While the part played by fresh air in the prevention of occupational disease is generally admitted, the vague character of the standards in vogue in different States has proved a great handicap to the manufacturer who is desirous of adopting the system best suited to the needs of his operatives, As Roach points out (indict trial Management, October 1917) : °The terms 'adequate' and 'sufficient) have left him free to spend thousands of dollars on experiments, the results of which have too often given little of the protection to the health of the worker promised by irresponsible contractors.° Expensive systems of air conditioning are naturally unnecessary in the ordinary workroom where nothing more than fresh air is needed, and they are rarely installed except where the process of manufacture requires absolutely dustless conditions or a stable degree of humid ity. For ordinary purposes, draft deflectors placed at both top and bottom of windows afford satisfactory ventilation.
While plants with non-dusty processes often find this window equipment all that is neces sary for ventilation, it is admitted that it cannot be depended upon where noxious vapors or excessive humidity have to be considered. The same objection can be made to so-called °nat ural draft° ventilators, which, while they often work satisfactorily when there is a sufficient breeze present, fail to accomplish their purpose on humid days when the noxious air lies close to the floor.
Where industrial dust or vapors must be removed from the air the adoption of the most approved dust exhaust system becomes neces sary. In this connection Roach says: °The usual and inexpert practice in building a dust exhaust system, such as is required for buffing, polishing or grinding wheels, is to pro portion the main section pipe so that at all cross-sectional points it only equals the com bined areas of the entering branch pipes; while the inlet of the exhauster used on such a sys tem has an area that but equals the combined areas of all the branch pipes used on the system. For example, for 25 4-inch branch pipes the lar gest diimeter of main pipe and exhauster would be 20 inches. A 50-inch exhauster would have an inlet 20 inches in diameter; if it were neces sary to get a suction-head at each branch pipe sufficiently strong to displace 2 inches of water in a pressure gauge (commonly called a U shaped tube) it would require an actual veloc ity of 4,000 lineal feet per minute in the branches, and it would be necessary for the ex hauster to handle 8,720 cubic feet of air per minute. It would require approximately 16 horse power to obtain these results, which in itself is an important item.
°This kind of a system should no longer be permitted. Standards based on actual working tests and experience prove that efficiency re quires for 25 4-inch pipes a main pipe with an area 20 per cent larger at all its cross-sectional points, than the combined areas of entering branch pipes. The inlet of the exhauster at tached to the system must have an area 20 per cent larger than the combined areas of all the branch connections on the system. This kind of system would require a 55-inch exhauster having a main pipe 22 inches in diameter and, to obtain a suction sufficient to displace 2 inches of water in a U-shaped tube, the air in each branch pipe would be obliged to have a velocity of 4,000 lineal feet per minute. The exhauster would handle 8,720 cubic feet of air a minute and would take about 12 horse power to operate it?' In many plants the hygienic and sanitary control is in the hands of the industrial physi cian whose duties comprise a more or less close supervision over the physical condition of the operatives from the day they enter the employ of the company. Many concerns have adopted the policy of examining all applicants for em ployment before engaging them, with a view to determining the physical fitness of the man for the job which he is to be expected to per form; a smaller number of establishments in sist upon periodic re-examination, in order that his physical defects may be detected as quickly as possible and he may be assisted in remedying them, while all employers who employ the phy sician have found that his services in accident prevention and general health supervision have proved of sufficient value to more than offset the cost of the service. So well established has this fact become that even plants that are too small to employ a permanent physician have es tablished dispensaries, where they meet all re quirements for first-aid through a plant nurse, the physician being called upon for examina tions, or, when necessary, for more important services.
