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U. S. DEPARTMENT OF LABOR BUREAU OF LABOR STATISTICS R O Y A L M E E K E R , C o m m issio n e r BULLETIN OF THE UNITED STATES ) BUREAU OF LABOR STATISTICS ) LABOR AS I N A D N AFFECTED U D S T R E BY I A F F L I • • • •■ T HE H C E I \T~ WAR A E L N SERI ES T C FINAL REPORT OF THE BRITISH HEALTH OF MUNITION WORKERS’ COMMITTEE FEBRUARY, 1919 W A S H IN G T O N GOVERNM ENT P R IN T IN G 1919 O F F IC E OAQ H Y PUBLICATIONS OF THE BUREAU OP LABOR STATISTICS. T h e publication of the a n n u a l a n d special reports a n d of the b i m o n t h l y bulletins w a s discontinued in July, 1912 , a n d since that time a bulletin has been published at irregular intervals. E a c h n u m b e r contains m a t t e r devoted to o n e of a series of general subjects. These bulletins are n u m b e r e d consecutively , beginning with No. 101. U p to No. 236 they also carried consecutive n u m b e r s u n d e r each series. Beginning with No. 237 the serial n u m b e r i n g has been discontinued . A com p l e t e list of the reports a n d bulletins of the B u r e a u will be furnished o n application. A list of the series n o w issued by the B u r e a u is as follows: Wholesale Prices. Retail Prices and Cost of Living. Wages and Honrs of Labor. Employment and Unemployment. Women in Industry. Workmen’s Insurance and Compensation (including laws relating thereto). Industrial Accidents and Hygiene. Conciliation and Arbitration (including strikes and lockouts). Labor Laws of the United States (including decisions of courts relating to labor)w, Foreign Labor Laws. Vocational Education. Labor as Affected by the War. Miscellaneous Series. LABOR AS AFFECTED BY THE WAR. T h e present bulletin is the s e c o n d in the n e w series o n “Lab o r as affected by the war** T h e following bulletins, published since July 1, 1912, contain matt e r relating to the subject: B u). 170, M aj7, 1915. F oreig n fo o d p rices as a ffected b y the w ar. B ui. 219. M ay, 1917. In d u strial p oison s used or p rod u ced in the m a n u fa ctu re o f e xp losiv es. B ui. 221, A p ril, 1917. H ou rs, fa tig u e, and hea lth in B ritish m u n ition fa cto rie s. B ui. 222, A p ril, 1917. W e lfa re w ork in B ritish m u n ition fa cto rie s . B ui. 223, A p ril, 1917. E m p loy m en t o f w om en and ju v e n ile s in G reat B rita in d u rin g the w ar. B ui. 230, J uly, 1917. In d u stria l efficiency and fa tig u e in B ritis h m u n ition fac tories. Bui. 237, October, 1917. Industrial unrest in Great Britain. CO N TEN TS. Sections. Page. I. Introductory...................................................................................... 7-14 II. Preliminary and historical survey..................................................... 15-32 III. Relation of fatigue and ill health to industrial efficiency.................. 33-45 IV. The industrial employment of women............................................... 46-63 V. Hours of labor....................................................................................64-84 VI. Shifts, breaks, spells, pauses, and holidays....................................... 85-92 VII. Sunday labor and night work.......................................................... 93-100 VIII. Lost time and incentive................................................................. 101-107 IX. Food and canteens......................................................................... 108-127 X. Sickness and ill health................................................................... 128-136 XI. Injuries and accidents....................................................................137-148 XII. Eye injuries.................................................................................... 149-156 XIII. Special industrial diseases..............................................................157-174 XIV. Cleanliness, ventilation, heating, and lighting............................... 175-185 XV. Sanitary accommodation, washing facilities, and cloakrooms.........186-195 XVI. Seats, weights, clothing, and drinking water................................. 198-202 XVII. Welfare supervision for women and girls........................................ 203-222 XVIII. Welfare supervision for boys and men............................................ 223-232 XIX. Welfare outside the factory............................................................ 233-249 XX. Summary of conclusions................................................................. 250-266 Appendixes. A. List of persons who gave evidence or otherwise assisted the commit tee............................................................................................. 267,268 B (I). Dr. Janet Campbell’s report on “ A further inquiry into the health of women munition workers” ........................................................ 269-297 B (II). Dr. Janet Campbell’s “ General findings of inquiries into the health of women munition workers ” ........................................................ 298-315 C. Dr. Vernon’s memorandum on “ A comparison of the systems em ployed for dividing up working hours into spells and breaks,J.. 316-333 D. Summary of Capt. Greenwood’s memorandum on “ The causes of wast age of labor in munition factories employing women ” .............. 334-338 E . Canteen planning and equipment.................................................. 339-342 F. Hostel planning and equipment..................................................... 343-359 G. Medical certificate of incapacity for work.......................................... 360 II. Police, Factories, etc. (Miscellaneous Provisions) Act, 1916, sec tion 7......................................................................................... 361, 362 1. Home Office order in regard to first-aid appliances........................ 363, 364 J. Ministry of Munitions memorandum on “ The duties of welfare super visors for women ” ...................................................................... 365-368 K. Concessions in regard to expenditure on provision of welfare facil ities, canteens, recreation, etc.......................... 1....................... 369,370 Index............................................................................................................. 371-374 PEEFACE. This bulletin reproduces in full the final report of the British Health of Muni tion Workers Committee, and completes the group of bulletins which the Bureau of Labor Statistics of the United States Department of Labor undertook to publish in compliance with the following resolution voted April 7, 1917, by the Council of National Defense: That the complete reports of the committee appointed by the British Minis ter of Munitions to investigate conditions affecting the health and welfare of workers be edited so that the salient features thereof may be made applicable to the conditions pertaining in the United States, and printed in condensed form by the Department of Labor. The first bulletin (Bulletin 221) published in compliance with the foregoing resolution contains documents, official and unofficial, dealing with hours, fatigue, occupational diseases, and the provisions of the Munitions of War Act relating to labor disputes and the restoration of trade-union conditions after the war. The second bulletin (Bulletin 222) contains memoranda relating to welfare supervision and welfare work. The third bulletin (Bulletin 223) con tains reprints of official and unofficial documents dealing with the employment of women and juveniles. The fourth bulletin (Bulletin 230) includes the in terim report of the Health of Munition Workers Committee on industrial efficiency and fatigue, which sets out the result of a number of investigations which had been made for the committee. The final report of the committee, re printed in this bulletin, gives a concise survey of the problems set forth in the various memoranda of the committee covered in the above bulletins. It is believed that these bulletins, published at the request of the Council of National Defense, will be of great service alike to employers and workers in this country because they give the experience of Great Britain in dealing with labor in the production of the largest quantity of munitions in the shortest space of time— an experience which offers many suggestions capable of prac tical application in the promotion of peace time industry. 5 B U L L E T IN U . S. B U R E A U no. 249 O F OF THE L A B O R S T A T IS T IC S . W ASH IN G TO N February, 1919 INDUSTRIAL HEALTH AND EFFICIENCY. FINAL REPORT OF THE BRITISH HEALTH OF MUNITION WORKERS’ COMMITTEE. TERMS OF REFERENCE. The committee were appointed in September, 1915, by the Right Hon. David Lloyd George, M.P., with the concurrence of the Home Secretary. The committee were invited u To consider and advise on questions of industrial fatigue, hours of labor, and other matters affecting the personal health and physical efficiency o f workers in munition factories and workshops.” The reference and appointment were subsequently approved bv the succeeding Ministers of Munitions, the Right Hon. E. S. Montagu, M.P., the Right Hon. C. Addison, M.P., M.D., and the present Min ister, the Right Hon. Winston S. Churchill. CONSTITUTION OF COMMITTEE. Sir George Newman, K.C.B., M.D., F.R.C.P. (Chairman) ; chief medical officer, board of education; member of the central control board (liquor traffic) ; emeritus lecturer in preventive medicine at St. Bartholomew’s Hospital. Sir Thomas Barlow, Bart., I£.C.V.O., M.D., LL.D., F.R.S., physi cian extraordinary to H.M. the K ing; late president of the Royal College of Physicians. Gerald Bellhousc, Esq., C.B.E., H.M. deputy chief inspector of factories, Home Office. Professor A. E. Boycott, M.D., F.R.S., director of pathological de partment, University College, London. J. R. Clynes, Esq., M.P., parliamentary secretary to the Ministry of Food. E. L. Collis, Esq., M.B., H.M. medical inspector of factories, Home Office; director of health and welfare, Ministry of Munitions. Sir Walter M. Fletcher, K.B.E., M.D., Sc.D., F. R, S., F. R. C. P., secretary to the medical research committee; fellow of Trinity Col lege, Cambridge. 7 8 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . Leonard E. Hill, Esq., M.B., F. E. S., director, department of ap plied physiology and hygiene, medical research committee; professor of physiology, London Hospital Medical School. Samuel Osborn, Esq., J.P., managing director Clyde Steel Works, Sheffield. Miss E. E. Squire, O.B.E., H.M. deputy principal lady inspector of factories, Home Office. Mrs. H. J. Tennant, C.H. E. H. Pelham, Esq., (secretary); assistant secretary, board of edu cation. To the E ight H on. W inston S. C hurchill, M. P., M inister op M unitions. Si r : 1. The committee now beg to submit the following final report. 2. Since their appointment the committee have held 39 meetings, and in addition subcommittees have met on numerous occasions. 3. Immediately on their appointment the committee arranged to sit and take evidence not only in London but also in Birmingham, Sheffield, Newcastle, Glasgow, Manchester, and Coventry. Special arrangements were also made for taking evidence at Woolwich. Witnesses were heard representative of emplo3Ters, workers, factory inspectors, and other interested persons. From time to time special witnesses have also been heard on particular questions. In addition, a number of other persons have—by the submission of memoranda or by other means—placed their special knowledge at the disposal of the committee. The committee have decided to content them selves with quoting extracts from the evidence, and not to publish it in full. In arriving at this decision they have been influenced not only by the urgent need for economy in paper, but also by the fact that much of the evidence was either not intended for publication or had special reference to particular conditions then existing, but now largely modified. Some persons, while allowing their state ments to be made use of, have desired that their names should not be published. 4. Throughout their inquiries the committee have found it desirable to rely for much of their information on visits paid to factories. Such visits, which wrere generally paid by two or three members of the committee together, enabled them not only to interview a num ber of employees, foremen, and workers whose evidence would hardly otherwise have been available, but also to ascertain at first hand the conditions under which munition work was being carried out. In addition, individual members of the committee, whilst discharging other duties, have collected a considerable body of information bear ing on questions under consideration. INTRODUCTION. 9 5. From the first the committee have been strongly impressed with the importance of obtaining exact and scientific data. The Medical Research Committee not only gave permission for Dr. Leonard Hill, F. R. S., head of their applied physiology department, to serve upon the committee, but placed the experimental resources of his labora tories at the disposal of the committee, and offered to render any other assistance in their power. The assistance thus offered lias proved of the highest value. In addition ta other work Dr. Leonard Hill has conducted a number of detailed inquiries in regard to the dietaries of munition workers, and also in regard to ventilation. Dr. Benjamin Moore, F. R. S., and his staff have carried out a long series of experiments and inquiries in regard to the effects of TNT upon the health of workers (separately published). In conjunction with that committee arrangements were made for Mr. P. Sargant Florence, Mr. H. M. Yernon, M. D., fellow of Magdalen College, Oxford (with whom has been associated Mr. W. Neilson Jones), Prof. Thomas Loveday, Armstrong College, University of Durham, and Capt. M. Greenwood, R. A. M. C. (with whom has been associated Mr. S. H. Burchell), to collect data bearing on the relationship of output to hours of work and other industrial problems. Capt. T. II. Agnew, R. A. M. C., conducted, on behalf of the committee, a medical inspection of about 3,000 male workers. Two series of medical in spections covering together about 2,500 women and girls were organized under the supervision of Dr. Janet Campbell (a senior medical officer of the board of education). 6. In Appendix A are set out the names of— (a) the witnesses, other than those who desired that their names should not be pub lished; (h) the medical officers, inspectors, and others who assisted in the medical inspections; and ( c) certain other persons who, by the submission of memoranda or by other means, placed their special knowledge at the disposal of the committee. The committee desire to place on record their cordial appreciation of the assistance rendered, often at much personal inconvenience, by all those who have thus enabled the committee to collect a body of reliable in formation, without which it would have been impossible for them adequately to perform the duties with which they were charged. The committee are also under a great obligation to the many muni tion firms and their staffs for the facilities so readily accorded for the pursuit of inquiries. Finally, the committee desire to express their thanks to the Home Office (factory department), the Ministry of Munitions, the board of education, and the national insurance commissioners for the assistance afforded the committee by the loan of their officers and the supply of information. 7. In view of the urgency of many of the problems involved by their terms of reference the committee decided that it was desirable 10 INDUSTRIAL HEALTH AND EFFICIENCY. that they should submit their views and recommendations in regard to particular matters in separate memoranda rather than that they should defer making any report until their investigations were com pleted. In accordance with this decision the committee have sub mitted to the ministry the following 21 memoranda: No. 1. Sunday labor. (Cd. 8132.) [Summarized in Monthly Review, May, 1916, pp. 66, 67; reprinted in Bui. 221.] No. 2. Welfare supervision. (Cd. 8151.) [Summarized in Monthly fleview, May, 1916, pp. 68, 69 ; reprinted in Bui. 222.] No. 3. Industrial canteens. (Cd. 8133.) [Summarized in Monthly Review, May, 1916, pp. 69, 70; reprinted in Bui. 222.] No. 4. Employment of women. (Cd. 8185.) [Summarized in Monthly Review, June, 1916, pp. 74-76; reprinted in Bill. 228.] No. 5. Hours of work. (Cd. 8186.) [Summarized in Monthly Review, June, 1916, pp. 77-79; reprinted in Bui. 221.] No. 6. Canteen construction and equipment. 3.) (Cd. 8199.) (Appendix to No. [Summarized in Monthly Review, June, 1916, p. 91; reprinted in Bui. 222.] No. 7. Industrial fatigue and its causes. (Cd. 8213.) [Summarized in Monthly Review, June, 1916, pp. 79-81; reprinted in Bui. 221.] No. 8. Special industrial diseases. (Cd. 8214.) [Summarized in Monthly Review, June, 1916, pp. 83-88; reprinted in Bui. 221.] No. 9. Ventilation and lighting of munition factories and work shops. (Cd. 8215.) [Summarized in Monthly Review, June, 1916, pp. 81-83; reprinted in Bui. 221.] No. 10. Sickness and injury. (Cd. 8216.) [Summarized in Monthly Review, June, 1916, pp. 88-90; reprinted in Bui. 221.] No. 11. Investigation of workers’ food and suggestions as to dietary. (Second appendix to No. 3.) (Cd. 8370.) [Summarized in Monthly Review, January, 1917, pp. 56, 57; reprinted in Bui. 222.] No. 12. Statistical information concerning output in relation to hcrnrs of work. (Cd. 8344.) [Summarized in Monthly Review, December, 1916, pp. 105-119; reprinted in • Bui. 221.] No. 13. Juvenile employment. (Cd. 8362.) [Summarized in Monthly Review, December, 1916, pp. 92-97; reprinted in Bui. 223.] No. 14. Washing facilities and baths. (Cd. 8387.) [Summarized in Monthly Review, January, 1917, pp. 150, 151; reprinted in Bui. 222.] No. 15. The effect of industrial conditions upon eyesight. 8409.) (Cd. 11 INTRODUCTION. [Summarized in Monthly Review, April, 1917, pp. 538-540; reprinted in Bui. 221J No. 16. Medical certificates for munition workers. (Cd. 8522.) [Reprinted in Bui. 230.] No. 17. Health and welfare of munition workers outside the fac tory. [Summarized in Monthly Review, August, 1917, pp. 91, 92; reprinted in Bui. 230.] No. 18. Further statistical information concerning output in rela tion to hours of work, with special reference to the influence of Sun- , day labor. (Cd. 8628.) [Summarized in Monthly Review, November, 1917, pp. 61, 62.] No. 19. Investigation of workers’ food and suggestions as to diet ary. (Second appendix to No. 3.) Revised edition. (Cd. 8798.) No. 20. Weekly hours of employment (supplementary to Memo randum No. 5.) (Cd. 8801.) [Reprinted in Monthly Review, February, 1918, pp. 82-87.] No. 21. Investigation of the factors concerned in the causation of industrial accidents. (Cd. 9046.) [Summarized in Monthly Labor Review, July, 1918, pp. 161-164.] All of these memoranda with the exception of No. 17 (Health a!nd welfare of munition workers outside the factory) have been published and placed on sale. An interim report, entitled “ Industrial efficiency and fatigue,” was also published (Cd. 8511) in February, 1917, in which was set out the results of a number of investigations which had been made for the committee. The studies included were: 1 (a) Industrial fatigue and its causes (reprint of Memorandum No. 7). (b) Output in relation to hours of work (reprint of Memorandum No. 12). (c) The comparative efficiencies -of day work and night work. (cl) The causes and conditions of lost time. (e) Incentives to work, with special reference to wages. (/) Report on the health and physical conditon of male munition workers. (g) Inquiry into the health of women engaged in munition fac tories. Finally, in December, 1917, the committee, acting on your instruc tions, issued a handbook on the “ Health of the munition worker,” 2 summarizing shortly and concisely the principal suggestions con tained in their earlier publications. 8. The committee are satisfied that the procedure thus adopted has been justified by the results attained. The publication of separate 1 The report was summarized in Monthly Review, July, 1917, pp. 14-19 ; the studies included in the report, with the exception of (a) and (b), were reprinted in Bui. 230. 2 Summarized in Monthly Review, April, 1918, p. 311. 12 INDUSTRIAL HEALTH AND EFFICIENCY. memoranda has undoubtedly rendered the committee’s recommenda tions more readily accessible. The demand for the memoranda has been large and continuous; upward of 210,000 of the committee’s memoranda and reports have been sold or distributed, and the rec ommendations contained in them have received a wide measure of acceptance, both officially and unofficially. 9. The committee consider that they have now reached a definite stage in their work. Though doubtless fresh matters for inquiry may arise from time to time there can be no doubt that the position is now substantially different from what it was when the committee were first appointed in September, 1915. There is apparently an increased appreciation of the importance of the whole question of industrial hygiene, and there can be no doubt that the environment and conditions of employment of munition workers throughout the country are now vastly better than they w^ere two and one-half years ago, though there is still much room and much need for improvement. The developments which have occurred may be roughly grouped under the following heads : {a) The various memoranda and reports already prepared by the committee may be broadly regarded as containing recommendations in regard to all the principal questions which fall within their terms of reference. All these recommendations have been generally ac cepted as reasonable, and have been widely adopted. (b) In January, 1916, the Ministry of Munitions established a welfare section under the direction of Mr. B. S. Eowntree, for the purpose of the executive work arising out of the committee’s recom mendations and other necessary undertakings for promoting the health of the large body of workers for which the ministry was re sponsible. The activities of the department were at first concen trated on securing improved conditions of health and welfare within “ controlled ” factories by encouraging factory managers to appoint some person or persons to maintain a close personal relationship with the workers, and also to make the requisite structural provision.1 Early in 1917, the pressure of other duties prevented Mr. Eowntree from continuing to direct the department, which was about the same time entirely reorganized under the direction of Dr. E. L. Collis, a member of the committee. The new department was made re sponsible for all matters concerned with the health and welfare of munition workers in national as well as in “ controlled ” factories, including the medical problems involved in the prevention of TNT poisoning and the maintenance of the health of those employed in the manufacture of lethal gas. The sphere of the department was at the same time extended to cover the conditions of life of munition 1 The conditions under which such expenditure may be met out of excess profits are given in Appendix K. INTRODUCTION. 13 workers outside the factory, together with the inspection of the large number of temporary hostels for munition workers that were being provided. In addition, special provision was made for research and the collection of accurate knowledge upon which administrative action could be based. More recently the department has been taking steps to deal with the various maternity problems which arise in munition areas. The staff, in addition to the central administrative officers, includes men and women welfare officers1 charged with the inspection of conditions inside the factories, the supervision of con ditions outside the factories and the inspection of hostels, medical officers charged with the supervision of the doctors appointed to in dividual factories and also with advising on all health questions, and special research investigators. (c) Under section 7 of the Police, Factories, etc. (Miscellaneous Provisions), Act, 1916, the Home Office were given power to make orders requiring special provision to be made at a factory or work shop for securing the welfare of the workers. The matters to which the section applies include: Arrangements for preparing or heating and taking meals; the supply of drinking water; the supply of pro tective clothing; ambulance and first-aid arrangements; the supply and use of seats in workrooms; facilities for washing; accommoda tion for clothing; arrangements for supervision of workers. As the result of these developments the questions now at issue are concerned not so much with the determination of general policy as with the application of agreed principles to particular cases. They are, in fact, administrative rather than advisory in character. In saying this the committee must not be regarded as in any sense underrating the urgent necessity for the continuance and develop ment of the various scientific inquiries which they have initiated. Other means can, however, be found for attaining this end, and the committee concur in the propriety of the decision of the ministry to discharge their reference and to establish in their place an office com mittee in association with the executive. 10. It has only remained accordingly for the committee to prepare a final report of their proceedings. In this report, which they now submit, they have endeavored to survey concisely (even at the risk of some repetition), the nature and development of all the various problems covered by their memoranda. Many of the memoranda would, in any case, have required substantial modification in view of developments which have occurred since their publication, but what is more important, the bringing together of the various matters which have been dealt with in their various memoranda serves to emphasise in a manner otherwise impossible the close relationship 1 There are now probably about 800 welfare supervisors employed in munition fac tories ; of these approximately 80 per cent are for women and girls and 20 per cent for boys. 14 INDUSTRIAL HEALTH AND EFFICIENCY. and interdependence which exists between the problems involved. Though it is too early yet to draw any final conclusions as to the permanent effect on the health and physical efficiency of the muni tion work of the abnormal conditions which have existed during the war, it is at any rate possible to set out the extent to which normal restrictions have been abandoned, to suggest some conclusions as to the results wTliich have followed, and, finally, to indicate certain conclusions as to the steps which should be taken to maintain and promote permanently the health of industrial workers when more normal conditions are restored. SE CTIO N II.— P R E L IM IN A R Y A N D H IS T O R IC A L SU R V E Y . 11. At the outset of their investigation and inquiry the committee were confronted with the width and complexity of the reference with which they were charged. It had to do with the environment of the worker and the worker himself; it was concerned with immediate as well as remote problems; its issues had to be viewed in relation to present exceptional and ephemeral conditions and circumstances, and also in relation to what would be practicable and permanent after the war; it involved the consideration of the health, not only of the munition worker in the narrow sense, but of all industrial labor—for all branches of labor are interdependent upon each other— and of many health questions, such as housing and maternity pro vision, which lie outside the walls of the factory or work place; and lastly, it raised far-reaching social and even moral questions which are not commonly thought of as appertaining to health. The fact is that this report of the committee’s work, though con cerned primarily with the munition worker, deals also with vital principles and practical methods affecting all forms of industry. Moreover, the health of the industrial worker—man and woman— is but part, essential, plastic, living, of the health of the people as a whole, which in its turn raises manifold problems of administration, economics, social relationships, and even ethics, which, though ap parently remote from questions of medicine, are in truth intimately associated. The nation a century ago was wise in its generation in recognizing the relation obtaining between “ the health and morals of apprentices,” and, a hundred years later, it is found that some of tha most intricate problems of health and physical efficiency are in separable from large issues of physiology, of social relationship or morals, and of human conduct. It is sufficient to name two examples: First, there is the advent of the woman worker—an advent which brings with it new issues of physique, of physiological function, of staying power, of nutrition, of maternity. The entrance into the ranks of labor of the “ young person ” of either sex raises many ques tions concerning the development of the adolescent and the effects of labor conditions upon such growth and the national results which are likely to follow. All such questions are doubly difficult in the case of the woman worker. There has been witnessed what can not be de scribed otherwise than as a mighty revolution in industry, and the committee have been deputed to study some of the physiological con- 15 16 INDUSTRIAL HEALTH AND EFFICIENCY. comitants or effects of this revolution. They do not profess to solve the problems thus presented. They are under no delusion in the matter. They can but open the door and invite other students to enter this unexplored region of science and labor. They are con vinced that it offers a wide field for research, for careful experiment, for firm, frank, and bold statecraft, for a large and sympathetic understanding, which shall secure the inestimable advantages of woman’s skill and energy without those irremediable and far-reach ing evils which will inevitably arise if her contribution be not wisely and effectually safeguarded. Secondly, there is the old problem of the relation of the man to the machine. During the industrial revolu tion in England there was a tendency, to put it no higher, for the man to be made subservient to the machine. But physically, socially, and even morally, this seems to reverse the proper order. Their in vestigations have convinced the committee that to secure harmony and smooth working, to secure efficiency and maximum output, the machine must be subservient to the man; it is his individual health, mental development, and moral well-being wThich is the guaranty of effective labor. The reference here is not to the social relationships between master and man, or between man and man, though the propo sition may be true in that regard also. It is oniy in respect of the physiological basis of labor and of all endeavor of whatever kind. In short, physical health is the fundamental basis. There must be a proper distribution of function of labor, a correct understanding of the part played by nutrition, by rest, by fatigue, by health condi tions, if waste is to be avoided and maximum energy attained. The human being is a finely adjusted physiological instrument, which must no longer be wasted, much less destroyed, by ignorant or willful misuse. A workingman’s capital is, as a rule, his health and his capacity to perform a full day’s work. Once that is impaired or damaged beyond recuperation, two things happen: First, his whole industrial outlook is jeopardized and he becomes by rapid stages a liability and even a charge on the State. Secondly, if the bodily defense is undermined by stress and strain the man falls a ready prey to disease, such as tuberculosis. Therefore, as the problems to which reference is made in this report concern the future as well as the present, so also they are concerned with the new preventive medicine which has as its object the removal of the occasion of dis ease and physical inefficiency combined with the husbanding of the physical resources of the worker in such a way and to such a degree that he can exert his full powers unhampered, and with benefit to himself and all concerned. 12. Any account of steps which have been taken to promote the health of workers in the engineering and other trades with which PRELIMINARY AND HISTORICAL SURVEY. 17 this report is immediately concerned must inevitably deal in a large measure with the efforts that have been made generally to promote the health of all industrial workers during the century and a quarter which has elapsed since public opinion first became aroused on the subject. At first the health of children in cotton factories was the primary matter for concern. The evils of long hours of work and insanitary surroundings, though they had existed previously, had become accentuated by the aggregation of large numbers of workers in factories and by a marked increase in the demand for child labor. The children were helpless to protect themselves against the demands of the employer for cheap labor and against the cupidity of the parents. That any action was taken was due partly, no doubt, to a fear that the conditions of employment might react, not only on the health of those immediately concerned, but on that of the nation as a whole. Action was, however, mainly due to the gradual awakening of the political and social conscience which occurred during this period. It was a time, not only of factory legislation, but of educa tional advancement and of prison reform. The awakening was religious as well as social, and the first factory act was concerned not only with the health of apprentices but with their “ morals.” It dealt with their education and religious training as well as with their physical welfare. The modern factory acts were only gradually evolved; legislation was directed to removing particular evils as they became recognized, rather than to the realization of definite principles, based on a critical examination of the causes of the evils. That progress was slow was due in the main to the strength and character of the individualistic views then held and to the widespread belief that any curtailment of the liberty of action of the manufac turer must be prejudicial to the national prosperity. More than half a century passed before there was any general acceptance of the principle that the State has both a right and a duty to concern itself with the physical and moral welfare of its people. 13. The movement of reform expressed itself in two ways. First, there was the individual effort of the more enlightened pioneering em ployers, and secondly, there was the intervention of the State through its central board of health and, subsequently, the factory department of the Home Office. From the days of Robert Owen, and before his days, down to the present time, there has been a succession of benevo lent employers who have made it their business to provide for the well-being of their workers, and have thus set a standard and an ex ample to the State. Wood and Walker, of Bradford, who inspired Oastler; John Fielden, who, in 1836, felt he was “ the trustee of the interests” of those he employed; Robert Gardner, of Preston; and 80035°— 19-------2 18 INDUSTRIAL HEALTH AND EFFICIENCY. others were forerunners in a long line of famous employers who have taken upon themselves the responsibility of the care of their workers. “ We manufacturers, ” wrote Robert Owen, “ are always perfecting our dead machinery, but of our living machinery we arc taking no care. ” The movement began with the reduction of hours of labor, but it now comprehends the whole wide compass of “ welfare. ” The medical examination of applicants, the provision of surgeries, conva lescent homes and dental clinics; a nursing staff, prevention of acci dents, supervision of sick, slow, or backward workers; canteen accom modation, recreation agencies, clubs, swimming baths and playing fields, libraries, allotments, educational classes; welfare supervisors; improved wage systems savings clubs, profit-sharing—make a form idable array of agencies for the benefit of the worker. “ It is taken for granted,” writes an employer, “ that before any so-called scheme of welfare work can be of lasting good a living wage must be paid and hours of labor and hygienic conditions must not involve the de terioration of the workers. It must be quite evident that clubs and classes, savings funds and libraries are quite thrown away upon work ers who are overworked and underfed.” 1 14. It is important to observe that, with few exceptions, the pioneer reforms of employers were inspired by social and moral motives rather than by scientific or economic evidence. There was, indeed, all through this long period of tardy reform, little or no appeal to the actual facts of the relation between the hours and conditions of labor on the one hand and the energy and output of the workman on the other. It seems now, on looking back, an extraordinary thing that there should have been little or no scrutiny or inquiry, no ex periment, no research, no investigation into the real state of the case. Men guessed, or assumed, or were guided by their own prejudice, or at best, were compelled by humane or religious ideals. One of the first control experiments on this subject made in the workshop was that initiated in 1892 by the Eight Hon. Sir William Mather in the en gineering works of Messrs. Mather & Platt at Salford. As a result of negotiation between employer and employed it was arranged to make a year’s trial (1st March, 1893-28th February, 1894) of a 48 hours’ system, excluding the two hours of work before breakfast (7.45 to 12 noon and 1 to 5.30). The results showed— (a) that there was an increase of 0.4 per cent in the ratio of the wages cost to the turnover; (b) that there was a saving in gas, electricity, fuel, wear and tear, etc., amounting, by coincidence, to 0.4 per cent; (c) that there was a fall in the amount of lost time from 2.46 per cent in the 53-hour period to 0.46 per cent in the 48-hour period; (d) that though pieceworkers lost 1.76 per cent at the beginning of the trial year, this fell to 0.78 per cent at the end; and (e) that there was 1 Experiments in Industrial Organization, by Edward Cadbury, 1912. PEELIMIISTAKT AND HISTORICAL SURVEY, 19 “ increased cheerfulness and brightness ” on the part of the work people. 44We seem,” wrote Sir William Mather in 189-1, 44to have been working in harmony with a natural law, instead of against it, as in the unnatural conditions of men beginning the work of th« day without provision required by nature for the. proper exercise of their mental faculties and physical powers. * * * Of this I am assured, that the most economical production is obtained by employing men only so long as they are at their best—when this stage is passed there is no true economy in their continued work. ” The committee have had the advantage of discussing this admirable experiment with Sir William Mather, and they are satisfied that his experience, and those of other employers who followed his enlightened example of inquiry and of reform, demonstrates the value to the workman, the employer and the community as a whole, of applying to industry the scientific method and the scientific spirit. 15. Secondly, alongside the ameliorative efforts of individual em ployers, sometimes guiding them, sometimes guided by them, there has been the ever-increasing intervention of the State. For a hundred years the movement has been slowly, with tardy steps, gaining ground. To-day, in the presence of a wide interest in 44welfare, ” it is important to remember that the foundations have been laid for many years. It is no new discovery either as need or remedy. For a proper understanding of the present situation it is necessary to take cognizance of the past. For convenience the matter may be considered under four subheadings: (1) The hours of employment, (2) factory environment, (3) personal well-being, and (4) the effect of occupation on health. (I ) LIMITATION OF HOURS OF EMPLOYMENT. 16. When at the beginning of the last century public opinion first became seriously concerned with conditions of industrial employment interest was mainly concentrated on the excessive hours of employ ment of children and adolescents, and somewhat later of women. Though the hours of employment of men were the subject of contin ual agitation amongst the workers, legislation on the subject was never seriously contemplated, the action of the legislature being con fined to limiting the hours of women, young persons and children, and to the provisions necessary to secure the effective enforcement of the limits decided upon. The earlier factory acts applied only to the textile industries, mainly because they were more highly, devel oped, and regulations were consequently easier to enforce. It was not until limitations of hours, substantially as they exist to-dav, had been established, that their extension to other industries was seriously considered. 20 INDUSTRIAL HEALTH AND EFFICIENCY. 17. The Health and Morals of Apprentices Act, passed in 1802, was concerned solely with apprentices. Their working hours were lim ited to 12 a day, and their employment was forbidden between the hours of 9 p. m. and 6 a. m. Except as a statement of principle this act was of but little effect. It did not apply to the large and increas ing number of children who were employed otherwise than as ap prentices, and even as regards apprentices its administration was lax. It was not, indeed, until 1819 that the agitations headed by Eobert Owen,1 himself a cotton manufacturer, led to the passing of a fresh act under which the emplojanent of all children under 9 years of age was prohibited, and the employment of young persons between 9 and 16 years of age was limited to 12 hours. No further develop ment of importance occurred until the agitation led by Richard Oastler and Michael Sadler commenced about 1830. These agita tions were in a large measure concerned with the establishment of a 10-hour day for juvenile workers, though it was anticipated that any limitation of the hours of children would result in a similar limita tion in the hours of employment of all workers. The opposition during this period was primarily based on the view that any restric tion of the hours of employment must seriously prejudice the pros perity of the country. Even as late as 1844 the view that “ the longer the hours, the greater the profit,” was still being expressed in its crudest form. 18. In 1833 commissioners were appointed to inquire into the ex isting conditions and to consider the need for further legislation. They reported that children employed in the principal branches of manufacture throughout the country worked during the same hours as adults; that the effect of labor during such hours was, in a number of cases, permanent deterioration of the physical condition and the production of diseases wholly irremediable, and that at the age when children suffered injuries from the labor they underwent they were not free agents. The commissioners were accordingly of opinion that a case was made out for the interference of the legislature on behalf of children employed in factories.2 The Factory Act, 1833, which resulted from the report of the committee, distinguished for 1 Robert Owen stated in evidence that the reduction of hours in his own factory had not appreciably affected the output. He explained that “ a larger quantity may be produced by a greater attention of tlie hands while the machinery is at work, in pre venting breakages, and by not losing time in commencing in the morning, at meals, or when stopping at night.” 3 While they rejected the proposal of 10 hours a day they pointed out the fallacy underlying the arguments of the opposition. “ It appears in evidence that .the practice of working more than the ordinary hours a day in each branch can not be turned to account to any such extent. * * * When work is protracted beyond these hours the workmen become inefficient, the quality of the work is injured, the amount of waste augmented and, moreover, additional expense for light is incurred.” Reports of com missioners on employment of children in factories, H. C.f 1833, XX, XXI, and H. C., IS34, XIX, XX. PRELIMINARY AND HISTORICAL SURVEY. 21 the first time between “ children ” and “ young persons.” Children between the ages of 9 and 13 were only to be employed for 9 hours a day and 48 hours a wyeek, while young persons between the ages of 13 and 18 might be employed for 12 hours a day. No person under 18 years of age was to be allowed to work at night; that is to say, betweeen 8.30 p. m. and 5.30 a. m. Owing to frequent abuses a medi cal certificate was required that a child was of “ the ordinary strength and appearance ” of a child of 9 years of age. Finally, the ineffec tiveness (complained of by employers and workers alike) of earlier attempts to enforce the law through persons appointed by the local justices led to the appointment of factory inspectors. 19. The demand for factory reform and for a 10-hour day con tinued and was gradually enforced by the reports of the factory in spectors as to the difficulties experienced in administering the act of 1833. The Factory Act, 1844, which was largely supported by the employers as wTell as by the workers, contained numerous provi sions for the better enforcement of the limitations already imposed and for preventing encroachment on meal times, but the most im portant innovation was the limitation of the hours of employment of all women to those permitted for young persons.1 The struggle for a 10-hour day was practically ended by factory acts passed in 1847 and 1850, under which the hours of employment of women and young persons were limited to 10J hours (with hours for meals) a day and 60 hours a week, while to prevent evasions of the law it was prescribed that the legal working day was to be from 6 a. m. to 6 p. m., thus coinciding in length with the legal period of em ployment. 20. The children’s employment commission, the first commission of inquiry into the general conditions of industries other than tex tile, was appointed in 1840 as a result of representations made by Lord Ashley. The commission in their first report dealt with the mining industry; their second report,2 which was published in 1843, showed that in the metal ware and other industries children were generally employed for as long as adults, sometimes for as much as 16 or 18 hours without intermission. Night work wTas also common. Though the reports of the commission resulted in legislation in re gard to coal mines and the extension of the factory acts to certain tex tile industries not hitherto included, no action was taken to remedy the abuses shown to be existing in the metal ware and other nontextile trades. 1 As one inspector pointed out,. 12 hours’ daily work is more than enough for anyone, but however desirable it might be that excessive working should be prevented, there are great difficulties in the way of legislative interference with the labor of adult men. The case, however, is very different as respects women; for not only are they less free agents, but they are physically incapable of bearing a continuance of work for the same length of time as men, and deterioration of their health is attended with far more serious consequences to society.” 2 House of Commons Report, 1843, X III-X V . 22 INDUSTRIAL HEALTH AND EFFICIENCY. 21. It was not until 1862 that the second children’s employment commission was appointed. The inquiries of this commission were conducted under circumstances widely different from those which had existed 20 years earlier. The extent of the restrictions on hours of employment to be imposed by the factory acts was no longer a matter of dispute. It was, moreover, generally recognized that the industries affected had benefited by the imposition of these restric tions. The old opposition to the factory acts had largely disap peared. It is evident from the reports 1 that the character of the metal industries had widely changed during the 20 years which had elapsed since the previous inquiry. The increased use of machinery and the regulation of hours in other trades had tended to secure to a far larger degree regular hours of work. The phrase “ overtime ” is now used in something approaching the modern sense of hours of work in excess of the normal day. In continuous processes regular day and night shifts, and occasionally the three-shift system, are found established. The commission quoted with approval the evi dence of a number of witnesses who were opposed to overtime. The following, among others, were quoted: I f overwork lasts only for a short time 20 per cent increase o f hours’ labor gives only about 10 per cent increase of result in production. I f overtime is continued for any length it gives no increase o f result at all. W e find that those on piecework make as much in 10$ hours as they do when they know that they have 2 hours longer. I f they have been working their full time well they have not the energy left to get through much more at the end of it. Bad management and carelessness is the source o f all overtime. When they work on till 8 p. m. they get wearied— men and boys. There is quite time enough from 6 a. m. to 6 p. m. for a man to do all he can do satisfactorily. 22. The commission recommended the inclusion of the metal trades within the provisions of the factory acts, and legislation followed in 1867. Sunday work was forbidden, and also night work except to a limited extent permitted for male young persons employed in iron mills and blasting furnaces. Overtime was not allowed in the metal industries. 23. The report2 published in 1876 of the commissioners appointed to inquire into the working of the factory and workshop acts, with a view to their consolidation and amendment, did not recommend any change in the limitation of hours of employment then imposed, and no material change has since been made. The commission also con sidered in this relation the desirability of placing special restrictions upon the occupation of married women in the interests of themselves as well as of their offspring. They, however, regarded it as imprac ticable to place any prohibition on the employment of women imme- 1 II. C., 1864, X X II ; H. C., 1865, XX. 9 II. C., 1876, X X IX and XXX. PRELIMINARY AXD HISTORICAL SURVEY. 23 diatelj before or after childbirth, and confined themselves in con demning their employment and to recommending the provision of public nurseries in factory towns. And it was not until the Factory and Workshop Act, 1891, that it was provided that an occupier of a factory or workshop shall not knowingly allow a woman to be em ployed therein within four weeks after 3he has given birth to a child. 24. The Factory and Workshop Act, 1901, so far as the limitation of hours of employment was concerned, was mainly important as con solidating the law on the subject and as setting out the law as it at present exists. A summary of the principal divisions is given in Section V. 25. In 1911 a departmental committee was appointed on the night employment of male young persons in factories and workshops. In their report (published in 1912)1 they stated that they were strongly of opinion that the employment of boys under 18 years of age at night in factories was undesirable and ought not to be allowed to any greater extent or at an earlier age than was absolutely necessary. They considered that this applied especially to boys between 14 and 16 years of age, a when the rate of growth is most rapid and when the conditions of life ought to be rendered as favorable as possible for mental and physical development.” This committee reluctantly came to the conclusion that the adoption of a system of three 8-hour shifts was not generally practicable. They recommended the pro hibition of all night employment *of boys under 18 years of age in blast furnaces, and of boys under 16 years of age in iron mills. They considered it important that provision should be made for the period ical medical examination of boys employed at night until they are 18 years of age, at least once in six months. They added that records should be kept at the works of any physical defects or other matters calling for watchfulness on the part of the occupier, the examining doctor or the inspector of factories. 26. Such, briefly, are the outlines of the story of the struggle for a standard of working hours which should not overstrain the workman. For upwards of a century the State has accumulated indisputable evidence that it is the conditions of employment rather than its character which undermine the physical strength and endurance of the worker. Apart from exceptional occupations which are in themselves injurious, the principal of the undesirable conditions, the most radical and persistent, the commonest, is that of long hours. It is a significant fact that all through the history of the industrial system of this country the dominant evil is not accidents or poisoning or specific disease, but the stress and fatigue due to long and unsuit able hours of labor, entailing inadequate opportunities for rest, rec- mOS, 1912. 24 INDUSTRIAL HEALTH AND EFFICIENCY. reation and nourishment. In a word, it is not the work but the continuity of the work which kills. (2) FACTORY ENVIRONMENT. 27. Though in the earlier controversies of the last century public attention was primarily concerned with the limitation of hours of employment, the necessity was also recognized of attention to the environment of the worker in the factory. The Health and Morals of Apprentices Act, 1802, required that in all cotton factories in which more than 20 persons were employed (whether as apprentices or not), provision should be made for limewashing and “ for a sufficient number of windows and openings in such rooms or apartments to insure a proper supply of fresh air in and through the same.” From the first, therefore, the importance of ventilation and cleanliness ayas recog nized (unlike the limitation of hours of employment) as necessary for men as well as for women and young persons. 28. Various commissions called attention to the matter. The chil dren’s employment commission in their report, published in 1843, on the metal ware and other industries stated that— In the great m ajority o f instances the places o f work are very defective in drainage, ventilation, and in due regard o f temperature, while little or no at tention is paid to cleanliness. 29. The reports of the children’s employment commission (1862) show7 that, notwithstanding the great developments which had taken place during the previous 20 years in the organization of industry, conditions in these respects remained much as before. The factory acts (extension acts, 1864 and 1867) contained provisions in regard to cleanliness and ventilation. As a direct result of the inquiries of Dr. Greenhow provisions for the first time appear dealing with over crowding and with the provision of fans or other mechanical means for the prevention of the inhalation of dust. The development of opinion in regard to public health matters led to the Factory and Workshop Act, 1878, incorporating certain provisions of the Public Health Act, 1875, and requiring that the factory should be kept free from effluvia and other nuisances. 30. With the development of machinery the prevention of acci dents became a question of increasing importance. The Factory Act, 1844, first provided for the fencing of machinery, though its provi sions were largely confined to machinery “ near to which children and young persons are liable to pass,” and it was only by the Factory and Workshop Act, 1878, that requirements as to the fencing of ma chinery were extended to all workers. The same act introduced for the first time restrictions as to the cleaning of machinery by women, young persons and children. Notification of accidents to the certify PRELIMINARY AND HISTORICAL SURVEY. 25 ing surgeon, first introduced in 1844, was now extended to cover notification also to the factory inspector. The Factory Act of 1901 consolidated the measures for the improvement of the environment, and included requirements regarding cleanliness, ventilation, light ing and sanitary accommodation. 31. The enforcement of legislative requirements in regard to the environment of the worker has inevitably been a gradual process. The difficulties were greater than in the case of limitation of hours, since in the main the requirements w^re couched in general terms, words such as “ adequate” left many loopholes for evasion, and the raising of the standard was and is largely dependent upon the exer tions of the workers, the employers and the factory inspectors. Nor must it be forgotten that pari passu with improvement in factory environment there has been an immense advance in general sanita tion outside the factory. (3) PERSONAL WELL-BEING OF THE WORKER. 32. Since the earliest developments of the factory system there have always been employers who have not felt their social and moral obligations satisfied by fulfillment of the minimum requirements of the law, but have actively concerned themselves in promoting the health and welfare of their workers, not only by providing clean and well-ventilated work places and moderate hours of employment, but by providing facilities for obtaining food and by other means outside the ordinary range of factory management. Thus one of the special commissioners appointed to make inquiries for the commis sioners on the employment of children in 1833 reported that— The greatest mills I have always found to be the cleanest, the machinery most securely fenced off, and the hands of the neatest and most respectable appearance * * *. In Messrs. Strutt’s mill at Belper each hand is allowed a pint o f good tea or coffee, with sugar and milk, for $ penny, and medical assistance gratis. A dancing room is also found for them in this establishment. 33. In one of the earliest reports of the factory inspectors it is stated—■ In some cases an active and anxious interest in the w elfare o f those em ployed has been evinced by the establishment o f institutions and different regulations for the improvement o f their moral and social condition which have been productive o f great advantage. Some o f these institutions have in view the providing o f medical advice and medicines when ill, and occasional pecuniary assistance during sickness. Such cases were, however, exceptional, and there is no doubt that it was not usually considered a part of the duty of the employer to make any special provision in these respects. 26 INDUSTRIAL HEALTH AND EFFICIENCY. 34. The children’s employment commission reported in 1843 that— Even in those trades and manufactures in which deleterious substances are used there is in general no accommodation for the workpeople to change their clothes on leaving their place o f work, or to wash themselves if they remain at meal tim es; and it is very uncommon for any means to be provided for w ork people to dress and warm their food. 35. In the report of the royal commission on labor,1 there is con siderable evidence as to the need for increased interest being taken in these matters, especially as regards women— In ordinary employments the lady assistant commissioners call attention to various common causes o f unhealthfulness such as the absence o f place for dry ing outer clothes when wet, absence o f dining rooms and provision o f hot water, o r means o f cooking or obtaining proper food in or near works. 36. In this gradual development of opinion as to what is needful to secure the well-being and efficiency of the worker, the factory in spectors have played an important part; though primarily concerned with the enforcement of the law, they have inevitably developed a wider view of their responsibilities. Since the first appointment of women inspectors, in itself a significant fact, this movement has been increasingly valuable, and the annual reports of the chief inspector contain constant evidence of tlie interest shown in such matters as the provision of washing facilities, baths, cloakrooms, overalls, canteens and messrooms. The influence of these wider views has, moreover, not been limited to individual employers and factories, but has led to the insertion, with the concurrence of the employers concerned, in orders governing employment in certain “ dangerous ” trades of elab orate requirements binding upon the whole trade. (4) EFFECT OF OCCTOAXIOJT ON HEAITH. 37. Though individual writers had already drawn attention to the effect of different occupations upon health, it was in the beginning of the nineteenth century the common view that all occupations were equally healthful, provided that the hours of employment were not excessive and the conditions of ventilation and cleanliness were rea sonable. It was only gradually that the influence of occupation upon health became more fully appreciated. The commissioners on the employment of children in 1833 reported as follows: That this excessive fatigue, prevention o f sleep, pains in various parts o f the body and swelling o f feet experienced by young workers, coupled with constant standing, the peculiar attitudes of the body and the peculiar motions o f the limbs required in the labor o f the factory, coupled with * * * the impure atmosphere did sometimes terminate in the production o f serious permanent and incurable disease. 38. About the same time Dr. Turner Thackrah2 drew attention to the effects of the principal trades and professions on health and lon iH . C ., 1893, X X X II-X X X IX . *The Effect of Arts, Tracies and Professions on Health, by C. Turner Thackrah, 1832. PRELIMINARY AND HISTORICAL SURVEY. 27 gevity. He pointed out that mortality was greater in the manufac turing districts, and called attention to the effect on health, not only of atmospheric impurities and excess of labor, but also of dust and gaseous impurities, posture, muscular effort and other conditions of employment. He pointed out that in many occupations injurious conditions existed which might be immediately removed or dimin ished. 89. The children’s employment commission (1810), which was the first commission to make investigations into the conditions outside the textile trades, reported that— The work in which children and young persons are employed is seldom in itself oppressive, or even la b oriou s; and very few indeed o f the processes in the care and management o f which children take any part are in their own nature in ju rious; but to this there are some lamentable exceptions in certain processes connected with the manufacture o f metal wares, earthenware, and o f glass. 40. In 1853 and 1854 were published two reports by Mr. A. G. Finlaison, the actuary of the national debt, on the subject of sickness and mortality among members of friendly societies. He showed that the demand for sickness allowances depended, not so much on differ ence of locality or on the density of the aggregation of the popula tion, as upon the amount of the expenditure of physical force.1 41. In 1857 Dr. H. Greenhow, lecturer on public health at St. Thomas’s Hospital, made an elaborate investigation into the incidence of mortality from lung disease and other causes. He found that there existed no fixed relation between the prevalence of pulmonary affec tions and the size of towns. He suggested that various disturbing causes seemed capable of displacing the normal proportion and, of these, probably occupations and modes of life were the most in fluential. It is well ascertained that the great mortality among grinders and cutlers arises from the irritation caused by the mechanical particles produced during the process o f manufacture and received into the lungs with the air in respira tion. 42. This report was published by the board of health, with an introduction by their medical officer, Sir John Simon. The public health act passed in that year led to the transfer of powers of the board to the privy council, and one of the earliest acts of Sir John Simon as the medical officer of the new central authority was to instruct Dr. Greenhow to investigate on the spot the conditions in 1 “ The only practical difference in the distribution of sickness that can be discovered was seen to turn on the amount of physical force called out by the occupation of the contributors; other features of the employment, the circumstances of the place, or of shelter or exposure under which that occupation was carried on, seeming to have but very minor influence on the question.” 28 INDUSTRIAL HEALTH AND EFFICIENCY. certain areas where lung diseases were specially prevalent.1 Dr. Greenhow included amongst the conditions which his inquiry had shown to be direct causes of pulmonary disease, the inhaling of fine dust of metal and the breathing of air polluted by fumes or over heated. Other causes included habitual exposure to hot and exceed ingly moist atmosphere, working in ill-ventilated and overheated factory rooms, vicissitudes of temperature, and strained posture. 43. The inquiries of the children’s employment commission (1862) showed that, in spite of the general development of industry, many of the evils revealed by the children’s employment commission, ap pointed in 1840, still existed and called for redress.2 Though pri marily concerned with the conditions of employment of children and young persons, the commission necessarily dealt with many condi tions which affected all workers. The conclusions of Dr. Greenhow, which were fully confirmed by their own inquiries, were freely quoted. The Factory Acts (Extension Acts), 1864 and 1867, which followed, marked the end of a stage. Parliament had intervened to remove certain general conditions of employment obviously prejudi cial to health. Though the reports of the registrar general have con stantly drawn attention to the influence of occupation upon mor tality, public interest and scientific inquiry have since been largely diverted to questions affecting the health and welfare of the worker outside the walls of the factory. 44. The Education Acts, 1870 and 1876, placed education w7ithin the reach of every child, and established compulsory attendance. The Sanitary Act of 1866 was followed by the Public Health Act, 1875, which is still the principal measure dealing with all questions of public health. That any further general intervention by Parliament was unnecessary in the trades already under the factory acts was the considered opinion of the commission on the consolidation and amendment of those acts, which reported in 1876. For the future legislation was to be largely confined to dealing with the special con ditions of particular industries. It took two forms: First, acts were passed dealing with single industries, such as laundries; and sec ondly, the State was given power to confirm, or later themselves to make, codes of regulations specially designed to protect the worker against the effects upon health of “ dangerous ” trades or processes. 1 Reports by Dr. Greenliow are included in the third and fourth reports of the medical officer of the privy council, which were laid before Parliament in 1860 and 1861. 2 Thus of one center of the metal industry they report that— Considering, therefore, the early age at which the children go to work, the injurious state of their places of work, the lowering and exhausting modes of their employment, the unreasonable and excessive hours of work, irregular and undefined hours for meals, late work on Saturdays, or extra work in the earlier part of the week to make up the time granted for relaxation on Saturday afternoon, and exposure to frequent accidents of all kinds from machinery, it will be acknowledged that on physical ground legislative interference is required as a protection to the young in this large and important de partment of manufacture. PRELIMINARY AND HISTORICAL SURVEY, 29 45. Under the influence of Dr. Greenhow’s reports the factory Acts (Extension Acts), 1864 and 1867, conferred upon employers the power, with the approval of the secretary of state, to make special rules to secure the requisite conditions of cleanliness and health. Further, where any process was carried on by which dust was gener ated and inhaled by the workman to an injurious extent the inspector was given power to require the provision of a fan or other mechanical means for the prevention of inhalation. Under section 8 of the Factory and Workshop Act, 1891, if the secretary of state certified any machinery or process as dangerous or injurious to health, the chief inspector might, subject to certain safeguards, make proposals and require the adoption of special methods. These rules, like those made under the Act of 1864, only referred to single factories. Section 28 of the Factory and Workshop Act, 1895, strengthened these powers and extended them to cover rules prohibiting employment, or modi fying or limiting the period of employment for all or any class of persons. 