C1LI'MIIE | car. For PUBLIC HEALTH Us. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE _ + Public Health Service P /{. 5. pub + 1314, X FY A x Hh at B . iE TE — an =a ria al The Health of Women Who Work Alice Hamilton, M.D., (1869- ) pioneer in the field of occupational health, first woman to hold a teaching position at Harvard University, and author of the first American textbook on industrial toxicology. Her stud- ies of lead and other industrial poisons, which began in 1910 and continued for many years, were a major contribution to the health of workers. The Health of Women Who Work MARGARET F. McKIEVER, B.A. U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Public Health Service PUBLIC HEALTH SERVICE PUBLICATION NO. 1314 U.S. Government Printing Office, Washington : 1965 For sale by the Superintendent of Documents, U.S. Government Printing Office Washington, D.C., 20402 - Price 30 cents HD7268 M3 FUBLIC HEALTH LIBRARY Preface THE NUMBER OF WOMEN now in the labor force and their importance to the national economy prompted the Division of Occupational Health, Public Health Service, U.S. Department of Health, Education, and Welfare, to con- sider the health aspects of their employment and to bring together information from various sources. The purpose of this publication is to make available in one source facts and expert opinions that will stimulate interest and help those concerned with the employment of women (1) to achieve a clearer perspective of women’s capabilities, and limitations, as workers; (2) to understand and evaluate the primary factors affecting the health of working women; and (3) to take whatever steps are necessary to protect the health and safety of this essential part of the labor force. The changes that have taken place in women’s employment over the last half-century are an integral part of the basic transformation in American life. To describe the various factors that have wrought these changes would require retelling the history of the United States, the National Manpower Council reports. This Council, established at Columbia University under a grant from the Ford Foundation, says, “Growth and change in the economy, advances in science and technology, an expanding urban population, develop- ments in education, the role of government as an employer, the crisis situa- tions of war and depression, social values and attitudes, patterns of marriage, childbearing, and life expectancy—all have contributed significantly to the revolution in women’s employment. . . . Currently women are represented in every professional field, and they hold top posts in management and gov- ernment. They handle baggage, work in railroad yards, and are teamsters. They are atomic physicists and engineers, bankers and real estate agents, clergymen and college presidents, artists and automobile mechanics. They run newspapers and hospitals. They work on assembly lines and farms and in offices, stores and restaurants. They are psychologists and mathemati- cians. They operate hydraulic presses and electronic computers. Hardly any significant area in the world of work still carries the tag ‘For Men Only’. Women now make up one-third of the labor force, and more than one-third of all women in the United States 14 years of age and over are employed. In 1963, 14.1 million working women were married with husband present; an additional 5.0 million women workers were widowed, divorced, or married with husband absent. These married and formerly married women con- stituted 77 percent of the female labor force. About half of them (9.3 million v 055 women) had children under 18 years of age. Forty-five percent of all moth- ers with children 6-17 years old and 24 percent of those with younger children were working. The 5.6 million employed single women represented only 23 percent of the female labor force, but 41 percent of all single women in the United States. Detailed information regarding women and their employment activities is available in the Women’s Bureau Handbook on Women ? and reports of the President’s Committee on the Status of Women.® Several tables providing information from the Handbook and other sources will be found in the Appendix. They substantiate the fact that the current female labor force includes a high percentage of mature, experienced, intelligent, stable and productive women whose health and welfare are extremely important to the nation as well as to their employers and communities. Today the average woman worker is 41 years old, is better educated than the average male worker, and is less apt to change jobs to improve her status or through layof!. Since the manuscript of this publication was completed, the Governor’s Committee on the Education and Employment of Women has made its report and recommendations to the Governor of New York. Mrs. Oswald B. Lord, Chairman, described the Committee’s objectives in words that apply equally to the preparation of this book: “We have tried to look at the statistics but see the people, to understand the problems but see them as opportunities, to build upon the great volume of good work and good thought that has been given to the world of women by national, state, and local experts in many areas. . . . The job is not done, for it never will be. The changing world of women will not stand still. But we have come to you with action recommendations. . . . And it is our hope that the program you may adopt will do its part to contribute to the growth and development and full utiliza- tion of the talents of . . . women, today and in the years to come.” ** vi Contents PREFACE x vos 0m sms 600 580 858500 x 5s 3 5 35 7 0 0 hs co ke 9 1: Hearre AnD SAFETY STATUS. con nner umminsnnsmrmasmssns Disability reported in the National Health Survey. .......... Sick absence in relation to occupation and industry. ......... Sick absence in relation to marital status... ................ Safety record. ............. nnn BFR EE BEE 2. THE WORKER AND THE WORKPLACE................oooon. Work capacity: Physical ability. ....cocnivinuinioninssmsnssnsmrmmrng ens Industrial fatigue. ................. on The work environment. . ..................cooiiiieiiiinn. Safely Measures. «i «ous evar vinirvsnssnrursnrenryinncns Safety counseling. . ........ocoviniciimnininninsmrsnran ins Supervision. . ......coeviiiriiiiiiiii asain 3. STANDARDS AND LAWS GOVERNING EMPLOYMENT. .......... Hour standards. .. .. o.oo eee Health standards. . ....c.covvurnrsiinsinsns snsmannsy SR Safety standards. .............. cc. Hour Jaws. . . ooo eee Health laws. ....... oon Occupational limitations... 4. HEALTH SERVICES IN INDUSTRY.......... 0.0... The medical department. . ......ccvivsrvsrvvrvrnvimomnsns an Health maintenance. . «oceans insmuinssnivisnims ares: Special health considerations. ............................. Cancer detection. ...........ouuieunin inane Health counseling... cc usu cssrenssrnntarsvsvonvrms snsmnns 5. PREGNANCY. .......viiiiiiinnniiiniinnnrssrnnneersssnnns Ability towork. .............. Maternity policy... .c.cvvvexrarinsavinrmminnnniassnsrcnnss Effect of work during pregnancy: Maternal considerations. . .................oiiiiiiian. Fetal considerations. .................uounnnennnneenenn. Maternity benefits. ......cvvivsnvrnroninrnnnnicnsesnninss 3 GUE DN < Oo 12 14 15 17 19 19 19 20 20 21 22 23 24 26 28 28 31 33 33 34 36 36 37 vii REFERENCES: cove veemesiien ss sins 0 05 50 835% 550 ee men mss APPENDIX Executive Order 10980, Establishing the President’s Commis- sion on the Status of Women. .......... .... .... .. Tables 1. 10. 1]. viii Number of work-loss days due to illness and injury and number of days per person, by employment status, sex, and age: United States, July 1959-June 1960... .......... .. - Number of work-loss days due to illness and injury among the currently employed and work-loss days per currently employed person by sex and age: United States, specified years, July 1959-June 1962........................... . Number of work-loss days due to illness and injury and days per currently employed person per year, by family income, sex, and age: United States, July 1959-June 1960... . . ... - Number of work-loss days due to illness and injury and days per currently employed person per year, by residence, sex, and age: United States, July 1959-June 1960............ - The incidence of acute conditions per 100 currently em- ployed persons, by type of condition, sex, and year of occurrence: United States, specified years, July 1959- kL - Number of days lost from work per 100 currently employed persons, because of acute conditions, by type of condition and sex: United States, specified years, July 1959-June J902. cnvumens carunnmimmemennsas emsmerns perms meses . Number of work-loss days associated with chronic condi- tions, work-loss days per 1,000 currently employed persons per year because of the condition, and average number of persons absent each day, for selected conditions, by sex: United States, July 1959-June 1960...... ............. - Restricted-activity and bed-disability days among usually working persons, by type of disability, sex, and age: United States, July 1959-June 1960. ....................... .. . Number of workers, mean age, and illness rates on an aver- age workday, by occupation and sex, civilian wage and salary workers: United States, July 1959-June 1960... . .. Number of workers, mean age, and illness rates on an aver- age workday, by type of employment and sex, civilian wage and salary workers: United States, July 1959-June 1960. . Mean age and illness rates on an average workday, by in- dustry and sex, private civilian wage and salary workers: United States, July 1959-June 1960. ................... 41 44 45 46 47 49 50 51 52 53 54 55 12. 13. 14. 15. 16. 17. 18. Mean age and illness rates on an average workday, by type of manufacturing and sex: United States, July 1959-June 1960. «oo Days of sick absence per person per year for employed civilian wage and salary workers. by marital status, age and sex: United States, July 1959—June 1961............ The 25 largest occupations of women: United States, BOO0. «even vm rmmrm sn ms Boab Es SHEET EEE mw as pw yw Major industry group of employed women: United States, 1964, 1950 and 1940... ............... iin. Women in manufacturing industries: United States, 1964 BUA TOO. co ccm nmr si RE EWES E RS SMM RE Women in selected nonmanufacturing industries: United States, 1964 and 1960. . . ................. ao. Rates of job changing, by age and sex: United States, 1961 BEAL BOBS... cr vinnie WEARER SRR Hs sp fs 773-197 0—65——2 56 57 58 59 60 61 62 ix Chapter 1 Health and Safety Status Is THE AMERICAN FEMALE more fragile than the male? Much can be said on this subject and opinions differ, but according to Dr. Claire Ryder it is possible for women to reply, “We survive.” Dr. Ryder’s statement is based on her experience with the Public Health Service and her familiarity with mortality statistics. She explains that under the harsh conditions of life in a rural primitive environment, male and female mortality tend to be similar, but industrialization and urbanization have apparently been accompanied by growing female superiority in life ex- pectancy. Underlying this “advanced country” theory is the possibility, suggested by recent studies, that women have a better constitutional resist- ance to degenerative diseases which enhances their survival chances once infectious diseases have been controlled. The most important factor in this survival quality is woman’s strikingly greater resistance to heart disease, the chief killer of our contemporary society. American men 40 to 74 years of age appear to be twice as vulner- able to heart disease as women of that age. During the past 20 years there has been a 30 percent increase in the cardiovascular-renal disease death rate for men and a 30 percent decrease for women. The male is the more physically active sex and therefore is more susceptible to accidents and other hazards, as well as to the stress and strain involved in economic survival. However, biologic and statistical data now available appear to place the burden of proof upon those who would deny an actual “built-in” superiority in resistance to disease in women.* Statistics on sick absence rates of men and women workers appear at first hand to belie woman’s claim to being the more “durable” of the sexes. Cer- tainly all available figures indicate that women workers lose more time from work than men. The difference, however, is not large, recent reports in- dicating only a 4 percent higher rate of sick absence for women than for men. Furthermore, the higher rate does not apply in all age, occupation, and marital status groups. National estimates of work absence due to illness are now available in considerable detail from the National Center for Health Statistics, U.S. Public Health Service. The figures are based on data derived from a continuous probability sample of the noninstitutional civilian population residing in 1 the United States. Information is obtained from nationwide household in- terviews, and the sample is so designed that interviews are conducted every week of the year in every State. The total sample size for the 3-year period, July 1957-June 1960, was approximately 111,000 households or 360,000 persons. Many survey reports include information regarding work loss, and one publication is restricted entirely to selected statistics relating to work loss associated with acute and chronic conditions.” Significant information from these and other reports on sick absence are discussed below. Disability reported in the National Health Survey National Health Survey reports classify the working population in two ways: (1) usually working and (2) currently employed. Usually working persons are defined as those whose major activity during the survey year was working. The term “currently employed” is more inclusive, since it covers both usually working persons and those who reported that at any time during the 2-week period covered by the survey interview they either worked at or had a job or business. Work-loss and other survey figures vary somewhat according to which definition of the work force is used. The amount of disability is naturally greater for currently employed persons, but since usually working persons make up nine-tenths of the currently employed, the rates for the two groups are fairly comparable. When the rates provided in Table 1 are reviewed, the greatest difference between usually working and currently employed persons appears to be in the youngest and oldest age groups. During the three survey years, July 1959-June 1962, male workers aver- aged 5.5 days and female workers 5.7 days of work loss per person per year. (Table 2) Among both men and women, the average number of days lost per person increased with age. Until 45 years of age, women had a higher work-loss rate than men. Between 45 and 55 years of age, the rates are more comparable. Men 55 and over experienced more work-loss than women, the difference probably being due, at least in part, to the fact that women are apt to retire at an earlier age than men. Work days lost by men and women, during the survey year 1959-60 varied according to family income. (Table 3) Men with family incomes under $2,000 had a much greater work loss due to illness and injury than any other income group male or female, the rate being 9.8 days per person in contrast with 6.5 days for female workers in the same low-income group. Women with family incomes of $2,000-$6,999 had a higher work-loss rate than men in the same category. Male and female workers with incomes of $7,000 or more had the same work-loss rate of 4.9 days per person. Work-loss rates also varied according to place of residence. Among workers in urban areas, women lost an average of 5.9 days during the year, or approximately two-thirds of a day more than men. In rural areas (farm and nonfarm) men had a higher rate of work absence, the difference between the sexes amounting to approximately one day per person per year. (Table 4) 2 Acute and chronic illness—An estimated 369.9 million days were lost from work by currently employed persons during the survey year July 1959-June 1960. There were 241.4 million such days associated with acute conditions (65.3 percent) and 195.7 million associated with chronic conditions (52.9 percent). The summation of these figures exceeds the total number of days lost because it sometimes happens that a person loses time from work because of concurrent conditions. During the survey period, 67.2 million work-loss days (18.2 percent of the total) were estimated to have been associated with more than one condition.’ Table 5, which gives the incidence of acute illness and injury among the currently employed, for 3 survey years, shows that men averaged about 1.5 and women 1.9 acute conditions per person annually. In each year, the difference in the rates for the two sexes was principally due to the higher incidence of respiratory diseases among women. Also, deliveries and condi- tions associated with pregnancy are included in the figure for “all other” acute conditions. Acute conditions due to injuries of various types occurred more frequently among men. The average woman worker is over 40 years of age, and older women continue to enter industry. Nearly 10 million over 45 years of age were employed in early 1965. They have a good work record and lose less time because of illness and injury than men in the same age group. Their sick absence rate also compares favorably with that of younger women. (Courtesy Standard Oil Company of New Jersey.) Illness due to acute conditions causes slightly more work loss among women than among men. During the four survey years covered in Table 6, the annual average was 3.8 days per year per person among currently em- ployed women, or approximately one-half day more than among men. Res- piratory conditions caused over half of the work loss among women and almost one-half of the loss among men. Men had a substantially higher work loss due to injuries. During the survey year 1959-60 chronic conditions caused the average man to lose approximately one-half a day more from work than the average woman. For the majority of the chronic conditions listed in Table 7, men had a higher work-loss rate than women. The highest rates for women were due to conditions of the genito-urinary system, orthopedic impairments, high blood pressure, and arthritis and rheumatism. Men had their highest rates as the result of orthopedic impairments, heart conditions, arthritis and rheumatism, and peptic ulcer. National Health Survey estimates indicate that the average working woman experiences about 2.4 days more restricted activity than the average working man, the difference being due primarily to higher rates among women under 45 years of age. Women who were absent from work because of sickness averaged about 1 day a year more bed disability than men, this difference also being due to higher rates among younger women. After 45, women had the lower rate. (Table 8) Sick absence in relation to occupation and industry Information on illness among male and female workers in selected occupa- tions and industries is available in a report on work absence because of illness lasting a workweek or more, from a monthly survey of the labor force during the period July 1959-June 1960, by the Bureau of Labor Statistics, U.S. Department of Labor.® The figures relate only to employed civilian wage and salary workers; the self-employed and unpaid family workers are not included. The period for which the information was secured is not entirely repre- sentative of other years since the illness rates during the first quarter of 1960 were relatively high. Nevertheless, the data provide a fairly comprehensive picture of illness by occupation and industry among male and female civilian workers in the United States and are considered to be generally consistent with other information available regarding illness resulting in work absence. Among the 55 million workers included in the study, the age-adjusted illness rates for an average work day were 13.3 per 1,000 for men and 15.9 per 1,000 for women. The rates varied considerably according to type of occupation, and in all occupational groups except two, women had a higher rate. Of special interest is the fact that almost one-third of the women in the study were employed as clerical and kindred workers, where the sick- absence rate for men exceeded that for women. (Table 9) The greatest 4 differences were between men and women employed as managers, officials and proprietors, except farm; as laborers, except farm; and as operatives and kindred workers. Since only a small proportion of women were in two of these occupational groups (managerial and labor) the standard error in regard to these rates was high. Women in agricultural and government employment had lower illness- absence rates than men, but in private, nonagricultural industries, where four-fifths of the workers were employed, the rate for women was higher. (Table 10) A breakdown into type of private, nonagricultural employment shows some very interesting rate differences among members of the same sex, as well as between men and women. (Table 11) Male illness rates exceeded female rates in six industrial groups—construction, railroad, other transportation industries, finance, business and repair, and educational serv- ices. The greatest differences were found among workers in manufacturing establishments and in the entertainment field. Women in these two indus- trial groups and those in telecommunication and other public utilities had exceptionally high rates. Among workers in various types of manufacturing industries, the differ- ences in rates for the two sexes often were considerable, and the female rate was higher in every type of manufacturing except primary metals. In some industries, the rate for women was two to three times greater than for men in the same industry. Women in the automobile industry and in the manu- facture of instruments had exceptionally high absence rates. (Table 12) Sick absence in relation to marital status An analysis of Bureau of Labor Statistics data collected by the U.S. De- partment of Labor in connection with a monthly survey of the labor force considers sick absence in relation to age, sex, and marital status. The sample from which the data were derived represents the experience of about 56 million wage and salary workers over a 2-year period. About 10 million self-employed and unpaid family workers were not included.” Women averaged more days of sick absence than men in both the single and ever-married groups, but this was not true of every age group. (Table 13) Among single persons, females had higher rates only at ages under 35; between 35 and 45 the rates for both sexes were approximately the same; after 45 single women had considerably lower rates than single men. Among ever-married persons (those who are or have been married) the contrast between days of sick absence for men and women was greater than among single persons. Ever-married women in every age group also had con- siderably higher sick absence rates than single women. The figures in Table 13 show a rise in sick absence with age for each sex- marital status group except ever-married women. According to the author of the article, “This is of interest, since biologically it would be expected that illness causing incapacity to work should increase with age. It seems probable, therefore, that the lack of a relationship between age and sick 5 In 1919, the British Munition Workers’ Committee recommended these models of protective clothing. Recommendations include mention of gloves, veils, and respirators, but omit safety glasses. Women workers of this period, and later, are often pictured working without eye protection. (Courtesy U.S. Department of Labor.) absence among ever-married women is the result of nonbiologic factors and, moreover, that these factors are importantly involved in the generally high sick absence rate for ever-married women.” When ever-married persons were considered in relation to their current marital status, women of all ages who were married with spouse absent, and those widowed and divorced, had higher sick absence rates than either single women or married women with spouse present. Men with spouse absent and those widowed or divorced also had high rates. Because sick absence generally increases with age and because the age distribution of the four groups compared in Table 13 differs, age-adjusted rates were also computed. These adjusted rates showed single women with fewer sick absence days per person than single men, but in each of the other three categories the rates for women were higher than for men. On the basis of his observation, the author of the study from which this information was taken concludes that “the higher sick absence among women as compared with men, noted in other studies, is characteristic only of persons who are or have been married. Among single persons, after accounting for age differences between working men and women, sick absence is higher among men than among women. The highest female sick absence appears to be where the spouse is absent or the marriage has been dissolved, either by death or divorce. It is hypothesized that responsibility for child rearing is an important factor in the higher female sick absence. Were it possible to remove the influence of this and other sociocultural factors, females would no doubt have a superior sick absence record when compared with men.” Safety record On the question of whether men are more prone to accidents than women, the AMA Council on Occupational Health reports that opinions and per- tinent evidence seem equally divided. Safety records for women differ considerably according to type of employment. In general, fewer accidents are reported in the occupations and industries employing many women than in those where men predominate. To an undetermined extent, the difference is probably due to the nature of the work in industries with a large proportion of men employees. A number of industries with a large percentage of women workers have markedly low injury rates; others have rates exceeding the all-manufacturing average. For example, food processing industries, such as meat, poultry products, and bakery products, and canning and preserving establishments have rates that are high. Rates are also high for industries manufacturing household furniture, and certain branches of the textile, dairy, and leather products industries. Nonmanufacturing industries in which the proportion of women workers is substantial and where injury rates are relatively high include the restaurant and hotel industries, laundries, retail food establish- ments, and hospitals. mM3-197 0—65——=8 Match-makers around the turn of the century were exposed to phosphorus poi- soning. A report by the Department of Labor in 1910 led to the first major Congressional act to control occupational disease—the imposition of a pro- hibitive Federal tax on yellow (white) phosphorus matches. In 191 1, Illi- nois passed a law requiring monthly examinations of workers in industries using phosphorus and several other hazardous substances but did not require that workers showing symptoms of disease be removed from danger. Mis- souri passed similar legislation in 1913. In hospitals, where four-fifths of the employees are women, the national injury-frequency rate of 8.6 per million employee hours worked in 1953 was considered by the U.S. Department of Labor to be neither good nor very bad. Strains and sprains were prominent in the records of all of the listed occupa- tions, but they were heavily concentrated among attendants, the different classes of nurses, kitchen helpers, maids, and cooks. Injuries of this type, as well as hernias, which are common to most of the same occupational groups, are generally associated with heavy lifting or other forms of over- exertion. A relatively high proportion of the reported injuries were fractures.’ Chapter 2 The Worker and the Workplace IN THIS CHAPTER, the emphasis has been placed upon women’s work capacity and the workplace. Health and safety standards and health services by a physician or nurse are considered elsewhere, although they relate directly to effective placement and utilization of the worker. According to the Council on Occupational Health, American Medical As- sociation, women can be employed successfully in a great variety of jobs, provided in their placement and utilization reasonable care is taken to avoid overtaxing their physical strength and to change and interrupt their work during pregnancy and the puerperium, as required by medical and valid nonmedical considerations. (See Chapter 5.) By and large, in the line of work for which they are suited by their physical strength and in other ways, women can be utilized with only those measures being taken for their health protection and safety that should be taken for male employees.’ Work capacity Physical ability—]It is important to know exactly how much consideration should be given to the various physiological factors that might affect a woman’s employment; otherwise, unnecessary limitations may be placed on opportunities for employment and advancement. On the other hand, definite harm can be done by allowing a woman to work under conditions or on jobs that are highly unsuited for her. Decisions should be based on facts and not on traditional attitudes and unfounded prejudices sometimes found among employers, employees, and the public. The Women’s Bureau recom- mends a fair attitude, supported by a good preplacement examination and sound medical advice, as the most productive and satisfactory method of dealing with the question. Women are generally built on a smaller anatomical scale than men; their stature, sitting height, elbow height, span, arm length and size of hands and feet are all proportionately smaller. Although women tend to weigh almost as much as men of the same height, the average woman is shorter than the average man and is only about 85 percent as heavy. The difference in strength is much more marked. When measured by their ability to lift or 0 grip or pull against a resistance, women show only between 55 and 65 percent as much strength as men. The vital capacity of women is only about 70 to 80 percent of the average male capacity. It is obvious, therefore, that the average woman is not able to do as heavy physical work as the average man. She cannot lift or hold as heavy weights or direct as much weight or strength to the pushing or pulling of loads; her grip is not as strong or her reach as long. However, a woman’s physical ability does not necessarily depend upon her size, since size and weight vary with the amount of skeletal and adipose tissue as well as with the size of the muscles. Also, the strength of certain muscles may be greater than others in any one individual because of past training.!! Industrial fatigue—Industrial fatigue differs from anatomical injury to the organs resulting from excessive physical strain. Fatigue can result from a number of different conditions associated with work. In modern industry, where excessive physical labor is minimized, it is apt to be related to psycho- Routine work and close quarters contribute to fatigue and lowered efficiency wherever they occur. Crowding is also responsible for the rapid spread of respiratory diseases—the major cause of sick absence. BC .. Ne TL = Few jobs today bear the tag “For Men Only.” One-fourth of the workers in manufacturing industries are women, (Courtesy Industrial Hygiene Newsletter.) logical factors and to physiological changes in the nervous system, either peripheral or central, which result from constant use of nerve paths in re- peated or maintained muscular contractions and in maintaining a constant tension on tendons and joints due to a fixed position. Health risks for women workers are often intimately related to the problem of fatigue. Increased mechanization has multiplied the number of simple jobs to be performed at very high speed and with sustained attention; women are often preferred for such jobs because they are dexterous and attentive. “Many of the real problems of industrial fatigue,” according to the Inter- national Labour Office, “are bound up in the performance of work which is seemingly light, but which, by its rhythm and repetitive character, involves a considerable expenditure of energy and a high degree of tension and ner- vous strain, and constitutes a danger to the physical and mental health of the 11 women workers concerned. A number of studies of workers in automated offices have pointed to a comparatively high incidence of nervous troubles among women workers on certain kinds of telephone switchboards and office computing or other machines, particularly among those who have been called upon to adapt themselves to new techniques, and it is not impossible that, if special preventive measures are not taken, the general ambiance and condi- tions of modern office work may have serious repercussions on the nervous systems of men and women alike.” 