According to the report of the committee of the Detroit Executives' Club, a plant employing from 1,400 to 2,000 persons should devote three rooms to hospital purposes— a reception room, an examining room and a surgery or dressing room.
furniture needed in a reception room is enough chairs so that patients will not have to stand, and a stretcher. The examining room should have a rest cot, scales and other instru mental equipment, with two or more booths to facilitate examinations. The surgery room needs an operating table, an instrument case with necessary first-aid instruments, drugs and dressings, one or two pedestal wash basins and one waste can' So general has health supervision become in industry that the physicians engaged in such ac tivities have organized an association, the Con ference Board of Physicians in Industrial Prac tice, and it was in their behalf that Magnus
W. Alexander, in August 1917, published his report on the °Cost of Health Supervision in Industry?" The purpose of this report, as its compiler stated, was to inform employers of the actual cost of health supervision in the different indus tries. °To this end, the data were secured from plants engaged in many industries, in light, me dium and heavy work, in comparatively safe as well as hazardous occupations, and in shops of various sizes and character, located in vari ous parts of the United States. . . . The chief significance of these data, from a general viewpoint, is that it is possible to give such a large amount of medical and surgical service at a cost which averages only $2.21 per em ployee per year. . . . Where the average cost appears to be unusually high . . . the size and character of the medical staff is usu ally the determining factor. In some cases the cost is influenced greatly by the number of in juries treated in private or public hospitals, in others, by the amount of care given to all in juries, whether serious or slight, or by the ex tension of the service to include physical ex amination of all employees, treatment of sick ness of employees at the plant and at home, and even by medical care of employees' families, or by a combination of all these features?' Mr. Alexander concludes his report with the statement that °convincing proof of the eco nomic value of health supervision in industry is afforded by the fact that it was found that no employer had abandoned the health super vision activities established in his plant. On the contrary, the prevailing tendency has been to invest even more money in extending the service?' In several plants in this country, health su pervision includes the care of the teeth and eyes, examinations being made by specialists in the employ of the firm; subsequent treatments usually being at the expense of the employee, though at greatly reduced rates. • The adoption of sanitary standards was the means taken to overcome the °sweat-shop') conditions that had operated so injuriously to several branches of the tailoring industry and, wherever there has been sufficient organization to adopt and enforce such regulations effective results have been reported. The standards adopted by the Joint Board of Sanitary Con trol in the cloak, suit and skirt industry of Greater New York forbid cellar shops and tend to prevent the establishment of work rooms under conditions that might prove in jurious to health. They provide that shops lo cated in buildings more than one story in height must have fire-escapes properly equipped with ladders to an adjoining building or with care fully adjusted full-length drop ladders. Where automatic sprinklers are not provided, there must be a sufficient number of chemical extin guishers or fire-buckets, and special caretakers should be appointed in each shop to see that the fire-buckets are kept filled and are ready for use in case of fire. No smoking is per mitted in the workshops, doors must not be locked during working hours, signs marking exits and fire-escapes are to be conspicuously placed about the shop, fire-proof receptacles with tin lining and covers must be provided for rubbish, all openings and exits to fire-escapes must be left unobstructed by tables, machines, partitions or iron bars, and stairs are to be provided with secure handrails and safe treads.
As to lighting, the regulations stipulate that there shall be sufficient window space to ensure that the shop shall be well lighted from 9 a.m. to 4 P.M.; where artificial illumination is needed, arc-lights or incandescent mantles shall be used for gas, and all lights should not only be well shaded, but should be placed above the opera tives and not too near them.
In the matter of ventilation it is provided that at least 400 cubic feet of space, exclusive of bulky furniture and materials, shall be pro vided for every person within the shop, and all work-rooms are to be thoroughly aired, before and after work hours and during the lunch hour, by the opening of both windows and doors.
Other regulations provide that (1) no coal shall be used for direct heating of irons, and where stoves are used for this purpose they must be surrounded by a metal sheet at least five feet high; (2) walls and ceilings of shops and toilets should be kept clean; the floors to be scrubbed weekly, swept daily and kept free of refuse, while the toilets should be flushed. It is advised that a special caretaker should be designated to oversee this work. (3) A sufficient number of water-supplied wash basins are to be provided in convenient and light locations; (4) separate dressing rooms arc to be provided for the sexes, with suitable hangers for the street clothes of employees; (5) there shall be separate toilet arrangements, with solid partitions from floor to ceiling, as well as separate vestibules and doors, and (6) all seats provided in the are to have backs. JoHN it MEADER.