46. Finally, the Factory and Workshop Act, 1901, consolidated previous legislation which had for its object the protection of the health of the worker. It conferred powers upon the secretary of state to make regulations applying to all factories where particular proc esses injurious to health were in operation. The regulations are nor mally divided into two parts—the duties of the employer and the duties of persons employed. They deal with such matters as the re moval of dust or fumes, method of manufacture, certificates of fitness before employment, periodic medical inspection, suspension of af fected persons, costume (overalls, respirators, clogs, gloves, etc.), provision of messrooms and cloakroom, provision for the partaking of food in work places, and washing and bath accommodation. The act also continued the power given by previous acts to the inspector to re quire the provision of a fan or other means for preventing inhalation. A provision first included in the Factory and Workshop Act, 1895, is also continued, under which the secretary of state may require the notification of certain diseases contracted in the factory or work shop, including those arising from lead, phosphorus, arsenic, mer cury, or anthrax. By special order of 1916 this provision was ex tended to toxic jaundice.1 47. In addition to dealing, as has been seen, with the hours of labor and factory sanitation, the act of 1901 carried further previous enact ments for the safeguarding of personal health. Home work was brought under special control; notification of the occurrence of 1 Under section 8 of the Workmen’s Compensation Act, 1906, the secretary of state hag power to make orders extending the provisions of the act to disease contracted in the course of employment. 30 INDUSTRIAL HEALTH AND EFFICIENCY. industrial poisoning was extended; dangerous machinery had to be more strict!}7 fenced, and certain dangerous employments were for bidden to y’oung persons; and lastly, the provision of the act of 1891 that a woman might not be employed within four weeks of giving birth to a child received under the new act increased administrative attention. 48* In submitting their report the committee desire to make cer tain qualifications and reservations for the consideration of those who study its pages. First, they wish to express the view that a true understanding of the questions dealt with in the report is only practicable if the facts and findings set out in these pages are con sidered in relation to the history of industrial hygiene in England. There is no greater mistake than to suppose that care for the health of the worker and the introduction of welfare supervision are new and untried ideas invented, or at least patented, by the committee. In this matter, the committee enter into other men’s labors; but to them has been given the opportunity of urging the application of previous knowledge in a great national emergency, rapidly and on a considerable scale. During the last 20 years immense progress has been made under the factory department of the Home Office in many of the essentials of health in the workshop. The reports of the chief inspector of factories have set out year by year the milestones of this advance. For several years before the European War there were not wanting signs that employers were beginning to recognize the im portance of humanizing the life of industrial 'workers arid pro viding for them better conditions, and tlie Police, Factories, etc. (Miscellaneous Provisions), Act of 1916, promoted by Mr, Herbert Samuel when home secretary (which passed parliament subsequent to the issue of tlie committee's first reports), is evidence of the desire of the central authority in the same behalf. Secondly, the committee wish to point out that in spite of the great progress which had been made it remains true that up to 1914 relatively little attention had been paid by employers and others responsible to the steadily accumulating evidence of the in fluence -of occupation upon health, and but little effort had been made scientifically to investigate its causes. Efforts to protect the health of industrial workers had been mainly based cm the need of miti gating or removing admitted evils as they arose, rather than on the actual results of scientific inquiry and research. No doubt, partly as a result of the appointment of medical inspectors by the Home Office, increasing attention had in recent years been devoted to the critical examination of certain “ dangerous ” trades; but most trades aTe not “ dangerous,” and the vast bulk of industrial disease did not find its origin in dangerous trades. Yet there is the strongest evi dence that rates of sickness and mortality amongst males had been PRELIMINARY AND HISTORICAL SURVEY. 31 materially affected by occupation. In spite of this well known fact much remained to be learned as to what are its causes, whether they are peculiar to individual occupations or are common to many, whether they are the same for sickness as for mortality, to what extent they depend upon variable factors, and to what extent they are removable. Then as to the injurious effects of industry upon women and young persons, reliable data may be said to have been almost wholly lacking, as they are equalty lacking in respect of the relation of fatigue to disease. Again, the proper length and distribution of hours of labor—spells, pauses, overtime—in relation to output is another problem which has never yet been scientifically explored. The committee here also found themselves without data. Once more, though attention is now being given to so-called “ scien tific management,” evidence is still wanting to show how far the speed of working can be increased or the method modified without involving an undue physical or mental strain on the worker, which counterbalances or even destroys the advantages claimed. In the absence of reliable data on these and other problems of industrial organization, the difficulties in the way of a wise handling of the special problems arising out of the war have been greatly increased. The committee mention these points with a view to laying emphasis upon the imperative need of a more accurate understanding and a firmer and more comprehensive grasp of the whole problem of health and physique in relation to industry. In the committee’s view it is necessary to make arrangements, without delay, for a national scheme of industrial medical research, and to accord fuller recognition to the importance of industrial hygiene. 49. Thirdly, it is important to remember that the work of the committee has been concerned with an emergency. The situation to be explored was continually changing and expanding. It would have been improper and impracticable to undertake any investi gation which delayed output or interrupted the arrangements of the factory. Consequently the committee have been debarred from making various experiments and inquiries which had suggested themselves as likely to contribute to the elucidation of the matters referred to them. Notwithstanding these limitations, there has been, during the period of the committee labors and owing to the public spirit and foresight of the ministry and of directors, proprietors, managers, foremen, and workpeople, a very remarkable advance in all that makes for industrial betterment. The munition wTorker is a type of all workers, and the principles of the present report con cern, in fact, all forms of industrial labor. The committee earnestly hope that every effort will be made to secure this progess as a per manent gain to the whole nation. 32 INDUSTRIAL HEALTH AND EFFICIENCY. 50. Lastly, the committee recognize that the various questions raised in the present report are intimately related to larger social and industrial problems, which lie outside their reference, but as to which they are deeply concerned. First and foremost there is the fundamental question of shorter hours of labor from a political and economic point of view (as well as from a health point of view) ; the committee are convinced that this question lies near the root of the whole labor problem. Secondly, there is the far-reaching issue of the social and economic conditions of women’s labor (over and above the issues of health with which the present report deals), a matter of vital importance to the future of the British race, for the health conditions of women are even more inseparable from the social condition than in the case of men. Thirdly, there is the question of the solidarity of industrial society, the interdependence between em ployer and workman, which is closely related to the whole issue of the status, health and physical equipment of the worker. And fourthly, there is the title of the worker to an effective voice in regard to the conditions under which he works. If industry be indeed a national service, the object of those engaged in it is the good of the community as a whole, and the worker should have a fair and legiti mate share in the responsibility of the transaction. The committee are convinced that these four problems must be faced and solved if ever the State is to lay sound foundations for the health and physical efficiency of the industrial worker. SECTIO N III.—R ELATIO N OF FA T IG U E AND IL L H EALTH TO INDUSTRIAL EFFIC IEN C Y . INTRODUCTION. 51. The personal health and physical efficiency of the munition worker, as of all industrial workers, are measurable by two stand ards—first, that of fatigue, weariness and exhaustion of the healthy physical faculties and functions of the individual; and secondly, that of disease. It is not possible always to differentiate these two de partures from the normal, or to say when fatigue passes beyond the confines of what is physiological to that which is pathological. It is obvious there comes a stage in the processes of fatigue where recovery in any individual falls short of the diurnal rhythm of rest and work, and its degree or character is so severe as to be, in fact, a form of disease. Indeed, the truth of this proposition is one which is neces sary to a sound understanding of the problem which presents itself. It is necessary to widen the whole view and apprehension of the subject of health and disease in relation both to industry and to the personal welfare and capacity for work of each workman. The sci ence and art of medicine is not restricted to the diagnosis and cure of disease in its gross forms; it includes also a knowledge of how dis ease comes to be, of its earliest beginnings, and of its prevention. It is, in fact, the science and art of health, of how man can learn to live a healthful life at the top of his capacity of body and mind, avoid ing or removing external or internal conditions unfavorable to such a standard, able to work to the highest power, able to rest to the fullest, growing in strength and in the joie de vivre. The new pre ventive medicine must not be understood to consist only of sanitation, of the isolation from the community of cases of infectious disease, of disinfection and outward cleanliness, and of the registration of births, deaths and other vital statistics. These are, of course, matters of the first importance. But much more is required. The individual man ms an animal—the body in all its parts, the senses and their functioning. the nutrition of the body, its growth and development, its ca pacity for work, its powers of resistance—must receive practical consideration. The fight against disease is something more than the closing of its channels of communication, something more than an avoidance of the ways and means of its infection and invasion, cer tainly much more than a registration of its effects, a record of the 80935°— 19------3 S3 34 INDUSTRIAL HEALTH AND EFFICIENCY. morbidity and mortality which follow in its train. The turning point of the battle is elsewhere. The first line of defense is a healthy, well-nourished and resistant human body. And to this end the whole man must be dealt with, for he is something more than animal. His body is in greater or less degree the instrument and expression of emotion, intellect and will. There is thus a psychological aspect of preventive medicine hitherto greatly neglected. Nor is the indi vidual, taken at any one moment, the whole of the issue. There is his life history, his heredity, his family, his domestic life, his per sonal habits and customs, his home as well as his workshop. In short, preventive medicine to be effective must deal with the man, the whole man, as an individual as well as a member of the community. While this is true of preventive medicine generally it is particularly true in regard to that portion of it which has been referred to the committee for examination. The subject of industrial efficiency in relation to health and fatigue is thus in large degree one of preventive medicine, a question of physiology and psychology, of sociology and industrial administration. Before dealing with many of the practical ques tions involved the committee think it desirable to refer briefly to some of the principles underlying present knowledge of fatigue and personal health, for upon a right understanding of fatigue, its causes and its relation to efficiency, the practical solution of the problems raised seems to depend. DEFINITION AND CAUSATION OF EATIGUE. 52. Fatigue is the sum of the results of activity which show them selves in a diminished caducity for doing work .—In ordinary expe rience fatigue is generally associated with familiar bodily sensations and these sensations are often taken to be its measure. It is of vital importance for the proper study of industrial fatigue, however, to recognize not only that bodily sensations are a fallacious guide to the true state of fatigue which may be present, and a wholly inade quate measure of it, but also that fatigue in its true meaning ad vances progressively, and must be measurable at any stage by a diminished capacity for work, before its signs appear plainly, or at all, in sensation. 53. In the animal body the performance of work depends on the activities of parts which are best considered under three groups: First. The complex nervous mechanisms of the brain and spinal cord, which are concerned in the initiation and distribution of im pulses to action. Second. The nerves, which conduct the impulses to muscles. Third. The muscles themselves, which by contracting finally per form external work. RELATION OF FATIGUE TO INDUSTRIAL EFFICIENCY. 35 Fatigue has been separately studied in all these parts, In its essen tial features the fatigue of all alike has been found, when it occurs, to depend not upon the simple using up—“ exhaustion ”—of the sub stances supplying the chemical energy which is liberated during work, but upon the accumulation within the living elements of the products of the chemical changes involved. Fatigue of the animal machine, that is to say, is not to be compared with the failure of fuel as in a steam engine, or with the running down of a clock weight, but rather with the clogging of the wheels in some mechanism by dirt. 54. The chemical products of activity in the nervous and muscular elements are removed by the blood, in part directly by irrigation and in part indirectly through chemical changes in the tissue itself produced by constituents of the blood. Eest after activity is not a passive state, therefore, but is itself an active process, or a series of active processes, leading to a restoration of the normal capacity for work. Time is required for these, and the time taken will be in proportion to the amount of restoration needed. There will be a definite relation accordingly between the degree of any given activity and the time necessary for the completion of the subsequent restora tion process. If the activity is repeated too quickly to give time enough for restoration after each action, fatigue will become pro gressively more intense as the debit balance accumulates, and each repeated act in consequence will be more and more impeded, and will become smaller, until further action is impossible. 55. Of the three groups of organs just mentioned—the nervous sys tem, the nerves, and the muscles—particular chemical and structural characters will decide in each case what time relation must exist beween action and the rest needed for complete repair. In the tired man the symptoms of fatigue are referred to the muscles; they ache, or they may appear to “ give way under him,” but in reality the most severe bodily activity fails to produce any close approach to complete fatigue of the muscles. The fatigue is fatigue of the nerv ous system, though in sensation its effects may be referred to the muscles themselves. A hunted animal may be driven to intense muscular fatigue, but in this extreme case the blood becomes charged with chemical products of activity, for the elimination of which no opportunity is given, and the muscles, with every other organ of the I'cdy, become poisoned. Even in laborious work it is doubtful ' hcther a man by voluntary effort can cause his muscles to approach advanced fatigue. It is well known that a man apparently “ run t< a standstill ” in a race may upon some new excitement run freshly again, under augmented stimulus from the nervous system, initialed there perhaps in part along new paths. The problems then of indus 36 INDUSTRIAL HEALTH AND EFFICIENCY. trial fatigue are primarily and almost wholly problems of fatigue in the nervous system and of its direct and indirect effects. THE RHYTHM OF ACTION AND REST. 56. The necessary time relation between an action and the recovery from it in rest has been mentioned already. For every acting ele ment a given rhythm of activity will allow exact recovery after each act, and will maintain the balance between action and repair through out a long series. The heart, for instance, in alternating contraction and relaxation, may continue to beat incessantly through the life of a man without any accumulated fatigue for 70 years or more. Among the great variety of nerve centers there will be found a great variety in these time relations. Some may allow a relatively rapid rhythm, as in the act of breathing, where the rhythm, which is a nervous rhythm, may be almost incessant for years, while at the other end of the scale there are slower rhythms like those shown in the need for diurnal sleep. 57. In connection with this natural pace of the animal machine, to and fro, from action to rest, reference must be made to the wide adaptability of the animal mechanisms, and especially to that of the nervous system, in response to training, use and habit. Complicated coordinations in the nervous system, at first easily fatigued, may by training, and, as it seems, by some improvement in the routes of con nection due to the increase of traffic itself, become capable of maxi mum efficiency at a more rapid rhythm. A man will swing each leg, weighted with a heavy boot, as in walking, for 10,000 times in an unbroken march without notable fatigue, but he can not as an im promptu exercise raise his lightly weighted finger for more than a few score times at no faster rate before the movement comes to com plete standstill. 58. The problem of scientific industrial management, dealing as it must w7ith the human machine, is fundamentally a problem in indivi dual capacity, physical and mental, and in industrial fatigue. The rhythms of industrial conditions required by the hours of labor, the pace of machinery or that of fellow workers, or otherwise, are im posed upon the acting bodily mechanism from outside. I f these in dustrial rhythms are faster than the natural rhythms of the body they must produce accumulated fatigue, and cause an increasing debit, shown in a diminished capacity for work. It is therefore the prob lem of scientific management to discover in the interests of output and of the maintained health of the workers what are the “ maximal effi ciency rhythms” for the various parts and faculties of the human machine. These must be determined by the organized collection of experience or by direct experiment. They must be separately deter- RELATION OF FATIGUE TO INDUSTRIAL EFFICIENCY. 37 rained, moreover, not only for tlie performance of relatively simple muscular movements, all of which depend on the action of “ lower55 nervous centers, but also for the manifold faculties of the various systems of the body, and for the “ higher ’’ coordinating centers, and for all of these the natural rhythms must be studied for the best arrangement of industry, the hours, shifts, spells, pauses, the periods of sleep and holiday on the one hand, and the conditions of factory environment on the other. SIGNS AND SYMPTOMS OF FATIGUE. 59. It must be repeated that the bodily sensations of fatigue are not a measure, or even an early sign, of it. Real or objective fatigue is shown and is measurable by the diminished capacity for perform ing the act that caused it. BODILY FATIGUE. GO. Fatigue following muscular employment is primarily nervous fatigue, as explained already, and it has been seen that no advanced degree of muscular fatigue as such can be obtained by voluntary action, for fatigue in the nervous system outstrips in its onset fatigue in the muscles. In accustomed actions, however, as in walking or dig ging, where there has been habituation, the activity may be so pro longed without great nervous fatigue as to give approaching “ exhaus tion ”—that is, notable loss of chemical substance—in the muscles. Industrial work is habitual work, but the case in which muscular labor is so intense and prolonged as to give exhaustion in this sense need not be considered here, nor the causation of the special symptoms which arise. It must be noted, however, that practically the whole of the mechanical energy and heat yielded by the body during work comes from the chemical energy stored in the muscles. In proportion as this store is called upon, and quite apart from the question of fatigue, it must be made good by supplies from the blood and ulti mately from the food. Practically the whole of the energy trans formed in the muscles is derived from carbohydrate material, and the importance of this in relation to the diet of workers is well known. Gl. While referring to this point of muscular fatigue, the com mittee wish to record the view that for work in which severe muscu lar effort is required it seems probable that the maximum output over the day’s work and the best conditions for the workers’ comfort and maintained health will be secured by giving short spells of strenuous activity broken by longer spells of rest, the time ratio of rest to action being here, for maximal efficiency, greater than that for the employments in which nervous activity is more prominent or more complicated than in the processes involved during familiar muscular work. 38 INDUSTRIAL HEALTH AND EFFICIENCY. NERVOUS AND M ENTAL FATIGUE. 62. It is under this head, as has been seen, that the special problems of industrial fatigue arise. The signs and symptoms of the fatigue will depend upon the nature of the particular work done, whether it be general bodily work of this or that kind, carried out in fixed routine, or whether it involve mental activity of a simple or of a more complicated kind. The fatigue may spring— (a) from the main tained use of intelligence and observation with varying degrees of the muscular effort necessary in every kind of work; or (b) from the maintenance of steady concentration upon one skilled task; or ( c ) of distributed attention, as when several machines are to be tended or other manipulations performed 5 or ( d) it may depend upon the continued use of special senses and sense organs in discrim ination, whether by touch or sight; or ( e) upon other parts of the body acting upon the nervous system. It will be affected greatly according to whether the worker has opportunity for obeying his natural rhythms, or whether unnatural rhythm is imposed upon him by the pace of the machine with which he works or by that of his fellow workmen. Considerations so inexplicable at present in terms of physiology as to be called “ psychological ” will also arise; if the work is of a u worrying ” or “ fussy ” kind, with a multiplicity, that is to say, of imposed and irregular rhythms, fatigue will be more rapid, perhaps on account of the more numerous, and “ higher,” nervous centers which become implicated. 63. Monotonous work—and much industrial work is monotonous— presents some special problems. It has been seen that uniformly repeated acts tend to become in a sense “ automatic,” and that the nerve centers concerned become less liable to fatigue—the time ratio of necessary rest to action is diminished. But when monotonous series are repeated fatigue may appear in what may be called the psychical field, and a sense of “ monotony ” may dimish the capacity for work. This is analogous to, if it does not represent, a fatigue process in unrecognized nervous centers. Conversely, winterest ” may improve the working capacity even for a uniform monotonous activ ity, and the interest may spring from monetary incentives, emotional states, or, as some think, from states of anticipatory pleasure before meal time and rest (“ end spurt ” ), or, again, from a sense of patriot ism eager to forward the munitions output. 64. For practical purposes in industrial management two chief characteristics of nervous fatigue must be observed. First, during the continued performance of work the objective results of nervous fatigue precede in their onset the subjective symptoms of fatigue. Without obvious sign and without his knowing it himself, a man’s capacity for work may diminish owing to his unrecognized fatigue. His time beyond a certain point then begins to be uneconomically RELATION OF FATIGUE TO INDUSTRIAL EFFICIENCY. 39 spirit, and it is for scientific management to determine this point, and to determine further the arrangement of periods of rest in re lation to spells of work or other body or environmental conditions that will give the best development over the day and the year of the worker’s capacity. Second, the results of fatigue which advances beyond physiological limits (“ overstrain ” ) not only reduce capacity at the moment, but do physical or mental damage of a more perma nent kind which will affect capacity for periods far beyond the next normal period of rest. It will plainly be uneconomical to allow this damage to be done. 65. For these reasons, chief among others, it is important to detect latent fatigue at the earliest* opportunity, and since sensations of fatigue are unpunctual and untrustworthy, means must be sought of observing the onset of fatigue objectively. TESTS OF IlO U STKIAL FATIGUE. OUTPUT. 66. The true sign of fatigue is dimished capacity, of which meas urement of output in work will give the most direct test. The out put must be measured under the ordinary conditions, of the work, and, in cases where from the nature of the work the output can not be automatically measured, it must be tested by methods which do not allow the workers to be conscious at particular times of the test being made. In this way the errors due to special effort from inter est or emulation will be eliminated. The results of work expressed in output must be corrected by allowance for all variable factors save that of the worker’s changing capacity; changes in supply of steam or electric power and of raw material, for instance, must be determined for correction and interpretation of the actual output returns. The output must be estimated for successive short periods (e. g ., each hour) of the day’s work, so that the phenomena of u begin ning spurt” and “ end spurt” and other variations complicating the course of fatigue as such, may be traced and taken into account. Isolated tests of output taken sporadically will be misleading. The records must also extend over longer periods to show the onset of fatigue over the whole day and over the whole week, and under par ticular seasonal or other conditions, in order to detect and measure the results of accumulating fatigue. 67. Measurements of output must obviously be recorded at so much for each individual or for each unit group. The size of total output will be meaningless of course without reference to the numbers en gaged. But it will also be important for proper management to take account of the output of particular individuals. This in many fac tory processes is easily possible, and when it has been done the re 40 INDUSTRIAL HEALTH AND EFFICIENCY. suits have shown surprising variations of individual output which are independent of personal willingness and industry, and have gen erally been quite unsuspected by the workers and their supervisors before the test was made. Information so gained is valuable in two respects. Good individual output is often the result of escape from fatigue by conscious or unconscious adoption of particular habits of manipulation or of rhythm. Its discovery allows the propagation of good method among the other workers. In the second place, these tests of individual capacity (or its loss by fatigue) give an oppor tunity for a rearrangement of workers and their assignment to par* ticular and appropriate processes of work. Astonishing results, bringing advantage both to employer and employed, have been gained in this and other countries by the careful selection of indi viduals for particular tasks, based not upon the impressions of fore men but upon the results of experiment. 68. In passing it may be said that if the proper adaptation to par ticular kinds of labor of the relations of spells or shifts of work to rest intervals and to holidays is to be determined, as it can alone be, by appeal to experiment, it will of course be an essential condition for success that the workers should cooperate with the employing management *and give their highest voluntary efforts toward the maximum output during the spells of work. It is not surprising that where employers, following tradition rather than experiment, have disobeyed physiological law^ in the supposed interests of gain—and for a century this has been almost universal—the worker^ have them selves fallen very commonly into a tradition of working below their best during their spells of labor. In so far as hours of work in excess of those suitable for maximal efficiency have been imposed, during the last two or three generations of modern industry, upon the workers a tradition of slowed labor must necessarily have arisen, probably in large part automatically, as a kind of physiological self protection. Without some conscious or unconscious slackening of effort indeed during working hours of improper length in the past, the output might have been even more unfavorable than it is known to have been for the hours of work consumed. ACCIDENTS AND SPOILED W O R K . 69. An important and early sign of fatigue in the nervous center*, is a want of coordination and failure in the power of concentration. This may not be subjectively realized, but may be shown objectively in an increased frequency of trifling accidents, due to momentary loss of attention. Such accidents may result in personal damage to tht. worker, trifling or serious, breakages of tools or materials, or the spoiling of work. In well-managed factories the incidence of acci dents of this kind is recorded for unit periods throughout the day, RELATION OF FATIGUE TO INDUSTRIAL EFFICIENCY. 41 and these records may provide a good secondary index to fatigue, but only in so far as they are corrected by reference to the rate of work being done and other variables. The subject of accidents will be considered subsequently. ASSOCIATED FATIGUE AND LABORATORY TESTS. 70. The primary sign of fatigue in a given function is diminished capacity. But there is evidence to show that accumulated fatigue in connection with a given act may affect adversely the condition oi other parts of the nervous system not immediately employed. There is little experimental knowledge, however, as to whether this effect, shown in “ associated fatigue,” is more direct and definite in kind than the effect upon general health to be mentioned below. The ap pearance of associated fatigue will need for its detection and study the application of special tests, involving the use of suitable appa ratus and laboratory accommodation. 71. It should be remembered, however, that experiments of this kind will have no validity unless the fallacies due to emotions and ideas, such as a sense of novelty, interest in the desired result, antici pation of release from experiment, unconscious suggestion by the observer, and so on, are eliminated by the most rigid attention to experimental conditions and by long series of control observations. The objects of experimentation must be trained for the purpose, and it is unlikely that tests of this kind will offer results of sufficient value to justify the special education of teams of selected workers for the prolonged studies which the method demands. 72. In view of the fact that the committee’s sphere of experiment and observation comprised actual factories and workshops in all parts of the country, they have not engaged in any laboratory tests of fatigue, mechanical methods, experiments with the ergograph, etc. They have preferred to make their investigations of fatigue under conditions actually obtaining in the industrial world and comprising many individuals instead of few. LOST TIME AND “ STALENESS.” 73. The accumulated results of fatigue are damaging to general health, and they will be reflected in the sickness returns and in the returns of lost time. Many problems arise here which can not now be discussed in detail,1 and they are complicated by the influence of other factors. 74. Reference must be made here, however, to a pronounced and common symptom of industrial fatigue, wiiich appears to be the reflection in the workman of the results of accumulated nervous 1Further reference is made to this subject below and in the chapter on sickness and injury. 42 INDUSTRIAL HEALTH AND EFFICIENCY. fatigue rather than a direct and measurable sign of it. In many munition factories the complaint has been made by workers, and not least by the most intelligent and willing of them, that they are feeling u done u p 55 or “ fair whacked,” to use local phrases, and the evidence shows that this state of “ staleness ” has been common and obvious. By experienced managers and medical officers this condition of stale ness is attributed almost wholly to persistent long hours and the dep rivation of weekly rest. It has grave accompaniments, which para doxically appear not only in a state of lethargy and indifference, but also in a craving for change and excitement. No doubt the restless ness of the condition must often predispose also to indulgence in the apparent alleviations given by alcohol. At all points the state is apt to set up a vicious circle in which the very, need for change and rest prevents the proper use of such chances of rest as are given. 75. The committee hold the view that proper attention early in the war to the need for a weekly rest would have prevented a large part of the diminished capacity of this kind that was allowed to appear, and would have averted much costly and wasteful expenditure upon imperfect work. But stress must be laid here on a further point. For the avoidance of staleness in conditions of strenuous labor it is not enough to treat workmen in the bulk and to regulate daily and weekly rests upon a physiological basis devised for the average. Good management will consider always the individual workman as well. The committee have no doubt that in many cases, in which staleness is well marked or has even advanced to definite sickness, a single “ day off,” given occasionally at the right time, would have avoided much wasteful reduction of capacity and in the worst cases the total loss of many clays work. TH E STU D Y OF IN D U ST R IA L FATIGU E AN D IL L H E A L T H . 76. By studies of industrial fatigue measured by tests of individual output a large body of valuable information has already been gained in various countries, and its application wherever management is scientific has become a commonplace of administration.1 It must be admitted, however, that in England, and no doubt to the detri ment of both health and wealth, management based upon the experi mental science of industrial fatigue is far less common than in the factories and business concerns of America and of Germany. Hith erto there has been a surprising uncertainty commonly found in this country, even where professional knowledge is to be expected, with regard to the proper solution of some of the most elementary prac tical problems of labor management. 1 References to published work may be found conveniently in Fatigue and Efficiency, by Josephine Goldmark, New York, 1913 (third edition), and in the Interim Report to the British Association (Manchester, 1915) by the committee upon the question of fatigue from the economic standpoint. RELATION OF FATIGUE TO INDUSTRIAL EFFICIENCY. 43 77. There is the most urgent need for the application of the results of experience scientifically acquired. Upon a sudden national emer gency the accumulation of fatigue and its results on workers may well be temporarily disregarded, but when the race is to be a long one, a failure to conserve the maximum efficiency of the workers must be disadvantageous. Misguided efforts to stimulate workers to fever ish activity in the supposed interests of industry or national welfare are likely to be as damaging to the desired result as the cheers of partisans would be if they encouraged a long-distance runner to a futile sprint early in his race. E^en during the urgent claims of a war the problem must always be to obtain the maximum output from the individual worker which is compatible with the maintenance of his health, strength, and capacity. Life itself must not be sacrificed to output. In war time the workmen wrill bo willing, as they have shown in so many directions, to forego comfort and to work nearer the margin of accumulating fatigue than in time of peace, but the country can not afford the extravagance of paying for work done during incapacity from fatigue just because so many hours are spent upon it,1 or the further extravagance of urging armies of workmen towards relative incapacity by neglect of physiological law. 78. The committee have found an increasing number of instances in which the onset of industrial fatigue has been avoided (1 ) by intelligent observation of the output; (2) by regular study of the returns of sickness and of lost time; (3) by prompt initiative in adapting the hours and conditions of work to physiological need; (4) by providing proper facilities for the feeding, resting and recrea tion of the worker. These cases are, however, still far from uni versal. Taking the country as a whole, the committee are bound to record their conviction that conditions of reduced efficiency and low ered health have often been allowed to arise which might have been avoided without reduction of output by attention to the details of daily and weekly rests and other similar means of welfare and favor ing conditions. The signs of fatigue are even more noticeable in the case of the managers and foremen, and their practical results are probably more serious than in the case of the workmen. 80. Finally, it must be remembered that when fatigue passes be yond physiological limits (“ overstrain ” ) it becomes ill health, which leads not only to reduced output but to more or less serious damage of body or mind. There is also, of course, much industrial sickness and disease which bears no exact relation to fatigue, though it may follow or precede it. Subsequent sections of the present re 1 On the question of Sunday work by exhausted men, one foreman said he did not believe in “ a holiday on double pay.” Another remarked that Sunday work gav« “ six days’ output for seven days’ work on eight days’ pay.” 44 INDUSTRIAL HEALTH AND EFFICIENCY. port are concerned with general and special diseases associated with factory life and an account of means for their amelioration. Hero it is only necessary to draw attention to the primary and funda mental importance of maintaining a high standard of health in the industrial worker. For without health there is no energy, and without energy there is no output. The actual conduct of businc.:. is thus primarily dependent upon physical health. Moreover, health bears a direct relation to contentment, alertness, and the absence of lassitude and boredom, conditions bearing directly upon industrial efficiency. In this matter the interests of the employer and the workmen are identical. Nor are their respective responsibilities separable. The employer must provide a sanitary factory and suit able conditions of labor. The workplace must be clean and whole some, properly heated and ventilated; there must be suitable and sufficient sanitary accommodation; dangerous machinery and injuri ous processes must be safeguarded; circumstances necessitate in many factories the establishment of industrial canteens, the provision of seats, suitable overalls, lavatories and baths, rest rooms, and first aid appliances. Owing to the factory employment of many workers for the first time, and of increased numbers of women, often at a distance from home, arrangements must be made for individual supervision and the maintenance of their health. The employment of boys also calls for special vigilance and attention. Further, it has been recognized for many years that the wise em ployer considers the personal well-being of his workpeople. He can not be only satisfied with external betterment. He will have regard to the individual worker. Their nutrition, their rest and recreation, their habits of life, are all of interest and importance in relation to their health and efficiency. 81. The problems of industrial fatigue and ill health, already soluble in part by reference to an available body of knowledge well known and used in other countries, have become acute during the great recent development of the munitions industries of Great Britain. It is not too much perhaps to hope that the study of indus trial fatigue and the science of management based upon it, which is now being forced into notice by immediate need, may leave lasting results to benefit the industries of the country during succeeding years of peace. 82. The national experience in modern industry is longer than that of any other people. It has shown clearly enough that false ideas of economic gain, blind to physiological law, must lead, as they led through the nineteenth century, to vast national loss and suffering. It is certain that unless industrial life is to be guided in the future— RELATION OF FATIGUE TO INDUSTRIAL EFFICIENCY. 45 (1) by the application of physiological science to the details of its management, and (2) by a proper and practical regard for the health and well-being of our workpeople in the form both of human izing industry and improving the environment, the nation can not hope to maintain its position hereafter among some of its foreign rivals, who already in that respect have gained a present advantage. SE C TIO N IV .— T H E IN D U S T R IA L E M P L O Y M E N T O F W O M E N . 83. In considering the conditions of employment of women work ers* as compared with those of men, the committee have recognized that account must be taken not only of physiological differences but also of thovSe contributions which women alone can make to the wel fare of the community. Upon the womanhood of the country most largely rests the privileges first of creating and maintaining a whole some family life, and secondly, of developing the higher influences of social life—both matters of primary and vital importance to the future of the nation. In modern times, however, many of the ideals of womanhood must find outward expression in industry, and in re cent years hundreds and thousands of women have secured employ ment within the factory system. The problems thus raised are nu merous, but broadly they may be considered as chiefly concerned with the wise and effective organization of women’s industry, in such a way as to protect and safeguard their unique contribution to the State. The engagement of women in the manufacture of munitions in the present war presents many features of interest. Probably the most striking is the universal character of their response to the coun try’s call for their help. Of equal social and industrial significance is the extension of the employment of married women, the increased occupation of young girls, and the revival of the employment of women at night. The munition workers of to-day include dress makers, laundry workers, textile workers, domestic servants, clerical workers, shop assistants, university and art students, women and girls of every social grade and of no previous wage-earning expe rience; also in large numbers, wives and widows of soldiers, many married women who had retired altogether from industrial life, and many, again, who had never entered it. In the character of the re sponse lies largely the secret of its industrial success, which is re markable. The fact that women and girls of all types and ages pressed into industry, on account of the war, showed a spirit of patriotism wThich was as finely maintained as it was quickly shown. Conditions of work have been accepted without question and without complaint which, immediately detrimental to output, would, if con tinued, be ultimately disastrous to health. It is for the State to safe guard the devotion of its workers by its foresight and watchfulness lest irreparable harm be done to body and mind both in this gener ation and the next. More than ever in the past should considera tion now be given to the well-being of young girls fresh from school, of the prospective mother, and of the working mother whose care is 46 INDUSTRIAL EMPLOYMENT OF WOMEN. 47 especially claimed by her infant during the first months of its life; for more than ever is their welfare of importance to the nation, and much more than ordinarily is it threatened by conditions of employ ment. 84. Speaking generally, there are five principal matters which, apart from the question of wages, concern the health and industrial output of the woman worker, and which demand the careful and continuous attention of employers in regard to the employment o f women in factories on any large scale, viz, (a) the physical condition and capacity of the woman worker, including the far-reaching issue of maternity; (h) the period of employment (including night work, length of hours, overtime, etc.), and its relation to home duties: (c) the necessity of rest pauses and the convenient provision of meals; ( d ) the s'anitary condition of the factory and the hygiene of the worker; ( e ) questions of management and supervision. The com mittee recognize that certain collateral issues, such as housing, transit, and the means of recreation, are also intimately concerned in the ^welfare of women workers, although they may be somewhat out side the immediate sphere of the employer. The committee have given careful consideration to the subjects enumerated above, and they desire to offer some observations under each heading. They appreciate the exceptional importance of women’s labor in the pres ent emergency, and in the future, and they do not desire to suggest the imposition of conditions which are likely to embarrass employers or restrict the usefulness of women. They confine themselves, there fore, to matters which in their view are both necessary and urgent in the interest of the women themselves, and the industrial output of which they are caj)able. THE PHYSICAL CONDITION OF WOMEN WORKERS. 85. In considering the physical ability of woman successfully to withstand the fatigue consequent upon continued heavy work in a factory it should be remembered that her body is physiologically different from, and less strongly built than, that of a man; that her muscular system is less developed; and that she may have lived a sedentar}7 or domestic life without contracting the habit of taking active and regular exercise. The nature of her work should there fore be determined with due regard to its effect on her immediate and future health. Certain ailments and forms of physical disability to which women are liable are readily caused, or at least accentuated, by inattention to these matters. Among such conditions are: (a) Disturbances of digestion, due to unsuitable food, irregular and hur ried meals or fatigue; (&) anemia with possibly associated disease of the heart and circulatory system; (<~) headache; (d) nervous ex haustion; (e) muscular pain and weakness, flat foot, etc.; and (/) 48 INDUSTRIAL HEALTH AND EFFICIENCY. derangement of special physiological functions. Though these con ditions may not in all cases be immediately incapacitating, they fre quently have a tendency to become chronic in nature and far-reach ing in effect; they lead directly to malnutrition and a reduction of body energy; if allowed to persist they inevitably lay the foundations of ill health and disease in later years; and in some cases they may exert an injurious effect on maternal functions. With a view to the adequate consideration of this subject the committee made arrange ments in 1915-16 and in 1917 for two medical inquiries to be carried out in.various factories where women were employed. The commit tee were fortunate in securing the services of Miss Janet M. Camp bell, M. D., M. S. (one of the senior medical officers of the board of education), in this behalf, and they have received from her most valuable assistance not only in the clear and comprehensive reports of these particular inquiries but in all their consideration of health questions in relation to the employment of women. The report of the first medical inquiry, in which 1,326 women and girls were examined, will be found in the Interim Report (published 1917), pages* 110 to 121; the second inquiry, in which 1,183 women were examined, is reported in Appendix B to the present volume. The medical exami nation of these women workers could not be made as complete or exhaustive as might well have been wished, partly because suitable accommodation for the examination was not always available, partly because the time at disposal was limited (women being summoned from their work), but chiefly because presumably healthy women are naturally shy and hesitant of all medical examination. In esti mating the physical condition and the amount of ftitigue, reliance had to be placed to a large extent by the doctor on statements and descrip tions of symptoms given by the women. The heart, lungs, and abdo men could not be fully examined as a routine in all cases. (For par ticulars of medical inquiry see Appendix B.) As in the previous in quiry the workers were classified into three groups: (A) Normal and apparently free from fatigue; (B) suffering from some fatigue; and (C) suffering from well-marked fatigue. The results in regard to fatigue in the second inquiry were as follows: ‘ England. A (healthy). B (slight fatigue). C (marked fatigue). Number of workers examined. Number. Percent Number. Percent Number. Percent age. age. age. 1........ ................... 2 ........................... 3 ........................... 4 ........ .................. 5............... ........... 6............................ 7 ..................... 8........ .................. 193 264 116 157 199 T3 67 114 110 199 63 112 77 45 35 51 56.9 75.3 54.3 71.3 38.6 61.6 52.2 44.7 70 53 46 41 114 19 30 52 36.2 20.07 39.6 26.1 57.2 26.02 44.7 45.6 13 12 7 4 8 9 2 11 6.7 4.5 6.03 2.5 4.02 12.3 2.9 9.6 Total................................. 1,183 692 58.4 425 35.8 66 5.5 Factory Factory Factory Factory Factory Factory Factory Factory No. No. No No. No. No. No. No. .... INDUSTRIAL EMPLOYMENT OF WOMEN. 49 86. It is interesting to observe in the following table the results of the two inquiries which, in spite of different conditions of the exam ination, are surprisingly similar: Number of Class A (healthy). workers examined. Inquiry No. 1............................... ........... .................. Class B (some fa tigue or illhealth). Class C (marked fatigue or illhealth). 1,326 763= 57.5per cent.. 451= 34.0 per cent.. 112=8.5 per cent. 1,183 No. 692= Inquiry 2 58.5 per cent. . 425= 35.8 per cent.. 66= 5.7 per cent. 87. These tables indicate generally the amount and degree of fatigue observed among typical women workers chosen at random. The following points clearly emerge: (a) The proportion of serious fatigue amounting to marked ill health and incapacity for work is relatively small, approximately 5 per cent to 6 per cent of the cases examined. (b) There is a considerable amount of slight fatigue, which varies from 20 to 57 per cent. (c) The total proportion of women exhibiting definite signs of fatigue is about 40 per cent of all cases. But this percentage does not represent the full burden of fatigue, for the following reasons: (a) Much earlier fatigue is latent and objectively unrecognizable; (b) the women most seriously affected tend to drop out of factory life before they have served for any long period, and therefore are not included; ( c) women knowing themselves to be fatigued were not willing in all cases to subject themselves to examination; and ( d) the examination was necessarily superficial and incomplete, and only such as could detect definite and obvious fatigue, amounting almost to sickness. 88. It might have been anticipated that the findings of the second series of examinations would indicate an increase of fatigue, over strain, or sickness owing to the longer period of work undertaken (nine months or more). On the other hand, the hours of work had been shortened, there had been less overtime and no Sunday labor, and there had been an immense improvement in the conditions of factory life. Dr. Janet Campbell discusses in her report the relation to the health of the woman worker of: (a) the character of the work; (b) the length of hours of work; ( c ) her nutrition and physi cal health; (d) the tax imposed upon her by bad housing conditions and inconvenient means of transit; and ( e ) the “ welfare ” conditions surrounding her at the factory. The committee concur in Miss Campbell’s view of the relative importance of these matters. In spite of long hours and arduous labor there is no doubt that much fatigue is reduced or removed by active incentives to labor, such as interest, a sense of patriotism, higher wages, and a great improve ment in the conditions of labor. 80935°— 19-------4 50 INDUSTRIAL HEALTH AND EFFICIENCY. 89. It is evident that while, physiologically, fatigue may be meas ured by a diminution in the capacity for doing w^ork, it may easily increase to such a degree that it affects the health of the worker. Avil to this point Dr. Janet Campbell and her colleagues turned their attention. The ailments most frequently observed were indi gestion, serious dental decay, nervous irritability, headache, anemia, and disorders of menstruation. Something like a quarter of the women workers examined failed in one respect or another; 7 per cent had throat trouble; 8 per cent suffered from eyestrain; and 0 per cent from swollen feet (see Appendix B). The report states that— Tlie -commonest causes o f indigestion among women are dietetic, e. un suitable or improperly prepared food, the persistent use o f certain unwhole some articles o f diet, such as unduly rich substances or food containing excess o f carbohydrates. Alcohol may be a cause, especially in older women, but this w as not . observed in the present examination. Headache wTas fairly common. It could often be attributed to one or more causes, such as fatigue in transit, noise in the factory, eyestrain, general tired ness, and wras often associated with anemia, indigestion, or carious teeth. Neu ralgia was complained o f by a number o f workers evidently suffering from nervous fatigue. Sleeplessness, especially among women on night shift, was frequently accompanied by headache. Anemia is most common among ill-fed, overworked girls in industrial d is tricts, who have to work in badly ventilated and badly lighted rooms, under conditions which prevent proper exercise, especially in the open air and sun shine. A large number o f the workers classed G showed signs o f more or less severe anemia, frequently accompanied by hsemic murmurs. A higher percent age was noted in one or two factories where it w as mainly due to prewar rather than postw ar conditions* such as chronic malnutrition or work in artificial light. The improved diet and the usually healthy factory environment liave no doubt acted as preventives o f anemia, and as far as can be judged on gen eral grounds, munition workers compare favorably in this respect with young women w orkers in other trades and industries. Indigestion, constipation, anemia, and headache are so closely associated that it is often difficult to say which is primary and which secondary. That all depend in considerable degree upon environment and habits o f life, and they are remedied less by drugs or direct medical treatment than by improved hygiene and nutrition. Sunshine, fresh air, exercise, good food, and sufficient sleep are the most potent factors in the restoration to health. Mitxfidar pains, including aching or stiffness o f the neck or limbs, are naturally common during the early weeks at the factory until the workers become habituated to unaccustomed muscular exercise. Among more expe rienced workers muscular pains may be complained o f tow ard the end o f a shift or attributed to a particular operation. They may indicate the com mencement o f fatigue in the worker or that the work is unduly heavy or otherwise unsuitable. Nervous symptoms, such as neuralgia, irritability, nervousness, sleeplessness, or an undue tendency to w orry were complained o f by many women who were beginning to feel tired and worn. The symptoms were dependent on the gen eral state o f health rather than upon any organic defect. INDUSTRIAL EMPLOYMENT OF WOMEN*. 51 *90. The committee are relieved to find tliat the results of these inquiries indicate that, although for the reasons given in paragraph 87 (c) above, the amount of existing fatigue and sickness probably exceeds in considerable degree that discovered by the investigators, the women and girls emploj'ed at these factories are as a whole bear mg the strain of their munition work remarkably well. The commit tee concur in the conclusions stated by Dr. Janet Campbell, viz: (1) That there is a definite burden of fatigue, which though rela tively small in amount as regards severe fatigue is considerable as regards that of a less severe character; (2) That the fatigue and ill health are less than might have been anticipated liaving regard to the hours of work and the nature of the employment, and that this is due, broadly speaking, to the greatly improved attention to the health and welfare of the workers; (3) That fatigue and sickness are greatest where heavy work is combined with long hours at the factory and associated with onerous domestic duties after factory hours; (4) That unless brought under control, the considerable amount of moderate weariness and ill health now present is likely to reduce immediate efficiency and also exercise in many cases an injurious effect on subsequent health and on capacity for maternity; (5) That although there has been substantial improvement in the conditions and circumstances of women’s work in factories, further action is necessary if the amount of fatigue is to be diminished rather than increased. In particular the findings of this inquiry seem to .indicate the necessity— (a) For further shortening of the hours of labor for women; (b) For restricting women’s work in the heavier branches of in dustry to those who are young, physically fit, and capable, and who have not arduous home duties to perform; {£•) For the continuation and development, wherever women are employed in factories, of hygienic conditions and especially “ wel fare ” arrangements (including industrial canteens) ; and ( d) For making appropriate provision for effective medical super vision, both on entrance to the factory (in heavy and exceptional oc cupations) and subsequently, by means of the services of medical officers (women preferred) and nurses, and in the form of suitable accommodation as to rest rooms, first-aid appliances and wellequipped surgeries. 9L Maternity .—The employment of large numbers of women of child-bearing age has also raised the problem of maternity and, ow ing to causes associated directly with the making of munitions, it is apt to become acute and urgent in an unusual degree. The over crowded condition of many munition areas and the abnormal influx 52 INDTJSTKIAL HEALTH AND EFFICIENCY. of women into these *areas naturally strain to the breaking point the always inadequate provision for maternity which exists locally. The impression the committe have gained from inquiries at numerous factories and among many of those responsible for the supervision and welfare of the workers is that though the problem in an acute form is limited to a relatively small proportion of women workers, there is somewhat urgent need for immediate action in regard to the care of those expectant mothers, married and single, who are unable to make suitable arrangements for themselves. 92. The care of the mother naturally falls into three stages—pre natal, natal, and postnatal. Prenatal .—The married woman with a home of her own usually leaves the factory in the early months of pregnancy, or at least as soon as her condition becomes obvious. No special provision is re quired for her apart from the provision for women as a whole. A certain number of women, however, are obliged to work almost until their confinement as they have no other means of livelihood. In filling factories it is usual, on account of the danger due to explosion or the handling of poisonous materials, to discharge a woman as soon as she is known to be pregnant. In engineering factories the practice varies. Where the work is heavy and it is not possible to transfer women to lighter processes they may be discharged as soon as their condition is recognized. Where lighter work is available and the general environment suitable they may be retained until, say, the seventh or eighth month. There is the further difficulty of suita ble accommodation for the pregnant woman awaiting confinement. Natal.—Again, the number of lying-in homes and hospitals is notoriously inadequate to the needs of the country as a whole. In many overcrowded munition areas the workhouse is the only institu tion to which women can go for their confinements, an arrangement naturally repugnant to most women. Nor is there always available sufficient or skilled midwifery and nursing attendance. Postnatal .—Thirdly, the postnatal care of the mother’s own health is complicated by the need for suitable arrangements for her child. Practical questions, as Dr. Campbell points out, soon present them selves: “ Where is she to live?” “ How is she to support herself until fit to resume factory work?” “ What is to become of the child whilst she is absent night or day ? ” The only statutory provision which relates to the employment of pregnant women or nursing mothers is section 61 of the Factory and Workshops Act, which states that a woman must not be employed within four weeks of giving birth to a child. It is obvious that the mother’s first duty is to her young infant and that in the interests of its health she should not return to the factory until the expiration of a much longer period than INDUSTRIAL EMPLOYMENT OF WOMEN. 53 four weeks. But she may have to choose between remaining with her baby without adequate means of support or returning to wellpaid work as soon as possible, even though this entails virtual sepa ration from the child. A breast-fed infant is more likely to thrive than one which is brought up by hand, but an ill-nourished mother is either unable to nurse her baby or continues to do so only at undue cost to herself. Until the State is prepared to recognize the claims of nursing mothers to assistance and financial aid the lesser of the two evils may be for the mother to go back to work as soon as she is physically fit to do so, provided that she can insure the care of the baby during her absence. 93. It appears that the practice in regard to the employment of mothers with young infants varies in different factories. In some, with a view to encouraging breast feeding, no woman is supposed to be employed who has a child under 9 to 12 months of age. In others, no general rule exists and cases are judged on their merits. In some, no attention is paid to the age of the child. It is, of course, impossi ble to investigate all cases fully, and a woman who is badly in need of employment has often little difficulty in evading inquiries. Children are thus commonly left with relatives or “ minders,” or sent to a day nursery when there is one. 94. Dr. Janet Campbell has submitted for our consideration the following maternity scheme for the assistance of munition workers: (a) Skilled supervision o f pregnant women is necessary, both factory and domiciliary, by a qualified and competent officer, in order to ensure that suitable a r r a n g e m e n t s a r e m a d e for t h e confinement at h o m e or in lodgings (engagement o f the m idwife or doctor, antenatal care, postnatal care, etc.) and fo r the care o f the infant after birth. Such an officer would be able to bring the woman into touch with local agencies for assistance. She would also encourage thrift and proper preparation for the confinement. This supervision might be arranged by the w elfare staff o f the factory, though in large factories an extra officer with midwifery qualifications might be desirable for home visitation, etc. ( b ) The provision o f light employment may be made available inside or outside the factory during the later months o f pregnancy, say from the 4th or 5th to the 8th or 9th month, and also after the birth o f the child. In some fa c tories this might be arranged as part o f the general organization, in other fa c tories all the work is too heavy or the general conditions too unsatisfactory to admit of pregnant women being employed at least after the early months. In such cases separate workrooms would be necessary, which might serve more than one factory, where lighter work such as sewing and mending might be undertaken (e. g., the sewing o f exploder bags, the making o f lighter boxes, the manufacture o f overalls, etc.). Such small separate departments might also be used by other women tem porarily ailing from one cause or another. (c ) Favorable welfare conditions are essential for all pregnant women, in cluding the abolition o f night work and, where possible, reduction in the length of the day shift. Arrangements for an adequate supply o f suitable food, includ ing milk, through the canteen or otherwise, is also advisable. ( d ) Maternity homes should be established for women who cannot be con fined at home or in their lodgings. These institutions should also provide, 54 LRDUSTPJAL HEALTH AXD EFFICIENCY. where necessary, fo r preconflneinent residence and lying-in accommodation. Maternity homes might be organized— (i) As a branch o f an existing lying-in ^hospital available for normal and abnormal cases; or (ii) as an ad hoc matermaty home o f six or a dozen beds in charge o f a competent mid wife. In connection with these homes, but not necessarily under the same roof, there should be accommodation for women before and, if necessary, -after con finement. Arrangements should be available for married or unmarried women, and as far as possible the schemes should be self-supporting. Exchequer grants w ould be necessary for the establishment o f such homes and also to make good deficits in the -cost <jf w orking and maintenance, but the greater part o f tlie maintenance expenses should fee met by payments from the women themselves. ( e ) Lastly, in many districts a creche or day nursery is necessary for the children where they may be cared for during absence o f the mother. The num ber o f available “ minders ” to whom children would ordinarily have been sent has steadily diminished, largely because these women have themselves sought regular employment. Mothers working long shifts are physically unable to devote a.s much attention as they would wish to the care o f theig* homes and children. There is thus a substantial case for an increased provision o f nur series which would take charge of children under school age by day and, if necessary, by night. 95. Sympathetic administration is essential to the success of such a scheme, the aim and intention of which is to encourage the women to report their condition at an early stage and to afford them such ad vice and assistance as are needed without exercising a burdensome or inquisitorial supervision. 96. The committee consider this scheme valuable and suggestive. They are glad to know that in many munition works successful effort has been made on these lines, and they are satisfied that a similar scheme is feasible for industrial women workers generally.1 1 A woman welfare supervisor in a national ordnance factory has written to the com m ittee as follo w s: “ A pregnant woman in this faet-ory is expected and encouraged to see me, that I may assure myself that her work is not harmful to tier in any way. FTtte is questioned as to her home circumstances, aad permission to put her in touch with tke medical officer of health is asked. This, if granted,, insures her a visit from the inspector of midwives staff, who sees that a suitable midwife is, or will be, engaged. Provided that the work on which the woman is engaged is not injurious to her, she is retained its long as possible. In many cases a woman has worked on her lathe until the eighth month of pregnancy, Others require to be transferred quite early to lighter employment such as disk oiling and cleaning, hammerhead crane driving, or in the overall department. “ During enforced absence before confinement, if the worker’s income is insufficient, her case is brought before a small subcommittee of the hospital and benevolent fund, and a grant made to her of 7s. 6d. or 10s. '[$1.83 or $2.43] weeldy. After the birth of the child in the case of a married woman, in consideration of the health insurance benefit of 60s. [$ 1 4 .6 0 ], the allowance from the fund stops for four weeks and is not re sumed until the child is three months old, when the mother is reinstated at her old work. I have fixed that period of absence, as I find that once nursing is established during tii-ese -months, it is possible it may be partially continued with good results to both mother an.d child. If not continued, the three months’ nursing is of inestimable value to the child. Another reason I advocate these three months’ absence is, that the work is heavy for a recently confined woman. “ The case o f the unmarried mother presents greater difficulties, and more individual &t»dy -and care is required. It is a great anxiety to me to obtain tlie necessary knowl edge early enough .to be able to assure the girl that care will be taken of her .during her pregnancy and help given her in Tier trouble. My experience -convinces me that serious consequences to the health of many girls have arisen from their fear of facing tfee situation. I have found that once her confidence is gained and the girl understands that for her child’s sake she is entitled to every care, a much happier .and healtkiex INDUSTRIAL EMPLOYMENT OF WOMEN. 