical associa-
tion, Feb. 8, 1902, v. 38:380-382.)
Scientific discussion of keenness of sight
as related to specific occupations.
e tº e g º e º 'º Phosphor-necrosis of the tem-
poral bone. Milwaukee, 1898. Pam-
phlet, reprint.
|Description of unusual case of phosphorus
polSoning.
Wyman, Walter. River exposure and
its effects upon the lungs. (Annual .
report of supervising surgeon-gen-
eral, United States marine-hospital
service. I876–77, p. 157-164.)
Describes conditions of work which result
in “river phthisis”.
Wynne, James. Report on vital statis-
tics of the United States made to
the Mutual life insurance company
of New York, 1857. “Occupations”,
p. 205-2IQ.
Mortality statistics for England and for
Massachusetts.
Zenner, P. Auctioneer’s cramp. (Jour-
nal of nervous and mental diseases,
N. Y., 1886, v. I3: 616–622. Cincin-
nati lancet-clinic, 1886, n. s. v. I7:
207-209.)
Description of a single case.
Abel, F. Des propriétés dangéreuses
des poussières. Revue internation-
ale de science biologique, Paris,
1882, v. Io: 351, 462.
Ackerman, V. B. Des maladies
spéciales aux ouvriers employés
dans les fabriques de sulfate de
quinine. Paris, 1880.
Action populaire, Reims. Extraits
des discours prononcés au Sénat
sur: Interdiction de la céruse à l'in-
* Many additional titles will be found in the
list of references. On occupational diseases
and industrial hygiene in the quarterly bibli-
ography on labor topics published as a sup-
plement to the Bulletin of the International
Labor Office by the Association for Labor
Legislation.
térieur des bâtiments. Reims; Par-
is, V. Lecoffre [1908.] 34 p. (Actes
sociatix; publication documentaire
riodius de l’Action populaire, no.
I5
Adelmann, G. Ueber die Krankheiten
der Künstler und Handwerker nach
den Tabellen des Instituts für
kranke Gesellen der Kunstler und
Handwerker in Würzburg von den
ſººn 1786 bis 1802, Würzburg,
Iö03. 9
Alfassa, Georges. Les poisons indus-
triels. Rapport présenté à l’Asso-
ciation internationale pour la pro-
tection légale des travailleurs. . .
Paris, 1906. 34 p. +.
398
American Labor Legislation Review
Allan, J. W. Lectures on trade dis-
eases. Glasgow medical journal,
19oo, v. 53: 332-338. 9
Allevi, Giovanni. Le malattie dei la-
voratorie. L'igiene industriale. Mi-
lano, U. Hoepli, I908. 4I5 p.
Alliance d'hygiene sociale. 2” Con-
gres, Montpelier, 19o5. 2"° Con-
grès d'hygiène sociale tenu à Mont-
pelier I9-2I mai I905. I Bordeaux,
1905] 49I p.
Amado, J. J. Hygiene des professions,
cultures, et métiers insalubres. Con-
grès international de medicine des
colonies, 1883, Amsterdam, 1884, p.
95-IOI.
Angey, C. Les risques professionels;
les accidents et les maladies du tra-
vail. Paris, A. Rousseau, I907. 207
p.
Paris, F. Alcan, [etc.] I9II. IO7 p.
[Its Publicationsl 6° ser., no. 5)
a e º La réforme de la proce-
dure de la mise en demeure, organi-
sée par la loi du 12 juin 1893-II juil-
let i9o3 sur l'hygiène et la securité
des travailleurs. Rapport de M. E.
Briat. Paris, Felix Alcan, éditeur,
191o. 15o p. (Its Publicationsl 6°
ser. no. 2)
Association ouvrière de l'hygiène et
de la sécurité des travailleurs et
des ateliers. 3d congress, Paris,
19o7. Troisième congrès de l'hy-
giène et de la sécurité des travail-
Annaratone, C. A. Contributo alle
malattie professionali dell' orec-
chio. Giornale medico del rº esercito
e della rº marina, I905, v. 53: 739-
742.
Arlidge, John Thomas. The hygiene,
diseases and mortality of occupa-
tions. London, Percival & co.,
1892, xx, 568 p.
. . . . On occupations in their re-
lation to health and life. British
medical journal, 1878, v. 2: 239-244.
º i . On the position of the
study of industrial diseases; its past
neglect and its scope. Sanitary in-
stitute (London). Journal, Jan.
I895, v. I5: 5I7-52O.
º o º The state of sickness among
laborers. (In international congress
of hygiene and demography. 8th,
Budapest. Comptes-rendus et
mémoires. Budapest, 1896. v. 8,
pt. 3: 37-4o.)
Arnould, J. La fabrication du bleu
d'outremer, hygiène industrielle et
hygiène administrative. Annales
d'hygiène (Paris), 1884, 3. sér., v.
I2: 4O4-423.
Association des industriels de France
contre les accidents du travail. Bul-
letin. . No. 22-23. Paris, 19Io-
(Annual)
. . . . . Bulletin bimestriel. . .
I9Io. Paris, 19Io.
Association nationale francaise pour
la protection legale des travailleurs,
Paris. Les maladies profession-
nelles; rapport de M. L.-J. Breton.
leurs et des ateliers. 1907. . . Par-
is, L'Èmancipatrice, impr. com-
muniste, 1907. I23 p., 2 I.
4th congress, Paris, 1909.
Quatrième congrès de l'hygiène et
de la sécurité des travailleurs et
des ateliers, 1909. . Paris, L'Èman-
cipatrice, 1909. I69 p., I I.
Associazione degli industriali d'Italia
per prevenire gli infortuni del la-
voro, Milan. Avvisi a stampa. Mi-
lan, n. d.] I8 broadsides. (Post-
ers containing directions for the
prevention of accidents and instruc-
tions pertaining to industrial hy-
giene.)
. . . . . Esercizio. 1898. Mi-
lano, etc., etc.] I899.
is º Le misure preventive por
proteggero gli operai delle indus-
trie contro la malattie del carbon-
chio. Note dell' Ing. F. Massarel-
li. Milano, 1909. 56 p. -
Astegiano, G. Contributo allo studio
delle malattie professionali. Gior-
nale medico del rº esericito e della
rº marina, 1886, v. 34: Io25-Io48.
Austria. Arbeitsstatistisches Amt.
Bleivergiftungen in hittenmännis-
chen und gewerblichen Betrieben,
º º Wien. Alfred Hölder, 1905-
I907. 7 v. in 5.
Baraks, Hélène R. Les névrites pro-
fessionnelles, Paris, 19oI.
Barnett, Henry Norman. : Accidental
injuries to workmen with reference
to Workmen's compensation act,
I906. With article on injuries to
the organs of special sense, by Ce-
cil E. Shaw . . . and legal intro-
duction by Thomas J. Campbell . .
. London, Rebman limited, 1909. vii,
376 p. Appendices: a. Text of the
act. b. List of industrial diseases.
Bibliography (Other Than American)
399
c. Report of Departmental com-
mittee, etc.
Barth, C. G. De mobis ex vitae gen-
ere. Lipsiae, ſ 1764].
Baum, Marie. Der Einfluss der ge-
werblichen Arbeit auf das person-
liche Leben der Frau. Der Ein-
fluss der gewerblichen Gifte auf den
Organimus der Frau, von. Agnes
Bluhm . . Jena, Fischer, IQIO.
69 p. (Schriften des standigen Aus-
schuss zur Fördering der Arbeiter-
inneninteressen. Hft. 3)
Beaumont, William Mardon. Injuries
of the eyes of the employed and
the Workmen’s compensation act;
problems in prognosis. London, H.
K. Lewis, 1907. viii, 160 p.
Beauvais, de. Rapport sur un cas
d’ostéo-periostite, aiguë, multiple,
très-étendue, chez un apprenti ajus-
teur-mécanicien. Annales d'hygiè-
.. (Paris), 1878, 2. sér., v. I: 362-
3ö4.
Becker, Hans. Die Erkranks- und
Sterblichkeitsverhältnisse. (In Aus-
tria. Statistische Zentralkommis-
sion. Statistische Monatschrift.
Wien, 1905. n. f., Io. Jahrg. [Nr.]
4, p. [205]-343) º
Behrend, F. J. Ueber die Einfluss der
Beschäftigung auf die Gesundheit
und Sterblichkeit, Zeitschrift für
die Staatsarzneikunde, 1860, v. 70:
I; 1861, v. 71: 78.
Belgium. Ministère de l’interieur.
Enquète sur la condition des classes
ouvrières et sur le travail des en-
fants. Bruxelles, 1846-48. 3 v.
e tº dº tº º ffice du travail. Les fila-
tures de lin. Etude d'hygiène pro-
fessionnelle. Bruxelles, 1902
463 p. ©
Bender, —. Industrial hygiene. 1906.
Bender, W. Ueber die Lebens-und
Gesundheitsverhältnisse der Textil-
arbeiter der Stadt Bocholt. Zeit-
schrift für Gewerbe-Hygiene ſetc.],
1904, v. II: 285-309; 334; 360.
Benoit, F. Reglementation du tra-
vail; manual d'hygiène et de me-
canique industrielles. Paris, 1893.
Bericht tiber die 21. und letzte Gen-
eralversammlung des Vereins zur
Pflege des Gewerbehygienischen
Museums in Wien am 18. Jänner
1910. Mitteilungen des Gewerbe-
hygienischen Museums, Wien, no.
335.
Bertillon, J. Sur la morbidité et spec-
ialement sur la morbidité profes-
sionnelle. Revue d'hygiène et de
police sanitaire (Paris), 1890. v. I2:
I IOS-II 32.
. . . . De la morbidité et de la
mortalité par profession. Journal
de la societé de statistique de Paris,
1892, v. 33: 341, 382.
. . . . Morbidity and occupation.
Journal of the royal statistical so-
ciety, London, Dec. 1892, p. 559.
Bertin, G. Essai sur l'hygiène de
l'ouvrier au point de vue de l'hab-
itation, de l'alimentation et du tra-
vail. Paris, 1864.
Berufskrankheiten. Zeitschrift für
Gewerbe-Hygiene ſetc.] 1899, v. 6:
344; 357. & ©
Betta, Enrico de. Sulle professioni
considerate come causa di Malattia.
Pavia, 1849.
Beyer, E. Die Fabrik-Industrie des
Regierungsbezirkes Düsseldorf vom
Standpunkt der Gesundheitspflege.
[Berlin?]. 1876.
Bielefeldt, A. Der Einfluss der
deutschen Arbeiterversicherung auf
die Verhütung und Bekämpfung
von Volkskrankheiten. Kranken-
flege (Berlin), 1902, v. 2: 67-71.
Bierbaum, J. Arbeit und ihr gesund-
heitlicher Schutz. Deutsche Zeit-
schrift für die Staatsarzneikunde,
1867, n. S., v. 25: 3-66.
Biondi, C. La valutazione medico-
legale delle infezioni nel campo del-
la patologia del lavoro. Clinica
moderna (Firenze), 1906, v. 12: 301-
305. *
Blackburn, Eng. Special committee
appointed to enquire into the sub-
ject of steaming in weaving sheds.
Report of the Special committee
appointed to inquire into the sub-
ject of steaming in weaving sheds.
[Blackburn, 1888] 232 p.
Blaise, E., Napias, H. Note sur les
poussières industrielles, modifica-
tions à apporter a la legislation en
matière d'hygiene industrielle. Re-
vue d'hygiène, Paris, 1883, v. 5: 940-
95I.
Blandet. Maladies des professions
insalubres. Paris, 1845.
Blaschko, . A. Zur Aetiologie und
Pathogenese des Gewerbeekzems.
Deutsche medicinische Wochen-
schrift, 1892, v. 18: 144-146.
