Dangerous Trades

DANGEROUS TRADES. By the British Factory and Workshop Act 1901, cases of industrial lead, phosphorus, arseni cal and mercurial poisoning, also of anthrax, must be reported to the Chief Inspector of Factories, Home Office. Subsequently, carbon bisulphide, aniline and chronic benzene poisoning, also cases of toxic jaundice and of epitheliomatous and chronic ulcer ation, were included. Accidents in mines and factories had pre viously been notifiable. The inclusion of industrial poisoning at first presented difficulties from the point of view of workmen's compensation ; for, could lead poisoning, for example, be regarded as an accident, since it is usually not of sudden onset? As in the case of anthrax, however, a workman might develop and die from pneumonia within 24 hours after infection, it was clear that cer tain industrial diseases must be scheduled. This circumstance marks a distinct and humane advance in factory legislation.

Lead Poisoning

was among the first of the industrial diseases thus made notifiable; it is therefore compensable. Lead miners do not suffer from the malady but from disease of the lungs due to inhalation of rock dust. Smelters of the ore and refiners de velop plumbism (Lat. plumbum, lead) through inhalation of the fumes. Workers in white lead factories are peculiarly prone to plumbism owing to white lead dust (carbonate) being soluble in the respiratory and digestive passages. A similar liability applies to house painters—especially during the "burning-off" and "dry rubbing down" of old lead painted surfaces. The substitution of "wet" for "dry" rubbing down will diminish plumbism among painters. Opinions are divided as to whether the occupational illness of painters may not be as much due to the turpentine in the paint as to the pigments. Persons working in lead become anaemic. There is a personal and family idiosyncrasy to plumb ism, and young females are if anything more predisposed to it than males. The symptoms are colic, the presence of a blue line on the gums close to the teeth, paralysis of the muscles of wrists and fingers, albuminuria, and in the acute and serious form blind ness and convulsions. Lead is found in the internal organs after death.

As a result of periodical examination of workers in lead fac tories, also in potteries which use lead glazes, cases of plumbism have considerably decreased during the last 25 years, as well as in consequence of better ventilation of the workrooms, means for the removal of dust, personal hygiene, and attention to the bowels. Lucifer match making is no longer a dangerous trade owing to the substitution of sesquisulphide of phosphorus f or the harmful white phosphorus. Mercurial poisoning occurs among men employed in the preparation of rabbits' skins by nitrate of mercury for hat making, in makers of scientific instruments of precision such as thermometers and barometers, and in men repairing electric meters. Carbon bisulphide used as a solvent in rubber industries causes a peculiar form of intoxication not unlike alcoholic, accompanied by staggering gait and mental excitement, also paralysis of the limbs in the more chronic cases. Carbon bisulphide is used extensively in the manufacture of artificial silk from cellulose. Benzene or Benzol used in "dry-cleaning" causes headache and drowsiness, while its nitric acid products, nitro benzene and amido-benzene, destroy the red blood corpuscles inducing pallor of face with marked blueness of the lips, tongue and finger nails, irregularity of the heart's action and collapse.. The blueness mentioned is due to the formation of aniline in the body. Toxic jaundice was occasionally met with during the war in persons in munition works handling the material of or inhaling vapours of dust from high explosives. Anthrax, Wool-Sorters' Disease or Splenic fever attacks workers employed in opening bales of infected wools. In the form of a local pustule the disease occurs in butchers and in men handling infected hides. It is due to an organism, the bacillus anthracis, which may gain entrance into the lungs by inhalation of dust to which spores are adherent ; it may also enter through the broken skin or by the alimentary canal through persons eating infected flesh. The pulmonary form is extremely dangerous; it may cause death within 24 hours. If seen early the local pustule can be excised satisfactorily. A pre ventive serum has been used with encouraging results, but the essential thing is to have all bales of imported wool carefully opened and thoroughly disinfected before distributing it to the workers. During 1926 in Great Britain there occurred 38 cases of anthrax with three deaths.

Cancerous

Uleeration.—Epitheliomatous or cancerous ulcera tion occurs in tar and mineral oil workers, makers of arsenical dip for sheep, and in mule spinners in cotton mills. Chimney sweeps have long been known to be subject to scrotal cancer. Workmen exposed to splashings of hot pitch and mineral oil develop brown patches and warts on their forearms. The warts may disappear or break down and are followed by ulceration which becomes malignant. Mule spinners in cotton mills have recently exhibited a high morbidity rate of epitheliomatous ulceration. In view of the increase of cancer generally, the large number of cases of scrotal cancer in mule spinners is not only a cause of anxiety but a matter calling for research.

Coal Mining.

The winning of coal is a hazardous occupation; the risks are : explosions followed by fire ; gassing ; also accidents mainly due to falls of stone from the roof. Apart from these, coal mining is not an unhealthy occupation.