55 97. The Ministry of Munitions decided, in 1916, to make special grants in aid of the establishment and maintenance of nurseries for the children of munition workers as follows: (a) A grant of 75 per cent of the approved expenditure on the ini tial provision and equipment of the nursery. (b) A grant of 7d. [14.2 cents] for each day or night attendance made by the child of a munition worker. It has been arranged that the board of education, as the depart ment charged with the administration of grants in aid of ordinary day nurseries, should be responsible for the inspection of munition nurseries and for advising the ministry in regard to the provision of schemes and payment of grant. The number of munition nurseries wholly or partly occupied by the children of munition workers is nov? 81. In most cases the nurseries are open by night as well as by day for the benefit of women working on night shifts. 98. It is sometimes suggested that the nurseries should be in or close to the factory, so that a mother may be able to nurse her baby during the dinner interval. On the whole the committee think that it is not usually desirable to have the nursery in close association with the factory, however, partly because this entails bringing babies and little children night or morning in trains or trams which are often already overcrowded. Further, the usual interval of an hour is scarcely sufficient for the mother to get her own meal and feed her baby unless a dinner can be provided for her at the nursery. Though arrangements have been made for a few individual eases nothing has been attempted in a general way. Probably in certain exceptional cases some provision is also needed for the younger children who are able to attend school but are too young to look after themselves during school hours while the mother is at work. A few children’s “ hostels ” have been established through voluntary en terprise, to which such children may go for all meals and for play state of mind and body exists. Should there be no home care available for the girl during her confinement, the only place for her in this town is the workhouse infirmary. Under these circumstances we generally manage to keep her at quiet work until very close to her confinement, and she is admitted to the infirmary immediately on applica tion. “ I have never deviated from my rule regarding the three months* absence from the factory after confinement, even in the case of the homeless girl, but some arrangement has always been made for her care and well-being. Friends have been found for her and she has had a weekly grant from the hospital and benevolent fund, also advice and help given her a§ to putting her in the way of receiving maintenance from the father of her child. I have, at different times, brought in a girl, whose case has been difficult to deal with, to work as cleaner in the canteen on days only. The baby comes with its mother and lies (in summer) in a cot on the veranda. This works very well. The baby thrives and is a source of interest and joy to the factory girls. I have always found that the help given to a girl in her trouble has a wonderful result in improving her character and deepening her sense of maternal responsibility. “ The problems in work such as this are many and all different and have each to be considered under no very hard and fast lines, but I hope I have outlined the maia points sufficiently clearly to show our aims and ideals.” 56 INDUSTRIAL HEALTH AND EFFICIENCY. and recreation, small payments being made by the mothers to cover the cost of the food. 99. In this connection the committee consider it is desirable that the lifting and carrying of heavy weights1 and all sudden, violent, or physically unsuitable movements in the operating of machines should, as far as practicable, be avoided. Often a simple appliance, or the alteration of a movement, modifies an objectionable feature when it does not altogether remove it. By similar thought and care much may be done to mitigate the strain of prolonged standing, which should be restricted to work from which it is inseparable.2 Prolonged standing has been found a highly provocative cause of trouble to women and girls. When standing is absolutely unavoid able, the hours and spells of employment should be proportionately short, and seats should be available for use during the brief pauses which occasionally occur while waiting for material, or for the ad justment of a tool. Where so much depends upon the character of a movement, upon the angle and position at which a weight is lifted or carried, it is not advisable to lay down a standard of prohibited weights. But serious accidents and injuries to health have been caused in factories in the past by the excessive carrying of weights, and it is trusted that employers will give this matter their earnest consideration, especially in view of the heavy work which now de volves upon women in factories.3 PERIODS OF EMPLOYMENT AND HOME DUTIES. 100. Night work .—The imperative necessity of war has revived, after almost a century of disuse, the night employment of women in factories, with its associated economic, physical and moral disabili ties. In a working-class home, however, the difficulty in obtaining rest by day is great; quiet can not be easily secured; and the mother of a family can not sleep while the claims of children and home are pressing upon her; the younger unmarried women are tempted to take the daylight hours for amusement or shopping; moreover, sleep is often interrupted in order that the midday meal may be shared. The employment of women at night is, without question, undesirable, yet now it is for a time inevitable; and the committee have, there fore, directed their efforts to the consideration of those safeguards which would reduce its risks to a minimum. 101. In practically all factories where night shifts are worked it is customary to change the shifts weekly or fortnightly. The frequent 1 For further observation on weights, see paragraphs 4 1 8 -4 2 4 . 2 See medical evidence on the grave effects of long hours of standing on the health of women, given before the Select Committee on Ships, 1895 (p. 219, answers 5401 to 5 4 0 6 ), and the effects of industrial strain on the working woman (Trans. Fifteenth Inter national Congress on Hygiene and Demography, Washington, 1912, vol. iii., pt. 2, p 9 3 3 ). * Report of Departmental Committee on Accidents, 1911 (Cd. 5 5 3 5 ). INDUSTRIAL EMPLOYMENT OF WOMEN. 57 change of shift has proved more convenient and acceptable to the women than more prolonged periods of night or day duty. The importance of adequate pauses for rest and meals during the night is now fully realized; arrangements for the comfort of the women have steadily improved and most women have learned the advantage of suitable and substantial food when on night work. 102. While the urgent necessity for women’s work remains, and while the mother’s time, and the time of the elder girls, is largely given to the making of munitions, the home and the younger children must inevitably suffer. Where home conditions are bad, as they are ’frequently, where a long working day is aggravated by long hours of traveling, and where, in addition, housing accommodation is inade quate, family life is defaced beyond recognition. If the home is to be preserved from such processes of destruction reasonably satis factory conditions of transit and housing must be secured, as well as the best possible hours of work by night and day. It has been far from uncommon to find some two or three hours spent on the journey each way, generally under the fatiguing conditions of an over crowded train or tram, often with long waits, and a severe struggle before even standing room could be obtained. Often, far from offer ing a rest from the fatigue of the day, the home conditions have offered but fresh aggravation. A day begun at 4 or even 3.30 a. in., for work at 6 a. m., followed by 14 hours in the factory, and an other two or two and a half hours on the journey back, may end at 10 or 10.30 p. m., in a home or lodging where the prevailing degree of overcrowding precludes all possibility of comfortable rest. Beds are never empty and rooms are never aired, for, in a badly crowded district, the beds, like the occupants, are organized in day and night shifts. In such conditions of confusion, pressure, and overcrowding, home has had no existence. 103. Though much has been now done to remedy these conditions, there is still a great need for improvement in means of transit, and this alone would help to relieve the unsatisfactory conditions of housing; but, however great the increased facilities of service, the journey between home and factory must still add, in many cases, a couple of hours to the working da}^ When considering hours in relation to efficiency and fatigue this influence upon the total length of day should be remembered; the factory day can not always stand by itself as the only contribution toward fatigue. 104. Happily there should be in the matter of hours of labor for women little conflict between the interests of the home and the inter ests of munitions, for the hours which conduce most to a satis factory home life and to health conduce most to output. Long hours, particularly when they are worked during the night, are among the chief factors in fatigue, and the committee are of opinion that in 58 INDUSTRIAL HEALTH AND EFFICIENCY. the interest of output and health alike they should be restricted within proper limits; that there should be suitable pauses for rest during the working period; and that there should be adequate cessa tion from work at each week end in addition to periodic holidays. It may be stated broadly that conditions which press hardly upon the average man press, because of her different constitutional develop ment, with greater severity upon the average woman; while, simi larly, though conditions of mental fatigue are probably equally in jurious to boys and girls, conditions of muscular strain well borne by the ordinary boy may be highly detrimental to the girl of corre sponding vigor and physique. It is therefore especially important* that women and young girls should be relieved from those conditions of overstrain to which they have been so widely exposed. 105. Since the early days of the war the tendency has been toward the reduction of the weekly total of hours worked and the length of the shifts. The overtime system which was then common has now been practically abolished and the weekly hours for women limited to 60 or less. In order to avoid undue fatigue an increasing number of firms have three eight-hour shifts in the place of two of 12 hours. Though not always easy to organize from the factory point of view, when accompanied by an adequate minimum wage the system of eighthour shifts appears to yield the best results in the long run. On the one hand the machinery is used for the maximum part of the 24 hours and effort is better sustained throughout the shift. On the other hand, less strain is put upon the worker, with a resulting reduction in the amount of ill health, disability, and lost time. The special strain of night work is imposed less frequently, and^ partly for this reason, a class of labor is attracted which would otherwise be unrecruited. It has been suggested that in certain districts, and for certain industrial processes, it may be possible, during the stress of the war, to employ married women on half time, in two or more shifts daily of four or five hours each. The committee recognize that such a system possesses its own inherent difficulties, which may, however, not prove insurmount able. ARRANGEMENTS FOR REST AND MEALS. 106. Pauses, well distributed and adapted in length to the needs of women workers, are of the highest value in averting breakdown and in giving an impetus to output. The factory acts permit in tex tile factories a maximum of four and a half hours continuous work; in nontextile the limit is five, but many managers believe that four hours is the longest period during which a woman can maintain con tinuous work at full vigor. Within this period a pause of 10 minutes has been found to give excellent results, and where the spell is con tinued for five hours some such pause should certainly be made for a cup of tea or cocoa. It is particularly valuable in the morning INDUSTRIAL EMPLOYMENT OF W O M E I. 59 spell in those numerous cases where breakfast has been hurried or omitted altogether. The proper arrangement of intervals for food needs special consideration in filling factories, where work on some of the high explosives seems to create a special feeling of hunger. Here there is the added reason that a well-fed person is the better able to resist the influence of poisonous materials. Facilities should be provided, especially during the night shift, for rest in cases of faint ing or other temporary illness. Rest rooms are now frequently found in well-equipped works; they usually consist of a few comfortable chairs and a camp bed for the more serious cases, placed in the surgery or rest room now being provided by many employers. A nurse is gen erally m attendance, whose assistance may be claimed by men and women alike. 10T. The week-end rest has been found to be a factor of such impor tance in maintaining health and vigor that it has been reinstated by employers who had taken it for work at the beginning of the war. The committee are strongly of opinion that for women and girls a portion of Saturday and the whole of Sunday should be available for rest, and that the periodic factory holidays should not, on any account, be omitted. Where women are employed on eight-hour shifts an in terval of half an hour for a meal may be regarded as normally suffi cient, but where longer hours are worked, it is important that they should be allowed an hour for dinner and for the principal meal dur ing the night. Indigestion can not easily be avoided if a substantial meal is followed immediately by work without an intervening period for rest. Half an hour, especially in large factories, and in filling factories where the actual consumption of food in the danger area is prohibited, provides but scant time even for the eating of the meaL Ten minutes are easily spent in reaching the mess room and return ing to work, certainly another five are occupied in washing the hands and the service of the dinner; and so but 15 remain for the meal. The provision of well-managed and suitably equipped canteens in convenient proximity to the workrooms has now been made in a large number o f factories and the mess-room accommodation and arrange ments for heating the workers’ own food have been much improved. These are available both night and day at suitable hours. The com mittee desire once more to emphasize the importance of providing seats with backs and similar amenities with a view to securing the comfort and relaxation of the workers. THE SAOTTAEY COlTDITIOlSf OP THE FACTOBY. 108. The effect upon the health and energy of women and girls which results from clean, bright, and airy workrooms, well warmed in winter, can hardly be exaggerated. The factory act secures a mini 60 INDUSTRIAL HEALTH AND EFFICIENCY. mum of these essential things, but the highest standard attained in the best factories is not too high. Women desire these things in their working hours, and appreciate and respond to.a good environ ment. Cleanliness and good order contribute to increased output as well as to the discipline and morale of the factory. The provision of washing accommodation has become increasingly important. The refreshing effect of washing and its influence on self-respect, espe cially where women are heated by their work, have been dwelt upon by many witnesses who have given their evidence before the com mittee. For those processes in which poisonous substances are used, such, for example, as the filling of shells and fuses with high explosives, special regulations for washing have been framed.1 It is a great convenience when the lavatories and cloakrooms can be grouped with the canteens. The lavatories should be of sufficient size to accommodate all those workers from a room or department who cease work at the same time, and must be properly equipped and maintained. If suitable facilities are easily accessible and are suffi cient to enable the workers to wash without undue encroachment upon their mealtimes, experience shows that they are much appre ciated and fully used. 109. Cloakrooms should also be provided, and wherever possible should be near the canteens and lavatories. It is of importance that they should afford facilities for changing clothes and boots and for drying clothes. The cloakrooms should be kept scrupulously clean.2 110. The provision of adequate and suitable sanitary accommo dation is a matter of special importance. The necessity for proper equipment and maintenance of cleanliness, privacy, and convenience of access should be borne in mind. It is the more necessary to call attention to this matter since in man}^ instances women are now employed in factories where, until recently, there have been male workers only. The conveniences for women should be so situated as to be readily accessible at all times, with due regard to the privacy of the approach; they should be adequate in number, suitably planned, and of sound sanitary construction. A high standard of cleanliness must be maintained, and it is desirable that an attendant shall be in charge of the conveniences throughout the period of employment.3 MANAGEMENT AND SUPERVISION. 111. sity of vision works The committee have received abundant evidence of the neces wise and suitable arrangements for the management and super of women’s labor. Their personal visits to large and small where women and girls are employed, as well as the evidence 1 For further consideration of the provision of washing facilities see paragraphs 392-404. 2 For further suggestions as to cloakroom accommodation see paragraphs 411-412. •For further suggestions as to sanitary accommodation see paragraphs 388-391. INDUSTRIAL EMPLOYMENT OF WOMEN. 61 placed before them, have led them to the opinion that there is hardly any condition of greater importance than this, in respect both of smooth working and of maximum output. The modern development of commercial undertakings, not to speak of the vast size of many factories, precludes the personal oversight and interest of the respon sible employer and makes it all the more necessary to appoint efficient substitutes. This is particularly important in regard to the occu pation of women unaccustomed to the organized factory life, business methods, and discipline of large engineering shops often with unsuitable accommodation for women, difficulties of discipline, and long hours. Briefly the committee recommend that in all cases where women are employed consideration should be given by the management to the appointment of forewomen, nurses, and welfare supervisors, whose position and status should be properly assured and whose duties should be prescribed. In this way provision is made for each woman worker to have ready access to an officer of her own sex in case of difficulties occurring in regard to her work, her health, or the conditions of her employment. Surgeries for the treatment of minor as well as serious accidents, rest rooms for workers temporarily incapacitated, are of special importance where women are employed. “ Welfare supervision,” in its broadest sense, which has abundantly proved its value to both management and workers, is essential for women workers if their well-being is to be fully safeguarded. 112. The ultimate purpose of wise supervision is twofold. First, there is the purpose of securing sound and helpful conditions of labor, under which the employer obtains diligence and skill from those in his employ, and the worker is occupied, healthily and not unreason ably, to his own satisfaction and to the best of his capacity. Here, without doubt, the highest interest of employer and worker is one and the same. There is, or should be, satisfaction and advantage on both sides. A second purpose of supervision is economical manage ment and the accurate adjustment of energy applied to the end in view. The committee have been interested to observe the diverse operation of these purposes in connection with the health of women workers, and have decided that it was desirable to investigate further a point which had much'impressed them, namely, the apparently large amount of “ wastage ” of women workers in munition factories. It was reported to them that large numbers of women were drifting in and out of factories without sufficient reason, and they sought the aid of Capt. M. Greenwood, the statistician, in endeavoring to find an explanation of this phenomenon. Accordingly he made investi gations 1 in 16 factories, or parts of factories, employing altogether 1 Dr. Greenwood’s memorandum on The Causes of Wastage of Labor in Munition Factories employing Women is being published, as a special report, by the Medical Research Committee. m INDUSTRIAL HEALTH AKD EFFICIENCY, gome 40,000 women workers. An abstract of his report will be found in Appendix D. Briefly his conclusions are: .(■a) That of 37,000 women workers under observation for at least a month, illness or physical unfitness or incapacity was given as a cause of leaving work in 1,651 cases, the lost workers owing to ill health being practically the same at all ages in “ light ” factories, but increasing at the age of 22 years in “ heavy” factories. In oth<j;* words, girls over 23 years of age have fewer sickness losses in “ heavy ’’ than in “ light ” factories-; (b ) That in sum total the “ wastage” is substantial, and such dis continuance of employment appreciably reduces output; ■(c) That much of this “ wastage ” is inexplicable; of 11,000 women who left work as many as 6,700 gave no adequate reason for so doing; (d) That, whilst prevention appears obscure, the remedy is organ ized welfare work, including intelligent and sympathetic following up of absentees. The committee concur with Capt. Greenwood’s recommendations that wherever any factory loses more than 20 per cent of its en trants within three months a special inquiry should be instituted, and that older women (who more usually have home duties) should be put on lighter work in order to reduce the double demand made upon them. 113, Clearly, everything possible should be done to reconcile tlie woman’s conflict of interests between her duties to her home or chil dren and her work in the factory. Wherever other labor is available the employment of mothers with infants is to be deprecated, as is also that of the mother of any young family, for it must be remem bered that the mother’s work is certainly not ended with her factory day. Her children make many claims upon her time and energy, more especially, of course, at the period of the midday meal and at bedtime. In some factories the majority of the women employed at night are married, and many of them express a preference for their work because it leaves them free for domestic work during the day. In thus undertaking double duties their zeal may easily outrun their strength, and factory and home equally may suffer. Where married women are indispensable every effort should be made to give them the preferential treatment common, in normal times, in some factory districts and also in France. It is the experience of managers that concessions such as half an hour’s grace on leaving and arriving, or occasional “ time off,” is not injurious to output, as the lost time is made good by increased activity, and under the system of 8-liour shifts it might be arranged, without industrial dislocation of any kind, that married women are employed only in $hat shift which would cause least dislocation in their home. For organization of this kind, as well as for the care of young girls individually during the INDUSTRIAL EMPLOYMENT OF WOMEN. 63 first few months of their employment, the welfare supervisor has proved herself to be invaluable; she can secure short periods of rest or such interchange of occupation as tends to lessen either the spell of muscular fatigue or the continued exposure to an injurious proc ess. Her supervision possesses particular value during night shifty when ordinary supervision tends to become relaxed, CONCLUSION. 114. Finally, the committee desire to state their considered opinion that, if the maximum output of which women are undoubtedly capa ble is to be secured and maintained for an extended period, the fol lowing essentials must be provided fo r : (a) Short hours of work with suitable shifts, pauses, and intervals; (£) Adequate and suitable medical supervision, including the pro vision ©f rest rooms, surgeries, and first-aid appliances, properly staffed1; (c) The careful selection of women for work within their capacity, the heavier work being allocated to the younger women; ( d) Good and sufficient food obtainable at convenient times; women appear to require food and refreshment more frequently than men and always before commencing work in the morning; (e) A suitable factory environment; women are probably more susceptible than men to the benefits of effective ventilation (including ample fresh, moving air), sanitary accommodation, and convenient washing facilities; ( /) Sympathetic management and tactful supervision. 115. The committee recognize that emergency conditions must obtain in many cases, but they are satisfied that every effort should be made to organize women’s labor effectively and promptly. The committee take the view that to use up or damage its women by over strain in factory work is one of the most serious and far-reaching forms of human waste which a nation can practice or permit. It may be that in the entanglement of problems new and old the coming of the new and their imperative claim for solution will help the solving of the old. There is impulse now as there was impulse long ago when the eause of the children in the cotton mills of Lancashire won the early factory acts for the generations that followed. There is need now as there was need then. There is need for the work of women in industry; there is need also for safeguarding that service. Happily there is manifest a public spirit and a devotion able to overcome diffi culties and solve problems. There is also a fuller recognition of the claims of women and of their children and of their vital importance to the State, which is reward for the sacrifice and courage of those women now working steadfastly in the ranks of labor. SE CTIO N V .— H O U RS OF L A B O R . LEGAL RESTRICTIONS ON HOURS OF LABOR. 116. The Factory and Workshop Act, 1901, imposes certain restric tions on the hours of employment of protected persons; that is, of women and young persons (i. e., boys and girls between 13 and 18 years of age who are legally exempt from attendance at school). The following are the principal provisions bearing on employment in non textile factories: (a) The hours o f employment o f protected persons on the first five days of the week are not to exceed a fixed daily period o f 12 (including l i hours for m eals), and on Saturday 8 hours (including one-half hour for m eals). The period o f work may commence at 6 a. m., 7 a. m., or 8 a. m. That is to say, the maximum weekly hours o f employment, exclusive o f mealtimes, are 60. (Sec. 2G ( i ) , (ii) , ( iii).) (&) Sunday labor is forbidden. (Sec. 34.) (c ) Protected persons may not be employed continuously for more than 5 hours without an interval o f at least one-half hour for a meal. (Sec. 26 (iv ) .) (d) Women may be employed in certain industries for 2 hours overtime in addition to the ordinary hours on any day except Saturday: Provided, That an additional one-half hour is allowed for meals after 5 p. m .; that no woman is so employed for more than 8 days in any 1 week, and that the number o f days in the year on which any woman is employed on overtime shall not exceed 30. (Sec. 49.) No similar exception is allowed for young persons. (e ) Night work is not allowed for women and girls, but is allowed for boys over 14 if employed in certain specified trades, e. g., blast furnaces and iron mills. (Sec. 54.) No restrictions are placed upon the hours of employment of men. 117. Section 150 of the act provides that— In cases o f any public emergency the secretary o f state may, by order to the extent and during the period named by him, exempt from this act any factory or workshop belonging to the Crown, or any factory or workshop in respect o f work which is being done on behalf o f the Crown under a contract specified in the order.1 118. Under this provision orders have been made by the Home Office allowing relaxations of the limitations set out above. These orders are of two kinds— (a) General orders setting out the conditions under which women and*young persons may ordinarily be employed 1 By regulations made under the Defense of the Realm Act, and dated June 10, 1915, and October 3, 1916, the power of the secretary of state is extended to any factory or workshop in which he is satisfied that by reason of the loss of men through enlist ment or transference to Government service, or of any other circumstances arising out of the present war, exemption is necessary to secure the carrying on of work and that it can be granted without detriment to the national interests. 64 HOURS OF LABOR. 65 in munition works (the last general order w^as issued in September, 1916); (&) Special orders authorizing variations of the general order in particular cases. 119. Under section 6 (i) of the munitions of war (amendment) act, 1916— The Minister o f Munitions shall have power by order to give directions * * * (subject, so far as the matter is one which is dealt with by the factory and w ork shops acts 1901 to 1911, to the concurrence o f the secretary o f state) as to hours o f labor or conditions o f employment o f the female workers so employed. 120. No order has as yet been issued under this section, hours of emplo3^ment continuing to be dealt with under the factory acts. A committee, including representatives of the Ministry of Munitions, of the Home Office, and of other departments concerned, has been estab lished at the ministry to consider special applications for permission to work on Sundays 'or for exceptional hours. WEEKLY HOURS OF EMPLOYMENT. 121. Prior to the war the weekly hours of employment of women and young persons were as a rule substantially below the limits im posed by the factory and workshop act. This was due, partly to the action of employers who believed that shorter hours were desirable from the point of view of health and output, and partly to the action of the trades-unions in regard to the hours of adult male workers. In the engineering trades the normal weekly hours of adult male workers were, as a rule, about 52 to 54, though in a few instances they were as low as 48. These normal hours were generally liable to extension (overtime) to meet special emergencies. Since if overtime were to become a regular practice the value of the normal day would largely be lost, it was usual to restrict overtime by requiring wages at a higher rate for the additional hours and by limiting the additional hours which might be worked in a given period. Thus the agreement exist ing at the outbreak of war between the Engineering Employers’ Fed eration and the engineering trades-unions concerned provided that overtime should not exceed 30 hours a month. The establishment o f the normal working day for engineering trades is not entirely a modern development. As early as 1836 the London engineers secured the normal 60-hour week with additional wages for overtime, and more than 50 years ago the principle o f a normal day and overtime was already widely recognized. 122. At a very early stage of the war the ordinary restrictions on hours of employment were widely relaxed. Sunday labor, previously forbidden for women and young persons, and practically unknown for men except in a few continuous processes, became common. Night employment, which for 50 years had been abolished entirely S0935°— 19------ 5 INDUSTRIAL- HEALTH AND EFFICIENCY. for womea and- in the main for boys became regular. The strain of these hours, in itself severe, was increased through large numbers of men and women taken into employment being unaccustomed to such labor, or being physically less able to bear the strain than the selected body of workers previously employed. The difficulties of housing and transit became accentuated and the conditions of em ployment were frequently makeshift and inconvenient. The em ployment of men for TO to 90 hours a week was common,, for over 90 hours was not infrequent, and there were even eases of hours in excess of 100. The highly skilled workers (tool and gauge makers, tool-setters,, etc.) were generally the most difficult to obtain and were thus most frequently employed for long hours. These hours were defended on the ground that— (a). The dearth of workers and other causes prevented an}^ general adoption of the shift system; ( b ) The demand for output was urgent and immediate, and had to be met even at some risk of future breakdown; ( c ) Patriotism introduced a new incentive which rendered unre liable all previous experience as to the number of hours which could be successively worked; (d) Even though the rate of output might be reduced, and the cost o f working increased, these long hours did result in a larger output than short hours would have done. 123. The evidence, however,, showed that the long hours are open to certain serious objections: (a) They are liable to impose too severe a strain on the workers; (b) At any rate, after a period, the rate of production tends to de crease, and the extra hours produce proportionately little or no addi tional output; moreover, the quality of the output may be adversely affected during the whole period of work, and not only during the hours of overtime; (c) A large proportion of the hours gained may be lost through broken time; the workers become exhausted and take a rest; sick ness tends to increase, at any rate among the older men and those of weak constitution; (d) They lead to an undue curtailment of the periods of rest and sleep available for those who have to travel long distances to and from work;. ( e ) The fatigue entailed increases the temptation of men to in dulge in the consumption of alcohol; they are too tired to eat. and therefore seek a “ stimulant.” (/) A very serious strain was imposed upon the management, the executive staff, and the foremen, both on account of the actual length of the hours worked and of the increased anxiety over the main HOUES OF LABOR. 67 tenance of tlie output and quality of the work; the staff can not take days off like ordinary workers* 124. Whatever may have been the justification for the long hours worked, they undoubtedly imposed a severe strain on the workers, as evidenced by the following statements made by trades-union repre sentatives : Some of his men had been working from G a. m. to 9 p. m. These hours were undoubtedly a severe, strain and some men were just at the limit o f their powers. They stayed away for a day or two to rest, but did not see a doctor if they could help it. The men were reaching the “ fed-up ” stage. They were getting nervous and irritated through working long hours. They could not keep up their physical efficiency; he could see it in their faces. Men on overtime were more tired* They were liable to have time fo r only about five hours’ sleep. The excessive hours now being worked were too much for the men. They led to a diminished output per hour. Men were continually having to stop w ork in g; they were obliged to rest, it was not a question o f slackness. For fear o f being called slackers they hesitated to get a doctor’s certificate. 125. Though, as stated, the long hours thus undoubtedly placed severe strain upon the workers, the committee did not find that they had caused any serious breakdown among workers. This was in some measure due to the tendency, after a time, to reduce hours. Further, there was good reason for believing that the increased pay and better food which workers were able to enjoy helped to counteract the strain of long hours* There is little doubt, too, that workers were stimulated to make special effort by an appreciation of the national importance of their work. These influences have been thus, summarized by a trades-union official: (1) W ill pow er: Men have continued at w ork in a condition that under ordi nary circumstances would have put them off for a week or two. Even when a man comes off for a time he is anxious to get back again as quickly as possible. I have had one or two cases o f serious breakdown. The main factor is that practically all the men want to do their best. (2 ) Better wages mean better food fo r a large number o f men w ith families, and they mean a little better provision for those families, whieh again reacts upon the man’ s health and his work. In these cases it is not so much the saving or possibility o f saving money, but the satisfactory spending o f it, which is the factor o f importance. (3 ) The possibility o f getting more money has also its effect. You read much about the slacker. There is quite a large proportion o f workmen really too anxious for overtime— employers will corroborate— even tmder normal conditions. 120. It would, however, have been a mistake to depend too largely on the operation of influences of these kinds, or to hope that they could continue indefinitely to be effective against fatigue. The com mittee was satisfied that if workers were to be asked to work for any* thing approaching 15 hours a day for weeks and months on end, one 68 INDUSTRIAL HEALTH AND EFFICIENCY. of two results must follow—either the health of the worker would break down, or they would not work at full pressure. 127. While the committee, at an early stage of their inquiries, were convinced as to the urgency of recommending some limitation of hours, it was a matter of serious difficulty to determine what limita tions to recommend. Not only was there an almost complete absence of any scientific data as to the relation of hours of employment to output, but the evidence of witnesses differed widely as*to the limits which might properly be imposed. 128. Men .—This conflict of opinion was specially marked as re gards hours of adult male workers. On the one hand, those who had been employing their workers for 15 hours a day, sometimes with Sunday work in addition, stated with confidence that such hours were not excessive, that they had been worked in times of peace, and that they could not be reduced without loss of output. Amongst those who favored the longer hours were to be found some of the largest employers of labor, and whatever their views might be as to the ulti mate gain from the reduction of hours, they hesitated to incur the responsibility for any reduction of output, since such reduction, even though temporary in character, might, owing to the large number of workers involved, prove serious in bulk while it lasted. As a repre sentative of one of the largest firms in the country said: Once a reduction was made it was impossible to go back to the previous posi tion. In consequence one must be sure of the ground before making experi ments. Previous experience is not a complete guide on this occasion, because patriotism is a new and important factor. 129. On the other hand, witnesses, many of whom had devoted a close study to questions of industrial fatigue and scientific manage ment, were emphatically opposed to overtime, except for quite short periods. As regards overtime, be did not consider it efficient, nor was it profitable, if paid for at one and one-half rates. It did not induce any increased output, except when working for a short spell to attain a definite object. I f continued for a long period the tendency of. overtime is to reduce rather than to increase output. The strain caused by the work is a mental rather than a physical one. The monotony o f always being at one job was also productive o f fatigue. In his opinion, the greatest economical efficiency o f engineering labor is ob tained with a week o f 48 to 55 hours. Longer hours, in the long run, meant a diminished output, inferior quality o f work, and much greater cost o f produc tion. Though attending to heavy machinery might involve periods o f rest from physical strain, it involved mental strain, owing to the amount of damage caused if anything went wrong. 130. Between these two extreme views a middle course was also advocated. It allowed a maximum of 10 to 12 hours of overtime a week. Thus a large employer of labor, who was also engaged in organizing national factories, expressed the view: HOUES OF LABOR. 69 Definite restrictions should be placed on overtime. No workman ought to w ork for more than 80 hours in any one week, or to maintain an average o f more than 65 hours a week. 131. Similar views were expressed by trades-union representatives: W here there is overtime beyond two hours daily there is evidence o f fatigue and men can not be employed economically, from health and production point of view, on continuous overtime o f three and four hours daily. Fatigue is rarely reaching the point o f breakdown, but does affect health and production, and in my opinion will manifest itself later. In some cases where such overtime is worked; apart from night shifts, men are allowed one early night per week, and I think this is wise and economically sound. The witnesses were inclined to think that, to meet the present abnormal cir cumstances, men should be able to work as much as 60 to 65 hours a week over a long period. The exact length o f hours would necessarily depend on the character o f the work. Thus 65 would certainly be too high for gauge makers. The hours at night involve greater strain and should not exceed 60. Even these hours were justified only by the present crisis, and were no criterion o f what was reasonable and proper in ordinary times. 132. In the agreement between the Engineering Employers’ Fed eration and the engineering trades-unions already referred to a simi lar limit was adopted. 133. Boys .—In the case of boys the evidence showed that the hours of employment were largely determined by the fact that they fre quently worked with men. The Home Office had found it necessary to sanction the employment of boys for 671 hours a week, and for even longer periods in special cases, the period of the working day being extended to 14 or even 15 hours, as compared with the 12 hours allowed by the factory and workshop act. Though as in the case of men no substantial breakdown occurred there w-as no doubt that the hours worked in many cases involved a serious strain. Dr. Agnew, as a result of a medical examination of 1,500 boys employed in all parts of the country and under varying conditions of employment, reported as follows: My general impression is that hours tend to be too long for the proper preser vation o f health and efficiency. Large numbers o f boys are working a net average of 68| hours per week. Under certain conditions the effect upon their health is not so deleterious as in others, but, whatever the conditions, where more than one hour has to be spent in going to and from the factories, in my opinion, 68^ hours are too many. Many o f these boys are just over 14 years old, and they spend considerably more than two hours per day in traveling, thus having very little time for recreation or for rest. The natural bent o f most o f us is to revolt against a yoke o f any kind in modern times. This is just what happens. The boys have found from experience that they can not com fortably work over 60 hours per week, and as evidence o f this— in one shop where 600 boys worked, 500 o f them on a Saturday afternoon did not return to work. The same state o f affairs, with a few exceptions, is found up and down the country. On the night shifts, boys do not tolerate well long hours, and in one factory a very large percentage o f the boys complained o f sleepiness and disin clination for work. It has to be borne in mind that the average age o f the 10 INDUSTRIAL HEALTH AN]> EFFICIENCY. boys- examined w ould certainly not exceed 15 years, and it makes one consider very seriously tlie future o f the rising generation. 134. A social worker with considerable experience of bo}^ labor in munition works informed the committee that— So far as he knew, there had been no general breakdown, but then he did not expect to see im mediate effects* notwithstanding the long distances that some boys had to travel. He suggested, however, that the boys are drawing on their strength, and pointed to the fa ct that the boys fall asleep in the trains and trams, and often travel on beyond their stations. They have no leisure, no recreation, and no classes, and he w as very anxious as to what w ould become o f the boys after the war. He suggested that too b ig a price was being paid for output. Even the hours allowed under the factory acts were very lenient. The granting o f relief at the week end was a great boon. 135. In considering what hours of employment are reasonable for boys, it is necessary to distinguish between boys under 16 years of age and those over. A witness with wide experience expressed the view that— Boys between. 16 and IS w ere quite different from boys under 1 6 they were much stronger. Boys under 16, on the other hand, were probably more delicate than girls o f the same age, and more likely to break themselves up. The essen tial safeguards were the reduction o f hours and w elfare work. Apart from the strain on the health involved, long hours had disastrous effects upon the char acters o f boys. They also might make an adequate amount o f sleep difficult and, perhaps most im portantr they prevented adequate facilities for recreation. Such facilities were o f primary importance both for the physical and the moral w elfare o f the boys. T h is latter dangei was accentuated by the monotonous character o f their work, which afforded no intellectual interest. In the absence o f healthy recreation the boys’ minds and conversation were likely to become unhealthy and to lead to a general deterioration in character. Eight hours o f sleep at least were essential, nine hours would be better. Unfortunately many boys got only six: or seven hours. 136. Women .—Important as it is that the hours of work for men should be kept within reasonable limits, it is essential that hours of work for women and girls should be even more closely safeguarded. Admittedly women and girls are unable to bear the strain of long hours as well as men. Conditions which press hardly on the average man, press, because of difference in constitutional development, with greater severity upon the average woman. Under the general order issued by the Home Office in September, 1915r women and girls over 16 years of age were allowed to be employed up to 67^ hours a week. While this order applied to the great majority of munition works, permission was granted in special eases for between 70 and 80 hours a week. The maximum hours of daily employment was extended to 14 hours as compared with 12 hours allowed under the factory acts. 137. Though, as in the case of men and boys, no serious breakdown of health can be pointed to, the committee were left in no doubt as to the strain involved. H OURS OF LABOR* 71 A medical exam ination1 which w7as conducted of over 1,300 women selected from varying types o f work in different parts o f the country showed that though for various reasons no general breakdown had then occurred, there un doubtedly existed a serious amount o f strain. Only 57 per cent were classified as healthy as compared with 78 per cent in the case o f a similar examination of m en ; even if full allowance is made for variations in the standard adopted by different medical officers, the difference between these tw o percentages is still significant. In one factory where the women were employed for 77 hours weekly, 15.5 per cent o f the workers showed evidence o f marked fatigue and it was reported that the workers were practically unanimous that the hours should be shortened. 138. Many witnesses expressed the opinion that the hard work was telling on the women though they were keen to work, feeling that they were performing a patriotic duty. Though some employers sought for permission and used to the full power to employ women for more than 65 hours a week, the majority limited their application to that figure. Moreover inquiries showed that in many factories the maximum hours were not worked continuously. Employers sought permission for a wider limit of hours than was ordinarily necessary or desirable in order that they might have latitude for dealing with special emergencies. 139. The nature of the evidence available made it clear to the com mittee that any recommendations they put forward in regard to the limitation of weekly hours of employment must necessarily be tentative and provisional in character. Moreover, if the recommendations were to be of practical value, and secure any wide measure of ac ceptance, it was necessary that they should satisfy two essential con ditions. First, they had to be such as would be regarded as reason able and moderate by the great mass of employers and workers, and secondly, while taking account of the probable duration of the war, they had to have regard to the immediate urgency of output at that time. Any recommendations which might involve even a temporary diminution of output would have been doomed to failure. It was evident in fact that any reduction of hours proposed must be gradual, and the committee accordingly based their recommendations on what appeared to be immediately practicable, rather than on what was ultimately desirable, or might be defensible on a physiological basis. Further, they found it necessary to confine themselves to suggestions as to the maximum limits within which weekly hours of employ ment should be restricted, and they did not endeavor to set out the extent to which, in their opinion, it was necessary or desirable to reduce these limits to meet varying industrial conditions. 140. The limits of the weekly hours of employment provisionally suggested in their Memorandum No. 5 (Hours of W ork), which was prepared in January, 1916, were: 1 See Committee’s Interim Report (Cd. 8511), pages 110-121. 72 IN D U STRIAL H E A L T H AND EFF IC IE N C Y . (a) For men, that the average weekly hours of employment should not exceed 65 to 67 (exclusive of mealtimes), i. e., a 13 to 14 hour working day. (b) That boys under 18 should be allowed to work the same hours as men, provided that— (i) The hours of boys under 16 should be limited to 60 so far as possible; (ii) Substantial relief at the week ends should be insisted on; (Hi) Night work should be limited as far as possible to boys over 16. (c) That for women and girls employment should be restricted within the normal legal limit of 60, i. e., a 12-hour working day, though within these limits moderate daily overtime might be al lowed, and that the employment of girls under 18 at night should be limited as far as possible. 141. These recommendations were generally accepted as fair and rea sonable and were widely adopted. In September, 1916, the Home Office, after consultation with the Ministry of Munitions, issued a new general order reducing the maximum hours of work for women and young persons which had been allowed in the previous general order. Under this order which was based upon the recommendations of the committee—■ ( a) The employment o f women was limited to the 60 hours a week per mitted under the factory and workshop act, though within this limit night work was allowed and work fo r not more than 14 hours (including mealtimes) instead o f 12 on any one day. The employment at night o f girls between 16 and 18 was only allowed in special circumstances where the superintending inspector o f factories was satisfied that the work was suitable and o f a specially urgent character. The employment o f girls under 16 at night was not per mitted at all. (fc) The hours o f employment o f boys over 16 were limited to 65 by day (excluding mealtimes) and 63 by night. Night work for boys under 16 and their employment fo r 65 hours by day was only permitted where the superin tending inspector o f factories was satisfied that the urgency o f the work and other circumstances made it imperative that they should do so. 142. The order made the relaxation of the requirements of the fac tory act subject to the fulfillment of the following general conditions: ( a) Employment on night shifts shall be subject to the provision, to the satisfaction o f the factory inspector, of proper facilities for taking and cook ing meals, and in the case o f female workers, for their supervision by a wel fare worker or a responsible forewoman. ( b) No woman or young person shall be employed continuously at any time for more than five hours without an interval o f at least half an hour, except that where not less than one hour is allowed for dinner, an afternoon spell o f six hours may be worked, with an interval o f quarter o f an hour only for tea, if the factory inspector is satisfied that adequate provision is made for the workers to obtain tea in the works and for tea to be actually ready for them as soon as they stop work. H O U ES OF LABOR. 73 (c ) I f w ork commences before 8 a. m. and 110 interval is allow ed for break fast, an opportunity shall be given to take refreshm ent during the morning. ((?) A woman or young person shall n ot.b e allowed to lift, carry, or move anything so heavy as to be likely to cause injury to the woman or young person. (e ) D ifferent schemes o f employment may be adopted and different intervals for meals fixed fo r different sets o f workers. 143. In a covering circular the Home Office stated that— The order which .fixes the maximum lim its o f hours does not discrim inate be tween the various form s o f w ork carried on in munition factories, and subject to these lim its it is fo r the occupier to decide, having regard to the nature o f the work, the time taken by the w orkers in getting to and from the factory, and other circumstances, what are the best hours to be adopted at his particular works in order to secure the maximum efficiency and output over a long p e r io d ; and lie is empowered by the order to fix different schemes o f hours for different sets o f workers. Further, it w ill be necessary fo r occupiers to instruct managers and forem en to w atch closely how each scheme w orks in practice. Experience shows that some slight alteration or adjustm ent in the hours o f work, such as, fo r example, the rearrangement or extension o f the meal intervals or, in cases where overtime is worked, a short cessation oc casionally from overtime, may be sufficient to check staleness or fatigue and cause a marked improvement in the w orkers’ efficiency. 144. Since the issue of the order the Home Office and the ministry have taken other steps to reduce hours. Special concessions have been withdrawn notably as regards the employment of women for more than 60 hours a week and the employment at night of girls between 14 and 16. In addition action is being taken which is result ing in the steady abolition of the employment at night o f girls be tween 16 and 18. Special concessions as to the employment at night of boys between 14 and 16 are also being reduced. 145. As already stated the recommendations originally put for ward were only provisional, and the evidence which has since ac cumulated has shown the necessity for their revision. From the commencement of their work the committee have attached the highest importance to the collection of exact data affecting the problems at issue. The field to be covered is a very wide one, while the process o f collection has been slow and laborious. The com mittee, however, consider that the data which have already been col lected on their behalf by Dr. Vernon and others are of great prac tical value and demand the most serious attention. The results of these investigations are the more valuable in that they have been undertaken in the workshop and not in the laboratory, solely in a spirit of scientific investigation and with no preconceived opinions. The selection of factories for inquiry was based entirely on the likelihood of reliable data being forthcoming. Further, in none of the operations studied was there any change in the nature of the operation or the type o f machinery during the period under review. IN D U ST R IA L H E A L T H A N D E FF IC IE N C Y . H The data were so chosen as to eliminate any possible disturbance due to increasing skill. There is no reason to suppose that the data were vitiated by any artificial restriction o f output. On this last point Dr. Vernon reports— When the hourly outputs o f individuals are plotted on a diagram, the distribution in the m ajority o f operations is roughly symmetrical, persons who exceed the value reached by the largest group being about as numerous as those who fall short o f it. In certain operations ( “ d ra w in g ” and “ rectify ing ,r cartridge cases) where the machine itself places an upper limit upon the possible speefl o f production, the shape o f tl>e diagram was different, the num ber that exceeded? the output most frequently attained— what may be termed the fashionable or Mmodal ” value— being much smaller than that which fell short o f it. A corresponding result w as obtained for women sorting cartridge cases, when paid at tim e rates, but for sim ilar operatives when paid at piece rates the symmetrical distribution w as once more observed. It is accordingly contended that the form o f distribution, whether approxim ately symmetrical or asymmetrical, may be a useful test as to the existence o f lim itation o f out put, and that in the m ajority o f the operations here studied no such lim itation occurred. The following diagram was prepared by Dr. Vernon to show the variation in output of women turning fuse bodies:— 40 vtZO tu uQ N .10 0 ns us iss m relative hourly output 146. The result of Dr. Vernon’s investigations, which covered a period of over a year, are set out in memoranda Nos. 12 and 18*1 but it appears desirable shortly to set out again the principal results o f his investigations in so far as they concern the relation of weekly hours of employment to output. The following are the four sets o f data which bear on this subject: 147. During the period November 14 to December 19 Sunday work (eight hours) was done on five out of six Sundays; during the 1 Ca. 8344 and Cel. 8628. ♦ HOURS OF LABOB. 75 eight weeks ending on July 2 on three Sundays, the nominal weekly hours in these three weeks being 66.5 instead of 58.5, an average of 61.5. During the period ending December 16 the timekeeping was bad, the normal weekly hours of work averaging about 55. Dr. Vernon accordingly suggests that with good timekeeping a nominal 50-hour week ought to yield the same actual hours of work (namely, 45.6) ; that is to say, that for women engaged in moderately heavy lathe work a 50-hour week yields as good an output as a 66-hour week, and a considerably better one than a 75-hour week. T able I.—NINETY-FIVE OR 80 WOMEN * TURNING ALUMINUM FUSE BODIES. W eek ending— N o m i P er cent of tim e lost per week as— nal hours of w ork B roken Short Absent per w eeks. weeks. Total. tim e. w eek. F eb . 27-A p r. 16......................................... 74.8 64.3 M ay 14................ ........................................ M ay 21.................... ..................................... M ay 28.......................................................... .Tune 4 _ , . _______ _________ __________ June 11.............. .......................................... .Tune 18......................................................... June 25......................................................... July 2 ........................................................... July 9 ........................................................... July 16......................................................... July 23......................................................... July 30.......................................................... A u g. 6 ........................................................... •Vug 12 A u g. 19......................................................... 58.5 66.5 66.5 66.5 58.5 58.5 58.5 58.5 62.5 52.5 51.0 66.5 62.5 49.5 49^5 8.2 5.9 ■ 2.1 6.0 1.3 5.1 A ctual hours of w ork per week. 11.6 17.0 5.4 2.6 3.0 11.0 4.6 3.9 1.1 9.6 • 7.1 7.1 3.3 17.5 58.5 1 58.5 \ 58.5 56.5 J 5.8 5.5 2.6 r 1 13.9 | I R e la tiv e ou tpu t per w orking hour. 66.2 53.4 100 123 55.8] 58.5 56.1 59.1 54.8 51.0 50.3 53.1 54.2 56.0 48.5 50.0 45.6 56.2 48.6 47.0 40.3 4 3 !0 130' 128 132 136 134 137 142 133 133 126 134 132 135 128 122 124 126 121 48.611 f 1 51.3 49.9 ) 52.6 47.2 I I 136' 133 >135 128 143. H ours o f w ork X relative output. 6,620 (= 1 0 0 ) 6,568 ( = 99) 7,343 (= 1 1 1 ) 2 .......................................................... 9 ....................................... 16........................................................ 23........................................................ Sept. 30........................................................ 29.5 24.0 136 O ct. 7 ............................................................ O ct. 14.......................................................... O ct. 21...................................................... O ct. 28.......................................................... N ov . 4........................................................... N ov. 11......................................................... N ov . 18......................................................... N ov . 25......................................................... D ec. 2 ........................................................... D ec. 9 ........................................................... D ec. 16......................................................... D ec. 23......................................................... 58.5 58.5 58.5 54.5 58.5 53.5 58.5 50.0 49.5 58.5 58.5 29.5 43.5 49.2 52.0 4 8 .3 46.9 50.0 44. r 48.8 41.8 45.6 41.6 48.8 48.8 24.5 1371 146 153 144 132 152 143 141 156 158 152 174 179 149 ■ 6.0 7.5 2.8 16.3 ? • 6.5 8.3 2.0 16.8 I T otal o u tp u t on ly 1 p e r c e n t less than in pre-Christm as period , th ou gh w eek ly hours of w ork are 12.8 less. T o ta l o u tp u t reaches a m a x im u m 11 per cent greater than that of pre-Christm as p eriod , though w eekly hours of w ork are 11.4 less. W orkers w ent on to n ight shift for three weeks. 6,737 ( -1 0 2 ) H ou rly ou tp u t rises again to th at of th© M ay-June p eriod, b u t a b olition of Su n day labor has n ot yet h ad an y ob v iou s effect. Fu rth er four d a y s’ h olid a y (general h olid ay, b y G ov ernm ent ord e r). 6,955 (= 1 0 5 ) F u rther rise of h ou rly ou tp u t due to h olid ay and to ab olition of S un day labor. 7,205 (= 1 0 9 ) Influen ce of shorter hours and of abolition of Sunday labor n ow w ell established. T ota l ou tpu t 9 per cent greater than it was a year ago, though w eek ly hours of w ork are 20.6 less. 1 T h e figures show n in the table d o not represent the ou tpu t of the same n um ber of w om en . In N ovem b er the n u m ber of w om en w hose o u tp u t w as being studied was 95, b u t A u gust, 29 had d rop p ed out. T o the rem aining 66 w om en were added 14 others, m aking the total from that tim e on 80, instead of 95. (See H ealth of M unition W orkers Com m ittee: M em orandum N o. 18, p . 4.) % O 8 S £ r* wW > F all of ou tp u t m ay be due to slackness resultant on d ep rivation of usual h olid a y . N o m ore Sunday labor after A u g . 6. H o lid a y for a w eek (to com pensate for loss of W h it suntide and A u gu st h olid a ys). A u g. 26......................................................... Sept. Sept. Sept. Sept. R em arks concernin g output. rh W ;> % a w M Q Table II.—FORTY WOMEN MILLING A SCREW THREAD. W eek ending— 1.3 4.1 2.4 1.7 9.6 11.7 f ■ 4.9 4.3 1 .6 1 0 .8 • 7.1 5.5 2 .6 15.2 : 1 j) i 1 jJ 5.2 3.5 .7 9.4 f 1 ) [ f 6 .2 i j 7.9 2 .0 I 16.1 ] I H ours o f w ork X relative output. 64.9 55.4 62.5’ 63.1 40.6 46.3 •54.6 51.9 56.8 54.8 59. Si 55.6 53.5 •54.8 50.5; 29.5 38.1 100 109 113' 111 118 113 •114 118 114 109j 118 122 121 . 119 127j 123 122 51.11 f 47.5| J 38.51 45.5 1 45.0J I 26.4 44.8 49.31 48. 7 49.5 48.1 49.9 43.1 48.3 1 2 1 ]| 126 1 2 1 1171 12lJI 119 110 1321 132 139 133 130 134 129 R em ark s concerning output. 6,490 (= 1 0 0 ) 6,039 ( = 93) 6 ,224 ( = 96) (T otal ou tp u t reaches its m axim u m , 2 p er cen t m ore 6,631 ( = 102) ^ than in N ovem b er-D ecem b er p eriod , though ( w eek ly hours of w ork are 1 0 .1 less. (R ed u ction of hours ow ing to tem porary shortage of \ m aterial. H olid a y for a w eek. 5,506 ( = 85) 6 ,397 ( = / N o im m ediate response to abolition of Su n day labor, ( so total ou tp u t falls considerably. LABOBk 57.0 51.0 44.5 48.5 29.5 54 5 54.5 58.5 55.5 58.5 58.5 58.5 5.9 5.9 R e la tiv e o u tp u t per w ork in g hour. OF 71.8 62.9 .66.5 6 6 .5 55.0 55.0 50.5 66.5 62.0 • 6 6 .5 6 6 .5 6 6 .5 59.0 33.5 44.5 A ctu a l hours o f w ork per w eek. EOXJES N ov. 21-D ec. 19......................................... Feb. 27-A p r. 1G....................................... M ay 28.......................................................... June 4 ........................................................... June 11......................................................... June 18......................................................... June 25......................................................... July 2 ............................................................ Julv 9 .......................................................... July in .......................................................... J u ly 23.......................................................... July 30...................................................... A u g. 6 ....................................................... A u g. 1 2 ......................................................... A u g. 19......................................................... A u g. 20......................................................... Sept. 2 .......................................................... Sept. 9 ...................................................... Sept. 10........................................................ Sept. 23...................................................... Sept. 30........................................................ O ct. 7 ........................................................ O ct. 14.......................................................... O ct. 21...................................................... O ct. 28.......................................................... N ov . 4........................................................... N ov . 11......................................................... N ov . 18..................................................... N o m i Per cent o. tim e lost per week as— nal hours of w ork Broken Short A bsent per Total. weeks. weeks. w eek. tim e. (T otal o u tp u t on ly l ’per cent less than in N o v e m b e r99) ^ D ecem ber p eriod , th ou gh w eekly h ours of w ork [ are 16.8 less. -a •4 IN D U ST R IA L H E A L T H A N D EFF IC IE N C Y . 148. D r . V e r n o n e x p la in s th a t th e r e a s o n w h y a r e d u c t io n o f h o u r s d id n o t le a d t o a n im p r o v e m e n t o f t o t a l o u t p u t s im ila r t o th a t in th e fu s e -b o d y t u r n in g o p e r a t io n is th a t f o r fo u r -fift h s o f th e t o t a l tim e r e q u ir e d to m ill th e s c re w t h r e a d o n th e fu s e b o d y th e o p e r a t iv e h a d n o o p p o r t u n it y o f q u ic k e n in g h e r w o r k in g s p e e d , s in c e sh e h a d m e r e ly to s ta n d i d l y w a t c h in g h e r m a c h in e , wrh e re a s th e la th e w o r k e r h a d to a p p ly se v e n d iffe r e n t c u t t in g a n d b o r i n g t o o ls in su cce ssio n t o e a c h fu s e b o d y , a n d c o u ld q u ic k e n u p h e r sp e e d o f w o r k a t a lm o st e v e r y sta g e. T able H i;—F IF T Y -S IX W eek ending— N ov . 14-D ec. 19............ .. F eb . 27-Apr. 1 G................. M ay 28.............................. JlITlO 4 ............................... J unc 11................................. June 18................................ June 25............................. July 2.................................... July 9.................... 1 ............. July 16.................................. July 2 2 .................................. July 29.................................. AU£?. 