12 The work environment The International Labour Office points out, quite appropriately, that most kinds of work regarded as dangerous or unhealthy for women are equally dangerous or unhealthy for men, with certain specific and important excep- tions. It is the work itself or the conditions in which it is done that should be changed and improved, with consequent benefit to men and women alike. The trend is to extend measures protecting health and safety to all workers according to the nature of the work and the individual needs of the workers. This implies more positive and systematic labor inspection and medical super- vision of all workers in occupations of whatever nature, particularly those engaged in work presenting special risks because of its intensity or the dangers inherent in it. The many new industrial processes now in use have greatly increased the importance of fitting the individual to the job, an area in which the industrial hygienist, the medical department, the safety manager, and personnel officials must work together. Employees must be physically fit to perform the work to which they are assigned, the work environment must be satisfactory, and both the worker and the working conditions should be checked periodically. Physicians and nurses, as well as safety and industrial hygiene personnel, should visit the work place periodically. Checking the work environment to observe working conditions and to keep harmful substances at a minimum is especially important where women are working because of their smaller lung capacity and fewer red corpuscles. A guide to threshold limit value is revised and issued periodically by the American Conference of Governmental Industrial Hygienists.”> The preg- nant woman needs special protection against certain harmful substances. (See page 34.) A clean and comfortable work environment is especially important for women and is an excellent morale builder. Good seating arrangements, proper toilet facilities, and properly equipped rest rooms should be provided. Where needed, locker rooms and showers should also be made available. The Council on Occupational Health states that the belief found in some quarters that women are more susceptible than men to occupational disease, particularly dermatoses, lacks foundation and is probably erroneous.’ An article in National Safety News helps support the AMA statement by conclud- 12 The emission spectrograph enables the occupational health scientist to detect even minute quantities of toxic substances in biological or other materials. Here, a sample of air contaminants is being tested. The sample is vaporized by heating to a very high temperature. Each metal released creates a dis- tinctive spectrum which is measured and recorded by the spectrograph. (Courtesy Pennsylvania Department of Health.) ing that investigations to date suggest that sensitivity to irritants depends upon skin type and substances to which a person is exposed and not upon sex. For example, people with oily skins are more susceptible to irritation by oils, greases, and waxes; those with dry skins are more likely to suffer irritation from fat solvents such as benzol and naphtha. Workers should be instructed in the proper use of primary irritants and should be cautioned against using certain agents to cleanse the skin, such as turpentine, thinners, etc. Occupational contact dermatitis is almost always an external problem and it is not contagious.'* Health and safety risks may be found in any occupational environment. For example, growing mechanization has increased the risk of accidents and occupational disease for agricultural workers. The increased use of chemi- cals, including some that are highly toxic, is also a growing source of danger. Health education and preventive measures are needed to protect agricultural workers, and it is important to see that both men and women are protected. Approximately one million women in the United States are engaged in agriculture. They represent one-fifth of the agricultural labor force. An 13 additional 4.5 to 5 million women are engaged in housekeeping in rural farm areas and are also apt to be exposed to certain health hazards associated with agricultural pursuits. National Health Survey data show that usually working males and females residing in rural farm areas experience more work loss and days of restricted activity than those in urban areas. A report on occupational disease in California shows that the agricultural industry ex- periences the highest occupational disease rate in the State—over 50 percent higher than the industry in second place, and almost three times as high as the average rate of all industries.’ Safety measures Women require the same safety features in protective clothing and equip- ment as men, but greater attention to appearance is important. The majority of women will cooperate when safety measures are properly explained. Ed- ucational campaigns and exhibits of safe clothing will help. A National Safety Council report provides the following guides: Clothing—Work clothing for women should be comfortable in the tem- perature in which it is worn. It should be appropriate for the job and, where possible, attractive. Where skirts are a hazard, slacks or coveralls should be used. Clothing must fit and not interfere with the worker’s move- ments. Tight-fitting garments cause strain that increases fatigue. Outer garments should not have loose sleeves, tails, full skirts, flounces, ties, lapels, or cuffs. No loose-fitting open sweaters should be worn. Jewelry can also be a hazard and should be avoided. Head and hair protection—Caps with stiff visors, hair nets, and ventilated turbans are available to protect hair from catching in the moving belts, spindles, and other moving machinery and equipment. Paper caps are used in some food plants where the main object is to protect the hair and scalp from dust or to keep foreign material out of the product. These are usually provided by management and are changed frequently. Static electricity is a hazard as it pulls the hair toward the machinery where, if not confined, it can be caught in moving parts. Hand and arm protection—Gloves should fit snugly, should not be cumber- some, and should extend a sufficient distance beyond the wrist to fit under sleeves. Sleeves should reach from the wrist to the armpit and should be fastened at both ends. They should fit over the gloves and should be roomy enough to allow for flexing the elbows without sliding up and down the arm. Aprons—These should be full and should cover the front of the body from well below the knee to the neck. They should fasten around the neck and waist without loose ends. Shoes—Women’s work shoes should conform to standards that apply to men’s—adequate in weight, comfortable and well-fitting—and should be equipped with steel toes where hazards so indicate. They should provide proper support, have low or medium heels with no open toes. Sling backs and high heels on the job should not be permitted. 14 Stockings—Right size is important to reduce pressure and avoid fatigue from that cause. Cotton stockings are required in certain hazardous loca- tions such as hospital operating rooms, where synthetic textiles may cause static sparks.™ Safety counseling Both health and safety counseling are important items to be considered in relation to the worker and the workplace. Since health counseling is a proper function of the medical department, it is considered in Chapter 4. Concerning safety counseling, the counselor for women’s safety, repre- senting a large insurance company, has some worthwhile suggestions. “Counseling,” she advises, “must take woman ‘by the hand’ and show her This young woman, a sports car driver, has learned that she can be both attrac- tive and safe. She protects her eyes from flying particles while using polish- ing wheel. (Courtesy Society for Prevention of Blindness.) 15 773-197 0—65———4 = y Chemical workers packaging parathion dusts are protected by gloves. They work through special windows in air conditioned, well ventilated area. KEach employee is given a cholinesterase test weekly. objectively the result of unsafe acts or thoughtlessness. If she doesn’t wear goggles, counseling should point out flying objects can injure her eye- sight. . . . Walking in the dark will expose her to mishaps. She should recognize and avoid that which can harm her. Exposing herself to moving machinery without wearing a cap which protects her head; exposing herself to falling objects without wearing safety shoes—these are examples of poor work practices counseling can point out. Advising her to ‘Be careful’ may miss the mark, though. On the other hand the ‘self-interest approach’ will give the idea a chance to germinate within her. It should be predicated on the question: ‘Do you want to stay whole?” If the answer is affirmative then counseling is objective to the degree that it tells you that what you're doing won’t keep you whole or how what you are doing can be done in a way to keep you whole. . . . What you can envision you can prepare for. . . . Counseling that is based on exact information, mutual understanding and good sense can do much to improve improper attitude found among workers who are unhappy, careless, resentful, and inattentive. Workers in these categories are more likely to have accidents than those who have a high morale and are content with their work.” 1 16 “There is another step in this counseling service,” this counselor reports, “that woman is often without power to take. It pertains to that which fore- men or members of other departments plan for her to use or to be in contact with. She’s the unsuspecting victim of someone else’s doing.” Improper supervision can result in health as well as safety problems. Supervision Intelligent supervision is the basis for good working relationships. Pro- duction, turnover, absenteeism, sickness and accidents among members of both sexes will vary with the character of supervision. Supervisors, par- ticularly those who supervise women, should be trained both in health and safety factors relating to the work environment and in proper treatment and effective use of workers. Physicians and nurses can help supervisors by cooperating with them in solving health and safety problems and instructing them in matters affecting employee health. Supervisors often undertake the supervision of women with reservations because they believe that women are different. “Women are different,” one plant manager explains, “but that doesn’t mean difficult.” Accordingly to him, supervisors will not do a good job if they are needlessly intimidated about how sensitive and temperamental women are. Women workers have special needs, but like men, they usually conform to a general behavior pattern when it is expected of them. With most problems that come up they accept a fair solution based on company policy. To think that a woman’s abilities are limited to certain types of work, like typing and clerical work, is to deprive a department of workers with needed skills. “Over-all,” this manager con- cludes, “there are few radical differences in the way men and women em- ployees should be supervised—the differences are mainly in degree and emphasis. And it may give male supervisors added confidence to know that a women employee usually prefers a male boss. If he is firm yet fair, she’ll be a loyal efficient worker. Just don’t take her for granted.” ** 17 Chapter 3 Standards and Laws Governing Employment IN MANY INSTANCES, standards for employment of women have been volun- tarily adopted by employers or by employer-employee cooperation through collective bargaining. These voluntary standards represent an earnest effort to provide satisfactory working conditions, but they vary from firm to firm leaving many people inadequately covered or completely uncovered. States, therefore, generally have set up standards for women’s employment that govern wages, hours, and conditions of work, but these also vary in many respects. The Women’s Bureau 1965 Handbook on Women Workers * con- tains recommended standards for employment of women and summarizes State labor laws for women. The following information regarding hours and leave, health and safety standards, and occupational limitations has been taken from this source. Information from another Women’s Bureau pub- lication, regarding legislation and regulations pertaining to maternity, is considered in Chapter 5. Hour standards 1. A workweek of 8 hours a day and 40 hours a week with worktime over 8 hours a day or 40 hours a week to be paid at time and a half the worker’s regular rate of pay. . Atleast 1 day of rest in 7, preferably 2 consecutive days in 7. 3. Meal periods of at least 30 minutes; no work period of more than 5 hours without a break for meal and rest. 4. A rest period of at least 10 minutes in the middle of each half-day work period, to be allowed in addition to the lunch period and without lengthening the workday. 5. Nightwork, except in continuous-process industries and essential serv- ices, kept to a minimum; observance of the International Labour Orga- nization standard, that is, a guarantee of an uninterrupted rest period of 11 consecutive hours, including a rest period of at least 7 consecutive hours between 10 p.m. and 7 a.m. I Health siandards 1. Vacation with pay after 6 months on the job; longer vacation after longer service. 19 2. Time off with pay on legal holidays. 3. Sick leave and maternity leave without loss of job or seniority rights; maternity leave to cover a minimum of 6 weeks before and 2 months after confinement, with extension of either period on advice of the worker’s physician. Paid maternity leave or comparable insurance benefits should be provided. 4. Working environment with adequate ventilation, lighting, and heating to preserve health and reduce strain and fatigue. 5. Washrooms, toilets, restrooms, dressing rooms, and drinking water convenient and available to all workers; lunchrooms with nourishing food at reasonable prices when the size of the plant makes it practicable; facilities to conform to high standards of health and sanitation. 6. Medical services in the plant commensurate with needs of the workers. 7. A program to discover and protect against occupational hazards arising from the use of dangerous substances or processes. 8. Provision of mechanical aids for lifting weights. Elimination of undue physical strain for workers. 9. Suitable seats, in adequate numbers; workers should be free to use them when not actively engaged in the performance of duties that require a standing position, or at all times when the nature of the job permits. Safety standards L. Equipment and machinery in good working condition, with guards against injury. 2. Safety equipment and clothing as needed such as goggles, safety shoes, protective gloves; should be maintained in good condition. 3. Safe and uncrowded workspace; stairways, floors, halls, rooms, and passageways kept in good condition and adequately lighted. 4. A continuing safety program and training in safety on the job for all workers. Hour laws Forty-three States and the District of Columbia have laws which regulate the number of daily and/or weekly hours of employment for women in one or more industries. Virtually all State hour laws cover manufacturing; most of them apply to a variety of other industries as well. Standards are usually the same for manufacturing and nonmanufacturing industries. Twenty-five States and the District of Columbia have set maximum hours of 8 a day, or 48 or less a week, or both. Eight States have a maximum 9-hour day and a maximum 50- or 54-hour week. Nine States have a maxi- mum 10 hours a day and from 50 to 60 hours a week. One State has no daily hour limitation but limits weekly hours to 54. Half of the States and the District of Columbia and Puerto Rico provide that meal periods, varying from one-third of an hour to one hour in duration 20 must be allowed women employed in some or all industries; in 4 States, these provisions apply to men as well as women. Twelve States and Puerto Rico have provided for specific rest periods (as distinct from a meal period) for women workers; 6 by statute and 7 by wage order. In Puerto Rico, the rest period provision applies to men as well as women. In 21 States and Puerto Rico, night work for adult women is prohibited and/or regulated in certain industries and occupations. Nineteen States and Puerto Rico have industrial homework laws or regulations. Twenty-three States and the District of Columbia have established a maxi- mum 6-day workweek for women employed in some or all industries; in 6 of these States this standard is applicable to both men and women. Health laws Six States and Puerto Rico prohibit the employment of women in one or more industries or occupations immediately before and/or after childbirth. These standards are established by statute or by minimum wage and welfare orders. Women may not be employed in— Connecticut ———————___—____ 4 weeks before and 4 weeks after childbirth. MassachsSetls amu wmm wisn 4, weeks before and 4 weeks after childbirth. Missouri ___ 3 weeks before and 3 weeks after childbirth. New York_______________ 4. weeks after childbirth. Puerto Rico ———————_____. 