4OO
American Labor Legislation Reviezv
Blum, F. Medizinisches uber die
Bleivergiftung. [Leipzig, G. Thieme,
1912] I6 p.
Boobyer, Philip. Abstract of report
upon the health of lace dressing
operatives. [Nottingham, I907] 48
p. (With Nottingham, Eng. Health
dept. Annual health report for
Igo6)
. . . . The health of lace-dressing
operatives. Royal sanitary insti-
tute. Journal, 1907, v. 28: 480-482.
Boulin, M. Les fonderies de plomb.
Paris, Imprimerie nationale, 1907.
Io7 p. “Extrait du Bulletin de l'in-
spection du travail, 1906, nos. 5 et
6.”
Bourdin, C. E. Association philo-
technique. Section de Choisy-le-
Roi (Seine). Du progres considéré
particulièrement au point de vue da
bienêtre hygiènique des classes la-
borieuses. Paris, 1865.
Boycott, A. E., Damant, G. C. C.,
Haldane, J. S. Prevention of com-
pressed-air illness. Journal of hy-
giene, 1908, v. 8: 342.
Braye, F. J. Quelques réflexions sur
l'influence exercée par diverses pro-
fessions sur l'économie animale.
Paris, 1836.
Breton, J. L. L'interdiction de la cé-
ruse dans l'industrie de la peinture.
French section, International asso-
ciation for labor legislation. Third
series. no. I.
º º . Les maladies profession-
elles. Encyclopédie parlementaire
des sciences politiques et sociales.
Paris, Dunod and Pinat. I9II.
Bristowe, J. S. Industrial diseases
(in London. International health
exhibition. Conference, 1884. Lon-
don, 1884. no. 2, p. 99-I39.)
Broca, A. Ostéite des nacriers. Ga-
zette des hopitaux, May I, I904, v.
77: 6II-617.
Bunge, Augusto. Las conquistas de
la higiene social . . . t. 1. Buenos
Aires, Talleres gráficos de la Pen-
itenciaria nacional. Ig1o.
Calmettes, . Emile. Le staturnisme.
Prophylaxie, législation comparée,
Paris, Giard et Brière, 191o. I56 p.
Canada. Lavs, statutes, etc. I9IO-
II. An act to prohibit the manu-
facture and importation of matches
made with white phosphorus. Ot-
tava, Printed by C. H. Parmelee,
19Io-II] 3, II] p. (Parliament,
19Io-II. H. of C. Bill no. Io)
Carozzi, Luigi. L'assimilazione delle
malattie professionali agli infor-
tuni del lavoro in Francia . . . Fi-
II p.
renze, Tip. L. Niccolai, 19Io.
º a . Avvelenamenti e infezioni
professionali esposti per ordine al-
fabetico... Milano, 1909. IIo p.
Bibliography, p. IIo.
Contributo allo studio delle
condizioni igienico-sanitarie nel-
la trattura della seta. Firenze,
I9Io. I2 p. (Estratta dal “Ram-
azzini” giornale italiano di medicina
sociale, anno IV, Fasc. II-I2...)
. . . . Inchiesta igienica-sanitaria
nell' industria poligrafica in Italia.
I Firenze, Tip. Luigi Niccolai, I9II]
4 pts. (Associazione internazionale
per la protezione legale dei lavora-
tori. Sezione italiana. Pubblicaz-
ioni, n. s., n. 2, 4, 6
. . . . I lavoratori del libro di
fronte ai problemi dell' ingiene del
lavoro e dell' assiscurazione malat-
tia... Milano, 19Io. 22 p. (Estrat-
to dal giornale 'Il Lavoratore del
libro”, anno XXXVI, n. 17.)
. . . . Linee per una statistica di
morbilita delle classi lavoratrici...
Firenze, 19Io. Io p.
. . . . Organizzazione e funzion-
amente delle consultazioni dall
dott. L. Carozzi... Estratto deg-
li Atti della Societá medico-biolo-
gica, vol. IV° fasc. 3, 1909. Milano,
I9Io. 8 p.
º o º Reperti ematologici e loro
valore statistico nel saturnismo
professionale dal dott. Luigi Car-
rozzi... Milano, Tip. ditta F. Fos-
sati, I909. 28 p. (Estratto dal Cor-
riere sanitario, n. 5-6, 1909, anno
e C e Ricerche sperimentali sul
carbonchio da inalazione... [I-II]
I909-Io. 2v. Pt. I “Estratto dal
Milano, Società editrice libraria,
periodico 'Il Morgagni'. n. Io,
I909”. Pt. II “Estratto dal Cor-
riere sanitario. n. 21, I9Io, anno
XXI”. Bibliography in footnotes.
º º a Le malattie professionali
alla sezione petto e cuore dell' Am-
bulatorio policlinico. Tribuna med-
ica (Milano), 1905, v. II: 97-Io6.
Bibliography (Other Than American)
40I
e tº e ºs Il servizio delle consult-
azioni della clinica del lavoro. Mi-
lano, 191 I.
Castellani and Chambers.
tropical medicine. Igio.
poisoning”: p. II8.
Castelnau, B. de. Note sur l’influence
de la détention, des diverses indus-
tries, et du nouveau régime des mai-
sons centrales, sur les setenus de
la maisons de Nimes, pour l’année
1839. Annales d'hygiène, 1842, v.
27: 198-215.
Central-Verein für das Wohl der ar-
beitenden Klassen. Bericht tiber
Manual of
“Lacquer
seine Entwickelung und Tätigkeit *
von 1844 bis 1883, vorgelegt der all-
gemeinen deutschen Austellung
für Hygiene und Rettungswesen.
Berlin, 1883.
Chatelain, L. La protection interna-
tionale ouvrière. Paris, A. Rous-
seau, 1908. x, 243, [1] p. “Biblio-
graphie”: p. ſ.vii}-x.
Chevallier, A. De la fabrication des
amorces; des dangers qu’elle peut
causer, de la responsabilite du fabri-
cant. Annales d'hygiène, 1875, 2.
sér., v. 43: 330–335. o
Christie, J. On the hygiene of
trades. Sanitary journal (Glas-
gow), 1882-83, n. S., v. 6: I93-207.
Chyzer, Bela. Des intoxications par
le plomb se présentant dans la cé-
ramique en Hongrie. Budapest,
Impr. A. Schmidl, 1908. 36 p. (As-
sociation internationale pour la
protection des ouvriers. Edition
de la section hongroise, no. I)
º gº º . Az akkumulatorokkal ka-
posolatosan elofordulo ipari beteg-
segekrol. Gyögyászat, 1905, v. 45:
784; 8o3. º e
. . . . . Gewerbekrankheiten. Zeit-
schrift für Gewerbe-Hygiene, 1907,
V. I4: 475; 503. tº
. . . . Über die im ungarischen
Tonwarengewerbe vorkommenden
Bleivergiftungen... Jena, 1908. 32
D. (Schriften der Ungarischen
Vereinigung für gesetzlichen Ar-
beiterschutz. Heft. I)
Clinica delle malattie professionali di
Milano. Patologia ed igiene del la-
voro. Serie I, 1912. F. Fossati, Mi-
lano.
tº e de Istituti clinici di perfez-
ionamento di Milano. Programma
degli nisegnamenti del
Milano, Ig II.
• * * Istituti clinici di perfe-
zionamento di Milano. Regola-
mento della clinica delle malattie
professionali. Milano, 1910.
Congres international d'hygiene, de
sauvetage et d’economie sociale,
Bruxelles, 1876. Rapport sur l’hy-
giène en Suède, rédigé, par ordre
du Comité suédois, par. O. Printz-
sköld. Stockholm, 1876.
Congresso internazionale per le mal-
attie del lavoro, Ist, Milan, 1906.
Atti del I.” Congresso internazion-
ale per le malattie del lavoro, Mi-
IQII-I9I2,
lano 9-14 Giugno 1906. Milano,
1906. 784 p.
to º . 2d, Brussels, 1910. [Pro-
ceedings] 1911.
Congresso nazionale per le malattie
del lavoro. Ist, Palermo, 1907. Atti
del I Congresso nazionale per le
malattie del lavoro (malattie pro-
fessionali ) Palermo, 19–21 ottobre
1907. Palermo, Stab. tip. Virzi,
1908. xxiii, 342 p., I I.
Contini, C. Igiene dell’ operaio. Ro-
ma, 1881.
Coreil, Francois. Les industries in-
salubres; Établissements classés....
par Francois Coreil... et León
Nicolas... Paris, H. Dunod & E.
Pinat, 1908. 778 p.
Coronel, S. S. De gezondheidsleer
toegepast op de fabrieknijverheid.
Amsterdam, 1863.
Criegern, von. Ueber eine gewerb-
liche Vergiftung beobachtet bei der
Rauchwaarenfärbung mit Paraphe-
nylendiaminpräparaten, welche un-
ter dem klinischen Bilde eines
Bronchialasthmas verläuft. Ver-
handlungen des Congresses für in-
nere Medicin (Wiesbaden), 1902, v.
20: 457-464.
Cutts, William Henry. On the injur-
ious effects of close confinement
and overwork. Australasian medi-
cal gazette, Jan. 1885, v. 4: 90-95.
Dammer, Otto. Handbuch der Ar-
beiterwohlfahrt. Bearb. von dr. As-
cher, prof. Büsing, privatdocent
stabsarzt dr. Dieudonné ſetc.]
Stuttgart, F. Enke, 1902-03. 2 v.
illus., diagrs.
Darwall, J. De morbis artificum prae-
4O2
American Labor Legislation Review
cipue eorum qui Birminghamiae hab-
bitant. Edinburgi, I82I.
De l'influence des professions sur la
durée de la vie, Annales de demog-
raphie internationale, Paris, 1880, v.
4: 2I3-22I.
Delperier, Louis. La protection de la
santé des travailleurs du com-
merce. Paris, A. Rousseau, I9Io.
vii, 23o p. “Bibliographie”: p. [v]-
Avii.
Desbouis, J. Ètude sur les maladies
professionnelles considérées comme
accidents du travail. Paris, 1904.
Devoto, L. La clinica delle malattie
professionali di Milano, sua azione
scientifica e sociale. Clinica medi-
italia (Milano), 1908, v. 47: I73-
I7o.
. . . . . Le malattie del lavoro. La-
voro (Pavia), 19O3, v. 2: 34: 49.
La clinica delle malattie
pro1essionali di Milano. Corriere
sanitorio (Milano), 1908, v. 19: 255-
235.
o º fo
. . . La clinica del lavoro di
Milano nelle sue origini. Genova.
I9II.
e º a I8 Mesi di clinica dei
verniciatori di Milano. Conferenza
popolare. Milano, 19 II.
. . . . Le alterazioni dei vasi,
dei reni e delle articolazioni nel sat-
urnismo cronico. Igi I, F. Fossati,
Milano.
Devoto, L. and Carozzi, L. Rapport
sur la protection hygienique des
travailleurs dans l'industrie typogra-
phique, Roma, 1912. Association in-
ternationale pour la protection legale
des travailleurs.
Dictionaire des sciences médicales, par
une société de médecins et de chi-
rurgiens: MM. Adelon, Alard, Ali-
bert... [ et autres] Paris, C. L. F.
Panckoucke, 18I2-22. 6o v. plates
(partly fold.) tables (partly fold.)
“Maladies des artisans”: v. 3o, p.
2o9-236.
Didot, A. Diseases of artisans. San-
itary record (London), 1875, Io9-III.
Discussion on the diseases of occu-
pation. British medical journal,
I9OI, v. 2: 40I-4I2.
Disque, –. Ueber den Einfluss der
Fabrikarbeit auf die Gesundheits-
verhältnisse der Arbeiter in Thann
im Ober-Elsass. Archiv fur Óffent-
liche Gesundheits-Pflege in El-
sass-Lothringen, 1882, v. 7: 99-II3.