5 ................................... A u g. 12............................. A u g. 19................................. A u g. 26................................. Sept. 2 .................................. Sept. 9................................... Sept. 16............................ .. Sept. 23................ '........... Sept. 30. O ct. 7.................................... O ct. 14.................................. O ct. 2 1 .................................. O ct. 28.................................. N ov . 4 .................................. N ov . 11................................. N ov . 1 8 ........................... ... N ov . 25.............................. . D ec. 2.................................... D ec. 9.................................... D ec. 16.................................. D ec. 23................................. MEN. S IZ IN G FU SE Per cen t of tim e lost per. N om w e e k as— inal hours o f w oxlc Broken Short A b sen t per T otal. weeks. weeks. tim e. w eek. 66.7 62.8 66.o 63.5 58.5 53.5 . 58.5 58.5 61.0 66.5 55.5' 58.5 53.2 31.0 39.5 58.5 58.5 44.5 53. 5 29 5 54. 5 54.5 55.3 51.8 58.5 58.5 56.0 55. 2 54.5 58.5 58.5 29.5 \ 5.6 8 .6 2 .8 5.8 5.2 8.3 .9 5 .2 9.0 2.7 5.6 4.8 1 .1 1 .6 .9 6 .6 5.0 .7 9.9 J \ 4 -1 I 4.2 A ctual hours of w o rk per week. R e la tiv e H ours of o u tp u t per w ork X rela w ork in g tiv e o u tp u t. hour. 1 2 .8 19.6 4.4 5.2 | B O D IE S . 58.2 50. o 54.91 . 55.8 : 49.9 4=6.0 ■52.1 ; 14.4 51.2 48.3 51.7 59.1 • 47. 6 16.9 • 45.9 ■46.3 ■ . 45.3 27.8 33.0 109 122 1171 122 118 119 119122 118 112 120 119 124 • 123 126 130 136 r I 11.5 ) | 131]| 1351 [ 135 13311 139! 135 1331 142 138 r 137 133 138 138 136 135 140 i 139 141 146 136 51.6] f 49.21 4-7. 6 I 40.11 1. 49.4j [ 2 S. 2 51.3] 51.4 50.2 51.3 47.7 55.7 : 53.3 50.6 50.7 51.2 49.1 50.6 53.0 27.1 5> 820 (= 1 0 0 ) 6 ^ 161 (==106) 6 ,, 200 (= 1 0 7 ) 6 ,42& (-1 1 0 ) 7,028 (=-121) 7,117 (=122) 149. D u r in g th e p e r io d e n d in g D e c e m b e r 1 6 , th e n o m in a l w e e k ly h o u r s w e r e s u b s ta n tia lly less th a n d u r in g th e p e r io d e n d in g A p r i l 16, b u t o w in g to t h e c e s s a tio n o f S u n d a y la b o r th e t im e k e e p in g w as- so m u c h im p r o v e d th a t th e a c tu a l h o u r s o f w o r k w e r e g r e a te r th a n d u r in g th e e a r lie r p e r io d . HOURS OF LABOB. T able IV.—FIFTEEN YOUTHS BORING TOP CAPS. Statistical period^ Nkjv:. 15-D ec. 15:............ Jan. 3,-Feb, 13................. Fed). 21-A p r.. Mk. M ay 1-M ay 28................ M ay 21kJ u ly 2 . .............. July 3-S ept. 23 (d&y shift-);. Jufy 2 -S ep t. 23 (night shift); Sept. 25-D ec. 16 (d a y shift). Sept. 24-D ec. 16 (night shift). N o m P e r cent o f tim e lo st as— . W e e k s in inal' whichA ctual: hours hours o f Sun day of AbB to* w o rk p er labor , Short w o rk , sent Total. . k en w eek. was waeks. per w eeks. tim e. perform ed. week. 3»& 5.8 5.4 5 .8 1 ,9 s 5.5 . 4.0; 7:& 1 .0 8.5 5 .8 2.3 , 13.5’ 3.0 2.3 1 1 .1 5.3 ■. 7l2r 3.9 * " 2 *2 * ir . 6 5.'Out:af 5 .. 4 out of 6 . . (To u t a£ 8 . . 2 out of 4 .. Ol ou t o f 51. 2 out. of 6 . . 78*5 75.5 6314 61.5 51,1. 59.7 0 o u t of 6 _. 61.6 . 2 . 6 0 out af 6 . . 54.8 3.7 7.3 0 out of 6 . . 58.2 2.7 ...... '~~i.T 4.8- 1.4* a. 8 1 1 .0 3.3 6 .0 R e la tiv e ou tp u t parw ork in g hour. 72. & 69.1. 5 4 .8 ;: '54.7. 47.4! m 106 1£& 117 m 52.8) lo4v5 5 6 .2j | 128) ( 12al\m \ H ours of w o rk X relative output. T,250 ( — 1 0 0 ; 7,325 ( - 1 0 ! ) 6,400 88) 7,030 ( = 97) [ 126l= 48.7) \12& 6,514 ( = 90) k5L7 { 5 4 .7\ 126 150. T h is p r o c e s s is la r g e ly a u t o m a t ic ; in c re a s e o f o u t p u t c o u ld o ® iy b e a tta in e d b y a m o r e c o n t in u o u s fe e d in g o f th e m a c h in e s t h r o u g h o u t w o r k in g h o u rs. 151. S p e a k in g g e n e r a lly , th e a b o v e d a t a s h o w t h a t a r e d u c t io n in th e w e e k ly h o u r s o f a c tu a l w o r k , v a r y in g f r o m 7 t o 2 # h o u r s p e r w e e k , in mo case r e s u lte d in m o r e t h a n an in s ig n ific a n t d im in u t io n o f t o t a l o u t p u t , w h ile o n th e a v e ra g e it p r o d u c e d a s u b s ta n tia l in cre a se . A s D r . V e r n o n p o in t s o u t, th e c la s s ific a tio n o f th e o p e r a t io n s a c c o r d in g t o th e p o s s ib ilit y th e y o ffe r f o r sp e e d in g -u p - p r o d u c t io n d e m o n s tr a te s a n ew th e s e lf-e v id e n t fa c t th a t th e a lte r a tio n s o f h o u r s m a y h a v e v e r y d iffe r e n t e ffe cts in d iffe r e n t o p e r a tio n s . T h e e x a c t m e a su re o f s u ch a lte r a tio n s ca n n o t b e p r e d i c t e d ; it c a n o n ly b e a s c e r ta in e d b y o b s e r v a tio n a n d e x p e r im e n t. I t a p p e a r s e v id e n t, h o w e v e r,, t h a t f o r p ro c e s s e s s im ila r t o th o s e e x a m in e d b y D r . V e r n o n th e w e e k ly h o u r s ca n a d v a n t a g e o u s ly b e r e d u c e d t o a t o t a l o f fr o m 50 to 55 h ou rs,, a n d h e s u g g e s ts th a t e v e n lo w e r lim its m ig h t g iv e a n e q u a lly g o o d o u tp u t. 152. T w o fu r t h e r p o in t s o f im p o r t a n c e e m e rg e f r o m c o n s id e r a t io n o f th ese d a ta - I n th e firs t p la c e th e r a te o f p r o d u c t io n c h a n g e d g r a d u a lly , a n d fr e q u e n t ly fo u r m o n th s e la p s e d b e f o r e an e q u ilib r iu m v a lu e w a s r e a ch e d . T h is g r a d u a l c h a n g e a p p e a r s to. n u l l if y th e s u g g e s tio n th a t th e e ffe c t u p o n o u t p u t o f th e c h a n g e o f h o u r s w a s a m e re co n s e q u e n ce o f th e d e sire t o e a r n th e sa m e w e e k ly w a g e s as b e fo r e th e h o u r s w e r e s h o r te n e d . T h e e x p la n a t io n is r a th e r t o b e tr a c e d t o th e w o r k e r fin d in g u n c o n s c io u s ly a n d g r a d u a lly b y e x p e r ie n c e th a t lie ca n w o r k m o r e s tr e n u o u s ly a n d q u ic k ly f o r a s h o r t -h o u r w e e k th a n f o r a lo n g -h o u r w eek . I n th e secon d ' p la c e th e e v id e n c e s u g g e s ts th a t a c o n s id e r a b le in c re a s e i n th e a v e ra g e h o u r ly o u t p u t is p o s s ib le , q u it e a p a r t f r o m a n y in c re a s e d r a p id it y o f w o r k in g . T h u s , as th e r e s u lt o f s p e c ia l in v e s tig a tio n s , D r . V e r n o n fo u n d th a t in th e c a s e o f th e first b o d y o f w o r k e r s m e n tio n e d a b o v e t h e tim e lo s t in c o m m e n c in g a n d s t o p p in g 80 IN D U STRIAL H E A L T H AND EFF IC IE N C Y , w o r k d u r in g th e first p e r io d a v e r a g e d 37 m in u te s as c o m p a r e d Avith o n ly 26^- m in u te s d u r in g th e t h ir d p e r io d . (S e e C d . 8G 28.) 153. P r o f . L o v e d a y , in h is m e m o r a n d u m o n T h e C a u ses a n d C o n d it io n s o f L o s t T im e , w h ic h is in c lu d e d in th e c o m m it t e e ’s in te r im r e p o r t o n I n d u s t r ia l E ffic ie n c y a n d F a t ig u e ,1 a lso s u p p lie s v a lu a b le d a ta , th o u g h o f a s o m e w h a t d iffe r e n t c h a r a c te r . I n th e first p la c e , h e p o in t s o u t th a t th e p r o p o r t io n o f lo s t tim e th a t is d u e t o sick n e s s a n d o th e r u n a v o id a b le ca u se s is, as a r u le , g r e a t ly u n d e r e s tim a te d in f a c t o r y r e c o r d s , a n d th e p r o p o r t io n d u e t o sla ck n e ss c o n s e q u e n tly o v e r e stim a te d . I n th e s e c o n d p la c e , h e e x p r e s s e s th e v ie w th a t lo n g h o u r s , m u c h o v e r tim e , a n d e s p e c ia lly S u n d a y la b o r , e x e r t a p e r n ic io u s e ffe c t u p o n h e a lth , p a r t ic u la r ly o f p e r s o n s o c c u p ie d in h e a y y tra d e s. I n p a r a g r a p h 33 ( 5 ) o f th a t m e m o r a n d u m h e g iv e s t w o ta b le s, th e fir s t d e a lin g w it h a b o d y o f a b o u t 180 m e n , a n d th e s e c o n d w it h b e tw e e n th re e a n d fo u r h u n d r e d m e n e m p lo y e d o n h e a v y w o r k , th e ir n o r m a l h o u r s b e in g f r o m 65 t o 70. I n b o t h th ese ca ses, w h e n c o m p a r is o n is m a d e w it h th e fig u re s o f lo s t tim e f o r J u n e , 1915, a n d f o r a y e a r la te r, th e fa c t e m e rg e s th a t th e re w a s a m a te r ia l in c re a s e in th o a m o u n t o f lo s t tim e , a n d t h a t b y f a r th e la r g e r p o r t io n o f th e in c re a se w a s d u e t o r e c o r d e d sick n ess. I n b o t h ca ses, t h r o u g h o u t , r e c o r d e d sick n ess r e p r e s e n te d a n o t ic e a b ly h ig h p r o p o r t io n o f th e t o t a l a m o u n t o f tim e lo st. 154. P r o f . L o v e d a y a lso d e v o te d c o n s id e r a b le s tu d y t o th e e x a m in a t io n o f fig u re s c o n c e r n in g th e a m o u n t o f tim e lo s t b e f o r e b r e a k fa s t. H e c o n c lu d e s — (a) T h a t i f e a r ly h o u r s b e w o r k e d , th e lo ss is lik e ly to d e cre a se i f th e sta rt b e la te r th a n 6 a. m . (& ) T h a t w h e n th e t o t a l h o u r s o f th e d a y -s h ift w e e k a re th e sa m e, th e re a re lik e ly t o b e m o r e h o u r s a c t u a lly w o r k e d w it h o u t th a n w it h w o r k b e fo r e b r e a k fa s t, o th e r c o n d it io n s b e in g s im ila r . (c) T h a t a r e d u c t io n o f h o u r s m a y b e c o m p e n s a te d f o r o r e v e n o u t w e ig h e d b y th e a b o lit io n o f e a r ly h o u r s , p a r t ly o w in g t o r e d u c e d a b sen ces, p a r t ly o w in g to r e d u c e d w a ste o f tim e , a n d p a r t ly to th e g r e a te r v i g o r o f w o r k a ft e r t a k in g fo o d . 155. H e q u o te s fig u re s f o r a n u m b e r o f d iffe r e n t fa c t o r ie s w h ic h c o n fir m th ese c o n c lu s io n s . H e s t r o n g ly p resses th e v ie w t h a t f o o d s h o u ld p r e c e d e w o r k . H e p o in t s o u t th e u n d e s ir a b ilit y o f h u n g e r w o r k , its b a d e ffe ct u p o n h e a lth a n d th e te m p t a t io n t o lo se tim e in th e s h o r t e a r ly sp e lls. 156. T h e r e ca n b e lit t le d o u b t th a t th e re is a n in c r e a s in g r e c o g n i t io n o n th e p a r t o f b o t h e m p lo y e r s a n d w o r k e r s o f th e b r o a d fa c t w h ic h e m e rg e s fr o m th e in v e s t ig a t io n s o f D r . V e r n o n a n d P r o f . L o v e d a y , n a m e ly , th a t s u b s ta n tia l r e d u c t io n o f h o u r s c a n b e e ffe c te d w it h o u t a n y r e d u c t io n o f o u tp u t. W h e r e a s at th e b e g in n in g o f 1 Cd. 8511. HOUES OF LABOR. 81 th e w a r th e r e w a s a g e n e r a l b e lie f th a t lo n g e r h o u r s n e c e s s a r ily p r o d u c e d la r g e r o u t p u t , it h a s n o w b e c o m e w id e ly r e c o g n iz e d th a t a 13 o r 1 4 -h o u r d a y f o r m e n a n d a 1 2 -h o u r d a y f o r w o m e n , e x c e p t in g f o r q u ite b r ie f p e r io d s , a re n o t p r o fit a b le f r o m a n y p o in t o f v ie w . F e w , p r o b a b ly , w o u ld d is a g r e e w it h th e s ta te m e n t c o n t a in e d in th e s u m m a r y p r e p a r e d b y th e R ig h t H o n . G . N . B a r n e s , M . P ., o f th e r e c e n t r e p o r t o f th e c o m m is s io n s o n in d u s t r ia l u n r e s t 1 th a t— There is a general concensus of opinion that Sunday and overtime labor should be reduced to a minimum, that holidays should not be curtailed, and that hours of work should not be such as to exclude opportunities for recreation and amusement. 157. I t m u s t b e r e c o g n iz e d th a t th e c o n d it io n s a re n o t th e sa m e n o w as th e y w e r e in th e e a r ly d a y s o f th e w a r ; n o t o n ly h a v e la r g e n u m b e r s o f th e y o u n g e s t a n d s tr o n g e s t w o r k e r s b e e n w it h d r a w n f o r m ilit a r y s e r v ic e , b u t th o s e w h o r e m a in h a v e u n d e r g o n e thfc s tr a in in s e p a r a b le f r o m a c o n tin u o u s p e r io d o f lo n g h o u r s o f e m p lo y m e n t. T o th is m u s t b e a d d e d th e str a in c a u se d b y f a m ily a n d o t h e r a n x ie tie s a r is in g o u t o f th e w a r. W h ile m u c h h a s b e e n d o n e t o im p r o v e c o n d it io n s o f e m p lo y m e n t th e y a re s t ill in m a n y ca ses f a r fr o m id e a l, n o t a b ly as r e g a r d s h o u s in g a n d tra n s it. F u r t h e r , la r g e n u m b e r s o f w o m e n a re n o w e m p lo y e d o n h e a v y w o r k a n d o n s k ille d o p e r a t io n s w h ic h w e r e c o n s id e r e d t w o y e a rs a g o t o b e q u ite b e y o n d t h e ir c a p a c it y . I t m a y b e tr u e th a t n o s e r io u s b r e a k d o w n o f h e a lth h a s as y e t b e e n o b s e r v e d a m o n g th e g r e a f m a ss o f th e w o r k e r s , b u t it ca n n o t b e a ssu m e d th a t th is c o n d it io n w ill c o n t in u e in d e fin ite ly . T h e e ffe cts o f th e s tr a in m a y ev e n h a v e b e e n a lr e a d y m o r e s e r io u s th a n a p p e a r s o n th e s u r fa c e , f o r w h ile it is p o s s ib le t o ju d g e r o u g h ly th e g e n e r a l c o n d it io n o f th o s e w o r k in g in th e fa c t o r y t o -d a y , lit t le in fo r m a t io n is a v a ila b le c o n c e r n in g th e la r g e n u m b e r o f w o r k e r s w h o , f o r o n e r e a s o n o r a n o th e r, a n d o ft e n b e ca u se t h e y fin d th e w o r k t o o a r d u o u s , a r e c o n t in u a lly g i v in g u p th e ir e m p lo y m e n t. T h is is a n im p o r t a n t p o in t w h ic h is lia b le t o b e o v e r lo o k e d , s in c e th e s u p p ly o f la b o r h a s h it h e r t o b e e n a d e q u a te t o fill t h e ir p la c e s . T h e i r r it a b ilit y a n d n e rv o u s n e s s m e n tio n e d b y th e c o m m is s io n o n in d u s t r ia l u n r e s t a re m o r e o v e r w e ll-r e c o g n iz e d s y m p t o m s o f fa t ig u e , w h ile it m u s t n o t b e fo r g o t t e n th a t th e e ffe c ts o f fa t ig u e a re a c c u m u la tiv e . H o w g r e a t is th e b u r d e n im p o s e d u p o n w o m e n b y a 1 2 -h o u r s h if t is s h o w n b y th e f o l l o w i n g e x t r a c t f r o m a r e p o r t r e c e n t ly p r e p a r e d f o r th e c o m m itte e u p o n a n in q u ir y a m o n g s t in d iv id u a l w o m e n as t o th e c o n d it io n s o f e m p lo y m e n t in a fa c t o r y , w h e r e m u c h o f th e w o r k w a s h e a v y in c h a r a c t e r : 1 These reports (eight in number) have been published and can be purchased through the usual channels. 80935°—19------6 82 INDUSTRIAL HEALTH AND EFFICIENCY. It appears that out of 140 women 99 were having under eight hours* sleep to fit them for a night of 12-hour shift plus traveling time. Moreover, out of 146 women only 16 felt that they were able to go out at all during the week. Where replies were not given it was in general because of the obvious absurdity of asking the women what they did in their spare time, after having heard their account of domestic responsibility. It may therefore be very strongly urged that these hours of work, coupled with the distances to be traveled, are such as to preclude the women taking any outside interests if they are to get sufficient rest. It is obvious that the majority of the women recognize this and are content to save themselves only for their work. Such a sacrifice may be with justice demanded for a short period through the exigency of a great and unexpected emergency, but should certainly not be enforced for a longer duration than is absolutely necessary. It may again be noted that already many of these women have worked on these long hours for j 3 months. 158. A f t e r c a r e fu l c o n s id e r a t io n o f a ll th e c ir c u m s ta n c e s , th e c o m m itte e a re c o n v in c e d t h a t th e m a x im u m lim it s o f w e e k ly e m p lo y m e n t p r o v is io n a lly s u g g e s te d a r e t o o h ig h e x c e p t f o r q u ite s h o r t p e r io d s , o r p e r h a p s in ca ses w h e r e th e w o r k is lig h t a n d th e c o n d it io n s o f e m p lo y m e n t e x c e p t io n a lly g o o d . I n th e g r e a t m a jo r it y o f ca ses, h o w e v e r , th e h o u r s o f w o r k s h o u ld n o w b e r e s tr ic te d w it h in lim it s lo w e r th a n th o s e q u o te d in p a r a g r a p h 140 a b o v e . I t is im p o s s ib le t o la y d o w n a s in g le r u le as t o th e b e s t h o u r s in a ll c a s e s ; th e b e st sch e m e c a n o n ly b e d e t e r m in e d a ft e r a c a r e fu l c o n s id e r a t io n o f a n u m b e r o f d iffe r e n t fa c t o r s , e. g . : (a) T h e s tr a in in v o lv e d in th e w o r k , its c h a r a c t e r (h e a v y o r lig h t , c o n t in u o u s o r in t e r m it t e n t ), th e m e n ta l d e m a n d w h ic h it m a k e s u p o n th e w o r k e r , a n d th e le n g t h o f p ro c e s s . (b) T h e e x te n t t o w h ic h th e p a c e o f th e w o r k is g o v e r n e d b y th e m a c h in e . ( c ) T h e f a c t o r y e n v ir o n m e n t — te m p e r a tu r e , v e n t ila t io n , e tc. (d) T h e in d iv id u a l p h y s ic a l c a p a c it y o f th e w o r k e r s , a n d th e ir a g e , se x , a n d e x p e r ie n c e . (e) T h e o r g a n iz a t io n o f th e f a c t o r y (in c lu d in g w e lfa r e s u p e r v is io n . ( / ) T h e s u fficie n cy a n d s u it a b ilit y o f th e w o r k e r s ’ f o o d , ca n te e n a c c o m m o d a t io n , etc. (g) T h e a r r a n g e m e n ts o f th e h o u r s o f w o r k (s p e lls , b r e a k s , a n d p a u se s). (h) C o n d it io n s o u ts id e th e fa c t o r y — e. g ., h o u s in g a n d tra n s it. 159. I n a r r a n g in g th e h o u r s o f w o r k f o r a f a c t o r y a llo w a n c e s h o u ld b e m a d e , as f a r as d is c ip lin e a n d o r g a n iz a t io n p e r m it , f o r th e fa c t th a t th e b e s t h o u r s o f e m p lo y m e n t w ill n o t b e th e sa m e f o r a ll p ro c e s s e s , e v e n in th e sa m e fa c t o r y . 160. T h o u g h n o e x a c t s ta te m e n t is p o s s ib le as t o h o w f a r th e r e d u c t io n o f h o u r s c a n a d v a n t a g e o u s ly b e c a r r ie d o u t, e ith e r n o w o r in th e n e a r fu t u r e , it is n o t w it h o u t s ig n ific a n c e th a t so e x p e r ie n c e d a n HOUES OF LABOR. 83 e m p lo y e r as L o r d L e v e r h u lm e s h o u ld b e n o w a d v o c a t in g th e e s ta b lis h m e n t o f a s ix -h o u r d a y . T h o u g h m a n y w ill n o t b e p r e p a r e d a t th e p re s e n t tim e t o a g re e as to th e fe a s ib ilit y o f so r a d ic a l a p r o p o s a l th e g r o u n d o n w h ic h th e p r o p o s a l is a d v o c a t e d , as s ta te d in a m e m o r a n d u m s u b m itte d t o th e c o m m itte e , a p p e a r s w o r t h y o f q u o t a t io n : But under the present system o f hours o f work the thorough education o f our children is practically impossible. An absolutely essential step in the direction o f a more efficient educational system is the shortening o f the hours o f labor and the improving o f the conditions o f living for the worker. W e are only just beginning to make a considered study o f the inefficiency and resulting waste that is produced by fatigue. W e can not claim even yet that we have any very profound knowledge on the subject, but the w asteful ness o f fatigue has been abundantly proved by the researches already made. Therefore it is essential that work in the factory, the workshop, and the office should be so arranged as to avoid fatigue, and by maintaining the general health o f the workers, to prolong their activity and increase their skill and efficiency. Moreover, modern conditions o f production requiring costly plant, machinery, and factory buildings make it obvious that such division o f the 24 hours must be made as will (w hilst utilizing the mechanical utilities to their utmost capacity so as to get as large an output from plant, machinery, and mechanical utilities as possible) tend to relieve the human element from fatigue. Only by so doing can we reduce to a minimum all overhead charges for interest, depre ciation, and rent, etc. It is obvious from the above that when our modern industries are run on a less fatiguing system o f say two shifts each o f six and a half hours with half an hour olf for meals (making six working hours in all per d a y), the efficiency o f the worker by thus avoiding fatigue can be increased by at least 33 per cent, and consequently that as much work can readily be done in six working hours as under present conditions is done in eight. But in addition to the ability o f the employee to produce as big an output in six hours as is now produced in eight, there would be the added advantage that the plant, machinery, etc., would be running for 50 per cent longer time, viz, 12 hours instead of eight, which running of machinery would reduce the overhead charges proportionately and Increase the output enormously. At the close o f the war we shall be in a unique position to try this experiment as a Nation. W e shall want all the output o f manufactured goods we can pro duce. W e shall not have immediately the power largely to increase our plant and machinery. W e shall have the return o f our heroes from the field of b a ttle; therefore we shall have ample supply of labor to test the experiment. The w orld’s demand for manufactured articles after the war w ill be overwhelming and unprecedented. The six-hour working day does not mean some hours gained for loafing. It is not intended to produce a loa fer’s paradise within the United Kingdom, and I say, without hesitation, that there is not a single man or woman o f those who would be benefited by a six-hour working day who would not feel themselves to be insulted if he or she were thought capable o f viewing the proposal in that light. 161. T h o u g h th e e x te n t t o w h ic h h o u r s o f la b o r c a n b e a d v a n t a g e o u s ly r e d u c e d m u st n e c e s s a r ily v a r y , th e c o m m itte e d e s ire s t r o n g ly t o e m p h a s iz e th e ir o p in io n t h a t th e tim e is n o w r ip e f o r a fu r t h e r su b 84 IN D U ST R IA L H E A L T H AND EFF IC IE N C Y . s t a n t ia l r e d u c t io n in tlie h o u r s o f w o r k . I f th is b e e ffe c te d w it h d u e r e g a r d t o th e v a r y in g c o n d it io n s p r e v a ilin g in d iffe r e n t b r a n c h e s o f in d u s t r y , th e y a re s a tisfie d th a t r e d u c t io n s c a n b e m a d e w it h b e n e fit t o h e a lth a n d w it h o u t in ju r y t o o u tp u t. I t is h ig h ly s ig n ific a n t in t h is c o n n e c t io n th a t th e G o v e r n m e n t s h o u ld h a v e r e c e n t ly a n n o u n c e d t h e ir d e c is io n t o in t r o d u c e a n e x p e r im e n t in s o m e G o v e r n m e n t n a t io n a l fa c t o r ie s o f a w e e k o f 50 h o u rs . I t is t o b e h o p e d t h a t th e e x p e r im e n t w il l b e c lo s e ly w a t c h e d a n d its r e s u lts a c c u r a t e ly r e c o r d e d . 162. I t m u s t b e o b v io u s th a t a n y r e d u c t io n o f h o u r s w h ic h c a n b e a c c o m p lis h e d w it h o u t lo s s o f o u t p u t is p r o fit a b le n o t o n ly t o th e e m p lo y e r , in t h a t it r e d u c e s r u n n in g e x p e n se s, b u t t o th e w o r k e r s in c e e v e n i f h is o r h e r d a ily m e a su r e o f w o r k in v o lv e s th e sa m e a m o u n t o f fa t ig u e a lo n g e r p e r io d is l e f t f o r r e c o v e r y , f o r th e e n jo y m e n t o f a d e q u a te sle e p a n d re st, a n d f o r th e n e ce s s a r y o p p o r t u n it y f o r r e c r e a t io n , e x e r cis e , a n d th e d is c h a r g e o f th e o r d in a r y d u tie s o f c itiz e n s h ip a n d d o m e s tic l if e . SECTION VI.— SHIFTS, BREAKS, SPELLS, PAUSES, AND HOLIDAYS. SHIFTS AND DAILY HOURS OF EMPLOYMENT. 163. I f w e e k ly h o u r s o f e m p lo y m e n t a re lim it e d , as s u g g e s te d in th e la s t s e c tio n , it n e c e s s a r ily fo llo w s th a t a v e r a g e d a ily h o u r s o f e m p lo y m e n t w ill a lso b e c o n fin e d w it h in m o d e r a te lim its . T h e s p e c ia l q u e s tio n s w h ic h a r is e in r e g a r d to th e m c a n t h e r e fo r e b e d e a lt w it h b r ie fly . 164. T h e d a ily e m p lo y m e n t o f w o r k e r s is o r g a n iz e d in s in g le s h ift s , in d o u b le s h ift s , o r in th re e s h ifts . F r o m th e p o in t o f v ie w o f o u t p u t s in g le s h ift s a re o p e n t o o b je c t io n o w in g t o th e la r g e n u m b e r o f h o u r s o u t o f th e 2 4 d u r in g w h ic h th e m a c h in e r y lie s id le . I n th e e a r lie s t sta g e s o f th e w a r , w h e n it w a s fr e q u e n t ly fo u n d im p o s s ib le t o o r g a n iz e a s e c o n d s h if t o w in g t o th e d e a r th o f w o r k e r s , a n d e s p e c ia lly o f s k ille d o p e r a tiv e s , a n e n d e a v o r w a s m a d e t o s e c u re la r g e r o u t p u t b y p r o lo n g in g th e h o u r s o f e m p lo y m e n t, m e n , a n d e v e n w o m e n , b e in g e m p lo y e d o v e r l o n g p e r io d s f o r 14 o r e v e n 15 h o u r s a d a y . F o r r e a s o n s a lr e a d y e x p la in e d it is n o w g e n e r a lly r e c o g n iz e d t h a t th ese lo n g h o u r s a re u n p r o fita b le , a n d th a t m u c h s h o r te r h o u r s c a n b e w o r k e d w it h o u t a n y lo s s o f o u tp u t. M a n y m u n it io n e m p lo y e r s , as a r e s u lt o f r e c e n t e x p e r ie n c e , n o w ta k e th e v ie w th a t f o r w o m e n a n d y o u n g p e r s o n s a 1 2 -h o u r d a y is t o o lo n g , a n d h o u r s are n o w fr e q u e n t ly lim it e d t o a 1 0 h o u r o r e v e n a s h o r te r d a y , lo n g e r h o u r s b e in g o n ly w o r k e d o c c a s io n a lly t o m e e t s p e c ia l e m e rg e n cie s . 165. D o u b le s h ift s a re th e fo r m o f e m p lo y m e n t n o w m o s t c o m m o n ly a d o p te d . T h o u g h f o r re a s o n s t o b e sta te d in a la te r s e c tio n , n ig h t w o r k is in it s e lf o p e n t o s e r io u s o b je c t io n s as a p e r m a n e n t p a r t o f th e in d u s t r ia l o r g a n iz a t io n o f th e c o u n t r y — a t le a st, so f a r as w o m e n a re c o n c e r n e d — it m u st f o r th e p re s e n t b e r e g a r d e d as in e v ita b le , a t a n y ra te , f o r a d u lt w o r k e r s , s in c e it e n a b le s th e m a c h in e r y t o b e e m p lo y e d f o r th e g r e a te r p a r t o f th e 2 4 h o u r s ; a n d so l o n g as th e h o u r s o f w o r k a re n o t u n d u ly lo n g , a n d d u e a tte n tio n is p a id t o th e e n v ir o n m e n t o f th e w o r k e r , it is u n d o u b t e d ly p r o d u c t iv e o f in c r e a s e d o u tp u t. 166. F o r m e n th e t w o s h ift s a re m o s t c o m m o n ly e a c h o f 12 h o u r s ’ d u r a t io n , t h o u g h o c c a s io n a lly t o m e e t lo c a l c o n d it io n s th e n ig h t s h ift is o f 13 h o u r s , as c o m p a r e d t o 11 h o u r s o f th e d a y s h ift . S u c h a n a r r a n g e m e n t ca n h a r d ly b e e c o n o m ic a l, in v ie w o f th e g r e a te r s tr a in in v o lv e d b y n ig h t w o r k , a n d th e a r r a n g e m e n t s h o u ld c e r t a in ly b e a v o id e d w h e r e v e r p o s s ib le . W h e r e th e n a tu r e o f th e w o r k d o e s n o t r e n d e r it e ss e n tia l th a t th e e n d o f o n e s h if t s h o u ld c o in c id e w it h th e 85 86 INDUSTRIAL H EALTH AND EFFICIENCY. c o m m e n c e m e n t o f th e n e x t, i t is u n q u e s tio n a b ly a d v a n ta g e o u s t o le a v e a n in t e r v a l b e tw e e n th e t w o s h ift s . T h e s h o r te r h o u r s th u s r e n d e r e d p o s s ib le a re b e n e fic ia l f r o m th e p o in t o f v ie w o f b o t h th e h e a lth o f th e w o r k e r s a n d o f o u tp u t. A p a r t f r o m th is , o p p o r t u n it y is a ffo r d e d f o r c le a n in g a n d v e n t ila t in g th e s h o p s — a m a tte r o f m u c h im p o r t a n c e . T h is p o in t w a s e m p h a s iz e d in th e c ir c u la r issu e d b y th e H o m e O ffice w it h th e ir g e n e r a l o r d e r o f S e p te m b e r , 1916. T h e y s t a t e d : The Secretary o f State desires to emphasize the desirability o f allow ing an interval o f half an hour or more between the two shifts unless the process is one which must necessarily be carried on continuously. Such an interval is o f great value in affording an opportunity for cleaning and ventilating the shops. 167. M e n a re o c c a s io n a lly e m p lo y e d o n a sy ste m o f th re e 8 -h o u r s h ift s . O f th e o p e r a t io n o f th is s y s te m in c e r ta in steel w o r k s a p r o m in e n t t r a d e s -u n io n is t s p o k e as f o l l o w s : W hile it is too early to make any definite statement as to the effect o f the change upon the health o f the workers, employers had borne testimony to the great success o f the ch an ge; bad men had become good and good men better. Under the old system a worker was completely worn out by his w ork ; under the new system he was able to take up hobbies such as allotments, bowling, or fishing, which kept him out o f the public house. Thus at one place it was re ported that among a population o f over 30,000 people there had not been during the last year a single conviction for drunkenness; the shorter hours enabled the worker to get home and get dressed and generally encouraged self-respect. 168. I f o n ly o n a c c o u n t o f th e d e a r th o f m a le w o r k e r s th e sy ste m , w h a te v e r its a d v a n ta g e s , is n o t c a p a b le o f g e n e r a l a d o p t io n a t th e p re s e n t tim e . 169. T h e t h r e e -s h ift sy ste m , e s p e c ia lly f o r w o m e n , h a s m u c h t o c o m m e n d it w h e r e it c a n b e o r g a n iz e d . I t im p o s e s lit t le o r n o s tr a in u p o n th e w o r k e r s , w h ile th e p e r io d s f o r w h ic h th e m a c h in e r y s ta n d s id le a re m u c h r e d u c e d . D iffic u ltie s in r e g a r d t o a n a lte r n a tiv e s u p p ly o f la b o r d o n o t a r is e t o th e sa m e e x te n t as in th e ca se o f m e n , a n d th e re is n o d o u b t th a t th e t h r e e -s h ift sy s te m y ie ld s th e b e s t re su lts w h e re it c a n b e a r r a n g e d fo r . T h e s tr a in o f n ig h t w o r k , in d e e d , th e str a in o f w o r k g e n e r a lly , is s e n s ib ly d im in is h e d . G r e a te r v ig o r o f w o r k is m a in ta in e d t h r o u g h o u t th e s h i f t ; less tim e is lo s t b y u n p u n c t u a lit y o r illn e ss. I n th e e ig h t -h o u r s h if t e a c h h o u r h a s a su s ta in e d v a lu e in c o n t r a s t t o th e d im in is h in g v a lu e o f th e la te r h o u r s in a lo n g e r s h ift . T h e n ig h t s h ift , w h ic h is th e m o s t t r y in g , r e cu r s e v e r y t h ir d in s te a d o f e v e r y o th e r w eek . 170. O n th e o t h e r h a n d th e re a re c e r ta in d iffic u ltie s o f o r g a n iz a t io n v /h ic h h a v e t o b e s u r m o u n t e d : (a) M a le t o o l se tte rs h a v e o r d in a r ily t o b e e m p lo y e d o n t w o 12h o u r s h ifts . D iffic u ltie s c o n s e q u e n tly a rise in c o m b in in g th e h o u r s o f m e n a n d w o m e n w o r k e r s , n o t a b ly as r e g a r d s m e a l h o u r s a n d th e s u p e r v is io n o f w o r k . SHIFTS, BREAKS, SPELLS, PAUSES, AND HOLIDAYS. 87 (b) T h e b r e a k f o r m e a ls b e in g lim it e d t o h a lf a n h o u r m a y a ffo r d a n in a d e q u a te tim e f o r r e fr e s h m e n t, e s p e c ia lly a t n ig h t . ( c ) T im e m a y b e lo s t a t th e c h a n g e o f s h ifts . (d) W o r k e r s m a y o b je c t t h r o u g h fe a r t h a t s h o r te r h o u r s w ill m e a n s m a lle r w a g e s. ( e ) T h e b e n e fit o f s h o r te r h o u r s o f e m p lo y m e n t in th e fa c t o r y m a y b e lo s t t h r o u g h m isu se o f le is u r e tim e , o r b y its d e v o t io n t o h o u s e h o ld d u tie s. D iffic u ltie s a re a ls o s o m e tim e s e x p e r ie n c e d in th e h o m e a n d in lo d g in g s t h r o u g h m e a ls b e in g r e q u ir e d a t tim e s in c o n v e n ie n t f o r o th e r w o r k e r s . 171. E x p e r ie n c e s h o w s th a t th ese d iffic u ltie s, t h o u g h s u b s ta n tia l in p a r t ic u la r cases, a re s e ld o m in s u r m o u n ta b le ; th e re a re n u m e r o u s in s ta n c e s t h r o u g h o u t th e c o u n t r y w h e r e th e t h r e e -s h ift sy ste m h a s b e e n s u c c e s s fu lly o r g a n iz e d . T h u s , it w a s r e p o r t e d o f o n e fir m — The firm believe the three-shift system to be the best for output and health. They are satisfied that the difficulties are not substantial and that they can all be met by reorganization and shop management. They consider there should never be a shortage o f material, loss o f time, friction in taking over shifts, or any o f the other difficulties alleged against the three-shift system. In their opinion * * * all the alleged difficulties can be overcome. • BREAKS. 172. T h e o r d in a r y d a ily h o u rs o f w o r k a re o r g a n iz e d u n d e r th e “ t w o -b r e a k ” sy ste m o r th e u o n e -b r e a k ” sy stem . U n d e r th e fo r m e r w o r k u s u a lly co m m e n c e s at 6 a. m ., a n d th e o r d in a r y b r e a k s a re h a lf a n h o u r f o r b r e a k fa s t a n d on e h o u r f o r d in n e r. U n d e r th e “ o n e b r e a k ” sy ste m w o r k c o m m e n c e s a ft e r b r e a k fa s t at 7 o r 8 a. in ., a n d th e re is g e n e r a lly o n ly a s in g le b r e a k o f o n e h o u r f o r d in n e r , t h o u g h a b r e a k f o r tea is p r o v id e d w h e re it is n e ce s s ita te d b y th e h o u r s o f A vork in g. T h is b r e a k is g e n e r a lly o f h a lf an h o u r ’s d u r a t io n b u t is so m e tim e s r e d u c e d t o 15 o r 20 m in u te s in o r d e r to p e r m it th e w o r k e r s to r e tu r n h o m e e a r lie r. I n th e ca se o f w o m e n a n d y o u n g p e r s o n s th is lim it a t io n o f th e in te r v a l f o r tea is o n ly a llo w e d w h e re a d e q u a te p r o v is io n is m a d e f o r th e w o r k e r s to o b ta in tea in th e w o r k s a n d f o r tea t o b e a c t u a lly r e a d y f o r th e m as s o o n as th e y s to p w o r k . 173. P r o f . L o v e d a y h a s d e v o te d c o n s id e r a b le a tte n tio n t o in v e s t i g a t in g th e c o n d it io n s o f th e “ o n e -b r e a k ” sy ste m , a n d th e re su lts o f h is in q u ir ie s a re set o u t in h is m e m o r a n d u m o n T h e C a u ses a n d C o n d it io n s o f L o s t T im e , w h ic h is in c lu d e d in th e c o m m it t e e ’s in t e r im r e p o r t o n I n d u s t r ia l E ffic ie n c y a n d F a tig u e . H e s u g g e s ts t h a t th e s y s te m h a s th e f o l l o w i n g a d v a n t a g e s : (a) A la r g e n u m b e r o f 66 q u a rte rs ” a re lo s t b e f o r e b r e a k fa s t. T o so m e e x te n t th is lo ss is n o d o u b t u n a v o id a b le a n d d u e t o th e w o r k e r s b e in g fa g g e d , t o m in o r a ilm e n ts (c o ld s a n d r h e u m a tis m ) o r to tr a n s it 88 INDUSTRIAL HEALTH AND EFFICIENCY. d iffic u lt ie s ; b u t m u c h o f th e lo s s is a v o id a b le . I n h is o p in io n th e s h o r tn e s s o f th e s p e ll b e f o r e b r e a k fa s t in c re a se s th e t e m p t a t io n t o m iss it. H e s a y s : The regularity with which a greater number o f quarters is lost on certain days indicates deliberate choice o f those days, and the preference for “ sleeping in ” on Monday even when there has been no Sunday shift disproves any direct connection between overtime and much o f the loss o f early hours. (b) T h e a m o u n t o f tim e lo s t b e fo r e b r e a k fa s t is o ft e n s u fficie n tly la r g e t o ca u se s e r io u s d is o r g a n iz a t io n . (0) I t is o n ly a m in o r it y o f w o r k e r s w h o c a n p u t in th e ir b e s t w o r k b e fo r e h a v in g a p r o p e r m e a l in th e m o r n in g . (d) T h e r e is less in t e r r u p t io n o f w o r k . D r . V e r n o n , in h is firs t r e p o r t (s e e M e m o r a n d u m N o . 1 2 ) , h a s c a lle d a tte n tio n t o th e la r g e a m o u n t o f tim e w h ic h is lo s t in s t a r t in g a n d fin is h in g w o r k . 174. P r o f . L o v e d a y , in p a r a g r a p h s 5 1 -5 4 o f h is r e p o r t , g iv e s p a r t ic u la r s o f a n u m b e r o f fa c t o r ie s in w h ic h w o r k b e f o r e b r e a k fa s t h a s b e e n a b a n d o n e d w it h g o o d re su lts. E v e n w h e r e th e c h a n g e h a s in v o lv e d a s m a ll r e d u c t io n in th e n u m b e r o f w e e k ly h o u r s th is r e d u c t io n ^has fr e q u e n t ly b e e n m o r e th a n c o m p e n s a te d f o r b y th e r e d u c t io n in th e a m o u ift o f tim e lo s t. A p a r t fr o m a c o n s e r v a t iv e ' fe e lin g a g a in s t a n y c h a n g e o b je c t io n h a s b ee n m a d e to th e a d o p t io n o f th e “ o n e -b r e a k ” sy ste m o n th e g r o u n d th a t— (1 ) W h e r e a r e d u c t io n o f h o u r s is in v o lv e d a lo s s o f w a g e s is fe a r e d . ( i i ) D o m e s t ic in c o n v e n ie n c e m a y b e c a u s e d t h r o u g h th e w o r k e r r e q u ir in g h is b r e a k fa s t b e f o r e h e le a v e s h o m e . ( i i i ) A la te r s ta r t m a y in v o lv e a la te r h o u r o f fin is h in g w o r k . ( i v ) T h e w o r k e r s d o n o t in fa c t a lw a y s g e t a g o o d b r e a k fa s t b e f o r e t h e y sta rt. O n th is p o in t a r e p r e s e n ta tiv e tr a d e s -u n io n is t s ta te d th a t— In some cases the “ single break ” system is in force under w hich work gen erally starts at 7. This arrangement is based on the assumption that the worker w ill have had breakfast before he comes. Where, as is frequently the case, workers have to travel an hour or more to reach the works, this involves a very long period w ithout food, in addition to the fact that an early start frequently involves at any rate a hurried breakfast and, in some cases, none at all. Even the men get a sinking feeling and can not work properly. It is worse for women. 175. P r o f . L o v e d a y is d o u b t fu l as to th e f o r c e o f th e fir s t th r e e o f th e se o b je c t io n s . A s r e g a r d s th e la st h e s u g g e s ts th a t, w h e r e th e w o r k e r s liv e fa r f r o m h o m e , w o r k s h o u ld c o m m e n c e a t 8 a. m . r a th e r th a n a t 7 a. m . W h e r e th e e a r lie r h o u r is a d o p te d it is g e n e r a lly d e s ir a b le th a t a s h o r t b r e a k f o r r e fr e s h m e n t s h o u ld b e p r o v id e d in th e m id d le o f th e m o r n in g , a n d th e H o m e O ffice g e n e r a l o r d e r o f S e p te m b e r, 1 916, r e q u ir e s in th e ca se o f w o m e n a n d y o u n g p e r s o n s th a t— - SHIFTS, BREAKS, SPELLS, PAUSES, AND HOLIDAYS. 89 When work commences before 8 a. m. and no interval is allowed for break fast an opportunity shall be given to the workers to take refreshment during the morning. 176. P r o f . L o v e d a y ’s v ie w th a t th e “ o n e -b r e a k ” s y s te m is p r e f e r a b le t o th e “ t w o -b r e a k ” s y s te m is c o n fir m e d b y th e e v id e n c e o f e m p lo y e r s w h o h a v e p r a c t ic a l e x p e r ie n c e o f it. T h u s S ir W illia m M a th e r , as a r e s u lt o f h is g r e a t e x p e r ie n c e , in fo r m e d th e c o m m itte e th a t— The two hours before breakfast were practically wasted owing to the long walk to the works, the absence o f breakfast or the temptation to get a drink on the way to work in order to keep warm. Both morally and physically the worker was a better man if he had a good breakfast with his fam ily before leaving for work. His firm tried the experiment fo r a whole year and the results were such as to leave them no hesitation in adopting the system per manently and nothing had since occurred to m odify their views. The chango had proved salutary as well as profitable. T h rift and sobriety had been en couraged. The worker was a better individual. Even now that owing to the w ar they w ere working two 12-hour shifts they still attached great importance to the day shift only starting work after breakfast. 177. D r . Y e r n o n , in h is m e m o r a n d u m (se e A p p e n d ix C ) o n A C o m p a r is o n o f th e S y s te m s E m p lo y e d f o r D iv i d i n g U p W o r k i n g H o u r s in t o S p e lls a n d B r e a k s , g iv e s th e re su lts o f in q u ir ie s in t o th e o u t p u t o f w o r k e r s b e fo r e b r e a k fa s t ; h e th u s s u m m a r iz e s h is c o n c lu s io n s : Day-shift workers on the one-break system were found to work up to their maximum output each morning rather more quickly than the night shift worked up to their m axim um ; but day-shift workers on the two-break system, in which work was begun at 6 a. m., and was follow ed by a breakfast interval at 9 a. m., had 7 per cent to 18 per cent less output in these three prebreakfast hours than the night-shift workers had in their first three working hours. This was presumably due to the night shift having had a good meal before starting work. SPELLS AND PAUSES. 178. A t t e n t io n h a s a lr e a d y b e e n d r a w n t o th e im p o r t a n c e o f th e p r o p e r d is t r ib u t io n o f re st p a u se s in p r o v id i n g a g a in s t fa t ig u e . I n A m e r ic a , m u c h a tte n tio n h a s b e e n d e v o t e d t o th e p r o p e r le n g t h a n d d is t r ib u t io n o f p a u se s, a n d th is is o n e o f th e m o s t im p o r t a n t a sp e cts o f “ s c ie n tific m a n a g e m e n t.” I n th is c o u n t r y , as y e t, th e s u b je c t h a s r e c e iv e d b u t lit t le a tte n tio n . E x p e r ie n c e h a s in d e e d p r o v e d th a t u n d e r p re s e n t c ir c u m s ta n c e s m any* w o m e n a n d y o u n g p e rs o n s c a n n o t p r o fit a b ly b e e m p lo y e d f o r th e f u ll s p e ll o f fiv e h o u r s o n c o n t in u o u s w o r k as a llo w e d b y th e f a c t o r y a ct, a n d e v e n w h e r e th e s p e ll is s o m e w h a t less th a n fiv e h o u r s , th e re is a g e n e r a l t e n d e n c y a m o n g e m p lo y e r s t o a llo w s h o r t in t e r v a ls f o r r e fr e s h m e n t in th e a ft e r n o o n , a n d fr e q u e n t ly in th e m o r n in g a lso. T h e s e p a u se s n o t o n ly p r o v id e an o p p o r t u n it y f o r r e fr e s h m e n t, b u t a p e r io d o f re st a n d r e c o v e r y f r o m fa t ig u e , a n d a b r e a k in th e m o n o to n y o f th e w o r k . 90 INDUSTRIAL HEALTH AND EFFICIENCY. 179. D r . V e r n o n , in p a r a g r a p h 31 o f h is r e p o r t o n S t a t is t ic a l in fo r m a t io n c o n c e r n in g o u t p u t in r e la tio n t o h o u r s o f w o r k (M e m o r a n d u m N o . 1 2 ), d r a w s a tte n tio n t o th e im p o r t a n c e o f th is s u b je c t. H e says: The custom in many munition works is for the operatives to w ork for a spell o f five hours, and then, after an hour’s interval, for another spell o f fou r and a h alf to five hours. Such spells are undoubtedly too long in many types o f munition work, but if a second break is introduced in the working day much extra time is lost in starting and stopping work. I f the operatives, are left to themselves, they take rests at irregular and often unsuitable times. Hence it would be much better if the rest pauses were chosen for them. For instance, a 10-minute break in the middle o f the morning and afternoon spells, during which the operatives remain at their machines, but take tea or other nutriment brought them by boys or by traveling canteens, has been found a valuable aid to output in some munition works. Some types o f work need longer and more frequent rest pauses than others, and the best times can be determined only by experiment. A fter being fixed they should be made compulsory, and rest pauses at other times be checked so far as possible. 180. I n h is m e m o r a n d u m o n A C o m p a r is o n o f th e S y s te m s E m p lo y e d f o r D iv i d i n g U p W o r k i n g H o u r s in t o S p e lls a n d B r e a k s , D r . V e r n o n r e c o r d s th e re su lts o f c e r ta in in q u ir ie s in t o th e o u t p u t o n fiv e h o u r s ’ s p e lls ; h e c o n c lu d e s th a t— Five-hour spells o f work are too long, for it appeared that by cutting up the 10-liour day into three spells of, e. g., 4, 3 and 3 hours, separated by two breaks (the first o f which is too late to function as a breakfast break) the output might be increased 5 per cent to 12 per cent above that experienced when two 5-hour spells were worked. W hat is probably a better system still o f avoiding 5-hour spells is to stop work for a quarter o f an hour in the middle o f each spell and provide the workers with refreshment by means o f traveling canteens. The introduction o f one such extra |-hour break in a cartridge factory, together with the abolition o f the breakfast interval, increased the hourly output 5 per cent. 181. I n th e sa m e m e m o r a n d u m D r . V e r n o n a lso r e c o r d s c e r ta in d a ta h e c o lle c t e d as to rests v o lu n t a r ily ta k e n b y w o r k e r s . I n th e ca se o f so m e m e n e n g a g e d o n h a n d -t a p p in g fu se s h e fo u n d th a t— On an average they took seven to nine minutes o f voluntary rest pauses in all except the first full hour o f w o r k ; and as they were all o f them men who had been engaged for many months on the operation and were paid at piece rates, there can be no doubt that they found by experience that such pauses improved their total output. It was curious to note, however, that they worked on no sort o f system, but often took rests in a most irregular manner. 182. D r . V e r n o n e x p r e sse s th e o p in io n th a t re st p a u se s a re e ss e n tia l in a c tiv e w o r k f o r b o t h m e n a n d w o m e n , t h o u g h as m ig h t b e a n t ic i p a t e d h e fo u n d th a t th e e x te n t o f th e se v o lu n t a r y rests v a r ie d g r e a t ly a c c o r d in g t o th e e x te n t t o w h ic h th e n a tu r e o f th e w o r k in v o lv e d e n fo r c e d p e r io d s o f in a c t iv it y . 183. S o f a r as th e c o m m itte e a re a w a re , b u t fe w firm s h a v e m a d e a n y e n d e a v o r t o in v e s t ig a t e s c ie n t ific a lly th e p a r t ic u la r d is t r ib u t io n o f re st p a u se s n e e d e d t o s e c u re th e b e s t o u t p u t in t h e ir o w n w o r k s . T h e f o l l o w i n g ca se o f th e a d v a n t a g e o f s u ch p a u s e s m a y b e q u o te d SHIFTS, BREAKS, SPELLS, PAUSES, AND HOLIDAYS. 91 f r o m th e m e m o r a n d u m o n In c e n t iv e s t o W o r jc , in c lu d e d in th e c o m m it t e e ’s in t e r im r e p o r t : A group o f workers, men and women, paid on a time wage, were found em ployed from 6 a. m. to 6 p. m., with two half-hour meal intervals, at the process o f emptying and filling a series o f presses. Bach press, after being filled, has to be left under hydraulic pressure for 85 minutes, during which time other presses in the series are emptied and filled. The management calcu lated the number o f presses to each series, which would allow the w ork to be done in 35 minutes at a reasonable p a ce ; but the workers on their own initiative have adopted a different method. They work with a rapidity so organized that the series o f presses is emptied and filled in less than 25 minutes, after which they rest for 10 or 12 minutes until the time comes to begin again. The w ork entails the expenditure o f a fair amount o f physical energy, and it was interest ing to watch these operatives swing into their labor in order to obtain their rest pause. HOLIDAYS. 184. T h e c o m m itte e c o n s id e r it m o s t im p o r t a n t th a t th e o r d in a r y f a c t o r y h o lid a y s s h o u ld b e m a in ta in e d . A s a tr a d e s -u n io n is t p u t it — > I f once in every two or three months a man could have two or three days off it would prove the finest medicine, much better than a bonus as extra pay. 185. T h e e v id e n c e le a v e s n o d o u b t as t o th e b e n e fic ia l e ffe c t o f su ch h o lid a y s b o t h o n h e a lth a n d o u tp u t. D r . V e r n o n , in h is fu r t h e r r e p o r t o n o u t p u t in r e la tio n t o h o u rs o f w o r k (M e m o r a n d u m N o . 1 8 ), th u s d e sc rib e s o n e ca se w h ic h h e in v e s t ig a t e d : In the February-April period * * * the hourly output had risen to 123. * * * Though the hourly output during the February-April period was fairly steady, the workers had not become completely adapted to the re duction o f hours from a normal 12-hour to a normal 10-hour day which had been effected four weeks previously. After Easter, when they had a full week’s holiday, their relative hourly output went up to 134 on the average and re mained fairly steady for the next eight weeks, although the actual hours o f work were slightly greater than before Easter. * * * After a week’s holiday at the end of August the hourly output went up again to its May-June level, but it was not. until October or after another holiday (the fou r days ordered by Government) that a marked rise of hourly output set in. This rise continued in subsequent weeks until, in the fortnight before Christmas week, it reached the astonishing figure o f 177. 186. I n c o m m e n t in g o n th ese fig u re s D r . V e r n o n p o in t s o u t th a t— The workers, refreshed and more vigorous, unconsciously start work on a , higher level o f speed and maintain that level permanently, whereas a reduction of hours unaccompanied by a holiday, i. e., by a chance o f breaking through settled habits o f work, is generally very much slower in conducing to the de sired reaction. 187. P r o f . L o v e d a y , in h is m e m o r a n d u m o n T h e C a u ses a n d C o n d i tio n s o f L o s t T im e (se e th e c o m m itte e 's in te r im r e p o r t , p p . 52, 5 3 ), d r a w s a tte n tio n to th e b e n e fic ia l e ffe ct o f a h o lid a y in r e d u c in g th e a m o u n t o f b r o k e n tim e d u e to sick n ess. H e q u o te s an in s ta n c e in 92 IN D U ST R IA L H E A L T H AND E FF IC IE N C Y , w h ic h th e sick n e s s rate0 f o r th e th re e w e e k s im m e d ia t e ly f o l l o w i n g a c o n s id e r a b le h o lid a y a t th e e n d o f A u g u s t a n d b e g in n in g o f S e p te m b e r, 1916, w a s 4.2 p e r c e n t as a g a in s t 5.4 p e r c e n t in th e w e e k im m e d ia t e ly p r e c e d in g th e h o lid a y , a n d 8.6 p e r c e n t in th e w e e k b e f o r e th a t. T h e r a te h a d n o t b e e n so lo w f o r m a n y m o n t h s p r e v io u s ly . 188. A n o t h e r a s p e c t o f th e q u e s tio n o f h o lid a y s is th a t th e y a ffo r d m u c h n e e d e d o p p o r t u n it ie s f o r c a r r y in g o u t r e p a ir s t o p la n t a n d m a c h in e r y ; in th e a b se n ce o f s u ch o p p o r t u n it ie s th e d e fe c t iv e c o n d it io n s m a y b e c o m e so se r io u s as m a t e r ia lly t o a ffe c t o u tp u t. 189. T h e c o m m itte e d e s ir e s p e c ia lly t o e m p h a s iz e th e n e e d f o r g i v in g p e r io d ic h o lid a y s t o m e m b e r s o f th e m a n a g e m e n t a n d t o f o r e m e n . T h e y c a n n o t ta k e o d d d a y s o ff lik e th e o r d in a r y w o r k e r , a n d ca se s o f t e m p o r a r y b r e a k d o w n h a v e b e e n r e g r e t t a b ly c o m m o n . SECTION VII.— SUNDAY LABOR AND NIGHT WORK. SUNDAY LABOR. Man, man is the great instrument that produces wealth. The natural differ ence between Campania and Spitzbergen is trifling when compared with the difference between a country inhabited by men full of bodily and mental vigor, and a country inhabited by men sunk in bodily and mental decrepitude. There fore it is that we are not poorer but richer, because we have, through many ages, rested from our labor one day in seven. That day is not lost. While industry is suspended, while the plough lies in the furrow, while the Exchange is silent, while no smoke ascends from the factory, a process is going on quite as important to the wealth of nations as any process which is performed on more busy days. Man, the machine of machines, the machine compared with which all the contrivances of the Watts and Arkwrights are worthless, is repairing and winding up, so that he returns to his labors on the Monday with clearer intellect, with livelier spirits, with renewed corporal vigor. Never will I believe that what makes a population stronger, and healthier, and wiser, and better, can ultimately make it poorer.— (Macaulay, speech on the 10-hour bill, House of Commons, May 22, 1846.) 190. T h e m o s t u r g e n t p r o b le m a w a it in g th e c o n s id e r a t io n o f th e c o m m itte e a t th e tim e o f t h e ir a p p o in t m e n t w a s th a t o f S u n d a y la b o r . P a r t ly o n a c c o u n t o f th e h e a v y d e m a n d f o r o u t p u t a n d p a r t ly t h r o u g h th e a t t r a c t io n o f th e h ig h e r r a te o f w a g e s p a y a b le , S u n d a y la b o r f o r m e n w a s c o m m o n . S o m e tim e s th e h o u r s w e r e th e sa m e as o n w e e k d a y s ; so m e tim e s t h e y w e r e s h o r te r , w o r k c o m m e n c in g la te r o r fin is h in g e a r lie r . E ls e w h e r e th e y w e r e lo n g e r th a n o n o r d in a r y d a y s as w h e n th e t r a n s fe r fr o m th e 1 2 -h o u r d a y s h ift t o a 1 2 -h o u r n ig h t s h if t w a s m a d e b y w o r k in g f o r a c o n t in u o u s p e r io d o f 18 h o u r s , o n e s h if t w o r k in g (s a y ) f r o m 6 p . m . o n S a t u r d a y t o 12 n o o n o n S u n d a y , a n d th e o t h e r fr o m n o o n o n S u n d a y t o 6 a. m . on M on day. 191. T h e e m p lo y m e n t o n S u n d a y s o f w o m e n a n d b o y s w a s m u c h m o r e r e s tr ic te d a n d w a s o n ly a llo w e d o n s p e c ia l a p p lic a t io n t o th e H o m e O ffice. I n O c t o b e r , 191 5, f o r th e w h o le o f th e U n it e d K i n g d o m th e r e w e r e in o p e r a t io n a b o u t 50 o r d e r s a llo w in g th e e m p lo y m e n t o n S u n d a y s o f w o m e n , g ir ls , a n d b o y s , a n d a ls o a b o u t a n o th e r SO f o r b o y s o n ly . A s a r u le su ch e m p lo y m e n t w a s o n ly s a n c t io n e d w h e n h o u r s o f w o r k o n o t h e r d a y s o f th e w e e k w e r e lim it e d , a n d e v e n w h e n it w a s a llo w e d it w a s u s u a l t o im p o s e r e s t r ic t io n s , s u c h as— (a) T h a t w o m e n a n d y o u n g p e r s o n s s h o u ld n o t b e e m p lo y e d o n t w o c o n s e c u tiv e S u n d a y s ; ( J ) T h a t th e y s h o u ld h a v e tim e o ff o n S a t u r d a y ; 93 94 IN D U ST R IA L H E A L T H AN D E FF IC IE N C Y . ( c ) T h a t t h e y s h o u ld o n ly b e e m p lo y e d o n S u n d a y in ca ses o f em ergen cy; (d) T h a t th e y s h o u ld b e e m p lo y e d f o r a p o r t io n o f S u n d a y o n ly . 192. Sunday labor is in itself wnpopular.— T h e r e e x is ts a la r g e b o d y o f o p in io n t h a t th e se v e n th d a y , as a p e r io d o f rest, is g o c J f o r b o d y a n d m in d . E m p lo y e r s o b je c t t o it o n th e g r o u n d tlia i s u p e r v is io n is d iffic u lt, a n d th a t it im p o s e s a se v e re s tr a in o n f o r e m e n , su b s titu te s b e in g d iffic u lt t o o b ta in . I n th e e a r ly d a y s o f th e w a r h ig h r a te s o f p a y m a d e S u n d a y la b o r p o p u la r w it h m a n y w o r k e r s , b u t th is p o p u la r it y h a s s te a d ily d e cr e a s e d a n d a n y d iffic u ltie s in v o lv e d h a v e g e n e r a lly p r o v e d c a p a b le o f a d ju s tm e n t. H i g h ra tes o f p a y o n th e o t h e r h a n d h a v e b e e n a n o th e r o b je c t io n r a is e d b y e m p lo y e r s w h o h a v e a ls o c o m p la in e d o f in c r e a s e d c o s t o f r u n n in g th e ir w o r k s . S u n d a y la b o r is in fa c t o n ly d e fe n s ib le i f it c a n b e s h o w n t o b e p r o d u c t iv e o f g r e a te r o u t p u t o v e r a lo n g e r o r s h o r te r p e r io d . 193. But Sunday labor is uneconomical .— A s h a s a lr e a d y b e e n p o in t e d o u t, fa t ig u e m a y b e m e n ta l as w e ll as p h y s ic a l. A c c o u n t h a s t o b e ta k e n n o t o n ly o f th e h o u r s o f la b o r , f a c t o r y e n v ir o n m e n t, a n d th e p h y s ic a l s tr a in in v o lv e d b u t a ls o o f m o n o to n y , w h ic h m a y p r o v e as s e r io u s an o b s ta c le to g o o d o u t p u t as p h y s ic a l fa t ig u e . T h e c u r e f o r fa t ig u e , w h e th e r p h y s ic a l o r m e n ta l, lie s in a d e q u a te p e r io d s o f rest, a n d th e p r o b le m o f S u n d a y la b o r is p r im a r ily o n e o f th e e x te n t t o w h ic h th e w o r k e r r e q u ir e s w e e k ly o r p e r io d ic rests i f h e is t o r e ta in h is h e a lth a n d e n e r g y o v e r lo n g p e r io d s . 194. T h e e v id e n c e is c o n c lu s iv e th a t S u n d a y la b o r b y d e p r iv in g th e w o r k e r o f h is w e e k ly re st o ffe rs h im n o su fficien t o p p o r t u n it y f o r r e c o v e r in g fr o m fa t ig u e , a n d is n o t p r o d u c t iv e o f g r e a te r o u t p u t e x c e p t f o r q u ite s h o r t a n d is o la te d p e r io d s . E m p lo y e r s s ta te d in e v i d e n ce , th a t th o u g h a tte n d a n c e o n S u n d a y is g e n e r a lly g o o d it is n o t a lw a y s a c c o m p a n ie d b y a s a t is fa c t o r y in d iv id u a l o u t p u t ; n o t in f r e q u e n tly a h o lid a y s p ir it is a p p a r e n t. M o r e o v e r , a tte n d a n c e a t w o r k o n S u n d a y is o ft e n a c c o m p a n ie d b y b a d tim e k e e p in g o n o t h e r d a y s o f th e w eek . S ta te m e n ts h a v e b ee n m a d e th a t s e v e n d a y s ’ la b o r o n ly p r o d u c e s s ix d a y s ’ o u t p u t , a n d th a t r e d u c t io n s in S u n d a y w o r k h a v e n o t in fa c t in v o lv e d a n y a p p r e c ia b le lo s s o f o u tp u t. T r a d e s -u n io n officia ls h a v e c o m p la in e d th a t th e ir m e m b e r s w e r e g e t t in g t ir e d a n d n e e d e d m o r e rest. I n s e v e r a l in sta n ce s t h e y p re s s e d f o r th e r e d u c t io n o f S u n d a y w o r k . 195. E v id e n c e in th e fo r m o f s ta tis tic s o f o u t p u t in r e g a r d t o S u n d a y la b o r is n o t e a s ily o b ta in a b le . E v e n w h e n th e o u t p u t o f w o r k h a s b e e n s u ch as w o u ld in n o r m a l c ir c u m s ta n c e s p e r m it o f th e c o l le c t io n o f e x a c t d a ta , th e r a p id g r o w t h in th e n u m b e r o f p e r s o n s e m p lo y e d , th e g r e a te r e m p lo y m e n t o f w o m e n , th e in c r e a s e d e ffic ie n c y o f in e x p e r ie n c e d w o r k e r s , a n d o t h e r s im ila r ca u se s h a v e g e n e r a lly SUNDAY LABOR AND NIGHT WORK. 95 r e n d e r e d c o m p a r is o n s d iffic u lt, u n r e lia b le , a n d im p o s s ib le . E v e n w h e r e th e d a ta w a s a v a ila b le th e M a n a g e m e n t h a v e n o t g e n e r a lly fo u n d it p o s s ib le t o a r r a n g e f o r its c o lle c t io n a n d ta b u la tio n . T h e r e p r e s e n ta tiv e o f o n e im p o r t a n t firm , h o w e v e r , in fo r m e d th e c o m -* m itte e t h a t in o n e o f t h e ir s h o p s w h e r e h e a v y m a c h in e w o r k w ah d o n e b y m e n o f g o o d a v e r a g e t r a d e -u n io n t y p e th e y h a d b y e x t e n d in g th e r e lie f a t th e w e e k e n d r e d u c e d th e a v e r a g e w e e k ly h o u r s f r o m 78J t o 65|. T h o u g h th e n o r m a l h o u r s w e r e th u s r e d u c e d b y 13, th e a v e r a g e n u m b e r o f h o u r s (6 0 ) a c t u a lly w o r k e d d u r in g th e th re e m o n th s s u c c e e d in g th e c h a n g e e x c e e d e d th e a v e r a g e n u m b e r o f h o u r s (5 9 £ ) w o r k e d d u r in g th e s ix m o n th s p r e c e d in g th e c h a n g e . M o r e o v e r , in h is o p in io n th e o u t p u t p e r h o u r w a s im p r o v e d . 196. P r o f . L o v e d a y , w h o c o n d u c t e d c e r ta in in q u ir ie s in t o lo s t tim e , sta te s in p a r a g r a p h 11 o f h is m e m o r a n d u m (s e e th e c o m m it t e e ’s in t e r im r e p o r t o n I n d u s t r ia l E ffic ie n c y a n d F a t ig u e ) — In so far as long hours lead to loss o f time by fatigue and sickness, insistence on them is most deplorable. The keenest men are not always the most robust, and it is the keenest who have most strain to bear. The hours gained are more costly than the hours lost. * * * The effects o f Sunday labor are, as has now been recognized, still worse than those o f overtime hours in the evening or on Saturday afternoon. 197. D r . V e r n o n , in th e c o u r s e o f h is in v e s t ig a t io n 1 c o n c e r n in g o u t p u t in r e la tio n t o h o u r s o f w o r k , h a s s h o w n th a t in th e ca se o f a b o d y o f 80 to 100 w o m e n th a t th e r e d u c t io n o f th e h o u r s o f e m p lo y m e n t b y th e s t o p p a g e o f S u n d a y w o r k in v o lv e d n o r e d u c t io n o f o u t p u t, t h o u g h th e f u ll e ffe c t o f th e c h a n g e t o o k a fe w m o n th s to o p e r a te . A s im ila r in v e s t ig a t io n in r e g a r d to a b o d y o f 56 m e n , s iz in g a n d fu s e b o d ie s , s h o w e d t h a t t h o u g h th e n u m b e r o f n o m in a l h o u r s o f w o r k w e r e b y th e c e ssa tio n o f S u n d a y la b o r r e d u c e d b y s ix , th e tim e k e e p in g w a s so m u c h im p r o v e d th a t th e a c tu a l h o u r s o f w o r k r e m a in e d th e sam e. T h e w it h d r a w a l o f S u n d a y la b o r seem s t o h a v e le d th e m e n t o o b s e rv e m u c h m o r e r e g u la r h o u r s a n d d u r in g th e ir r e g u la r h o u r s t o in c re a s e th e ir o r d in a r y o u t p u t so m e 16 p e r c e n t a b o v e its p r e v io u s le v e l. T h e a b o lit io n o f S u n d a y la b o r h a s s o m e tim e s b e e n d e m u r r e d to o n a c c o u n t o f th e lo w M o n d a y o u tp u t, w h ic h fr e q u e n t ly fo llo w s a w e e k -e n d rest. D r . V e r n o n , h o w e v e r , p o in t e d o u t th a t in th e ca ses q u o te d , t h o u g h th e M o n d a y o u t p u t w a s lo w c o m p a r e d t o o t h e r d a y s o f th e w eek , it r e a ch e d a c o n s id e r a b ly h ig h e r le v e l th a n wTas e v e r o b ta in e d in th e a b se n ce o f a w e e k -e n d rest. 198. T h e c o m m itte e , in th e ir M e m o r a n d u m N o . 1, s u b m itte d in N o v e m b e r , 1915, t o th e m in is t r y , o n S u n d a y la b o r , e x p r e s s e d th e ir c o n v ic t io n th a t i f th e m a x im u m o u t p u t w a s to b e se c u re d a n d m a in ta in e d f o r a n y le n g th o f tim e a w e e k ly p e r io d o f rest m u s t b$ a llo w e d . E x c e p t f o r q u ite s h o r t p e r io d s , c o n tin u o u s w o r k , in t h e ir v ie w , is a 1 See paragraphs 1 4 6 -1 5 0 above. 96 INDUSTRIAL HEALTH AND EFFICIENCY. p r o f o u n d m is ta k e a n d d o e s n o t p a y . O u t p u t is n o t in c re a s e d . O n e c o n o m ic a l a n d s o c ia l g r o u n d s a lik e th is w e e k ly p e r io d o f re st is b e s t p r o v id e d o n S u n d a y . S p e a k in g g e n e r a lly , th e r e li e f f r o m w o r k o n S u n d a y is m o r e u r g e n t f o r w o m e n a n d y o u n g p e r s o n s th a n f o r a d u lt m e n a n d f o r m e n o n o v e r tim e th a n f o r th o s e o n d o u b le s h ifts . T h e n e e d m a y a lso v a r y s o m e w h a t a c c o r d in g t o th e n u m b e r o f h o u r s w o r k e d d u r in g th e w e e k a n d th e e n v ir o n m e n t a n d c h a r a c t e r o f th e w o r k , b u t th e c o m m itte e c o n s id e r th a t th e d is c o n tin u a n c e o f S u n d a y la b o r s h o u ld b e o f u n iv e r s a l a p p lic a t io n a n d s h o u ld e x te n d t o a ll cla sses o f w o r k e r s , e x c e p t t h a t w h e r e th e w o r k m u s t n e c e s s a r ily b e c o n t in u o u s s p e c ia l a r r a n g e m e n ts w ill b e n e ce sssa ry . 199. A c t i n g o n th e r e c o m m e n d a tio n s o f th e c o m m itte e , th e m in is t r y . in D e c e m b e r , 1915, issu e d a c ir c u la r o n S u n d a y la b o r t o a ll c o n t r o lle d e s ta b lish m e n ts, in w h ic h th e f o l l o w i n g o p in io n s * w e r e e x p r e s s e d : The minister is o f opinion that it is necessary in the interests both o f the workers and o f production that a weekly rest period— preferably Sunday— should be secured to all workers. This recommendation applies equally to all classes o f labor, male and female, adult and juvenile, though there must be certain necessary exception s. in the case o f labor such as that employed upon furnaces which could not be discon tinued without grave dislocation. Even in these cases, though it may not be possible to arrange fo r a general rest on any particular day in the week, it would still be desirable so to arrange the w ork that all persons engaged upon the w ork had, if on different days, a regular period o f rest. It is in 'th e opinion o f the minister preferable to w ork a moderate amount o f overtime in the w^eek, allowing a break on Sunday, rather than work con tinuously from day to day. It is still more strongly his view that where over time is worked in the week Sunday labor is not desirable. 200. T h e m in is t r y s u b s e q u e n tly a p p o in t e d in c o n s u lt a t io n w it h th e H o m e O ffice a c o m m itte e t o c o n s id e r d e m a n d s f o r S u n d a y la b o r a n d t o se cu re its d is c o n tin u a n c e w h e r e v e r p o s s ib le . I n A p r i l , 1917, a fu r t h e r le tte r w a s issu e d b y th e m in is t r y , in w h ic h i t w a s sta te d th a t— The minister, after further consultation with the various departments con cerned, is o f opinion that it is advisable that Sunday labor, with the exception o f shifts beginning on Sunday night or ending on Sunday morning, or o f work in connection with the necessary repair o f plant machinery, should be discon tinued as far as possible from the beginning o f May, and would be glad if you would make arrangements in your establishment to that end. 2 01. D u r in g th e p a s t t w o y e a r s th e r e h a s b e e n a s te a d y a n d c o n t in u o u s r e d u c t io n o f S u n d a y la b o r . F r o m r e p o r t s o f th e v a r io u s c o m m is s io n s a p p o in t e d in J u ly , 1917, t o in q u ir e in t o th e ca u ses o f in d u s t r ia l u n r e s t i t is e v id e n t t h a t w h a t S u n d a y la b o r s t ill r e m a in s is u n p o p u la r a n d m o r e th a n o n e c o m m is s io n u r g e d its d is c o n t in u a n c e : The temptation to engage on Sunday labor so as to earn higher rates o f pay has been pointed out to us as being conducive to overstrain, and we believe that it will be generally recognized that Sunday labor (w hich still prevails to 97 SUNDAY LABOR AND N IGH T WORK. some extent) should be discontinued except to meet absolute emergencies. (Northeast area.) W e consider that overtime and Sunday work should be reduced as much as possible. W e do not believe that they increase production in the long run. W e recognize that things are much better in this respect than they were, but there is still room for improvement. (W est Midlands area.) The amount o f overtime and week-end and Sunday work should be reduced to a minimum, subject to the exigencies of the national requirements. (Lon don and Southeastern area.) 202. T h e c o m m itte e r e c o g n iz e th a t th e a m o u n t o f S u n d a y la b o r at a n y m o m e n t m u s t n e c e s s a r ily v a r y to s o m e e x te n t a c c o r d in g t o th e n a tu r e a n d d e g r e e o f th e u r g e n t d e m a n d s f o r th e im m e d ia te d e liv e r y o f p a r t ic u la r t y p e s o f m u n itio n s . F ig u r e s , h o w e v e r , c o lle c t e d b y th e M in is t r y o f M u n it io n s s h o w th a t in c o n t r o lle d e s ta b lis h m e n ts e n g a g e d o n n o n c o n t in u o u s p ro c e s s e s th e n u m b e rs o f m e n a n d w o m e n e m p lo y e d o n S u n d a y w e r e , in J a n u a r y , 1918, v e r y s u b s ta n tia lly s m a lle r th a n th e y h a d b ee n 12 m o n th s e a r lie r. 203. A s r e g a r d s o r d e r s m a d e b y th e H o m e O ffice a u t h o r iz in g th e e m p lo y m e n t o n S u n d a y o f w o m e n a n d y o u n g p e r s o n s (o t h e r th a n v o lu n te e r w o r k e r s n o t e m p lo y e d d u r in g th e w e e k ), th e p o s it io n o n J a n u a r y 31, 1918, w a s s h o r t ly as f o l l o w s : General Orders.— (i) The general order (Munitions o f W ar) allows the Sun day employment o f workers employed on the three-shift system, and also (w here authority is granted by the superintending inspector o f factories) o f workers on the two-shift system, if a day off is given in lieu o f Sunday. No inform a tion is available as to the number o f firms taking advantage o f these con cessions. (ii) An order for national filling factories authorizes the employment o f women and young persons over 16 years on alternate Sundays, with a weekly limit o f 60 hours (excluding mealtim es). Little use is made o f this alternative. Special orders fo r individual w orks.