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(6) Requiring the organization of a regular system of medical supervision on the works and wherever possible a permanent staff of medical officers.
(c) Fixing exactly the periods of employment and the manner of locking in and unlocking, according to the depth of the works and the pressure.
(d) Prescribing suitable hygienic regulations respecting the air supply in the caisson and 'air locks, variations of temperature, accommodation for workmen on the works, the conduct of workmen, etc. (e) Prescribing all necessary arrangements for the protection of life and health.
Insuring that suitable appliances for treating persons taken ill-especially a properly fitted up recompression lock—and the necessary staff for attending them shall be available.
(9) Requiring a register to be kept on the works, containing the name and forename of every person subject to medical examination, particulars of the result of each examination, and particulars of all cases where medical treatment was given on the works and the results of the same.
Since divers, especially those employed in salvage operations, are liable to be called upon to work in foreign waters or on ships of a different nationality, it seems advisable that their occupation should be regulated by international agreement.
The members of the permanent council of hygiene shall collect from every country the regulations and official and private instructions respecting diving operations.
The international labor office shall thereupon transmit copies of these regulations, etc., to the members of the special commission, which shall prepare a report on the subject for the next delegates' meeting.
XI. THE PREVENTION OF ACCIDENTS.
The bureau is instructed to make a further report to the next delegates' meeting regarding the international prevention of accidents and the protection of those employed on railroads and in the carrying trade. The sections are requested to petition their Governments for the introduction of automatic couplers.
XII. WORKMEN'S INSURANCE.
EQUAL TREATMENT OF FOREIGN WORKMEN.
. 1. The association requests the American section to continue its efforts to secure the passage in the several States of the Union of suitable laws for insurance against sickness and accident, which shall not discriminate against alien workers and thus carry out Resolution IX adopted at Geneva, and Resolution X adopted at Lucerne, and it thanks this section for the initiative which it has taken in this question of the protection of immigrants.
2. A special commission is appointed with instructions to seek ways and means by which the equal treatment of native and foreign workmen may be guaranteed, not only in respect to insurance against industrial accidents but also in other departments of social insurance, and to report to the next delegates' meeting.
REPORT OF ILLINOIS COMMISSION ON OCCUPATIONAL
In March, 1907, the Illinois Legislature authorized the appointment by the governor of a commission consisting of four State officials, two reputable physicians, and three other representative citizens of the State to thoroughly investigate causes and conditions relating to diseases of occupation and to report on desirable legislation respecting this subject. The time limit at first set was too short for anything to be attempted, and it was not until 1909 that the commission was able to begin its work effectively. The commissioners served without compensation, and practically the whole amount appropriated for its use-$15,000—was used for direct expenses of investigation. The volume issued in January, 1911,' contains the report of the commissioners and a series of monographs embodying the findings of the various investigators.
The commissioners give an outline of the extensive field of industrial hygiene, and point out the impossibility, with the limited time and means at their disposal, of making any attempt at a comprehensive study. In the main their investigations were confined to the industrial use of poisons and the resulting effects upon the health of the workers.
The most elaborate study in the report is that by Dr. Alice Hamilton on industrial lead poisoning. Eighteen different industries or trades involving this danger, she finds, are carried on in Illinois. The degree of danger involved varies widely. Smelting and refining lead, the manufacture of white lead, the painting trades, and the manufacture of storage batteries are the most widely harmful. The danger is present in two forms-that of inhaling particles of the metal in the shape of metallic dust or fumes and that of swallowing them with food or drink. The road to comparative safety lies along the lines of prevention or diminution of dust and fumes in the worker's atmosphere by the use of hoods, exhausts, and similar devices, the provision of clean, well-ventilated workplaces, the substitution of wet for dry processes wherever practicable, with a free use of water to keep down
1 Report of commission on occupational diseases to his excellency Charles 8. Deneen, January, 1911, 219 pages.
* That this can be done to a considerable extent is shown by the situation in England, where many of the most dangerous processes in the manufacture of white lead as carried on.in America have been wholly abolished, with markedly beneficial effects to the workers.
dust, and the enforcement of strict rules concerning personal hygiene upon all workers handling lead or engaged in any of the dangerous processes. Two extremely simple precautions are the provision of respirators to be worn in all necessarily dusty work and the provision of ample facilities for washing-in some cases for bathing-and insistence upon their use. If the further precaution were taken of testing the employees and putting those who show special susceptibility to the effect of lead at the least exposed operations, the dangers of the work would be immensely diminished.
Along the first line conditions have improved considerably of late years. Machinery is steadily displacing hand workmen, and the growing demand for the metal is leading manufacturers to avoid the waste involved in the escape of dust and fumes. In regard to the personal care and instruction of the workers little or nothing is being done. Some of the industries, like smelting and the manufacture of white lead, have gained such a bad name among workmen that the better class will scarcely enter them. As a consequence, those employed in such work are, according to the report, mainly the poorest and most ignorant foreigners or Negroes. They either have no knowledge that danger exists or else have only a vague fear, with no idea where the risk lies or how it can be met. They are a notoriously unsteady, shifting class, continually moving in and out of the lead trades, thus greatly increasing the difficulty of giving instructions and taking precautions which would diminish their risks. This migratory character greatly increases, also, the difficulty of tracing cases of lead poisoning and finding how harmful the work really is.