Drouineau, G. Note sur l'industrie
des buandiers et la législation ac-
tuelle concernant les établisse-
ments insalubres; avec discussion.
"e d'hygiène, 1879, v. I: 647-
o s . . . Sur les conditions sani-
taires des ouvriers des grands chan-
tiers. Revue d'hygiène, I88I, v. 3:
498-5oo. ſº s
Duchesne, Laurent. Réponses aux
questionnaires de l'Office interna-
tional du travail. I902. Publication
no. IV. Belgian section of the In-
ternational association for labor leg-
islation.
Duckering, G. Elmhirst. Cause of
lead poisoning in the tinning of
metals. Journal of hygiene, 1908,
v. 8: 474-503. o
Ducrot, M. Le saturnisme dans la
typographie. France. Direction du
travail. Bulletin de l'inspection du
travail, I906, no. 5 and 6.
Dullin, Albert. L'hygiène et la se-
curité des travailleurs dans la lég-
islation française. Paris, A. Rous-
seau, 19O3. xi, 35o p. “Bibliograph-
ie”: p. [vii]-xi. Èdition contenant
les dispositions récentes de la loi
générale du 19 février Igo2 et les
reglements nouveaux concernant:
I° Les industries manufacturières.
2° Les industries minières. 3° L'in-
dustrie agricole.
Edis, A. VV. Counter seats for shop-
vomen. The standing evil. Lon-
don, I878. -
Ehrenfeld, Richard. Die Aktion der
österreichischen Regierung zur Be-
Kämpfung der Bleivergiftungen in
hüttenmännischen und gewerblichen
Betrieben, Wien, F. Deuticke,
I9Io. 97 p. (Schriften der &sterr.
Gesellschaft für Arbeiterschutz. xiv.
Hft.)
Eingabe des Vorortes an die Kantons-
regierungen und Gemeindeverwal-
tungen vom. Io. März Igo5, betref.
Ersetzung des Bleiweisses im Mal-
ergewerbe durch bleifreie Farben.
I9o5. Publication no. Io, Swiss sec-.
tion, International association for
labor legislation.
Eisenstadt, H. L. Beiträge zu den
RIrankheiten der Postbeamten.
Berlin, I9II. o
Bibliography (Other Than American)
403
Enfermendades profesionales. (In
Congreso medico internacional de
accidentes del trabajo de Lieja de
1905. Apuntes y consideraciones.
Barcelona, Igos. p. 37-42.)
Erismann, Gigiena fabrichnikh
rabochikh, remeslennikov i. po-
denshchikov. Sbornik sochinenii
po sudebnoi meditsinie, 1877, V. I;
798; 976.
Eulenberg, H. Handbuch der Ge-
werbe-Hygiene auf experimenteller
Grundlage. Berlin, I876.
Ferrero, L. O. Contribuzioni e studi
igienici sur lavoro nelle campagne
e in parecchie arti e industrie in
provincia terra di lavoro. Caserta,
1884.
Fischer, R. Der Entwurf einer Liste
der gewerblichen Gifte. Bericht an
die Internationale Vereinigung für
gesetzlichen Arbeiterschutz erstat-
tet. Frankfurt a. M., IQIo. 48 p.
º e º º Die industrielle Herstel-
lung und Verwendung der Chrom-
verbindungen. Berlin, 1911. I71 p.
(Schriften des Instituts für Ge-
werbehygiene zu Frankfurt a. M.
Iv. Il) . . *
. . . . Die Krankheits- und Un-
fallverhütung im Gewerbetrieb
Gewerbehygiene, Arbeiterschutz,
Frankfurt a. M., E. Griesser, ſ 19- )
40 p. (Aufwarts, Bücherei zur Be-
lehrung und Erholung... Nr. 5.)
[Flegel, Charles.] The abuse of the
scaphander in the sponge fisheries.
From Bulletin of the Bureau of
fisheries, volume xxviii, 1908. Pro-
ceedings of the Fourth Internation-
al fishery congress, Washington,
1908. Washington, Govt. print. off.,
I9Io. I p. 1, p. 513:543. (U. S.
Bureau of fisheries. Doc. no. 668)
France. Conseil d'hygiène publique
et de salubrité du départment de la
Seine. Maladies professionnelles.
(In its Rapport générale sur les
travaux, 1862-1866. Paris, 1870. p.
61-75.) . . -
tº º . Direction du travail. Hy-
giène et sécurité des travailleurs
dans les ateliers industriels. Lég-
islation française et étrangère. Par-
is, Imprimerie nationale, 1895. 659
p. (Ministère du commerce, de l'in-
dustrie, des postes et des télé-
graphes. Office du travail)
tº º . Poisons industriels. Paris
Imprimerie nationale, 1901. vii p.,
I I., 449 p. “Extraits de lois et
règlements des principaux pays in-
dustriels sur l'hygiène des ateliers
dans les industries insalubres:” p.
265-433. -
º tº . Laws, statutes, etc. Lois,
décretes, arretés concernant la rég-
lementation du travail et nomen-
clature des établissements danger-
eux, insalubres ou incommodes.
(Juillet) Paris, Nancy, Igo&. I49
D. -
. I909. , IS5 p.
© tº . Ministère du travail et de
la prévoyance sociale. Les condi-
tions du travail aux États-Unis,
étudiés spécialement dans la tan-
nerie au chrome pour chaussures.
Mission du Ministère du travail (mai
1908) Rapports présentés à M. le
ministre du travail par M.M. F. Pin
... et H. Chaumartin ... Ch. Fritz
et F. Richard et Charles
Barrat, enquêteur permanent au
Ministère du travail, chef de la
mission. Paris, É. Cornély et c”,
1910. 2 p. 1., [vii.1-xvi, 317 p., 1. 1.
incl. tables.
. . . . Préfecture de police. Rap-
port sur les opérations du service
d'inspection des établissements
classés... IQ09. Paris, IQIO.
Freund, L. Die Berufskrankheiten
und ihre Verhütung, mit besonder-
er Berücksichtigung der graphi-
schen Gewerbe. Halle a. S., Igoi.
Freycinet, C. de. Hygiène industriel-
le en Angleterre; rapport sur l'as-
sainissement des fabriques ou des
procédés d’industries insalubres en
Angleterre. Annales d'hygiène,
I864, 2. Sér., v. 22: 245; 1865, 2.
sér., v. 23: 51-I97.
* Traité d’assainissement in-
dustriel, comprenant la description
des principaux procédés employés
dans les centres manufacturiers de
1’Europe occidentale pour protéger
la Santé publique et l'agriculture
contre les effets des travaux indus-
triels. Paris, Dunod, 1870. 2 p. 1.,
x, 473 p. incl. tables. and atlas of
2I pl.
Friedrich, V. Gewerbekrankheiten
und déren Erreger. Archiv für Un-
fallheilkunde, Gewerbehygiene und
404
American Labor Legislation Review
Ge, A. Porajenie nosovoi polosti
rabochich prigotovliajoutschich dvu-
chromokisloe kali. Meditsinskii
Vestnik, 1882, v. 21: 735; 749; 746;
OO.
Gewerbehygiene und Gewerbekrank-
heiten. Rundschau des Instituts
für Gewerbehygiene zu Frankfurt
a. M. [v. II- 1911- Berlin, 191 I-
monthly. -
Gilbert, W. H. Beiträge zu den neuer-
en Heilverfahren in ihrer Bedeutung
für die Behandlung der Berufs-
krankheiten und Unfallsverletzun-
gen. Berlin, IQ03.
Gine, J. Higiene del trabajo. Inde-
pendencia médica (Barcelona), 1877,
v. I2: 2OI; 213; 225; 261; 273; 289;
302.
Glogner, W. Die Krankheiten, welche
durch den Gewerbebetrieben verur-
sacht werden, und die volksthüm-
lichen Heilmittel derselben. Lieg-
nitz, 1880.
Godfrain, J. Sur l'hygiène des ouv-
riers des manufactures. Paris, 1852.
Golebiewski, Ed. Atlas and epitome
of diseases caused by accidents . . .
authorized translation from the Ger-
man, with editorial notes and addi-
tions by P. Bailey. Philadelphia,
W. B. Saunders & co., Igoo. 1 p.
1., II-549 p. illus., col. pl. (Saund-
ers’ medical hand-atlases).
Goliner, Dr. Gewerbliche Gesundheits-
gººge. Gross-Lichterfelde, 1910.
5 p. -
Gollmann, W. Ueber Künstler-Krank-
heiten. Wien, 1875.
Gosse, A. L. Sur les maladies causées
par 1’exercice des professions. Par-
is, 1816.
Gt. Brit. Board of trade. Royal com-
mission on labour, 1894. Papers
showing the action taken by the
Board of trade with regard to cer-
tain recommendations of the Roy-
al commission on labour respecting
Seamen of the mercantile marine.
Presented to both houses of Par-
liament by command of Her Ma-
jesty. London, Printed for H. M.
Stationery off., by Eyre and Spottis-
woode, 1894. 7 p. ([Parliament.
Papers by command] C. 7540)
Gewerbekrankheiten,
I2I–I37.
I900, V. 4:
. . . . Orvosi haladás az IQ00;
évben az impari megbetegedés ter-
en. Orvosi hetilap (Budapest),
1901, v. 45: 320; 337; 353; 370; 388;
40I.
Friedrich, Wilhelm. Die Phosphor-
nekrose in Ungarn. Jena, I9Io. 69
19. (Schriften der Ungarischen
Vereinigung für gesetzlichen Ar-
beiterschutz . . Hiſt. 4)
Friedrich, W. Zur Frage der Lungen-
krankungen unter den industriellen
Arbeitern. Archiv für Unfallheil-
kunde, Stuttgart, 1899, v. 3: I-33.
• * *. Report on grinding of
metals and racing of grindstones.
Parliamentary papers, London, 1909,
Cá. 4913.
e e º Ventilation of factories
and workshops, pt. I and 2. Cd.
3552, 3553.)
Friedrich, W. and F. Tauszk. Der
Einfluss der accuten Arbeit auf das
Verhalten des Herzens. Wiener
medizinische Presse, 1892, v. 33:
497; 544; 583. -
Frischmann, G. A foglalkozási meg-
bet egedesekrol. Gyögyászat (Bud-
apest), 1900, v. 40: 580.
Frois, Marcel. Pratique de l'hygiène
industrielle à l'usage des industriels,
des ingénieurs et des architects d’
usines, des conseils d'hygiene et des
commissions sanitaires... par...
Marcel Frois & Paul Razous...
Paris, 1907. 215 p.
Gaboriau, A. P. Contribution à
l'étude des spasmes professionnels.
Paris, 1887.
Gallard, Frank. L'hygiène d'ouvrier
aux États-Unis, considérée au dou-
ble point de vue du milieu profes-
sionnel et de l'assistance adminis-
trative. Paris [etc.] Berger-Levrault
& c”, 1905. xvii, 200 p. incl. illus.,
plan, tables. At head of title: Rap-
port présenté à M. le ministre du
commerce, de l’industrie, des postes
et des télégraphes.
Gaskell, P. Artisans and machinery:
the moral and physical condition of
the manufacturing population con-
sidered with reference to mechani-
cal substitutes for human labour.
London, J. W. Parker, 1836. xv,
399, [I] p.
tº e º 'º º Consulate. Düsseldorf, Ger-
many. Ankylostomiasis. Reports
on the outbreak in the Westphalian
Bibliography (Other Than American) 405
tº º e º 'º'
colliery district in Germany... Lon-
don, 1903. 23 p. (Cd. I67I)
© e. Foreign office. Belgium.