— Particulars o f these orders are set out in the follow ing ta b le : N u m b e r o f orders affecting— E x te n t o f Sunday w ork. T o ta l n u m b e r of factories. W om en (o v e r 18). A .— E v e r y S u n d a y ....................................................................... 13.—In special e m e rg en cy ................................... : ..................... 0 .—Cases in w h ich a d a y o ff is allow ed in li e u .................. D .— Cases under 8 -hour sh ift sy ste m s.................................... 1 0 .— O ther cases: T w o Sundays in th re e ................................................. One Sunday, in t w o ...................................................... One Sunday*in th re e........ .......................................... *1 6 33 17 1 5 20 16 1 9 5 6 7 5 6 T o t a l.............................................................................. s 73 G ir ls 1 (14 to 18). • B oy s (14 to 18). 3 4 4 5 8 6 2 1 4 2 3 1......... N. B.— The above statements take no account o f course o f cases where night work ends on Sunday morning or begins on Sunday night. 1 O n ly one of these allow s th e e m p lo y m e n t o f girls u n d e r 16 on Sunday. 2 In th is case th e w om en w o rk n o t m ore th an s ix hours on Sun day, a n d on ly three hours on tw o M ondays in three—th e th ird M on d a y b e in g free fro m em p lo y m e n t. 3 In five instances the sam e fa c to r y is represented tw ice u n d er the headings A to E . 80935°— 19-------7 98 INDUSTRIAL HEALTH AND EFFICIENCY. 204. S u b s e q u e n t e x p e r ie n c e h a s f u ll y c o n fir m e d th e o r ig in a l r e c o m m e n d a t io n o f th e c o m m itte e th a t it is e ss e n tia l f o r h e a lth a n d o u t p u t a lik e th a t S u n d a y la b o r s h o u ld b e c o n fin e d t o — (a) S u d d e n e m e rg e n cie s , in c lu d in g th e m a k in g u p o f a r re a rs in p a r t ic u la r s e c t io n s ; a n d (& ) R e p a ir s , t e n d in g fu r n a c e s , e tc. (t h e m e n so e m p lo y e d b e in g g iv e n a c o r r e s p o n d in g p e r io d o f re st d u r in g so m e o t h e r p e r io d o f th e w e e k ). 205. S u c h t e m p o r a r y c o n c e s s io n s as m a y b e u n a v o id a b le s h o u ld be c o n fin e d w it h in n a r r o w lim it s a n d te r m in a te d as s o o n as p r a c t ic a b le . NIGHT WOBK. 206. T h e r e is n o le g a l r e s t r ic t io n u p o n n ig h t w o r k f o r m e n . I t is o n ly le g a l f o r b o y s in c e r ta in s p e c ifie d c o n t in u o u s p ro c e s s e s . T h e e m p lo y m e n t o f w o m e n a t n ig h t h a s b e e n p r o h ib it e d f o r m o r e th a n 70 y e a r s in th e t e x t ile tra d e s , a n d h a s n e v e r b e e n a llo w e d in n o n t e x t ile tr a d e s s in c e t h e y w e r e b r o u g h t u n d e r th e p r o v is io n s o f th e fa c t o r y a c ts 50 y e a r s a g o . I t w a s fin a lly a b o lis h e d b y in t e r n a t io n a l a g r e e m e n t fr o m 12 E u r o p e a n c o u n tr ie s w h ic h s ig n e d a c o n v e n t io n d r a w n u p a t th e in t e r n a t io n a l c o n fe r e n c e h e ld a t B e r n e in 1906. T h e s e c o u n tr ie s in c lu d e d , in a d d it io n t o G r e a t B r it a in , A u s t r ia a n d F r a n c e , G e r m a n y , B e lg iu m , I t a l y , P o r t u g a l, S p a in , a n d S w it z e r la n d . T h e a g r e e m e n t w a s b a s e d u p o n th e re su lts o f in q u ir ie s in t o th e e ffe cts — e c o n o m ic a l, p h y s ic a l, a n d m o r a l— o f n ig h t w o r k f o r w o m e n . T h e o b je c t io n s t o n ig h t w o r k m a y b e s h o r t ly s u m m a r iz e d as f o l lo w s : (a) I t is u n e c o n o m ic a l o w in g t o th e h ig h e r c o s t o f w a g e s , lig h t in g a n d h e a tin g . (b) S u p e r v is io n a t n ig h t is n o t a lw a y s s o g o o d as b y d a y o w in g t o less e ffe c t iv e l ig h t i n g o r t o th e e m p lo y m e n t o f fe w e r o r less e x p e r ie n c e d fo r e m e n . ( c ) T h e i n f e r i o r it y o f lig h t in g m a y m a k e w o r k a n d e s p e c ia lly fin e w o r k m o r e d ifficu lt. (d) T h e w o r k e r s m a y b e u n a b le t o o b t a in a d e q u a te s le e p b y d a y . T h is m a y b e th e r e s u lt o f th e d is lo c a t io n o f th e o r d in a r y h a b its o f l i f e o r o f s o c ia l ca u se s, e. g ., n o is e s a n d d is tu r b a n c e s , o r th e c a re o f c h ild r e n . W o r k e r s a r e t e m p t e d t o c u r t a il th e ir p e r io d o f sleep t h r o u g h r is in g t o jo i n th e fa m ily m id d a y m e a l o r t o o b t a in so m e r e c r e a t io n a n d a m u se m e n t. (e) S o c ia l in te r c o u r s e , r e c r e a tio n a n d a m u se m e n t m a y b e s e r io u s ly in t e r fe r e d w ith . S u it a b le o p p o r t u n it ie s f o r a tte n d a n c e a t in s t r u c t io n a re im p o s s ib le , u n le ss s p e c ia l fa c ilit ie s a re a llo w e d . ( / ) F i n a ll y i t is n o t n a tu r a l to t u r n th e n ig h t in t o d a y a n d t o d e p r iv e th e b o d y o f th e b e n e fic ia l e ffe c ts o f s u n lig h t. SUNDAY LABOR AND NIGHT WORK. 99 207. U n d e r e x is t in g c o n d it io n s n ig h t w o r k at a n y r a te f o r m e n a n d w o m e n is in e v ita b le . I t is th e m e a n s b y w h ic h th e m a c h in e r y is e m p lo y e d f o r th e g r e a te s t p r o p o r t io n o f th e 2 4 h o u r s a n d so lo n g as th e h o u r s o f w o r k are n o t u n d u ly l o n g a n d d u e a tte n tio n is p a id to th e e n v ir o n m e n t o f th e w o r k e r , it is u n d o u b t e d ly p r o d u c t iv e o f in c r e a s e d o u tp u t. N ig h t w o r k m u st t h e r e fo r e c o n t in u e f o r m e n a n d w o m e n w h ile th e p re s e n t e m e r g e n c y la sts, h o w e v e r c o n c lu s iv e m a y b e th e a r g u m e n ts a g a in s t its in t r o d u c t io n as a p e r m a n e n t p a r t o f th e in d u s t r ia l o r g a n iz a t io n o f th e c o u n t r y . 208. T h e c o m m itte e a re n o t sa tisfie d t h a t th e r e is th e sa m e ju s t ifi c a t io n f o r th e e m p lo y m e n t a t n ig h t o f g ir ls a n d -b o y s . T h e o b je c tio n s t o n ig h t w o r k f o r w o m e n a re g r e a t ly a c ce n tu a te d in th e ca se o f g r o w i n g g ir ls a n d th e c o m m itte e a re s t r o n g ly o f o p in io n t h a t a ll n ig h t w o r k f o r g ir ls u n d e r 18 s h o u ld b e te r m in a te d . A s a lr e a d y s ta te d in p a r a g r a p h 144, step s h a v e a lr e a d y b e e n ta k e n b y th e H o m o O ffice a n d th e M in is t r y o f M u n it io n s to t e r m in a te a ll n ig h t e m p lo y m e n t o f g ir ls u n d e r 16 a n d t o r e s tr ic t w it h in v e r y n a r r o w lim it s th e e m p lo y m e n t o f g ir ls b e tw e e n 16 a n d 18. F o r b o y s a lso, a n d e s p e c ia lly th o se u n d e r 16, n ig h t w o r k is h ig h ly u n d e s ir a b le , a n d th e c o m m itte e f u ll y in d o r s e th e r e c o m m e n d a tio n c o n ta in e d in th e r e p o r t o f th e d e p a r tm e n ta l c o m m it t e e 1 o n T h e N ig h t E m p lo y m e n t o f M a le Y o u n g P e r s o n s th a t— W e are strongly o f opinion that the employment of boys under 18 years o f age at night in factories is undesirable and ought not to be allowed to any greater extent, or at an earlier age, than is absolutely necessary. This applies specially to boys between 14 and 16 years o f age, when the rate o f growth is most rapid, and when the conditions o f life ought to be rendered as favorable as possible for mental and physical development. 209. A q u e s tio n o f c o n s id e r a b le im p o r t a n c e in c o n n e c t io n w it h th e s h if t sy ste m is h o w lo n g th e w o r k e r s s h o u ld r e m a in o n n ig h t s h if t at a n y on e tim e . A w e e k is th e m o s t c o m m o n p e r io d . C h a n g e s a re so m e tim e s m a d e f o r t n ig h t ly o r m o n t h ly a n d in s o m e in s ta n c e s th e r e is n o a lte r n a tio n a t a ll, th e w o r k e r s r e m a in in g c o n t in u o u s ly o n d a y o r n ig h t w o r k , e x c e p t f o r o c c a s io n a l c h a n g e s a m o n g s t in d iv id u a ls c a r r ie d o u t f o r th e c o n v e n ie n c e o f th e p e r s o n s c o n c e r n e d . O n p h y s io lo g ic a l g r o u n d s in fr e q u e n t c h a n g e s a re t o b e p r e fe r r e d . T h e q u e s t io n is, h o w e v e r , o n e th a t is la r g e ly in flu e n c e d b y th e s o c ia l c o n d it io n s u n d e r w h ic h th e w o r k e r liv e s a n d w o r k s . I n th e H o m e O ffice g e n e r a l o r d e r o f S e p te m b e r , 1916, n o r e q u ir e m e n t is m a d e as t o p e r io d ic a l ch a n g e s. T h e m a tte r is l e f t t o th e in d iv id u a l e m p lo y e r s to s e ttle w it h th e ir w o r k p e o p le . 210. I n v ie w o f its im p o r t a n c e th e c o m m itte e d ir e c t e d th e ir in v e s tig a t o r s to p a y s p e c ia l a tte n tio n t o th is s u b je c t. T h e d a ta c o lle c t e d b y th e m h a s b e e n b r o u g h t t o g e t h e r in th e m e m o r a n d u m o n T h e C o m p a r a t iv e E ffic ie n c ie s o f D a y W o r k a n d N ig h t W o r k in c lu d e d in th e 1Cd. 6503, 1912. 100 INDUSTRIAL HEALTH AND EFFICIENCY. c o m m it t e e ’s in t e r im r e p o r t . th e f o l l o w i n g c o n c lu s io n s : A n e x a m in a t io n o f th e d a ta s u g g e s ts W om en.— (i) In monotonous processes which call for little physical effort, such as those concerned with cartridge making, discontinuous night work o f women gives an output which rarely falls much more than 10 per cent below, and usually approximates closely to that obtained by day. (ii) Continuous night work is productive o f definitely less output than is the discontinuous system ; and the committee have failed to obtain evidence that the output o f the continuous day shift balances this inferiority. (iii) The timekeeping o f girls and o f women o f 10 years o f age and upward, working for alternate weeks o f day and night shifts, is even better maintained than when they work on permanent day shifts. (iv ) Timekeeping o f girls o f 14 to 18 is practically the same whether they work on permanent day shifts or on day and night shifts. The committee, basing their opinion upon these conclusions, consider it undesirable to adopt for women continuous night shifts in any factory not at present so working or not yet open, and suggest that wherever practicable this system should be discontinued. M en.— The conclusions arrived at with respect to women are true, with slight modifications, for men. (i) There is no significant difference between the rate o f output in niglit and day shifts managed on the discontinuous system. (ii) W ith men, as well as with women, the discontinuous system is prefer able to continuous night work. 211. T h e in fe r io r it y o f c o n t in u o u s n ig h t w o r k ca n p r o b a b ly b e r e fe r r e d t o a fa ilu r e t o se cu re p r o p e r re st a n d s le e p in th e d a y tim e . W o m e n o n c o n tin u o u s n ig h t w o r k a re lik e ly t o p e r f o r m d o m e s t ic d u tie s , w h ic h w h e n th e y w o r k a lte r n a te ly in th e t w o s h ift s , is im p r a c t ic a b le . E v id e n c e , in d e e d , e x is ts o f w o m e n e m p lo y e d in p e r m a n e n t n ig h t s h ift s w h o s t ill c a r r y o n t h e ir o r d in a r y d a y t im e a v o c a t io n s . t h o u g h it is n o t su fficie n tly e x te n s iv e (s t a t is t ic a lly ) t o b e o ffe r e d as a p r o o f o f th e s u g g e s t io n ju s t m a d e . SECTION VIII.— LOST TIME AND INCENTIVE. 212. T lie a m o u n t o f tim e lo s t in in d u s t r y v a r ie s w id e ly in d iffe r e n t fo r m s a n d p ro c e s s e s , a n d in a c c o r d a n c e w it h v a r y in g c o n d it io n s a n d c ir cu m s ta n ce s o f la b o r , e n v ir o n m e n ta l a n d p e r s o n a l. I t rise s in th e b u lk o ft e n t o as m u c h as h a lf a d a y p e r w e e k , t h o u g h it v a r ie s in o c c u r r e n c e b o t h in th e d a y a n d in th e w e e k , b e in g g r e a te s t as a r u le a t th e t w o en d s o f th e d a y a n d th e t w o e n d s o f th e w e e k , v a r y in g in r e la tio n t o th e le n g t h o f th e w o r k in g d a y . I t is f o r th is r e a s o n th a t it is n e ce ssa r y , in th e c o n s id e r a t io n o f lo s t tim e , first t o a sc e r ta in th e tim e w o r k e d . I t is o f n o v a lu e t o d e te r m in e th e tim e lo s t u n le ss it b e c o r r e la te d w it h th e tim e w o r k e d , w h e th e r n o r m a l o r o v e r tim e . T h e m e re r e c o r d o f so m a n y h o u r s lo s t o r su ch a n d su ch a p e r c e n ta g e o f lo s t tim e is v a lu e le ss a n d e v e n m is le a d in g . 213. S p e a k in g g e n e r a lly th e c o m m itte e h a v e fo u n d th a t th e w h o le s u b je c t o f lo s t tim e c a lls f o r m u c h m o r e c a r e fu l c o n s id e r a t io n a n d d e te r m in a tio n th a n it h a s h it h e r t o r e c e iv e d . T h e te r m is o n e w h ic h c o v e r s v a r y in g c o n d it io n s . F ir s t , th e re is w h a t m a y b e d e s c r ib e d as g r o s s lo s t tim e , n a m e ly , a c tu a l a b se n ce fr o m w o r k , f o r w h o le d a y s o r w eek s, o r su b s ta n tia l p o r t io n s o f d a y s o r w eek s, a d e g r e e o f b r o k e n tim e w h ic h g r a v e ly in t e r fe r e s w it h th e m a n a g e m e n t o f a f a c t o r y , a n d w h ic h is d u e t o v a r io u s d o m in a n t fa c t o r s , s o c ia l o r in d u s t r ia l. S e c o n d ly , th e re is w h a t is k n o w n as lo ss o f “ q u a r te r s ,” a n d p a r t ic u la r ly o f th e “ m o r n in g q u a r te r .” I n h is in v e s tig a tio n s f o r th e c o m m itte e , P r o f L o v e d a y e x a m in e d th is p o in t in 14 cla sses o f w o r k — lig h t , m e d iu m , a n d h e a v y (in c lu d in g a p p r o x im a t e ly 17,000 p e r s o n s ) — w o r k in g a n o r m a l d a y s h if t o f 53 h o u rs , c o m m e n c in g a t 6 a. m . o r b e tw e e n G a n d 7 a. m ., w it h th e r e s u lt th a t h e fo u n d th a t th e p e r c e n ta g e o f lo s t tim e b e fo r e b r e a k fa s t v a r ie d f r o m 2 0 t o 58. W it h o u t d e c id in g w h e th e r th is lo s s w a s “ a v o id a b l e ” o r n o t, th e fa c t is th a t it o c c u r r e d , a n d it o c c u r r e d in th e m o r n in g q u a rte r, a n d w a s g r e a t ly in e x ce ss o f a n y s im ila r lo s s in fa c t o r ie s w h ic h s ta r te d w o r k la te r th a n 6 a. m . A l l o v e r th e c o u n t r y m u n it io n w o r k s h a v e h a d th is e x p e r ie n c e o f lo s t tim e in th e “ m o r n in g q u a rte r ” u n d e r th e t w o b r e a k sy ste m (w h ic h b e g in s b e f o r e b r e a k fa s t a n d so in v o lv e s t w o m e a l b r e a k s d u r in g th e d a y ) . T h e m a g n it u d e o f th is c o m m o n e x p e r ie n c e , th e a c tu a l n u m b e r o f a b se n ces, th e f u t il i t y o f w o r k in g b e f o r e h a v in g h a d a m o r n in g m e a l, a n d th e w a s te o f tim e in c u r r e d in t w o b r e a k s d a ily , h a v e le d m a n y e m p lo y e r s t o th e v ie w t h a t th e t w o b r e a k sy s te m m ig h t w e ll b e a b o lis h e d . T h ir d ly , th e r e is tim e lo s t in s t a r t in g w o r k , e v e n b y th e g o o d tim e k e e p e r , a n d s im ila r ly tim e 101 102 INDUSTRIAL HEALTH AND EFFICIENCY. is lo s t in e n d in g w o r k . A s t a t e m e n t 1 m a d e t o th e c o m m it t e e b y D r . V e m o n m ay be q u oted : In most works the motive pow er is electric, and in some the pow er supplied to each section is registered by a separate wattmeter. The machinery is started running shortly before w ork begins, and as the operatives get going, one after another, the power consumption steadily rises to a maximum, which is attained when all the operatives have started. By means o f these power records the rate o f starting and stopping w ork can readily be ascertained in many instances, though not in factories where time is spent in a prelim inary collection o f necessary tools and material, and in their adjustment. The ac companying figure records the increments o f electric power, over that required to drive the- free-running machinery, on starting and stopping the afternoon spell o f work. The continuous line represents the power supplied to. a large shell shop which turned out 30,000 3-inch shrapnel shells per week. W e see Starting work. Stopping work. that the pow er supplied started mounting up twTo minutes after starting time, and reached h alf its fu ll value in fou r minutes. The dotted-line curve, repre senting the power supplied to a section o f 200 women turning fuse bodies, did not begin to rise till five minutes after starting time, and did not attain h alf its maximum value until 11 minutes after starting time. In other words, the operatives wasted about seven minutes more in starting than did the operatives in the shell shop, most o f whom were men. On the other hand, the fuse turners finished m ore strongly than the shell-shop operatives, as can be seen by com paring the tw o curves given on the right side o f the figure, and it was found that both sets o f operatives lost, on an average, about the same aggregate of time in starting and finishing during the course o f the wThole day, viz, 34 min utes. The shell-shop operatives did not start much more prom ptly than the fuse turners in the morning, partly because there was more delay in the arrival o f their material, but in spite o f this, if the operatives o f both shops had started equally prom ptly and finished equally strongly, 9 minutes out o f the 34 would have been saved. There was no inherent reason why w ork should iSee Memorandum No. 12 (Cd. 8344),, LOST TIME AND INCENTIVE. 103 have been started promptly in one shop and not in the other. It was merely a custom o f the particular shop, and even then the custom was not a fixed one. A series of meter readings of the women’s section were taken for several days before and after the Easter holiday, and 9 days before the holiday the aver age amount o f time wasted in starting after dinner was found to be 11 minutes; 2 days before it was 14 minutes. Two days after the holiday it was 16 min utes ; 3 days after it was 15 minutes; and 5 days after it was 12 minutes. That is to say, it increased with the slackness o f the operatives caused by the immediate approach of the holiday, and still more with their postholiday lassitude. There can be no necessity for the waste even of 25 minutes in starting and finishing work. Ten or 15 minutes should be an ample allowance, and the 20 minutes thereby saved could be deducted from working hours without any reduction of output At dne large works the manager informed me that he made a point o f going into the various shops at starting time, and seeing that the operatives began work promptly. In this way a considerable amount at time was saved. 214. S u b s e q u e n tly 1 D r . V e r n o n w a s a b le t o r e p o r t a fu r t h e r in v e s t i g a t io n in r e g a r d t o w o m e n t u r n in g a lu m in u m fu s e b o d ie s . T h e m a c h in e r y w a s s ta r te d u p a fe w m in n te s b e f o r e n o r m a l s t a r t in g tim e , th e p o w e r (r e c o r d e d b y w a t t m e t e r ) r e q u ir e d f o r th is p u r p o s e b e in g d e d u c t e d f r o m s u b se q u e n t r e a d in g s . T h e r e s u lts w e r e : TIME LOST IN STARTING AND STOPPING W O R K . Average number of minutes lost w h e n Time of year at which power records were taken. Apr. 13-May 1,1916........................................ June 6 7, 1916................................................... Jan. 10-18, 1917................................................ Total Relative number hourly starting Finishing Starting Finishing of min work in work in work in work in utes lost. output. morning. morning. afternoon. afternoon. U.O 12.5 10.0 L5 15 .5 12.3 10.0 7.0 9.3 S.0 0.0 37.1 33.0 26.5 13* 137 151 In an adjoining section, consisting mostly of women turning smaU brass time fuses and primers, but including also the women engaged in milling a screw thread, the total times lost in starting and stopping were 34.7, 33.5 and 28.3 minutes in the April, June, and January periods, respectively. In the next two sections, occupied by men engaged in tool making and in controlling automatic machines, the average times lost were nearly the same throughout, but thin may have been due to the fact that most of the workers were paid at a time rate and not at a Apiece rate. However, in two other sections o f lathe workers, mostly women, which were situated in a different part of the factory, there was likewise no appreciable reduction in the time lost, though these workers were paid at a piece rate and must have had a bigger hourly output in January, 1917, than in April, 1916. It is very likely that they wasted less time by taking fewer and shorter rest pauses during the progress of their work, but on this point I made no observations. 215. I t is o f in te r e s t t o n o te in p a s s in g t h a t D r . V e r n o n c la im s th a t th e in c r e a s e d h o u r ly o u t p u t r e s u lta n t o n a r e d u c t io n o f h o u r s is d e p e n d e n t, a s a r u le , o n t w o fa c t o r s . F ir s t , a s p e e d in g u p o f m a n y o r • See Memorandum No. 18 (Cd. 8628), 104 INDUSTRIAL HEALTH AND EFFICIENCY. a ll o f th e a c tu a l m o v e m e n ts r e q u ir e d in th e m e c h a n ic a l p r o c e s s ; a n d s e c o n d ly , th e a v o id a n c e o f lo s t tim e b y s t a r t in g w o r k p r o m p t ly , b y t a k in g fe w p a u se s d u r in g th e p r o g r e s s o f th e w o r k , a n d b y c o n t in u in g th e w o r k m o r e n e a r ly t o th e n o m in a l s t o p p in g tim e . T h is o b s e r v a t io n le a d s u p to a fo u r t h k in d o f lo s t tim e , n a m e ly , th a t d u e t o u n r e g u la t e d rest p a u se s, a b se n ce o f p a u se s, t o o lo n g s p e lls a n d o t h e r s im ila r p o in t s in f a c t o r y o r g a n iz a t io n o f h o u r s . T h e c u s to m in m a n y w o r k s is f o r o p e r a t iv e s t o w o r k f o r a s p e ll o f fiv e h o u r s , a n d th e n a ft e r a n h o u r ’s m e a l in t e r v a l f o r a n o th e r s p e ll o f fo u r a n d ah a lf t o fiv e h o u rs . S u c h sp e lls , in th e v ie w o f th e c o m m itte e , a re t o o lo n g f o r m o s t w o r k e r s , a n d y e t, i f a s e c o n d o r t h ir d in t e r v a l w7e re in t r o d u c e d , e x t r a tim e w o u ld b e lo s t in s t a r t in g a n d s t o p p in g . U n d e r p re s e n t c ir cu m s ta n ce s , h o w e v e r , m u c h tim e is o ft e n lo s t b y th e o p e r a tiv e s t a k in g re st a t ir r e g u la r o r u n s u ita b le tim e s. T h e c o m m it t e e r e c o m m e n d a p r o p e r ly r e c o g n iz e d sy ste m o f re st p a u se s. A d e fi n it e ly fix e d te n -m in u te b r e a k in th e m id d le o f th e m o r n in g a n d a ft e r n o o n sp e lls , d u r in g w h ic h o p e r a t iv e s r e m a in a t th e ir m a c h in e s (a n d p o s s ib ly ta k e lig h t r e fr e s h m e n t c o n v e y e d t o t h e m ), h a s b e e n fo u n d in p r a c t ic e a v a lu a b le a id t o th e r e d u c t io n o f lo s t tim e a n d in c re a s e in o u tp u t. S o m e t y p e s o f w o r k n e e d lo n g e r a n d m o r e fr e q u e n t re st p a u se s th a n o th e rs, a n d th e b e s t tim e s a n d o c c a s io n s c a n b e d e t e r m in e d o n ly b y e x p e r im e n t. L a s t ly , th e r e is th e lo s t tim e d u e to t o o l o n g h o u r s o f w o r k a n d e x c e s s iv e o v e r tim e . “ O v e r t im e m a y a c t,” w r it e s P r o f . L o v e d a y , “ e ith e r as fin a l o r efficie n t ca u se o f lo s t tim e .” E m p lo y e e s m a y d e lib e r a t e ly m iss n o r m a l h o u rs , o r w o r k s la ck , in o r d e r t o m a k e th e b e t t e r -p a id h o u r s o f o v e r tim e m o r e e x p e d ie n t o r e v e n n e ce ssa r y . O r , a g a in , o v e r tim e o r t o o lo n g h o u rs , b y th e ir e x h a u s t in g e ffe ct, r e s u lt in lo s t tim e as a co n s e q u e n ce . T h e p r o lo n g e d h o u r s a n d th e S u n d a y la b o r d u r in g th e e a r ly p e r io d o f th e w a r p re s s u r e o n in d u s t r y a c t u a lly r e s u lte d a ft e r a tim e in m a n y ca ses in r e d u c in g s t a y in g p o w e r a n d in c r e a s in g lo s t tim e , o w in g t o in c re a s e o f fa t ig u e a n d sick n e s s, o f d e cr e a s e d b r is k n e s s a n d r e s ilie n c e a m o n g th e w o r k ers. “ T h e r e c a n b e n o d o u b t ,” a c c o r d in g t o P r o f . L o v e d a y , “ th a t f o r th e a v e r a g e m a n h ig h w a g e s e a r n e d b y lo n g h o u r s a re t o o d e a r ly e a r n e d .” THE CAUSES OF LOST TIME. 216. A c o n s id e r a t io n o f th e c h a r a c te r o f lo s t tim e m a k e s m a n ife s t its p r in c ip a l ca u se s. S o m e o f th e m a re in h e r e n t in th e c ir c u m s ta n c e s o f th e p r e s e n t tim e , a r is in g o u t o f th e w7a r o r th e e x c e p t io n a l c o n d i t io n s o f i n d u s t r y ; o th e r s a re r e la tiv e ly m o r e “ a v o id a b le .” T h e m o r e , h o w e v e r , th a t th e ca u se s a re e x a m in e d o r c o n s id e r e d in r e la tio n t o th e v a r y in g lo c a l o r o th e r c ir c u m s ta n c e s , th e less is it p o s s ib le t o c la s s ify wTith a n y d e g r e e o f p r e c is io n , o r s a y o f a n y g iv e n ca u se th a t LOST TIME AND INCENTIVE. 105 i t is in h e r e n t a n d u n c o n t r o lla b le , o r th a t it is c o n t r o lla b le a n d a v o id a b le. I t w ill b e fo u n d in p r a c t ic e to b e s o m e tim e s o n e a n d so m e tim e s th e o th e r . I t s h o u ld b e u n d e r s t o o d t h e r e fo r e th a t th e f o l l o w i n g c la s s i fic a tio n is m e r e ly m a d e f o r c o n v e n ie n c e . ( i ) C a u ses m a in ly in h e r e n t : (a) N e c e s s ity o f e m p lo y in g p e rs o n s o f i n fe r io r p h y s iq u e , ir r e g u la r h a b its , a n d w it h o u t e x p e r ie n c e o f fa c t o r y l i f e o r d is c ip lin e ; (b) I n m a n y d is tr ic ts in a d e q u a te h o u s in g a c c o m m o d a t io n s .a n d in su fficie n t tr a n s p o r t fa c ilit ie s , b o th c o n d it io n s m a d e m o r e a cu te b y a b n o r m a l c o n g e s t io n o f in d u s t r ia l p o p u l a t io n ; (c) W i n t r y w e a th e r , d a r k e n e d streets, a n d in e q u a litie s o f f o o d supply; ( d ) In s u ffic ie n c y o r ir r e g u la r it y o f s u p p ly o f r a w m a te r ia l, m a c h in e r y , o r t o o ls c o m in g t o th e f a c t o r y ; ( e ) D o m e s t ic d u tie s o f m a r r ie d w o m e n a n d w a r p r e o c c u p a t io n s a n d e x ig e n c ie s o f a ll w o r k e r s ; ( / ) S ic k n e s s a n d d ise a se c a u se d b y c o n d it io n s e x te r n a l to th e fa cto ry . ( i i ) C a u ses m a in ly c o n t r o l l a b le : (a) F a tig u e , sick n ess, a n d a c c id e n t o f f a c t o r y o r ig i n ; ( b) In su fficie n t w a g e i n c e n t iv e ; ( c ) F a u lt y in te r n a l o r g a n iz a t io n , le a v in g th e e m p lo y e e w it h o u t w o r k , le a d in g to t e m p o r a r y a n d s p o r a d ic b r e a k d o w n o r d e la y in m a n a g e m e n t, o r fa i l in g to p r o v id e f o r th e r e a s o n a b ly c o m fo r t a b le c o n d it io n s (lig h t in g , h e a t in g , rest, fe e d in g , e t c .) f o r m a x im u m a n d su s ta in e d e f f o r t ; (d) I n d iffe r e n c e , sla ck n e ss, la zin e ss, d is c o n t e n t ; ( e ) T h e p r a c t ic e o f e a r ly m o r n in g “ q u a rte rs ” o r d is lo c a t io n b e t w e e n s h if t s ; ( / ) P r o lo n g e d h o u r s , o v e r tim e , in su fficie n t re st p e r io d s o r h o li d ays; (g) E x c e s s iv e c o n s u m p t io n o f a lc o h o lic b e v e r a g e s . 217. O th e r ca u se s o f less im p o r t a n c e u n d o u b t e d ly o c c u r , a n d ev en th o s e m e n tio n e d d iffe r c o n s id e r a b ly , b o t h in e ffe c t a n d in lo c a lit y . W h ils t th e c o m m itte e d e c lin e t o g e n e r a liz e o r d r a w fin a l c o n c lu s io n s , th e y a re sa tisfie d th a t th e lo s s o f tim e , d ir e c t ly a n d in d ir e c t ly , d u e to fa t ig u e a n d ill h e a lth is s u b s ta n tia l, a n d is, as a r u le , g r e a t ly u n d e r ' e s tim a te d . O n th e o th e r h a n d th e re w o u ld seem t o b e a te n d e n c y t o o v e r e s tim a te th a t d u e to sla ck n e ss, la z in e ss, o r w il l f u l id lin g . O n th e w h o le , e v id e n c e fr o m a ll p a r ts o f th e c o u n t r y s h o w s, b e y o n d q u es t io n o r d is p u te , th a t a v e r y r e m a r k a b le a n d e n t ir e ly e x c e p t io n a l e ffo r t h a s b e e n m a d e b y a ll g r a d e s o f w o r k e r s t o m e e t th e in d u s t r ia l d e m a n d s o f th e n a t io n a l e m e r g e n c y . T h is lo n g -s u s ta in e d w ill t o serv e th e c o m m o n w e a l h a s p la y e d , in th e c o m m it t e e ’s v ie w , a p r o m in e n t 106 INDUSTRIAL HEALTH AND EFFICIENCY. p a r t in t h e m a in te n a n c e o f o u t p u t u n d e r d iffic u lt c ir c u m s ta n c e s a n d h a s c o n t r ib u t e d t o r e d u c e th e lo s t tim e d u e t o ill h e a lth . I n s p ite o f th e p r o lo n g e d a n d h e a v y s tr a in th e c o m m it t e e ’s m e d ic a l in v e s t ig a t o r s h a v e fo u n d a n u n e x p e c t e d ly la r g e m e a su re o f g o o d h e a lth a m o n g b o t h m e n a n d w o m e n , d u e , as f a r as th e e v id e n c e g o e s , t o th e p o w e r fu l im p e tu s o f a sen se o f p a t r io t is m , t o in c r e a s e d s o b r ie t y , t o h ig h w a g e s a n d th e ir r e s u lta n t h o m e c o m fo r t , t o th e r e s t r ic t io n o f h o u r s , a d o p te d n o n e to o s o o n , t o d iv is io n o f la b o r , a n d t o a v a s t im p r o v e m e n t in th e c o n d it io n s o f fa c t o r y life , e s p e c ia lly th e a r r a n g e m e n ts f o r “ w e l fa r e ” s u p e r v is io n a n d th e p r o v is io n o f ca n te e n fa c ilit ie s . W it h o u t th e o p e r a t io n o f th ese f a v o r i n g c o n t r ib u t o r y fa c t o r s th e c o m m itte e b e lie v e th a t th e re w o u ld h a v e b e e n m u c h h e a v ie r lo s s o f tim e a n d w id e s p r e a d b r e a k d o w n o f h e a lth . E v e n as it is, th e c o m m itte e c a n n o t e sca p e th e c o n c lu s io n th a t th e im m e n se in d u s t r ia l e ffo r t o f th e w a r is lik e ly to le a v e b e h in d m a n y s e r io u s p h y s ic a l d is a b ilitie s . 218. T h e ca u se s a n d c o n d it io n s o f lo s t tim e a re m a tte r s o f n a t io n a l im p o r t a n c e f o r th e fu t u r e , a n d th e c o m m itte e h o ld s t r o n g ly th a t th e p a s t n e g le c t o f th is s u b je c t s h o u ld b e r e m o v e d o n c e a n d f o r a ll. T h e y a d v o c a te s h o r te r h o u r s , im p r o v e d c o n d it io n s o f la b o r , a n d a h ig h e r s ta n d a r d o f e fficie n t w o r k m a n s h ip i f in d u s t r y is t o c o m e in t o its o w n a n d w o r k e r s o f a ll g r a d e s a re t o o b t a in th e ir f u l l r e w a r d , w it h o u t let, h in d r a n c e , o r im p a ir m e n t. T o th is e n d th e c o m m itte e r e c o m m e n d th a t m a n a g e r s a n d o th e r r e s p o n s ib le a u th o r itie s in f a c to r ie s s h o u ld k e e p c a r e fu l r e c o r d s — (a) O f lo s t a n d b r o k e n t im e ; ' (h) O f a b se n ce o r b r o k e n tim e d u e t o s ic k n e s s ; a n d (c) W h e r e p r a c t ic a b le , o f th e o u t p u t p e r w o r k e r p e r h o u r . T h e r e g u la r s t u d y o f th e se r e c o r d s ca n n o t f a i l t o p r o v e v a lu a b le 'a s a g u id e to th e ca u ses a n d c o n d it io n s o f lo s t tim e a n d th e m e a n s o f its r e d u c t io n o r r e m o v a l in in d iv id u a l w o r k e r s . I t is im p o r t a n t to r e m e m b e r th a t th e m a n o r w o m a n is n o t a m a c h in e , a n d s h o u ld n o t b e tr e a te d as su ch . W h a t is n e e d e d is n o t a c a s t -ir o n sy ste m o f e m p lo y m e n t , b u t a s y m p a th e t ic a n d c o r r e c t u n d e r s t a n d in g o f th e p h y s ic a l a n d m e n ta l c a p a c it ie s o f e a ch w o r k e r a n d th e ir m o st s a tis f a c t o r y a n d e c o n o m ic a l a p p lic a t io n . INCENTIVES TO WORK. 219. C lo s e ly r e la te d to th e q u e s tio n o f lo s t tim e is th a t o f in c e n t iv e t o w o r k , a n d in th e c o u r s e o f t h e ir in v e s t ig a t io n s th e c o m m itte e h a v e o b s e r v e d a r e la tio n e x is t in g b e tw e e n su ch in c e n tiv e s a n d th e h e a lt h o f th e w o r k e r . I n d e e d , t h e y are d is p o s e d t o p la c e th e h e a lth a n d p h y s ic a l fitn e ss o f th e in d iv id u a l w o r k e r as th e firs t n e ce s s a r y c o n d i t io n o f o u tp u t, a n d t o th a t e n d th e y d e s ir e t o la y e m p h a s is u p o n th e e x tre m e v a lu e o f a ll f a c t o r y c o n d it io n s w h ic h c o n t r ib u t e t o s u c h LOST TIME AND INCENTIVE. 107 h e a lth — g o o d lig h t in g , e ffe c t iv e v e n t ila t io n , su fficie n t h e a t in g , c le a n lin e ss , re st r o o m s , p r o p e r c a n te e n a c c o m m o d a t io n , p r o t e c t io n f r o m in d u s t r ia l p o is o n in g a n d d a n g e r o u s m a c h in e r y , s u r g e r ie s , s u ita b le w e lfa r e w o r k w it h in a n d o u ts id e th e fa c t o r y — a ll th e se a re c o n d it io n s o f first a n d fu n d a m e n t a l im p o r t a n c e fr o m th e p o in t o f v ie w o f h e a lth a n d in c e n t iv e t o w o r k . A h y g ie n ic e n v ir o n m e n t a t h o m e a n d in th e w o r k s h o p is in d e e d th e first n e ce s s ity f o r s e c u r in g a h e a lt h y p o p u la t io n o f w a g e e a rn e rs t o w h o m a w a g e sy ste m m a y a p p e a l as an in c e n t iv e t o w o r k . S e c o n d ly , th e c o m m itte e w o u ld p la c e a p r o p e r ly o r g a n iz e d fa c t o r y , g o o d o r d e r a n d d is c ip lin e , a n d s u ita b le h o u r s o f w o r k (c o m b in e d w it h p r o p e r rests a n d p a u se s, a n d a m in im u m o f n ig h t e m p lo y m e n t ) as c o n d u c iv e t o e fficie n t w o r k m a n s h ip . “ W h e n o n c e in d u s t r ia l l i f e h a s b e e n e n te r e d u p o n ,” w r it e s P r o f . L o v e d a y , “ th e o r d e r e d a n d sy s te m a tic r o u tin e o f a m o d e r n f a c t o r y is a d ir e c t s tim u lu s d u r in g e v e r y 24 h o u r s t o th e r h y t h m o f a c t iv it y a n d r e s t ; th e b e tte r th e o r g a n iz a t io n , a n d th e b e tte r th e h y g ie n ic e n v ir o n m e n t th e g r e a t e r is th e s tim u lu s t o a c t iv it y .” T h e t h ir d in c e n tiv e , t h o u g h p r o b a b ly th e o n ly o n e t h o u g h t o f b y m a n y e m p lo y e r s , is th a t o f w a g e . T o b e a n in c e n tiv e in a c tu a l p r a c t ic e , h o w e v e r , th e w a g e s y s te m a d o p t e d m u st b e e q u ita b le , w e ll a d ju s te d a n d c le a r ly u n d e r s t o o d . T h e c o m m itte e h a v e b e e n th e w itn e s se s o f n o t a fe w m is u n d e r s t a n d in g s le a d in g to lo s t tim e , r e d u c e d o u t p u t , a n d d is c o n t e n t w h ic h a r o s e n o t o n th e a m o u n t o f w a g e , b u t o n th e sy ste m o r m a n n e r o f its p a y m e n t. F o u r t h ly , u n d e r c o n d it io n s o f r e p e t it io n w o r k , e s p e c ia lly i f m o n o to n o u s , p ie c e ra tes a p p e a r to p r o v id e b e tte r in c e n tiv e th a n tim e w a g e s , a n d tim e w a g e s w it h a b o n u s th a n a fla t tim e ra te . F in a lly , in r e la tio n t o in c e n tiv e s to la b o r it is n e ce ssa r y t o r e m e m b e r th e se r io u s e ffe c t u p o n tim e k e e p in g a n d o u t p u t o f h o u r s o f la b o r , w h ic h p r e c lu d e a tte n tio n t o h e a lth a n d r e c r e a t io n a n d d o m e s t ic l ife , a n d o f a s c a le o f w a g e s w h ic h p la c e s th e w a g e e a r n e r a b o v e o r b e y o n d th e o r d in a r y a n d c u s to m a r y r e q u ir e m e n ts o f h is s ta n d a r d o f c o m fo r t . T h e c o m m itte e h a v e seen lo s t tim e d ir e c t ly r e s u ltin g fr o m b o th o f th e se c o n d it io n s a n d t h e y h a v e n o d o u b t th a t m u c h o f th e p r e s e n t la b o r u n r e s t is d u e t o th e in t e r r e la t io n s h ip o b t a in in g b e tw e e n w a g e s a n d th e s ta n d a r d o f c o m fo r t . I t is, o f c o u r s e , o b v io u s th a t su ch c o n d it io n s r a is e fa r -r e a c h in g a n d c o m p le x s o c ia l issu es w h ic h lie o u t s id e th e s c o p e o f th e p r e s e n t r e p o r t . B u t th e y a re m a tte r s w h ic h m u st b e b o r n e in m in d in c o n t r iv in g sch e m e s f o r r e d u c in g lo s t tim e a n d e n c o u r a g in g s te a d y w o r k . SECTION IX.— FOOD AND CANTEENS. 220. T h e r e is n o w a n o v e r w h e lm in g b o d y o f e x p e r ie n c e w h ic h p r o v e s th a t p r o d u c t iv e o u t p u t in r e g a r d to q u a lit y , a m o u n t, a n d sp e e d is la r g e ly d e p e n d e n t u p o n th e p h y s ic a l e ffic ie n c y a n d h e a lth o f th e w o r k e r . I n its tu r n su ch p h y s ic a l fitn e ss is d e p e n d e n t u p o n n u t r it io n . T h e p u r p o s e o f n u t r it io n is t o se cu re th e h e a lth , th e p r o p e r d e v e lo p m e n t a n d g r o w t h , th e r e p a ir a n d v it a l e n e r g y , o f th e h u m a n b o d y . F o o d e n e r g y is s p e n t in m a in t a in in g th e tissu es o f th e b o d y a n d th o b o d y h e a t a n d in d o in g w o r k . N u t r it io n is s tim u la te d b y th e c o o lin g e ffe c t o f fr e s h a ir, a n d b y b o d i ly e x e r cis e , a n d its n e e d s m u s t b e m e t b y a f o o d s u p p ly s u ita b le in c h a r a c te r a n d su fficien t in a m o u n t t o m e e t th e e x p e n d itu r e o n b o d y h e a t a n d w o r k . 221. T h e h u m a n b o d y c a lls th e n f o r a c o n s ta n t s u p p ly o f f o o d , first f o r its g r o w t h , f o r th e b u ild in g u p o f its tissu es a n d f o r r e p a ir , a n d s e c o n d ly as fu e l f o r th e p r o d u c t io n o f h e a t a n d e n e r g y . B o t h r e q u ir e m e n ts are in d is p e n s a b le , a n d f r o m th e n e c e s s ity f o r th e se th e r e is n o e sca p e. T h o u g h n o h a r d a n d fa s t lin e o f d iv is io n c a n b e d r a w n , it m a y b e sa id th a t c e r ta in k in d s o f f o o d w h ic h a re r e la t iv e ly r ic h in p r o t e in a n d m in e r a l m a tte r (m e a t, ch eese, m ilk , h e r r in g s , d r ie d p e a s, b e a n s, b r e a d , o a tm e a l, flo u r ) c o n t r ib u t e b o t h t o th e fo r m a t io n o f th e b o d y a n d its r e p a ir a n d s u p p ly it w ith fu e l f o r th e p r o d u c t io n o f h e a t a n d e n e r g y ; o th e r k in d s su ch as fa t (la r d , b u tte r , d r ip p in g , m a r g a r i n e ) , s u g a r , s a g o , a n d t a p io c a , a ffo r d an a b u n d a n t s u p p ly o f fu e l, b u t c a n n o t m a in ta in g r o w t h a n d r e p a ir . S t ill o th e r k in d s o f fo o d s (fr e s h fr u it s , g r e e n v e g e t a b le s ) c o n ta in a s m a ll p r o p o r t io n o f n u t r i m e n t, b u t in s u r e th e p r o v is io n o f th e b o d y w it h c e r ta in im p o r t a n t p r in c ip le s c o n d u c iv e t o g o o d h e a lth .1 T h e c o n s titu e n t p a r t s o f a d ie ta r y a re im p o r t a n t i f th e h ig h e s t v a lu e is t o b e o b ta in e d , b u t, s p e a k in g g e n e r a lly , fr e s h , d ig e s t ib le a n d a p p e t iz in g f o o d is m o r e im p o r t a n t th a n c h e m ic a l c o m p o s it io n o r p r o p o r t io n . I t w ill b e u n d e r s t o o d th a t d ig e s t ib ilit y is d e p e n d e n t p a r t ly u p o n th e f o o d it s e lf b e in g o f a n a tu r e w h ic h is e a s ily d ig e s t ib le a n d p a r t ly u p o n th e o r g a n s o f d ig e s t io n b e in g h e a lt h y a n d in g o o d w o r k in g o r d e r . F u r t h e r , it 1 When work is nervously exhausting, e. g., night work, the food of the worker re quires to be particularly light and digestible, well cooked and appetizing, for the organs of digestion then lack an adequate supply of nervous energy, and can not deal success fully with heavy indigestible and unappetizing meals. The warmth of the food is o f great importance. Hot drinks stimulate the tired worker. The proper adjustment of the food to the expenditure of nerve energy saves a great deal of indigestion and the minor complaints and lost time which result. 108 FOOD AND CANTEENS. 109 s h o u ld b e n o t e d th a t a v a r ie t y o f fa c t o r s a ffe ct th e r e la tiv e v a lu e o f f o o d t o th e in d iv id u a l c o n s u m in g it. F o r in s ta n c e , th e re is th e n a tu r e o f th e e m p lo y m e n t , w h e th e r s e d e n ta r y o r a c tiv e , a n d th e a m o u n t o f e n e r g y c a lle d fo r . W i t h in c re a s e o f w o r k th e re m u st b e p r o p o r t io n a t e in c r e a s e in q u a n t it y a n d in n u t r it iv e v a lu e o f th e f o o d ea ten . I l l - p a id la b o r e r s a n d o th e r s w h o s e f o o d a m o u n ts o n ly t o a b a r e m in im u m ca n n o t e ith e r p u t fo r t h th e sa m e e n e r g y o r w o r k at th e sa m e sp e e d as a w e ll-n o u r is h e d m a n . T h e m a n w h o h a s t o w o r k h a r d , lo n g , o r r a p id ly n e e d s a p r o p o r t io n a t e ly a m p le f o o d s u p p ly , c o m p o s e d o f h ig h ly n u t r it iv e in g r e d ie n ts , t o w ith s ta n d th e s tra in . F a t ig u e b o t h p r e v e n ts d ig e s t io n a n d d e m a n d s fo o d . A g e , sex , w e ig h t, a n d c o n s t it u t io n lik e w is e e x e r t in flu e n ce . W o m e r r e q u ir e o n an a v e r a g e a b o u t fo u r -fift h s o f th e f o o d s u p p ly o f a m a n a n d an a d o le s c e n t a b o u t s e v e n -te n th s. S e a s o n a n d c lim a te a lso a ffe c t th e q u e stio n . L a s t ly , th e p r e d is p o s in g in flu e n ce u p o n th e a lc o h o lic h a b it o f 'm a ln u tr itio n , b a d fe e d in g , a n d l o n g p e r io d s o f w o r k w it h o u t r e fr e s h m e n t s h o u ld b e b o r n e in m in d . T h e r e ca n b e n o d o u b t th a t “ in d u s tr ia l a lc o h o lis m ” is, in p a r t , d u e t o th e la c k o f c h e a p , g o o d fo o d . 222. W h a t , th e n , in g e n e r a l te rm s, is th e n e ce s s a r y d ie ta r y f o r a w o r k e r ? B r o a d ly , th e a n sw e r is a d ie ta r y c o n t a in in g a su fficien t p r o p o r t io n a n d q u a n tity o f n u t r it iv e m a te r ia l, s u ita b ly m ix e d , w h ic h is e a s ily d ig e s tib le , a p p e tiz in g , a n d o b ta in a b le a t a r e a s o n a b le co st. Character of food required.— The amount o f physical force expended in daily w ork and the environment o f the work have a great effect on the requirements o f the body for food. Hard labor and exposure to open air together call for increased food su pply; sedentary work in an artificially heated and confined atmosphere, on the other hand, reduces the output o f energy and less food is required. Natural foods yield the essentials required to replace the energy expended and for the repair and growth o f the body. They contain these essentials in the form o f protein, fat, and carbohydrates, and also supply salts and certain sub stances o f unknown nature, called vitamines, which exist in minute quantities in fresh foods and are necessary for the growth and health o f the body. Vita mines are removed by some o f the processes o f milling, e. g., in the preparation o f white flour, and polished white rice. They are destroyed by prolonged cook ing, and are absent from foods preserved in tins; they are present in butter, dripping, and margarine when made from beef fat, though absent when it is made from vegetable fat. For the preservation o f good health it is essential that fresh natural foods should be eaten in sufficient amount. Fortunately, the potato affords such a cheap natural food and makes a good diet with bread and tinned food. Protein is the chief solid constituent o f lean m eat; it is also pres ent in milk, cheese, and eggs and occurs in all vegetables, particularly in flour (bread ), peas, and beans; it is not only a source o f energy, but it is also a body builder, and no dietary can be complete without it. The body requires protein in the food in order to build up its cgvn living substance, and can not do so with the aid o f fat and carbohydrate alone. Protein stimulates the body to a greater expenditure o f energy than does an equivalent value o f carbohydrate or fat. There is reason to believe that more protein is required by tkose who work forcibly and rapidly than by those who work in a slow, steady manner, e. g., 110 INDUSTRIAL HEALTH AND EFFICIENCY. soldiers in the front line require more protein than agricultural laborers. Fat is chiefly derived from anim als; nuts (from which one kind o f margarine is made) also are rich in fat, but other vegetables only contain fat in a much smaller degree. Carbohydrates are mainly derived from vegetables in the form o f flour, potatoes, or sugar. Fat and carbohydrate can replace one another in a diet, but the body digests and deals best with a certain proportion o f each. Fat, however, yields weight fo r weight more than twice as much energy as carbohydrate, and so in cold climates and cold weather more fa t is naturally eaten. Experience shows that the diet should inelude raw food, fruit, or salads, in order to secure the vitamines which prevent scurvy. Fruit which is not overripe is particularly valuable.1 Potatoes, cabbage, onions, carrots, and turnips also contain the vitamines which prevent scurvy. Eight ounces o f potatoes a day w ill supply sufficient. Particu larly in times o f scarcity, when there is any restriction o f diet, it is advisable that vegetable food, such as potatoes, should form a large proportion o f the available diet, for the vegetables contain salts which neutralize the acids formed in the vital processes o f the body. Fortunately, the cheaper foods (bread, margarine, porridge, milk, herrings, cheese, beans, onions, cabbages, swedes, and the cheapest cuts o f meat) provide all the requisite nourishment, and are probably better adapted to maintain health than are more highly flavored and expensive foods which artificially stimulate the appetite. The drinking o f strong tea many times in the day is physiologically unsound, as also is the consumption o f sweetmeats between meals, especially by boys and girls. Sugar is not a natural food, but an arti ficially separated foodstuff. It should not be allowed to lessen the appetite for the natural complete foods. Calculation of energy value o f foodstuffs.— The energy value o f a foodstuff can be determined by burning a weighed quantity o f it in a suitable apparatus called a calorimeter and ascertaining how much heat it gives off. The large calorie, which is used as the unit o f energy value, is the amount o f heat required to raise 1 kilogram (2.1 pints) o f water fr o m ^15° to 16° C. through 1° C. (1.8° F .). Calculation has shown that, when dried, foodstuffs possess the follow ing energy v a lu e : One gram * o f— Calories. Protein is equivalent to___________________________________ 4 .1 Carbohydrate is equivalent to_____________________________4.1 Fat is equivalent to_______________________________________ 9. 3 The energy expended in mechanical work can also be expressed in calories, for 1 calorie has been found by experiment to be equivalent to the energy e x 1 It should, however, be remembered that at the present time fruit, with few e x c e p t io n s , is a prohibited import, and that foreign fruit is consequently in very short s u p p ly . Supplies should, therefore, as far as possible, be d r a w n f r o m home-grown fruit or s a la d s Children will eat this a n d vegetables. Raw fruit can be replaced by r a w s w e d e turnip. r a w , or it can be grated down and eaten on bread. 2 To express in terms of calories per pound it should be remembered that one pouiid is equal to 453.6 g r a m s; one ounce is equal to 28.35 g r a m s . Jirwample.— ^Suppose 1 pound of roast beef contained— Per cent. Protein----------- -------------------------------------------------------- — —.— 26. 75 F a t _______________________________________ __________ ______ 12. 90 In this case there would be ( 2 6 .7 5 X 4 .1 ) + ( 1 2 .9 0 X 9 .3 ) = 2 2 9 calories per 100 grams. In the pound of meat there would, therefore, be 2 2 9 X 4 .5 3 6 = 1 ,0 4 0 calories. F o r fuller information reference should be made to A n Inquiry into the Composi tion o f D ie ta rie s, with Special Reference to the Dietaries o f Munition W o r k e r s , by Viscount D un lu ce an d Capt. M. Greenwood, R. A. M. C. (T ), published as a special report by th e m ed ica l research com m ittee. Ill FOOD AND CANTEENS. pended in lifting 1 kilogram through 425.5 meters, which is about the energy expended by a man 70 kilograms (11 stone) in weight in walking up a staircase 6 meters (about 20 feet) in height. Sueh a man would require 1 extra calorie in the energy value o f his food to make good this expenditure o f energy. Even in walking on the level the body is raised at each step, and the calculation has been made that to walk 2.7 miles in an hour on a level road calls for the ex penditure o f 160 calories in a man o f 11 stone. Investigations made by a number o f scientific w orkers indicate, that about 15 per cent o f the energy expended is derived from protein, and about 80 per cent from fats and carbohydrates com bined; that is to say, that normally protein supplies only one-fifth o f the total energy expended. Numerous investigations have shown that the energy daily required by a man engaged in moderately light munition work is about 3,500 calories o f food as purchased. W here calcu lations are based on food as eaten, the minimum diet may be taken to be about 3,000 calories when balanced among the three classes o f foodstuffs in the fol low ing proportions o f dried w eigh ts: Protein--------------------------------------------------------------- ----------- grams__100 F a t______________________________________________________ do____ 100 C arbohydrate___________________________________________ do____ 400 Such would be contained in the follow ing d i e t : 1 Lean m ea t________________ ____ ____________ _________ ounces___ F a t ___ ____ _ ________________________ _____________d o ____ B u tter_____________________________________ do B r e a d ______ ___ _________________ ____ Potatoes ^ r . _ _ ____ .... __ ______ do_____ Ofltmpfll _____________ ________________ __ do M ilk . . _ __ pin t- 5 31 1 16 16 3 t An average adult woman worker requires rather less (about 0.8 or 0.9) than a man. Men engaged in hard physical work, especially in the open air, require a good deal more energy-producing food, and may consume as much as 4,500 calories with advantage. On the other hand, the energy required from fo#d by a man clothed, lying at complete rest, at ordinary room temperature, in a still atmos phere, is about 1,600 calories o f eaten f o o d ; while for a man engaged in a sedentary occupation, tailor or clerk working in warm room, as little as 2,200 calories may suffice.* A STATEMENT OF THE PROBLEM. 223. T h o u g h th e re is lit t le d o u b t t h a t w o r k e r s , o n th e w h o le , a re g e t t in g a b e tte r t y p e o f f o o d th a n a g e n e r a t io n a g o , it m u st b e a d m itte d th a t la r g e n u m b e rs o f w o r k e r s o f b o t h sex es a re n o t g e t t in g a n e ffe c tiv e d ie ta r y d a y b y d a y . M u c h e v id e n c e is fo r t h c o m in g th a t th is is b e in g in c r e a s in g ly r e c o g n iz e d b o t h b y e m p lo y e r s a n d w o r k e r s . T h e d iffic u ltie s in th e w a y o f a d e q u a te fe e d in g a rise m a in ly w h e r e th e w o r k e r m u st h a v e h is m e a ls a w a y fr o m h o m e . I n p a s t 1 Temporary shortages of supplies of particular articles of food may, of course, involve modifications of this diet. 2 There is evidence that the workers in Germany are not getting more than this value in their ration, and the remainder of the civil population considerably less, receiving, in fact, a ration which has not beea regarded hitherto as sufficient for maintenance. 112 INDUSTRIAL HEALTH AND EFFICIENCY. y e a r s , a n d e v e n n o w in n o r m a l tim e s, th e w o r k e r liv e d f a i r l y c lo s e t o h is w o r k , a n d w a s fr e q u e n t ly able, t o r e tu r n h o m e f o r h is m e a l. A t p re s e n t (a p a r t fr o m f o o d s h o r t a g e ) th e d iffic u ltie s o f s e c u r in g a d e q u a te f o o d a re in c r e a s e d o w in g t o th e p r e v a le n c e o f n ig h t la b o r , a n d to th e fa c t th a t th e la r g e n u m b e r o f m e n a n d w o m e n h a v e t o t r a v e l a c o n s id e r a b le d is ta n c e t o t h e ir w o r k . (a) I n su ch ca ses th e s im p le s t a lte r n a tiv e is f o r th e w o r k e r t o b r in g o r r e c e iv e f r o m h is h o m e o r lo d g in g s f o o d r e a d y p r e p a r e d f o r e a tin g . T h e o b je c t io n t o th is a r r a n g e m e n t is th e lim it a t io n in th e k in d s o f f o o d s u ita b le , a n d th a t it is n e c e s s a r ily c o ld , a n d lia b le t o b e sta le. T h e r e is a s p e c ia l d a n g e r o f its b e in g c o n fin e d t o w h a t c a n b e m o s t q u ic k ly p r e p a r e d th e n ig h t b e fo r e , w it h o u t m u c h r e g a r d t o its n o u r is h in g c h a r a c te r . W h e n th e w e a th e r is w a r m , o r th e f o o d is k e p t f o r a n y le n g t h o f tim e in a h o t w o r k s h o p , it r e a d ily u n d e r g o e s d e g e n e r a tio n . ( b ) A s e c o n d a lte r n a tiv e is f o r w o r k e r s t o b r in g f o o d w h ic h c a n b e e ith e r w a r m e d u p o r c o o k e d a t th e fa c t o r y . T h is is s o m e tim e s d o n e b y th e w o r k e r h im s e lf, o r fa c ilit ie s f o r th e p u r p o s e a re p r o v id e d b y th e e m p lo y e r . A r r a n g e m e n t s o n th ese lin e s a re p r o b a b ly b e tte r th a n th o s e u n d e r w h ic h th e w o r k e r b r in g s h is f o o d w it h h im r e a d y p r e p a r e d . O n th e o t h e r h a n d , it is t o b e r e m e m b e r e d th a t w a r m e d -u p f o o d is g e n e r a lly n o t so n o u r is h in g as fr e s h ly c o o k e d f o o d , th a t i f a la r g e a m o u n t o f f o o d is t o b e w a r m e d u p it is a lw a y s d iffic u lt t o d e a l s a t is fa c t o r ily w it h w id e ly v a r y in g k in d s o f f o o d , a n d th a t v a lu a b le tim e is lo s t i f th e w o r k e r is c o m p e lle d t o c o o k h is o w n m e a l. (c) I n so m e d is t r ic t s w o r k e r s c a n o b t a in a s u b s ta n tia l m e a l a t p u b lic h o u se s, c o o k s h o p s , o r o th e r p r o p r ie t a r y e s ta b lis h m e n ts in th e n e ig h b o r h o o d , b u t th e a c c o m m o d a t io n in th ese p la c e s is o ft e n in a d e q u a te a n d u n su ita b le . (d) L a s t ly , th e re is th e in d u s t r ia l ca n te e n a t o r n e a r th e w o r k s .1 224. T h is th e n is th e p r o b le m — t o s u p p ly s u ita b le f o o d a t a lo w p r ic e f o r la r g e n u m b e r s o f p e r s o n s a t s p e c ifie d tim e s. T h e m o d e m p r o g r e s s o f f a c t o r y m a n a g e m e n t r e v e a ls a v a r ie t y o f e ffo r ts t o fin d a s o lu t io n . T h e r e h a s b e e n , it is tru e , c o n s id e r a b le d e v e lo p m e n t in th e p r o v is io n o f p r o p r ie t a r y c o n c e r n s in th e fo r m o f im p r o v e d c o ffe e h ou se s a n d r e fr e s h m e n t r o o m s . P h ila n t h r o p ic m o v e m e n ts h a v e a lso b ee n in it ia t e d w it h a s im ila r p u r p o s e . B u t b y f a r th e m o s t h o p e fu l e n te r p r is e h a s b e e n th e e s ta b lis h m e n t b y e m p lo y e r s o f in d u s t r ia l c a n tee n s, o r w o r k p e o p le ’s d in in g r o o m s in o r n e a r th e f a c t o r y it s e lf. H it h e r t o th e r e h a s b e e n n o s t a t u t o r y o b lig a t io n u p o n th e e m p lo y e r , 1 In Memorandum No. 19 (Cd. 8798) will be found the results of a number of analyses made by Dr. Leonard Hill, F. R. S., of the caloric value of various workpeople’s dietaries. Canteen meals yielded 8 0 6 -1 ,4 3 3 calories (1 6 3 -3 0 5 dry weight in grams) ; “ carried food,” 6 8 3 -1 ,7 1 9 ; and women’s dietaries, 397 (tea shop) to 1,143 (carried food). Particulars are also given of caloric value of hostel dietaries, food substitutions, and ration? FOOD AND CANTEENS. 113 th o u g h a c tio n in th is d ir e c t io n h a s r e c e iv e d th e w h o le -h e a r t e d c o m m e n d a t io n o f th e f a c t o r y d e p a r tm e n t o f th e H o m e O ffice a n d th e M in is t r y o f M u n itio n s . T h e e a r lie s t a n d b e s t e x a m p le s o f stich r e s ta u ra n ts in fa c t o r ie s a re t o b e fo u n d in th e f o o d in d u s t r y , b u t m a k e rs o f s o a p , p a p e r , c lo t h , t o b a c c o , a n d tin b o x e s h a v e f o l l o w e d s u it, a n d n o w in a ll p a r ts o f th e c o u n t r y a c c o m m o d a t io n o f g r e a t e r o r less d e g r e e o f s u it a b ility a n d a ttra ctiv e n e s s is b e in g p r o v id e d . T h is p io n e e r p r a c t ic e h a s a b u n d a n t ly ju s tifie d it s e lf fr o m a b u sin e ss a n d c o m m e r c ia l p o in t o f v ie w , a n d in th e o p in io n o f th e c o m m itte e th e tim e h a s c o m e f o r a la r g e e x te n s io n o f th is m e th o d o f s o lv in g th e p r o b le m . 225. S p e a k in g g e n e r a lly , it m a y b e s a id th a t th e a c c o m m o d a t io n p r o v id e d a c c o r d s w it h o n e o r o th e r o f th e f o l l o w i n g t y p e s : (a) A n a v a ila b le r o o m f o r th e w o r k e r s t o ea t t h e ir p r e p a r e d f o o d ; ( b ) A r o o m fu r n is h e d w it h a “ h o t - p la t e ” o r “ w a r m in g c u p b o a r d ” 1 a n d p r o v id e d w it h h o t w a t e r ; ( c ) A r e fr e s h m e n t b a r r o w t o p e r a m b u la te th e w o r k s h o p s a t a p p o in t e d h o u r s (p a r t ic u la r ly u s e fu l f o r l ig h t r e fr e s h m e n ts d u r in g l o n g s p e lls o r n ig h t s h i f t s ) ; ( d ) A fix e d r e fr e s h m e n t b a r o r b u f f e t ; ( e } K d in in g -r o o m o r c a n te e n s u p p ly in g c h e a p h o t a n d c o ld d in n ers; ( / ) S u c h a d in in g r o o m a s s o cia te d w it h a n in s titu te o r c lu b , w it h fa c ilit ie s f o r rest a n d r e c r e a t io n (e. g ., re st r o o m s , r e c r e a tio n o r r e a d in g r o o m s , p o r t a b le g y m n a s iu m , b a th s, r o o f g a r d e n , o r e d u c a t io n a l cla sses, e t c .) 226. S o m e o f th ese ty p e s m a y b e s u it a b ly c o m b in e d , a n d a lth o u g h a r r a n g e m e n ts in d ic a t e d in ( c ) a n d (d) m a y p r o v e su fficien t a n d sa t is fa c t o r y in c e r ta in c ir cu m s ta n ce s , th e p r o v is io n o f p r o p e r m e a ls seem s o b ta in a b le o n ly in th e t y p e s ( e ) a n d ( / ) . T h e c o m m itte e r e c o g n iz e th a t th e n e ce s s ity f o r , a n d c h a r a c te r o f , a n in d u s t r ia l c a n te e n a re d e p e n d e n t u p o n th e n a tu r e o f th e n e e d a n d its d e g r e e in e a ch fa c t o r y . T h e y a re, h o w e v e r , c o n v in c e d t h a t in th e h ig h e s t in te re s t o f b o th e m p lo y e r a n d w o r k e r , p r o p e r fa c ilit ie s f o r a d e q u a te fe e d in g a r r a n g e m e n ts s h o u ld b e a v a ila b le in o r n e a r, a n d s h o u ld f o r m an in t e g r a l p a r t o f th e e q u ip m e n t o f , m o d e r n fa c t o r ie s a n d w o r k s h o p s . ESSENTIAL CHARACTERISTICS OF THE INDUSTRIAL CANTEEN. 22T. I n o r d e r to in su r e e ffe c tiv e re su lts fr o m th e e s ta b lis h m e n t o f in d u s t r ia l ca n te e n s , c e r ta in c o n d it io n s seem t o b e essen tia l. S p e a k 1 “ Warming cupboards ” can be installed in or near the mess-room and heated by steam. The cabinet may be constructed of sheet iron (finished off with asbestos and wood cov ering). with shelves of perforated sheet iron. Employees deposit their food in basins or dishes when they come to work, the cupboard is closed and steam applied under regula tion for a specified time. At the dinner hour the employees fetch their food. 8 0 9 3 5 ° — 19-------- 8 • 114 INDUSTRIAL HEALTH AND EFFICIENCY. ing generally, these conditions concern— (a) establishment and (b) management, the former including questions of site, building, and equipment. ESTABLISH M ENT. S it e . 228. The first important consideration in the erection o f a new can teen is the question of a site for the building. The site should, if possible, have a pleasant, open outlook and southern aspect, and should be central and easy o f access for the workers. With high buildings adjoining and mess rooms looking out upon blank walls not many yards distant, the canteen may prove unattractive and its success be to a great extent impaired. The canteen should, if prac ticable, be placed where water, gas, and electric mains are adjaeent, as well as drainage capable of carrying off the discharge of soil and rainwater pipes and of sinks and lavatory wastes. An appropriate proximity to the works must also be considered. B u i l d in g s . 229. Much will depend on the nature of the scheme adopted, whether it is (a) a mess room, with or without hot closet, hot plates, or hot water; (b) a buffet bar; or (c) a full restaurant canteen with kitchen, scullery, larder, stores, etc. There may be a combination o f the three types. The amount and character o f the accommodation necessary depends— ( 1 ) O n th e s it u a t io n o f th e f a c t o r y a n d th e o p p o r t u n it y f o r a ll o r a n y o f th e w o r k e r s t o g o h o m e f o r m e a ls ; (2) On the proximity of outside restaurants; (3) On the hours of work (day or night) and the meal intervals; ( 4 ) O n th e c h a r a c t e r o f th e w o r k (h e a v in e s s , e x p o s u r e , p o is o n , o r dan ger z o n e s ); (5) On the usual customs of the district and the particular food necessities o f the workpeople. The seating accommodation must also be considered from the point o f view of shifts and relays. 230. The attached plans have been prepared showing canteens suitable for 200 and 500 diners (pages 341 and 344). The ques tion which immediately arises is whether the building shall be of (a) temporary or (b) permanent construction. During the early stages o f the war there was much to be said for the erection o f a temporary building, mainly on the ground of cost, rapidity o f erec tion, and the smaller demands made upon labor. 231. Permanent buildings naturally take longer to erect, the cost 114 KITCHEN OF A LARGE C ANTEEN. 115 CANTEEN K ITCH EN. FOOD AND CANTEENS. 115 v a r ie s f r o m 25 t o 40 p e r c e n t m o r e th a n in th e c a se o f a t e m p o r a r y b u ild in g , a n d th e d e m a n d s m a d e u p o n la b o r a re g r e a te r . O n th e o t h e r h a n d , a p e r m a n e n t b u ild in g is, o f co u r s e , m o r e s a t is fa c t o r y , a n d c o s ts p r o p o r t io n a t e ly less th a n th e t e m p o r a r y b u ild in g f o r m a in te n a n c e . I n n o r m a l tim e s th e ca se f o r th e p e r m a n e n t b u ild in g is a s t r o n g o n e , b u t a t th e p re s e n t tim e f o r c a n te e n p u r p o s e s th e t e m p o r a r y b u ild in g s h o u ld b e c o n s id e r e d , t h o u g h it m a y b e f o u n d in p r a c t ic e th a t ev e n n o w a p e rm a n e n t b u ild in g is p r e fe r a b le . 232. T h e c o n s t r u c t io n o f su ita b le b u ild in g s is in d ic a t e d in su ffi c ie n t d e ta il o n th e d r a w in g s . I t s h o u ld n o t b e o v e r lo o k e d th a t th e w e a r a n d te a r o f th e flo o r s is c o n s id e r a b le , w h e th e r in th e m ess r o o m s o r in th e k itc h e n s , a n d , in v ie w o f th is , th e flo o r s g e n e r a lly s h o u ld b e o f c o n c r e te , fin is h e d w it h a g r a n o lit h ic fa c e . T h is t y p e o f flo o r is s m o o th , h a r d , d u r a b le , a n d im p e r v io u s , a n d is e a s ily w a s h e d d o w n a ft e r m e a ls. A d v a n t a g e s h o u ld , w h e r e v e r p o s s ib le , b e ta k e n o f u s in g lo c a l m a te r ia l t o sa v e c a r r ia g e , etc. 233. I n a la r g e n u m b e r o f ca n te e n p r o p o s a ls it m a y b e fo u n d th a t th e d im e n s io n s o f a v a ila b le sites w ill n o t a d m it o f th e b u ild in g s b e in g e r e c te d in a c c o r d a n c e w it h th e s u g g e s te d d e s ig n s , b u t th e p r in c ip le s a re th e sa m e. T h e ca n te e n o r d in in g h a ll, b e in g th e p r in c ip a l a p a r tm e n t, s h o u ld b e a r r a n g e d w it h th e m o s t c o n v e n ie n t m e th o d s o f e g re ss a n d in g r e s s f o r th e w o r k e r s a n d w it h d ir e c t a p p r o a c h to th e s e r v in g c o u n te r , so th a t t r a v e r s in g th e w h o le o r a n y g r e a t p o r t i o n o f th e d in in g h a ll t o o b t a in f o o d is a v o id e d . S h o r t b a r r ie r s in f r o n t o f th e c o u n te r s a re a d v is a b le t o a llo w o f e a ch d in e r o b t a in in g h is o r h e r f o o d in th e o r d e r o f a r r iv a l a n d t o p r e v e n t c o n g e s t io n a n d d is o r d e r . A d e q u a t e g a n g w a y s o r p a s s a g e w a y s f o r e a c h d in e r t o p r o c e e d t o th e d in in g ta b le s w it h o u t in t e r r u p t io n t o o th e r d in e r s a re e sse n tia l. F r o m 8 t o 10 sq u a re fe e t s u p e r fic ia l a rea s h o u ld b e a llo w e d p e r p e r s o n se a te d . S e p a r a te d in in g r o o m s a re u s u a lly p r o v id e d f o r m e n a n d w o m e n , b u t t h e y m a y b e so d e s ig n e d as t o b e t h r o w n t o g e t h e r f o r s o c ia l, r e c r e a tiv e o r e d u c a t io n a l p u r p o s e s . T h e k itc h e n s h o u ld b e s itu a te d as c e n t r a lly as p o s s ib le w it h r e g a r d t o th e d in in g r o o m , w h ic h it s h o u ld a d jo in in o r d e r to fa c ilit a t e c o u n te r s e r v ic e . I t m a y b e u c e n tr a l ” o r “ te r m in a l.” T h e w a sh u p o r s c u lle r y s h o u ld o p e n o u t o f th e k itc h e n a n d s h o u ld a b u t im m e d ia t e ly u p o n th e m a in d in in g h a ll. A c o u n t e r o r s h e lf w it h c o m m u n ic a t in g h a tc h s h o u ld b e p r o v id e d t o a d m it o f d ir t y c r o c k e r y b e in g h a n d le d d ir e c t t o th e sin k s. I n a d d it io n t o th e sin k s in th e s c u lle r y , su ch a c c o m m o d a t io n is a ls o r e q u ir e d in th e k itc h e n f o r th e u se o f th e c o o k in th e p r e p a r a t io n o f fo o d . T h e sin k s s h o u ld b e s u p p lie d w it h h o t w a te r f r o m a n in d e p e n d e n t b o ile r , w h ic h s h o u ld b e p la c e d as n e a r as p r a c t ic a b le t o th e sin k s. T h e la r d e r a n d s t o r e s h o u ld o p e n u p o n a y a r d w it h e a s y a cce s s f o r tr a d e s m e n ’s c a rts. T h e y s h o u ld b e fitte d w it h s h e lv in g o f d e a l, 1 in c h t h ic k s u p p o r t e d o n 2 -in c h b y l| -in c h fr a m e d b e a r e r s 116 INDUSTRIAL HEALTH AND EFFICIENCY. a n d u p r ig h ts . T h e s h e lv in g s h o u ld b e k e p t 1 in c h a w a y fr o m th e w a lls . T h e la r d e r s h o u ld , i f p o s s ib le , fa c e n o r t h a n d b e p e r m a n e n t ly v e n t ila t e d b y p e r fo r a t e d z in c p a n e ls. T h e s a n ita r y a c c o m m o d a t io n f o r th e c a n te e n s h o u ld p r e f e r a b ly b e s itu a te d in a n is o la t e d b lo c k o f b u ild in g s a d ja c e n t t o th e ca n te e n , b u t th e r e q u ir e m e n ts in th is r e s p e c t d e p e n d u p o n th e s a n ita r y a c c o m m o d a t io n a lr e a d y e x is t in g in a d jo in i n g b u ild in g s , a n d e a c h ca se w ill h a v e t o b e c o n s id e r e d o n its m e rits. V e n t il a t io n , W a r m in g , a n d L ig h t in g . 