As the investigation was undertaken to afford a basis for legal action, the economic and legal aspects of the dangers incurred by lead workers naturally took a prominent place. In the brief time available it was impossible to discover how extensively lead poisoning prevailed and how far it was responsible for economic loss and suffering, primarily to the workers and through them to the community as a whole. Five hundred and seventy-eight cases of lead poisoning, occurring during the years 1908, 1909, and 1910, were found, 12 of which resulted in permanent disability, 8 involved temporary or partial paralysis, and 18 resulted in death. One hundred and sixteen men reporting on the point showed a loss of working time from lead poisoning amounting to 65 years, and 102 men reporting on wages lost showed an aggregate loss of $63,940. Where the burden of this loss fell is more than indicated, it is emphasized, by the fact that of the 578 workmen affected only 3 had received any compensation from their employers. One employee in smelters and metal shops was paid full wages while disabled, one paint factory worker was paid part of his wages, and another's medical expenses were paid; beyond this the workmen and their families alone bore the cost of illness arising from trade conditions—unless some part of it was borne by the general community in the form of philanthropic relief. On this point the report is silent. The largest number of cases found, 181, was among the workmen in smelters and metal shops; 5 of these reported an average of two months apiece lost time, and 4 reported an average loss of $71.25 each in wages. The painting trades stand next in point of numbers with 157 cases; 77 workmen reported time lost aggregating 43 years 4 months, and 72 reported an aggregate wage loss of $46,092.
From the legal side the study throws considerable light on the responsibility of the workmen and on their assumption of the risks of the employment. Many of the dangerous conditions, such as the prevalence of dust and fumes, are absolutely beyond the workmen's control; either they must stay out of the occupation altogether or they must accept such degree of danger as the employer does not guard them against. In some of the most dangerous occupations, such, for instance, as the work in smelters and white-lead factories, intelligent workmen, as a rule, take the first alternative, and only the most ignorant, unskilled, and helpless class will enter them. How far these workmen are responsible for their own disregard of precautions, and how far they deliberately assume the risks of their employment is shown by the following quotation:
For instance, a young Bulgarian went to work in a white-lead factory the first week he arrived in Chicago, and was put to emptying pans of dry white lead. He was given no respirator and had no idea that he had a right to ask for one. Nobody told him the white dust on his hands and mustache was poisonous. He had only one suit of clothes and wore his working clothes home. He had a severe attack of lead poisoning at the end of five weeks. Another foreigner, a Russian Jew, was set to making red-lead paste in a storage battery factory. He was utterly ignorant of the substances he was handling and used to moisten his fingers in his mouth as he made the paste. He became severely poisoned after 10 days' work. We have found almost no effort in the lead works to instruct the foreigners in the care of their persons and in the avoidance of danger.
Another illustration is afforded by the mechanical artists or retouchers. This is highly skilled work, employing about 520 workers in Chicago, carried on by educated and intelligent people. “They use white paint, putting it on with a fine brush, which they habitually suck to bring it to a fine point." They also use an air brush which by means of compressed air sends a fine spray of white paint where needed. Most of the artists believe that they are using white-zinc paint and say that their employers and foremen assured them of this. Nevertheless, they say they all find the work very unhealthful and that many could not stand it more than a few years. On analyzing the white paints used it was found that 7 out of 11 were whitelead paints, and only four establishments were found in which at least one variety of white-lead paint was not used.
From the practical side the report shows that it is entirely possible at no prohibitive cost to make most processes safe and to reduce immensly the risks of the most dangerous operations. Some employers are voluntarily taking the necessary precautions, but others neglect them altogether. The difference in the risks when strict regulation is enforced and when regulations are left almost entirely to the employer's option is strikingly shown by some comparisons between conditions in England and in Illinois:
In one English white-lead factory employing 182 men careful medical inspection failed to discover one case of lead poisoning in the year 1909–10. In an Illinois factory employing 142 men partial inspection revealed 25 men suffering from lead poisoning last year. In another English factory employing 90 men no case was discovered for five successive years. In an Illinois factory employing 94 men 28 per cent of all employees have had lead poisoning, and 40 per cent of all employed in the dustier work. The other two Illinois factories have not had medical inspection and accurate figures can not be given. One has sent four cases of lead poisoning to a hospital during the last month, the other three. These figures certainly do not represent even one-half of the probable number of cases, for many do not seek hospital care, yet even these would mean an average yearly of 36 and 48 cases, respectively. .
The report does not claim to be more than a preliminary view of the field, indicating where more study is needed. It was impossible in the limited time and with the limited means available to make anything like a complete survey, to show how many were exposed to given dangers or to obtain full data as to the number and severity of the cases of lead poisoning annually occurring. It gives some indication of the annual amount of physical suffering, impaired capacity, and economic loss suffered by workers in the lead trades in Illinois, and it shows-in some cases by citing conditions prevailing abroad, in others by the experience of the more enlightened and careful employers in Illinois—how the dangers attendant on the various lead employing industries can be reduced or wholly obviated.
The study by Dr. Hayhurst of brass working in Chicago and zinc smelting in La Salle County shows that numerically these are less important than the lead employing industries. The risks seem less and the toxic effects, when incurred, less immediately and acutely harmful. Nevertheless, the work is very generally recognized as unhealthful. The brass worker's danger comes principally from zinc, though lead and other metals are used in some branches of the industry. In plating, polishing, and lacquering acid fumes and metallic dusts are encountered. Zinc is one of the important constituents of all the brass compounds, and as it volatilizes at a much