Report on the precautions taken to
combat ankylostomiasis (Miner’s
worm disease) in Belgium. Lon-
don, 1907. 22 1. (Diplomatic and
consular reports. Misc. ser. no. 656)
Col. 3284)
tº e . Germany. Report on the
regulations respecting the manufac-
ture of lucifer matches in Germany
and Prussia... London, 1894. 6 p.
(Parliament. Papers by command.
Cd. 6856-59)
Home dept. Dangerous
trades. Action taken by the Home
office under the factory and work-
shop acts... • London, 1906. 6 p.
(Cd. 3037)
tº e º e e Factory and workshop acts.
Dangerous and unhealthy industries.
Regulations and special rules, in
force on Ist January, 1908. Lon-
don, Printed for H. M. Stationery
gº by Darling & son, ltd., 1907.
9 p.
. . . . . Factory and worshop acts.
1901 and 1907, and Notice of acci-
dents act, 1906. Preliminary tables
(subject to correction) of cases of
industrial poisoning, fatal and non-
fatal accidents, and dangerous oc-
currences in factories, workshops,
etc... I9IO. London, IQII. ([Par-
liament. Papers by command]
5548, 6472.)
Lead compounds in pottery.
Report to Her Majesty’s principal
secretary of state for the Home de-
partment on the employment of
compounds of lead in the manufac-
ture of pottery, their influence upon
the health of the workpeople, with
suggestions as to the means which
might be adopted to counteract
their evil effects. By Professor T.
E. Thorpe... and Professor Thom-
as Oliver... London, 1899. 50 p.
(Cd. 9207)
tº º . Lead smelting. Special
report on dangerous or injurious
processes in the smelting of mater-
ials containing lead and in the man-
ufacture of red and orange lead, and
flaked litharge. By Edgar L. Col-
lis... London, IQIO. 29 p. (Cd.
5152)
e e º - e. Tinning of metals.
e - e º & Manufacture of patent fuel.
Special report on ulceration of the
skin and epitheliomatous cancer in
the manufacture of patent fuel, and
of grease, by T. M. Legge, M.D.
London, Igio. IO p.
tº ſº e º & Report to the Secretary of
state for the Home department on
the health of Cornish miners. By
J. S. Haldane... London, 1904. IO7
p. (Cd. 2091)
e e - e. e. Report upon the conditions
under which bronzing is carried on
in factories and workshops. By Ed-
gar L. Collis... London, 1910. 32 p.
(Cd. 5328)
Special
report on dangerous or injurious
processes in the coating of metal
with lead or a mixture of lead and
tin. By Miss A. M. Anderson, H.
M. principal lady inspector of fac-
tories, and T. M. Legge, M.D., H.
M. medical inspector of factories.
Together with a report on an exper-
imental investigation into the condi-
tions of work in tinning work shops,
and appendices. By G. Elmhirst
Duckering, one of H. M. inspectors
of factories. Presented to both
houses of Parliament by command
of His Majesty. London, Printed
for H. M. Stationery off., by Darl-
ing & son, ltd., 1907. 42 p. diagrs.
Parliament. Papers by command.
(Cd. 3793) ©
. . . . Use of phosphorus in the
manufacture of lucifer matches. Re-
ports... on the use of phosphorus in
the manufacture of lucifer matches;
by Professor T. E. Thorpe... Pro-
fessor Thomas Oliver... and Dr.
George Cunningham... London,
1899. 236 p. (Cd. 9188)
. . . . Workmen's compensation act,
1906. Order of the Secretary of
state for the Home department, dat-
ed May 22, 1907, extending the pro-
visions of the workmen’s compensa-
tion act, 1906, to certain industrial
diseases. London, 1907. 4 p. (Cd.
3539)
tº e º 'º - Workmen’s compensation act,
1906. Order of the secretary of
state for the Home department, dat-
ed December 2, 1908, extending the
provisions of the workmen's com-
pensation act, 1906, to certain indus-
406
American Labor Legislation Review
trial diseases, and amending the pre-
vious order of May 22, 1907. Lon-
don, 1908. 4 p. (Cd. 4419) ſe
Committee on compensation
for industrial diseases. Report of the
departmental committee on compen-
sation for industrial diseases [with
Minutes of evidence, appendices,
and index.] London, Printed for H.
M. Stationery off., by Wyman and
sons, limited, 1907. 2 v. in I. diagrs.
([Gt. Brit. Parliament. Papers by
command] Cd. 3495-3496).
- º º Committee on lead, etc., in
potteries. Report of the depart-
mental committee appointed to in-
quire into the dangers attendant on
the use of lead, and the danger to
health arising from dust and other
causes in the manufacture of earth-
enware and china and in the pro-
cesses incident thereto, including
the making of lithographic trans-
fers... [with appendices and min-
utes of evidence] London, Printed
for H. M. Stationery off., by J.
Truscott & son, ltd., 1910, 3 v. in 1.
plates. ([Parliament. Papers by
command] Cd. 5219, 5278, 5385)
tº tº º e º Dangerous trades (anthrax)
committee. Report of the Depart-
mental committee appointed to in-
quire into the conditions of work in
wool-sorting and other kindred
trades. London, 1897. 35 p. (Cd.
8506)
º e º e º Dangerous trades (anthrax)
committee. Report of the Depart-
mental committee appointed to in-
quire into the conditions of work
in wool-sorting and other kindred
trades. London, 1897. 35 p. (Cd.
8506).
º - e º º Dangerous trades committee.
Reports of the Departmental com-
mittee appointed to inquire into and
report upon certain miscellaneous
dangerous trades... London, 1898–
99. 3 v. (Cd. 8522, 9073, 9420, 9509).
e - e º & Treaties, etc., 1901-1910. (Ed-
ward VII.) Accession of the Unit-
ed Kingdom to the International
convention signed at Berne, Sep-
tember 26, 1906, prohibiting the use
of white (yellow) phosphorus in
the manufacture of matches. De-
cember 28, 1908 . . . London
[1909] 8 p. (Treaty series no. 4,
1909.) (Cd. 4530)
....... Report on grinding of metals
and racing of grindstones. Parlia-
mentary papers, London, 1909. (Cd.
© º & © tº º ...Ventilation of factories and
workshops, pt. I and 2. (Cd. 3552,
3553.)
. . . . . Report of a committee of
the Admiralty on deep water diving.
London, IQO7.
Greer, William Jones. Industrial dis-
eases and accidents, by W. J. Greer.
... Bristol, J. W. Arrowsmith; [etc.,
etc.] I909. xiii, [I], 326 p. viii pl. 4 l.
“List of authors and works of ref-
erence used in the text”: p [xi]—
xiii. “Section on injuries and dis-
eases of the eye. By R. J. Coulter’’:
p. 277-3 I2.
Grillet, Louis. L'hygiene du travail
dans les établissements industriels
et commercializ. Paris, [1906?] I92
D.
Gubler et Napias. Des moyens de
diminuer les dangers qui résultent
pour les travailleurs des différentes
industries de l'employ des substan-
ces minérales toxigues: mercure,
plomb, arsenic, etc. Congrès inter-
national d'hygiene, 1878. Paris,
1880, p. 598-654.
Guer, E. Guerlin de. Les établisse-
ments insalubres. L’industrie et hy-
giene, Paris, 1883, 43 p. 80. Berger-
Levrault et Cie.
Guerard, A. Hygiène des ouvriers
chargés du service des moteurs à
vapeur. Annales d'hygiène, 1873, 2
sér., v. 40: 347-365.
Guy, William A. Contributions to a
knowledge of the influence of em-
ployments upon health. Royal sta-
tistical society of London. Jour-
nal, Aug., Dec. 1843, v. 6: 197-2II;
283-3O4.
Hahn, Martin. Die Gesundheitsver-
hältnisse in polygrapischen Ge-
werbe Deutschlands mit besonderer
Berücksichtigung der Bleivergif-
tung. Bericht an die Internationale
Vereinigung für gesetzlichen Ar-
beiterschutz... Berlin, Druck der
vaterländischen Verlags- und
Kunstanstalt [1909?] 59 p.
tº º Der Fabrikarzt. Soziale
Medizin und Hygiene, 1906, v. 1:
238–242.
Haldane, John Scott. Report to the
secretary of state for the Home de-
Bibliography (Other Than American)
407
partment on ankylostomiasis in
Westphalian collieries, by J. S. Hal-
dane... Presented to both houses
of Parliament by command of His
Majesty. London, Printed for H.
M. Stationery off., by Darling &
son, ltd., 1903. I3, [I] p. (IGt.
Brit. Parliament. Papers by com-
mand] Col. I843)
e G tº Effects of abnormal at-
mospheric pressure and tempera-
ture on the human subject. Lan-
cet (London), 1907, v. II; IO52.
tº tº ſº Hygiene of work in com-
pressed air. Engineering maga-
zine, April, Igo&, v. 35: 97-99.
. . . . Hygiene of work in com-
pressed air. Lancet (London), I907,
Halfort, A. C. L. Entstehung, Ver-
lauf und Behandlung der Krank-
heiten der Künstler und Gewerbe-
treibenden. Berlin, I845.
Handbuch der Arbeiterkrankheiten.
Jena, G. Fischer, 1908. 859 p.
Handbuch der Unfallerkrankungen,
Einschliesslich der Invalidenbegu-
tachtung... Bearb. von C. Thiem. ..
2. ganzlich umgearb. Aufl. Stutt-
gart, F. Enke, 1909-Io. 2 v. in 3.
“Litteratur”: vol. I-2.
Hannover, A. Haandvaerkernes Syg-
domme, et Bidrag til Kundskab na-
ermest Om Forholdene i Kjoben-
havn. Kjobenhavn, 1861.
e g º 'º e Die Krankheiten der Hand-
werker. Monatsblatt für medicin-
ische Statistik und offentliche Ge-
sundheitspflege, 1861, v. — p. 33; 4I;
49.
Harbaugh, –. Causes of disability.
(In Saunders’ medical hand atlas of
diseases caused by accidents.)
Hauck, Karl. Die Gesundheitsver-
hältnisse der Glasmacher. (In, Con-
cordia, Zeitschrift der Zentral stelle
für Volkswohlfahrt, hrsg. von H. Al-
brecht. Berlin, 1910. xvii Jahrg.,
no. 17 [und] I’8. p. 350-55, 382–87.
Heijermans, L. Handleidung tot de
kennisder beroepsziekten. Rotter-
dam. W. L. & J. Brusse, 1908. 550
p.
Heller, Mager and von Schrotter. Die
Luftdruckerkrankungen. Vienna,
IQOO.
Hellström, J. Om yrkessyukdomar
% industriel hygien. Stockholm,
I896.
Herzheimer, —. Ueber die gewerb-
lichen Erkrankungen der Haut.
Deutsche medicinische Wochen-
schrift, 1912, no. I.
Hill, Leonard. Prevention of caisson
sickness. Engineering magazine,
May, 191 I, v. 4I: 33I-335.
tº tº sº º Physiology of submarine
work. Nature, Oct. 26, 1911, v. 87:
567-573. e
* † e Caisson sickness and the
physiology of work in compressed
a11. IQI2.
Hill and Macleod. Caisson disease and
diver’s palsy. Journal of hygiene,
I903, p. 401.
Hirt, L. Die Arbeiterhygiene auf der
internationalen Ausstellung in Brüs-
sel. Deutsche Vierteljahrsschrift
für öffentliche Gesundheitspflege,
1877, v. 9: 39 I-396.
. . . . . Die Krankheiten der Ar-
beiter. Breslau, 1871–1878.
Hoffel, Ueber die Gesundheits-
verhältnisse der Arbeiter in den Fa-
briken von Buchsweiler. Archiv für
Öffentliche Gesundheits-Pflege in E1–
sass-Lothringen, 1878, v. 3: III-I27.