234. A m p le w in d o w s p a c e (w it h a la r g e p r o p o r t io n o f th e w in d o w s o p e n in g ) is d e s ir a b le f o r lig h t a n d v e n t ila t io n , a n d in n o ca se s h o u ld th e t o t a l g la s s a rea o f th e w in d o w s b e less th a n o n e -te n th o f th e flo o r a re a o f th e v a r io u s r o o m s in w h ic h th e y o c c u r . T h e f a n lig h t s f o r c a s e m e n t w in d o w s s h o u ld b e h in g e d a t th e b o t t o m a n d fa l l in w a r d s . G la z e d c h e e k s o r g u sse ts s h o u ld b e p r o v id e d t o a d m it o f c o n tin u o u s v e n t ila t io n , a n d a t th e sa m e tim e p r e v e n t d o w n d r a u g h t. A l l ca se m e n t w in d o w s s h o u ld b e m a d e t o o p e n f o r u se in w a r m w e a th e r a n d t o flu s h th e r o o m s w it h a ir a ft e r th e p r in c ip a l m e a l. L o u v e r v e n t ila t o r s u n d e r th e r o o f o r in tu r r e ts p r o v id e v e n t ila t io n f o r th e m a in m e ss r o o m . A s im p le c o r d a tta c h m e n t t o w o o d e n fla p s s h o u ld b e p r o v id e d t o a d m it o f th ese v e n t ila t o r s b e in g c lo s e d d u r in g c o ld o r w in d y w e a th e r . T h e k itc h e n s h o u ld b e p r o v id e d w it h a c o n t in u o u s lo u v e r v e n t ila t o r , as in d ic a t e d o n th e d r a w in g s . I t is d e s ir a b le , w h e r e e le c t r ic o r o t h e r p o w e r is a v a ila b le , t h a t a n e x h a u s t fa n s h o u ld b e p la c e d in th e k itc h e n t o e x t r a c t th e h e a t a n d ste a m f r o m th e k itc h e n a n d s c u lle r y a n d , in c id e n t a lly , a ssist in th e g e n e r a l v e n t ila t io n o f th e d in in g r o o m s . L a r d e r s s h o u ld fa c e n o r t h a n d h a v e n e a r ly h a l f th e g la s s o m it t e d in th e w in d ow - p a n e s a n d p e r f o r a te d z in c p a n e ls s u b s titu te d t o p r o v id e s u ita b le v e n t ila t e d s to r a g e f o r p e r is h a b le fo o d . 235. C e n tr a l h e a t in g b y r a d ia t o r s o r h o t -w a t e r p ip e s w o u ld , n o d o u b t, p r o v id e th e m o s t s a t is fa c t o r y m e a n s o f h e a t in g th e b u ild in g . T h e c o st, h o w e v e r , o f su ch a h e a t in g in s t a lla t io n a d d s so c o n s id e r a b ly t o th e in it ia l c o s t o f th e w h o le sch e m e th a t it b e c o m e s e x t r e m e ly d o u b t fu l i f th e e x p e n d itu r e is w a r r a n te d , e s p e c ia lly in v ie w o f th e f a c t th a t f o r f o u r o r fiv e m o n th s o f th e y e a r n o a r t ific ia l h e a t in g is r e q u ir e d . W h e r e c e n tr a l h e a t in g is n o t p r o v id e d , u se m a y b e m a d e o f in d e p e n d e n t sto v e s, s t a n d in g o n th e c o n c r e te flo o r , tlie s t o v e p ip e b e in g c a r r ie d u p t h r o u g h th e r o o f. S u c h s to v e s m a y b e o b t a in e d fr o m a n y ir o n fo u n d e r o r ir o n m o n g e r a t v a r y in g p r ic e s . 236. T h e s te p s t o b e ta k e n f o r th e p r e v e n t io n a n d e x t in c t io n o f fire s s h o u ld b e f u l l y c o n s id e r e d . T h e m e th o d o f c a r r y in g th e s t o v e p ip e t h r o u g h th e r o o f s h o u ld b e c a r e f u lly p la n n e d , as, o w in g t o th e c o m b u s tib le n a tu r e o f th e t im b e r in r o o fs , d e fe c t iv e c o n s t r u c t io n a t th is 116 COUNTER SERVICE. SURGERY. 117 {See page 144.) FOOD AND CANTEENS. 117 p o in t m a y p r o v e a s o u r ce o f cla n g e r t o th e b u ild in g f r o m fire. T h e c o n s t r u c t io n m a y s im p t y c o n s is t o f a sb e sto s p a c k in g , a s h e e t-ir o n sle e v e p ie c e , w it h l| -in c h s p a ce b e tw e e n th e s le e v e p ie c e a n d th e s to v e p ip e , a n d h o o d t o k e e p th e r a in o u t. 237. W h e r e e le c t r ic it y is a v a ila b le it is, n o d o u b t , th e m o st s a tis f a c t o r y m e a n s o f a r t ific ia l illu m in a t io n , o th e r w is e g a s s h o u ld b e u sed . E xternal and I n t e r n a l M a t e r ia l s . 238. F o r in e x p e n s iv e p e r m a n e n t c o n s t r u c t io n w a lls m a y b e 9 -in c h b r ic k w o r k r e n d e r e d e x t e r n a lly w it h P o r t la n d c e m e n t f in c h t h ic k a n d fin is h e d w it h r o u g h ca st s u r f a c e ; w it h la r g e s p a n r o o fs , b r ic k p ie r s o f g r e a te r th ic k n e s s w ill b e r e q u ir e d u n d e r th e r o o f p r in c ip a ls . R o o f s m a y b e b o a r d e d a n d s la te d , a n d flo o r s m a d e o f c o n c r e te w it h g r a n o lit h ic s u r fa c e . 239. T h e s e le c tio n o f m a te r ia ls , o w in g t o th e h ig h p r ic e s o b t a in in g , p re s e n ts s o m e d iffic u lty a t th e p re s e n t tim e . F o r m e r ly o n e o f th e m o s t fa v o r e d e x t e r n a l c o v e r in g s f o r t e m p o r a r y b u ild in g s w a s g a l v a n iz e d c o r r u g a t e d sh eet ir o n . T h e c o s t a n d s u p p ly o f th is m a te r ia l, h o w e v e r , is n o w p r o h ib it iv e , a n d a lte r n a tiv e s m u st b e s o u g h t in fe lt a n d o th e r fo r m s o f r o o fin g . F e lt s a re u s u a lly la id o n th e b o a r d in g w it h a la p p e d jo in t a n d p a te n t c e m e n t s u p p lie d b y th e m a k e rs, th e. sh eets b e in g th e n se c u re d w it h g a lv a n iz e d c lo u t o r la r g e fla t h e a d e d n a ils. O n ly th e sto u te st m a te r ia l o f th e r e s p e c tiv e m a k e rs s h o u ld b e u se d t o in su r e a w a t e r -t ig h t r o o f. L i g h t a sb e stos sla tes a lso p r o v id e a s a t is fa c t o r y , a lt h o u g h s o m e w h a t h e a v ie r , r o o f c o v e r in g . A l l r o o fin g fe lt s n e e d c a r e fu l la y in g , o th e r w is e b u lg in g o c c u r s , w h ic h , in a d d it io n t o b e in g u n s ig h t ly , is a fr e q u e n t ca u se o f a d e fe c t iv e r o o f. 240. A la r g e v a r ie t y o f m a te r ia ls h a v e b e e n a v a ila b le d u r in g th e w a r f o r th e e x te r n a l c o v e r in g s o f th e w a lls , a m o n g s t w h ic h m a y b e m e n t io n e d fe a th e r -e d g e d w e a th e r b o a r d in g (tr e a t e d w it h c r e o s o t e ) , u n g a lv a n iz e d p a in t e d sh eet ir o n , p la s te r fin is h e d in c e m e n t, s e c u r e d t o th e w o o d f r a m in g b y e x p a n d e d m e ta l, a sb e stos sla tes, o r o t h e r m a te ria ls . In tern a H y ,- p la s te r a n d ce m e n t o n e x p a n d e d m e ta l, a sb e stos sh eets (t h e jo i n t c o v e r e d b y a s m a ll fille t ) , m a tc h b o a r d in g , o r v a r io u s o th e r m a te r ia ls h a v e b e e n u se d a b o v e th e d a d o . T h e d a d o s h o u ld , h o w e v e r , b e s o m e w h a t s t r o n g e r ; t h r e e -fo u r th s -in c h m a t c h b o a r d in g is s u ita b le . T h in sh eet ir o n (p a in t e d ) h a s a lso b e e n u se d , o r lin o le u m o n fla t -jo in t e d b o a r d in g p r o v id e s a s u ita b le d a d o a n d is e a s ily c le a n e d . T h e in t e r io r o f th e b u ild in g s h o u ld p re s e n t a c le a n a n d c h e e r fu l a p p e a r a n c e , a n d d is te m p e r s o f a f a i r l y lig h t t in t a re p r e fe r a b le . S t r a w c o lo r , p r im r o s e , d u c k ’s -e g g g r e e n , o r F r e n c h g r a y a re s u g g e s te d as s u ita b le . A n a lte r n a tiv e c o lo r sch e m e w o u ld b e a d a r k -g r e e n d a d o a b o u t 5 fe e t h ig h w it h 2 -in c h b la c k lin e , a n d th e 118 INDUSTRIAL HEALTH AND EFFICIENCY. r e m a in d e r o f th e w a lls , in c lu d in g th e r o o f , fin is h e d w h ite , th e r o o f p r in c ip a ls b e in g s ta in e d a d a r k b r o w n . C o o k in g A p p a r a t u s and K it c h e n E q u ip m e n t . 2 41. T h e c o o k in g a r r a n g e m e n ts in a n in d u s t r ia l c a n te e n n a t u r a lly f o r m a n im p o r t a n t p a r t in th e e q u ip m e n t o f th e b u ild in g . T h e r e a re v a r io u s m e a n s o f c o o k in g f o o d , b u t f o r c a n te e n p u r p o s e s a tte n tio n m a y b e c o n fin e d t o : (а) G a s. ( б ) C o a l. (ic ) S te a m . ( d) E le c t r ic it y . 242. G a s, b y r e a s o n o f its c le a n lin e s s , e fficie n cy , a n d th e s a v in g in la b o r w h ic h re su lts fr o m its u se, is p r o b a b ly th e b e st c o o k in g f a c t o r in s m a ll a n d m e d iu m s iz e d ca n te en s. I n la r g e ca n te e n s , w h ile th e r o a s t in g is d o n e b y g a s , it is e c o n o m ic a l t o u se ste a m f o r b o ilin g , s te a m in g , a n d f o r w a r m in g th e h o t clo s e ts. T h e u se o f ste a m is e s p e c ia lly e c o n o m ic a l i f it c a n b e d r a w n fr o m th e f a c t o r y b o ile r s , b u t in th e la r g e r ca n te e n s it is w o r t h w h ile t o in s t a ll a n in d e p e n d e n t b o ile r t o s u p p ly th e ste a m f o r c o o k in g p u r p o s e s i f it c a n n o t b e s u p p lie d o th e r w is e . C o a l is u se d w h e r e g a s is u n o b ta in a b le o r e x p e n s iv e . I t is m o s t efficie n t as a m e a n s o f c o o k in g , b u t is less c le a n ly th a n ga a a n d is o b je c t io n a b le in su m m e r o n a c c o u n t o f th e h e a t d e v e lo p e d b y la r g e c o a l ra n g e s. E le c t r ic it y is th e n e w e st m e a n s o f c o o k i n g ; n o t o n ly , h o w e v e r , is th e o r ig in a l in s t a lla t io n c o s t ly b u t, u n le ss th e s u p p ly o f c u r r e n t is e x c e p t io n a lly c h e a p , th e r u n n in g c o s t is h ig h . 243. T h e r e la tiv e p o s it io n o f c o o k in g a p p a r a tu s n a t u r a lly v a r ie s w it h th e t y p e o f a p p a r a tu s u sed , b u t, g e n e r a lly s p e a k in g , it h a s b ee n fo u n d b e tte r t o h a v e th e s to v e s a n d r o a s te r s in th e c e n te r o f th e k itc h e n , w it h th e ste a m e rs o r b o ile r s b e h in d a n d th e c a r v in g ta b le a n d h o t c lo s e ts a d ja c e n t t o th e s e r v in g c o u n te r . T h e s e r v in g o f te a , e tc ., s h o u ld b e k e p t q u ite s e p a r a te fr o m th e g e n e r a l s e r v ic e ta b le . 244. I t is m o s t e ss e n tia l th a t th e re s h o u ld a lw a y s b e a p le n t ifu l s u p p ly o f h o t w a t e r t h r o u g h th e s in k ta p s f o r w a s h in g -u p p u r p o s e s . T h e r e a r e s e v e r a l a lt e r n a t iv e m e t h o d s ’ o f p r o d u c in g th is , a m o n g w h ic h a re th e f o l l o w i n g : ( 1 ) C ir c u la t o r b o ile r c o n n e c t t o a s to r a g e sy ste m . ( 2 ) L a r g e h o t -w a t e r g e y s e r . ( 3 ) S e p a r a te b o ile r o v e r e a c h sin k . 245. T h e m a in te n a n c e o f cle a n lin e s s is o n e o f th e m o s t im p o r t a n t p o in t s in th e w h o le s c h e m e o f a c a n te e n , a n d it is o n e th a t th e w o r k e r s a re q u ic k t o a p p r e c ia te . I n th e m e ss r o o m a ll flo o r s , ta b le s, sea ts, a n d w in d o w s s h o u ld b e t h o r o u g h ly c le a n s e d e v e r y d a y , a n d in th e k itc h e n a ll c o o k in g a p p a r a tu s s h o u ld b e w e ll s c o u r e d a n d k e p t s c r u p u lo u s ly d e a n . T h e ta b le e q u ip m e n t s h o u ld a lw a y s b e w e ll FOOD AND CANTEENS. 119 w a s h e d a n d p o lis h e d . T h e im m e d ia te s u r r o u n d in g s o f th e ca n te e n s h o u ld b e k e p t fr e e f r o m a c c u m u la te d r u b b is h a n d r e fu s e , as b y th is m e a n s t r o u b le f r o m flie s is g r e a t ly r e d u c e d .1 M ANAGEMENT. 246. I n th e e a r ly p a r t o f th e w a r e x c e lle n t a n d d e v o t e d w o r k w a s a c c o m p lis h e d b y s o m e 8 o r 10 p u b lic -s p ir it e d v o lu n t a r y s o c ie tie s , in c lu d in g th e Y . M . C . A ., L a d y L a w r e n c e ’s M u n it io n M a k e r s ’ C a n te e n C o m m itte e , th e S a lv a t io n A r m y , th e C h u r c h A r m y , th e W o m e n ’s L e g io n , e tc ., in r e g a r d t o c a n te e n m a n a g e m e n t. O n th e w h o le , h o w e v e r , th e c o m m itte e a re s a tis fie d t h a t th e in d u s t r ia l c a n te e n s h o u ld b e u n d e r ta k e n b y th e p r o p r ie t o r s o f th e fa c t o r y (w h e t h e r p u b lic o r p r iv a t e ) a n d s h o u ld b e r e g a r d e d as a n in t e g r a l a n d p e r m a n e n t p a r t o f th e f a c t o r y o r g a n iz a t io n , c o n t r o lle d lik e a n y o t h e r b r a n c h o f th e w o r k s u n d e r a d u ly a p p o in t e d a n d c o m p e te n t m a n a g e r o r m a n a g e re ss. T h e p r o p r ie t o r s h o u ld s c r u tin iz e th e a c c o u n ts o f th e t r a d in g , o r a r r a n g e f o r th e ir p r o p e r a u d it. H e s h o u ld w a t c h th e w o r k in g a n d s a t is fy h im s e lf th a t f u ll v a lu e is b e in g o b t a in e d in th e s h a p e o f in c r e a s e d n u t r it io n , e ffic ie n c y a n d c o n te n tm e n t . o f th e w o r k e r , a n d th a t c u r r e n t c h a r g e s a re r e a s o n a b le . T h e s e le c tio n o f th e ca n te e n m a n a g e r d e m a n d s -n o less c a re th a n th e s e le c tio n o f a h e a d o f a n y d e p a r tm e n t o f th e b u sin e ss. T h e q u a lific a tio n s p r in c ip a lly r e q u ir e d a re o r g a n iz in g a b ilit y , p o w e r s o f d is c ip lin e , a t h o r o u g h k n o w le d g e o f b u y in g fo o d s t u ffs a n d a f a i r w o r k in g k n o w le d g e o f th e e c o n o m ic a l p r e p a r a t io n a n d c o o k in g o f fo o d . S y m p a t h y , t a c t a n d a n u n d e r s t a n d in g o f th e p u r p o s e o f th e ca n te e n a re a lso n e ce ssa r y . F ood and D i e t a r ie s . 247. T h e f o o d s u p p lie d s h o u ld b e v a r ie d , fr e s h a n d g o o d ; s u ita b le in q u a lity a n d su fficien t in q u a n t it y ; w e ll c o o k e d , a p p e t iz in g , a n d o b ta in a b le a t lo w co st. I t is o b v io u s th a t th e t a r iff m u s t d iffe r in a c c o r d a n c e w it h f o o d p r ic e s , a n d a d m in is t r a t iv e c h a r g e s a n d in c id e n t a l e x p e n d itu r e . I t w ill o ft e n b e fo u n d e x p e d ie n t t o a llo w th e w o r k m e n ’s c o m m itte e o f m a n a g e m e n t t o e x a m in e th e t r a d in g a c co u n ts p e r io d i c a lly . T h e f o l l o w i n g fig u r e s s h o w a p p r o x im a t e ly th e n a tu r e o f a ca n te e n t a r iff d u r in g th e e a r lie r w a r p e r i o d : Dinner ; meat or fish, tw o vegetables----------------------- 4d. Hot-pot, cottage pie, meat puddings------------------------- 3d. Meat pies and other prepared meat dishes_________ 3d. Soup, bovril, oxo, etc. (w ith b r e a d )------------------------- 2d. to8d. to 6d. to 6d. to 3d. [8.1 [6.1 [6.1 [4.1 to to to to 16.2 cents.] 12.2 cents.] 12.2 cents.] 6.1 cents.] 1 C o st.— About 6d. [12.2 cents] per foot cube, exclusive of central heating and lighting, Is now (1 9 1 8 ) the standard cost for building the fabric. Equipment varies from 30s. to 50s. [$ 7 .3 0 to $12.17] per person seated. Total cost for building and equipment of can teen for 500 persons will work out from £7 to £9 [$34.07 to $43.80] per place. 120 INDUSTRIAL HEALTH AND EFFICIENCY. Puddings and stewed fruits_________________________ 2d. to 3d. Suet, bread, currant, jam, or fruit puddings----------- 2d. to 3d. Bread and cheese___________________________________ Id. to 2d. Vegetarian and cheese dishes_______________________ 2d. to 4d. Cakes, buns, tarts, bread and butter, sandwiches___Id. to 3d. Tea, coffee, cocoa, milk, lemon, barley, aerated and mineral waters, etc., per cup or glass____________Id. to 2d. (Good quality important.) Fresh fruit in season, as practicable. [4.1 [4.1 [2 [4.1 [2 to to to to to 6.1 cents.] 6.1 cents.] 4.1 cents.] 8.1 cents.] 6.1 cents.] [2 to' 4.1 cents.] 248. I n c e r ta in d is t r ic t s a n d in s p e c ia l c ir cu m s ta n ce s , th e re m a y b e a ca se f o r th e e s ta b lis h m e n t o f a “ w e t ” ca n te e n , w h e r e a lc o h o lic b e v e r a g e s m a y b e o b ta in e d . S p e c ia l s u p e r v is io n a n d r e s tr ic tio n s a re n e ce s s a ry in su ch cases. P r o m p t S e e v ic e . 249. T h e q u ic k s e r v ic e o f m e a ls is essen tia l. T h r e e m e th o d s a re p ra c tic a b le . (M e t h o d ( 1 ) is p r o b a b ly b es t, as a r u le , f o r la r g e n u m b e r s ): (1 ) L o n g s e r v in g co u n te r s (w it h s h o r t b a r r ie r s as a t r a ilw a y b o o k in g offices) f r o m w h ic h w o r k e r s fe t c h t h e ir fo o d . A n u m b e r o f p o r t io n s s h o u ld b e p r e p a r e d b e fo r e h a n d a n d s to r e d in h o t clo s e ts u n d e r th e c o u n te r . P o r t io n s s h o u ld b e s ta n d a r d iz e d . ( 2 ) F o o d p la c e d r e a d y o n th e ta b le b e f o r e w o r k e r s a d m itte d . T h is m a y b e c o n v e n ie n t f o r b r e a k fa s ts o r tea s, o r w h e re th e f o o d p r o v id e d is c o ld a n d th e sa m e f o r a ll, b u t it is n o t a lw a y s p r a c t ic a b le f o r h o t d in n e rs . (3 ) W a it e r s o r w a itre ss e s, o r g a n iz e d in s h ifts . C o n v e n ie n t H o u r s . 250. T h e ca n te en s h o u ld b e o p e n a t a n y h o u r s w h ic h m e e t lo c a l n eed s a n d c ir cu m s ta n ce s . M id d a y is c le a r ly th e p r in c ip a l o c c a s io n o f its u tility . B u t in m a n y w o r k s it s h o u ld a lso b e o p e n in th e e a r ly m o r n in g h o u r f o r b r e a k fa s t, a n d a t s u p p e r tim e . W h e r e th e re a re n ig h t s h ift s m e a ls a n d r e fr e s h m e n ts s h o u ld b e a v a ila b le as b y d a y . P r o v is io n s h o u ld a ls o b e m a d e f o r th e s u p p ly o f w a te r , m ilk , tea , o r c o ffe e a t s p e c ifie d tim es. P aym ent. 251. D iffe r e n t m e th o d s o f p a y m e n t a re in v o g u e , b u t i f p a y m e n t a t th e tim e b y b i ll o r c h e c k is fo u n d , w h ic h is u s u a lly th e ca se, t o b e im p r a c tic a b le , th e m o s t a p p r o p r ia t e m e th o d is f o r w o r k e r s t o b u y b o o k s o r series o f tick e ts o r c h e ck s p r e v io u s ly t o th e m e a l o r a t th e door. FOOD AND CANTEENS. A 121 ccounts. 2 52. T h e f a c t o r y a c c o u n t s h o u ld b e a r th e c a p it a l c h a r g e s a n d c e r t a in c u r r e n t e x p e n se s, le a v in g t o th e c a n te e n a c c o u n t th e c o s t o f fo o d , w a g e s , a n d g e n e r a l a d m in is tr a tiv e c h a r g e s . O r g a n iz a t io n . 253. T h e c o m m itte e h a v e b e e n im p r e s s e d wTith th e im p o r t a n c e o f p r o p e r e c o n o m ic a l a n d e ffe c tiv e o r g a n iz a t io n o f in d u s t r ia l c a n te e n s. T h e ir p u r p o s e , it m u s t b e c le a r ly r e c o g n iz e d , is t o p r o v id e su fficie n t a n d s u ita b le f o o d a n d n o t t o y ie ld a re v e n u e . T h e r e v e n u e o f a c a n te e n is im p r o v e d h e a lth , c o n te n tm e n t, a n d p h y s ic a l e fficie n cy o f th e w o r k e r s , a n d n o t a ca sh b a la n ce . 254. S p e a k in g g e n e r a lly , th re e m e th o d s o f o r g a n iz a t io n a re a v a ila b le a n d a re n o t m u t u a lly e x c lu s iv e . F ir s t , th e e m p lo y e r m a y m a n a g e d i r e c t l y ; s e c o n d ly , h e m a y h a n d o v e r th e m a n a g e m e n t t o a p r o p e r ly c o n s titu te d c o m m itte e o f th e w o r k e r s o r o f th e w o r k e r s a n d th e sta ff c o n jo in t l y ; o r t h ir d ly , th e e n tire d ir e c t io n m a y b e c o n t r a c te d o u t t o a p r o fe s s io n a l o r v o lu n t a r y c a te re r. I n n o t a fe w o f th e m o s t su cc e s s fu l ca n te e n s jo i n t c o n t r o l is e x e r c is e d b y e m p lo y e r a n d m e n (e . g ., an e le c te d s h o p c o m m itte e w it h a c h a ir m a n r e p r e s e n tin g th e m a n a g e m e n t )-w h o m a y o r m a y n o t c o n t r a c t o u t th e c a te r in g . T h e m e th o d o f c o n t r o l is m a t e r ia lly a ffe c te d b y th e p r o p r ie t o r s h ip . I n a ll cases it s h o u ld b e d is in te r e s te d a n d s o le ly f o r th e b e n e fit o f th e w o r k e r s . E x p lo it a t io n in a n y f o r m s h o u ld b e a v o id e d a n d efficie n cy , e c o n o m y , a n d s m o o th w o r k in g k e p t s te a d ily in v ie w .1 I t m u st b e b o r n e in m in d t h a t m o n e y c a n n o t b e d e d u c te d f r o m w a g e s b y th e e m p lo y e r f o r f o o d o r d r in k w it h o u t a c o n t r a c t u n d e r th e t r u c k a c t.2 255. I t is n o t p o s s ib le f o r th e c o m m itte e t o la y d o w n h a r d a n d fa s t lu le s o r m e th o d s f o r th e s u c c e s s fu l o r g a n iz a t io n o f ca n te en s. I n o n e d is t r ic t o r set o f c ir cu m s ta n ce s , o n e c o n d it io n o r fa c t o r , a n d in a n o t h e r d is t r ic t a n o th e r c o n d it io n is p r e d o m in a te . B u t w h a te v e r b e th e lo c a l c ir c u m s ta n c e s t o secu re an e ffe c tiv e in d u s tr ia l c a n te e n it is n e ce s s a r y (a) th a t it s h o u ld b e a cce s sib le a n d a t t r a c t iv e ; (& ) th a t it s h o u ld b e s u it a b ly c o n s tr u c te d a n d e q u ip p e d ; (c) th a t th e d ie t o ffe r e d s h o u ld be fr e s h , v a r ie d , g o o d , a n d in a c c o r d a n c e w it h p o p u la r t a s t e ; (d) th a t th e s e r v ic e s h o u ld b e p r o m p t ; (e) th a t th e c a n te e n s h o u ld b e 1 T h e t a r if f c a n b e k e p t l o w o n l y b y c a r e f u l m a n a g e m e n t . T h e f o o d m a t e r ia l s c a n u s u a l l y be m a d e t o p a y , b u t t h e i n c id e n t a l e x p e n d it u r e is r e la t i v e l y h e a v y . W orkers a r e n o t a c c u s t o m e d t o p a y i n g f o r f o o d in c a n t e e n s , a n d w il l n o t a l w a y s p u r c h a s e t h e m o s t n u tr itio u s fo o d . T a c t , d i s c r e t i o n , a n d a n a p p r o p r i a t e m e n u o f p o p u la r d is h e s a r e necessary. C o n s t a n t s u p e r v i s io n a n d t h e c a r e f u l a d a p t a t i o n o f m e a n s t o e n d s a r e n e e d e d t o p r e v e n t l o s s i f g o o d f o o d is t o b e s o ld q u ic k ly , a t t h e l o w p r i c e t h e w o r k e r c a n a f fo r d t o p a y . 2 T h e T r u c k A c t , 1 8 3 1 , S e c. 2 3 , p r o v i d e s t h a t “ n o d e d u c t i o n s h a ll b e m a d e f r o m th e w a g e s o f a w o r k m a n in r e s p e c t o f v i c t u a ls d r e s s e d a n d p r e p a r e d u n d e r t h e r o o f o f t h e e m p lo y e r u n le s s a n a g r e e m e n t o r c o n t r a c t f o r s u c h s t o p p a g e o r d e d u c t i o n s h a ll b e m a d e in w r i t i n g a n d s ig n e d b y th e a r t if i c e r .” S u c h a n a g r e e m e n t c a n be r e a d i ly m a d e a n d m a y p r o v e t o s a v e t im e a n d p r e v e n t w a s te . 122 INDUSTRIAL HEALTH AND EFFICIENCY. o p e n a t c o n v e n ie n t h o u r s o f t h e d a y o r n ig h t ; a n d ( / ) t h a t th e a r r a n g e m e n ts f o r p a y m e n t s h o u ld b e s im p le a n d c o n v e n ie n t. 256. T h e c o m m itte e r e c o g n iz e th a t s in c e th e issu e o f t h e ir fir s t m e m o r a n d u m o n th e s u b je c t ( C d . 8 1 3 3 ) in N o v e m b e r , 1 9 1 5 , s u b s ta n tia l p r o g r e s s h a s b e e n m a d e , d u e in n o s m a ll d e g r e e t o th e a c t iv it y o f th e ca n te e n c o m m itte e o f th e C e n tr a l C o n t r o l B o a r d . T h e in d u s t r ia l ca n te e n is r a p id ly b e c o m in g a s o c ia l a g e n c y . T h e c o m m itte e w e lc o m e th e P o lic e , F a c t o r ie s (M is c e lla n e o u s P r o v is io n s ) A c t o f 1916, s e c tio n 7 (s e e A p p e n d ix H , ) a s a s t a t u t o r y e n a c tm e n t lik e ly t o m a k e u n i v e r s a l a n d p e r m a n e n t th e a d v a n ta g e s o f t h is a g e n c y . RESTTLTS. 257. T h e c o m m itte e h a v e b e e n im p r e s s e d w it h th e c o n s e n su s o f o p in io n w h ic h th e y h a v e r e c e iv e d fr o m a ll p a r t s o f th e c o u n t r y as t o th e s u b s ta n tia l a d v a n ta g e s b o t h t o e m p lo y e r s a n d w o r k e r s f o l l o w in g th e e s ta b lis h m e n t o f a n e ffe c tiv e a n d w e ll-m a n a g e d ca n te e n . T h e s e b e n e fits h a v e b e e n d ir e c t a n d in d ir e c t . A m o n g th e fo r m e r h a s b e e n a m a r k e d im p r o v e m e n t in th e h e a lth , n u t r it io n , a n d p h y s ic a l c o n d it io n o f th e w o r k e r s , a r e d u c t io n in fa t ig u e a n d sick n e s s, less a b se n ce a n d b r o k e n tim e , less t e n d e n c y t o a lc o h o lis m , a n d a n in c re a s e d e ffic ie n c y a n d o u t p u t ; a m o n g th e la tte r h a s b e e n a s a v in g o f tim e o f th e w o r k m a n , a s a lu ta r y t h o u g h b r i e f c h a n g e f r o m th e w o r k s h o p , g r e a t e r c o n te n tm e n t, in c r e a s e d o p p o r t u n it y f o r r e c r e a t io n , a n d a b e tte r m id d a y v e n t ila t io n o f th e w o r k s h o p . T h e c o m m itte e a re sa tisfie d th a t th e e v id e n c e o f th ese r e s u lts is s u b s ta n tia l, in d is p u t a b le , a n d w id e s p r e a d . I n th e is o la te d ca ses w h e r e th e ca n te e n h a s f a ile d it h a s b e e n e v id e n t th a t its fa ilu r e h a s b e e n d u e t o e x c e p t io n a l cir c u m s ta n c e s , m isu se b y th e w o r k e r s , o r m is m a n a g e m e n t. I n a lm o s t a ll la r g e w o r k s th e c o m m itte e fin d th a t th e r e is a b o d y o f m e n o r w o m e n (a v e r a g in g a t le a st 25 p e r c e n t ) w h o in th e in te r e s t o f p h y s i c a l h e a lth a n d v i g o r n e e d ca n te e n p r o v is io n a t th e fa c t o r y . T h e y a r e c o n v in c e d th a t th is g r o u p o f i ll - f e d w o r k e r s a c c o u n ts in a la r g e d e g r e e f o r su ch in e fficie n cy as e x is ts a n d th a t its e n e r g y a n d o u t p u t a re r e d u c e d in th e a b se n ce o f s u ita b le fe e d in g a r ra n g e m e n ts . W h il s t it is im p o s s ib le t o s e p a r a te th e b e n e fit d e r iv e d f r o m ca n te e n s fr o m o th e r w e lfa r e a g e n c ie s o r t o r e n d e r s ta tis tica l e v id e n c e as t o th e e ffe c t u p o n o u tp u t, th e c o m m itte e h a v e r e c e iv e d a n u m b e r o f sta te m e n ts in f a v o r o f in d u s t r ia l c a n te e n s , fr o m w h ic h th e y s e le ct th e f o l l o w i n g : (a) In answer to your inquiry as to the effect which our canteen arrangements have had upon the health and efficiency of our own workpeople, we were so fully alive to the importance of this as to erect a complete installation, separated from the factory proper, for the use of those who live too far away from the works to dine at home. From 1,500 to 2,000 workpeople make use of these rooms daily. The building has a well-equipped kitchen, but the majority of those who din* at the works, although buying tea and light refreshments, bring their own dinner. FOOD AND CANTEENS. 123 This habit obtains elsewhere. W e make a point, however, o f having, in addition to other things, one or two cheap and very nutritious dishes, e. g., a Id. [2-cent] basin o f soup or stew, o f which some hundreds are sold daily. In fa n n in g the dining block we felt it was not m erely^ question o f supplying food, but o f doing so under restful and com fortable conditions in rooms well lighted and ventilated and properly warmed. A great deal more was done than was required for bare efficiency, and it is not necessary to build on so costly a scale. W e have never had a moment’s doubt as to the importance o f a comfortable dinner hour for our people from the point o f view o f their efficiency in the afternoon. The health o f our workpeople has unquestionably improved in recent years, and we feel sure that the dining room has helped to bring about this result. At the same time, as there are many factors which have come into play, it is im possible to value with any approach to accuracy the part that each o f these has played. The proper ventilation o f the workrooms, medical and dental attendance freely given at the works, with facilities for those in poor health getting to a convalescent home, are among the many factors which have each exercised an influence. (b ) A large number o f our men workers still prefer to bring their own food with them and to infuse their own tea in a building which we have supplied for the purpose. About 80 per cent o f our female workers earn a perfect timekeeping bonus each week, which means that they have not lost a minute, whereas the percentage o f men who do so rarely exceeds 55 and is generally under that figure. I do not suggest that the whole o f the credit for these differences is due to the fact that the women feed in the canteen and the men do not, but I have no hesitation in giving it as my opinion that this is one o f the factors o f the question. Especially as this factory is placed 11 miles from Glasgow and miles removed from the nearest village, we simply could not do without a canteen, and I think you will agree that it is very satisfactory to know that although all our workers have to spend practically *an hour morning and evening in getting from their homes to the factory and vice versa, which has the effect o f keeping many o f them out o f their homes for a round o f the clock, w e have an excellent bill o f health and have so far been able to resist very satisfactorily even the special dangers to health which attend working with amatol, TNT, and cordite. At the present moment in our whole staff o f 10,000 workers w e have not a single TN T sickness case. I might add that our medical officer fully concurs in the opinion given as re gards the value o f a canteen from the health point o f view. At first we had some trouble in getting our girls to take a substantial meal in the middle o f the day. The home conditions o f many o f them had evidently been such that they were accustomed to a diet consisting largely o f tea, bread and butter, pastry, etc., and they preferred to continue to feed themselves in that way even when they did buy food in the canteen. There are clear evi dences that their tastes in this respect are improving and they are appreciating a properly cooked meal. It has taken a good deal o f effort on the part o f the management to get as fa r in this matter as we have, but I feel certain that once they fu lly experience the advantages to their own health with better food the workers will not readily return to their old methods. W hilst our experience in this respect is principally in regard to women w ork ers, we are certainly o f opinion that the benefit is a very considerable one, as not only have the canteens conduced to better timekeeping, but the direct effect o f the substitution o f well-cooked food for the cold (often tipped) or even re heated food brought by the workers and eaten under uncomfortable and often 124 INDUSTRIAL HEALTH AND EFFICIENCY. insanitary conditions, has certainly liad an excellent effect 011 the healtli and appearance^of the women. The provision o f canteens where the workers can obtain well cooked and suit able food at a minimum cost is th e r e fo r advantageous— apart from whether there are other means for them to obtain their food in the neighborhood o f the factory— whilst the provision o f hot drinks and soups on cold nights tends considerably to improve production. The institution o f a canteen is also essential if a three-shift system (as in the case o f our women w orkers) is to be adopted without an undue loss o f time for meal hours. (d ) One solution o f the problem, both from the point o f view o f the girl her self, who will get a good meal cheaply (ow ing to wholesale buying and more expert cooking) and from that o f the factory, both as to health and output o f energy, is undoubtedly the provision o f meals by the canteen for all workers. Practical proof o f this is shown by this factory, where incidentally the pro vision of two square meals a day, with 1| hours each to take them in and get out in the fresh air afterwards, has put a stop to the fa r too frequent fainting whilst at work, to much constipation and other disorders, due often to defective nutrition, and to much dissatisfaction among the workers themselves, really due to their feeling out o f sorts from these causes. Proper feeding and proper ventilation, with cleansing o f the workers before food and after leaving work, and attention to the flushing o f the internal drain age o f the body, will produce the maximum of immunity to TN T poisoning or any other infection which may be prevalent, provided the w orker starts healthy. Of this I am quite convinced. The medical department is occupied in sifting applicants for work in order to exclude obviously unsound persons and to put less unsound persons into working order— by regulating their bowels and cleansing their mouths from the far too frequent sepsis before allowing them to work in TNT. It is the privilege o f the management to see that these reasonably sound workers get suitably fed and housed, that their w ork is suitably apportioned, and that they are trained up by competent per sons to do this work with as little waste o f energy as is compatible with the perfect performance o f the particular duty on which they are engaged. ( e ) The advantage o f having freshly cooked meals, well served in the can teen, removed from the noise o f machinery and the odor o f the factory, has had a marked beneficial effect on the health and spirits o f the workers. The meal hours in the canteen are now welcome breaks in the monotony o f what was previously too often a 12-hour “ shift.” Since the introduction o f canteens the employees have really worked in a “ shift ” which consists o f three parts, with added initial energy for each part. The increased energy, good spirits, im proved health, and “ staying ” power is appreciably noticeable to the most casual observer. An experiment has been tried in this factory o f having concerts in the can teen during the long meal hour. The conduct o f the workers is the best index o f their success. The employees have packed the canteen; the best o f their talent has been freely given for the benefit o f their w ork ers; the audience has been ideal in discipline and appreciation o f the efforts o f the entertainers. ( / ) A canteen properly managed and in which the management o f the fac tory take*as great an interest in regard to its efficiency as they would do in any department of their work presents an unlimited scope for all high-thinking employers for the betterment o f their workers. The first advantage o f this is that it w ill d r a # employees and employers together on domestic matters, as I consider that the management o f the canteen should be under the factory con trol, and that all supervision should be undertaken by a committee o f the em FOOD AND CANTEENS. 125 ployees w ith the manager or some high official as ex officio chairman. The vari ous little questions that arise for discussion, though small in themselves, w ill be found to be o f that nature which w ill inevitably result in the chairman hav ing the opportunity o f displaying a “ human touch ” which he may rarely have an opportunity o f at present, I do not wish to be misunderstood by this, that the manager would be reduced to coddling or merely sentimental action; such w ould be strongly resented by the workers themselves; but the very fact that there would be the “ chief ” taking an interest in the questions o f their daily livelihood w ill be, I venture to believe, a big advance in bringing the two together. ( g ) Knowing your interest in the details o f these matters, wre would like to mention how useful has been the installing o f a number o f small tea depots, distributed throughout the shops, which are open for a quarter o f an hour in the afternoons and again fo r a quarter o f an hour during the night shift, for the sale o f tea and cakes. This has been done that we might put an end to the promiscuous tea making that went on previously. The running o f these tea depots has been only possible by the existence o f the canteen, and from an administrative point o f view we are indebted to the canteen management that it has been possible to adopt this system o f tea depots. 258. S u c h d e c la r a t io n s a re, a ft e r a ll, su b s ta n tia l e v id e n c e , a n d t h e y c o n fir m th e c o n v ic t io n o f th e c o m m itte e as t o th e b e n e fit a r is in g as a r e s u lt o f a g o o d in d u s t r ia l ca n te e n . T h e c o m m itte e h a v e b e e n im p r e s s e d n o t o n ly w it h th e im p r o v e d n u t r it io n m a n ife s t e d b y th e u se rs o f th e ca n te e n , b u t b y a le sse n e d te n d e n c y t o e x ce s s iv e c o n s u m p t io n o f a lc o h o l, b y th e p r e v a le n c e o f th e s p ir it o f h a r m o n y a n d c o n te n tm e n t e n g e n d e r e d , a n d b y a d e c la r e d in c r e a s e in e fficie n cy a n d o u tp u t. CONCLUSIONS. 259. F r o m w h a t h a s b e e n sa id in th e p r e s e n t s e c tio n it w ill b e u n d e r s t o o d th a t th e c o m m itte e w e r e c o n v in c e d a t a v e r y e a r ly sta g e o f th e ir in q u ir ie s o f th e v a lu e a n d , in d e e d , n e c e s s ity o f e s ta b lis h in g in d u s t r ia l ca n te e n s in o r d e r t o p r o v id e f o r th e p r o p e r n o u r is h m e n t o f m u n it io n w o r k e r s . A s h o w e v e r , th e C e n tr a l C o n t r o l B o a r d (liq u o r t r a ffic ), o f w h ic h L o r d D ’A b e r n o n w a s c h a ir m a n , h a d in J u n e , 1915, a p p o in t e d (u n d e r th e s t a t u t o r y p o w e r s c o n fe r r e d o n th e m b y D e fe n s e o f th e R e a lm R e g u la t io n N o . 5 o f 1 9 1 5 ) a c a n te e n c o m m itte e (th e c h a ir m a n o f w h ic h w a s S ir G e o r g e N e w m a n ), th e h e a lth o f m u n it io n w o r k e r s c o m m itte e d e e m e d it in e x p e d ie n t t o in te r v e n e in th e w o r k w h ic h th a t c a n te e n c o m m itte e h a d a lr e a d y c o m m e n c e d . A c c o r d in g l y th e b u r d e n o f w o r k in c o n n e c t io n w it h th e e s ta b lis h m e n t o f in d u s t r ia l ca n te e n s h a s fa lle n u p o n th e ca n te e n c o m m itte e o f th e liq u o r -c o n t r o l b o a r d , a ssiste d b y H is M a je s t y ’ s O ffice o f W o r k s , w h o h a v e th u s f a c i l i t a t e d th e s u p p ly o f p r o p e r a n d su fficien t n o u r is h m e n t f o r th e m u n itio n w o r k e r n o t o n ly in th e in te re s ts o f s o b r ie t y , b u t a lso in th e in te re s ts < f in d u s t r ia l e ffic ie n c y .1 I n th e firs t e n th u sia sm o f th is g r e a t m o v e m e n t 1 See first [Cd. 8 1 1 7 ], second [Cd. £ 2 4 3 ] , third [Cd. 8 5 5 8 ], an d -fourth [Cd. 9 0 5 5 ] reports of the Central Control Board (liquor traffic) appointed under the Defense of the Realm Consolidation Act, 1914, and Defense of the Realm (Amendment) (No. 3) Act, 1915. 126 INDUSTRIAL HEALTH AND EFFICIENCY. a n u m b e r o f v o lu n t a r y a ssista n ts a n d v o lu n t a r y w o r k e r s u n d e r t o o k th e r e s p o n s ib le d u tie s in c o n n e c t io n w it h th e e s ta b lis h m e n t a n d m a in te n a n ce o f ca n te en s. E v e n t u a lly , h o w e v e r , i t b e c a m e n e ce ssa r y o w in g t o th e m a g n it u d e o f th e u n d e r t a k in g t h a t th e S ta te s h o u ld s h o u ld e r in c re a s e d r e s p o n s ib ilit ie s in th e m a tte r . T h e M u n it io n s o f W a r A c t , 1915, p r o v id e d th a t “ c o n t r o lle d ” e m p lo y e r s , in w h ic h c a t e g o r y w e re in c lu d e d p r a c t ic a lly a ll m a n u fa c t u r e r s o f m u n itio n s , in th e w id e m e a n in g th a t m o d e r n w a r fa r e im p a r t e d t o th e te r m , w e r e t o r e ce iv e o n ly th e ir s ta n d a r d p r e w a r p r o fit s p lu s o n e -fift h , th e r e m a in d e r b e in g p a id t o th e e x ch e q u e r . I t see m ed h a r d ly r e a s o n a b le t o e x p e c t th e m t o sa c r ific e p r o fits s o r ig id l y lim it e d in o r d e r t o p r o v id e ca n te e n s f o r t h e ir w o r k e r s , a n d it c o u ld f a i r l y b e a r g u e d th a t, as th e a d v a n ta g e s o f th e in c re a s e d o u t p u t a n t ic ip a t e d fr o m th e e s ta b lis h m e n t o f in d u s t r ia l ca n te e n s w o u ld a c c r u e t o th e S ta te , th e S ta te s h o u ld fin d th e m o n e y . O n th e in it ia t iv e o f th e liq u o r -c o n t r o l b o a r d it w a s th e r e fo r e d e c id e d th a t “ c o n t r o lle d ” e m p lo y e r s s h o u ld b e a llo w e d t o c h a r g e t o r e v e n u e th e e x p e n d itu r e w h ic h th e y m ig h t in c u r w it h th e a p p r o v a l o f th e b o a r d o n th e e s ta b lis h m e n t o f ca n te e n s a t th e ir w o r k s ; in o th e r w o r d s , t h a t th e c o s t o f th e e s ta b lis h m e n t o f ca n te e n s s h o u ld b e b o r n e fr o m fu n d s w h ic h w o u ld o th e r w is e a c cr u e t o th e e x ch e q u e r . A t th e sa m e tim e th e m in is te r g a v e in s tr u c tio n s f o r th e p r o v is io n , w h e re n e ce ssa r y , a t a ll G o v e r n m e n t m u n it io n e s ta b lis h m e n ts ( r o y a l a rse n a ls , n a t io n a l fa c t o r ie s , e t c .) o f a d e q u a te c a n te e n a c c o m m o d a t io n at th e e x p e n s e o f th e S ta te , a n d in tr u s te d th e b o a r d w it h th e g e n e r a l r e s p o n s ib ilit y f o r th e o r g a n iz a t io n o f th e ca n te e n a t th ese e s ta b lis h m e n ts. 260. T h e liq u o r -c o n t r o l b o a r d h a v e th u s b ee n th e r e s p o n s ib le a u t h o r it y f o r th e o r g a n iz a t io n o f in d u s tr ia l ca n te e n s in m u n it io n w o r k s th r o u g h o u t th e c o u n t r y . T h e y e s ta b lis h e d th e n e ce s s a r y d e p a r t m e n ta l a n d e x p e r t s ta ff f o r th e e ffe c t iv e p e r fo r m a n c e o f th is d u t y , a n d in its e x e c u tio n h a v e t h r o u g h th e ir r e p r e s e n ta tiv e s v is it e d a ll th e la r g e r a n d m a n y o f th e s m a lle r m u n it io n w o r k s , a n d h a v e u r g e d th e p r o v is io n o f ca n te e n s w h e r e v e r a r e a l a n d u n d o u b t e d n e e d w a s fo u n d t o e x is t, w h e th e r th a t n e e d a r o se o n g r o u n d s o f liq u o r c o n t r o l o r o f n u t r it io n o f th e m u n it io n w o r k e r . T h e b o a r d h a v e m a d e it th e ir s t u d y t o d o a ll th a t w a s p o s s ib le t o a ssist e m p lo y e r s in th e d e s ig n , e q u ip m e n t, a n d m a n a g e m e n t o f ca n te en s. T h e s e r v ic e s o f th e ir e x p e r t sta ff h a v e b e e n p la c e d fr e e ly a t th e d is p o s a l o f e m p lo y e r s , a n d th e y h a v e p u b lis h e d a h a n d y c o m p e n d iu m o f in fo r m a t io n o n th ese s u b je c t s in th e fo r m o f a p a m p h le t e n title d “ F e e d in g th e m u n it io n w o r k e r ,” t o th e u s e fu ln e s s o f w h ic h t h e y h a v e r e c e iv e d n u m e r o u s te s tim o n ie s . 261. T h e p o l ic y o f th e liq u o r -c o n t r o l b o a r d , w it h w h ic h th e c o m m itte e h a v e f u ll y c o n c u r r e d , h a s b e e n firs t t o e n c o u r a g e th e e m p lo y e r o r o w n e r t o m a k e s u ita b le p r o v is io n f o r c a n te e n a c c o m m o d a t io n FOOD AND CANTEENS. 127 w h e r e n e c e s s a r y ; s e c o n d ly , t o fa c ilit a t e su ch p r o v is io n b y v o lu n t a r y o r o th e r a g e n c ie s ; o r , t h ir d ly , t o e sta b lish a ca n te e n th e m se lv e s, e ith e r m a n a g in g d ir e c t ly o r h a n d in g o v e r th e m a n a g e m e n t t o a p r o p e r ly c o n s titu te d c o m m itte e o f e m p lo y e r s a n d w o r k m a n . A t th e e n d o f 1 917 so m e 840 in d u s t r ia l ca n te e n s h a d b e e n e s ta b lis h e d in n a tio n a l a n d c o n t r o lle d m u n ition , fa c t o r ie s a n d a t d o c k s c o n c e r n e d in t r a n s p o r t in c o n n e c t io n w it h th e w a r (a t a n a p p r o x im a t e c o s t o f u p w a r d o f o n e a n d om e-q u a rter m illio n s ). T h e ca n te e n s e s ta b lis h e d u n d e r th e a u s p ic e s o f th e liq u o r -c o n t r o l b o a r d h a v e b e e n , w it h fe w e x c e p tio n s , k n o w n a s u te m p e r a n c e ” o r “ d r y ” ca n te e n s— th a t is t o sa y , n o i n t o x i c a n ts h a v e b e e n s u p p lie d . I n a fe w e x c e p t io n a l ea ses th e liq u o r b o a r d h a v e m a d e s p e c ia l o r d e r s p r o v id in g f o r th e “ o n ” sa le a n d c o n s u m p t io n Off b e e r lim it e d in s p e c ific g r a v it y a n d in q u a n tity p u r ch a sa b le . E x c e p t io n a l c o n d it io n s in v a r io u s a rea s, o w in g t o c o n c e n tr a tio n o f m u n it io n w o r k e r s , c o n g e s tio n o f p o p u la t io n , th e b u ild in g o f la r g e fa c t o r ie s in is o la te d p la c e s , th e e m p lo y m e n t o f w o m e n a n d n ig h t e m p lo y m e n t, h a v e n e ce s s ita te d e x c e p t io n a l a rra n g e m e n ts. S p e a k in g g e n e r a lly , th e c o m m itte e are g la d t o r e c o g n iz e th a t th e liq u o r -c o n t r o l b o a r d h a v e in itia te d , g u id e d , o r a ssisted a s o c ia l a n d in d u s t r ia l r e fo r m w h ic h f o r c e o f c ir cu m s ta n ce s h a s r e n d e r e d im p e r a t iv e in th e p r e s e n t e m e r g e n c y , a n d w h ic h h a s, th e c o m m itte e a re s a tis fie d , c o n t r ib u t e d s u b s ta n tia lly t o th e s u c c e s s fu l o u t p u t o f m u n itio n s . T h e in d u s t r ia l c a n te e n h a s, in fa c t , p r o v e d it s e lf on e o f th e m o s t e ffe c tiv e in s tr u m e n ts in s e c u r in g a n d m a in t a in in g a h ig h s ta n d a r d o f in d u s t r ia l w o r k . I t h a s c o n tr ib u te d t o in c re a s e d s o b r ie t y ; it h a s r e d u c e d “ in d u s tr ia l d r in k in g ” ; it h a s se rv e d a s a c o u n t e r a t t r a c t io n t o the pu blic-bouse; it h a s s u p p lie d im p r o v e d n u t r it io n to th e w orker, w h ic h h a s le d t o a r e d u c t io n in sick n e s s a n d t o in c r e a s e d e n e r g y , b e t t e r tim e k e e p in g , a n d im p r o v e d o u tp u t. T h e c o m m itte e e a r n e s tly t r u s t th a t th ese su b s ta n tia l g a in s m a y b e m a in ta in e d in th e fu t u r e a n d th a t t h e in d u s t r ia l ca n te e n w ill b e c o m e a p e r m a n e n t a n d essen t ia l fa c t o r o f th e m o d e r n fa c t o r y . SECTION X.— SICKNESS AND ILL HEALTH. 262. T h e e ffe c t o f in d u s t r ia l o c c u p a t io n u p o n th e h e a lth o f th e w o r k e r h a s b e e n a s u b je c t o f m e d ic a l in v e s t ig a t io n sin c e th e s e v e n te e n th c e n tu r y . E a r ly in th e n in e te e n th c e n tu r y s im ila r in q u ir ie s w e re in s titu te d in E n g la n d , a n d in 1831 T h a c k r a h s h o w e d th a t th e e n v ir o n m e n t a n d c o n d it io n s o f fa c t o r y life , o r th e m e n ta l a n d p h y s i c a l s tr a in e n ta ile d , w e r e a s s o cia te d w it h e x c e p t io n a l d is a b le m e n t, d is ease, o r m o r t a lit y a m o n g th e p e rs o n s e m p lo y e d . N u m e r o u s c o m m is s io n s h a v e b e e n a p p o in t e d b y th e G o v e r n m e n t t o a s c e r ta in m o r e p r e c is e ly th e e x a c t ca u se s o f su ch e ffects, a n d th ese h a v e c o n s id e r e d su c c e s s iv e ly th e g e n e r a l c ir c u m s ta n c e s o f th e w o r k e r , th e in ju r io u s in flu e n ce s o f th e fa c t o r y sy ste m , th e s p e c ia l c o n d it io n s o f c e r ta in o c c u p a tio n s , th e r is k s in c u r r e d in th e u se o f m a c h in e r y , a n d th e r e su lts a r is in g a m o n g th o s e e m p lo y e d in d a n g e r o u s tra d e s . T h u s h a s b ee n a c c u m u la te d a b o d y o f m e d ic a l e x p e r ie n c e , g r o w in g w it h th e g r o w t h o f in d u s t r y a n d w it h th e in c re a s e o f o u r k n o w le d g e o f th e ca u ses o f d ise a se. C o n c u r r e n t ly w it h th e a p p e a r a n c e o f e v id e n c e o f a m e d ic a l a n d s o c ia l c h a r a c te r fu r t h e r lig h t h a s b e e n t h r o w n u p o n th e s u b je c t b y a ctu a rie s, in s u r a n c e a g e n ts , a n d s ta tisticia n s . A s l o n g a g o as 1853 F in la is o n , th e a c tu a r y o f th e n a tio n a l d e b t, s a id t h a t “ th e r e a l p r a c t ic a l d iffe r e n c e in th e d is t r ib u t io n o f sick n e ss seem s t o tu r n u p o n th e a m o u n t o f e x p e n d itu r e o f p h y s ic a l fo r c e ,” a n d 50 y e a r s la te r, in 1903, W a t s o n , w h o h a d s tu d ie d th e s u b je c t fr o m a n a c tu a r ia l p o in t o f v ie w , w r o te th a t “ th e p r o p o r t io n o f m e m b e rs s ic k d u r in g a n y y e a r v a r ie s w it h o c c u p a t io n .” A g a in , th e e x p e r ie n c e o f in s u r a n c e a u t h o r i tie s c o n fir m s th e sa m e v ie w . T h e r e p o r t o n n a t io n a l h e a lth in s u r a n ce f o r 1 9 1 3 -1 4 sta tes th a t “ in m a n y cases th e r a te o f sick n e s s is a ffe c te d b y o c c u p a t io n s o r b y th e c o n d it io n s in c id e n t a l t o p a r t ic u la r o c c u p a t io n s .” L a s t ly , th e r e is th e in c o n t r o v e r t ib le e v id e n c e f u r n is h e d b y th e b ills o f m o r t a lit y s te a d ily a c c u m u la t in g in p r o o f as th e y e a r s p a ss. T h e d e c e n n ia l r e p o r t s o f th e r e g is t r a r g e n e r a l d e m o n str a te th a t c e r ta in o c c u p a t io n s h a v e a h ig h c o m p a r a t iv e m o r t a lit y , th a t th is m o r t a lit y is d u e t o w e ll-d e fin e d a n d p r e v e n t ib le d ise a ses, th a t th e o c c u p a t io n m a y e x e r t a g r e a te r in flu e n ce o n m o r t a lit y th a n th e a g g r e g a t io n o f p o p u la t io n a n d its a s s o cia te d c o n d it io n s , a n d th a t o c c u p a t io n a l m o r t a lit y is a ffe cte d b y th e a g e in c id e n c e o f th e w ork er. CAUSES OF SICKNESS. 263. S ick n e ss d u e , d ir e c t ly o r in d ir e c t ly , to th e in d u s t r ia l o c c u p a t io n ta k e s v a r io u s fo r m s a n d d e g r e e s , fr o m th e p a s s in g h e a d a ch e t o 128 SICKNESS AND ILL HEALTH. 129 se rio u s o r g a n ic d ise a se o f fa t a l issu e. T h e lu n g s , th e h e a r t, th e d ig e s t iv e o r g a n s , th e n e r v o u s sy ste m , th e m u s c u la r sy ste m — e a ch o r a ll m a y b e a ffe cte d w it h re su lts h a r m fu l b o t h t o in d u s tr ia l e fficie n cy a n d o u t p u t , a n d a lso t o p e r s o n a l h e a lth a n d e x p e c t a t io n o f life . M o r e o v e r it m u st b e r e m e m b e re d th a t a n u n d u e p r o p o r t io n o f s ic k n ess in a n y g r o u p o f w o r k e r s u s u a lly re p r e s e n ts a m o n g th o s e n o t a c t u a lly s ic k le sse n e d v ig o r a n d a c t iv it y w h ic h ca n n o t fa i l to r e d u c e o u tp u t. D is a b lin g c o n d it io n s o r in flu e n ce s w h ic h in ju r e so m e h a v e a te n d e n c y t o m a r k a ll. E m p lo y e r s a n d th e ir w o r k p e o p le s h o u ld t h e r e fo r e h a v e a g e n e r a l a p p r e c ia t io n o f th ese in ju r io u s c o n d it io n s i f t h e y a re to b e o n th e o u t lo o k to g u a r d a g a in s t o r m it ig a t e t h e ir e v il e ffe ct. S p e a k in g g e n e r a lly , a tte n tio n s h o u ld b e g iv e n to th e f o l l o w in g p o i n t s : (a) E x c e s s iv e ly lo n g h o u r s o f w o r k , p a r t ic u la r ly b y n ig h t , i f c o n tin u e d , p r o d u c e fa t ig u e , ir r it a t io n , a n d sick n ess. “ Y o u w ill fin d ,” w r ite s S ir J a m e s P a g e t , “ th a t fa t ig u e h a s a la r g e r sh a re in th e p r o m o t io n o r tr a n s m is s io n o f d ise a se th a n a n y o th e r s in g le ca u sa l c o n d it io n y o u c a n n a m e .” (b) C r a m p e d a n d c o n s tr a in e d a ttitu d e s o r p o s tu re s d u r in g w o r k w h ic h p r e v e n t th e h e a lt h y a c tio n o f th e lu n g s a n d h e a rt. (c) P r o lo n g e d a n d e x ce s s iv e m u s c u la r s tr a in , e. g ., th e l if t i n g o f h e a v y w e ig h ts o r p r o lo n g e d s ta n d in g , m a y p r o d u c e r u p tu r e o r v a r i c o s e v e in s. (d) M a c h in e r y a c cid e n ts . * (e) W o r k i n g in u n v e n tila te d o r in s u ffic ie n tly v e n tila te d s h o p s p r e d is p o s e s t o d ise a se a n d in te r fe r e s w it h in d iv id u a l e n e r g y a n d p h y s ic a l c a p a c it y . T h e e ffe ct o f c o n t in u o u s ly w o r k in g in a s ta g n a n t o r p o llu t e d a tm o s p h e r e is n o t t r iflin g o r in s ig n ific a n t. ( / ) T h e a ir, e v e n i f fr e s h , m a y b e t o o h o t o r t o o c o ld , t o o h u m id o r t o o d r y ; e ith e r e x tre m e s h o u ld b e a v o id e d i f r e a s o n a b le b o d ily c o m fo r t a n d th e m o s t efficien t w o r k a re t o b e in su re d . ( g) Imperfect lighting, whether by day or night, conduces to eye strain and headache. (A ) W o r k i n g w it h , o r in th e p re s e n ce o f g a ses, v a p o r s , p o is o n s , o r o t h e r ir r it a t in g su b sta n ce s m a y le a d t o d ir e c t p o is o n in g . (i) D u s t p r o d u c e d in c e r ta in in d u s tr ie s , u n le ss e ffe c tu a lly s a fe g u a r d e d , m a y p r o d u c e lu n g d isease. (j) T h e m a n u fa c t u r e a n d u se o f h ig h e x p lo s iv e s in v o lv e s risk s to th e w o r k e r s . 264. In considering the physical capacity of a woman for with standing the fatigue consequent upon prolonged industrial employ ment, it has to be remembered that her body is physiologically differ ent from and less strongly built from that of a man. Her muscular system is less developed. Account must also be taken of the fact that 80935°— 10-------9 130 INDUSTRIAL HEALTH AND EFFICIENCY. a t th e p re s e n t tim e m a n y w o r k e r s h a v e u n til r e c e n t ly liv e d a s e d e n ta r y o r d o m e s tic l i f e a n d h a v e n o t b ee n in th e h a b it o f t a k in g a c t iv e a n d r e g u la r e x e r cis e . C e r ta in a ilm e n ts a n d fo r m s o f p h y s ic a l d is a b ilit y t o w h ic h w o m e n a re lia b le a re r e a d ily c a u se d o r a t lea st a c ce n tu a te d b y in a t t e n t io n t o th ese c o n s id e r a t io n s ; a m o n g su ch c o n d it io n s a re — ( i ) D is tu r b a n c e s o f d ig e s t io n d u e t o u n s u ita b le f o o d , ir r e g u la r a n d h u r r ie d m e a ls, o r t o f a t i g u e ; ( i i ) A n e m ia , w it h p o s s ib ly a s s o c ia te d d ise a se o f th e h e a r t a n d c ir c u la t o r y s y s t e m ; (iii) H e a d a ch e; ( i v ) N e r v o u s e x h a u s t io n ; ( v ) M u s c u la r p a in a n d w e a k n ess, fla t fo o t , e t c .; ( v i ) D e r a n g e m e n t o f s p e c ia l p h y s io lo g ic a l fu n c t io n s . 265. T h o u g h th ese c o n d it io n s m a y n o t in a ll ca ses b e im m e d ia t e ly in c a p a c it a t in g , th e y fr e q u e n t ly te n d t o b e c o m e c h r o n ic in n a tu r e a n d f a r r e a c h in g in e ffe ct, a n d t h e y le a d d ir e c t ly t o m a ln u t r it io n a n d t o r e d u c t io n o f b o d ily e n e r g y . I f a llo w e d t o p e rs is t th e y in v a r ia b ly la y th e fo u n d a t io n s o f ill h e a lth a n d d ise a se in la t e r y e a rs . 266. S p e c ia l p r o b le m s a lso a rise in th e p r e v e n t io n o f sick n e s s a m o n g s t b o y s a n d g ir ls . B o t h p h y s ic a lly a n d m e n t a lly t h e y a re less c a p a b le th a n a d u lts o f p r o lo n g e d e ffo r t o r s u s ta in e d a tte n tio n t o w o r k . T h e y n e e d v it a l e n e r g y n o t o n ly f o r th e m a in te n a n c e o f h e a lth b u t f o r g r o w t h ; e v e n t h o u g h th e re a re n o s ig n s o f im m e d ia te ill h e a lth th e ir fu t u r e g r o w t h a n d d e v e lo p m e n t m a y b e c o m e stunte<J. 267. T h o u g h th ese a re a s u fficie n tly fo r m id a b le lis t o f d is a b lin g c o n d it io n s , o r c o n d it io n s w h ic h w it h o u t p r o p e r c a re a n d p r e c a u t io n m a y r e a d ily ca u se d is a b le m e n t, t h e y d o n o t c o m p le t e th e in v e n t o r y . A t le a st as im p o r t a n t as a n y o f th ese o c c u p a t io n a l in flu e n ce s, b u t in s e p a r a b le f r o m th e m , is th e p r e d is p o s it io n t o d ise a se a r is in g f r o m th e a b se n ce o f p e r s o n a l h y g ie n e . T h e n e ce ssitie s o f in d iv id u a l h e a lth a re fe w a n d s im p le , b u t t h e y a re essen tia l. S u it a b le a n d su fficien t f o o d , fr e s h a ir, w a r m th , m o d e r a t io n , c le a n lin e s s in w a y s a n d h a b its o f life , th e p r o p e r in t e r r e la t io n o f w o r k , r e p o s e , a n d r e c r e a t io n o f m in d a n d b o d y a re la w s o f h y g ie n e , th e e le m e n ts o f v it a l im p o r t a n c e f o r w h ic h fa c ilit ie s m u s t b e p r o v id e d i f th e m a x im u m in d u s t r ia l o u t p u t o f th e in d iv id u a l is t o b e s e c u re d a n d m a in ta in e d . T h e s e m a t te r s n e e d c o n s id e r a t io n b y th e m a n a g e m e n t ju s t as m u c h as th e h e a lt h y s u p e r v is io n o f th e e x te r n a l c ir c u m s ta n c e s o f th e fa c t o r y a n d its t e c h n ic a l p ro ce ss e s. IN D IC A T IO N S OF S IC K N E S S . 268. I n a d d it io n t o th e c lin ic a l s ig n s a n d s y m p t o m s o f i l l h e a lth a n d d ise a se, th e r e a re th r e e g e n e r a l in d ic a t io n s o f sick n e s s in a f a c t o r y w h ic h c a n b e g a u g e d b y th e m a n a g e m e n t : SICKNESS AND ILL HEALTH. 131 ( a ) A b s e n c e , b r o k e n t im e , ir r e g u la r t im e k e e p in g , o r d im in is h e d o u t p u t o f t h e in d iv id u a l w o r k e r . (& ) S ick n e s s r e g is te r . (c) D e a t h c e rtifica te s. T h e s e , t h o u g h fe w in n u m b e r, fo r m im p o r t a n t in d ic a t io n s o f th e h e a lth o f th e w o r k e r s as a w h o le . 269. E v e r y ca se o f lo s t t im e o r a b se n ce c a lls f o r in q u ir y . I t s h o u ld b e p r o p e r ly r e c o r d e d . T h e s tu d y o f su ch r e c o r d s is c e r ta in t o d is c lo s e th e e x is te n c e o f a d v e r s e in flu e n ce s o r c ir c u m s ta n c e s p r e v io u s ly u n s u s p e c te d w h ic h m a y d e n o te th e b e g in n in g o f sick n ess. U n f o r t u n a t e ly th e n u m b e r o f in sta n c e s w h e r e r e lia b le r e c o r d s a re k e p t is c o m p a r a t iv e ly fe w . E v e n w h e n t h e ir im p o r t a n c e is r e c o g n iz e d d iffic u ltie s h a v e a rise n o w in g t o p re s s u r e o n th e tim e o f th e s ta ff o r o w i n g t o th e u n s a t is fa c t o r y c h a r a c t e r o f m a n y o f th e m e d ic a l c e r t ific a te s s u p p lie d b y w o r k e r s . T h e s e c e r tific a te s fr e q u e n t ly g iv e n o in fo r m a t io n as t o th e ca u se o f illn e s s o r a s t o its p r o b a b le d u r a t io n . T h e y s e ld o m sta te w h e th e r im m e d ia te a b se n ce f r o m w o r k is essen t ia l o r w h e th e r it c a n b e p o s t p o n e d f o r a b r ie f p e r io d u n t il a p a r t ic u la r jo b h a s b e e n c o m p le t e d . A p a r t f r o m th ese, c e r tific a te s a re s o m e tim e s g iv e n o n o d d s lip s o f p a p e r o r d o n o t s h o w th e a d d r e s s o f th e m e d ic a l p r a c t it io n e r . I n th e ir M e m o r a n d u m N o . 1 6 1 th e c o m m itte e h a v e s u g g e s te d th e n e e d f o r a fo r m o f m e d ic a l c e r tific a te w h ic h , i f a d o p te d , s h o u ld d o m u c h t o o b v ia t e th ese d ifficu ltie s. A m o d e l f o r m is g iv e n in A p p e n d ix G . 270. P r o f . L o v e d a y , in h is m e m o r a n d u m o n T h e C a u ses a n d C o n d it io n s o f L o s t T im e , w h ic h is in c lu d e d in t h e c o m m it t e e ’s in t e r im r e p o r t o n I n d u s t r ia l E ffic ie n c y a n d F a t ig u e , sets o u t th e r e su lts o f a se rie s o f in v e s t ig a t io n s w h ic h h e m a d e o n b e h a lf o f th e c o m m it t e e i n t o th e lo s t tim e^ H e c o n c lu d e s th a t n e a r ly a ll r e c o r d s u n d e r s ta te , a n d m o s t r e c o r d s u n d e r s ta te g r e a t ly , th e p r o p o r t io n o f lo s t tim e d u e t o sick n e s s a n d o t h e r u n a v o id a b le cau ses. T h is is p a r t ly d u e t o th e d iffic u lty in r e g a r d t o m e d ic a l c e r tific a te s , a lr e a d y r e fe r r e d t o , a n d p a r t ly t o th e f a c t th a t m a n y a b se n ces f o r w h ic h n o m e d ic a l c e r t ifi ca te s a re o r c a n b e f o r t h c o m in g a re a ttr ib u ta b le t o fa t ig u e , c o ld s , o r o t h e r m in o r a ilm e n ts . W h il e s u c h a b se n ce s m a y in a sen se h a v e b e e n a v o id a b le , th e y fr e q u e n t ly se rv e t o p r e v e n t fu t u r e b r e a k d o w n . H e g iv e s r e a so n s in s u p p o r t o f th e v ie w th a t, e x c e p t w h e r e th e re is an u n d u e d e g r e e o f sla ck n e ss, m o r e t h a n h a lf o f th e t im e lo s t is lo s t t h r o u g h u n a v o id a b le ca u se s. V a r io u s m e th o d s a re s u g g e s te d f o r te s t in g th e a c c u r a c y o f sick n e s s r e c o r d s : ( a ) I f th e r e tu r n s o f b a d tim e k e e p in g a n d sick n e s s c o in c id e in d ir e c t io n . (& ) I f th e n u m b e r o f w h o le w e e k s lo s t t h r o u g h sick n e s s is a b n o r m a lly h ig h w h e n c o m p a r e d w it h th e s h o r t e r p e r io d s s im ila r ly lo s t. * Cd. 8522. 132 INDUSTRIAL HEALTH AND EFFICIENCY. ( c ) I f th e n u m b e r o f d a y s lo s t t h r o u g h s ick n e s s is a b n o r m a lly h ig h w h e n c o m p a r e d w it h th e n u m b e r o f “ q u a rte rs ” s im ila r ly lo s t. 271. A n a ffir m a tiv e a n sw e r t o a n y o f th ese q u e s tio n s , u n le ss e x p lic a b le o th e r w is e , g iv e s g o o d r e a s o n f o r s u p p o s in g th e r a te o f s ic k n ess t o b e u n d e r s ta te d . W h ile n o d o u b t in s o m e p la c e s a n d in s o m e tr a d e s t im e k e e p in g h a s r e a lly b e e n s la ck , th e re seem s lit t le d o u b t th a t th e u n d e r e s tim a te o f sick n e s s a n d u n a v o id a b le a b se n ce g e n e r a lly h a s le d to m a n y m is in fo r m e d a n d u n ju s t sta te m e n ts a b o u t th e le t h a r g y a n d ir r e g u la r it y o f th e w h o le b o d y o f w o r k e r s in c o n t r o lle d fa c t o r ie s . 272. I n s c r u t in iz in g sick n e s s r e tu r n s a n d in s t u d y in g t h e ir r is e a n d f a l l a c c o u n t m u s t b e ta k e n o f v a r io u s ca u ses o f flu c t u a t io n : (a) Climatic conditions .— I t m a y b e a ssu m e d t h a t th e ra te o f s ic k n ess w ill b e a b o v e th e a v e r a g e in J a n u a r y , F e b r u a r y , M a r c h , A p r i l , a n d o c c a s io n a lly in N o v e m b e r . I n th e r e m a in in g m o n th s i t w ill o r d in a r ily b e b e lo w th e n o r m a l. I f th e sick n e s s r a te d o e s n o t r e s p o n d t o c o n s id e r a b le c h a n g e s in w e a th e r , o r flu ctu a te s in d e p e n d e n t ly o f th e m , o th e r ca u se s o f flu c tu a tio n m u st b e o p e r a t iv e a n d s h o u ld b e d e te r m in e d . (5 ) The approach o f a holiday. — A w o r k e r , t h o u g h fe e lin g u n w e ll, m a y h o ld o n i f a h o lid a y is a p p r o a c h in g , a n d a r e d u c t io n in th e s ic k n ess ra te m a y a c c o r d in g ly re su lt. (c) A holiday just past. — I f th e sick n e s s c u r v e fa ils t o r e s p o n d t o a h o lid a y , a n d e s p e c ia lly t o a b r e a k o f se v e r a l d a y s , o r i f its s te a d i n ess o r r is e c a n n o t b e a ttr ib u te d t o w o r s e n e d c lim a t ic c o n d it io n s , e p id e m ic s , o r th e lik e , th e re is r e a so n f o r r e c e iv in g sta te m e n ts as t o . s ick n e s s w it h c a u t io n a n d s o m e tim e s w it h s u s p ic io n . (d) Patriotic enthusiasm. — M a n y w o r k e r s w ill k e e p a t w o r k w h e n t h e y a re c o n v in c e d o f its u r g e n c y a n d n a t io n a l im p o r t a n c e e v e n t h o u g h th e y m a y b e u n w e ll a n d n e e d rest. C o n s e q u e n tly w h e n a p e r io d o f r e la x a t io n o c c u r s th e ra te o f lo s t tim e a n d a lso o f s ick n e s s m a y r is e s u b s ta n tia lly . ( e ) Long hours , much overtime , and especially Sunday labor , u n d o u b t e d ly e x e r c is e a m o s t d e t e r io r a t in g e ffe ct. P r o f . L o v e d a y q u o te s th e case o f a f a c t o r y w h e re th e re w a s m u c h S u n d a y la b o r d u r i n g th e s p r in g a n d w h e r e n o fe w e r th a n 22 p e r c e n t o f th e m e n w e re a t o n e tim e sick . D u r in g th e f o l l o w i n g A u g u s t , w h e n S u n d a y la b o r h a d b e e n m u c h r e d u c e d (b u t o v e r tim e o n w e e k d a y s r e m a in e d h e a v y ) , th e sick n e s s r a te w a s lit t le o v e r 4 p e r ce n t. T h is r e d u c t io n w a s p a r t ly a ttr ib u t a b le t o th e c h a n g e o f sea son , b u t th e fig u re s o f a n e ig h b o r in g f a c t o r y s h o w e d th a t in th a t d is t r ic t th e w e a th e r d u r in g th e s p r in g , t h o u g h in c le m e n t, w a s n o t a b n o r m a lly u n h e a lt h fu l, a n d P r o f . L o v e d a y sees n o r e a s o n t o d o u b t th e m a n a g e r ’s v ie w th a t th e w e a th e r w a s less a c c o u n ta b le f o r th e im p r o v e m e n t th a n th e r e s t r ic t io n o f S u n d a y w ork. SICKNESS AND ILL HEALTH. 133 273. A s r e g a r d s th e s ig n s o f i ll h e a lth m o s t c o m m o n ly m e t w it h a m o n g s t m u n it io n w o r k e r s , a la r g e b o d y o f in fo r m a t io n h a s b een r e n d e r e d a v a ila b le as th e r e s u lt o f th e m e d ic a l e x a m in a tio n s o f m a le a n d fe m a le w o r k e r s w h ic h w e r e c o n d u c t e d o n b e h a lf o f th e c o m m itte e . F u l l p a r t ic u la r s o f th e a ilm e n ts a n d d e fe c t s fo u n d b y D r . A g n e w as th e r e su lt o f e x a m in in g o v e r 3,0 0 0 m e n a n d b o y s a re g iv e n in a ta b le set o u t o n p a g e s 98 a n d 99 o f th e c o m m it t e e ’s in t e r im r e p o r t o n I n d u s t r ia l E ffic ie n c y a n d F a tig u e . D r . A g n e w r e p o r t s : There is no one defect that points conclusively to overwork or strain, but many o f the symptoms taken collectively indicate severe strain, and I would suggest that sleepiness on the night shift, headache, foot ache, and muscular pains are probably the most common signs o f overwork. The nervous symptoms added to these go far to complete the picture. The effect o f noise upon the individual and its contribution to feelings o f overtiredness and exhaustion must be considerable. In many o f the factories, though the work w as not heavy, the noise was such that the result of lengthened periods in these fa c tories was almost as severe as exposure to high temperature coupled with hard work. 274. O n p a g e s 120 a n d 121 o f th e sa m e r e p o r t s im ila r p a r t ic u la r s a re g iv e n o f th e d e fe c t s fo u n d as th e r e s u lt o f e x a m in in g o v e r 1,300 w o m e n a n d g i r ls ; th e r e su lts o f th ese e x a m in a tio n s w e re th u s s u m m a r iz e d : The ailments most frequently observed included indigestion, constipation, headache, anemia, and muscular pains. These are all frequently met with among women workers and can not be attributed especially to munition work. The great difficulty in estimating their precise importance is the lack o f any control investigation or data. In some cases the ailment had undoubtedly been caused or accentuated by conditions o f factory work. In other cases it has existed before beginning munition work. In others, again, the workers expressed themselves as in better health than formerly. METHODS OF R E M E D Y AN D TR EATM ENT. 275. A t th e fo u n d a t io n o f a n y s o u n d sy ste m o f d e a lin g w it h in d u s t r ia l d ise a ses lie t w o e le m e n ta r y p r in c ip le s : F ir s t , th a t p r e v e n t io n is b e tte r th a n c u r e ; a n d , s e c o n d ly , th a t f o r tre a tm e n t t o b e im p o s e d e ffe c t iv e ly it m u s t d e a l w it h th e b e g in n in g s o f d ise a se. B e a r in g th e se in m in d , th e p r e lim in a r y s a fe g u a r d s h o u ld b e to p r o v id e f o r th e m e d ic a l e x a m in a t io n o f a ll w o r k e r s in o r d e r to se cu re as f a r as m a y b e th e ir p h y s ic a l fitn ess f o r e m p lo y m e n t. I n so m e m u n it io n w o r k s , a n d e s p e c ia lly in th o se w h e r e d a n g e r o u s su b sta n ce s a re m a n ip u la t e d , a p r e lim in a r y m e d ic a l e x a m in a t io n o f a ll w o r k e r s is u su a l. D e n t a l tre a tm e n t is a lso s o m e tim e s p r o v id e d . S u c h e x a m i n a tio n s a re s p e c ia lly im p o r t a n t a t th e p re s e n t tim e o w in g t o th e s tr a in in v o lv e d b y th e c o n d it io n s o f e m p lo y m e n t a n d o w in g t o th e la r g e n u m b e r o f p e r s o n s w h o a re t a k in g u p in d u s t r ia l e m p lo y m e n t f o r th e first t im e ; b u t su ch e x a m in a tio n s a re a lw a y s lik e ly t o b e d e s ir a b le w h e r e th e w o r k in v o lv e s a n y s p e c ia l s tr a in , a n d p a r t ic u 134 INDUSIKIAL HEALTH AJSD EFFICIENCY. l a r l y s o in th e ca se o f w o m e n . A p a r t f r o m t h e ir v a lu e in d e t e c t in g e a r ly s ig n s o f a ilm e n t o r d e fe c t , m e d ic a l e x a m in a tio n s a re v a lu a b le a s a ffo r d in g c o n v e n ie n t o p p o r t u n it y f o r th e in c u lc a t io n o f s o u n d d o c t r in e s as t o p e r s o n a l h y g ie n e , c le a n lin e s s , a n d h e a lt h y h a b its . P e r io d ic r e e x a m in a t io n is p r a c t ic a lly c o n fin e d t o c e r ta in d a n g e r o u s t r a d e s a n d p ro c e ss e s, th e w o r k e r s in w h ic h h a v e t o b e p e r io d ic a lly e x a m in e d u n d e r th e r e g u la t io n s o f th e H o m e O ffice o r th e M in is t r y o f M u n it io n s . W h e r e t h e y c a n b e a r r a n g e d f o r , s u ch e x a m in a t io n s m ig h t u s e fu lly b e e x t e n d e d t o w o r k e r s e n g a g e d in o t h e r p r o c e s s e s i n v o lv in g s p e c ia l s tr a in o r r is k . 