4 weeks before and 4 weeks after childbirth. VV e110nL... cee een me isms = 2 weeks before and 4 weeks after childbirth. Washington___ 4 weeks before and 6 weeks after childbirth. A number of jurisdictions, through statutes, minimum-wage orders, and other regulations, have established employment standards for women relating Members of the health professions need special education and sometimes spe- cial types of protection against health hazards. (Courtesy Group Health As- sociation of America, Inc.) to plant facilities, such as seats, lunchrooms, dressing rooms, rest rooms, and toilet rooms, and to weight lifting. Forty-five States, the District of Colum- bia, and Puerto Rico have seating laws; all but one applies exclusively to women. Twelve States have statutes, rules, regulations or wage orders which specify the maximum weight women employees are permitted to lift, carry or lift and carry. Following are the highest standards established for weight lifting and carrying in the 12 States: Any occupation: 15 pounds in Utah; 25 in Alaska and Ohio; 30 in Georgia; 35 in Michigan. Foundries and core rooms: 25 pounds in Maryland, Massachusetts, Min- nesota, and New York. Specified occupations or industries ( by wage order) : 25 pounds in Cali- fornia and Oregon; 35 pounds and “excessive weights” in Washington. Occupational limitations Twenty-five States have laws or regulations which prohibit the employ- ment of adult women in specified occupations or industries or under certain working conditions, which are considered hazardous or injurious to health or safety. In the majority (17) the prohibition applies to women’s employ- ment in or about mines (clerical or similar work is excepted from the prohibition in half of these States). Nine States prohibit women from mix- ing, selling or dispensing alcoholic beverages for on-premises consumption, and one State prohibits their employment in retail liquor stores. Eleven States prohibit the employment of women in other places or occu- pations or under certain conditions: Arizona: In occupations requiring constant standing. Colorado: Working around coke ovens. Massachusetts: Working on cores over 2 cubic feet or 60 pounds. Michigan: Handling harmful substances; in foundries, except with ap- proval of the Department of Labor; operating polishing wheels, belts. Minnesota: Placing cores in or out of ovens; cleaning moving machinery. Missouri: Cleaning or working between moving machinery. New York: Coremaking, or in connection with coremaking, in a room in which the oven is in operation. Ohio: As crossing watchman, section hand, express driver, metal molder, bellhop, gas- or electric-meter reader; in shoeshine parlors, bowling alleys as pinsetters, poolrooms:; in delivery service on motor-propelled vehicles of over 1-ton capacity; in operating freight or baggage elevators if doors are not automatically or semiautomatically controlled; in bag- gage and freight handling; by means of handtrucks, trucking and han- dling heavy materials of any kind; operating emery wheels, belts; in blast furnace and smelter. Pennsylvania: In dangerous or injurious occupations. Washington: As bellhop. Wisconsin: In dangerous or injurious occupations. 22 Chapter 4 Health Services In Industry HEALTH SERVICES IN INDUSTRY consist of physical examinations, emergency care and preventive services designed to keep the worker well and on the job. They are closely associated with the workplace and should be distin- guished from health insurance benefits, which many employers finance or help finance in order to provide assistance during nonoccupational illness and injury. In this and the following chapter, the health services in industry are dis- cussed as though a health unit has been set up and physician and nursing service is available at the workplace. Most large and many medium-size industries have such medical departments. A few small plants also operate health units, but unfortunately most men and women work in small groups where the cost of equipping and staffing health units is high, and services are either very limited or not available. Emergency and health maintenance services are important to both em- ployers and employees. Many small companies have arranged for emer- gency care by a physician who visits the plant on call, other plants send patients and job applicants to the offices of physicians practicing individually or in groups. A few small businesses have joined with other small indus- tries and established cooperative health centers. Visiting nurses agencies in some communities are providing nursing services to small plants on a part- time basis. Employers who are interested in the health of their employees should con- sider the advantages of health services at or near the workplace. They should also inform themselves regarding available State and local health resources. Public health services in States and communities are constantly expanding, and great emphasis is now being placed on community health services. A number of services are also available through voluntary health agencies within the community. Small businesses interested in health main- tenance will probably find that health agencies such as the local heart, cancer, tuberculosis, diabetes, and arthritis groups are glad to cooperate when asked. The importance of reaching both the worker and his family through the workplace is often overlooked, and management and labor groups can help promote services by requesting them and encouraging workers to participate. 23 773-197 O—65——5 In the food processing industry, regular plant inspection by the occupational health nurse guards the health of both the employee and the consumer. The medical department Originally, services provided by an industrial medical department con- sisted principally of care of occupational illness and injury and emergency care for nonoccupational illness. More recently, the tendency has been to include certain preventive services and health education programs. A management survey made several years ago by the National Industrial Conference Board indicates that a transformation has occurred in employee health services during the last 10 to 15 years and that it has not yet ended. Broader objectives are being set, and medical departments are reported to be entering what may be the most significant phase of their existence. This situation is due to the changing attitude of many company managements, who were slow to realize the full potential of their health programs. The main reasons for this change, according to the Conference Board are as follows: 1. Anincrease in the number of older and disabled workers. 24 5. 6. Competition for efficient people and the need to safeguard the health of workers now on the payroll—workers in whom the companies have invested time and money. The great number of emotionally disturbed people, many of whom are on company payrolls. Industrial advances—growing automation and peacetime use of atomic energy (as they affect the individual workers) bring new and different problems to the employer. An increasing number of health insurance plans, many of which pay benefits on the first or second day of absence. Encouraging reports about the beneficial results achieved by companies that have learned the value of effective health programs. When the National Industrial Conference Board made its survey of 278 companies in 1959, most of them (four-fifths of those from the United States and almost nine-tenths of the Canadian companies) required preplacement physical examinations of every prospective employee. Periodic physical examinations were also becoming an increasingly common practice, with 86 percent of all participating companies reporting them for either all or a State employees in Pennsylvania take advantage of diagnostic screening offered at an annual health conference. Most workers will participate in health pro- grams if they are encouraged to do so and the benefits of the services are properly explained to them. (Courtesy Pennsylvania State Department of Health.) 25 selected group of employees. Many companies required physical examina- tions following layoffs; some also required exit (termination of employment) examinations. These health practices were not limited to very large com- panies, since more than 200 of those surveyed had less than 5,000 workers, including 64 with less than 1,000 employees. More than three-fourths of the companies had eye programs, some had auditory examinations and pro- vided for care of the ears, a few also had dental services and psychiatric programs.’® Preventive services and health education programs are now provided by many industries. Interest in such services continues to increase. They keep the worker well and on the job by the prevention and early detection of both occupational and nonoccupational diseases. The tremendous loss resulting from sick absence and the rising cost of health insurance, for which employers are paying or helping to pay high premiums, has increased interest in these services. The more liberal interpretation of workmen's compensation has been another incentive. Health maintenance Most of the health services in an industrial medical department are appli- cable to both sexes—physical examinations, immunizations, emergency care, health counseling, etc. It is necessary, however, for the physician and nurse providing these services to adapt them to the special needs of each sex, just as it is necessary to adapt them to the special needs of an individual or of workers engaged in specific occupations. Regardless of sex, health services should be made available to all employees who need them. For example, pre- placement examinations are advisable for both men and women. They are important regardless of the type of work for which the person is being con- sidered, for they provide the physician with information that enables him to advise on the type of work for which the individual is suited and to make suggestions regarding what is needed for a safe and satisfactory work environ- ment. They also establish the basis for future contacts with the medical department. Preplacement and other physical examinations have special significance for women. The physician and nurse have an excellent opportunity for health educa- tion and counseling. Often they are the only members of the health and medical professions with whom the employee comes in contact. In addition to providing consultation, the medical department personnel can put the employee in contact with his own physician and with public and community agencies through which health services are available. Health maintenance services should begin with the new employee. In many ways the medical department can help the new worker, who often needs encouragement in good health and safety practice and in adjusting to the work environment. Assistance during the probationary period will orient new workers to the health unit and encourage them to seek help when it is needed. 26 Health education is most successful when it is a joint project. Here a com- pany vice-president joins members of the medical staff and employees in a discussion of the heart and its diseases. (Courtesy Carson, Pirie, Scott, and Company.) The success of the medical department’s health maintenance program will depend to a considerable extent upon cooperation between physician, nurse, personnel department, and supervisor. It is important that members of the medical department be advised regarding signs of excessive fatigue, emotional distress, physical disorders, and a tendency to frequent absenteeism. The supervisor should adopt an intelligent attitude toward employee visits to the health unit, urge employees to take advantage of preventive and health educa- tion services made available in the health unit, and encourage them to follow advice given by the plant physician or nurse. As a result, respiratory, diges- tive, and functional disorders, which cause a major portion of work absence among women, can be prevented or receive prompt attention. Also, serious disorders will often be detected and referred for treatment. Participation by the physician and nurse in periodic checks of the work environment contributes greatly to health maintenance. Frequently they will detect conditions affecting employees that have escaped the attention of others. It is especially important for thé members of the health unit to have an opportunity to observe working conditions and be kept informed regarding new work processes and the possibility of exposing women to toxic substances, particularly expectant mothers. 27 Special health considerations The medical department is especially important to women workers. The various services that the physician and nurse can provide to pregnant women are discussed in Chapter 5. Other gynecological problems that must be considered in relation to women workers are menstrual disorders, pelvic pain, infections, and the menopause. Menstrual disorders may occasionally be associated with tuberculosis in young women. The disorder may also occur when a woman is starting a new position or where other circumstances cause worry or tension. She should be referred for medical diagnosis. If there is no organic disease, transfer to other work may help. Painful menstruation, which is often associated with psychosomatic fac- tors, not only affects the individual but also disrupts the work schedule, caus- ing a considerable number of hours to be lost from work. It is important to have facilities for rest where analgesic, heat or other remedies may be used. The worker suffering from “cramps” seldom needs to be sent home. Excessive bleeding at the time of the menses (excluding pregnancy), irreg- ular or intermenstrual bleeding, postmenopausal bleeding may indicate diseases of the reproductive system. This type of disorder is serious and the individual should be referred for medical care. Pelvic pains may be due to inflammation, infection, tumors, or to causes outside the pelvis. Older women in the labor force are free from menstrual abnormalities or pregnancy, but they often have symptoms of vasomotor and emotional in- stability associated with “change of life.” Instructions regarding the normal physiology of the condition may be helpful. They may be given by the industrial physician or by the nurse under his supervision. The effect of gynecological problems on working women can be mini- mized by an adequate preplacement examination, a good health maintenance program, and cooperation between the sick or injured worker’s private physi- cians and the plant medical department. Preplacement and other physical examinations should include a case history; a breast examination; and a pelvic examination, preferably vaginal. Women are becoming more aware of the value of breast and pelvic examinations, and the industrial physician and nurse have an excellent opportunity for education in this field.?? Cancer detection In industry, a readymade opportunity exists to examine and screen large numbers of women for malignancy. Two physicians discussing this matter at a meeting of the Pennsylvania Medical Society, in 1959, suggested that pelvic examinations should be performed on every woman in industry at approximately 6-month intervals, and that competent gynecologists should be on the medical staffs of every company that employs women. They quoted an American physician who had visited Russian clinics as reporting that about 90 percent of all women in Moscow receive examinations annually. In 28 certain industrial areas in that country every woman over 20 years of age is examined every six months. Before preventive medical and gynecological examinations for all working women in Russia were established in 1946, the overall mortality from cancer of the uterus was 34 percent of all deaths from cancer. It has now fallen to 16 percent. In our own country, even the employees of hospitals where gynecologists work are seldom required to have, or even are offered, pelvic examinations.?