Hoffman, Die Krankheiten der
Arbeiter in Theer- und Paraffinfabri-
ken in medicinisch-polizeilicher
Hinsicht. Vierteljahrsschrift für ge-
richtliche Medicin und Öffentliches
igitatsween 1893, v. 5: 358; v. 6:
I 285.
Hoffman, F. and B. A. Ramazzini. A
dissertation on endemical diseases
... together with a treatise on the
diseases of tradesmen. London,
I746.
Holitscher, Industrial hygiene.
Holland, G. C. The vital statistics of
Sheffield, 1843. .
Hungary. Kereskedelemügyi minister-
ium. Iparifelugelok tevekenysege..
1899-1900. Budapest, 1901. I v.
Inbert, A. Ueber professionelle
Krankheiten. Zeitschrift für Ge-
werbe-Hygiene [etc.], 1905, v. I2:
699-702. -
Influence of employments on health.
Journal of the royal statistical so-
ciety, London, v. 6: 197, 283; v. I2:
232. I843.
Institut fur Gewerbehygiene. Frank-
furt am Main. Bleimerkblatt für
Hüttenarbeiter... [Frankfurt a. M.,
I9Io?] I 1.
Ao8
American Labor Legislation Review
º . Das Institut für Gewerbe-
hygiene zu Frankfurt am Main...
Frankfurt a. M., I9Io. 72 p.
. . . . Mitteilungen des Institutes
für Gewerbehygiene zu Frankfurt
a. M. Beiblatt zur Sozial-technik.
I.– Berlin, A. Seydel, I9Io–
monthly. Issued also with Sozial-
technik.
. . . . . Programm des Kursus für
Unfallheilung und Gewerbekrank-
heiten... Frankfurt a. M., Englert
& Schlosser, 19II. [II] p.
e e e e Tätigkeitsbericht...
Frankfurt am Main, [I9II–
International association for labor leg-
islation. Deux mémoires présentés
aux gouvernements des états indus-
triels en vue de la convocation d'une
Conférence internationale de pro-
tection ouvrière. Publiés par le Bu-
reau de l'Association internationale
pour la protection legale des tra-
vailleurs. Paris [etc.] Berger-Lev-
rault & cie, 1905. 44, 32, [45]-49
p. (Publications de l'Association
internationale pour la protection le-
gale des travailleurs, no. 4)
º o Les industries insalubres.
Rapports sur leurs dangers et les
moyens de les prevenir, particu-
lièrement dans l'industrie des allu-
mettes et celles qui fabriquent ou
emploient des couleurs de plomb...
Jéna, G. Fischer [etc., etc.] 1903. 46o
I9IO–
International congress of first aid and
ID.
life saving. Ist, Frankfurt a. M.,
I908. Bericht iber den Internation-
alen Kongress für das Rettungs-
wesen zu Frankfurt a. M., Io.-I4.
juni I908. Hrsg. von der kongress-
leitung. Redigiert vom George
Meyer... Berlin, August Hirsch-
vald, I908-1909. 2 v.
International congress of hygiene and
demography. I3th, Brussels, 1903.
Compte rendu du Congrès... Brux-
elles, P. Weissenbruch, 19O3. 9 v.
Vol. 2-8: “Première division.-Hy-
giène”; v. 9: “Deuxième division.-
Démographie.” Contents.-t. I.
Compte rendu du Congrès –t. II.
Section I. Bactériologie.-t. III. Sec-
tion 2. Hygiène alimentaire.–t. IV.
Section 3. Technologie sanitaire.-
t. V. Section 4. Hygiène industrielle
et professionnelle. –t. VI. Section 5.
Hygiène des transports et communi-
cation-t. VII. Section 6. Hygiène
administrative – . VIII. Section 7.
Hygiène coloniale. –t. IX. Démog-
raphie.
. . I4th, Berlin, 19o7, Bericht
über den XIV. Internationalen
Kongress für Hygiene und Demog-
raphie, Berlin, 23.-29. September
I9o7. Redigiert vom generalsekre-
tär, professor dr. Nietner... Berlin,
A. Hirschwald, 1908. 4 v. illus., fold,
plates, fold. diagrs. In German,
French and English.
Italy. Commissione incaricata di stu-
diare le cause e provvedimenti pre-
ventivi delle malattie degli operai
nelle industrie. Atti della Commis-
sione incaricata di studiare le cause
e provvedimenti preventivi delle ma-
International conference on labor reg-
ulation. Ist, Bern, I9o5. Confér-
ence internationale pour la protec-
tion ouvrière à Berne. (Du 8 au I7
mai I905) [n. p., 1905] I28 p.
o o s - o 2d, Bern, 1906. Actes de la lattie degli operai nelle industrie...
Conférence diplomatique pour la I. pt. Roma, 1903.
protection ouvrière réunie à Berne . . . . . Ministero di agricoltura, in-
du 17 au 26 Septembre 1906. Berne, dustria e commercio. Igiene indus-
triale. legislative e
Impr. Staempfli & cie, 1906. I65 p.
Separatbeilage zum Bundesblatt nr.
45 vom 7, November 1906. Contents.
–Documents préliminaries –Procés-
verbaux des séances plénières et des
séances de commission –Textes
adoptés par la Conférence: Conven-
tion internationale sur l'interdiction
du travail de nuit des femmes em-
ployées dans l'industrie. Conven-
tion internationale sur l'interdiction
du phosphore blanc (jaune) dans
l'industrie des allumettes.
Disposizioni
regolamentari vigenti all'estero per
la tutela della salute degli operai e
per la prevenzione delle malattie
professionali. Roma, Bertero, I9II.
466 p. (Its Annali del credito e della
previdenza, n. 93)
fficio del lavoro. L'indus-
tria dei fiammiferi fosforici in Italia
e la lotta contro il fosforismo. Roma
1905. 44 p. (Its Pubblicazioni. ser.
., Il.
e - e o e I lavoratori delle miniere...
Bibliography (Other Than American)
409
Roma, (Its Pubblica-
zioni.
Jacquot,
giéniques
Paris, 1844.
Jarvis, E. Connection of occupation
with longevity. n. p., n. d.]
Juderias, Julian. La higiene y su in-
fluencia en la legislación; memoria
premiada por la Sociedad espanola
de higiene... Madrid, Imp. de la
Suc. de M. Minuesa de los Rios,
19Io. 86 p. (Associación interna-
cional para la protección legal de los
pajadores, sección española, núm.
I9
Juraschek, F. von. Einfluss der Be-
rufsverhâltnisse auf Erkrankung und
Sterblichkeit. Allegemeine Wiener
medizinische Zeitung, 1888, v. 23:
I43; I56; I8I; 209; 234.
Kaup, Ignaz. Blei- und Phosphorver-
giftungen in den gewerblichen be-
trieben Ósterreichs. Tatsachen und
Aufgaben der Gesetzgebung. Be-
richt erstattet der Internationalen
Vereinigung für gesetzlichen Ar-
beiterschutz. Wien, F. Deuticke,
I9o2. 79 p. (Schriften der Ósterr.
Gesellschaft für Arbeiterschutz. III.
Hft.)
e e se e º Bleivergiftungen in der kera-
mischen Industrie... Berlin, I9o8?
54 p. (Deutsche Sektion, Gesell-
schaft für soziale Reform)
Kay, J. P. The moral and physical
condition of the working classes em-
ployed in the cotton manufacture in
Manchester. 2d ed. London, Long-
man, 1832. I2o p.
Kerschensteiner, J. Die Fürther In-
dustrie in ihrem Einfluss auf die
Gesundheit der Arbeiter. Aerzt-
liches Intelligenz-Blatt, I874, v. 2I:
305; 3I5; 329.
Klebe, H. Die gewerbliche Bleiver-
giftung und ihre Verhütung. Mün-
chen, Th. Ackerman, I9II. I75 p.
Koelsch, F. Zum Kampfe gegen die
Tuberkulose. Führer durch das
K. Arbeiter-museum. München,
I9II] 3I p. (K. B. Arbeiter-museum
in München. Mitteilungen Nr. 8,
Nr. I, I9II)
Konrich, F. Ueber den Einfluss der
Beschäftigung auf den Organismus.
Würzburg, 1864.
Kummel, Hermann.
I9O7. I v.
ser. B. no. I7)
A. B. Considerations hy-
sur les manufactures.
Zahnarzt und
Arbeiterschutz... Berlin, 1903.
p.
Lakeman, J. B. Health in the work-
shop. London, 1884.
Lane, W. A. Some changes in the
form of the acetabular cavities, spi-
nal column, and joints of the hand,
illustrated by the anatomy of the
charwoman. Guy's hospital reports,
1887, 3d. ser., v. 29: 359-567.
Lawes, Edward Thornton Hill. Tin-
ning of metals. Report to His Ma-
jesty's secretary of state for the
Home department on the draft reg-
ulations proposed to be made for
factories and workshops in which
tinning of metal articles is cariº
1
I3I
on, by Edward Thornton
Lawes... London, I909. 22 p. (Cd.
474o)
Layet, A. E. Hygiène des professions
et des industries. Paris, 1875.
Lazarus, —. Eine neue Gewerbe-
krankheit. Allgemeine medicinische
Central-Zeitung, I9oo, v. 69: II99.
Legge, S. M. On the diseases of oc-
cupations. British medical journal
(London), I9oI, v. 2; 4oI-405.
º 0 º . Industrial lead poisoning.
ºrnal of hygiene, I9oI, v. I: 96-
IOS.
Lemoigne, A. Ligiene dei contadini
considerati nei loro rapporti col bes-
tiame. Milano, 1886.
Leroye. Die Fortschritte der Indus-
trie und ihr Einfluss auf die Berufs-
krankheiten der Arbeiter. Deutsche
Revue, Berlin, I879, v. 3: 382-398. -
Lewin, L. Die Grundlagen für die
medizinische und rechtliche Beurtei-
lung des Zustandekommens und
Verlaufs von Vergiftungs-und In-
fektionskrankheiten im Betriebe.
Berlin, C. Heimann, I9o7, 36 p.
9 0 Die Hilfe für Giftarbei-
ter. Sonderabdruck aus der Deuts-
chen Medizinischen Wochenschrift,
I904, no. 25. Leipzig, I9O4.
Lewis, W. Report on the laws and
ordinances in force in France on the
regulation of noxious trades and oc-
cupations. London, 1855 (?).
Lewy, E. Specielle Krankheiten ein-
zelner Industriezweige und die Ver-
hütung derselben. (In Internation-
al Congress of Hygiene and Demo-
graphy. 8th Budapest. Comptes-
rendus et mémoires, 1894. Buda-
pest, 1896. v. 8, pt. 3: 58-64.
41O
American Labor Legislation Review
Leymann, Dr. Die Bekämpfung der
Bleigefahr in der Industrie. Ergeb-
nisse der Preisausschreibens der In-
ternationalen Vereinigung für Ge-
setzlichen Arbeiterschutz. Im Auf-
trage des Internationalen Arbeits-
amtes zu Basel . Jena, G.
Fischer, 1908. 256 p.
Louis, Paul. L'ouvrier devant l’état;
histoire comparée des lois du trav-
ail dans les deux mondes. Paris, F.
Alcan, 1904. 480 p. “Hygiène et
securite”: p. 282-302.
Lundbye, J. T. Stov i industrien og
dets Bekaempelse. Igo3. Publica-
tion no. 4. Danish association for
labor legislation.
Luson, Thomas. The Diseases of
Workmen, by T. Luson, M. D. and
R. Hyde, M. R. C. S. With an in-
troduction by His Honour Judge
Ruegg, K. C. London, Butterworth
& co., 1908. viii, III, [5] p. “List
of references”: I p. following p. III.
Magruder, William Edward. Claims
arising from results of personal in-
juries; the relation injury bears to
disease and disease to injury; a
treatise showing how personal in-
juries may affect various diseases,
and how certain diseases may add to
claims for accidents by protracting
recovery. New York, Chicago, The
Spectator company [*1910] , 266 p.