It is generally known that in the United States more men are killed by accidents in proportion to the number of men working than in any of the leading European countries; on the other hand if fatalities are estimated by the number of tons of coal raised, fewer men are killed in U.S.A. than in any other country. Many mine accidents might be prevented by employing more super visors to look after haulage equipment and falls of roof. Com paring the lie of coal and underground conditions these are more favourable to a larger output per man in U.S.A. than in European countries; the coal is near the surface, the seams are thicker, they are generally flat and uninterrupted. During the five years ending 192o the average number of fatalities per one million tons of coal mined was, in U.S.A. 3.8 lives; in Great Britain 4.52 lives; France 6.9; Belgium 8•oi, and in Prussia 11.85 lives. The f ollow ing figures give the ratio of fatalities to numbers employed : Machinery and electricity are also becoming increasingly employed in winning coal, and there is always the possibility of an electric spark firing inflammable gas or igniting coal dust.

The lesser maladies to which miners are liable are displacement of the cartilage of the knee joint, also "beat hand," an inflamma tion of the cellular tissue of the palm, of the hand which may become septic. That coal miners are a comparatively healthy class is shown by the following table: Cotton Industry.—As indicating improvement in general oc cupational mortality the cotton industry may be cited. With reference to diseases of the nervous, respiratory and circulatory systems, and also to tuberculosis. As regards bronchitis and cir culatory diseases, the morbidity incidence is higher among certain operatives in cotton mills than in other textile workers. The phthisis rate, which in occupied and retired males was during 1900-02 187, and in 1910-12 141, was in cotton operatives for the same periods 197 and 120, while bronchitis, which was 58 and 38 in males generally, reached in cotton operatives 92 and 57 respectively. The unhealthy influences are dust and high temper atures with humidity. Males suffer more from chest diseases than females, the latter more from digestive troubles and anaemia. Dust rich in silica is present in all the dry processes. The high temperatures and humidity predispose to colds, and the dust to asthma. Female operatives standing at work all day in high tem peratures develop varicose veins and ulcers on the limbs, and suffer from debility and anaemia. Weavers suffer from "twister's cramp," an infection of the muscles of the forearm, thumb and index finger, attended by a considerable amount of pain and fol lowed by muscular weakness. Of accidents in cotton mills the largest numbers occur on Tuesday and on Friday, and in relation to the hours of the day the maximum appears to be reached be tween the hours of i o to I I A.M. with a progressive decrease thereafter to the end of the working day.

Compressed Air.--Divers

and men working in caissons in compressed air are liable to illness of a special kind. Inside the caisson men work practically speaking without discomfort ; in order to enter this iron chamber they must pass through an at tached "compression" lock and be gradually subjected to a rise of air pressure equal to that inside the caisson into which they will descend. Inside the caisson, beyond possibly experiencing unpleas ant sensations due to the drums of the ears being forcibly driven inwards, the men are capable of doing even more work than on the surface; but all the while, owing to air being passed into the chamber under high pressure, their blood and tissues are becoming supersaturated with the nitrogen in the atmospheric air. In the body the gas becomes liquefied. It is not until the end of the shift when men are about to leave work and undergo "decompres sion" that symptoms arise. The men return to the lock wherein they had been "compressed" to undergo "decompression," and if this is done too rapidly bubbles of nitrogen gas gradually appear in the minute blood vessels, which arrest the circulation, or blebs of gas develop in the liver and central nervous system. So that a man who has been too rapidly decompressed may emerge from the chamber apparently well, yet on his way home be overtaken with severe pains in the limbs (bends) and be seen to stagger and fall, paralysed in his legs. Should such an event happen close to his work and the individual be carried back and placed in a warmed "recompression" chamber, upon being subjected to in creasing increments of pressure and kept therein for two or three hours and then slowly decompressed, his pains will usually dis appear and the power of walking be regained. By this mode paralysed caisson workers have been relieved and their muscular function and equilibration restored three hours after having left work. Some men are more liable to the malady than others, stout men particularly, for fat dissolves by bulk more nitrogen than the blood and tissues. Men above 4o years of age should not be employed in caissons. Supersaturation of the body liquids and tissues with atmospheric nitrogen is determined by the amount of pressure in the caisson, duration of exposure, and the absorb ability of the tissues. Symptoms hardly ever occur in men who have worked under 281b. pressure. Danger arises when the pres sure mounts to 4o-5o1b. above that of the outside atmosphere. The essential thing is slow decompression, not less than 2mins. for every 31b. of pressure worked in, and should this have exceeded 3olb. then at a rate of 'min. per lb. Professor John Haldane introduced as a means of treatment "stage" decompression, i.e., decompression is suddenly made, for example from 3olb. to 15, and thereafter at a uniform slow rate.

of Chief Inspector of Factories (1926)

; Reports of Investigation Bureau of Mines U.S.A. (April 1924. Serial No. 2592. W. W. Adams) ; T. Oliver, Health of the Workers; W. F. Dearden, "Health Hazards in the Cotton Industry," in Journal of Industrial Hygiene (Nov. II, 1927) . (T. OL.)