276. I t is tr u e th a t u n d e r s e c tio n 63 o f th e f a c t o r y a n d w o r k s h o p a c t it is n e ce s s a r y f o r e v e r y b o y a n d g i r l u n d e r 16 t o b e c e r t ifie d b y th e f a c t o r y c e r t i f y in g s u r g e o n * as p h y s ic a lly fit f o r e m p lo y m e n t in th e fa c t o r y . U n fo r t u n a t e ly , th is c e r tific a te is n o t a lw a y s a d e q u a te f o r it s p u r p o s e . T h e d e c is io n o f th e s u r g e o n h a s n o r m a lly t o b e b a s e d s im p ly o n o n e b r ie f e x a m in a tio n . M o r e o ft e n th a n n o t h e h a s n o p r e v io u s k n o w le d g e o f th e b o y o r g ir l, a n d g e n e r a lly th e r e c o r d s o f th e s c h o o l m e d ic a l s e r v ic e a re n o t a v a ila b le . A f t e r a y o u n g p e r s o n h a s o n c e b e e n a d m itt e d t o a f a c t o r y n o fu r t h e r m e d ic a l e x a m in a t io n is r e q u ir e d e x c e p t in th e r a r e in s ta n c e s w h e r e th e f a c t o r y in s p e c t o r m a y s p e c ia lly r e q u ir e it. I n v ie w o f th e s tr a in w h ic h in d u s t r ia l e m p lo y m e n t m a y o ft e n im p o s e o n g r o w in g b o y s o r g ir ls , it w o u ld u n d o u b t e d ly b e a n a d v a n t a g e i f a r r a n g e m e n ts c o u ld b e m a d e f o r t h e ir p e r io d ic r e e x a m in a tio n . I t m a y b e p o in t e d o u t t h a t th e d e p a r t m e n t a l c o m m it t e e o n th e n ig h t e m p lo y m e n t o f m a le y o u n g p e r s o n s e m p h a s iz e d th e n e e d f o r su ch p e r io d ic a l e x a m in a t io n s o n c e a t le a st in e v e r y s ix m o n th s , a n d r e c o m m e n d e d th a t r e c o r d s o f th e r e s u lts s h o u ld b e k e p t. 277. T h e s e c o n d ste p is t o r e d u c e t o a m in im u m a n y u n fa v o r a b le c o n d it io n s o b t a in in g in th e f a c t o r y b y p r o v id i n g p r o p e r s a n ita r y c o n d it io n s a n d a c c o m m o d a t io n , s a fe g u a r d in g m a c h in e r y , c o n t r o llin g h o u r s o f la b o r , fu r n is h in g ca n te e n fa c ilit ie s , a n d s e c u r in g su fficie n tly w a r m e d , lig h t e d , a n d v e n t ila t e d w o r k r o o m s . 2 78. T h i r d l y , a r r a n g e m e n ts s h o u ld b e m a d e f o r a d e q u a te m e d ic a l a n d n u r s in g sch e m e s. M e d ic a l a tte n d a n c e is o b ta in a b le u n d e r th e n a t io n a l in s u r a n c e s y s te m , o r m a y b e m a d e a v a ila b le b y th e s p e c ia l p r o v is io n o f a m e d ic a l a n d h o s p it a l s e r v ic e f o r th e fa c t o r y . N u r s in g c a n o n ly b e o b t a in e d b y th e e m p lo y m e n t o f o n e o r m o r e t r a in e d n u r s e s t o u n d e r ta k e d u tie s in th e f a c t o r y b y n ig h t as w e ll a s b y d a y . S u c h a r r a n g e m e n ts h a v e b e e n in s titu te d in m a n y m u n it io n fa c t o r ie s , e s p e c ia lly w h e r e w o m e n a re e m p lo y e d , a n d h a v e p r o v e d o f g r e a t v a lu e t o e m p lo y e r s a n d w o r k e r s a lik e . T h e d u tie s o f th e fa c t o r y n u r s e m a y in c lu d e — 1 See memorandum on Certificates of Fitness, issued by the Home Office in 1915, and obtainable on application to that office. SICKNESS AND ILL HEALTH. 135 (a) S u p e r v is io n o f th e h e a lth o f th e w o r k e r s . (& ) S u p e r in te n d e n c e o f th e re st r o o m f o r th o s e w h o a re te m p o r a r i ly in d is p o s e d . ( c ) F o ll o w i n g u p ca ses o f sick n e s s a t h o m e . (d) T a k in g c h a r g e o f fir s t-a id tr e a tm e n t o f in ju r ie s . (e) I n th e a b se n ce o f m e d ic a l a d v ic e , o b s e r v in g a n d c o n t r o llin g in it s in it ia l s ta g e s a n y th r e a te n e d o u t b r e a k o f th e in flu e n z a t y p e o f sick n e s s, w h ic h , i f it e x te n d s , m a y t e m p o r a r ily p a r a ly z e o u tp u t. 279. T h e c o m m itte e a re g la d t o r e c o g n iz e th e in c r e a s in g fr e q u e n c y w it h w h ic h n u rse s a re n o w b e in g e m p lo y e d in fa c t o r ie s t o p e r f o r m s o m e o r a ll o f th e d u tie s m e n tio n e d a b o v e . T h e e m p lo y m e n t o f d o c t o r s is, o f c o u r s e , less c o m m o n . I n fa c t o r ie s e n g a g e d u p o n th e m a n u fa c t u r e o r m a n ip u la t io n o f p o is o n o u s su b sta n ce s a n d g a se s 51 m e d ic a l officers a re a t p re s e n t e m p lo y e d . O f th ese 14 a re w h o le t im e officers a n d 37 p a r t tim e . T h e ir d u tie s in c lu d e th e p r e lim in a r y m e d ic a l e x a m in a t io n o f th e w o r k e r s , th e s u p e r v is io n o f t h e ir h e a lth w h ils t a t w o r k , a c o n s ta n t in s p e c t io n o f th e w o r k in g c o n d it io n s o f th e fa c t o r y , a n d th e r e g u la t io n o f su sp e n sio n s. I n a d d it io n , t h e y are c o n s t a n t ly c o n c e r n e d w it h o t h e r m a tte r s m o r e o r less d ir e c t ly a ffe c t in g th e h e a lth o f th e w o r k e r s . T h e y r e p o r t p e r io d ic a lly t o th e m in is t r y o n m e d ic a l p r o b le m s a r is in g in t h e ir w o r k , A t m a n y o f th ese fa c t o r ie s d e n tis ts a re e m p lo y e d b y th e m a n a g e m e n t t o t r e a t n e w w o r k e r s w h o r e q u ir e t o h a v e c a r io u s te e th r e m o v e d b e f o r e t h e y c a n b e s a fe ty e m p lo y e d . I n o th e r fa c t o r ie s th e e m p lo y m e n t o f m e d i c a l officers is s t ill r a r e , t h o u g h it is in c r e a s in g , a n d d e v e lo p m e n t is l ik e ly t o b e e n c o u r a g e d t h r o u g h th e n e e d f o r s e c u r in g th e p r o p e r s u p e r v is io n a n d m a in te n a n c e o f tlie fir s t-a id a p p lia n c e s , th e p r o v is io n o f w h ic h is r e q u ir e d b y th e r e ce n t H o m e O ffice o r d e r .1 T h e n e e d f o r t r a in in g w o r k e r s in th e u se o f th ese a p p lia n c e s w ill a lso r e q u ir e t o b e p r o v id e d fo r . T h e th re e ca ses q u o te d b e lo w in d ic a t e o t h e r d ir e c t io n s in w h ic h d e v e lo p m e n t m a y b e a n t ic ip a t e d : (a) At an engineering factory employing about 2,250 workers (m ostly men) whole-time medical officer has been appointed, who acts also as panel doctor fo r most o f the employees. He makes a medical examination o f all new employees. Absentees are follow ed up by him if they have not seen him before leaving work, and they again see him before resuming work. The number o f patients seen varies from 60 to 75 a day, and the medical officer’s work consists in the supervision o f the dressing carried out by his male dresser, ordinary diagnosis, minor surgical treatments, and any attendance on the workers where necessary in their homes or at the neighboring cottage hospital. (&) At an engineering factory, where about 2,500 men and women are em ployed, a medical officer attends at the surgery daily from noon till 1 p. m. H e sees cases o f injuries which have been held over fo r his inspection or which have come up to be redressed. He also examines all workers before engage ment, when any physical defects, such as hernia, hydrocele, varicocele, varicose veins, or heart trouble are entered in a book and the entry countersigned by a *See paragraph 289 and Appendix !• 136 INDUSTRIAL HEALTH AND EFFICIENCY. tlie w orker; in this way claims in respect o f that particular defect at some later date are avoided. The medical officer also treats at his own house cases sent to him by the nurses on duty. Employees have to report every accident, no matter how slight, to the fore man, who passes the case on to the ambulance room. The workers are in no case allowed to treat any wound themselves. A ll wounds are dressed by nurses under the supervision o f the medical officer. Patients are not sent to their own doctor, for the latter have not time for, and can not be expected to, treat daily a large number o f minor and apparently trifling injuries. Under the system adopted every wound, however slight, is dressed within a few minutes o f its occurrence, and is properly cared for until it is healed. As a result, the proportion o f workers who lost time on account o f accidents was markedly lowered, and there was an increase in the proportion o f cases that lost no time at all. This scheme is also o f interest because the firm on starting it decided to carry their own insurance for all claims less than £100 ($486.65), and they found after, due allowance was made for tlie doctor’s salary and the expenses associated with the nurses, that they had at the end o f 18 months a credit balance o f nearly £500 ($2,433.25). To this balance must be added the indirect though considerable value o f working hours and weeks saved. (c ) A group of factories are employing one medical man, paid on a capitation basis, to make not less than four health inspections annually. His inspection includes the organization o f first-aid treatment; records o f the health and progress o f each w ork er; the condition o f the sanitary conveniences; the cleanliness o f the w indow s; the ventilation, temperature, and cleanliness o f each w orkplace; the facilities for obtaining food and drinking w a te r ; and the cloakroom and washing accommodation. He also advises on any medical sub ject connected with the work o f the factory and as to the health o f any worker specially referred to him. Any necessary observations or suggestions are en tered in writing fo r the inform ation o f the management and for reference on subsequent visits. S E C T I O N X I .— I N J U R I E S A N D A C C I D E N T S . 280. T h e p r o v is io n s o f th e F a c t o r y a n d W o r k s h o p A c t in r e g a r d t o a c c id e n ts f a l l in t o t w o m a in c a te g o r ie s — tfie p r e v e n t io n o f a c c i d e n ts , a n d th e n o t ific a t io n a n d in v e s t ig a t io n o f c e r ta in k in d s o f a c c i d e n ts. T h e p r o v is io n s f o r th e p r e v e n t io n o f a c c id e n ts in c lu d e th e p r o p e r fe n c in g o f m a c h in e r y (se c. 1 0 ), s a fe t y v a lv e s f o r b o ile r s (s e c. 1 1 ), th e p o s it io n a n d o p e r a t io n o f s e lf-a c t in g m a c h in e s (se c. 1 2 ) , th e c le a n in g o f m a c h in e r y b y w o m e n a n d y o u n g p e rs o n s (se c. 1 3 ) , m e a n s o f e sca p e in ca se o f fire (se c. 1 4 ), a n d th e m a k in g o f d o o r s t o o p e n o u t w a r d (se c. 1 6 ). T h e o c c u p ie r o f th e fa c t o r y is r e q u ir e d t o n o t i f y t o th e fa c t o r y in s p e c t o r a ll fa t a l a c c id e n ts a n d a ll a c c id e n ts s u fficie n tly s e r io u s to n e ce ssita te a b se n ce fr o m w o r k f o r a p e r io d o f o n e d a y in s o m e ca ses a n d o f sev en d a y s in o th e rs. N o t i fic a t io n is a lso r e q u ir e d o f d a n g e r o u s o c c u r r e n c e s , s u ch as fire s, o r c e r t a in t y p e s o f e x p lo s io n s o r a c c id e n ts t o m a c h in e r y o r p la n t. U n d e r th e P o lic e , F a c t o r ie s , etc. (M is c e lla n e o u s P r o v is io n s ) , A c t , 1916, s e c tio n 8, it is th e d u t y o f th e fa c t o r y c e r t i f y in g s u r g e o n t o in v e s t ig a t e a n d r e p o r t u p o n c e r ta in k in d s o f in ju r y c a u se d b y e x p o s u r e to g a s, fu m e s , o r o th e r n o x io u s su b sta n ce s, a n d a lso u p o n a n y o t h e r ca ses w h ic h m a y b e s p e c ia lly r e fe r r e d t o h im . 281. H o w g r a v e is th e a m o u n t o f d is a b le m e n t c a u se d b y in ju r ie s a n d a c c id e n ts is s h o w n b y th e fa c t th a t t h o u g h o n ly a c c id e n ts o f a c e r t a in d e g r e e o f s e v e r ity a re n o tifia b le , th e n u m b e r n o tifie d a n n u a lly a m o u n ts to o v e r 150,000. T o th ese m u st b e a d d e d a v a st n u m b e r o f m in o r in ju r ie s a n d a c c id e n ts w h ic h in th e a g g r e g a t e ca u se p e r h a p s an e v e n la r g e r a m o u n t o f in t e r r u p t io n to w o r k . A s o m e w h a t fo r m id a b le r e tu r n o f a c c id e n ts is t h e r e fo r e t o b e a n t ic ip a t e d in m u n it io n f a c to r ie s , w h ic h in c lu d e n o t o n ly m e ta l a n d e n g in e e r in g w o r k , b u t c e r t a in d a n g e r o u s tr a d e s a n d th e m a n u fa c t u r e o f e x p lo s iv e s . M o r e o v e r , th e in t r o d u c t io n o f n e w la b o r , a n d o f e m p lo y e e s u n a c c u s to m e d t o th e p ro c e s s e s c o n c e r n e d , p a r t ic u la r ly in c o n ju n c t io n w it h th e n e e d f o r s p e e d a n d p re s su re , o v e r tim e , a n d n ig h t w o r k , w ith th e c o n s e q u e n t fa t ig u e , m u s t in e v it a b ly le a d t o g r e a te r r is k o f a c c id e n t. T h e in ju r ie s in a t y p ic a l m u n it io n w o r k s a re n o t o n ly o p e n w o u n d s , c o n tu s io n s a n d a b r a s io n s , in ju r ie s t o th e ey e, s p ra in s , s im p le a n d c o m p o u n d fr a c t u r e s , a n d in ju r e d lim b s , b u t a lso scra tch e s, cu ts, b u rn s, a n d o th e r m in o r in ju r ie s w h ic h m a y r e a d ily le a d to m o r e s e r io u s c o n d it io n s b y n e g le c t. T h e s lig h te s t w o u n d m a y b e c o m e in fe c t e d w it h g e r m s , a n d a g r e a te r o r less d e g r e e o f se p sis o r b lo o d p o is o n - 137 INDUSTRIAL HEALTH AND EFFICIENCY. 138 in g s u p e rv e n e , w it h th e r e s u lta n t s e r io u s lo s s o f tim e a n d e ffic ie n c y , a n d p o s s ib ly e v e n r is k o f l i f e a n d lim b . An insurance company reports that out o f 27,500 accident claims in 1917, 2,700 were septic claims, over 2,000 o f these being septic conditions caused through wounds on the hand. 282. .M u ch v a lu a b le a n d s u g g e s tiv e in fo r m a t io n o n th e r e la tio n o f th e in c id e n c e o f a c c id e n ts t o o u t p u t a n d t o fa t ig u e is c o n t a in e d in D r , V e r n o n ’s m e m o r a n d u m o n A n I n v e s t ig a t io n o f th e F a c t o r s C o n c e r n e d in th e C a u s a tio n o f I n d u s t r ia l A c c id e n t s .1 T h e in q u ir y is o f th e g r e a te r im p o r t a n c e in th a t so f a r as th e c o m m itte e a re a w a re n o in q u ir y o f a s im ila r n a tu r e h a d p r e v io u s ly b e e n c o n d u c t e d , a t a n y ra te in th is c o u n t r y . A s h e p o in t s o u t p r e v io u s in q u ir ie s o n th e s u b je c t h a v e s u ffe r e d fr o m c e r ta in d e fe c ts . I n th e firs t p la c e th e a c c id e n t d a ta a re in n o ca se c o r r e la t e d w it h th e o u t p u t d a ta . S e c o n d ly , n o a llo w a n c e h a s b e e n m a d e f o r th e c o n s id e r a b le p e r io d o f tim e o ft e n lo s t a t th e b e g in n in g a n d e n d o f a s p e ll. A n d t h ir d ly , n o a llo w a n c e h a s b e e n m a d e f o r th e tim e w h ic h h a s e la p s e d b e tw e e n th e o c c u r r e n c e o f th e a c c id e n t a n d th e tim e w h e n th e w o r k e r a p p lie s f o r tre a tm e n t. T h is p e r io d is a lw a y s a p p r e c ia b le , a n d in th e ca se o f som e ty p e s o f a c c id e n t (e . g ., s p r a in s ) m a y b e c o n s id e r a b le . 283. A s t o w h a t are th e p r in c ip a l ca u ses o f a c c id e n ts D r . V e r n o n sta tes : Speed o f production is the essential factor in accident causation which can never be neglected. Its action depends especially on the degree o f nervous and muscular coordination possessed by the worker, and on psychical condi tions such as his alertness and attention. The various factors concerned in accident production may be classified under two main headings, according as they depend on the worker himself, L e., are o f personal origin, or depend on external conditions not directly under his control. Factors o f personal o rig in : I. Nervous and muscular coordination in relation to speed o f produc tion. II. Fatigue. III. Psychical influences. IV. Nutrition and alcohol consumption. Factors of external o rig in : V. Lighting. VI. Temperature, humidity, and ventilation. VII. Defects o f machinery and absence o f guards. 284. F o r an a d e q u a te a p p r e c ia t io n o f th e c h a r a c t e r a n d s c o p e o f D r . V e r n o n ’s in q u ir y , r e fe r e n c e s h o u ld b e m a d e t o th e r e p o r t it s e lf.2 H e r e it m u st su ffice t o g iv e a b r ie f s u m m a r y : Accident data were collected at fou r factories, for periods o f 9 to 25£ months. The accidents (over 50,000 in number) were classified separately under the headings o f cuts, foreign bodies in the eye, burns, sprains and injuries incurred *Cd. 9046. * See Committee’s Memorandum No. 21. (Cd. 9046.) INJURIES AND ACCIDENTS. 139 one or more days before they were first treated. Eye accidents afford the most reliable index o f accident incidence, as they are almost invariably treated within a few minutes o f their occurrence. Cuts are fairly reliable, but sprains are quite unreliable, as the workers generally do not come fo r treatment till some time after they are incurred. Hence their incidence resembles that of “ previous injuries,” or depends on the inclination o f the worker to attend the dressing station. This inclination varies greatly at different times. For in stance, day-shift women attended three times more frequently toward the end* o f the morning spell than at the beginning, but night-shift women attended most frequently at the beginning o f the shift, and only a fifth as frequently towards the end o f it. Speed of production.— Output determinations at a fuse factory were made by measuring the excess electric power supplied to the various sections o f the works, and verifying the results by direct enumerations o f the articles produced. The output rose steadily during the morning spell and was 11 per cent greater in the fourth hour o f full work than in the first hour. It remained high during the first hour o f the afternoon spell, but fell off during the rest o f the after noon. The incidence o f accidents showed a qualitative resemblance to these output variations but not a quantitative one, for accidents increased 10 to 30 times more rapidly than output during the morning spell. Nevertheless it was concluded that varying speed o f production is the factor largely responsible for the day-shift variations o f accidents in men, and not fatigue. Though the night-shift output follow ed a similar course to the day-shift output, the accident incidence, except that o f eye accidents, was entirely different. It was at a maximum at the beginning o f the shift, and fell gradually the whole night through to about half its initial value. This was due to the fact that the nightshift workers started work in a careless and excited state, and calmed down gradually during the night. At the other factories, where 6 , 9.2 and 15-inch shells were manufactured, there was very little hourly variation in the speed with which the operations on these shells were performed, and in correspond ence therewith the hourly incidence o f accidents incurred by the day shift was fairly steady. The night-shift accidents dwindled rapidly the whole night through, because o f the psychical factor. The diurnal variations o f accidents at the fuse factory generally corre sponded with the output variations, as both rose to a maximum in the middle o f the week and declined at the end o f it. This correspondence held for night shift as well as day shift, and the diurnal variation o f eye accidents was especially marked. In the shell factories the night-shift accidents rose rapidly in the course o f the week, and in women were 47 per cent more numerous on the last day than on the first day. This was a fatigue effect. The monthly variations o f accidents at the fuse factory corresponded with output variations, for the accidents gradually increased about 40 per cent, whilst the hourly out put at the same time increased 30 per cent. Fatigue.— The influence o f fatigue on accidents to women was strikingly shown at the fuse factory when the operatives were working a 1 2 -hour day, or 75 hours a week. The women’s accidents were tw o and a half times more numerous than in the subsequent 10 -hour day period, but the men’s accidents were not affected. The women’s accidents showed a five-fold increase during the course o f the morning spell, as compared with a three-fold increase during the subsequent 1 0 -hour day period, but the men’s accidents did not change as between these two periods. The women’s accidents were 45 per cent times more frequent in the afternoon spell than in the morning spell, whilst the men’s accidents were only 7 per cent times more numerous. Also the women were treated for faintness nine times more frequently than the men, and were givea 140 INDUSTRIAL HEALTH AND EFFICIENCY. sal-volatile 23 times more frequently, whereas in the subsequent 10-hour day period they were treated for faintness and given sal-volatile only three times more frequently. When the hours o f work at one o f the shell factories w ere equalized for the men and the women, whereby the women were made to work 9£ hours more than they had done previously, and the men 9 i hours less, the ratio o f women’s accidents to men’s accidents (corrected for the alteration o f hours) increased 19 per cent for the day shift and 61 per cent for the night shift. Psychical influences.— At ali the factories the night-shift workers suffered few er accidents than the day-shift workers, the average defect being 16 per cent. This was not due to the output being smaller, as at the fuse factory it was distinctly bigger by night than by day. It was psychical in origin, and due to the night-shift workers settling down to a calmer mental state than the dayshift workers, and so becoming less careless and inattentive. The psychical factor is one o f the most important in accident causation. Alcohol consumption.— Indirect evidence as to the effects o f alcohol con sumption was obtained by assuming (a ) that the increasing restrictions on the alcohol consumption o f the Nation in general during the w ar applied also to the munition w orkers; (b ) that such o f the ngiht-shift wTorkers astook alcohol did so shortly before coming on to work. It was found that the accidents treated during the three spells o f the niglit shift at the fuse factory fell off much more rapidly in men than in women— as one would expect them to do if the excess o f accidents in the first spell were due partly to alcohol consump tion— and that between February, 1916, and December, 1917, the fall steadily became less. Again, in the 12-hour day period (November, 1915, to January, 1916) the accidents were at a maximum on Monday and fell gradually to a minimum on Friday, which was 30 per cent less than the Monday value. Then they shot up again nearly to the maximum on Saturday. This suggests week end drinking, as no such variations were observed during the subsequent 1 0 -hour day period. Lighting.— Accidents due to foreign bodies in the eye were 7 to 27 per cent more numerous in the night shift than in the day shift, though all the other accidents were considerably less numerous. This was due to the artificial lighting, as the excess o f eye accidents was most marked in the worst lit fac tory. During day shift the eye accidents to men were most frequent in the winter months and most infrequent in the summer months, but this relation ship was- not observed in the women. Other accidents were not affected, for during day shift they were not more numerous in the hours o f artificial light ing than in those o f natural lighting. Temperature.— The temperature at the fuse factory was recorded continu ously for six months by means o f a thermograph. Accidents wTere at a mini mum at 65° to 69° F. and increased rapidly at higher temperatures (e. g., by 30 per cent at temperatures above 75°) and slowly at low er temperature?. Continuous records were obtained o f the external temperature o f the town in which the shell factories were situated, and it was found that in all o f them the accidents increased considerably as the wTeather grew colder and dimin ished as it grew warmer. In one factory the women’s accidents w^ere nearly two and a h alf times more numerous when the temperature was at or below freezing point than when it was above 47°, whilst the men’s accidents were twice as numerous. Prevention of accidents.— Various directions in which accidents could be diminished were suggested by comparing the accident frequency o f men and women at the different factories. The women suffered twTice as frequently as INJURIES AND ACCIDENTS. 141 the men from sprains and were especially liable to w rist sprains at the fuse factory, as they had not sufficient strength to push home the clamping lever o f the lathes. Both men and women suffered many more sprains at the 6 -inch shell factory than at the other shell factories, as they often moved the 90-pound shells by hand, instead o f with the tackle provided. The women at the shell factories suffered three times more burns than the men, chiefly from the hot metal turnings. Accidents arising from carelessness and inattention can be diminished by preventing the workers from talking to one another in the shops. M E A N S OF P R E V E N T IO N . 285. I t h a s b e e n e s tim a te d th a t f r o m 25 t o 40 p e r ce n t o f a ll in d u s t r ia l a c c id e n ts a re p r e v e n ta b le i f a ll p r a c t ic a b le m e a n s a re ta k e n . I n A m e r ic a it h a s b e e n e s tim a te d t h a t r o u g h ly 3 0 p e r ce n t o f a c c i d e n ts a re d u e t o illn e s s o r t o im p e r fe c t io n s in m a c h in e s o r in g u a r d i n g d a n g e r o u s p a r t s ; th a t 60 p e r ce n t a re d u e t o a p a t h y a n d la c k o f a p p r e c ia t io n o f d a n g e r o n th e p a r t o f o p e r a tiv e s a n d o n ly 10 p e r c e n t to w h o lly u n p r e v e n ta b le cau ses. W h a t e v e r th e p r o p o r t io n s m a y b e, th e r e is n o d o u b t th a t a la r g e n u m b e r o f a c c id e n ts a re p r e v e n ta b le , a n d th e S ta te w h ic h d e s ir e s th e m a x im u m o u t p u t o f m u n itio n s , th e e m p lo y e r w h o p a y s c o m p e n s a tio n , th e u n io n s w h o s u b s id iz e a b se n te es, a n d th e o p e r a tiv e w h o u n d e r g o e s s u ffe r in g a n d p a in , a n d p e r h a p s , p e r m a n e n t d is a b le m e n t, a re a lik e c o n c e r n e d t o se cu re a r e d u c t io n in th e n u m b e r o f a c cid e n ts . 286. I t is o b v io u s t h a t m u c h c a n b e d o n e b y a d o p t in g v a r io u s m e th o d s o f p r e v e n t io n , s u ch as th e p r o p e r a n d e ffe c tiv e g u a r d in g o f m a c h in e r y , th e p r o v is io n o f s a fe t y a p p lia n c e s , th e p r o p e r r e g u la t io n o f d a n g e r o u s p ro c e ss e s, th e a d e q u a te lig h t in g o f th e fa c t o r y , a n d th e m o r e c a r e fu l c le a n in g o f m a c h in e r y . B u t h o w e v e r c o m p le t e th e p r o v is io n m a d e f o r s e c u r in g th e s a fe t y o f th e w o r k e r , its su ccess m u st la r g e ly d e p e n d u p o n th e in te llig e n t c o o p e r a t io n o f w o r k e r s a n d fo r e m e n in th e m a in te n a n c e a n d u se o f th e a p p lia n c e s p r o v id e d a n d in th e e n fo r c e m e n t o f p r e c a u t io n a r y r e g u la tio n s . A s a lr e a d y su g g e s te d , m a n y a c c id e n ts o c c u r t h r o u g h ig n o r a n c e o r a p a t h y — “ fa m ilia r it y b r e e d s c o n t e m p t.” O n e m e th o d o f s e c u r in g th e n e ce s s a r y c o o p e r a t io n w h ic h m ig h t w it h a d v a n ta g e b e m o r e w id e ly a d o p te d is b y th e e sta b lish m e n t o f c o m m itte e s o f w o r k e r s . T h e d u tie s o f s u ch c o m m itte e s are to s tu d y th e ca u ses o f a c cid e n ts , to s u g g e s t a n d a d v is e s u ita b le m e a n s f o r p r e v e n t io n , t o k e e p c a r e fu l r e c o r d s , t o m a k e fr e q u e n t in s p e c t io n o f m a c h in e r y a n d p la n t, a n d t o n o te a n y d e fe c t s o r d a n g e r s . T h e in te re s t o f th e w o r k e r s m a y b e fu r t h e r e n c o u r a g e d b y g iv in g p r iz e s f o r s u g g e s tio n s o r b y a w a r d s t o th e c o m m itte e o f th e d e p a r tm e n t w h e r e th e g r e a te s t r e d u c t io n o f a c c id e n ts h a s b e e n se cu re d . I n so m e in s ta n c e s m o n t h ly p a m p h le ts o r b u lle tin s h a v e b e e n p u b lis h e d d e a lin g w it h th e s a fe t y a n d h y g ie n e , 142 INDUSTRIAL HEALTH AND EFFICIENCY. w it h p a r t ic u la r s o f a c c id e n ts , w it h n o te s as t o th e ir p r e v e n t io n a n d illu s t r a t io n s o f s a fe a n d d a n g e r o u s m e th o d s o f w o r k in g . 287. H o w e v e r p e r f e c t a n d c o m p le te m a y b e th e m e th o d s o f p r e v e n t io n a d o p te d , a c c id e n t s w ill a lw a y s o c c u r , a n d p r o v is io n m u s t th e r e f o r e b e m a d e f o r t h e ir s u ita b le tr e a tm e n t, a n d p a r t ic u la r ly f o r th e fir s t -a id tr e a tm e n t o f m in o r in ju r ie s . W h e r e v e r p o s s ib le t r a in in g in th e e ss e n tia ls o f first a id s h o u ld b e g iv e n t o a su fficie n t n u m b e r o f w o r k e r s t o p r o v id e th a t in e a c h s h o p th e re a re a t le a st o n e o r t w o p e r s o n s w h o k n o w h o w t o r e n d e r first a id in ca se o f in ju r y , a n d m u c h v a lu a b le w o r k h a s b e e n a c c o m p lis h e d in s p r e a d in g k n o w le d g e o f fir s t -a id p r a c t ic e b y th e S t. J o h n A m b u la n c e A s s o c ia t io n a n d s im ila r o r g a n iz a t io n s , w it h a r e su lt th a t in m a n y m u n it io n w o r k s th e r e a re e m p lo y e e s w h o p o sse ss th e r e q u is ite t r a in in g . U n fo r t u n a t e ly a t th e p re s e n t tim e lo n g h o u r s o f w o r k a n d th e d iffic u lty o f o b t a in in g te a c h e rs m a k e s t r a in in g d iffic u lt to o r g a n iz e . D is t r ib u t io n m a y a ls o u s e fu lly b e m a d e o f lea flets o r p la c a r d s o f in s t r u c t io n a n d a d v ic e . A n y in s t r u c t io n o r a d v ic e s h o u ld b e s im p le a n d p r e c is e a n d s h o u ld e m p h a s iz e th e n e e d f o r tr e a tm e n t in a ll ca ses a s w e ll as m e th o d s o f tre a tm e n t.1 288. I n th e m a jo r it y o f fa c t o r ie s s o m e p r o v is io n is m a d e f o r th e tr e a tm e n t o f in ju r ie s , b u t in s p e c t io n in d ic a te s th a t th e r e is g r e a t a n d u r g e n t n e e d o f im p r o v e m e n t , e s p e c ia lly f o r t r e a t in g m in o r in ju r ie s . W h ile o n e fa c t o r y m a y p o sse ss a w e ll-e q u ip p e d s u r g e r y w it h a tr a in e d n u r s e in c h a r g e , a t a n o th e r p r o v is io n f o r tr e a tm e n t m a y b e w h o lly a b se n t, o r th e s u r g ic a l e q u ip m e n t m a y b e r e p r e s e n te d b y a s o ile d r o ll o f s o m e s o -c a lle d “ a n t is e p t ic ” lin t o r g a u z e , a n o p e n p a c k e t o f a b s o r b e n t w o o l, a fe w b a n d a g e s , so m e a n t is e p t ic lo t io n , o r a n u n c le a n p a ir o f sciss o rs , a ll k e p t in a d u s ty d r a w e r . I t is o b V io u s th a t p r o v is io n o f e q u ip m e n t f o r firs t a id is w o r s e th a n u seless u n le ss it is p r o p e r ly k e p t a n d m a in ta in e d . 289. W h a t is r e q u ir e d is a n a d e q u a te t h o u g h s im p le o r g a n iz a t io n w h ic h p r o v id e s — (a) a lo c a l d r e s s in g s ta tio n o r a id p o s t in e a c h w o r k p la c e f o r m in o r in ju r ie s , a n d ( b ) a c e n t r a l d r e s s in g s ta tio n o r s u r g e r y f o r m o r e s e r io u s ca se s o r ca ses r e q u ir in g c o n tin u o u s t r e a t m e n t. A n o r d e r 2 r e c e n t ly m a d e b y th e H o m e O ffice u n d e r th e P o lic e , F a c t o r ie s , etc. (M is c e lla n e o u s P r o v is io n s ) , A c t , 1 916, s e c tio n 7 ,3 r e q u ir e s th a t in th e ca se o f b la s t fu r n a c e s , c o p p e r m ills , ir o n m ills , fo u n d r ie s , a n d m e ta l w o r k s a fir s t -a id b o x s h a ll b e p r o v id e d in th e p r o p o r t io n o f a t le a st o n e t o e v e r y 150 p e r s o n s , a n d a n a m b u la n c e r o o m w h e r e v e r 50 0 o r m o r e p e r s o n s a r e e m p lo y e d . A r r a n g e m e n t s 1 A leaflet (see note at end of section) has been issued by the Home Office and is tainable on application. *T he terms of the order are given in Appendix I. 9 The terms of the section are given in Appendix H. ob IN J U E IE S ^ N D ACCIDENTS. 143 s h o u ld a ls o b e m a d e f o r th e im m e d ia t e c o n v e y a n c e t o h o s p it a l o f ca ses w h ic h c a n n o t b e t r e a te d o n th e s p o t. LOCAL DRESSING STATION OB AID POST. 290. I n o r d e r t o b e e ffe c tiv e u n d e r in d u s t r ia l c o n d it io n s a n y fo r m o f tr e a tm e n t f o r m in o r in ju r ie s m u st b e e x t r e m e ly s im p le , e a s ily u n d e r s to o d , a n d r e a d ily a p p lic a b le . E la b o r a t e p r o v is io n f o r th e treat m e n t o f m in o r in ju r ie s is th e less n e c e s s a r y , b e ca u se o f its u n s u ita b i li t y u n d e r f a c t o r y c o n d it io n s a n d b e ca u se in m a c h in e s h o p s w o u n d s a re u s u a lly c o m p a r a t iv e ly fr e e fr o m g e rm s . F u r t h e r , th e tr e a tm e n t m u s t b e a lw a y s a n d p r o m p t ly a v a ila b le . T h e w o r k m a n w h o su s ta in s a s lig h t in ju r y w h ile at w o r k w ill o ft e n d e c lin e t o s u r r e n d e r a q u a r te r o f a n h o u r o f tim e a n d e a r n in g s in g o in g t o a n d fr o m a c e n t r a l s u r g e r y to h a v e h is w o u n d d ressed . T im e is a c o n s id e r a t io n , a n d th e e x ig e n c ie s o f f a c t o r y l if e d o n o t a llo w o f an e la b o r a te p r o c e d u r e . T h e a id p o s t m a y ta k e th e fo r m o f a c u p b o a r d o r b o x c o n t a in in g fir s t -a id m a te r ia ls , w it h b r ie f, s im p le , a n d c le a r in s t r u c t io n s as to t h e ir use. T h e b o x s h o u ld c o n ta in p a c k e ts o f s t e r iliz e d d re s s in g s , a s u p p ly o f io d in e s o lu tio n (a lc o h o lic s o lu t io n c o n t a in in g 2 p e r c e n t i o d in e ) , a b o t t le o f “ e y e d r o p s ,” a p a ir o f d r e s s in g sciss o rs , so m e t r ia n g u la r b a n d a g e s , s a fe t y p in s , a n d a r o ll o f p la s te r (1 in c h w id e ) . T h e s te r iliz e d d r e s s in g s m a y s u it a b ly b e o f th re e sizes :* (a) T h r e e d o z e n s m a ll size , f o r fin g e r s , c o m p o s e d o f a s t r ip o f g a u z e o r lin t 8 in c h e s lo n g a n d 1 in c h w id e , w it h n a r r o w ta p e a tta c h e d t o o n e e n d . T h e ta p e s h o u ld b e r o lle d u p in s id e th e s t r ip , w h ic h is th e n w r a p p e d in a c o v e r o f o r d in a r y n o n a b s o r b e n t w o o l a n d th e w h o le s te r iliz e d . I n u se th e w o o l is first r e m o v e d a n d th e d r e s s in g u n r o lle d r o u n d th e in ju r e d fin g e r , w h e n th e ta p e is d is c lo s e d r e a d y f o r t y in g th e d r e s s in g in p o s it io n . (b) O n e d o z e n m e d iu m size , f o r h a n d s o r fe e t, s im ila r t o th e a b o v e , b u t 18 in c h e s lo n g a n d 1^ in c h e s w i d e ; a n d (<?) O n e d o z e n la r g e size , f o r w h ic h th e o r d in a r y fie ld d r e s s in g m a y b e ta k e n as a p a tte r n . T h e a id p o s t s h o u ld b e u n d e r th e c a re o f a n officer, p r e f e r a b ly th e fo r e m a n o r fo r e w o m a n , tr a in e d in fir s t-a id w o r k . T h is officer s h o u ld k e e p a n o te o f e v e r y ca se d re s se d , a n d s h o u ld b e r e s p o n s ib le f o r see in g th a t th e b o x is k e p t s to c k e d a n d in p r o p e r o r d e r . O r d in a r ily o n e s u ch a id p o s t s h o u ld b e p r o v id e d in e a c h w o r k p la c e , b u t in la r g e e n g in e e r in g s h o p s se v e r a l m a y b e r e q u ir e d . 1 Such dressings may be obtained, amongst others, from Messrs. Cuxson, Gerrard & Co., Oldbury, Birmingham, and Southall Bros, and Barclay, Birmingham. Dressings are also prepared by Messrs. Burroughs, Wellcome & Co., Reynolds & Bransom, 13, Briggate, L e e d s ; C. P. Thackray. Great George Street, L e ed s; and the St. John Ambulance Asso ciation, St. John’s Gate, Clerkenweil. 144 INDUSTRIAL HEALTH AND EFFICIENCY. CENTRAL DRESSING STATION OE SURGERY.1 291. T h e c e n tr a l d r e s s in g s t a t io n 2 s h o u ld b e e a s ily a c ce s s ib le a n d s p e c ia lly c o n s tr u c te d o r a d a p te d f o r th e p u r p o s e . T h e r o o m o r r o o m s s h o u ld , in la r g e fa c t o r ie s , p r o v id e f o r a s u r g e r y , a r e s t r o o m , a n d a s to r e r o o m a n d n u r s e ’s r o o m . W h e r e a s u r g e r y is u se d f o r w o r k e r s o f b o t h sex es a s e c o n d s m a ll r o o m w ill b e fo u n d a d v a n ta g e o u s . T h e w a lls s h o u ld b e c o v e r e d w it h g la z e d tile s , e n a m e le d ir o n sh eets, o r w a s h a b le p a in t. T h e flo o r s h o u ld b e o f s m o o th , h a r d , d u r a b le , a n d im p e r v io u s m a t e r ia l; th e n a t u r a l a n d a r t ific ia l lig h t in g s h o u ld b e a m p l e ; h o t a n d c o ld w a te r s h o u ld b e la id o n o r b e im m e d ia t e ly a v a il a b le ; th e r o o m s h o u ld b e w a r m e d in w in te r . A g la z e d s in k is n e e d e d , th e w a ste p ip e o p e n in g o v e r th e d r a in , a n d t r a p p e d o u ts id e th e s u r g e r y . A f o o t b a th , p r e f e r a b ly fix e d a n d p r o v id e d w it h h o t a n d c o ld w a te r , is d e s ira b le . T h e fu r n it u r e s h o u ld c o n s is t o f a ta b le , s c o u c h , c h a irs , a n d c u p b o a r d s . T h e r o o m s h o u ld n o t c o n t a in a c a r p e t, r u g s , c u r ta in s , ta b le c lo th , w in d o w b lin d s , o r w a ll p ic tu r e s . T h e k e y n o t e s h o u ld b e s im p lic it y a n d cle a n lin e s s. T h e flo o r s h o u ld b e w a s h e d o n c e a d a y w it h a n tis e p tic flu id , a n d th e w a lls a t le a st o n c e a w eek. 292. T h e o b je c t o f th e c e n tr a l d r e s s in g s ta tio n b e in g th e tr e a tm e n t o f m o r e s e r io u s ca ses th a n c a n b e d e a lt w it h a t th e a id p o s t, a n d th e r e d r e s s in g o f ca ses o f m in o r in ju r y , it is d e s ir a b le th a t it s h o u ld b e p r o p e r ly e q u ip p e d . I t m a y a lso b e c o n v e n ie n t to u se it f o r th e m e d i c a l e x a m in a tio n o f a p p lic a n t s f o r w o r k . 293. T h e s ta tio n m u st b e in c h a r g e o f a c o m p e te n t p e r s o n w it h k n o w le d g e o f a m b u la n c e w o r k . W h e r e v e r p o s s ib le , a t r a in e d n u r s e s h o u ld b e o n r e g u la r d u ty , a m b u la n c e a ssista n ts b e in g s e le c te d f r o m e m p lo y e e s tr a in e d in fir s t -a id w o r k . M a n y la r g e w o r k s n o w h a v e a m e d ic a l officer o n th e s ta ff, w h o is r e s p o n s ib le f o r th e s u p e r v is io n o f th e s u r g e r y a n d a v a ila b le f o r se rio u s ca ses b e fo r e r e m o v a l t o h o s p it a l. T h e e q u ip m e n t o f th e s u r g e r y w ill la r g e ly d e p e n d u p o n th e c h a r a c te r o f th e a c c o m m o d a t io n p r o v id e d a n d th e e x p e r ie n c e o f th e p e r s o n in c h a r g e , b u t th e f o l l o w i n g w ill g e n e r a lly b e r e q u ir e d : ( i ) S tr e tc h e r s , s p lin ts , a n d s t r o n g b a n d a g e s f o r m a jo r a c c id e n t s ; ( i i ) B a n d a g e s a n d d r e s s in g f o r m in o r in ju r ie s (a s to c k s h o u ld b e k e p t t o r e p le n is h th e a id p o s t s ) ; ( i i i ) A s im p le s te r iliz e r a n d n e ce ssa r y s u r g ic a l in s tr u m e n ts su ch as sciss o rs , fo r c e p s a n d t o u r n iq u e t ; a n d ( i v ) S im p le lo t io n s a n d d r u g s (w it h su fficien t e n a m e le d b a s in s ). W h e r e a m e d ic a l officer is e m p lo y e d a t th e fa c t o r y h e s h o u ld b e p r o v id e d w it h a c c o m m o d a t io n a d jo in in g th e c e n tr a l d r e s s in g s ta tio n . T h e a c c o m m o d a t io n s h o u ld o r d in a r ily in c lu d e a c o n s u lt in g r o o m 1 F o r in fo r m a tio n la n c e room as to th e can be reg a rd e d as c o n d it i o n s an s e e A p p e n d ix K . * See illustration facing page 117. u n d e r w h ic h ex pense fo r th e c a p ita l p ui poses e x p e n d it u r e of th e ex cess on an p r o fits am bu d u ty , INJURIES AND ACCIDENTS. 145 (fit t e d w it h h o t a n d c o ld w a te r a n d a s t e r iliz e r ), a c le r k ’s office, a n d a w a it in g r o o m . I f a r r a n g e m e n ts a re m a d e f o r m e n a n d w o m e n to a tte n d a t d iffe r e n t h o u r s s e p a r a te w a it in g r o o m s w ill n o t o r d in a r ily be r e q u ir e d . 294. T h e fo llo w in g statem ent is o f interest, as show ing the ar rangem ents m ade at a large national fillin g fa cto ry fo r dealin g w ith eases o f sickness and in ju r y : Ambulance equipment.— At each o f our two factories we have a roomy ambu lance with accommodation for doctors’ consultations, first-aid dressings, sick ness cases. Each ambulance building has two separate casualty dressing rooms, one for men and one for women, a ward with eight beds where sickness and accident cases can be treated at ordinary times, and where in the event o f an explosion the victims can be promptly attended, a small emergency operating room, with sterilizers for dressings and instruments and a roomy cupboard for surgical emergency appliances. At the other end o f the ward there are two doctors’ consulting rooms, patients’ waiting room, storeroom, etc. The staff of the ambulance consists o f two doctors, one sister, and four nurses in the shell-filling factory (where we have 7,000 workers and a night shift as well as a day shift) and one sister with two nurses in the cartridge-filling fac tory (where we have about 8,000 workers and a day shift on ly). In connection with our ambulance station, we have an ambulance wagon, which is at our disposal day or night for removing patients to their homes to hospital. Arrangements are also made with the local ambulance association for the expedition o f ambulance wagons in the event o f any serious explosion at the factory. Tw o large local hospitals have arranged to receive our urgent cases when required in the event o f explosion or otherwise. Liberal contributions are made by the factory workers to these institutions. Any o f our TNT cases who have been ill enough to require hospital treat ment have been sent to the * * * Infirmary, where I am in touch with the superintendent and also with the house doctors and the pathologist, who inform me immediately o f any matter o f importance concerning a worker. Convalescent home for workers.— The Y. W. C. A. very kindly opened a con valescent home about 6 miles from here in a bracing part o f the country, and this has been kept almost entirely at our disposal and has been o f inestimable value to us. The expenses o f this establishment are defrayed partly by the Y. W. C. A. and partly by donations from our workers’ hospital fund. Home visitation of ivorkers who are sick.— Chiefly in order to obviate the risk o f girls suffering from TN T poisoning lying ill at home, undiagnosed, and pos sibly untreated, we adopted from the beginning a system o f home visitation. A postcard is sent to all workers in TNT parts o f the factory who are reported absent for two days or more. As soon as the postcard is returned asking for a visit our health visitor calls at the house and immediately reports to me. If, as a result o f this visit, it seems necessary that the doctor should call, that is done later. Girls who are in financial difficulties are assisted and in fectious cases may be reported. W orkers requiring subscribers’ lines for ad mission to hospital or to convalescent homes are notified, and so on. In con nection with this home-visiting department we have a w elfare secretary and a health visitor. The wrelfare secretary deals with all returned postcards. She arranges the work o f the health visitor and makes reports to the doctor, keeps a card index o f those visited, deals with the subscribers’ lines for convalescent or 80935°— 19------ 10 146 INDUSTRIAL HEALTH AND EFFICIENCY. homes, infirmaries, etc., keeps the “ com forts fund ” money and the accounts connected therewith, and so on. The health visitor is not a trained nurse, but is sympathetic, tactful, and conscientious, and is liked by the girls, who give her their confidence. Financial aid to sick workers.— A fund has been in our hands for about a year and a half. The money is spontaneously voted by the workers’ committee at their monthly meetings, and it is entirely subscribed by the w orkers them selves. Help is given from this fund to any worker who seems to be in finan cial distress, especially through illness or accident, and who is unable to pro vide herself with the necessary food and comfort. It is also given at times to provide holidays for necessitous cases. The money is chiefly distributed through the health visitor on the recommendation o f the doctor. This system has the advantage over other systems o f financial aid that it is given fo r neces sity observed by the doctors, nurses, or health visitors, and does not conduce to begging. 295. T h e f o l l o w i n g is a n a c c o u n t o f th e a r r a n g e m e n ts w h ic h h a v e b e e n m a d e a t a m u n it io n w o r k s in th e M id l a n d s : I commenced work here in 1914; for about two years I did the w elfare work and nursing, but by that time the number o f employees had increased so much that I had to give up the w elfare work and specialize on the w ork I was engaged for (nursing). W e have tw o ambulance rooms in different parts o f the works, but new; and larger ambulance rooms with rest rooms attached are under consideration. W e are starting classes in connectioh with St. John Ambulance and hope to have four St. John Ambulance people— two men and two girls— in each de partment, in charge o f an ambulance cupboard. At present all accidents are attended to by m yself in the daytime and a night nurse at night. Serious cases only are sent to hospital and minor cases attended to here. Repeated dressings are done each day at the w orks; this is more satisfactory, as it keeps us in touch with the people and we know when to expect them back at work. W e also give electrical massage to those patients recommended by the doctor. Besides this I am qualified to treat simple medical cases, and we find this prevents a great loss o f time by the employees. W e keep a report o f all accidents. All children under 16 are examined by a doctor when engaged; if they have bad teeth a note is given them and they are sent to the dental hospital for treatm ent; if anything is wrong with their eyes, to the eye hospital; if any thing is wrong with their throat, to the ear and throat hospital, and so on. The employees pay Id [2 cents] per week and from this fund so s u b s c r ib e they receive hospital notes and obtain free treatment at the hospitals. The m ajor portion o f this fund goes to the local hospital Saturday fund, and our employees can, when recommended by their doctor for a change o f air, get a fortnight’s free treatment at a convalescent hom e; there are two at Llandudno, one at Malvern and one at Droitw ich (fo r rheumatic subjects). Through the hospital Saturday fund our people can be supplied with artificial appliances, such as glasses and elastic stockings. The children o f our work people obtain the same benefits, the convalescent home for children being the Red House, Great Barr, near Birmingham. The distribution and the clerical w ork in connection with these notes is done e n t i t y by the nursing depart ment. The welfare superintendent looks the cases up and refers them all to me. 147 IN JU M E S AND ACCIDENTS# SYSTEMATIC RECORDS. 296. A s a lr e a d y s u g g e s te d , it is im p o r t a n t th a t a fu ll a n d a c cu ra te r e g is t e r s h o u ld b e k e p t o f a ll ca ses o f sick n e s s a n d a c c id e n t, w it h p a r t ic u la r s o f d re s s in g s , r e d r e s s in g s , a n d tre a tm e n t. 297. A ca se b o o k s h o u ld b e d r a w n u p s o m e w h a t a s f o l l o w s : Id e n ti fic a tio n num ber. 1 .............. D a te. 1915 N o v . 25 N a m e of injured person. N atu re of in ju ry or illn ess. H o w caused. M ary S m it h . Crushed t h u m b F all of s h e ll. . Progress of case w ith dates B a te of of su bsequen t dressings, final an d th e occurrence of a n y dressing. sepsis. 1915 N o v . 25, N o v . 26, N o v . 3 0 . . . 1915 D e c. 3 E a c h ca se w h e n first tr e a te d m a y a p p r o p r ia t e ly r e c e iv e a c a r d , n u m b e r e d t o c o r r e s p o n d w ith th e e n t r y in th e ca se b o o k , to b e b r o u g h t o n th e o c c a s io n o f su b se q u e n t d re s sin g s . This card must be brought to the surgery each time the patient comes for treatment. Identification n u m b e r. N am e. N atu re of in ju r y or illn ess. 1 .................................. M ary S m it h ............. C rushed t h u m b . . . N ote. D a te . N o v . 25,1915 N o v . 26,1915 N o v . 30,1915 In stru ction s. T o com e tom orrow . T o com e on 30th. T o com e on D e c . 3. — E x t r a c t fr o m fir s t -a id le a fle t issu e d b y th e H o m e O ffice. TR EATM EN T OF M IN O B IN J U R I E S . The follow ing suggestions have the approval of H. M. medical inspectors o f factories in rendering first aid in factories and workshops so as to prevent sub sequent septic infection or blood poisoning: A scratch or slight wound* D o not touch it. D o not bandage or wipe it with a handkerchief or rag o f any kind. D o not wasb it. Allow the blood to dry and so close the wound naturally; then apply sterilized dressing and bandage .1 I f bleeding does not stop, apply a sterilized dressing and sterilized w ool; then bandage firmly. I f the wound is soiled with road dirt or other foul matter, swab freely with w ool soaked in tbe iodine solution,® and allow the wound to dry before applying sterilized dressing. A bum or scald. Do not touch it. D o not wash it. Do not apply oil or grease o f any kind. W rap up the injured part in a large dressing o f sterilized w ool* a a 1 Minute wounds can be efficiently closed by applying collodion. * An alcoholic solution containing 2 per cent of iodine. • This would not exclude treatment by prepared paraffin or picric acid. 148 INDUSTRIAL H EALTH AND EFFICIENCY. An acid burn. Do not touch it, 01* apply oil or grease o f any kind. Flood the burn with cold water. Sprinkle it (after flooding) with powdered bicarbonate o f soda. Apply a sterilized burn dressing of suitable size .1 However slight the burn, if the area affected is extensive a doctor must be consulted. Do not remove any dressing, but, if the injured part becomes painful and begins to throb, gQ to a doctor at once. Destroy all dressings which have been opened but not u se d ; they soon become infected with microbes and then are not safe to use. N o t e . — Danger from minor injuries arises from blood poisoning which is caused when microbes infect a wound. The m ajority o f wounds are at first “ c l e a n t h a t is, they are not infected with m icrobes; such infection usually occurs later and comes from handkerchiefs or other materials applied to stop bleeding or to wipe away blood, and, in the case of eye injuries, from efforts to remove fixed particles with unclean instruments. It is better to leave a wound alone than to introduce microbes by improper treatment. The congealing o f blood is Nature’s way o f closing wounds against infection and should not be interfered with. Burns and scalds when the skin is not broken w ill heal if left a lo n e ; all that is necessary is rest and a protective covering. When blisters form they must not be pricked, except under medical advice. Rest is an important aid to healing. A short rest at first allows healing to commence and often saves a long rest later. An injured hand or finger can be rested in a sling, and an injured eye by a bandage, but an injured foot or toe can only be rested in bed. RESULTS. 298. T h e c o m m itte e a re sa tisfie d o f th e u r g e n t n e c e s s ity a n d v a lu e o f s o m e su ch o r g a n iz a t io n as t h a t s u g g e s te d a b o v e . T h e y h a v e b e e n m u c h im p r e s s e d in v is it in g m u n it io n w o r k s w it h th e u s e fu l p a r t p e r fo r m e d b y c o m p e te n t n u rse s a n d th e la r g e n u m b e r o f ca ses o f in ju r y a n d sick n e s s w h ic h r e c e iv e tre a tm e n t. T h u s in o n e m u n it io n w o r k s e m p lo y in g r a th e r over* 4,0 0 0 w o r k e r s th e a m b u la n c e d e p a r t m e n t d u r in g D e c e m b e r , 1917, d e a lt w it h 1,260 a c c id e n ts (i n c l u d i n g t6 3 5 cu ts, 291 b r u ise s , a n d 150 e y e c a s e s ), 1,703 r e d r e s s in g s , a n d 1,428 m e d ic a l ca ses ( in c lu d in g 415 in d ig e s t io n , e tc., 486 h e a d a c h e s , a n d 3 5 1 ~ c o ld s ), a t o t a l o f 4,391. F o r J a n u a r y , 1918, th e fig u r e s w e r e 1,186 a c c id e n ts (in c lu d in g 670 cu ts, 218 b r u is e s , a n d 2 02 e y e c a s e s ), 1,956 r e d r e s s in g s , a n d 296 m e d ic a l cases (in c lu d in g 118 in d ig e s t io n , e tc ., 71 h e a d a ch e s , a n d 70 c o ld s ) , a to t a l o f 3,438. 1 This would not exclude treatment by prepared paraffin or picric acid. S E C T IO N X I I .— E Y E IN J U R IE S . T H E E F F E C T OF IN D U S T R IA L C O N D IT IO N S U P O N E Y E S IG H T . 299. T h e r a p id e x te n s io n o f m u n it io n w o r k h a s b r o u g h t in its t r a in a g r e a t in c re a se in th e n u m b e r o f a c c id e n ts a n d in ju r ie s t o e y e s. T h e re su lt h a s b e e n n o t o n ly p e r s o n a l s u ffe r in g a n d in c o n v e n ie n c e b u t a ls o s e r io u s lo s s o f tim e a n d a r e d u c t io n o f o u tp u t. T h e e y e s e r e a m o n g th e h a rd e s t w o r k e d o f a ll th e o r g a n s o f th e b o d y , a n d th e y are e x tr e m e ly s e n s itiv e to e x te r n a l c o n d it io n s . I t is t h e r e fo r e n o t s u r p r is in g th a t a n u m b e r o f s p e c ia l ey e d ise a ses a n d in ju r ie s f r o m a c cid e n ts to th e ey es h a v e c o m e t o b e a s s o cia te d w it h p a r tic u r la r p ro ce ss e s in c e r ta in in d u s trie s . D is e a s e d c o n d it io n s o f th e e y e a n d d e fe c t iv e e y e s ig h t a re v e r y c o m m o n a n d a re a s e r io u s a n d w id e s p re a d ca u se o f in e fficie n cy . E v e r y e ffo r t, th e r e fo r e , s h o u ld b e m a d e t o p r e v e n t th em . T h e f o l l o w i n g sta te m e n t e m p h a siz e s th e p o i n t : The treatment o f superficial injuries o f the eyes is a subject which has during the past year acquired increased importance on account o f the large number o f superficial injuries occurring daily to the eyes o f workers in mu nition factories. The out-patient book kept at the ophthalmic department o f the Glasgow Royal Infirmary shows that the number o f those suffering from “ fires ” and other trivial eye injuries who applied for relief during August, 1916, was more than double the number o f those who had come suffering from similar injuries during the corresponding month in previous years. The fig ures in 1914 and 1915 are practically identical, and a scrutiny o f patients dur ing 1916 shows that the great increase has been brought ab 6 ut almost entirely by the attendance o f men and women engaged in the manufacture o f mu nitions. In such cases it is a matter o f national importance that patients should receive skillful medical help as soon as possible after the occurrence o f the accident, in order that there may be no unnecessary delay in their return to work. 300. T h e f o l l o w i n g sta tem en ts a re a ls o o f in t e r e s t: I think that it is somewhat o f an exaggeration to say that each o f these cases loses three days’ work. I f we take an average I should put it as more IJan h alf a day and less than a whole day. I think that I can safely say that these small accidents cause the loss o f about 2,000 days’ work in the town o f Cov entry alone. The mare serious ones are responsible for the loss o f weeks for each man, and I have in the past year had to remove about a dozen eyes after industrial accidents. Practically all o f them could be avoided by the use o f goggles. Most o f the trivial accidents would be prevented if the men would wear goggles at the emery wheel and for grinding. . , At the Northumberland, Durham and Newcastle Eye Infirmary there has been an increase in the number o f patients in 1914 and 1915, and this is largely due to the number o f people engaged on munition work. For example, in 1914, 2,491 eye^cases were referred for treatment from the Elswick W ork s; in 1915 149 150 INDUSTRIAL H EALTH AND EFFICIENCY. there were 4,973 similar ca ses; and in 1917, 4,567 in spite o f the present atten tion at the spot by ambulance workers. 301. I n d u s t r ia l w o r k m a y ca u se im p a ir m e n t o f e y e s ig h t in th re e p r in c ip a l w a y s — (a) I n ju r ie s d u e t o e x p o s u r e t o in te n se h e a t o r in d u s t r ia l p o is o n s . (b) A c c id e n t s d u e t o fly in g p a r t ic le s , etc. ( c ) E y e s t r a in d u e t o u n c o r r e c t e d e r r o r s o f r e fr a c t io n o r o th e r cau ses. 302. A p a r t fr o m th e im m e d ia t e ly ir r it a t iv e e ffe ct a s s o c ia te d w it h su ch w o r k as a c e ty le n e w e ld in g , th e in flu e n ce o f p r o lo n g e d e x p o s u r e t o in te n se h e a t a n d lig h t m a y ta k e so lo n g a p e r io d t o m a n ife s t it s e lf th a t th e d a m a g e w h ic h m a y re su lt is n o t lik e ly t o a p p e a r d u r in g th e w a r. T h e e ffe ct a lso u p o n e y e s ig h t o f c e r ta in in d u s t r ia l p o is o n s , su ch as le a d , is in th e b u lk s m a ll, a n d n o s p e c ia l a c t io n in r e g a r d t o th e m a tte r is c a lle d fo r . 303. Accidents .— I t h a s b e e n e s tim a te d th a t n o r m a lly in a n y g e n e r a l g r o u p o f in d u s t r ia l a c c id e n ts o v e r 5 p e r c e n t m u s t b e a s c r ib e d t o ey e in ju r ie s . T h e r e is r e a s o n f o r b e lie f th a t e y e in ju r ie s in m u n i t io n w o r k s a re r e la tiv e ly m o r e fr e q u e n t th a n in n o r m a l tim e s, a n d th a t f o r e n g in e e r in g fa c t o r ie s th ese ca ses p r o b a b ly r e p r e s e n t a b o u t 7 p e r c e n t o f a ll a c c id e n ts , a t o t a l w h ic h m a y , h o w e v e r , b e g r e a t ly e x c e e d e d . T h e a c c id e n ts a re m a in ly d u e t o p a r t ic le s o f m e ta l w h ic h e n t e r th e e y e ; th e m a jo r it y a re s lig h t in c h a r a c t e r a n d s h o u ld g iv e ris e t o n o p e r m a n e n t d a m a g e . T o th e d a m a g e w h ic h r e su lts fr o m in ju r ie s s u fficie n tly s e r io u s t o c o m e u n d e r o b s e r v a t io n m u s t b e a d d e d th e g r a v e r c o n d it io n s a r is in g fr o m in fe c t io n f o l l o w i n g u p o n “ fire s ” o r o t h e r t r iv ia l e y e in ju r ie s . A c c o u n t m u st a lso b e ta k e n o f th e t im e lo s t a n d t e m p o r a r y in c o n v e n ie n c e s u ffe r e d f r o m a m u c h la r g e r n u m b e r o f s lig h t ca u se s w h ic h m a y o n ly in c a p a c it a t e th e s u ffe r e r f o r s h o r t p e r io d s , p e r h a p s h a lf a d a y . I n so f a r as im m e d ia te r e d u c t io n o f o u t p u t is c o n c e r n e d , th e se s lig h t ca ses h a v e p r o b a b ly a g r e a t e r e ffe c t th a n th e m o r e s e r io u s in ju r ie s . S p e a k in g o f th e se ca ses, a n o p h t h a lm ic s u r g e o n in G la s g o w w r ite s :l In most instances the actual physical damage is slight, and the w orker w ill be«able to resume his duties in a few hours, or utmost in one or tw o days, if only the injury to the eye be promptly and skillfully treated. If, on the other hand, the injury be neglected, or i f it be treated by anyone who is unskillful or careless sepsis w ill almost certainly occu r; and all experience teaches that infection o f the wound is a fa r greater danger than the actual physical damage to the ocular structures. The occurrence o f sepsis at once transform s a very trivial injury to the cornea into a suppurative keratitis, which may run a pro longed 'course, lead to more or less impairment o f sight, and in serious cases even destroy the eye. 304. Eyestrain .— B r o a d ly s p e a k in g , e y e s tr a in m a y b e d u e t o d e 1 The Treatment of Superficial Injuries of the Eyes, paper by A. Maitland Ramsay M. D., lecturer on the eye, University of Glasgow. EYE IK JURIES, fe c t s o f v is io n o r t o th e n a tu r e a n d c o n d it io n s o f w o r k . I t m a y be a c c e n tu a te d b y a g e , fa t ig u e , o r u n s a t is fa c t o r y h e a lth o f th e w o r k e r , b y n e a r -d is ta n c e w o r k , in su fficie n t o r e x ce s s iv e illu m in a t io n , a b n o r m a l p o s it io n , o r lo n g h o u rs . F o r m u n it io n w o r k th e e y e s ig h t o f th e w o r k e r s h o u ld n e v e r fa ll m u c h b e lo w th a t o f n o r m a lly u s e fu l v is io n . F o r fin e w o r k th e e y e s ig h t s h o u ld b e a p p r o x im a t e ly n o r m a l. N o t w it h s t a n d in g th e im p o r t a n t b e a r in g o f g o o d e y e s ig h t u p o n o u tp u t th e q u e s tio n h a s n o t h it h e r t o r e c e iv e d a d e q u a te a tte n tio n . E v id e n c e h a s b ee n fo r t h c o m in g o f e y e s tr a in a n d h e a d a ch e s r e s u lt in g f r o m (a) in a d e q u a te lig h t , b o t h a r tific ia l a n d n a t u r a l; (b ) a r tific ia l lig h t s , a d e q u a te in a m o u n t, b u t so p la c e d as to t h r o w a g la r e u p o n th e e y e s o f th e w o r k e r s ; ( c ) e m p lo y m e n t o f w o r k e r s (w h o s e e y e s ig h t s h o u ld b e a id e d b y s u ita b le g la s s e s ) t o c a r r y o u t fine w o r k w it h o u t first te st i n g t h e ir e y e s ig h t. E y e s t r a in , in c lu d in g h e a d a ch e , m a y b e o n e m a n i fe s t a t io n o f g e n e r a l fa t ig u e . I t is th u s lik e ly t o b e c o m e m o r e m a r k e d w h e n lo n g h o u r s a re w o r k e d , w h e n n ig h t s h ift s a re n e ce s s a r y , o r w h e n w o r k e r s a re u n d e r n o u r is h e d , a n e m ic, o r o f p o o r g e n e r a l p h y s iq u e . 305. S e v e r a l o f th ese p o in t s a r e e x e m p lifie d b y th e r e p o r t o n a m e d ic a l in v e s t ig a t io n in r e g a r d t o th e h e a lth o f w o m a n w o r k e r s , in th e c o u r s e o f w h ic h a n in q u ir y w a s m a d e in t o th e e y e s ig h t o f 156 w o r k e r s e n g a g e d in d iffe r e n t d e p a r tm e n ts o f a fa c t o r y . M o s t o f th e e y e d e fe c t s w e re fo u n d in th e fu s e d e p a r tm e n t, w h e r e fin e p ro c e s s e s w e r e in o p e r a t io n in v o lv in g clo s e a tte n tio n a n d c o n s id e r a b le lik e li h o o d o f e y e s tr a in . I n th e w o r k o f m a c h in in g s h e lls o n ly a b o u t 19 p e r ce n t o f e y e d e fe c t s w e r e n o te d , b u t in th e fu s e d e p a r tm e n t th e p r o p o r t io n r e a c h e d 64 p e r cen t. T h e re su lts o f th e in q u ir y w e r e th u s s u m m a r iz e d : It w ill be noted that in the fuse department 8 per cent o f the workers were obliged to obtain glasses since starting factory work, 19 per cent complained o f eyestrain, o f whom 1 2 per cent found sight difficult on the night shift, and 2 per cent found the eyestrain increasing in severity. Besides these, 10 per cent appeared to have latent eyestrain, as shown by severe headache, blepha ritis, etc., and probably required to have their eyes tested. Conjunctivitis was present in 11 per cent. Many workers complained o f the artificial light falling directly on their eyes, and others said that the reflection o f the brass work o f the fuses was dazzling. The artificial lighting in the factory was by electric lights placed over the benches. Owing to difficulty in train service it was not possible to visit the factory during the night shift in order to watch the effect on the girls, or to observe if shade could be adjusted without undue interfer ence with the work, but this point appeared to need consideration. On the other hand, it must be remembered that cases of eyestrain or frequent headaches may not be due entirely to factory conditions- Several girls had been warned at school by the school medical officer that their sight was defec tive and had neglected to obtain glasses. Five workers had obtained glasses but did not wear th em ; in one instance the previous occupation o f dressmaking was probably responsible for the initial eyestrain, and in another case a girl who had previously been a domestic servant now visited the cinema three times a week, although suffering from marked eyestrain. It is also probable that 152 INDUSTRIAL H EALTH AND EFFICIENCY. some o f the employees were still feeling tlie effects o f overtime and seven days’ weekly work, which had recently been discontinued, and some visual improve ment might be expected on subsequent examinations. P R E V E N T IO N A N D T R E A T M E N T . 306. M a n y c o n d it io n s lik e ly t o ca u se t e m p o r a r y o r p e r m a n e n t d a m a g e to th e e y e s ig h t o f m u n it io n w o r k e r s a re a d m itt e d ly p r e v e n ta b le , w h ile p r o m p t a n d e ffe c t iv e tr e a tm e n t o f th e in ju r y w h e n it h a s o c c u r r e d w ill r e d u c e s u ffe r in g , h a ste n r e c o v e r y , a n d lessen th e c h a n c e o f p e r m a n e n t in ju r y . 307. Methods o f prevention c o n s is t first o f g e n e r a l m e a su re s d e s ig n e d t o im p r o v e th e p h y s ic a l h e a lth o f th e w o r k e r s , a n d so t o e n a b le th e m t o re sist th e e ffe cts o f fa t ig u e , a n d , s e c o n d ly , o f s p e c ia l m e a s u r e s d e s ig n e d t o a v o id u n d u e s tr a in o n th e e y e s ig h t o r t o r e d u c e th e lia b ilit y t o a c c id e n t t o a m in im u m . T h e g e n e r a l m e a su re s in c lu d e th e p r o v is io n o f s u ita b le lig h t in g , th e e s ta b lis h m e n t o f ca n te e n s , th e a llo w a n c e o f a d e q u a te tim e f o r sle e p a n d rest, a n d h a v e a lr e a d y b e e n d e a lt w ith e lse w h e re . T h e s p e c ia l m e a su res n a t u r a lly v a r y a c c o r d in g t o c ir cu m s ta n ce s . T h e f o l l o w i n g s u g g e s tio n s m a y , h o w e v e r , b e m a d e : 308. Examination o f eyesight .— W h e n o p e r a t iv e s a re b e in g e n g a g e d f o r fin e w o r k t h e ir e y e s ig h t s h o u ld b e te ste d b y a m e d ic a l o fficer, o r , i f h e is n o t a v a ila b le , a n u rse o r w e lfa r e s u p e r v is o r s h o u ld a p p ly s im p le e y e t e s t s 1 t o d is c o v e r w h e th e r th e v is io n is n o r m a l. A n y w o r k e r w h o fa ils t o r e a ch th e s ta n d a r d a d o p te d s h o u ld b e r e fe r r e d t o a n o p h t h a lm ic s u r g e o n o r e y e h o s p it a l f o r r e g u la r e x a m in a t io n a n d , i f n e ce ssa r y , b e s u p p lie d w it h gla sse s. W h e n w o r k e r s a re e x a m in e d f o r g la sse s th e n a tu r e o f th e w o r k t o b e p e r fo r m e d s h o u ld b e s p e c ifie d w h e n e v e r p o s s ib le . F o r m a n y p e o p le , a n d p a r t ic u la r ly th o s e p a s t m id d le life , th e g la sse s w h ic h g iv e th e b e s t a cu te n ess o f d is ta n t v is io n w o u ld n o t e n a b le th e o w n e r a lso t o d o fin e w o r k a t clo s e r a n g e , a n d v ic e v e rsa . W o r k e r s w h o c o m p la in o f fr e q u e n t h e a d a c h e , p a in in th e ey es, o r s h o w s ig n s o f c o n ju n c t iv it is s h o u ld a lso b e teste d . 309. E ye guards and goggles .