Bibliographies at end of chapters.
Mahler, Ueber Gewerbekrank-
heiten, Aerztliche Mittheilungen
aus Baden, 1905, v. 59: I67–172.
Maladies professionnelles. Revue in-
ternationale du commerce, de l’in-
dustrie et de la banque, Dec. IOII,
13. année: 881–883; Mar. IQI2, I4 an-
née: I48-185.
Mapother, E. D. The prevention of
artisan's diseases. (In Lectures on
* health. Dublin, 1874. p. 132-
I47.
Marek, Ferdinand. Measures against
phosphor-necrosis in Austria. In-
ternational, June, 1909, v. 5: 209-
2II.
Martial, René. Hygiène individuelle
du travailleur... Paris, V. Giard &
E. Brière, Igo7. 351 p.
. . . . L'ouvrier, son hygiène, son
atelier, son habitation... Paris, Oc-
tave Doins et fils, 1909. 419 p. Bib-
liography, [391]-405 p.
e e sº Sur l'assimilation des mal-
adies professionnelles aux accidents
du travail. Revue internationale de
la tuberculosis, 1909, v. 25: 245-260.
Masse, Daniel. Législation du travail
et lois ouvrieres. Paris, Nancy,
Berger-Levrault et cie, 1904. 874 p.
“Hygiène et securite”: p. 351-438.
Mercanti, F. Sulle malattie che più
frequentemente colpiscono i cerni-
tori di stracci. Corriere sanitario
(Milano), 1906, v. 17: 688; 698.
Miller, Maximilian. Die Erwerbsun-
fähigkeit im Sinne des Invalidenver-
sicherungsgesetzes und ihre Ursach-
en... [Berlin] Arbeiterversorgung,
1908, 194 p. “Literatur” p. [vil-
V111.
Monatsschrift für Unfallheilkunde und
Invalidenwesen. Festnummer an–
lässlich des 25.jährigen Bestehens
der Unfallversicherungsgesetze, un-
ter Mitwirkung mehrerer in der Be-
gutachtung und Behandlung Unfall-
verletzter, tátigen Aerzte und Heil-
anstaltsleiter, hrsg. und dem
deutschen Reichversicherungsamt
gewidmet vom Herausgeber und
Verlager der Monatsschrift für Un-
fallheilkunde und Invalidenwesen.
Leipzig, 1910. [297]-515 p.
Monin, E. L'hygiene du travail. Guide
medicale des industries et profes-
sions. Paris, 1888, J. Hatzet et Cie,
300 p.
Monin, F. A propos du malaise pro-
fessionnel. Lyon médical, Igoó, v.
IO6: 420-425. -
Mooren, A. Die Sehstórungen und
Entschädigungsprüche der Arbeiter.
Düsseldorf, 1891.
Mori, A. Contributo alle affezioni
professionali. Ramazzini (Firenze),
1908, v. 2: 78-84.
Muller, Richard. Die Bekämpfung der
Bleigefahr in Bleihütten. Von der
Internationalen Vereinigung für Ge-
setzlichen Arbeiterschutz preisge-
krönte Arbeit... Jena, G. Fischer,
I908. 207 p.
Munich, K. Bayerisches Arbeiter-mu-
setum. Bestimmungen über das Bay-
erischen. Tuberkulosewandermuse-
um. München, 1911. 8 p. (K. B. Ar-
beiter-museum in München. Mittei-
lungen, Nr. 9; Nr. 2, 1911)
Napias, H. L'inspection hygiènique
Bibliography (Other Than American)
4II
des fabriques et ateliers.
d'hygiène, 1883, 3. sér., v. Io: 412-
425.
Nasmyth, T. G. Diseases of occupa-
tion. Sanitary journal (Glasgow),
1895-96. n. S., v. 2: 514-525.
Naudet, S. V. O. Essai sur l'hygiène
du laboureur. Paris, 1861.
Neison, Francis G. P. The influence
of occupation upon health, as shown
by the mortality experienced. In-
stitute of actuaries. Journal (Lon-
don), July, 1872, v. 17: 95-126. .
Neisser, E. J. Internationale Uber-
sicht tiber Gewerbehygiene; Berlin,
Verlag Gutenberg [1907] .352 p.
tº e g º & Der erste international Kon-
gres für die Gewerbekrankheiten zu
Mailand (9-14. Jun.) Medicinische
Reform (Berlin), 1906, v. I4; 391-
394.
Netherlands (Kingdom) I815— Cen-
tral gezondheidsraad. Verslag over
het voorkomen van den mijnworm
boven den grond in Limburg. In
opdracht van de ministers van bin-
nenlandsche zaken en van landbouw,
nijverheid en handel samengesteld
door den Centralen gezondheids-
raad en den directeur-generaal van
den arbeid. [’s Gravenhage? I909?]
97 p. incl. tables.
tº º . Loodwitcommissie. [Eers-
ten and] Tweede voorloopig rapport
door de Loodwitcommissie, in Feb-
ruari 1908 uitgebracht aan den min-
ister van landbouw, nijverheid en
handel. Uitg. door het Departement
van landbouw, nijverheid et handel.
[’s Gravenhage, Drukkerij V/h H.
L. Smits, 1908. II p.
tº tº Rapport der Loodwitcom-
missie, benoemd bij besluit van den
minister van binnenlansche zaken
d. d. 12 September 1903, no. 7216,
afdeeling a. (Uitg. door het De-
partement van landbouw, nijverheid
en handel). 's-Gravenhage, Gebrs.
J. & H. van Langenhuysen [1909]
68 p. incl. tables. viii fold. diagr.
Newsholme, A. Occupation and mor-
tality. , Transactions of the Sanitary
Institute, 1893, London, 1894, v. I4:
8I-IOI.
New South Wales. Statistician’s of—
fice. Tuberculosis in New South
Wales. A statistical analysis of
the mortality from tubercular dis-
Annales
eases during the last thirty-three
years. By John B. Trivett . . . gov-
ernment statistician. Sidney, W. A.
Gullick, government printer, I909.
v, 81 p. incl. tables. 4 diagr.
Nikolaeff, F. Promishlennost kak
prichina bolaiznei. Vrachebniya
vaidomosti, 1876, v. I, no. 68: 4; no.
70: 3; no. 7 I : 4.
Noble, Daniel. Facts and observa-
tions relative to the influence of
manufactures upon health and life.
London, 1843. -
Noir, J. Une assurance en case de
décès à la suite de contagion d'ori-
gine professionnelle. Progrès médi-
cal (Paris), 1903, 3. sér., v. 18: I33.
Norgate, R. H. Diseases of the boot
and shoe trade. Journal of the Roy-
al institute of public health, Lon-
don, 1909, v. 17: 353–356.
Nusser, J. Ueber Krankheiten bei
Gewerben überhaupt und über eine
bei Seifensiedern vorkommende
Hautwassersucht. München, 1838.
Oldendorff, A. Der Einfluss der Bes-
chäftigung auf die Lebensdauer des
Menschen, nebst Erörterung der
wesentlichsten Todesursachen. Ber-
lin, 1877.
Oliver, Thomas. Dangerous trades:
the historical, social and legal as-
pects of industrial occupations as
affecting health, by a number of ex-
perts; edited by Thomas Oliver...
London, J. Murray, Igo2. 891 p.
tº gº © tº º Diseases of occupation from
the legislative, social, and medical
points of view. London, Methuen
& co. [1908] xix, 427, [I] p. 2 pl.
(Half-title: The new library of
medicine; ed. by C. W. Saleeby)
tº e º & & Lead poisoning and the race
... London, Eugenics education so-
ciety, [1911] II p. (Reprinted from
“The Eugenics review', July, 1911).
Ollive, G. and H. Le Meignen. De
l'assimilation des maladies profes-
sionnelles aux accidents du travail.
Gazette médicale de Nantes, IQ05,
2. Sér., v. 23: 621; 646.
On the influence of manufactures on
health. British and foreign medico-
chirurgical review, 1843, v. I5: 286–
3I4.
Orjollet, J. B. A. De l'influence de
certaines professions comme cause
de maladies, et de quelques moyens
préservatifs et curatifs. Paris, 1825.
4I2
American Labor Legislation Review
Österreichische Gesellschaft für Ar-
beiterschutz, Vienna. Antràge der
Osterreichischen Gesellschaft für
Arbeiterschutz betreffend I. Ver-
hitung der Bleivergiftung und der
Caissonkrankheit; 2. Schutz der
Heimarbeiter; 3. Erhebungen über
Arbeitszeit in Gesundheitsschäd-
lichen Betrieben und Arbeitsur-
laube. (Eingaben an die Regie-
rungen) . . Wien, Selbstverlag der
Österreichischen Gesellschaft für
Arbeiterschutz, IoII. I6 p.
Paraf, Georges G. Hygiène et sécu-
rité du travail industriel. Paris, V”
C. Dunod, 1905. vii, 632 p. illus.
Contents.-Introduction.—I. ptie.
Généralitiés.—2. ptie. Industries di-
verses.—3. ptie. Législation.
Parry, Leonard A. The risks and
dangers of various occupations and
their prevention. London, Scott,
Greenwood & co., 1910. IQ6 p.
Pecholier, G. and C. Saintpierre. Etude
sur l'hygiène des ouvriers peaus-
siers du département de l'Hérault.
Montpellier médical, I864, v. I2: 301–
332.
Périssé, S. Etude microscopique des
poussières industrielles. Revue
d'hygiene, Paris, 1894, v. 16: 397:417.
Permanent international committee
for the study of industrial diseases.
Bulletin de la Commission interna-
tionale permanente pour l'étude des
maladies professionnelles. I.-an-
née, avril 1908— Florence, IQ08–
pam. fold. pl. quarterly. “Biblio-
graphie et Fiches bibliographiques”
are included in each number.
* e º 'º º Medici ispettorato del lavoro.
Cusano, Tipografia A. Colombo e
figli, 1911. I76 p. (Its Pubblicaz-
ione 2.* della serie I.") Bibliography,
p. 173-176.
Perris, G. H. Industrial disease; the
quantitative aspect, London. Royal
institute of public health. Journal,
1895, v. 3: IO4-I-2.
Perroncito. La malattia dei minatori.
Torino, IQIO.
Pfennig, M. Ursache, Verhütung und
Behandlung der Nerven—, Lungen
—, Verdauungs— und Kehlkopf-
Leiden (als Berufskrankheiten der
Kaufleute, Lehrer, Beamten, etc.).
Stuttgart, [n.d.]
Phosphorus Treaty. International
convention respecting the prohibi-
tion of white (yellow) phosphorus
in the manufacture of matches. Text
of treaty signed at Bern on Septem-
ber 26, 1906 by representatives of
Germany, Denmark, France, Italy,
Luxemburg, Switzerland and the
Netherlands. Bulletin of the Inter-
national Labor Office, vol. I. p. 296.
Also Bulletin of U. S. Bureau of
Labor No. 86, p. I46.
Pieraccini, Gaetano. Patologia del
lavoro e terapia sociale... Milano,
I906. 695 p.
tº e º Lº La patologia del lavoro.
Clinica moderna (Pisa), I903, v. 9:
555-558. &
Poincare, Dangers de la fabri-
kation des objets en carton vernis-
ses et laqués. Annales d'hygiène,
1881, 3. sér., v. 5: I32-138.
Pol and Wattelle. Memoire sur les
effets de la compression de l’air.
Annales d'hygiène publique et de
medicine legale, 1854.
Popper, M. Beiträge zur Gewerbe-
Pathologie. Vierteljahrsschrift für
gerichtliche Medicin und Öffent-
liches Sanitätswesen, 1879, n. S., v.
30: 98-II8.