® The opportunity for cancer detection has greatly increased with the trend towards more frequent health examinations and the special screening pro- grams operated by some industrial medical departments. In addition, health education programs in other industries encourage women to participate in uterine and other cancer tests available through community programs. For many years the American Cancer Society has urged women to visit cancer detection centers periodically. Physicians at centers often detect asymp- tomatic, early lesions which are more amenable to successful treatment. A Chicago department store, Carson Pirie Scott, found that a health education program stimulated great interest in cancer detection among its women employees. The large number of employees being tested for cancer, A large department store encourages its employees to participate in the com- munity cancer detection program. Filmstrip and literature were furnished by the American Cancer Society. (Courtesy Carson, Pirie, Scott, and Company.) howing of the fe-suving film including many younger women, prompted the program. Filmstrip and literature were furnished by the American Cancer Society. The medical division of the DuPont Company initiated its own cancer detection program in 1948. Almost from the first, there were indications that it was going to succeed in its purpose and prove the value of cancer detection as part of an industrial health service; as news of the case finding filtered through the organization, interest in the service increased. Fach physician performing a routine annual or periodic examination in the medi- cal division of the DuPont Company was alerted to the possibility of case- finding. Normally, each employee receives an annual physical examination, which includes a blood count, chest roentgenogram, urinalysis, history, and physical examination. “Lead” questions, regarding rectal bleeding, vague gastrointestinal symptoms, and chronic cough, were put to the employees in an effort to uncover an occult neoplastic lesion. For a time, employees with suggestive gastric or vague gastrointestinal symptoms were subjected to a screening type of gastrointestinal x-ray examination, performed by a photo- fluoroscope roentgen unit similar to the one used by Morgan and his group at the Johns Hopkins University. The yield from this particular effort turned out to be meager, and the procedure was abandoned. Patients with rectal symptoms or signs of bleeding were advised to appear for a sigmoidoscopic examination. In 9,000 examinations on 1,500 DuPont Company employees, over an 11-year period, 55 malignant lesions of the breast, rectum, cervix, skin, thy- roid, and ovaries were detected. Over 100 basal cell carcinomas of the skin were also found. In addition to malignant conditions, approximately 10 per- cent of the total examinations revealed benign conditions requiring treatment, such as rectal polyps, ovarian cysts, uterine fibroids, cystoceles, and benign breast tumors. In 1958, all but one of the employees found to have a malignant lesion were alive. This represented a survival rate in terms of 1 to 10 years.” Two telephone companies report that uterine cancer tests by the tampon method have been made successfully but one has now discontinued them. On the basis of available information, a comparison between the two company programs cannot be made. The tampon method was used for screening 6,083 women over a 40-month period at the Michigan Bell Telephone Company. The test was reported as acceptable, practical, and effective. Thirteen case of previously undetected uterine malignancy were found. In addition, 42 cases with pelvic pathology that needed medical intervention were discovered. The screening was dis- continued because a large number of unsatisfactory smears had to be repeated and cytologists found the tampon smears more difficult to read. Employees are encouraged to have a pelvis examination, including a direct smear, as part of an annual physical 2? Employees of the New York Telephone Company participated in a pilot study designed to evaluate a self-administered detection technique for uterine 30 cancer. A total of 197 women were able successfully to insert and remove a detection tampon and make slides for cytologic examination, after recieving a minimum of demonstration and instruction. The technique was accomplished at home in complete privacy, and without further professional aids. The slides were examined by the laboratory staff of a cancer prevention clinic and were found to be easily readable in 98 percent of the cases. Reports nega- tive for cancer were returned in 180 cases; 17 cases were reported as sus- picious and requiring followup examination. An unexpected side result of the test was that 10 cases of monilia and 6 cases of trichomonas were also detected. The program is reported as giving evidence that the procedure used is not only practical, but one that is also readily acceptable to a large percentage of an industrial group.* Health counseling In addition to health problems peculiar to her sex, the woman in industry often needs special counseling on health and related matters arising from work or home environment. Many women are forced by circumstances to become gainfully employed when they would prefer to remain at home. Others could remain at home but prefer to work. The working wife has a dual job and may be physically exhausted; the working mother may be worried about her children and other problems. Single women, too, often have great home responsibilities, many of them, for example, having full financial and other responsibilities for dependent parents or younger brothers and sisters. Ten- sion-producing situations in industry, such as improper supervision, dead-end jobs, or deserved promotions that go to another, affect both men and women, but women appear to encounter them more freqeuntly and are more apt to seek counseling. An industriai physican with years of experience reports that he has found that a large proportion of the women who visit the medical department have complaints reflecting anxiety or tension. A few of these women may have serious psychiatric illnesses; all are looking for help. The fact that women seek help more frequently than men, he states, reflects a difference in attitude between the sexes and is not an accurate measure of need. “Man has too long held the role of dominance and independence of action. He may unload his troubles on friends, but knows he does not need to accept their advice. If he seeks his doctor, he is likely to feel ahead of time that he is apt to be re- stricted in some way or at least experience an uncomfortable amount of change or moderation. The woman, on the other hand, seeks help from the doctor or minister or lawyer, feeling in these professions the cloak of authority and the need for depending upon advice.” “Many of us listen,” the doctor states, “with ears alone, but not with attitude, and advise, and prescribe accordingly. This seldom helps much, for a woman is keenly sensitive to the degree of honesty of our interest and concern. When our heart is not in the interview, neither is hers in the ther- 31 apy. . . . We can be honest with ourselves and her by use of several acceptable means of approach and therapy. This involves a genuine interest in her problems, and the acceptance of the reality of her symptoms as we accept her as a valid patient, worthy of our time and effort. A complete examination, carefully made, is as important as attention to her history. Direct or indirect questions for clarification or explanation prove our atten- tion as her account unfolds. These basic good manners mark good doctor- patient relationships, and make for empathy. Just so, brusqueness, impatience or indifference on the part of the doctor surely dampen the revelation of significant facts.” 2* 32 Chapter 5 Pregnancy NATIONAL HEALTH SURVEY reports estimate that between July 1958 and June 1959, acute conditions due to deliveries and conditions associated with pregnancy occurred at the rate of 6.8 per 100 usually working females, the total for the year being 1.2 million such conditions. Ability to work According to the Council on Occupational Health, American Medical Asso- ciation, the healthy woman during a normal pregnancy can, with proper medical supervision, be employed in a wide variety of ways, with minimal limitations imposed for health, safety, and other considerations. It is impera- tive, however, that the worker make her pregnancy known promptly to the appropriate person at her place of work, and company policy should encour- age prompt reporting. Concealment of pregnancy invites untoward conse- quences, particularly during the first trimester, when concealment is easy. The pregnant employee, having reported her pregnancy, should be encour- aged to avail herself of care and guidance, including initial and periodic health examinations by her personal physician. The appropriate company medical department or personnel representative should maintain liaison with the per- sonal physician to insure continued proper and safe employment of the preg- nant employee. Health education and counseling of pregnant employees should be undertaken by the company medical department, with proper gynecological and obsterical guidance and with the use of approved pub- lished materials.® According to the Council, a woman should be considered physically able to work during at least the first 28 weeks of pregnancy. Should complications or other health impairments occur, the personal physician and the company physician have a joint responsibility in determining whether this employee’s work assignment should be changed or she should stop work. Indeed, women in exceptionally good health and with only light housework to do may con- tinue until the 32nd or even the 36th week of pregnancy in certain types of work, such as stenography, and in keeping with individual company policies. Conversely, a pregnant employee with an unstable blood pressure, for ex- ample, might have to be relieved before the 28th week of pregnancy from work involving excessive physical activity or emotional tension. As a safeguard, the Council recommends that certain restrictions be placed on the hours and the nature of the work permitted a woman during even a 33 normal pregnancy. These are dictated as much by common sense as by obstetrical, gynecological, and toxicological considerations. Awkwardness in movement and the shifting of the body’s center of gravity with advancing pregnancy must be taken into account. The pregnant woman should not be assigned to tasks involving undue stretching or reaching. Particular care should be taken to minimize the amount of lifting that the pregnant employee is required or permitted to do. Insofar as practical, the Council suggests, pregnant women should work on the normal daytime shift, in order to have sufficient evening and night hours at home to care adequately for her family and get the required amount of sleep with as little interruption as possible. She should be allowed a rest period of at least 15 minutes during the first and second halves of her work shift and a mid-shift break long enough to permit her to visit the rest room and lunch room and eat urthurriedly the sort of meal she requires. She should not work more than 5 days or 40 hours a week. Where practical, a place should be pro- vided, preferably in the medical department, where the pregnant worker can recline if she is indisposed or experiences symptoms possibly indicative of complications. There are certain harmful substances, forms of energy and conditions from which, according to available scientific evidence the pregnant woman should be spared to an even greater extent than the male or the healthy nonpregnant female worker. Among such substances are those which may damage the liver or kidneys, such as chlorinated hydrocarbons; those which may cause anemia, such as benzol and lead; and those which may cause anoxemia, such as carbon monoxide. Another occupational exposure which may exert a spe- cific effect on pregnancy is ionizing radiation. Excessive exposure to ion- izing radiation can produce marked injury to the fetus or harmful genetic effects.” Problems associated with the employment of women of child-bearing age in radiation work prompted the International Labour Office to adopt a resolu- tion in 1960. The resolution requests the Governing Body to invite member States to keep these problems under review in the light of advancing knowl- edge, to ensure the continuation of the study of these problems in collaboration with competent international organizations, and to take in respect to this study the action it may consider desirable, including the possibility of placing this question on the agenda of an early session of the Conference. The length of time a woman should be kept off from work after delivery should be determined by agreement between her personal physician and the company physician. This will depend on a number of factors, including State legislation. Ordinarily a woman should not return to work for at least 6 weeks after delivery. Maternity policy The policy of dismissing workers as soon as they are known to be pregnant, or shortly afterwards, has caused a number of women to conceal their preg- 34 nancy as long as possible with serious results for both employees and employers. On the other hand, a sound maternity policy will encourage women to report pregnancy early and seek prenatal care, with the understand- ing that their employment will be continued, health factors permitting. Such a policy prevents workers from being penalized economically for being preg- nant, and makes continued employment dependent upon their health and welfare rather than on an ill-founded arbitrary rule requiring prompt re- moval from their jobs. All women should be informed in detail about a company’s maternity policy at the time of their employment. A printed copy of the plan, giving specific instructions for procedure in the event of pregnancy, should be distributed to the new employee by the nurse or personnel director. As soon as the employee makes her pregnancy known, plans should be made for regular interviews with the nurse. Pregnant employées usually are not seen by the plant physician unless he is called on to evaluate a work- connected situation that might have an adverse effect on the woman’s condi- tion. The plant physician, nurse, or employer, should refer pregnant employees to their family physicians for medical care. If an employee is unable to pay for private medical care, she should be directed to one of the community clinic services. The kind of work performed by the employee should be fully explained to the family physician or clinic service so that they can determine whether the employe should continue to work at her present occu- pation and when she should stop working.