RESULTS OF THE PHYSICAL EXAMINATION OF 1413 WORKERS IN 'Of the 158 who had anemia only 31 had no other disease; of the 186 who had diseases of the digestive system only 36 had no other disease; the others had one, or more than one, other disease. 2 Five of these had chronic bronchitis and are included in that list. ช One of these had tonsilitis and is included under diseases of the digestive system. 'One of these had pharyngitis and is included under diseases of the digestive system. "One of these had chronic bronchitis and is included in that list. T All of these had chronic bronchitis and are included in that list. Total number of diseases among the tailors, about 950. Ratio of diseases to tailors, 15.5:10. We have no statistics in this country with which to compare the results obtained by our physical examination. We thus have no standard by which to judge the variations in the morbidity rate. Nor can a comparison be made with the morbidity statistics of Sommerfeld and others gathered from the German sick funds (Krankenkassen), for the reason that these morbidity rates are given mostly for those members of the sick-fund societies who are unable to work. Dr. Sidney I. Schwab's figures of the prevalence of neurasthenia among tailors, and Dr. Waters' claim of the large percentage of tuberculosis among tailors, may be referred to here as the only figures available on the morbidity of tailors. The standard mentioned by Hoffman of the incidence of 15.5 diseases to ten persons, being the German rate, can be compared to the 950 diseases for the 613 tailors examined, which makes a ratio of 15.5 to 10. The large number of bakers suffering from bronchitis, in comparison with the number of tailors suffering from that disease, seems to indicate the better sanitary conditions of the tailor shops, which, as has been noted above, belong to those that have received sanitary certificates from the Joint Board of Sanitary Control. On the other hand, the comparatively large number of digestive diseases among tailors may perhaps be due to their stooping posture and to their lesser muscular activity as compared with bakers, who are always on their feet and who change the character of their work a number of times during the day, while tailors sit at a machine for nine hours a day with only a single interval for relaxation. It seems to me that the comparatively high percentage of anemia, bronchitis, and digestive diseases noted among both the bakers and the tailors is at least suggestive of the defective ventilation of the shops in these industries, and that the confined air which bakers and tailors are compelled to breathe habitually has a strong etiological relation to these diseases. Much more intensive and extensive study of the subject is necessary, however, before the relation of confined air to the health of the workers can be definitely determined. "Publication No. 12, American Association for Labor Legislation. MR. J. T. AINSLie Walker, New York City: I have listened with great interest to the papers read this afternoon. Speaking as an Englishman, having been in this country but a few months, there is one phase of this problem which you do not consider as fully as I had hoped. We have heard of the precautions to secure proper ventilation, but the last speaker has dashed our hopes by stating that in many instances among tailors and bakers confined air is almost essential. To consider ventilation alone is not enough; we must deal with the presence of dust on all workroom floors. This problem has received attention at home and I hope soon to see it properly handled in this country. I know of no finer institution to take up such work than this Association. I think we all agree, also, that if this problem is to receive proper attention we must have the assistance of the manufacturers. There is no use in trying to force them to do what we want, but we must try to persuade them. If the moral argument is not sufficient, the best inducement is the one that appeals to the pocketbook. The best that a man can do in a day is one hundred units of work. Suppose a manufacturer is employing one hundred workmen. If you represent to him that, by neglecting certain precautions which you can show him how to handle successfully and economically, the loss of work and fall in efficiency is ten per cent, you have a direct argument to place before him. He sees that among one hundred workers a lowering of ten per cent in efficiency means that he is losing the work of ten able-bodied men every day. If this argument is put before the American manufacturer, as it has been successfully put before the English manufacturer, I think he will listen to you. You are more likely to achieve success this way than if you appeal from a moral point of view. A year or two ago an English doctor, bearing the famous name of Lister, called attention to the high death rate among printers. The attention of the federation of printers and allied trades was called to it by myself, and they decided to investigate the question first-hand. A certain area of floor space in one of the largest establishments in London was chalked off. One-half was sprinkled with a disinfection solution; the other half was sprinkled with water. Swabs were taken over each of these spaces and the contents examined. On the plate which was from the section sprinkled with water only there were crowds of bacteria; the other plate showed no colony of bacteria. Thus the disinfection was shown to be satisfactory. The publication of this result in the textile papers and trade journals had a marked effect on the minds of manufacturers in England. MR. MEHREN, New York City: We are engaged in efficiency engineering work, the improvement of factory conditions in order that the output may be the maximum and that the manufacturer may have the least possible cost and the worker the highest wage. From that standpoint the efficiency of the men is a very important consideration. We go to the manufacturer and say, "Betterment works of all sorts are not philanthropies; they are profitable investments." We have not gone into chemical factories and consequently much said this morning about the lead industry went over my head, but we have been able to make valuable use of efficiency tests. We found a short time ago a large establishment with fifteen hundred employees in which the manufacturers knew they had not full efficiency, although they had not been able to put their finger on the cause. We found that the ventilation was bad and that the common drinking cup had propagated colds in winter. Why not call in to aid the campaign for industrial hygiene the efficiency engineer, who is directly studying factory conditions with the idea of improving them? Legislation, strict enforcement of law, will produce much good. But the greatest result will be accomplished when you take advantage of all possible methods, one of which is to enlist the cooperation of the consultant in the engineering world. DR. LEONARD W. HATCH, New York Department of Labor: This point has come to my attention as bearing out what was said of the value to the manufacturer of medical care of his employees. A certain small New York plant employing two hundred and fifty people is quite a model establishment so far as ventilation goes. The firm established a benefit system and in connection with that a plan for giving the employees medical attention. It was arranged that a physician, employed by the firm, should be at the plant every day at five o'clock, and anyone who was employed there could con sult the physician by making his desire known to the watchman or porter. At five o'clock all who could be attended to that day were notified by the watchman. After a year's experience the head of the firm stated that, though they had never kept records of the time lost in previous years, he was sure that, even in that period, without any special hazards, they had saved enough of the workers' time to more than pay the cost. MR. PAUL KENNADAY, Secretary, New York Association for Labor Legislation, New York City: We have heard that it pays to keep the workmen well. In this Association we want to take the view that it is just to keep the workmen well. We should go to the labor unions, get out on the stump, use the newspapers, and teach the industrial population that they should keep themselves well for their own benefit and not to increase any dividends. And then, having aroused that feeling among them and a certain amount of enthusiasm, we should get after our state labor departments and get them to do their duty. Many are doing excellent work and many are not doing anything at all. They should make investigations into continuous processes, and give us the facts in regard to the number of men who are working seven days a week and the effect of such work on their health. At present we have no such facts. As one member of the Association I say, let us emphasize a little more strongly the fact that it is justice we are after and not the payment of higher dividends. Dr. Lee K. FRANKEL, New York City: I have been reminded of an old story about barking dogs that never bite. I suppose you know the story of the man who was running away from a dog. His friends told him, “Barking dogs never bite." But the man replied, "You know it and I know it, but the dog doesn't know it." The discussion here has centered largely around what might be done in the direction of preventing disease through efficient legislation and by the employer of labor, but nothing has been said about what can be done by the workman toward safeguarding his own health. I want to mention what has been done in the city of Vienna, where there is a federation of sick clubs, under the Austrian government, which records every disease that occurs among its members, and these clubs practically comprise every workman earning a cer |