* > . Lehrbuch der Arbeitkrank-
Stutt-
heiten und Gewerbehygiene.
gart, 1882.
Porée, Henri, Livache, Ach. Traité
théoretique et pratique des manu-
factures et ateliers dangereux, insal-
ubres, ou incommodes, etc. Paris,
1887, Marchal et Billard. 704 p.
Prendergast, W. Dowling. The potter
and lead poisoning... London, Mar-
shall, Russell & co., Longton,
Hughes and Harber, 1898. 54 p.
Projektierte Ausdehnung des gegen-
wärtigen französischen Arbeiterun-
fallgesetzes auf Krankheiten ge-
werblichen Ursprungs. Zeitschrift
für Gewerbe-Hygiene [etc.], 1905,
v. I2: 479; 507.
Proust, A. Nouvelle maladie profes-
sionnelle chez les polisseuses de
camées. Annales d'hygiène, 1878, 2.
Sér., v. I: 193-206.
tº º e Professions: maladies pro-
fessionnelles. International diction-
naire de médecine et chirurgie pra-
tique, Paris, 1880, v. 29: 509-583.
Pulligny, Leclerc de. Hygiène indus-
trielle, par Leclerc de Pulligny...
Bibliography (Other Than American)
4I3
[and others] ... Paris, 1908. 610
p. (Traité d'hygiène; pub... par
M.M. Brouardel, Chantemesse et
Mosny. [fasc.] 7)
Ramazzini, Bernardino. De morbis ar-
tificum diatriba. (In his Opera om-
nia [etc.]. Genevae, 1716. p. 470-
696.)
. . . . . Essai sur les maladies des
artisans. Paris, 1777.
. . . . Health preserved in two
treatises. I. on the diseases of
artificers, which by their particular
callings they are most liable to, with
the method of avoiding them and
their curse. II. on those distemp-
ers which arise from particular cli-
mates, situations, and methods of
life, with directions for the choice
of a healthy air, soil and water. 2d
ed. London, I750.
* * > * > A treatise of the diseases of
tradesmen, shewing the various in-
fluence of particular trades upon the
state of health; with the best meth-
ods to avoid or correct it, and use-
ful hints proper to be minded in reg-
ulating the cure of all diseases in-
cident to tradesmen. Written in
Latin by Bern. Ramazzini ... and
now done in English.
Printed for A. Bell [etc.] 1705. 6
p. 1., 274 p. e
. . . . A treatise on the diseases
of tradesmen to which they are sub-
ject by their particular callings. (In
Hoffman, Frederick, ed. A disserta-
tion on endemial diseases, etc. Lon-
don, 1746.)
Ramazzini; giornale italiano di medi-
cina sociale Anno I—Gennaio
1907—Firenze, L. Niccolai, 1907–
v. illus., plates (partly fold.) maps
(partly fold.) tables (partly fold)
diagrs. (partly fold.) monthly.
Rambousek, Josef. Gewerbehygiene
für österreichische Amtsärzte, Phy-
sikatskandidaten, Verwaltungsbeam-
ten und Gewerbeinspektoren. Wien,
1909. 368 p.
. . . . Gewerbliche Vergiftungen,
deren Vorkommen, Erscheinungen,
Behandlung, Verhütung. Leipzig,
Veit & comp., 1911. xv, 431 p. illus.
Bibliographical references in text.
. . . . . Der erste internationale
Kongress für Arbeiterkrankheiten
in Mailand. Zeitschrift für Gewer-
be-Hygiene [etc.], 1906, v. I3: 327;
359; 391.
London,
Rate of mortality. Laws of sickness,
influence of trade and locality on
health. Data by Neison from Friend-
ly Societies. Journal of the royal
statistical Society, London, v. 8: 290;
v. 9: 50. I845.
Razous, Paul. Réglementation du tra-
vail industriel. Commentaire pra-
tique, par Paul Razous ſet] Armand
Razous. Paris [etc.] Berger-Lev-
rault & cº", 1901. x, 328 pp. “Hy-
giène et securite du travail et des
travailleurs”: p. 107-425.
Reille, P. Les maladies profession-
nelles. Annales d'hygiène, 1908, 4
sér., v. 9: 38-74.
Repaci, F. Le stigmate e le modifi-
cazioni e lesioni organiche delle por-
tatrici di peso sul capo nelle Cala-
brie. Ramazzini (Firenze), 1907, v.
I: 483-496. &
Riadore, J. E. On the remediable
evils attending the life of the peo-
ple engaged in professions, com-
merce, trade and labour... London,
1847.
Richardson, B. W. Diseases incident
to public life. Asclepiad (London),
1885, v. 2: 289-298.
Rivalta, R. Malattie professionali ed
infortuni del lavoro nella vita civile
e nella vita militare. Rocca San
Casciano, 1908. 349 p.
Romanelli, L. L’influenza delle artie
dei mestiere sulla salute degli op-
erai: relazione igienico-statistica.
Napoli, 1879.
Ronzani, E. Intorno all’ influenza del-
le inalazioni di gas irritanti delle in-
dustrie; sui poteri di difesa dell'or-
ganismo verso le malattie infettive.
Annali d'igiene sper. Roma, Igo9, n.
S. V. IQ : I.39–I93.
Roose, R. The wear and tear of Lon-
don. London, 1886.
Ropke, F. Die Berufskrankheiten des
Ohres und der Oberen Luftwege.
Ohrenheilkunde der Gegenwart und
ihre Grenzgebiete, 1902, v. 2: I-I47.
º . Die Berufskrankheiten des
Ohres und der oberen Luftwege.
Wiesbaden, J. F. Bergmann, IQ02.
I47 p.
Rosenfeld, S. Gewerbekrankheiten
und ihre Verhütung in den Öster-
reichischen Fabriken. Wiener med-
izinische Blätter, 1898, v. 21: 6; 27;
39; 59; II9; 187.
Roth, Emanuel. Gewerbehygiene.
Leipzig, G. J. Göschen, I907. 156
4I4
American Labor Legislation Review
p. illus. (Sammlung Göschen.
[3501) “Literatur”: p. [I51]-I54.
* . . Kompendium der Gewerbe-
krankheiten und Einführung in die
Gewerbehygiene. Berlin, R. Schoetz,
I904. 27I p.
Royal society of arts, London. Shaw
lectures on industrial hygiene. De-
livered before the Royal Society of
arts in November and December,
I907; and February and March 1908.
London, Printed by W. Trounce,
I908. London, 63 p.
Rubin, J. Grundzüge der internen
Arbeiterversicherungsmedizin. Jena,
I909. 224 p.
Sanarelli, Discorso al Congres-
so per le malattie del lavoro. Cor-
riere sanitario (Milano), 1906, v. 17:
688; 698.
Sandwith, F. M. Diseases of miners,
wool-sorters and others. Clinical
journal, London, Igo&, v. 33: I33-
I38.
Schierbeck, N. P. Om bekaempelsen
af faren ved anvendelsen af giftstof-
fer i industrielle virksomheder....
Kobenhavn, 1907. I2 p. (Dansk
forening for arbeiderbeskyttelse. [2.
hfte.])
Schneider, H. Gefahren der Arbeit in
der chemischen Industrie; hrsg.
vom Verband der Fabrik-Arbeiter
Deutschlands. Hannover, Volks-
buchhandlung, 1911.
Schuler, F. and F. H. Whymper. Fa-
brikhygiene und Fabrikgesetzge-
bung. Deutsche Vierteljahrsschrift
für Oeffentliche Gesundheitspflege,
1888, v. 20: 283-302.
Schut, P. Bakker. Bericht tiber das
Verbot des Gebrauches von Bleifar-
ben und über die Versuche mit blei-
freien Farben in den Niederlanden
... Amsterdam, Drukkerij Plantijn,
1908. 21 p. (Nederlandsche ver-
eeniging voor wettelijke bescherm-
ing van arbeiders, section der In-
ternationalen Vereinigung für ges-
etzlichen Arbeiterschutz)
Schweizerische Vereinigung zur För-
derung des internationalen Arbei-
terschutzes, Bern. Eingabe des
Vorortes an die Kantons regierungen
und Gemeindewerwaltungen vom
Mârz 1905, betreffend Ersetzung des
Bleiweisses im Malergewerbe durch
bleifreie Farben. Bern, Buchdruck-
erei Beukomm & Zimmermann,
[1905] 7 p. ; (Its [Veröffentlichun-
gen] Hft. Io.) -
Mémoire du Vorort addres-
sé aux gouvernements cantonaux
aux administrations communales en
date du Io mars 1905 concernant la
substitution dans le métier de la
peinture en bâtiments de coleurs
sans plomb a la céruse. Berne,
Impr. coopérative de l'union, [1905].
8 p. (Association nationale pour
l'avancement de la protection inter-
nationale des ouvriers. [Publica-
tions] fasc. no. Io.)
Scott, A. Industrial diseases. Prac-
signer, London, Igo&, v. 81: 837–
45.
Sejournet. Etudes d'hygiène profes-
Sionnelle. France médicale, 1885, v.
2: I22I; I234; I245.
Shann, G. The influence of occupation
and habits on health. (In National
Association for the Promotion of
Social Science. Transactions, 1864.
London, 1865. p. 519–525.)
Statistical facts intended to
throw light on the influence of oc-
cupation on disease. British Medi-
cal Journal, 1862, v. 2: 248-253.
Silberstein, P. Die Berufskrankheit
der Caissonarbeiter. Oesterreich-
ische Sanitäts-Beamte, 1909, v. 21:
I25, IS3.
Smart, A. The effects of unhealthy oc-
cupations and their amelioration.
Medical press and circular. Lon-
don, 1883, n. s. v. 36: 505.
Smith, Constance. Dangerous trades.
Economic review, Oct. 1905. pp.
434–450.
Sommerfeld, Th. Der Gewerbearzt.
Jena, IgoS. p. 194.
Handbuch der
krankheiten. Berlin, 1898.
tº e º 'º º Liste der gewerblichen Gifte.
Jena, Gustav Fischer, 1912. 30 p.
Die Schwindsucht der Arbei-
ter, ihre Ursachen, Häufigkeit und
Verhütung. Berlin, A. Schlicke &
Co., IoI2. 64 p.
Sozial-technik, Zeitschrift für tech-
nische und wirtschaftliche Fragen
der Industrie, Unfallverhütung, Ge-
werbehygiene, Arbeiterwohlfahrt,
Gewerberecht. Organ des Vereins
deutscher Revisions-ingenieure. Ber-
lin, IQ– illus., diagrs. semimonthly.
Spain. Instituto de reformas sociales.
Proyecto de clasificación de indus-
Gewerbe-
* * * * *
Bibliography (Other Than American)
, 415
trias insalubres y peligrosas. Mad-
rid, Impr. de M. Servet, 1906. 24 p.
(Instituto de reformas sociales.
Sección 2.)
. . . . . Visita de inspección Á la
fábrica de sedas de Uygijar, por D.
Florencio Porpeta y Llorente; uné
informe de la Sección segunda tec-
nico-administrativa Madrid, Impr. de
M. Servet, IQ05. 37 p.
Steiner, K. Bosnische Arbeiterkrank-
heiten. Medicinisch- chirurgisches
Centralblatt, 1901, v. 36: 637-639.
. . . . . Zur Aetiologie der profession-
ellen Erkrankungen im Medianus-
gebiete. Münchener medicinische
'Wochenschrift, 1903. p. 381.
Steiner, Viktor. Handbuch der prak-
tischen Hygiene und Unfallverhü-
tung in Industrie, Gewerbe und
Bergbau unter besonderer Berück-
sichtigung und Namhaftmachung
der Bezugsguellen für sämtliche zur
Besprechung gelangenden Artikel
. . . Wien, Im Selbstverlage, 1908.