*® Employees should be encouraged to report pregnancy early. Interviews with the plant nurse should be scheduled at regular intervals, and close liaision with the employee’s private physician should be maintained, particularly where special health problems exist. Most women can continue working at their regular jobs during normal pregnancy, but education and counseling by the medical department can add much to their comfort, security, and effi- ciency during the prenatal period. FOOD VALUES Effect of work during pregnancy While the normal physiological changes of pregnancy actually do not compromise the patient markedly, there is a definite tendency toward the development of uncomfortable subjective and objective symptoms. In preg- nancy the physiologic often borders on the pathologic. Normal pregnancy may affect the patient’s ability to work at her most efficient level, and it is important to individualize the woman’s job to her condition insofar as this is possible. Undoubtedly careful antenatal management can circumvent many difficulties and assure the working mother much more comfort and security than she otherwise would have. Types of work to be avoided during preg- nancy are: (1) heavy lifting and hard manual labor, (2) prolonged stand- ing and fatigue, (3) continuous sitting and immobilization, (4) work requiring a good sense of balance, (5) occupations associated with possible severe injury, and (6) exposure to toxic substances. Maternal consideration—The effects of pregnancy on women in industry were discussed in detail by Drs. McCall and Trace at a Pennsylvania Medical Society meeting in 1959. In their opinion there is no indication that toxemia of pregnancy is more apt to occur in employed women. There is a greater danger, however, that superimposed acute toxemia may develop in women with chronic hypertensive vascular disease. The hemorrhages of late preg- nancy are not increased except in the rare instances where abruptio placentae occurs because of direct trauma to the abdomen. Employed pregnant women should be taken off jobs which are physically dangerous. Infection, according to these physicians, ordinarily is not of importance to the industrial pregnant patient, although it is possible for membranes to rupture prematurely. This always predisposes to amnionitis. Anemia is a common complication of pregnancy, and is usually caused by a nutritional deficiency of iron. However, in the pregnant woman who is working, chronic fatigue may be a factor and may affect her appetite. It is necessary to con- sider the possible development of anemia by certain noxious chemicals (aniline, benzol and toluol, carbon disulphide, carbon monoxide, chlorinated hydrocarbons, lead and its compounds, mercury and its compounds, nitroben- zol, phosphorus, radioactivity, turpentine, and other toxic substances that exert an injurious effect upon the blood-forming organs, the liver, or the kidneys). Benzol and lead are especially pernicious in this regard.” These physicians reported they have no reason to believe that shock or postpartum hemorrhage is more common in the employed women. By and large, the puerperium is as normal in the working woman as in the noncom- mercially employed woman, although there are many individual factors which come into play here, one of which is how soon the employed woman returns to work. Although there have been few studies on type of delivery in patients who are working compared to housewives, there seems to be no greater incidence of forceps delivery or cesarean section in working women, Fetal consideration—According to McCall and Trace, women in industry do not appear to be more susceptible to abortion than other women, except 36 among those exposed to noxious materials and possibly those resorting to criminal interference. Recent studies of premature labor, with one exception, appear to bear out other studies which indicate that premature delivery is more common among working women, and emphasize the fact that premature babies are unusually frequent among women who are working in late preg- nancy and those who lack domestic help.*’ Maternity benefits Millions of women in the United States, employed and unemployed, are eli- gible for maternity benefits through voluntary programs or through legisla- tive action or both. The amount and type of benefits for which they are eligible varies considerably according to place of employment and place of residence. Benefits in many cases also depend upon the willingness of the employee to share premium costs for programs available on a voluntary basis at the workplace. In addition to cash assistance and/or medical service, many women workers are permitted to use accumulated sick leave before and after child birth. Maternity benefit provisions for employed women are discussed in detail in Women’s Bureau Bulletin No. 272.2 The information on the following pages is based on that publication and on more recent data supplied by the Women’s Bureau. About two-thirds of all workers in the United States are protected by employee health benefit plans of some type. Maternity benefits are provided by 90 percent of existing plans that were negotiated between unions and management, and by an unknown percentage of other job-related plans. The publication also states that in the United States there is more legis- lation providing maternity protection for women than is generally realized. Medical and surgical care—Maternity care is often included in the medi- cal and surgical care insurance purchased by individuals, families, or groups, including employed groups. A majority of workers and the wives of workers have protection under some form of employee benefit plan or program, the cost of which is often paid for or shared by the employer. Maternity leave and compensation in industry—Provisions for maternity leave are many and varied. They may be spelled out in a negotiated or non- negotiated employee health plan, in clauses of union-management contracts other than health plans; in a company’s forml personnel policy; or they may be informal, tailored to the employee’s need and the company’s requirements. When the National Industrial Conference Board analyzed maternity leave provisions in 112 firms, about half the firms specified the maximum time during which the employee may continue to work—generally up to the fifth or sixth month of pregnancy. About a fourth also stipulated a definite period before the employee could return to work, usually not sooner than the second or third month after delivery. Duration of leave of absence (without pay) ranged up to 2 years with only one company allowing less than 3 months. Over one-third of the companies granted 6 months; one-fourth 12 months. About one-half allowed an extension of the original leave period. Three 37 fourths of the companies provided for “some degree of seniority protection,” but only one-fourth guaranteed reemployment in the same or a similar job. Cash benefits for disabilities resulting from pregnancy are provided for women workers under many health and insurance plans negotiated between unions and management. Many plans require a qualifying period—beyond any waiting period necessary to become eligible for insurance—before maternity benefits become available. With few exceptions, accident and sick- ness benefits are the same for women as for men. Most often, and increas- ingly, the amount of the benefit is the same for maternity cases as for other types of disabilities; but almost always, the benefit is available for a shorter period for maternity disabilities than for other disabilities. Maternity leave for Government employees—Though Federal law does not refer specifically to maternity leave for Federal civilian employees, Public Law 233 makes paid sick leave available to them. Sick leave accrues at the rate of one-half day for each full biweekly pay period and may be accumulated without limit. In the interest of achieving some degree of uniformity in apply- ing the regulations which permits the use of sick leave as maternity leave, the Civil Service Commission’s Interagency Advisory Group developed non- mandatory guides for granting maternity leave. The Guides’ recommenda- tions may be summarized as follows: 1. All absences on maternity leave for which sick leave is granted should be medically certified. 2. Leave approved for reasons related to pregnancy and confinement may be charged to any combination of sick leave (with acceptable certifica- cation), annual leave, and leave without pay. 3. The usual period of maternity leave authorized is approximately 14 weeks; 6 weeks before the expected date of delivery and 8 weeks after the actual date of delivery. These leave periods or extension thereof should, when the request for them is medically certified, be charged to available sick leave. In those instances in which the request is not medically certified, or in which sick leave is or becomes exhausted, the charge should be to available annual leave; and when that is ex- hausted, to leave without pay. 4. Employees who plan to return to work may be granted leave without pay beyond a medically certified period at the discretion of the agency. 5. Request for sick leave not yet accrued to be advanced for reasons of preg- nancy should usually be denied. Most States permit their employees to use annual and sick leave for preg- nancy, and leave without pay may also be granted. Practices vary among States, and vary within States except where comprehensive civil service programs or merit rating systems covering most or a large segment of em- ployees have been established. Most States do not in their laws refer spe- cifically to maternity leave. In New York, the following rules covering maternity leave without pay apply to State employees: I. A pregnant employee holding a position by permanent appointment shall be granted a leave of absence without pay for a period of 6 38 months which may be extended by the appointing authority up to one year. 2. The employee shall report to the appointing authority the existence of pregnancy not later than the end of the fourth month. 3. The appointing authority may thereafter place the employee on leave at any time when, in its judgment, the interest of either the department or the employee would be best served by such action. 4. The employee may be allowed to reduce the 6-month period of leave without pay by the use of any or all earned credits. 5. A physician’s statement as to the fitness of the employee for the per- formance of her duties may be required at any time before her leave com- mences, and may be required prior to her return to duty. Information on maternity leave provisions in local government units was obtained only for teachers. Among teachers, as among all employed women, the number who are married has continued to increase. Nearly nine-tenths (8,690) of the 232 urban school districts in 1962 granted maternity leave. Of the districts granting maternity leave, the minimum periods of absence after the birth of the child most commonly reported were 3, 6 and 12 months; 37 districts left it to the discretion of the mother and/or physician. An informal inquiry sent to 95 school superintendents in 39 States and the District of Columbia in 1963, showed that provisions for leave before childbirth ranged from “immediately upon becoming aware of pregnancy,” to 7months. Eighty percent of the school systems agreed on 4 to 6 months, most often 5 months. Among the systems that set definite time periods, 7 weeks was the earliest date at which return to work was permitted; more than half required that the child must be at least a year old; some 3 years old.> 10. 11. 12, 13. 14. 15. 16. 17. 18. 19, 20. 2. References . National Manpower Council, Womanpower. New York, Columbia University Press, 1957. 371 pp. . U.S. Department of Labor, Women’s Bureau. 1965 Handbook of Women Workers (Bul. No. 285). Washington, U.S. Government Printing Office. In press. . President’s Commission on the Status of Women, American Women, and special reports of the Committee. Washington, U.S. Government Printing Office, 1963. . Ryder, Claire F. The Fragile Sex: Male or Female, Journal American Medical Women’s Association 15: 978-981 (October) 1960. . U.S. Department of Health, Education, and Welfare, Public Health Service, Na- tional Center for Health Statistics. Currently Employed Persons, Illness and W ork- Loss Days, and other publications. Washington, U.S. Government Printing Office (April), 1962. 48 pp. . Enterline, Philip E. Work Loss Due to Illness in Selected Occupations and Indus- tries, Journal of Occupational Medicine 3: 405-411 (September) 1961. . Enterline, Philip E. Sick Absence for Men and Women by Marital Status. Archives of Environmental Health 8: 466-470 (March) 1964. . U.S. Department of Labor. Work Injuries and W ork-Injury Ratio in Hospitals (Bulletin No. 1219). Washington, U.S. Government Printing Office, 1958. 56 pp. . American Medical Association, Council on Occupational Health. Occupational Health Services for Women Employees. Chicago, The Association, 1961. 9 pp. U.S. Department of Labor, Women’s Bureau. The Industrial Nurse and the Woman Worker. Washington. U.S. Government Printing Office, 1949. 48 pp. Baetjer, Anna M. Women in Industry, Their Health and Efficiency. Philadelphia, W. B. Saunders Company, 1946. 344 pp. International Labour Conference. Women Workers in a Changing World. Geneva, International Labour Office, 1963. 133 pp. American Conference of Governmental Industrial Hygienists. Threshold Limit Value for 1964. Cincinnati, The Association, 1014 Broadway. 17 pp. (Revised periodi- cally.) What's So Special About Women? National Safety News (March) 1954. Wells, Lomax. The Woman Workers, Archives of Environmental Health 4: 69-74 (April) 1962. McAinsh, Ellen M. Counseling Women Employees, National Safety News (March) 1957. Grandt, Leland J. Some Guides for Supervising Women Workers, Supervisory Management 8: 9-12 (January) 1963. McKiever, Margaret F. and Siegel, Gordon S. Occupational Health Services for Employees: A Guide for State and Local Governments. Washington, U.S. Govern- ment Printing Office, 1963. 91 pp. Nadelhoffer, Luella E. Women in Industry: Gynecological Problems—Their Effect on the Working Woman, Journal American Public Health Association 50: 1337-1341 (September) 1960. McCall, Milton L. and Trace, Robert J. Effects of Pregnancy on Women in Industry, The Pennsylvania Medical Journal 63:1773-1777 (December) 1960. Bulger, T. J. and Fleming, A. J. Cancer Detection Activities in Industry, Journal of Occupational Medicine 1: 211-214 (April) 1959. . McLean, Brita et al. Uterine Cancer Detection by the Tampon Method, Industrial Medicine and Surgery 31: 1-5 (January) 1962. 41 23. 24. 25. 26. 27. 28. 42 Cloud, Luther A. A Self Administered Detection Technique for Uterine Cancer, Industrial Medicine and Surgery 26: 380-382 (August) 1957. Jones, Thomas T. The Nervous Woman, Louisiana Medical Society 113: 287-291 (July) 1961. Illinois Department of Public Health. Suggested Policies for Pregnant Women. Chicago, The Department, 1961. 15 pp. U.S. Department of Labor, Women’s Bureau. Maternity Benefit Provisions for Em- ployed Women (Bulletin 272). Washington, U.S. Government Printing Office, 1960. 50 pp. West, Irma. Occupational Diseases of Farm Workers, Archives of Environmental Health 9: 92-98 (July) 1964. Governor's Committee on the Education and Employment of Women. New York Women and Their Changing Environment. Albany, Executive Chamber, State Capitol, 1964. 96 pp. Appendix Executive Order 10980 ESTABLISHING THE PRESI- DENT’S COMMISSION ON THE STATUS OF WOMEN WHEREAS prejudices and outmoded customs act as barriers to the full real- ization of women’s basic rights which should be respected and fostered as part of our Nation's commitment to human dignity, freedom, and democracy; and WHEREAS measures that contribute to family security and strengthen home life will advance the general welfare; and WHEREAS it is in the national interest to promote the economy, security and national defense through the most effi- clent and effective utilization of the skills of all persons; and WHEREAS in every period of national emergency women have served with dis- tinction in widely varied capacities but thereafter have been subject to treatment as a marginal group whose skills have been inadequately utilized; and WHEREAS women should be assured the opportunity to develop their capaci- ties and fulfill their aspirations on a con- tinulng basis {irrespective of national exigencies; and WHEREAS a Governmental Commis- sion should be charged with the respon~ sibility for developing recommendations for overcoming discriminations in govern- ment and private employment on the basis of sex and for developing recommenda- tions for services which will enable women to continue their role as wives and moth- ers while making a maximum contribu- tion to the world around them: NOW THEREFORE, by virtue of the authority vested in me as President of the United States by the Constitution and statutes of the United States, it is ordered as follows: PART I—ESTABLISHMENT OF THE PRESI- DENT'S COMMISSION ON THE STATUS OF WOMEN Sec. 101. There is hereby established the President's Commission on the Status of Women, referred to herein as the “Com- mission”. The Commission shall termi- nate not later than October 1, 1963. Sec. 102. The Commission shall be com- posed of twenty members appointed by the President from among persons with a competency in the area of public affairs and women's activities. In addition, the Secretary of Labor, the Attorney General, the Secretary of Health, Education, and Welfare, the Secretary of Commerce, the Secretary of Agriculture and the Chairman of the Civil Service Commission shall also serve as members of the Commission. The President shall designate from among the membership a Chairman, a Vice-Chair- man, and an Executive Vice-Chairman. 