Stern, M. Zum Capitel Gewerbekrank-
heiten. Münchener medicinische
Wochenschrift, 1898, v. 45: IoS9.
Struve, H. W. E. Die Bestimmungen
der niederländischen Gesetzge-
bung gegen Ubermässige und ge-
fährliche Arbeit jūngerer Personen
und Frauen bezüglich die Heimar-
beit und Hausindustrie. IOO6. Dutch
association for labor legislation.
Sudeck, Paul. Der Arzt als. Begu-
tachter auf dem Gebiete der Unfall-
und Invalidenversicherung. Jena,
1906. 244 p. ©
Sutherst, Thomas. Death and disease
behind the counter, 1884.
Tallada, Jose Maria. El trabajo en
las câmaras de aire; Madrid, Imp.
de la sucesora de M. Minuesa de
los Rios, 1911. I4 p. (Asociación
internacional para la protección le-
gal de los trabajadores. Sección es-
pañola, näm. 24.)
* * * * * Los venenos industriales en
el trabajo à domicilo. Madrid,
Imp. de la sucesora de M. Minuesa
de los Rios, 1911. 7 p. (Asociación
internacional para la protección le-
gal de los trabajadores. Sección
española, näm. 22)
Tanquerel des Planches, R. Contri-
bution à l'étude des intoxications
professionnelles (cuprisme, zincisme,
hydrargyrisme). Paris, Igo2.
Teleky, Ludwig. Die Phosphorne-
krose. Ihre Verbreitung in Öster-
reich und deren Ursachen. Bericht
erstattet der Internationalen Verei-
nigung für gesetzlichen Arbeiter-
schutz. Wien, F. Deuticke, 1907.
v p., I 1., 182 p. incl. illus., tables.
(Schriften der Österr. Gesellschaft
für Arbeiterschutz. xii. hit. “Lit-
eratur”: [I79]-182. -
•' s e Die gewerbliche Quecksil-
bervergiftung. Dargestellt auf
Grund von Untersuchungen in Os-
terreich. (Schriften des Institutes .
für Gewerbehygiene). Berlin, Poly-
technische Buchhandlung, 1912, p.
I-228. Bibliography.
ê º º Vorläufige Mitteilungen
tiber die Quecksilbervergiftung in
Österreich. [Wien, 1910] 7 p. (Ös-
terreichische Gesellschaft für Ar-
beiterschutz)
. . . . Wiener Arbeiten aus dem
Gebiete der Sozialen Medizin. Wien,
Moritz Perles, 1910. ix, 189 p.
• * Vorläufige Mitteilungen
tiber die Quecksilbervergiftung in
Oesterreich. Arbeiterschutz, Wien,
I9IO, XX1. 22.
Thackrah, Charles Turner. The ef-
fects of arts, trades, and profes-
sions, and of civic states and habits
of living, on health and longevity:
with suggestions for the removal of
many of the agents which produce
disease, and shorten the duration
of life. 2d ed., greatly enl. Lon-
don, Longman, Rees, Orme, Brown,
Green, & Longman; [etc., etc.] 1832.
I p. 1., [viiil-viii p., I 1., 238 p.
Thienen, G. J. van. Gesetzlicher
Schutz der Caissonarbeiter. Neder-
landsche Vereeniging voor wet-
telijke Bescherming van Arbeiders.
Section der Internationalen Vereini-
gung für gesetzlichen Arbeiter-
schutz, Geschriften N. S. no. 6.
Amsterdam, 1910.
Thilo, O. Die árztliche Behandlung
der Arbeiter in Deutschland. St.
Petersburger medicinische Woch-
enschrift, 1898, n. S., v. 15: 259-267.
Thompson, Symes. On the influence
of occupation on health and life.
(In National Association for the
Promotion of Social Science. Trans-
actions, 1862. London, 1863, p. 587-
595.)
416
American Labor Legislation Review
Tissot, Samuel Auguste Andre David.
De la santé des gens de lettres. 2.
éd. augm. Lausanne, F. Grasset &
comp., 1769. xvi, 260 p.
e e . Essai sur les maladies des
gens du monde. 3d. ed.
I77I.
. . . . An essay on diseases in-
cident to literary and sedentary
persons. The 2d ed., with very
large additions... With a preface
and notes by Kirkpatrick, M .D.
London, Printed for J. Nourse
[etc.] I769. xxiv, 189 p.
Ubeda y Correal, Jose. Medios de
prevenir los peligros del manejo
del plomo en las fäbricas de colores,
de acumuladores, etc.,... Memoria
laureada por la “Asociacion inter-
nacional para la protección legal de
los trabajadores, de Basilea, en el
concurso internacional de IQ06. Ma-
drid, Imp. de la suc. de M. Minuesa
de los Ríos, 1908. 83 p. (Asocia-
ción internacional para la protec-
ción legal de los trabajadores; sec-
ción española, näm. 5)
Ueber die prakische Durchführung
der Fabrikhygiene. [Discussion]
Deutsche Vierteljahrsschrift für Oef-
fentliche Gesundheitspflege, 1878, v.
IO: I37–200.
L’Ufficio di consulenza medico-legale,
Milan. L’Ufficio di consulenza me-
dico-legale nel IQ09. Milano, IQIO.
Unhealthy occupations. Builder (Lon-
don), Feb. 5–19, 1876, v. 34: I28; 150;
I73-I74.
Untersuchung, inwiefern die psycho-
physichischen und die àusseren Be-
dingungen die Zahl und Schwere
der gewerblichen Unfälle und
Frankheiten der Erwerbenden be-
einflussen und Erörterung der Vor-
kehrungen, welche seitens der mass-
gebenden Faktoren und der Gesell-
schaft durchgeführt werden müssten
um auf diese Einflüsse entsprechend
einzuwirken. Zeitschrfit für Ge-
werbe-Hygiene [etc.], 1904, v. II:
49; 73; 97; I2I. tº
Vacher, F. Occupation in relation to
disease. Health lectures for the
people. Manchester & London,
1887.
Vandenbroeck, V. P. Aperçu sur l’
état physique et moral de certaines
classes ouvriers. Annales de méd-
Paris,
ecine belge et étrangère, 1834, v. -
220; 224; 234;; 242; 263; 272; 289;
293.
Vanderrijdt, H. Les industries insalu-
bres en Belgique. Igo2. Publica-
tion no. 3. Belgian section, Inter-
national association for labor legis-
lation.
Vaucel, C. N. Quelques causes de
maladies chez les ouvriers. Paris,
I833.
Vellguth, L. H. K. Ueber einen eigen-
artigen Erkrankungsfall in der
Zuckerindustrie. Göttingen, 190I.
Vernois, Maxime. Traité pratique d'
hygiène industrielle et administra-
tive, comprenant l'étude des étab-
lissements insalubres, dangereux et
incommodes. Paris, J. B. Baillière et
fils; New York, Baillière brothers;
[etc., etc.] I869. 2 v.
Vienna. Statistisches Departement. Die
Sterblichkeit an Tuberkulose und
Krebs in Wien im Jahre 1904, nach
Berufen. Wien, 1907. 87 p.
Viry, C. Quelques mots sur l'hygiène
des ouvriers de fabriques de crin vé-
gétal en Algérie. Revue d'hygiène
et de police sanitaire (Paris), 1884,
v. 6: IQI8-IO-22.
Vooys, Js. Peter de Bericht tiber
Bleivergiftung in den polygraphi-
schen Gewerben in den Niederland-
en... Amsterdam, Drukkerij Plan-
tiin. Igo3. 27 p. (Nederlandsche
vereniging voor wettelijke bescher-
ming van arbeiders, Section der
Internationalen Vereinigung für ge-
setzlichen Arbeiterschutz.)
Bleivergiftungen in der nie-
derländischen keramischen Indus-
trie, ... Amsterdam, Druck von J.
H. De Bussy, 1908. 83 p. (Neder-
landsche vereeniging voor wettelijke
bescherming van arbeiders, section
der Internationalen Vereinigung
für gesetzlichen Arbeiterschutz.)
. . . . Die gewerblichen Gifte
mit Ausnahme von Blei und Phos-
phor in den Niederlanden. Dutch
Association for labor legislation.
Wachter, Karl. Die gewerbliche Blei-
vergiftung und ihre Bekämpfung im
deutschen Reich. Karlsruhe i. B.,
G. Braun, 1908. 2 p. 1., Io? p. (Volks-
wirtschaftliche Abhandungen der
badischen Hochschulen . x. Bol.
2. Hft.)
Ward, Leonard. The effect, as shown
Bibliography (Other Than American)
4I7
by statistics, of British statutory
regulations directed to the improve-
ment of the hygienic conditions of
industrial occupations. Royal Sta-
tistical Society. Journal, Sept. 30,
1905, v. 68: 435-525.
Weyl, Theodor. Handbuch der Ar-
beiterkrankheiten. Jena. G. Fisch-
er, 1908. 809 p. Bibliographies at
end of chapters.
© . . Handbuch der hygiene...
Bearbeitet von Dr. Albrecht, Ber-
lin; Prof. Assmann, Berlin; [etc.,
etc.] Hrsg. von Dr. med. Th. Weyl.
Jena, G. Fischer, 1896-1901. Io
v. illus., fold. plates, plans, diagrs.
. . . . . Supplement. Jena, 1901–
Wieber, Franz. Der Arbeiterschutz
in der gesundheitsschädlichen und
schweren Industrie nebst statistis-
chen Erhebungen über Lohn, Ar-
beitszeit und hygienische Verhält-
nissé in den Hüttenwerken. Duis-
burg, Igo9. 247 p.
Wiener Arbeiten aus dem Gebeite der
sozialen Medicin... [I.— Folge]
1910— Wien, 1910—
Whitelegge, B. A. The epidemiologi-
cal aspects of industrial diseases.
(In Epidemiological Society of Lon-
don. Transactions, 1904-05. Lon-
don, 1905. n. S., v. 24, p. I-II.)
illis, T. Facts connected with the
social and sanitary condition of the
working classes in the city of Dub-
lin, with tables of sickness, medical
attendance, deaths, expectation of
life, etc.; together with some glean-
ings from the census returns, 1841.
Dublin, 1845.
ºr
Wing, C. Evils of the factory system
demonstrated by parliamentary evi-
dence. London, 1837.
Wolffensperger. De afhankelijkheid
der ziekten van oeconomische ver-
hondingen. Geneeskundige Courant
voor het Koningrijk der Nederland-
en, 1909, v. 63: 170.
Wretched state of the working classes.
Medico-chirurgical review and jour-
nal of practical medicine, (Lon-
don), 1845, v. 43: 290–326.
Zangger, Heinrich. Uber die Bezie-
hungen der technischen und gewer-
blichen Gifte zum Nervensystem.
(Sonderabdruck aus Ergebnisse der
inneren Medizin und Kinderheil-
kunde, V. Band, 1910.)
Zentralstelle für Arbeiter-Wohlfahrts-
einrichtungen. Kommunale Wohl-
fahrtseinrichtungen. Die plannäs-
sige Schwindsuchtsbekämpfung
durch Errichtung von Heilstätten
für Lungenkranke Berlin, C.
Heymann, 1897. 172 p. (Schriften
der Centralstelle für Arbeiter–Wohl-
fahrtseinrichtungen. Nr. 12)
. . . . . I4. konferenz, 1905. Die
Belehrung der Arbeiter tiber die
Giftgefahren in gewerblichen Be-
trieben. Vorbericht und Verhand-
lungen der I4. Konferenz der
Centralstelle für Arbeiter–Wohl-
fahrtseinrichtungen am 5. und 6.
Juni 1905 in Hagen I. W. Berlin,
C. Heymann, 1906. iv, I29 p.
(Schriften der Centralstelle für Ar-
ºfterwomanitentiºunsen. Nr.
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