44 Sec. 103. In conformity with the Act of May 3, 1945 (59 Stat. 134, 31 U.S.C. 691), necessary facilitating assistance, in- cluding the provision of suitable office space by the Department of Labor, shall be furnished the Commission by the Fed- eral agencies whose chief officials are members thereof. An Executive Secre- tary shall be detailed by the Secretary of Labor to serve the Commission. SEC. 104. The Commission shall meet at the call of the Chairman. SEC. 105. The Commission is authorized to use the services of consultants and experts as may be found necessary and as may be otherwise authorized by law. PART II—DUTIES OF THE PRESIDENTS COMMISSION ON THE STATUS OF WOMEN Sec. 201. The Commission shall review progress and make recommendations as needed for constructive action in the following areas: (a) Employment policies and practices, including those on wages, under Federal contracts. (b) Federal social insurance and tax laws as they affect the net earnings and other income of women. (c) Federal and State labor laws deal- ing with such matters as hours, night work, and wages, to determine whether they are accomplishing the purposes for which they were established and whether they should be adapted to changing tech- nological, economic, and social conditions. (d) Differences in legal treatment of men and women in regard to political and oivil rights, property rights, and family relations. (e) New and expanded services that may be required for women as wives, mothers, and workers, including educa- tion, counseling, training, home services, and arrangements for care of children during the working day. (f) The employment policies and prac- tices of the Government of the United States, with reference to additional affirm- ative steps which should be taken through legislation, executive or administrative ac- tion to assure nondiscrimination on the basis of sex and to enhance constructive employment opportunities for women. Sec. 202. The Commission shall submit a final report of its recommendations to the President by October 1, 1963. SEC. 203 All executive departments and agencies of the Federal Government are directed to cooperate with the Commission in the performance of its dutles. PART III—REMUNERATION AND EXPENSES Sec. 301. Members of the Commission, except those receiving other compensa- tion from the United States shall receive such compensation as the President shall hereafter fix in a manner to be hereafter determined. JOHN F. KENNEDY. THE WHITE HOUSE, December 14, 1961. TaBLE 1. Number of work-loss days due to illness and injury and number of days per person, by employment status, sex, and age: United States, July 1959—-June 1960 Number of work-loss days Currently employed Usually working Sex and age Days per Days Total days currently Total days el (millions) employed (millions) working person person Male All ages 17+ ............... 244.4 5.5 222.3 5.4 N7Bhs ono 0 oars 3 mm + + www 2 wn + 5 Sion + 18.9 3.3 15.5 3.7 D838. 1 win 1 5 00h «viva va BES ER 40. 6 4.1 39.0 4.0 Sls 5 5045 B05 § aiid Rios chien Aw 53.4 5.0 50.9 4.9 45-54. oo 55.3 5.9 51.9 5.7 BBB... 4.002 onsen ys worn 2 wim 5 5 miws ® ww 8 51.7 8.1 43.5 7.1 05 0d OVEr: «5s + svi 5+ 558 5 wan sowie s 24.5 11.0 21.5 11.7 Female Al ages 174..cuuiovivsnnns 125.5 5.6 102.9 6.0 ATE. i oii vino minions minim wm sown « wit » 17.9 4.4 14.9 5.4 DBS & oni 200.50 5 in 2k res mer oh 22.3 5.5 17.9 5.8 35-44... 28.9 5.4 22.8 55 BBB. . ovr nminss miwn oni ss wae» was 31.9 6.4 / 26.9 6.5 5564. ote 17.4 6.0 15/1 6.2 65andover....................... 7.2 7.4 5.3 F 7 | Note: A day is counted as lost from work if the person would have been going to work at a job or business that day but instead lost the entire work day because of an illness or an injury. If the person’s regular work is less than a whole day and the entire work day was lost, it would be counted as a whole work day lost. Currently employed persons are all persons 17 years of age or over who reported that at any time during the 2-week period covered by the interview they either worked at, or had a job or business. Current employment includes paid work as an employee of someone else, self employment in business, farming, or professional practice, and unpaid work in a family business or farm. Persons who were temporarily absent from their job or business because of a temporary illness, vacation, strike or bad weather are con- sidered as currently employed if they expected to work as soon as the particular event causing their absence no longer existed. Usually working includes persons 17 years of age or older whose usual status was working during the 12-month period. Source: U.S. Department of Health, Education, and Welfare, Public Health Service. Currently Employed Persons, 'lliness and Work-Loss Days (Series C, No. 7). Washington, U.S. Government Printing Office, 1962. TABLE 2. Number of work-loss days due to illness and injury among the currently employed and work-loss days per currently employed person, by sex and age: United States, specified years, July 1959-June 1962 Number of Work-loss days per currently employed person work-loss Sex and age days 1959-60 (millions) 1959-60 1960-61 1961-62 3.year average Male Al ages VT4 csv vmurams 244. 4 5.5 5.3 57 5.5 17-24... 18.9 3.3 3.4 3.1 3.3 25-34... 40. 6 4.1 35-44. 53.4 | 5. of 6 43 46 43 B55. cuir umeis mms sw as BEE 55.3 5.9 5508. «svn rs minim ns bE er 51.7 8. le. 8 6.8 %.4 Z.1 65andover................... 24.5 | 11.0 9.8 9.4 10.0 Female All ages 17+ ........... 125.5 5.6 5.6 5.8 5.7 17-24... 17.9 4.4 4.1 4.4 4.3 25-34... 22.3 5.5 3544. 28.9 | 5. os 3 3.6 6.9 5.7 A5-B..v cin vmisamminima sey 31.9 6.4 55-64. 17.4 | 6. oo 2 63! 44 6.2 65andover.................. 7.2 1.4 7.8 4.6 6.6 Note: For definitions of work loss and current employment see Table 1. Source: U.S. Department of Health, Education, and Welfare, Public Health Service. National Center for Health Statistics Publications (Series C, No. 7, and others). Washington, U.S. Government Printing Office, 1962 and 1963. TABLE 3. Number of work-loss days due to illness and injury and days per currently employed person per year, by family income, sex and age: United States, July 1959-June 1960 Family income Total All Under | $2,000- | $4,000- | $7,000 | Un- Sex and age Solin incomes | $2,000 | $3,999 | $6,999 [and over| known Number of days per currently employed person Male Allages17+...| 244.4 5.5 9.8 6.4 - wn » ° wn - 11-24, .....0000 pmues 18.9 3.3 5.9 2.7 2.5| 3.0 5.3 RT 40.6 4.1 5.6 5.1 3.4 3.9 4.6 35-44............... 53.4 5.0 9.2 5.5 4.9 | 4.4 3.9 BBB cutive wns va 55.3 5.9 10.5 6.5 5.0 5.7 5.5 B5=B4... co puunswnens 51.7 8.1 12.2 11.0 7.1] 6.1 1.5 63 and over.....us +s. 24.5 11.0 18.5 12.4 4.0] 9.1 | 10.2 All ages 174... 125.5 5.6 6.5 6. QD wn FS =~ ° > © 17-24. ciiviiivrrane 17.9 4.4 3.5 5.2 3.5| 5.7 3.8 0, RN 22.3 5.5 1.17 7.3 5.2 3.9 5.1 BE-AL.. rnc ss rower me 28.9 5.4 5.6 7.1 5.4 | 4.5 5.5 A884. sven vnns me 31.9 6.4 7.4 7.6 7.2] 5.1 2.8 LH 17.4 6.0 7.4 5.5 5.4 6.1 6.3 65 and over.......... 7.2 7.4 8.3 5.8 8.9| 6.9 5.1 Note: For definitions of work loss and current employment see Table 1. Source: U.S. Department of Health, Education, and Welfare, Public Health Service. Currently Employed Persons, Illness and Work-Loss Days (Series C, No. 7). 'Washing- ton, U.S. Government Printing Office, 1962. 47 TABLE 4. Number of work-loss days due to illness and injury and days per currently employed person per year, by residence, sex, and age: United States, July 1959-June 1960 Residence Se: d d Toul All Rural Rural Rand see (nlions) areas Urban Bonn oe Number of days per currently employed person Male All ages 174 ............... 244. 4 5:5 5.2 5.3 7.2 17-24... oii 18.9 3.3 2.9 4.2 3.9 25-34... 40.6 4.1 4.2 3.6 4.6 BFA ois n ms sao c gone gs BEES A 53.4 5.0 5.0 4.7 6:1 BEB, cs: wma v soma sR wT un my ns wns 55.3 5.9 5.0 6.7 8.8 S564... 51.7 8.1 8.1 7.6 8.9 65andover....................... 24.5 11.0 8.2 16. 4 14.2 Female All ages 17+ ............... 125.5 5.6 5.9 4.6 6.0 17-24... 17.9 4.4 4.9 3:1 3.8 25-34... 22.3 5.5 5.7 4.1 9.1 35. pme ns mmr wnat Bes bE 8 28.9 5.4 6.2 4.0 3.7 TL A TILT TIT Tray 31.9 6.4 6.7 4.9 7.8 S564... 17. 4 6.0 5.4 8.4 6.3 65andover....................... 7.2 7.4 2.3 5.4 7.2 Notk: For definitions of work loss and current employment see Table 1. Source: U.S. Department of Health, Education, and Welfare, Public Health Service. Currently Employed Persons, Illness and Work-Loss Days (Series C, No. 7). Washington, U.S. Government Printing Office, 1962. TaBLE 5. The incidence of acute conditions per 100 currently employed persons, by type of condition, sex, and yedr of occurrence: United States, specified years, July 1959-June 1963 Acute condition Number of acute conditions per 100 currently employed persons 1959-60 1961-62 1962-63 3.year average Male All acute conditions. .............o.ut 145.7 | 149.1 | 154.2 149.7 Infective and parasitic diseases. ............. 11.7 10.5 10.5 10.9 Respiratory conditions. . ................... 85.0 84.1 86.7 85.3 Digestive system conditions. ................ 8.1 8.7 8.6 8.5 IOJUIIS. ... oo eveveneeeeeanan anaes 27.9 31.1 31.3 30.1 All other acute conditions. .................. 13.1 14.6 17.0 14.9 Female All acute conditions. ................. 169.7 | 192.4 | 199.9 187.3 Infective and parasitic diseases. ............. nz 15.6 15.6 14.3 Respiratory conditions. . ................one 102.2 | 110.5 | 117.2 110.0 Digestive system conditions. ................ 10.2 15.0 11.8 12.3 TOUEI@S. «ooo eevee 19.6 24.5 21.0 21.7 All other acute conditions. .................. 25.9 26.7 34.3 29.0 Note: For definitions of work loss and current employment see Table 1. An acute condition is defined as one which has lasted less than 3 months and has involved either medical attention or restricted activity. Source: U.S. Department of Health, Education, and Welfare, Public Health Service. National Center for Health Statistics Publications (Series C, No. 7 and others). Washington, U.S. Government Printing Office, 1962 and 1963. TABLE 6. Number of days lost from work per 100 currently employed persons, because of acute conditions, by type of condition and sex: United States, specified years, July 1959-June 1962 Number of work-days lost per 100 currently employed persons Acute condition 1959-60 | 1961-62 | 1962-63 | 1963-64 | 4-year average Male All acute conditions. . . . . .... 342.6 | 330.7 | 355.7 | 323.1 338.0 Infective and parasitic diseases. . .... 26.1 26.1 24.0 23.9 25.0 Respiratory conditions. ........ .. .. 160.4 | 134.3 | 156.0 | 123.2 143.6 Digestive system conditions. . . . .... 30.0 19.9 15.2 20.2 21.3 Injuries. ................... ... . .. 89.5 | 119.0 | 121.4 | 123.0 113.2 All other acute conditions. ......... 36.6 31.3 39.0 32.8 34.9 Female All acute conditions. . . .... .. 404.0 | 365.2 | 436.0 | 329.8 383.8 Infective and parasitic diseases. . . . . . 25.6 37.8 31.7 40. 2 35.3 Respiratory conditions... .......... 211.1 | 175.9 | 224.2 | 127.2 184.6 Digestive system conditions. . . . . . .. 19.0 26.1 16.0 12.4 18.3 Injuries. ....................... .. 89.5 56.7 66. 2 77.8 72.5 All other acute conditions. . . ....... 59.0 68.8 91.9 72.1 73.0 Note: For definitions of work-loss and current employment see Table 1. An acute condition is defined as one which has lasted less than 3 months and has involved either medical attention or restricted activity. Source: U.S. Department of Health, Education, and Welfare, Public Health Service. National Center for Health Statistics Publications Washington, U.S. Government Printing Office, (Series C, No. 7 and others). 1962, 1963, and 1964. TaBLE 7. Number of work-loss days associated with chronic conditions, work-loss days per 1,000 currently employed persons per year, and average number of currently employed persons absent from work each day because of the conditions, for selected chronic conditions by sex: United States, July 1959-June 1960 Work-loss days Average number of cur- Ee rmy Selected chronic conditions New Clee ers er » hecauge of | the soulinons ousands) Both Both Male Female | Both Male | Female sexes sexes sexes Heart conditions. .......... 15,323 | 230.5 | 290.3 | 112.1 63 52 10 High blood pressure. . ...... 7,327 | 110.2 | 87.4 | 155.5 30 16 14 Varicose veins. . ........... 1,973 | 29.7 | 17.3 | 54.2 8 3 5 Hemorrhoids. .....cccvvuv... 5,518 | 83.0 | 83.6 | 81.8 23 15 7 Other conditions of circula- tory system. ............. 4,262 | 64.1 | 63.7 | 65.0 17 n 6 Chronic sinusitis. . ......... 5,003 | 75.3 | 71.4 | 83.0 20 13 8 Chronic bronchitis. ......... 3,512 | 52.8 | 67.1 | 24.6 14 12 5 Other conditions of respira- tory system.............. 3,753 | 56.5 | 66.9 | 35.8 15 12 3 Tuberculosis, all forms. . .... 205 3.1 4.6 * 1 1| (OD Other infective and parasitic ABEABEB. . + + vv ssn vivir rs 2,546 | 38.3 | 32.6 | 49.6 10 6 5 Headache and migraine. . . .. 1,718 | 25.8 | 17.6 | 42.2 7 3 4 Pepticulcer. .............. 10,295 | 154.9 | 188.3 | 88.7 42 34 8 Hernia.................... 6, 503 97.8 | 138.2 18.0 27 25 2 Disease of gallbladder. ...... 2,519 | 37.9 | 40.3 | 33.2 10 7 3 Other conditions of digestive BSI. ......:00000u0nnn 8,673 | 130.5 | 146.1 | 99.6 35 26 9 Menstrual disorders. . . ..... 1,274 | 19.2 |....... 57.1 8 Vows vue 5 Menopausal disorders. . . . ... 888 | 13.4 |....... 39.8 4 nsivan 4 Other conditions of genito- urinary system. .......... 12,555 | 188.9 | 150.8 | 264.3 51 27 24 Skin conditions. . . ......... 3,347 | 50.4 | 22.8 | 104.8 14 4 10 Anemia and related condi- SONS retire ol ws gutiomh goacks 436 6.6 | (* 18.0 21 (m 2 Asthma-hay fever. ......... 9,427 | 141.8 | 147.3 | 131.0 38 27 12 All other allergies. ......... 245 3.17 3.9 {*) 1 1 (® Goiter and other thyroid conditions. . ............. 936 | 14.1] (* | 38.7 4| 4 Diabetes... svi cnnscvvess 2,180 | 32.8 | 42.8 | 13.0 9 8 1 Mental and nervous condi- toms. ... ove 9,769 | 147.0 | 168.1 | 105.1 40 30 10 Residuals of fractures and dislocations. ............. 3,158 | 47.5 | 55.9 | 310 13 10 3 Arthritis and rheumatism. . . (12,108 | 182.1 | 199.0 | 148.7 49 36 14 Other diseases of muscles and joints. .............. 8,929 | 134.3 | 173.6 | 56.6 36 31 5 Orthopedic impairments. ... . . 17,416 | 262.0 | 311.7 | 163.6 71 56 15 All other chronic conditions. [33,924 | 510.3 | 511.7 | 507.5 | 138 92 46 *Does not meet standards of reliability. Source: U.S. Department of Health, Education and Welfare, Public Health Service. Currently Employed Persons, Illness and Work-Loss Days (Series C, No. 7). Washington, U.S. Government Printing Office, 1962. 51 TABLE 8. Restricted-activity and bed-disability days among usually working persons by type of disability, sex, and age: United States, J uly 1959-June 1960 Number of days (millions) | Number of days per person per year Sex and age Restricted Bed Restricted Bed activity disability activity disability Male All ages 17+............... 502.3 171.9 11.8 4.0 JT-24. crisis rms mn nen an 31.9 12.1 7.2 2.7 2-H. 198.9 72.7 9.6 3.5 45-64... 220.0 75.2 14.1 4.8 Cr 41. 6 9.5 24.8 5.7 7Sandover..................... .. 9.9 2.3 27.6 6.5 Female All ages 174+............... 265.2 92.8 14. 2 5.0 17-24... 37.8 16. 4 11.8 5.1 25-44. LL 105.0 36.8 13. 4 4.7 45-64... 106.9 33.5 15.5 5.1 653-~Th. vi iniisenniirmmenemmns omens 14.3 3.6 23.5 5.8 75 and over....................... (* * * * *Does not meet standards of reliability. NotE: A day of restricted activity was one in which a person cut down on his usual day-to-day activities because of an illness or injury; included in this count were days spent in bed or days lost from work. A person was considered to have had a day of bed disability if he spent all or most of the day (more than half of the daylight hours) in bed because of an illness or injury. A day spent in the hospital was considered to be a day of bed disability, even though the person was not actually in bed. For a definition of usually working persons see Table 1. Source: U.S. Department of Health, Education, and Welfare, Public Health Service. Health Statistics, Disability Days, United States, July 1959-June 1960 (Series B, No. 29). Washington, U.S. Government Printing Office, 1961. 52 salary workers: United States, July 1959-June 1960 TABLE 9. Number of workers, mean age, and illness rates on an average workday,* by occupation and sex, civilian wage and Occupation Group Male Illness rate per 1,000 Number of |Mean age t workers (years) Number of workers Illness rate per 1,000 (thousands) Crude Age- (thousands) Age- adjusted adjusted Alone neirn os nmnsenminss TE FETE ors wmarnsls doi BAA EE 36, 008 41. 19, 255 15.9 Professional, technical, and kindred workers............... 3,983 40. 2,448 11.1 Farmers and farm managers... ...........cooiueeeeinnns 47 L Jeanne olen smwn « Jomo nisin Managers, officials, and proprietors, except farm. v:samssss 2,931 493 48.6 8 20.5 Clerical and kindred workers... ...............ooiiinainn 3, 062 6, 256 36.4 5 12.4 Sales WOTKEIB. . . vou vvvnnteriineennnnseneanssoonnnans 2,375 1,448 41.8 . 6 18. 4 Craftsmen, foremen, and kindred workers................. 7,784 200 45.5 0 28.5 Operatives and kindred workers. ............ iii 8,491 3,226 40.9 A 26.5 Private household workers. ..............c.ooviiinieennns 42 2,090 42.0 I 1.3 Service workers, except private household. ................ 2,621 2, 742 41.4 8 16.8 Farm laborers and foremen. . ..........ooooiiiiiiiiinnns 1,157 264 40. 8 5 5.5 Laborers, except farm and mine. ..............oooinns 3,513 86 41.0 7 21.7 *[llness lasting a workweek or more. tJanuary-December 1959. Source: Enterline, Philip E. Work Loss Due to Illness in Selected Occupations and Industries, Journal of Occupational Medicine 3: 405-411 (September) 1961. TABLE 10.—Number of workers, mean age, and illness rates on an average workday,* by type of employment and sex, civilian wage and salary workers: United States, July 1959—June 1960 Male Female . ,000 Type of employment Natberet | Mpa ngs Illness rate per 1,000 Nutdhier wt | Musaange Illness rate per 1 workers (years) workers (years) (thousands) Age- (thousands) Crude Age- adjusted adjusted All wage and salary workers. ........................... 36, 008 140. 6 13.2 13.3 19, 255 140. 3 15.6 15.9 AGTICUIIE, + + 4 vot ti 200 emwen anne nam 5 sem Es a an se nmns @ 1,393 136. 6 7.4 7.8 293 136.2 7.1 2.7 Government. .................. oi 4,730 142.1 16.0 16.0 3,034 139.5 12.7 13.2 Public administration. ..................... .. .... .. 2,283 141.9 16.2 16. 4 870 138.5 16.1 12.1 Educational services. .............................. 925 141.3 10. 6 10. 7 1,514 140. 6 9.4 9.6 All other government. .................. .......... 1,521 142.9 18.9 18.7 650 138.1 15.2 16.1 Private nonagriculture. ............................... 29, 885 140. 8 13.0 13.3 15, 927 139.9 16.3 16.6 *Illness lasting a workweek or more. tJanuary-December 1959. 11950 Census. Source: Enterline, Philip E. Work Loss Due to Illness in Selected Occupations and Industries, Journal of Occupational Medicine 3: 405-411 (September) 1961. TasLe 11. Mean age, and illness rates on an average workday,* by industry and sex, private civilian wage and salary workers: United States, July 1959- June 1960 Male Female Illness rate Illness rate Industry Mean per 1,000 Mean per 1,000 aget aget (years) (years) Crude | Age- Crude | Age- adj d adjusted All private ponagricultural industries. . ..| 40.8 | 13.0 | 13.3 39.9 | 16.3 | 16.6 Forestry, fisheries, mining.............. 42.01 1729 118.1 |......].... ferns CoNSHREtION i + «wiv «wwe + 3 win sy woe 2 3 400 40.7 | 14.2 | 14.6 | 39.5 | 13.3 | 13.8 Manufacturing. . ........oonnnnenennn. 40.3 | 13.5 | 13.9 | 39.0 | 22.5 | 23.6 Railtoads........cccovvvvunnnnnnnnnnn 47.0 | 27.0 | 25.1 | 43.9 { 20.1 | 19.3 Other transportation. ................. 41.1 | 16.3 | 16.6 | 35.9 | 14.5 | 16.0 Telecommunications and other public atilitles. comes sr anes snus smmrrvrese 40.2 | 15.8 | 16.4 | 34.3 | 20.1 | 22.3 Wholesale......c..ovceevmvrrnnssvnnss 41.3 | 10.5 | 10.7 | 38.4 | 14.9 | 15.8 Retail. cui vein cmos woman » madi 4 S048 2 39.2 | 9.2| 9.5|40.6 | 16.6 | 16.8 FIRANCE vans 5 mmm 2.2 wiwrn « moww sv wine » wearin 4 5 44.3 15.0 | 14.4 | 36.9 | 14.2 | 15.1 Business and repair. . ................. 40.8 | 13.5 | 13.8 | 39.7 | 12.1 | 12.6 Private household. .................... 40.8 | 4.5] 4.3 (42.4 (11.6 | 11.1 Personal services, except private house- WONG, 1 © 0 atin: £0 sonen # 8 fav: wn. obec § Bs BRAT 44.0 | 12.1 | 11.6 | 43.0 | 17.1 | 16.8 Entertaliiiments, ox « voce» vw v won + sine 37.6 | 8.1| 8.4|36.9|21.8| 23.3 Educational services. .................. 40.9 | 5.9] 6.0 42.1 | 5.1 5.0 Other professional services. ............ 43.7 | 8.0| 7.8 (40.2 |10.9| 11.1 *Illness lasting a workweek or more. tJanuary-December 1959. Source: Enterline, Philip E. Work Loss Due to Illness in Selected Occupations and Industries, Journal of Occupational Medicine 3: 405-411 (September) 1961. TABLE 12. Mean age, and illness rates on an average workday,* by type of manufacturing and sex, private civilian wage and salary workers, in manu- facturing: United States, July 1959-June 1960 Male Female Illness rate Illness rate Industry Mean per 1,000 Mean per 1,000 aget aget (years) (years) Crude Age- Crude Age- adjusted adjusted SEBS HEL BPW E88 isi no ee we wo a sy 5 40.3 | 13.5 | 13.9 | 39.0 | 22.5 | 23.6 Durable goods........................ 40.4 | 14.6 | 15.0 | 37.6 | 24.5 | 26.5 Lumber.......................... 38.2 112.8 | 13.6 |......[......[...... FUrDIre. « cco vcs mina 5585000 1 monn» 38.8 | 18.3 | 19.2 | 36.1 | 17.4 | 19.5 Stone, clay products. .............. 39.6 7.9 8.21339) 21.7 24.5 Primary metals... .......... ...... 40.8 | 16.5 | 17.0 | 34.5 | 12.5 | 14.3 Fabricated metals. ............. ... 39.6 | 14.9 | 16.2 | 34.3 | 25.7 | 29.0 Machinery, except electrical. .. .. ... 40.4 | 15.4 | 15.9 | 34.2 | 15.8 | 18.0 Electrical machinery. ............. 38.1 | 87] 9.3|33.3(26.2]| 30.7 Automobiles...................... 39.51 20.2 | 21.2 | 34.6 | 38.3 | 43.7 Other transportation equipment. . ..| 40.0 | 12.8 | 13.4 | 35.0 | 16.6 18.8 Instruments...................... 38.9 | 12.3 | 12.9 | 34.3 | 35.1 | 39.7 Other durables. .................. 39.1 24.7 125.7 (35.1|36.8| 40.8 Nondurable goods. .................... 40.0 | 11.6 | 11.9 | 39.9 | 21.2 | 22.0 Food and kindred. ............ .... 38.8 14.4 115.3 | 35.8 | 25.1 | 27.9 Textile mill products. ............. 39.6 | 11.9 | 12.4 | 36.7 | 19.2 | 21.1 Apparel.......................... 41.5 10.7 | 10.7 | 37.3 | 21.2 | 22.9 Printing and publishing............[ 36.9 | 8.6 | 9.2 36.2 | 14.9 | 16.2 Chemicals and allied products. . . . .. 39.1 | 12.6 | 13.4 | 34.2 | 19.1 | 21.8 Other nondurables. ........... .... 40.0 | 11.0 | 11.4 | 35.7 | 26.4 | 29.3 *Illness lasting a workweek or more. 11950 Census. Source: Enterline, Philip E. Work Loss Due to Illness in Selected Occupations and Industries, Journal of Occupational Medicine 3: 405-411 (September) 1961. TasLe 13. Days of sick absence per person per year for employed civilian wage and salary workers, by marital status, age and sex: United States, July 1959-June 1961 * Ever Married Married | Widowed Sex and age Single married spouse sponses or present sent divorced Males Al ages... ....ccamassamss nny 3.0 4.9 4.7 5.2 7.3 14-19... .ccii ities 1.9 4.3 4.3 4.1 4.7 OO si ¢ niin v3 ag 0 rer 4 * ben hat 2.9 3.2 3.1 5.0 2.9 A TL 3.1 3.4 3.3 4.0 6.1 BEd ov vo monn ss Sidi 3 3 HEB MES 4.5 4.0 4.0 4.6 6.3 A Blhsv s «vn vwminn 8 niki 3 3 REE & 8 SEH 6.2 5.4 5.3 5.4 6.1 5564... 5.9 7.9 1.9 6.9 9.0 OA AOA OVEE. 53 sim 5 wn + wwe» omni » 4.9 9.0 9.0 10. 4 9.0 Age adjusted. .................... 4.3 4.7 4.7 5.1 6.2 Females Allages..........covueennnn 3.2 6.2 6.0 6.8 6.5 F005 srnaic ¢ 3 gwrsece wrmicin 1 9 ode 5.1. obs SAE 2.) 6.0 6.2 4.3 7.2 20-24... ee 3.5 5.4 5.4 5.1 7.0 DEB, «iow i 8 sins ww 2 wim Awe vw 3.17 5.9 5.6 1.9 6.2 A TT TIT 4.4 6.5 6.3 1.5 6.8 BBB. env mmin wn min 33 bind 8 8 WHR SpA» 4.1 6.1 6.1 5.8 6.4 SEHOR cvs « w wri v vmin: #4 v0 55 BEGET DEED 4.7 6.5 5.9 8.2 7.0 64andover..........coooiniiiiannn 2.4 5.1 5.4 3.4 52 Age adjusted. .................... 3.9 6.1 5.9 6.7 6.6 1 Data were derived from special tabulations prepared by the U.S. Bureau of the Census from the Monthly Survey of the Labor Force. Information was obtained on fully employed persons who did not work at all or who worked only part of the week preceding the interview. The sample from which the data were derived represents experience of about 56 million wage and salary workers over a 2-year period. Not represented are about 10 million self-employed and unpaid family workers. Source: Enterline, Philip E. Sick Absences for Men and Women by Marital Status. Archives of Environmental Health, 8: 466-470 (March) 1964. 57 TABLE 14. The 25 largest occupations of women: United States, 1960 Women employed Rank Occupation Percent of Number total in occupation 1. Secretaries. ................................ 1,423,352 97 2. Saleswomen, salesclerks (retail). ................ ._ .. 1, 397, 364 54 3. Private-household workers !. ............ .. .. 1,162, 683 96 4. Teachers (elementary schools). ............... .... .. 860, 413 86 5. Bookkeepers.......................... .... 764, 054 84 6. Waitresses. ................................... 714, 827 87 7. Nurses, professional. ............................ 567, 884 98 8. Sewers and stitchers (manufacturing).............. .. 534, 258 94 9. Typists...........oooiii 496, 735 95 10. Cashiers. ............................ 367, 954 78 11. Cooks (except private household). ........ .... .. . .. 361, 772 64 12. Telephone operators. ............................ .. 341, 797 96 13. Babysitters (private household)................... .. 319, 735 98 14. Attendants (hospitals and other institutions). ........ 288, 268 74 15. Laundry and dry cleaning operatives. ............... 277, 396 72 16. Assemblers. ........oouvnne ee iiirioneiinsan, 270, 769 44 17. Apparel and accessory operatives.................... 270, 619 75 18. Hairdressers and cosmetologists................. .... 267, 050 89 19. Packers and wrappers '...................... .. .. .. 262, 935 60 20. Stenographers. ........................ 258, 554 96 21. Teachers (secondary schools). .......... .......... 243, 452 47 22. Office-machine operators. ...................... . 227, 849 74 23. Checkers, examiners, inspectors (manufacturing). . . . . 215, 066 45 24. Practical nurses. .......................... .... 197,115 96 25. Kitchen workers! (except household)............. .... 179, 796 59 ! Excludes those listed separately by the Bureau of the Census. Source: U.S. Department of Labor, Women’s Bureau, 1962 Handbook of Women Workers (Bull. No. 285). Washington, U.S. Government Printing Office, 1963. 202 pp. 58 TasLe 15. Major industry group of employed women: United States, 1964, 1950, 1940 Number Percent distribution Percent of all workers Industry group (in thou- sands) 1964 1964 1950 1940 1964 1950 1940 Total, suis ss smn s sues 23,786 | 100 | 100 | 100 35 29 26 Services. ......oooveuernannns 10,128 43 36 45 60 55 59 Professional and related...| 5,700 24 16 17 60 55 57 Personal... cvinsvssscvsen 3,839 16 18 26 75 7 73 Business... ..:: snes senses 426 2 1 1 23 13 10 Entertainment and recre- ORION ci 5 le» svascie v0 antes 0.3 3 163 1 i 1 29 24 21 Manufacturing. .............. 4,667 20 23 21 26 25 23 Retail trade. ; oo «0 sive c vows s po 4,327 18 20 17 41 36 31 Finance, insurance, real estate.| 1,551 7 5 4 47 43 33 Public administration. ........ 1,048 4 4 3 28 25 20 Transportation, communica- BROS, «5 5 owim #4 SHE 4 8 Ww ¥ vom » 753 3 4 3 16 15 12 Agriculture. ............. 0. 597 3 4 5 15 10 6 Wholesale trade. . ............ 473 2 3 2 20 19 16 Construction. ................ 217 1 ® 5 2 2 IERIE orieiain 1 4 win w 8 poe #2 nnn « 25 ®) 0) 5 2 2 1 Less than 0.5 percent. Source: U.S. Department of Commerce, Bureau of the Census, Current Population Reports, Series P-60. (Prepared by the Women’s Bureau, U.S. Department of Labor.) 59 TABLE 16. Women in manufacturing industries: United States, 1964 and 19501 1964 Percent distri- Percent of all bution workers Industry Number of Percent women change 1964 1950 1964 1950 from 1950 Total manufacturing. . . . .. 4, 468, 000 +19 | 100 | 100 26 26 Nondurable goods Subtotal............... .. 2,722, 000 +8 61 67 37 37 Apparel, and related products. . . . 1, 035, 100 +21 23 23 80 74 Textile-mill products............ 390, 200 —26 9 14 44 43 Food and kindred products. . . . .. 377,100 +1 8 10 23 22 Printing, publishing, and allied industries. . ................ .. 273, 300 +34 6 5 29 27 Leather and leather products. . . . 179, 400 +2 4 5 52 66 Chemical and allied products. . . . . 164, 200 +44 4 3 19 18 Paper and allied products. . . ..... 130, 900 +16 3 3 Nn 24 Rubber and miscellaneous plastic PPOJQUCES. oi 5 ww i 5 3 500 Ha mo wm mn 118, 500 +39 3 2 29 29 Tobacco manufactures. .......... 37,300 —28 1 1 48 56 Petroleum refining and related dustin. .c.. suis nmes wna 16, 100 +55 | ® *) 9 5 Durable goods Subtotal............. .... 1, 746, 000 +40 39 33 18 16 Electrical equipment and supplies.| 570, 200 +69 13 9 37 36 Machinery (except electrical). . . . . 200, 500 +36 4 4 13 13 Fabricated metal products. . . . ... 195, 100 +21 4 4 17 18 Transportation equipment. . ..... 167, 500 +57 4 3 10 10 Instruments and related products. | 126, 500 +63 3 2 34 33 Stone, clay, and glass products. . . 94, 100 +16 2 2 15 16 Primary-metal industries. . . . .. .. 70, 000 +4 2 2 6 6 Furniture and fixtures. ........ .. 70, 000 +23 2 2 18 16 Lumber and wood products (ex- cept furniture). ........... .. 43, 000 -19 1 1 7 7 Ordnance and accessories. . . ... .. 48, 300 +973 1 ®) 18 17 Misc 1'aneous manufacturing in- dustries.................... .. 160, 900 +6 4 4 41 40 ! Data is for April of each year. 2 Less than 0.5 percent. Source: U.S. Department of Labor, Bureau of Labor Statistics, Employment and Earnings, August 1964, and Employment and Earnings Statistics, 1909-60 (Bulletin No. 1312). (Prepared by the Women’s Bureau, U.S. Department of Labor.) 60 TABLE 17. Women in selected nonmanufacturing industries: United States, 1964 and 1960 * April 1964 Percent of all workers Industry Number of Percent women change 1964 1960 from 1960 ! Finance, insurance, and real estate............. 1, 455, 000 +8 50 50 Banking. ..:c.oveneionmis rams tosnes bmn en 455, 300 +10 61 61 Credit agencies, other than banks.......... 162, 000 +17 54 55 Insurance agents, brokers, and services. . . .. 125, 200 +13 56 57 Insurance CAImIers. .... «vcs sows ssw vues an 432, 500 +4 49 50 BBA] CREAN. 1 vs tii 0 00m 43 0000% + iit cite 8 194, 400 ® 35 37 Security dealers and exchanges. ........... 39, 200 +14 31 31 Other finance, insurance, and real estate. . .. 36, 000 -1 48 47 MUInNINgG. co cnimess mney mous om os Das + 95a SAAR 5 55 35, 000 -3 6 5 Reta IAAE ss ovis 3 355 3 7 505 2.5 Bimeh 3 03d § 350 753 3, 743, 000 +3 43 43 Apparel and accessories stores. ............ 398, 800 —12 65 65 Eating and drinking places................ 995, 500 +13 55 54 Food STOR. winin 2 4 mie vs sins ssw ss swim 2 sll 2 45 470, 000 +5 33 33 Furniture and appliance stores. ........... 112, 000 pc 28 29 General merchandise stores. .............. 1, 124, 200 (?) 69 72 Other retail trade... ..................... 642, 200 +3 22 22 Services and miscellaneous: ARVErHBING : 5.50 « wie £ evi 43 wom v3 wins sawn 23.8 40, 000 +8 37 34 BUOBPRAIS. « « itv # tai dubs 4 Be lp hsb» ns, wh 1, 087, 900 +23 81 81 Hotels, tourist courts, and motels. ......... 284, 300 +20 48 47 Laundries, cleaning and dyeing plants. ..... 343,100 ¢) 67 65 Motion Plettres. «vv. ons wv es swiss sme so 56, 700 -15 34 36 Transportation and public utilities: Air transportation. . ..................... 49, 500 +19 23 22 Communication. ..............covuuuuunn. 417, 000 -3 50 51 Electric, gas, and sanitary services. ........ 93, 400 +1 15 15 Local and interurban passenger transit. . . .. 21, 000 +1 8 7 Motor freight transportation and storage. . . 75, 500 +2 8 9 Pipeline transportation. .................. 1,500 -12 8 7 Wholesale trade. .... ou :nusssnvissavssnmessns 694, 000 +3 22 23 1 Figures are for April of both years. 2 Less than 0.5 percent. Source: U.S. Department of Labor, Bureau of Labor Statistics: Employment and Earnings, August 1962 and August 1964. Department of Labor.) (Prepared by the Women’s Bureau, U.S. 61 TaBLE 18. Rate of job changing, by age and sex: United States, 1955 and 1961 Worked in 1961 Worked in 1955 Persons who changed Age and sex a Jobe one or more Toa Doracns in changed (thou- (thou- |— sands) Number Percent sands) Number Percent (thou- of total (thou- of total sands) sands) Total, 14 years and OVOL, 443 adi £33 wat o 80, 287 8,121 10.1 | 75,353 8, 366 11.1 Male, 14 years and over. ..| 49, 854 5, 509 11.0 | 47,624 5,940 12.5 14 to 17 years. ....... 2,926 261 8.9 2,541 328 12.9 18 and 19 years....... 1,946 457 23.5 1,618 444 27.4 20 to 24 years. ....... 4,507 1,101 24.4 3,509 976 27.8 25 to 44 years. ....... 21, 062 2,630 12.5 | 21,516 2,825 13.1 45 to 64 years. ....... 16, 512 960 5.8 | 15,331 1,262 8.2 65 years and over... .. 2,901 100 3.4 | 3,109 105 3.4 Female, 14 years and over.| 30,433 2,612 8.6 | 27,729 2,426 8.7 14 to 17 years. ....... 2,044 118 5.8 1,663 179 10.8 18 and 19 years....... 1,789 397 22.2 1,508 314 20.8 20 to 24 years... ..... 3,476 568 16.3 3, 367 501 14.9 25 to 54 years. ....... 17,995 1, 348 7.5 | 16,932 1.278 7.5 55t0 64 years. ....... 3, 782 156 4.1 3, 067 131 4.3 65 years and over... .. 1, 347 25 1.9 1,192 23 1.9 ! Persons who changed occupations but worked for the same employer were not considered job changers in the study. and Stuart Garfinkle. Source: Bancroft, Gertrude, Monthly Labor Review 86: 897-906 (August) 1963. 62 Job Mobility in 1961, U.S. GOVERNMENT PRINTING OFFICE : 1965 O—773-197 U. C. BERKELEY LIBRARIES iii C04?280117 : a