— U n d e r c e r ta in c o n d it io n s th e ey es s h o u ld a lw a y s b e g u a r d e d fr o m fly in g p a r t ic le s o f m e ta l. O n t h is p o in t th e o b s e r v a tio n s o f a n o fficia l A m e r ic a n p u b l i c a t i o n 2 m a y b e q u oted : The one feature o f safety in nearly all of these occupations is the use o f suit able goggles in those occupations known.to cause injuries to the eyes. No other protection can take the place o f this one. It is one o f the most difficult meas ures in accident prevention to carry out. Workmen object to the use o f these protectors, and even when provided they are not worn. The fault for this lies 1 Each eye should be tested separately, and the following standard is suggested as a minimum: 6 /9 in both eyes (Smellen’s types), though 6 /1 2 in one of the eyes may be sufficient in some cases, and the ability to read standard type 0.45 at 1 foot distance. The necessary standard types can be procured from any optician. 2 The Commonwealth of Massachusetts, State Board of Labor and Industries, Indus trial Bulletin No. 5, Boston, 191j6. EYE INJURIES. 153 often in the type or kind o f goggles that have been provided. Many o f these not only, decrease the efficiency o f the w orker who wears them but they cause injury to the eyes o f the wearer. Many conscientious w orkers refuse to wear goggles that are provided fo r the common use o f all workers in the establish ment. In this they are justified, as many infections o f the eye are capable o f transm ission by means o f eye protectors. The remedy is a better mutual under- ‘FrflTTRE 1. F igure 2. standing between employer and employee and an insistent educational cam paign on the value o f this protection. Frequently the nature o f the w ork is such that the lenses become clouded with steam or perspiration. Antisweat pencils should be provided to prevent this. The goggles worn should be o f such a thickness o f glass that they w ill withstand a hard blow, and o f such a quality and so securely fitted into the fram e that if broken the glass w ill not fly into small pieces but w ill remain in the frame. Goggles should be fitted to the wearer. 154 INDUSTRIAL H EALTH AND EFFICIENCY. T o b e e ffe c t iv e an e y e g u a r d s h o u ld — (a) P r e v e n t p a r t ic le s r e a c h in g th e e y e f r o m in fr o n t , fr o m e it h e r s id e , o r fr o m b e lo w . P r a c t ic a lly n o t h in g e n te r s f r o m a b o v e ; (b) B e lig h t a n d c o m fo r t a b le , a llo w in g fr e e p la y o f a i r ; (c) N o t im p e d e v is io n o r b e c o m e o b s c u r e d b y th e im p a c t o f p a r t ic le s ; (d) B e s t r o n g a n d c h e a p . 310. T w o fo r m s o f e y e g u a r d a re h e re illu s t r a t e d w h ic h h a v e b e e n d e s ig n e d t o m e e t th e r e q u ir e m e n ts sta te d a b o v e .1 T h a t s h o w n in fig u r e 1 2 h a s th e a d v a n ta g e th a t sp e c ta cle s r e q u ir e d to c o r r e c t a n y e r r o r o f r e fr a c t io n c a n b e w o r n b e h in d it. T h e e y e g u a r d s h o w n in fig u r e 2 3 is c o m p o s e d o f a s tr ip o f le a th e r w it h d e ta c h a b le e y e p ie ce s (se e fig . 3 ) p ie r c e d w it h h o le s f o r v e n tila tio n . 311. T h e fa c t t h a t n o p a r t ic le s a re lik e ly t o e n te r fr o m a b o v e is im p o r t a n t , b e ca u se th e u p p e r p a r t o f th e g o g g le c a n b e l e f t o p e n t o a llo w o f v e n t ila t io n . A c lo s e d scre e n is n o t o n ly h o t a n d u n c o m fo r t a b le , b u t th e t r a n s p a r e n t m e d iu m , u s u a lly g la s s , m a y b e c o m e o b s c u r e d b y c o n d e n s a t io n o f m o is tu re . W h e r e fin e w o r k h a s to. b e e x e c u te d th e re m u s t b e c le a r v is io n a n d f o r th is th e r e is n o b e tte r m e d iu m th a n g la ss. T h e o b je c t io n h a s B een r a is e d th a t g la s s b r o k e n b y a fly in g p a r t ic le m a y b e d r iv e n in t o th e e y e a n d ca u se a w o r s e in ju r y th a n i f it w e r e n o t p re s e n t. S u c h a c c id e n ts a p p e a r , h o w e v e r , t o b e v e r y e x c e p t io n a l a n d a fo r e ig n b o d y o f c o n s id e r a b le size w o u ld b e r e q u ir e d t o in flic t it. G la s s , su ch as is u se d f o r s h o o t in g g o g g le s , o f su fficien t s tr e n g th t o s ta n d th e im p a c t o f p e lle ts o f s h o t s h o u ld b e e m p lo y e d . T h e m a in o b je c t io n t o g la s s , o r in d e e d t o a n y o th e r t r a n s p a r e n t m e d iu m , is th a t a ft e r a t im e it b e c o m e s p it t e d a n d o b s c u r e d . E y e g u a r d s s h o u ld t h e r e fo r e b e so m a d e th a t th e g la ss c a n b e e a s ily r e m o v e d a n d c le a n e d o r r e p la c e d . W h e r e th e re is e x p o s u r e t o b r ig h t lig h t , as in th e p r o c e s s o f a c e ty le n e w e ld in g , th e g la s s s h o u ld b e tin t e d o r s p e c ia lly p r e p a r e d to o b s c u r e th e c h e m ic a lly a c t iv e r a y s a t o r b e y o n d th e v io le t e n d o f th e sp e c tr u m . D a r k -b lu e g la s s is u s u a lly e m p lo y e d f o r th e p u r p o s e , t h o u g h as th e f o l l o w i n g sta te m e n t s u g g e s ts , it is n o t th a t b e s t s u ite d f o r th e p u r p o s e . My own experience has been that workmen at acetylene welding have generally been provided with very dark neutral smoked protection glasses, and not with dark-blue glasses. These would certainly be better than dark-blue glasses, and of all the tints which could be employed probably a very deep rose tint would be the best that could be selected— dark blue would, in my opinion, certainly be unsatisfactory. As regards the use o f Crooks’ glass in protection goggles, this glass is very expensive, and is certainly unnecessary for ordinary mechanical protection purposes. The virtue o f it is the same as that o f rosetinted glass, for it has the power o f excluding the actinic rays. I should 1 Some oculists recommended Crook’s glass No. 1 or No. 2, with fine gauze side pieces. * From a design prepared by the Mentor Safety Appliance Co. •From a design prepared by Messrs. Wallach Bros. EYE INJURIES. 155 think it could hardly be necessary to employ this glass, o f which I believe only a limited quantity is available, for workers’ goggles. 312. W h ile g o g g le s m u s t b e r e g a r d e d as th e p r in c ip a l a n d m o st e ffe c tiv e p r o t e c t io n a g a in s t e y e a c c id e n ts , it is p o s s ib le in . so m e g r in d in g a n d c h ip p in g p ro c e s s e s t o fix a w ir e o r g la s s scre e n t o th e m a c h in e in su ch a m a n n e r as to p r o t e c t th e w o r k e r s ’ ey es. S u c h an a r r a n g e m e n t m a y , f o r e x a m p le , b e u s e fu l in e m e r y -w h e e l g r in d in g w h e r e th e m a c h in e is u sed b y m a n y d iffe r e n t w o r k e r s ir r e g u la r ly t h r o u g h th e d a y . 313. Treatment o f accidents .— F ir s t -a id tr e a tm e n t is a ll th a t ca n b e r e n d e r e d e ffe c t iv e ly in th e fa c t o r y . E v e r y p r e c a u t io n s h o u ld b e ta k e n t o a v o id in c r e a s in g th e in ju r y b y w e ll m e a n t b u t m is d ir e c t e d e ffo r ts to g iv e r e lie f. W h e r e a s u r g e r y e x is ts a ll e y e in ju r ie s s h o u ld be sen t d ir e c t to it, n o tre a tm e n t b e in g a tte m p te d in th e w o r k s h o p . I f a d o c t o r is a v a ila b le th e ca se s h o u ld b e r e fe r r e d t o h im a t o n ce . I f th e in ju r y is n o t se rio u s a n d h e is n o t a v a ila b le th e n u r se in c h a r g e o f th e s u r g e r y s h o u ld r e n d e r first a id , th e p a tie n t b e in g th e n sen t t o a d o c t o r o r h o s p it a l, ev e n t h o u g h th e in ju r y is a p p a r e n t ly s lig h t. A t a n y fa c t o r y w h e re su ch in ju r ie s a re c o m m o n th e n u r se s h o u ld h a v e h a d so m e o p h th a lm ic tr a in in g . T h e f o l l o w i n g sta te m e n t e m p h a s iz e s th e im p o r t a n c e o f s u ita b le p r o v is io n f o r first a i d : In every factory where such accidents are o f frequent occurrence there ought to be a rule that injuries should be reported at once, and provision should be made whereby “ first a i d ” may be given with the least possible delay. Such an arrangement would not be difficult to carry out, and timely first aid would effect a cure in the mildest cases and prevent, as far as possible, extension or increase in severity of the injury in those that were more serious. 314. I f th e re is n o a m b u la n c e p r o v is io n o r a n u rse , firs t a id c a n o n ly b e g iv e n b y a fe llo w w o r k m a n w h o s h o u ld b e in s tr u c te d as to th e r o u tin e tr e a tm e n t w h ic h m a y s u ita b ly b e a p p lie d . H e s h o u ld b e fo r b id d e n t o e x c e e d h is in s tr u c tio n s , o th e r w is e , t h o u g h h e m a y b e s u c c e s s fu l in r e m o v in g th e o ffe n d in g p a r t ic le , in fe c t e d u lc e r s m a y f o l l o w th e o p e r a t io n , o r h e m a y e v e n p e r fo r a t e th e c o rn e a . F ir s t a id is m a in ly n e e d e d t o r e lie v e p a in a n d s h o u ld u s u a lly b e lim it e d e ith e r t o th e u se o f e y e d r o p s , w h ic h m a y b e a p p lie d fr o m a s u ita b le b o t t le , o r t o a p a d a n d b a n d a g e .1 A c a m e l’s -h a ir b r u s h k e p t in th e i Eye Injuries (Home Office first-aid leaflet) : Apply the eyedrops (see note) to the affected eyeball by means of the camel’s-hair brush in the bottle. Do not try to remove any particle which can not be brushed away. Tie up with a clean handkerchief or bandage. Go to a doctor at once. Prevention is better than cure; therefore if your work entails danger to the eyes, wear goggles. Goggles have saved hundreds of eyes ; thousands have been lost for want of them. N ote.— Instructions to chemist for making eyedrops : Cocaine------------------------- --------------------------------------------- ------------------ 0.5 per cent Hyd. perchlor------------------------------------------------------------------------------1 in 3,000 In castor oil. Weigh 95 grams of castor oil into a flask capable of holding twice the quantity. Add 0.5 gram of powdered cocaine. Warm in a water bath till dissolved. While the solution 156 INDUSTRIAL H EALTH AND EFFICIENCY. a p p r o p r ia t e s o lu t io n m a y b e p r o v id e d f o r th e r e m o v a l o f v is ib le p a r t ic le s w h ic h a re n o t im p a c t e d o r e m b e d d e d , b u t its u se s h o u ld n o t b e e n c o u r a g e d . A f t e r r e lie f fr o m p a in th e p a t ie n t s h o u ld b e sen t at o n c e t o a d o c t o r o r h o s p ita l. is still warm (but not of mercuric chloride in rotating the flask. About half an ounce, bottle from the cork of hot) add 1 cubic centimeter of a solution containing 3.3 grams 100 cubic centimeters of absolute alcohol. Mix the solutions by or 15 cubic centimeters, of this solution should be supplied in a which a camel’s-hair brush is pendent in the fluid. S E C T IO N X I I I .— S P E C IA L IN D U S T R IA L D IS E A S E S . 315. T h e m a n u fa c t u r e a n d m a n ip u la t io n o f t o x ic c h e m ic a l su b s ta n ce s u p o n th e im m e n s e s c a le r e q u ir e d in w a r fa r e h a v e b r o u g h t m a n y s p e c ia l d a n g e r s t o th e h e a lth a n d liv e s o f m u n it io n w o r k e r s . T o so m e o f th ese th e c o m m itte e m a d e r e fe r e n c e in th e ir m e m o r a n d u m N o . 8 (S p e c ia l in d u s t r ia l d is e a s e s ), issu e d in A p r i l , 1916, in w h ic h th e y g a v e a b r ie f a c c o u n t o f th e in fo r m a t io n w h ic h w a s th e n a v a il a b le a n d lik e ly t o b e u s e fu l. L E G IS L A T IV E P R O V IS IO N S . 316. T h e F a c t o r y a n d W o r k s h o p A c t , 1901, c o n ta in s n u m e ro u s p r o v is io n s f o r s a fe g u a r d in g th e h e a lth o f w o r k e r s e m p lo y e d in c e r ta in ‘"d a n g e r o u s a n d u n h e a lt h fu l in d u s tr ie s .” S e c t io n 73 r e q u ir e s th e n o t ific a t io n t o th e c h ie f in s p e c t o r o f fa c t o r ie s o f cases o f p o is o n in g ’fr o m le a d , p h o s p h o r u s , a r se n ic , m e r c u r y , a n d a n th r a x b y th e m e d ic a l p r a c t it io n e r a t t e n d in g th e case. B y an o r d e r o f J a n u a r y . 1916, t o x ic ja u n d ic e w a s a d d e d , th a t is t o sa y , ja u n d ic e d u e t o te tr a c h lo r e th a n e , T N T , o r o th e r n it r o o r a m iclo d e r iv a t iv e s o f b e n z in e , o r o th e r p o is o n o u s su b sta n ce . T h e e m p lo y e r m u st a lso n o t i f y th ese ca ses t o th e in s p e c to r o f fa c t o r ie s . S e c t io n 79 g iv e s th e s e c r e ta r y o f sta te p o w e r t o c e r t ify th a t a p r o c e s s is d a n g e r o u s , a n d to m a k e su ch r e g u la t io n s as a p p e a r t o h im r e a s o n a b ly p r a c t ic a b le a n d t o p r e s c r ib e th e c o n d it io n s u n d e r w h ic h e m p lo y m e n t in th e p r o c e s s sh a ll b e c a r r ie d on . T h e s e r e g u la t io n s im p o s e d u tie s o n b o th th e e m p lo y e r a n d th e w o r k e r . S u c h r e g u la tio n s h a v e b e e n m a d e f o r v a r io u s le a d p ro c e s s e s , a n d a ls o in c o n n e c tio n w it h th e m a n u fa c t u r e o f T N T . S e c t io n 82 re q u ir e s th a t th e r e g u la tio n s s h a ll b e p o s te d u p in c o n s p ic u o u s p la c e s w h e re th e y m a y be c o n v e n ie n t ly r e a d b y th e p e r s o n s e m p lo y e d . A c t in g u n d e r p o w e r s c o n fe r r e d b y r e g u la t io n 35 A A . o f th e d e fe n s e o f th e r e a lm r e g u la tio n s , th e M in is t r y o f M u n it io n s , w ith th e c o n c u r r e n c e o f th e s e c r e ta r y o f sta te, h a s m a d e r e g u la tio n s d e a lin g w it h th e u se a n d m a n ip u la t io n o f T N T . U n d e r s e c tio n 8 o f th e W o r k m e n ’s C o m p e n s a t io n A c t , 1906, th e se c r e ta r y o f sta te h a s p o w e r t o m a k e o r d e r s e x t e n d in g th e p r o v is io n o f th e a c t t o d ise a ses c o n t r a c te d in th e c o u r s e o f e m p lo y m e n t. S e v e r a l o r d e r s 1 h a v e b e e n m a d e e x t e n d in g th e p r o v is io n o f th e a ct, u n d e r c e r 1 Statutory rules and orders, 1913, No. 8 1 4 ; 1914, No. 1 0 0 7 ; 1915. No. 660 ; 1916, No. 280. 157 158 INDUSTRIAL HEALTH AND EFFICIENCY. ta in c o n d it io n s , e. g ., t o t o x ic ja u n d ic e , d e r m a titis , a n d o th e r d ise a se s a r is in g f r o m th e m a n ip u la t io n o f T N T a n d o th e r in d u s t r ia l p o is o n s . T R I N IT R O T O L U E N E ( T N T ) . 317. A t th e v e r y b e g in n in g o f t h e ir w o r k th e c o m m it t e e h a d t h e ir a tte n tio n c a lle d t o ca ses o f sick n e s s a p p a r e n t ly d u e t o th e e x p lo s iv e t r in it r o t o lu e n e ( T N T ) , o f w h ic h th e m a n u fa c t u r e a n d u se w a s th en r a p id ly in c r e a s in g . T h is su b sta n ce h a d h a r d ly b e e n r e g a r d e d as t o x ic b e f o r e th e w a r ; n o i ll e ffe cts h a d b e e n tr a c e d t o th e s m a ll q u a n titie s p r e v io u s ly u se d , a n d it w a s g e n e r a lly b e lie v e d t o b e m u c h le s s t o x ic th a n d in itr o b e n z e n e , w h ic h h a d b e e n m a n u fa c t u r e d a n d U sed in th is c o u n t r y f o r m a n y y e a rs . A fa t a l ca se o f t o x ic ja u n d ic e , h o w e v e r , d e fin ite ly a s c r ib e d t o T N T p o is o n in g , w a s r e p o r t e d t o th e H o m e O ffice in F e b r u a r y , 1915, a n d th is a p p e a r s t o h a v e b e e n th e first r e c o r d e d fa t a lit y fr o m th is ca u se. A t th e tim e o f th e a p p o in t m e n t o f th e c o m m itte e in S e p te m b e r , 1915, th e fir s t fa t a lit y f r o m t o x ic ja u n d ic e d u e t o th e m a n ip u la t io n o f T N T h a d ju s t o c c u r r e d a t a fillin g fa c t o r y , a n d d u r in g th e s u c c e e d in g w in t e r m o n th s s ick n e s s d u e t o T N T p o is o n in g b e c a m e g e n e r a lly r e c o g n iz e d as a g r o w i n g m e n a c e p la in ly c o n c o m it a n t w it h th e in t r o d u c t io n o f n e w la b o r in r a p id ly e x p a n d in g p ro c e s s e s o f m a n u fa c t u r e a n d m a n ip u la t io n w h ic h h a d n e c e s s a r ily b e e n h a s t ily o r g a n iz e d . 318. T h e u r g e n t c a lls f o r a n in c re a s e b o t h in th e v o lu m e a n d r a te a t w h ic h T N T c o u ld b e s u p p lie d m a d e th e p o s it io n o n e o f g r a v e a n x ie t y , a n d h a d it n o t b e e n f o r th e p r e v e n t iv e m e a su re s, b a s e d o n p r e v io u s k n o w le d g e a n d e x p e r ie n c e o f th e n e a r e s t a n a lo g ie s , w h ic h w e re th e n p r o m p t ly a d v o c a t e d b y th e H o m e O ffice, th e m o r t a lit y f r o m t h is p o is o n in g , w h ic h a d v a n c e d d u r in g 1 9 1 5 -1 6 u n til th e a u tu m n o f 1916, w h e n it r e a c h e d its g r e a te s t h e ig h t , m u st h a v e b e e n f a r h ig h e r . I n J u ly , 1 9 1 5 , th e H o m e O ffice h a d w a r n e d th e fa c t o r ie s t h e n c o n c e r n e d t h a t T N T m ig h t b e a b s o r b e d t h r o u g h th e sk in , o r b y th e in h a la t io n o f d u s t a n d fu m e s , a n d h a d r e c o m m e n d e d a c c o r d in g ly th a t s u ita b le p r e c a u t io n s s h o u ld b e ta k e n a g a in s t b o t h a v e n u e s o f e n try . 319. D u r in g th e se m o n t h s th e c o m m itte e g a v e t h e ir c o r d ia l c o o p e r a t io n t o w a r d b r in g in g t o b e a r u p o n th e p r o b le m s c o n f r o n t in g th e m in is t r y th e a d v ic e w h ic h th e s k ill a n d e x p e r ie n c e o f th e f a c t o r y d e p a r t m e n t o f th e H o m e O ffice c o u ld s u g g e s t, as w e ll as th e k n o w l e d g e g a in e d b y s c ie n tific in v e s t ig a t io n s o r g a n iz e d f o r th is p u r p o s e . F r o m th e a u tu m n o f 1915 th e r e s o u rc e s o f th e a p p lie d - p h y s io lo g y d e p a r t m e n t o f th e m e d ic a l-r e s e a r c h c o m m itte e , u n d e r th e d ir e c t io n , f o r th is p u r p o s e , o f D r . B e n ja m in M o o r e , F . R . S ., h a d b e e n a p p lie d t o th e d e t e r m in a t io n o f th e m o d e , o r m o d e s , o f e n tr y o f th e p o is o n t o th e b o d y w it h a v ie w t o its e ffe c t iv e p r e v e n t io n ; a n d o th e r c o lla t e r a l in q u ir ie s w e r e set o n fo o t . T h e s y m p to m s o f T N T p o is o n in g a lr e a d y r e p o r t e d se e m e d c lo s e ly s im ila r , in r e s p e c t a t le a st o f th e fa t a l ca ses SPECIAL INDUSTRIAL DISEASES. 159 in w h ic h ja u n d ic e w a s c h a r a c te r is tic , t o th o s e w h ic h h a d o c c u r r e d e a r lie r in 1915 as d u e t o e x p o s u r e t o th e fu m e s o f te tr a c h lo r e th a n e , u se d as a c o n s titu e n t o f v a r n is h a p p lie d t o a e r o p la n e s — a ca u se o f in d u s t r ia l p o is o n in g t o w h ic h fu r t h e r r e fe r e n c e w ill b e m a d e b e lo w . T h is c o in c id e n c e in tim e o f th e t w o fo r m s o f p o is o n in g m a d e it n a tu r a l t o l o o k th e n u p o n th e in h a la t io n o f th e fu m e s o r th e d u st o f T N T as p r o b a b ly th e c h ie f ca u se o f th is n e w a n d u n e x p e c te d d a n g e r a t th e fillin g fa c t o r ie s , in s p ite o f th e fa c t th a t th e p a t h o f e n tr y t o th e b o d y in th e m o s t fa m ilia r e x a m p le s o f p o is o n in g f r o m th e in d u s t r ia l u se o f n it r o c o m p o u n d s w a s w e ll k n o w n t o b e b y w a y o f th e sk in . A d m i n is t r a t iv e m e a su re s a t th e fa c t o r ie s w e r e c h ie fly a d d r e s s e d d u r in g th e s p r in g a n d e a r ly su m m e r o f 1916, as n e w fa c t o r ie s s p r a n g in t o e x is t e n ce , t o th e p e r fe c t io n o f v e n t ila t io n a n d th e r e m o v a l o f d u s t a n d fu m e s fr o m th e a ir. A lt h o u g h it w a s w e ll k n o w n th a t d in it r o b e n z e n e a n d o th e r n it r o c o m p o u n d s c o u ld r a p id ly e n te r th e b o d y t h r o u g h th e sk in , th e a p p a r e n t im m u n it y w it h w h ic h th e g r e a t m a jo r it y o f p e r s o n s c o u ld fr e e ly h a n d le T N T w it h o u t s ig n s o f p o is o n in g h a d d o n e m u c h t o d iv e r t g e n e r a l a tte n tio n f r o m th e e x p lic it w a r n in g g iv e n b y th e H o m e O ffice in 1915 th a t a b s o r p t io n o f T N T b y th e s k in w a s t o b e g u a r d e d a g a in s t. 320. W i t h th e a d v e n t o f w a r m w e a th e r in th e s u m m e r o f 191 6 , c o in c id e n t w it h th e p r e p a r a t io n s f o r th e S o m m e o ffe n s iv e , a la r g e in c re a s e in th e a m o u n t o f T N T sick n e s s o c c u r r e d ; a n d a c o n fe r e n c e u p o n th is w a s h e ld o n A u g u s t 25 , 1916, a t th e m in is t r y , w h e n r e p r e s e n ta tiv e s o f th e h e a lth o f m u n it io n w o r k e r s ’ c o m m itte e m e t th o s e o f th e fa c t o r y d e p a r tm e n t o f th e H o m e O ffice a n d o f th e f a c t o r y m a n a g e m e n ts. T h e e x p e r ie n c e o f o n e v e r y la r g e f a c t o r y in w h ic h u p t o t h a t tim e n o d e a th h a d o c c u r r e d w a s b r o u g h t fo r w a r d t o s h o w th a t i f p r o p e r v e n t ila t io n w a s s e c u re d th e r is k o f p o is o n in g w a s s m a ll in s p ite o f a n a lm o s t u n iv e r s a l d is t r ib u t io n o f T N T p o w d e r o v e r th e f a c t o r y flo o r s a n d fu r n it u r e , as w e ll as u p o n th e sk in a n d c lo th e s o f th e w o r k e r s . I n th e f o l l o w i n g m o n th , h o w e v e r , s e v e r a l cases o f fa t a l t o x ic ja u n d ic e * w e r e n o tifie d f r o m t h is fa c t o r y , w h ile a t th e sa m e tim e e x p e r im e n ts c o n d u c t e d b y D r . M o o r e a n d h is c o lle a g u e s , b o t h in th e la b o r a t o r y a n d in fa c t o r ie s , s h o w e d c o n c lu s iv e ly n o t o n ly th a t th e p o is o n c o u ld e n te r th e sy ste m fr e e ly b y w a y o f th e s k in b u t th a t p o is o n , h a v in g so e n te r e d , c o u ld b e h e ld w it h in o r u n d e r th e sk in it s e lf a n d so r e m a in f o r c o n t in u e d a b s o r p t io n ev e n a ft e r , a n d som e-tim e s f o r m a n y d a y s a ft e r , th e w o r k e r h a d b e e n a lt o g e t h e r r e m o v e d f r o m th e n e ig h b o r h o o d o f T N T . T h e e x p e r im e n t a l e v id e n c e g a v e n o g r o u n d f o r a t t r ib u t in g a n y im p o r t a n t s h a re in th e p o is o n in g t o th e in h a la t io n o f d u s t o r fu m e s ; th e v a lu e o f v e n t ila t io n fr o m th is p o in t o f v ie w a p p e a r e d t o c o n s is t in a id in g th e m a in te n a n c e o f th e c h e m ic a l b a la n c e o f th e b lo o d a n d in r e m o v in g d u s t w h ic h m ig h t o th e r w is e 160 IN D U ST R IA L H E A L T H A N D E F F IC IE N C Y . # se ttle u p o n th e sk in o r f o o d , o r en te r th e n o se s a n d m o u th s , o f w o r k e rs, a n d f o r th ese p u r p o s e s v e n t ila t io n w a s n u g a t o r y in th e fa c e o f m a n u a l p ro c e s s e s in v o lv in g th e s c a t t e r in g o f T N T d u s t u p o n e v e r y e x p o s e d s u r fa c e o f th e w o r k s h o p a n d o f th e w o r k e r s . I t b e c a m e a p p a r e n t th a t a c a m p a ig n h a d t o b e fo u g h t in d e ta il f o r th e r e d u c t io n o f d a n g e r b y th e t r ia l a n d a d o p t io n o f e v e r y e x p e d ie n t f o r m in i m iz in g p h y s ic a l c o n t a c t b e tw e e n th e w o r k e r s a n d th e m a n ip u la te d T N T . F o r th e in t r o d u c t io n o f th e n e ce ssa r y m e a su re s w h e n d e v is e d , a n d , fu r t h e r , f o r t h e ir g e n e r a l e n fo r c e m e n t, n e w le g a l p o w e r s w e re r e q u ir e d . 321. W i t h a v ie w t o an im m e d ia te c o n c e n t r a t io n o f e ffo r t u p o n th ese p r o b le m s , M r . M o n t a g u , in O c t o b e r , 1916, a p p o in t e d a c o m m itte e to c o n s id e r a n d a d v is e h im as to ( 1 ) th e p r e v e n t io n o f p o is o n in g in fillin g fa c t o r ie s , a n d ( 2 ) th e tre a tm e n t o f ca ses o f su ch p o is o n in g , a n d to m a k e su ch in q u ir ie s a n d e x p e r im e n ts as th e y m ig h t d e e m d e s ir a b le f o r th ese p u r p o s e s . T h is T N T a d v is o r y c o m m itte e c o n t a in e d r e p r e s e n ta tiv e s o f th e fa c t o r y d e p a r tm e n t o f th e H o m e O ffice, m e m b e r s o f th e h e a lth o f m u n it io n w o r k e r s ’ c o m m itte e , th e m e d ic a l o ffice r f o r th e fillin g d e p a r tm e n t, to g e t h e r w it h e n g in e e r in g a n d a d m in is t r a t iv e r e p r e s e n ta tiv e s o f th e v a r io u s d e p a r tm e n ts c o n c e r n e d w it h in th e m in is tr y . T h is c o m m itte e , s it t in g d a ily a t first, w o r k e d a c t iv e ly t o w a r d th e fr a m in g o f d e fe n s iv e r e g u la tio n s a g a in s t T N T p o is o n in g . T h e y m a d e r e c o m m e n d a tio n s u p o n th e o r g a n iz a t io n a n d fu n c t io n s o f th e m e d ic a l officers o f th e fillin g fa c t o r ie s , u p o n th e p r o b a b le s c o p e o f th e le g a l p o w e r s lik e ly t o b e r e q u ir e d b y th e e x e c u t iv e , a n d th e y c o n s id e r e d a n d a d v is e d u p o n th e b e st m o d e s o f tr a n s l a t in g in t o p r a c t ic a l p r e v e n t iv e m e th o d s th e k n o w le d g e th e n b e in g g a in e d o f th e p o s s ib le m o d e s o f T N T p o is o n in g a n d o f th e ir p a t h o lo g ic a l resu lts. I n D e c e m b e r , 1916, D r . A d d is o n , h a v in g su cc e e d e d M r . M o n t a g u as m in is te r , r e a p p o in t e d th e a d v is o r y c o m m itte e , w h o s u b m itte d t o h im , in J a n u a r y , 1917, a d e ta ile d c o d e o f r e g u la tio n s g o v e r n in g th e u se <rf t r in it r o t o lu e n e in a ll fa c t o r ie s a n d w o r k s h o p s in w h ic h it, o r a n y m ix t u r e c o n t a in in g it, is u se d o r m a n ip u la te d . T h e n e ce s s a r y p o w e r s h a v in g b e e n o b t a in e d , th ese r u le s w e r e fo r m a lly g iv e n le g a l e ffe c t in F e b r u a r y , 1917, t h o u g h d u r in g s e v e r a l p r e c e d in g .m o n th s t h e y h a d b e e n w id e ly in t r o d u c e d in t o p r a c t ic e , o w in g t o th e d is s e m in a tio n o f k n o w le d g e o f th e d a n g e r s o f T N T b y th e m in is t r y ’s m e d ic a l officers a n d th e s c ie n tific w o r k e r s e n g a g e d , a n d n o less t o th e g o o d w ill o f th e f a c t o r y m a n a g e m e n ts. T h e s e r e g u la t io n s , s t ill in fo r c e , a re g iv e n b e lo w in s u m m a r y fo r m . 322. B e f o r e o u t lin in g th e p a t h o lo g y o f T N T p o is o n in g as su ch , r e fe r e n c e m a y b e m a d e t o th e r e m a r k a b le p r a c t ic a l re s u lts w h ic h h a v e c o in c id e d w it h th e p r o g r e s s iv e a p p lic a t io n o f th e fin d in g s o f s c ie n tific in v e s t ig a t io n t o p r a c t ic a l m e a su re s f o r th e p r e s e r v a t io n o f th e T N T w o r k e r s . T h e r e tu r n s o f th e H o m e O ffice o f ca se s o f SPECIAL INDUSTRIAL DISEASES. 161 t o x ic ja u n d ic e fr o m T N T f o r th e q u a rte r O c t o b e r -D e c e m b e r , 1916, s h o w 86 ca ses, in c lu d in g 23 d e a th s, as c o m p a r e d w it h 29 ca ses (4 f a t a l ) in th e c o r r e s p o n d in g q u a rte r o f 1917, t h o u g h th e n u m b e r o f th e w o r k e r s e x p o s e d in th e la tte r }^ear t o r is k w a s fa r g r e a t e r th a n in 1916. A c c o m p a n y in g th e ca ses o f ja u n d ic e th e re h a s a ls o b e e n a n u n m e a s u r a b le v o lu m e o f m in o r illn e ss, w h ic h h a s s h o w n a p a r a lle l r e d u c t io n in a ll f a c t o r ie s ; in o n e o f th e la r g e s t fa c t o r ie s , f o r in s ta n c e , in w h ic h th e sick n e s s r e tu r n s h a v e b ee n g e n e r a lly th e h ig h e s t, s ic k n ess a ttr ib u te d t o T N T h a s d e c lin e d f r o m b e in g 11 p e r c e n t o f th e o p e r a tiv e s in A u g u s t , 1916, t o 1 p e r ce n t in J a n u a r y , 1918. T h e la te st r e tu r n s s h o w th a t T N T sick n e s s h a s b e e n a lm o s t a b o lis h e d , w h ile n o f a t a l ca se h a s b e e n r e p o r t e d sin ce F e b r u a r y , 1918, a n d th e re is n o w g o o d g r o u n d f o r b e lie v in g th a t w h e n a ll fa c t o r ie s h a v e r e a c h e d th e s ta n d a r d s a tta in e d b y th e b est o f th e m fr o m th is p o in t o f v ie w , a n d n o w w it h in th e r e a ch o f a ll, T N T p o is o n in g m a y b e c o m e so r a r e as t o b e a lm o s t u n k n o w n . T h e re su lts so o b ta in e d m u st b e r e g a r d e d as a s t r ik in g te s tim o n y t o th e v a lu e o f c lo s e c o o p e r a t io n b e tw e e n r e se a rch w o r k o n th e o n e h a n d , c a r r ie d o u t n o t o n ly in th e la b o r a t o r y b u t a lso in th e fie ld o f its p r a c t ic a l a p p lic a t io n , a n d a d m in is tr a tiv e a c tio n o n th e o th e r . T h e y s h o w fu r t h e r th e b e n e fits o f a c o o p e r a t io n b e tw e e n f a c t o r y d o c t o r a n d fa c t o r y m a n a g e r e s ta b lis h e d n o w t o a d e g r e e a lm o s t u n k n o w n b e fo r e . 323. W h ile th e e x p e r im e n ta l a n a ly s is o f th e p a th s b y w h ic h T N T m a y e n te r th e b o d y , th e n e w tests w h ic h h a v e b ee n d e v is e d f o r t r a c in g its e lim in a t io n in c h a n g e d fo r m , a n d o th e r g a in s in k n o w le d g e h a v e g o n e t o se cu re th e p re s e n t s u c c e s s fu l m e a su re s o f p r e v e n t io n , m u c h s till r e m a in s to b e d is c o v e r e d w ith r e g a r d t o th e d e ta ile d n a tu r e o f th e c o m p le x t o x ic e ffe cts o f T N T o r o f its d e r iv a tiv e s , w h e n it h a s o n c e g a in e d a ccess t o th e sy ste m . W h e n M r . W in s t o n C h u r c h ill su c c e e d e d D r . A d d is o n as M in is t e r o f M u n it io n s in th e s u m m e r o f 1917, th e p r a c t ic a l p r o b le m s o f T N T p o is o n in g h a d b ee n so fa r s o lv e d , a n d th e m a in te n a n c e o f th e p r e v e n t iv e m e a su re s so o r g a n iz e d in th e h e a lth a n d w e lfa r e s e c tio n o f th e m in is t r y th a t h e fo u n d it u n n e c e ss a ry t o r e a p p o in t th e fo r m e r la r g e T N T a d v is o r y c o m m itte e , w h o s e wTo r k h a d b e e n in th e m a in c o m p le te d , a n d in s te a d h e fo r m e d a s m a ll c o m m itte e o f m e d ic a l e x p e r ts f o r th e p u r p o s e o f m a in t a in in g a n d c o o r d in a t in g fu r t h e r in q u ir ie s in to th is s u b je c t a n d o f a d v is in g h im w it h a v ie w t o a d m in is tr a tiv e a c tio n th a t m ig h t seem d e s ira b le in th e lig h t o f fr e s h k n o w le d g e . F u r t h e r r e se a rch e s a re b e in g a c t iv e ly p r o s e c u te d in t o th e t o x ic o lo g y o f T N T , a n d in th is d ir e c t io n a d e fin ite a d v a n c e in th e c u r a tiv e tre a tm e n t is s till t o b e .h o p e d fo r . B u t w h ile th ese s tu d ie s h a v e g r e a t t h e o r e tic in te re s t a n d a re lik e ly t o h a v e im p o r t a n c e in th e s tu d y o f t o x ic ja u n d ic e , k n o w n t o b e p r o d u c e d in s p e c ia l c o n d it io n s o r in p e r s o n s s p e c ia lly s u s c e p tib le , b y 8 0 9 3 5 ° — 1 9 -------- 11 1G 2 INDUSTRIAL HEALTH AND EFFICIENCY. o t h e r p o is o n s a n d c e r ta in d r u g s , th e p re s e n t su ccess o f p r e v e n t iv e m e a su re s a g a in s t T N T p o is o n in g a llo w s th e h o p e th a t th ese in v e s t ig a tio n s m a y h a v e o n ly an a c a d e m ic in te re s t f o r th e M in is t r y o f M u n i tio n s as su ch . 324. The pathology o f TN T poisoning .— I t w o u ld b e o u t o f p la c e h e re to g iv e d e ta ile d d e s c r ip t io n s o f th e p a t h o lo g ic a l r e s u lts th a t m a y b e p r o d u c e d b y th e a b s o r p t io n o f T N T . F o r th e se , r e fe r e n c e m a y b e m a d e c o n v e n ie n t ly t o th e f o l l o w i n g : Trinitrotoluene Poisoning (an account communicated on behalf o f the TNT advisory com m ittee; references to earlier work may be found here). British Medical Journal, December 16, 191(3. Report o f Discussion at the Royal Society o f Medicine. Proceedings Royal Soc. Med., January, 1917. The Causation and Prevention o f Trinitrotoluene (T N T ) Poisoning, by Dr. Benjamin Moore, F. R. S., medical research committee, Special Report Series No. 31, 191T. The Effect o f Trinitrotoluene upon the Blood, by Dr. P. N. Panton. The Lancet, July 2 1 , 1917. Preventive Measures against TN T Poisoning, by Dr. \V. D. O’Donovan. Proceedings Roy. Soc. Med., April, 1918. 325. T N T w h e n m a n u fa c t u r e d a n d u sed in a p u r e c o n d it io n o r c o m p o u n d e d w it h a m m o n iu m n itr a te (a m a to l o r a m m o n a l) is b y fa r th e m o st im p o r t a n t o f th e d a n g e r o u s su b sta n ce s u se d in th e p r o d u c t io n o f h ig h e x p lo s iv e s . D a n g e r a rise s n o t o n ly fr o m its e x p lo s iv e p o w e r b u t fr o m its lia b ilit y t o a ffe ct th e h e a lth o f th e w o r k e r s e x p o s e d t o it. O p e r a t iv e s e n g a g e d in its m a n u fa c t u r e , p a c k in g , o r lo a d in g m a y b e c o m e a ffe cte d . A p a r t fr o m th is , u n le ss th e in c id e n c e o f p o is o n in g is r ig id l y c o n t r o lle d , o t h e r w o r k e r s m a y b e c o m e d is o r g a n iz e d t h r o u g h fe a r o f c o n t a c t , a n d fr e s li la b o r m a y b e c o m e d iffi c u lt t o o b ta in . 3 2 6 . T N T m a y b e a b s o r b e d t h r o u g h th e s k in o r t h r o u g h th e d ig e s t iv e tr a c ts , o r b y in h a la t io n o f fu m e s o r d u st. P o is o n in g m a y ta k e on e o r m o r e o f th e f o l l o w i n g f o r m s : (a) T N T sta in s th e s k in y e llo w . S k in d ise a se (D e r m a t it is ) is clue t o a d ir e c t ir r it a n t a c tio n . S o m e w o r k e r s a re m o r e s u s c e p tib le th a n o th e r s. T h e e ffe cts , lik e th o s e o f o t h e r ir r ita n ts , a re in c r e a s e d b y flu s h in g , p e r s p ir a t io n , a n d m e c h a n ic a l fr ic t io n . L o c a liz e d ra sh e s, e s p e c ia lly w h e re th e r e is p re s s u r e o r fr ic t io n , a s fr o m b a n d s o r illfit t in g c lo th e s , a re c o m m o n . T h e p a rts m o s t fr e q u e n t ly a ffe c t e d are th e h a n d s , w ris ts , fa c e , n o ck , a n d ’ fe e t. T h e r e is g r o u n d f o r th e y ie w th a t d e r m a titis is d is t in c t in its in c id e n c e fr o m o th e r fo r m s o f its p o is o n in g . (7)) Digestive troubles .— G a s tr itis , s h o w n b y p a in in th e s to m a ch , v o m it in g , a n d c o n s t ip a t io n , is th e m o s t c o m m o n o f th e ill e ffe cts o f p o is o n in g . (c) Blood changes.— B lu e n e s s o f th e lip s a n d , r a r e ly , b r e a th le s s n e ss o n s lig h t e x e r tio n a re e v id e n t s ig n s o f a b s o r p t io n o f T N T . SPECIAL INDUSTRIAL DISEASES. 1G 3 T h e s e s ig n s a re an in d ic a t io n f o r c e s s a tio n f r o m T N T w o r k , d u r in g w h ic h th e y w ill g e n e r a lly d is a p p e a r r a p id ly . T h e y m u st b e ta k e n as a w a r n in g th a t th e a b s o r p t io n o f T N T is g o in g o n , a n d i f th is c a n n o t b e e x p la in e d b y fa u lt y fa c t o r y c o n d it io n s o r b y ca re le s s a n d u n n e c e s s a ry h a n d lin g . wTlie n p r o p e r p r e c a u t io n s o u g h t t o p r e v e n t r e c u r r e n c e , t h e y p o in t t o a s p e c ia l s u s c e p t ib ilit y , a n d th e w o r k e r s h o u ld b e t r a n s fe r r e d t o o t h e r e m p lo y m e n t. P a ll o r d o e s n o t n e ce s s a r ily s i g n ify a n e m ia , w h ic h is u n c o m m o n a m o n g T N T w o r k e r s . A r a r e a n d fa t a l f o r m o f a n e m ia (a p la s t ic a n e m ia ) h a s o c c u r r e d in a v e r y fe w in sta n ce s a n d is c h a r a c t e r iz e d b y a s lo w ly , in c r e a s in g d e b ilit y o r b y s u d d e n u n e x p la in a b le su b cu ta n e o u s o r u te rin e h e m o r r h a g e s. (d) Liver degeneration , “ toxic 'jaundice.” — J a u n d ic e is h e re a s ig n o f g r a v e ly s e r io u s illn e ss, a n d w ill b e s h o w n b y a y e llo w t in g e firs t o f th e w h ite s o f th e e y es a n d la te r b y y e llo w n e s s o f th e sk in . (T h i s m u st n o t b e c o n fu s e d w it h th e y e llo w s t a in in g w h ic h T N T it s e lf m a y ca u se in th e s k in b y d ir e c t c o n t a c t .) J a u n d ic e m a y a p p e a r w it h o u t o b v io u s w a r n in g , th o u g h r a r e ly b e fo r e th e fo u r t h wTee k o f e m p lo y m e n t, a n d it is p o s s ib le th a t in h a lf th e cases it a rise s a ft e r a p r e lim in a r y w a r n in g , w h ic h h a s b e e n g iv e n b y th e b lo o d c h a n g e s ju s t m e n tio n e d b u t w h ic h m a y h a v e b e e n o v e r lo o k e d . E v e r y e ffo r t s h o u ld b e m a d e t o r e c o g n iz e th e firs t b e g in n in g s o f th is illn e s s , a n d t o ta k e th e m as a n in d ic a t io n f o r im m e d ia te c e s s a tio n fr o m a ll T N T w o r k a n d f o r p r o p e r m e d ic a l tre a tm e n t. M a n y ca ses a re n o w k n o w n o f a p p a r e n t ly c o m p le t e r e c o v e r y a ft e r s e r io u s illn e s s o f th is k in d . 327. T o d e te c t a ca se o f T N T p o is o n in g c a re m u s t b e ta k e n t o a v o id c o n fu s io n w it h d ig e s t iv e d is tu r b a n c e s d u e t o o th e r cau ses. A c c o u n t s g iv e n b y p a tie n ts m a y b e u n in t e n tio n a lly m is le a d in g . T h e y e llo w s t a in in g w h ic h u s u a lly o c c u r s w it h T N T ca n n o t b e ta k e n as in it s e lf a s ig n o f p o is o n in g . T h e f o l l o w i n g p o in t s a re th e m o r e im p o r t a n t in d ic a t io n s o f T N T p o i s o n in g : (a) P a llo r o f th e fa c e a n d a n a s h e n -g r a y c o lo r o f th e lips> t e n d in g t o d is a p p e a r i f th e w o r k e r b e c o m e s e x c ite d , as b y m e d ic a l e x a m in a tio n . S o m e tim e s th e lip s a n d to n g u e are p u r p le in c o l o r ; th e t o n g u e is g e n e r a lly fr e e fr o m fu r . (b) T h e c h a r a c te r a n d s itu a tio n o f th e s to m a c h p a in s. (c) T h e p re s e n ce o f c o n s t ip a t io n a n d s to m a ch d is te n tio n . T r e a t m e n t w h e n ja u n d ic e is a b se n t s h o u ld be s im p le a n d s u cc e s s fu l. I t s h o u ld in c lu d e (1 ) th e im m e d ia te r e m o v a l f r o m c o n t a c t , a n d a ll th e fr e s h a ir p o s s ib le , ( 2 ) rest in b e d f o r a d a y o r tw o , ( 3 ) a d ie t c o n s is t in g o f m ilk , m ilk p u d d in g s , fr u it , arid g r e e n v e g e ta b le s , w it h d r in k s su ch as b a r le y w a te r , tea , a n d co ffe e . I f ja u n d ic e is p re s e n t, h o s p it a l in -p a t ie n t tre a tm e n t is n e ce ssa ry . M ilk s h o u ld b e g iv e n in s m a ll q u a n titie s t o b e g in w ith , th e a m o u n t b e in g s lo w ly in c r e a s e d t o 2 p in t s a d a y . 164 INDUSTRIAL HEALTH AND EFFICIENCY, T h e o c c u r r e n c e o f T N T p o is o n in g d e p e n d s so m e tim e s u p o n p e r s o n a l id io s y n c r a s y . W o m e n d o n o t a p p e a r t o b e m o r e r e a d ily a ffe c te d th a n m e n . B o y s a n d g ir ls m a y b e m o r e s u s c e p tib le th a n a d u lts , a n d , in co n s e q u e n ce , th e ir e m p lo y m e n t h a s b ee n fo r b id d e n u n d e r th e a g e o f 16, a n d is o n ly a llo w e d u n d e r th e a g e o f 18 w it h th e s p e c ia l c o n sen t o f th e m in is t r y . S e r io u s p o is o n in g s e ld o m o c c u r s w it h in th e first fo u r w eek s o f e m p lo y m e n t. W h ile th e g r e a t m a jo r it y o f w o r k e r s a re in s u s c e p tib le a n d r e m a in so, a sm a ll m in o r it y a re s u s c e p tib le a n d lia b le to su cc u m b b e tw e e n th e fift h a n d fifte e n th w e e k o f e x p o s u r e . T h e fe w a ffe c te d a re n o t a lw a y s th o se w h o o w in g t o ill h e a lth o r m a l n u t r it io n m ig h t b e e x p e c te d t o b e e s p e c ia lly lia b le . I n d u s t r ia l c o n d itio n s , t h o u g h im p o r t a n t , h a v e p e r h a p s less in flu e n ce th a n p e r s o n a l id io s y n c r a s y . 328. I t is e ss e n tia l th a t s t r ic t m e a su res b e ta k e n f o r p r e v e n t io n . T h e p r e c a u tio n s p r e s c r ib e d b y th e r e g u la t io n s o f th e m in is t r y f o r th e u se a n d m a n ip u la t io n o f T N T a re as f o l l o w s : (a) E x p o s u r e t o d u st a n d fu m e s s h o u ld b e r e d u c e d to a m in im u m b y c le a n ly m e th o d s o f w o r k a n d b y v e n t ila t io n a n d c le a n in g o f w o r k p la c e s. (b) N o p e r s o n m a y b e e m p lo y e d f o r m o r e th a n a fo r t n ig h t w it h o u t a n e q u a l p e r io d o f w o r k at a p r o c e s s n o t in v o lv in g c o n t a c t w it h T N T , u n le ss su ch e m p lo y m e n t h a s b ee n s p e c ia lly a p p r o v e d b y th e m e d ic a l officer o f th e fa ctor}^ . (<?) I t is o f th e u tm o s t im p o r t a n c e th a t a ll w o r k e r s s h o u ld o b t a in a m p le a n d s u ita b le fo o d . E v e r y p e r s o n e m p lo y e d s h o u ld b e s u p p lie d g r a t is d a ily w it h h a lf a p in t o f m ilk o r so m e e q u a lly n u t r it io u s su b stitu te . (d) S p e c ia l w o r k in g c o s tu m e s s h o u ld b e p r o v id e d f o r a ll p e r s o n s e m p lo y e d . T h e s e s h o u ld b e c le a n se d o r r e n e w e d a t le a st o n c e a w eek . (e) C lo a k r o o m s s h o u ld b e a v a ila b le w h e re c lo t h in g p u t o ff d u r in g th e w o r k in g h o u r s s h o u ld b e p la c e d . ( / ) W a s h in g fa c ilit ie s a re esse n tia l, w it h a s u ita b le s u p p ly o f s o a p , n a ilb r u s h e s , a n d to w e ls . (g) A c o n s ta n t m e d ic a l s u p e r v is io n s h o u ld b e e x e r c is e d , n o t o n ly b y fo r m a l m e d ic a l e x a m in a tio n b u t a lso b y s c r u t in y o f th e w o r k e r s w h ile at w o r k . T h e m e d ic a l officer s h o u ld h a v e p o w e r o f im m e d ia te s u s p e n s io n w h e r e n e ce s s a r y . C a r e fu l h e a lth r e c o r d s s h o u ld b e k e p t. (.h) A s p e c ia l o ffic ia l s h o u ld be a p p o in t e d t o se cu re th e c a r r y in g o u t o f th e p r e s c r ib e d r e g u la tio n s . A w o m a n w e lfa r e s u p e r v is o r is a ls o e ss e n tia l w h e r e v e r w o m e n a re e m p lo y e d . 329. S im ila r p r e v e n t iv e m e a su res a re r e q u ir e d b y th e H o m e O ffice a n d th e m in is t r y f o r th e m a n u fa c t u r e o f T N T . T h e f o l l o w i n g s ta te m e n t d e s c rib e s th e m e d ic a l a r r a n g e m e n ts m a d e in a la r g e n a t io n a l fillin g f a c t o r y : SPECIAL INDUSTRIAL DISEASES. 165 In the early days we were confronted by the specter o f TN T poisoning in a wide variety o f processes— shell filling with amatol and TNT blocks, liquid filling, “ hot-mixed ” filling press houses, incorporating houses, trotyl bag filling, etc.— and no one could tell us how it might be exorcised. Cleanliness.— Our first preventive measure was cleanliness. The method was to watch the shops from day to day, instruct workers and overseers in the meaning o f “ physiological cleanliness/’ and devise means o f preventing TX T from entering the bodies o f the workers by any o f the possible channels of ab sorption. A fter some initial difficulty with the management (who were natu rally chary o f m oisture) we wTere allowed to introduce our system o f damp dusting o f benches and damp mopping o f floors. A slightly moistened cloth was used for dusting the table, and the girls were instructed that the powder on tables and floors must be “ kept damp and kept down,” in order to prevent it getting into the air, and being thus swallowed and inhaled. The method o f dusting was to “ coax ” the powder off the table with the slightly moistened cloth, instead o f flicking it about and contaminating the atmosphere. The floors were swept with damp sawdust. This method was easily adopted in the trotyl bag-filling shops, and was most successful. In other parts o f the factory, such as the melts, press houses, rectifying rooms, etc., it was a much more difficult matter to obtain perfect physiological cleanliness, and it was only after many months o f hard, uphill work that any approach to this was reached. Every foreman, forewoman, and wTorker had to be convinced o f the necessity o f this cleanliness, and we had a long educative campaign. Then we had to introduce a new TNT cleansing department, with reliable overlookers, whose duty it was to keep all TNT shops free from powder. The staff o f this cleans ing department has been large and the expense to the factory has been con siderable, but the results have afforded ample repayment. Lectures to overlookers.— A necessary part of the doctor’s duty in a TNT fac tory is the education o f overlookers, foremen, etc., in the rationale o f the prophylactic measures to be employed. In this factory it has been our practice, as each new group o f overlookers was engaged, to devote one lecture of the course o f preliminary instruction to the question o f TNT poisoning and its prophylaxis. The overlookers are thus from the outset cooperators with the doctor in all efforts to prevent TN T sickness. Mouth icash and gargle.— As an additional precaution each worker is made to wash out her mouth and throat at lunch hour, and after each shift with a fluid provided (popularly called “ the g a rg le” ). Special “ gargling lavatories,” with numerous basins, are built for this purpose in connection with each TN T shop. These basins are also supplied with hot and cold water and the workers are encouraged to wash their hands thoroughly with hot water and soap before proceeding to the shifting house. (N. B.— Cold water has no advantages and many disadvantages.) Ventilation and other such obvious health measures are also kept under medical supervision. Questions of suitable clothing, boots, gloves, etc., are discussed jointly betflPfeen the doctor and the lady superintendent. Questions of food and canteen arrangements are discussed with the lady superintendent and the canteen superintendent. The doctor advises regarding suitable menus, adequate food substitutes, etc. On the advice o f the doctor a free breakfast consisting o f porridge and milk, sausage or egg, bread and butter and tea, is given to all workers while em ployed on TNT. This takes the place o f the milk originally recommended by the health o f munitions w orkers’ committee. 166 INDUSTRIAL H EALTH AND EFFICIENCY. In our early clays it was difficult to persuade tlie women workers to e*t substantial meals, and the doctor was asked to publish a leaflet making an appeal for more adequate feeding on tlie grounds o f health and patriotism. “ Post h o c ” (but due also to many other causes) we now find that the great m ajority o f our workers take a substantial midday dinner in the canteens. Choosing of suitable workers for TXT processes.— No worker is engaged for any occupation involving exposure to T X T without being passed by the doctor as suitable. During the first few months we engaged girls at the rate o f 500 to 600 per week. As, according to present knowledge, the chief dangers o f TNT are to the liver and the bone marrow, the attention of the doctor is directed chiefly to the detection o f anemia and “ biliousness ” or any liver trouble. No girl with any trace o f cyanosis o f lips or yellowness o f sclefotics is admitted as, although possibly healthy, such a girl would lead to difficulty for the doctor at her weekly medical inspection. The result o f this preliminary medical ex amination is that the TN T workers in the factory conform to a certain stand ard which, although arbitrary, is o f great assistance to the doctor in her sub sequent work o f inspection and diagnosis. Inquiry into epidemics, etc.— The doctor takes measures against the spread o f infectious diseases, and sees to the occasional examination o f water supply, milk supply, etc. A thresh disinfector for the sterilization o f clothing is in stalled in the factory. LEAD. 830. Disease and its causes.— O p e r a t iv e s c o m e in c o n t a c t w it h le a d a n d its c o m p o u n d s in a v a r ie t y o f p ro c e s s e s in m u n it io n fa c t o r ie s , e. g ., in s m e lt in g le a d a n d s p e lt e r ; in m a k in g sh eet le a d a n d b u lle t s ; in file c u t t in g ; in h a r d e n in g a n d t e m p e r in g m e ta ls ; in c o m m o n t i n n in g ; in s o ld e r in g a n d p lu m b in g ; in th e m a n u fa c t u r e o f a c c u m u la t o r s a n d o f in d ia r u b b e r ; a n d in th e u se o f le a d p a in ts a n d r e d le a d . U n d e r in d u s t r ia l c o n d it io n s le a d g a in s a ccess t o th e b o d y p r in c ip a lly b y th e in h a la t io n o f le a d fu m e s o r d u st. L e a d te n d s t o a c c u m u la te in th e b o d y , a n d c a r e fu l in v e s t ig a t io n s h a v e e s ta b lis h e d th a t a d a ily d o se o f as lit t le as 2 m illig r a m s m u st b e r e g a r d e d as c a p a b le , w h e n in h a le d as fu m e o r d u st, o f s e ttin g u p c h r o n ic p o is o n in g . L e a d m a y a lso e n te r th e sy ste m t h r o u g h th e d ig e s t iv e tr a c t, b y e a t in g w it h u n c le a n h a n d s , o r b y p u t t in g p ip e s o r o t h e r a r tic le s in t o th e m o u th w h ile th e h a n d s a re s o ile d w it h le a d . L e a d is a c u m u la tiv e p o is o n , th a t is t o sa y , e v e n sm a ll d oses a b s o r b e d d a y a ft e r clay te n d t o c o lle c t in th e sy ste m a n d fin a lly ca u se illn e ss. T h e e x is t e n ce o f a b lu e lin e a t th e g u m s is a n in d ic a t io n o f le a d a b s o r p t io n , a n d h e a d a ch e , c o lic , c o n s t ip a t io n , a n d m a r k e d p a le n e ss a r e e a r ly m a n ife s t a t io n s o f p o is o n in g . 331. Prevention .— T h e p r e v e n t io n o f in h a la t io n o f d u st o r fu fties is th e p r in c ip le u n d e r ly in g th e r e g u la t io n s m a d e b y th e S e c r e t a r y o f S ta te f o r th e c h ie f in d u s tr ie s c o n c e r n e d w it h th e m a n ip u la t io n o f le a d a n d its c o m p o u n d s . I n h a la t io n o f le a d in th e f o r m o f fu m e s o r d u st c a n o n ly b e a v o id e d w it h c e r t a in t y b y p r e v e n t in g th e p r o d u c t io n o f d u s t (e. g ., b y k e e p in g a ll le a d m a te r ia l d a m p ) , a n d b y SPECIAL INDUSTRIAL DISEASES. 167 in s u r in g th e le a d fu m e s d o n o t e sca p e in t o a n y p la c e in w h ic h w o r k is c a r r ie d o n . T h e n a tu r e o f c e r ta in p ro c e ss e s, h o w e v e r , m a y r e n d e r th e p r o d u c t io n o f d u s t in e v ita b le o r th e e sca p e o f fu m e s p o s s ib le . U n d e r s u ch c o n d it io n s lo c a liz e d e x h a u s t v e n t ila t io n s h o u ld b e a p p lie d as c lo s e ly as is p r a c t ic a b le to th e p o in t o f o r ig in , so as t o w it h d r a w th e d u s t o r fu m e s f r o m th e a tm o s p h e r e o f th e w o r k p la c e . R e s p ir a t o r s m a y b e r e q u ir e d in a fe w e x c e p t io n a l cases, b u t, as a p r o t e c t io n a g a in s t d u st, o n ly a fe w o f th e m a n y fo r m s o f r e s p ir a to r s o b ta in a b le a re e ffe c tiv e , a n d n o on e o f th e m is c o m fo r t a b le t o w e a r ; w h ile as a p r o t e c t io n a g a in s t fu m e s n o r e s p ir a t o r e x is ts w h ic h a n o p e r a t iv e ca n b e a sk e d t o w e a r f o r p r o lo n g e d p e r io d s . 332. T o p r e v e n t le a d e n te r in g th e s y s te m t h r o u g h th e d ig e s t iv e t r a c t th e f o l l o w i n g s p e c ia l ste p s s h o u ld b e t a k e n : (a) S m o k in g s h o u ld b e p r o h ib it e d in a ll p la c e s w h e r e le a d is m a n ip u la te d . (b) N o p e r s o n s h o u ld b e a llo w e d t o ta k e a m e a l o r t o r e m a in d u r in g th e tim e a llo w e d f o r m e a ls in a n y r o o m w h e r e le a d is u se d . (c) S p e c ia l m ess r o o m s o r ca n te en s s h o u ld b e p r o v id e d w h e r e w o r k e r s c a n ta k e th e ir m e a ls. G o o d f o o d is o f s p e c ia l im p o r t a n c e in h e lp in g a w o r k e r t o re sist p o is o n in g . I n p a r t ic u la r , w o r k e r s s h o id d n o t c o m m e n c e w o r k w it h o u t h a v in g ta k e n fo o d . E v id e n c e s h o w s th a t h u n g r y a n d i l l - f e d w o r k e r s s u cc u m b m o r e r e a d ily th a n o th e r s , a n d e x c e lle n t r e s u lts h a v e b e e n o b ta in e d fr o m s u p p ly in g w o r k e r s w it h a t lea st h a lf a p in t o f m ilk o r c o c o a b e f o r e s t a r t in g w o r k in th e m o r n in g . (d) O v e r a lls s h o u ld b e p r o v id e d a n d c lo a k r o o m s e s ta b lis h e d , sepa-. ra te p r o v is io n b e in g m a d e f o r th e k e e p in g o f o u t d o o r c lo th e s a n d o v e r a lls r e s p e c t iv e ly ; th e y s h o u ld n e v e r b e a llo w e d to c o m e in c o n ta c t w it h o n e a n o th e r. (e) S p e c ia l w a s h in g fa c ilit ie s s h o u ld b e p r o v id e d , a n d s h o u ld b e su fficien t t o e n a b le th e w o r k e r s n o t o n ly t o w a s h th e ir h a n d s b u t a lso th e ir faces* n e ck s, a n d a rm s. S u c h fa c ilit ie s w ill o n ly b e e ffe c tiv e i f a su fficien t s u p p ly o f h o t a n d c o ld w a te r , c le a n to w e ls , s o a p , a n d n a il b r u sh e s is a lw a y s a v a ila b le . I n s o m e p ro c e s s e s th e e m p lo y m e n t o f w o m e n , b o y s , a n d g ir ls is fo r b id d e n . W h e r e th e ir e m p lo y m e n t is a llo w e d , b o y s a n d g ir ls s h o u ld b e c lo s e ly w a tc h e d , b e ca u se th e y a re n o t so lik e ly t o o b s e r v e th e n e ce s s a r y p r e c a u t io n s as g r o w n -u p p e o p le . W o m e n s h o u ld b e e s p e c ia lly c a r e fu l, as th e in ju r io u s e ffe c t o f le a d in th e m s e r io u s ly in te r fe r e s w it h th e h e a lth o f t h e ir c h ild r e n . O n ly h e a lth y a n d te m p e r a te p e r s o n s s h o u ld b e e m p lo y e d . 333. T h e m a n ife s t a t io n s o f p o is o n in g ca n b e d e te c te d b y a m e d ic a l m a n , a n d t h e ir p r e s e n c e in d ic a te s th a t th e w o r k e r s h o u ld b e tr a n s fe r r e d t o o t h e r w o r k . T h e H o m e O ffice r e g u la tio n s r e q u ir e e m p lo y e r s t o h a v e p e rs o n s e n g a g e d in v a r io u s le a d in d u s tr ie s e x a m in e d p e r i 168 INDUSTRIAL H EALTH AND EFFICIENCY. o d ic a lly b y a s u r g e o n w h o is in tr u s te d w it h p o w e r s o f s u s p e n s io n fr o m w o r k . T h is m e d ic a l s u p e r v is io n h a s b e e n fo u n d o f m u c h v a lu e , a n d h a s b ee n w id e ly a d o p te d e v e n in in d u s tr ie s n o t g o v e r n e d b y r e g u la tio n s . I t m a y b e u s e fu lly e x te n d e d t o a ll fa c t o r ie s w h e r e th e use o f le a d o x id e s o r o t h e r o f its m a n y c o m p o u n d s m a y h a v e b e e n in t r o d u c e d in t o th e m a n u fa c t u r e o f m u n itio n s . I n th e h a n d lin g o f m e ta llic le a d , e. g ., b u lle ts , th e r is k o f p o is o n in g is v e r y s lig h t , a n d m e d ic a l s u p e r v is io n is le ss im p o r t a n t . A E R O P L A N E DOPE. 334. I n th e e a r lie s t s ta g e s o f th e w a r , c e r ta in d o p e s u se d f o r a e r o p la n e s c o n t a in e d a p o is o n — t e tr a c h lo r e th a n e — w h ic h g a v e r is e to ca ses o f t o x ic ja u n d ic e a m o n g s t th o s e e n g a g e d in its m a n u fa c t u r e a n d m a n ip u la t io n . I n a d d it io n , n u m e r o u s ca ses o f ill h e a lth o c c u r r e d . T h e m a n u fa c t u r e o f th ese d o p e s ce a se d in S e p te m b e r , 1916. T h e d o p e s n o w in u se, t h o u g h fr e e f r o m te tr a c h lo r e th a n e , a re s t ill n o t w it h o u t h a r m fu l e ffe c ts u p o n th e h e a lth o f th e w o r k e r . V o la t ile c o n s titu e n ts o f th e n e w d o p e s a n d v a rn is h e s , su ch as a c e to n e s u b stitu te s, b e n z o l, e tc., t h o u g h th e y h a v e n o t b e e n fo u n d so fa r t o p r o d u c e illn e s s o f th e n a tu r e p r o d u c e d b y te tr a c h lo r e th a n e , ca u se h e a d a ch e , d ry n e s s o f th e t h r o a t, c o u g h s , n a u sea , sick n e s s, a n d s e r io u s a n e m ia . 335. G o o d v e n t ila t io n o f th e d o p e r o o m d e cre a se s th e in t e n s it y o f th e s y m p to m s . O n th e o th e r h a n d , th e e ffe cts a re a g g r a v a t e d b y th e t e m p e r a t u r e o f 65 t o 7 0 ° F . w h ic h h a s t o b e m a in ta in e d , a n d it is o f g r e a t im p o r t a n c e t o p r o c u r e a s a t is fa c t o r y s o lu t io n o f th e p r o b le m o f v e n t ila t in g th e d o p e r o o m s w h ile m a in t a in in g th e r e q u is ite te m p e r a tu r e . The localized exhaust o f the dope fumes at the point o f their origin is hardly practicable in the case o f parts having the size o f aeroplane wings. In some works, however, a partial solution on these lines is obtained by laying the wing to be doped in a large shallow tank connected to an exhaust fan, and as the doping proceeds, drawing a spring roller-blind arrangement in stages across the open top o f the tank. Small components such as wheel covers can be doped under suitable lioods having a localized exhaust. The fuselage and cockpit can be doped separately in the doping room before the machine is erected, or the machine, when completed, can, if practicable, be run for doping into a cubicle provided with exhaust fans. I f the size or weight of tlie machine make it im practicable to use a doping cubicle the dope can be applied to the fuselage when in the erecting shop, provided the shop is o f large size and well ventilated by natural means, and provided the doping is done after the ordinary hours o f employment. The Home Office requirement with regard to the ventilation o f dope rooms is that the air shall be changed thirty times per hour. This standard also applies to doping cubicles. In order to attain it, in conjunction with the maintenance of a temperature o f 65° to 70° F., economy demands that the height o f the room should not be much more than sufficient to accommodate the largest size o f wing SPECIAL INDUSTRIAL DISEASES. 169 to be doped. The average height, the Home Office recommends, should not be greater than 15 to 20 feet or less than 10 feet. Dope rooms and cubicles should preferably be ventilated by means of extrac tion or propeller fans o f the open-blade type, having a free intake to the fan and a free discharge to the open air. Louvers* wind screens, or other obstruc tions should not be fitted on the discharge side, as these considerably reduce the output. As the fumes are heavier than air, the fans should be installed at, or arranged so as to draw from, a point near the floor level. I f the air inlets into the dope room are properly proportioned— the total inlet area should not be less than three times the discharge area of the fans— no draft should be felt in the room, either with the doors closed or opened temporarily to allow passage o f persons or materials. The air inlets should be provided at the side o f the room opposite the fans and at about 10 feet above the floor level. They may be o f the open hopper type, or be covered with cheesecloth, to serve as a dust filter and to diffuse the in-coming air currents. The provision of ample air inlets prevents the formation o f pockets of dense fumes in the room by drafts o f high velocity, and the impingement o f such drafts on the doped surfaces, with the consequent form ation o f white patches on the fabric. It may be remarked that the Home Office authorities have always been strongly opposed to plenum ventilation in dope rooms. The heating o f the air may be effected by means o f numerous steam or hotwater pipes and radiators placed close to the air-inlet openings, by hot-air plenum ducts, hot-air stoves, slow-combustion stoves, or hot chambers heated by steam pipes. It should always be remembered that the temperature and rate o f change o f air with a given plant are interconnected, and that if the air inlets are closed, the fans slowed down, or the outlets partially obstructed so as to attain the temperature required, the standard o f ventilation is correspondingly reduced. It is not advisable greatly to exceed the specified number o f changes o f air per hour— 30— as some have done to be on the safe side. I f the changes are made 60 to 100 per hour, the maintenance o f the required temperature in cold weather becomes impossible. In lofty shops, if difficulty is experienced with regard to the temperature, the height o f the room should be reduced by matchboarding or other nonconducting material, and the walls o f temporary buildings should be lined with wood. Doping should be commenced at the end o f the wing nearest the exhaust fan. The workers, when not applying the dope, should stand as near the fresh-air inlets as possible. W ork should not be commenced on an empty stomach. The workers must not be allowed to take a meal in the dope room. I f no provision is made for removing the wings to a separate drying room as soon as the dope is tacky, the wings should be placed to dry in a position between the workers and the fans, but not so as to obstruct the fans. 336. W it h a v ie w t o r e d u c in g ill h e a lth a m o n g s t th e w o r k e r s so fa r as p o s s ib le , th e f o l l o w i n g p r e v e n t iv e m e a su re s a re a lso d e s ir a b le : (a) P e r io d ic m e d ic a l e x a m in a t io n o f a ll w o r k e r s s h o u ld b e p r o v id e d fo r . (b) P e r io d s o f e x p o s u r e s h o u ld b e r c d u c e d to a m in im u m a n d n o t p r o lo n g e d b y o v e r tim e . ( c ) O p e r a tiv e s s h o u ld n o t b e a llo w e d t o r e m a in in th e w o r k p la c e d u r in g m e a l h o u r s . ( d ) A d e q u a t e fa c ilit ie s s h o u ld b e x> rovid ed f o r o b t a in in g su fficien t a n d n o u r is h in g fo o d . 170 INDUSTRIAL H EALTH AND EFFICIENCY, ( e ) O v e r a lls s h o u ld b e p r o v id e d . ( / ) A d e q u a t e w a s h in g a c c o m m o d a t io n s h o u ld b e p r o v id e d . p o is o n o u s gases . 337. T h e c h ie f d a n g e r s a r is in g fr o m th e m a n u fa c t u r e a n d m a n ip u la t io n o f p o is o n o u s g a ses are— (a) P o is o n in g b y th e le th a l a n d la c h r y m a t o r y g a s e s ; (& ) I r r it a t io n o f th e s k in , ey es, a n d o th e r e x p o s e d p a r t s o f th e b o d y , c a u se d b y th e h a n d lin g o f r a w m a te r ia ls o r fin is h e d p r o d u c t s ; (c) M e c h a n ic a l a c c id e n t s ; th ese, h o w e v e r s lig h t in th e fir s t in s ta n c e , m a y b e c o m e s e r io u s u n le ss t h e y r e c e iv e p r o m p t m e d ic a l a tte n tio n o n a c c o u n t o f th e p o is o n o u s c h a r a c te r o f th e b o d ie s h a n d le d o r m a n u fa c t u r e d . 338. A p a r t fr o m m e c h a n ic a l s a fe g u a r d s a g a in s t a c c id e n ts , th e p r i n c ip a l m e a su res n e ce s s a r y f o r p r e v e n t io n a n d tre a tm e n t a re— (a) T h e a p p o in t m e n t o f a m e d ic a l officer f o r e a ch f a c t o r y ; ( b ) T h e m e d ic a l e x a m in a t io n o f a ll w o r k e r s b e fo r e e n g a g e m e n t, a n d a t fr e q u e n t in t e r v a ls d u r in g e m p lo y m e n t ; (<?) S u it a b ly e q u ip p e d a m b u la n c e s ta tio n s in c h a r g e o f a t r a in e d n u r s e a n d u n d e r th e c o n s ta n t s u p e r v is io n o f th e m e d ic a l o ffic e r ; ( d ) H o s p it a l a c c o m m o d a t io n f o r s p e c ia l c a s e s ; (e) S u ita b le p r o t e c t iv e c lo t h in g (in c lu d in g o v e r a lls , h e lm e ts , r e s p i r a to r s , g lo v e s , g o g g le s , a n d c l o g s ) : a ll su ch c lo t h in g m u s t b e w o r n o n ly d u r in g th e p e r io d o f a c tu a l w o r k in g . O v e r a lls s h o u ld b e w a s h e d w e e k ly . ( / ) S u ita b le c lo a k r o o m s ; (g ) W a s h in g fa c ilit ie s su fficien t t o e n a b le w o r k e r s t o w a sh t h o r o u g h ly at th e e n d o f e a ch p e r io d o f w o r k ; ( h ) N o f o o d m a y b e ta k e n in t o a w o r k p l a c e ; (i) A d e q u a t e fa c ilit ie s f o r o b t a in in g fo o d . 339. N o t ific a t io n is r e q u ir e d o f a ll ca ses o f g a s in g , e c z e m a to u s a ffe c t io n o f th e sk in , in fla m m a tio n o f th e ey es, p o is o n in g , a n d m e c h a n ic a l a c cid e n ts . F U L M IN A T E OF M E R C U R Y . 340. Disease and its causes.— I n th e m a n u fa c t u r e a n d u se o f f u lm i n a te o f m e r c u r y th e re is a lia b ilit y o f m e r c u r ia l p o is o n in g a n d e cze m a . O w in g , h o w e v e r , t o th e s m a ll a m o u n ts m a n ip u la t e d , th e s y m p t o m s o f m e r c u r ia lis m a re s e ld o m m a r k e d , b u t a b lu e lin e m a y b e seen o n th e g u m s , a p p e tite m a y b e im p a ir e d , h e a d a ch e m a y b e p re s e n t, a n d th e re m a y b e n e rv o u s n e s s a n d d e p r e s s io n . T h e la st s y m p t o m is im p o r t a n t n o t m e r e ly as a s ig n o f illn e s s b u t as an in d ic a t io n th a t th e o p e r a t iv e s h o u ld b e r e m o v e d fr o m d a n g e r o u s w o r k w h ic h c a lls f o r a s te a d y h a n d a n d a c le a r h e a d . E c z e m a o f th e h a n d , fo r e a r m , a n d fa c e o c c u r a n d m a y ca u se se r io u s d is a b ility . SPECIAL INDUSTRIAL DISEASES. 171 A medical examination of 60 women workers employed on manipulating sub stances containing mercury fulminate showed that only 5 had remained in good health throughout their work at the factory. The most common symptoms were rasli on face or hands (41.6 per cent) often associated with severe internal pains, sickness, and diarrhea (30 per cent). The eyes are often affected, either with conjunctivitis (35 per cent) or inflamed lids (20 per cent). Soreness o f mouth and gums occurred in 21.6 per cent, though salivation was infrequent (7 per cent), and a blue hue on gums was only noticed in two instances. W orkers complained o f the difficulty caused by soreness o f the mouth, as this affected their appetite and was most painful if artificial dentures were worn. Disorders o f menstruation occurred in 20 per cent o f those examined, and depression was marked in 25 per cent. Sleeplessness was generally due to the irritation pro duced by the rash, probably increased by the fact that at least 25 per cent o f the women admitted that they slept in some clothes worn during the day. It was ascertained that 41.6 per cent w^ore neither veil nor respirator, although in about 30 per cent the onset o f symptoms was associated with sneezing or signs o f “ cold ” due to the inhalation o f the mercurial powder. The greatest susceptibility was shown in the case o f a woman in whom mere contact with a mercury worker wearing a dirty overall was sufficient to pro duce a rash. Rashes were more severe in those women who did not wear veils or respirators. It was noted that one worker who remained immune for tw o months habitually used a veil, respirator, and goggles, though it can not be said that these afford complete protection. 341. Prevention .— T h e p r in c ip a l p r e v e n t iv e m e a su res t o b e a d o p te d s h o u ld in c lu d e — (a) T h e p r o v is io n o f o v e r a lls a n d o f a d e q u a te c lo a k r o o m a n d w a s h in g a c c o m m o d a t io n ; (b) A d e q u a t e fa c ilit ie s f o r o b t a in in g fo o d . N o w o r k e r s h o u ld b e a llo w e d t o c o m m e n c e w o r k w it h o u t f o o d ; (c) C a r e fu l s e le c tio n o f w o r k e r s ; (cl) W h e r e e x p o s u r e is m a r k e d , p e r io d ic a l m e d ic a l e x a m in a t io n ; (e) T r a n s fe r e n c e t o o th e r w o r k o f th o s e s p e c ia lly a ffe cte d . T E TR Y L (T E T R A N IT R O M E T H Y L A K IL IN ). 342. Disease and its causes.— M a n ip u la t io n o f th is e x p lo s iv e p r o d u c e s a lig h t d u st, w h ic h m a y ca u se tr o u b le s o m e e cze m a . I n d i v id u a ls v a r y in th e ir s u s c e p t ib ilit y ; so m e a p p e a r t o b e a lm o s t im m u n e , w h ile o th e r s c a n h a r d ly e n te r a r o o m w h e r e t e t r y l is h a n d le d w it h o u t s u ffe r in g s e v e r e ly . O b s e r v a t io n s u g g e s ts th a t th is m a y d e p e n d o n th e v a r y in g n a tu r a l d r y n e s s o r m o is tn e s s o f th e s k in o f d i f fe r e n t p e rs o n s. T h e p a r t s m o s t fr e q u e n t ly a ffe c te d a re th e c o n ju n c t i v e , th e o p e n in g s o f th e n o s tr ils , a n d th e c h in . T h e h a n d s a n d a rm s a re less o ft e n a ffe cte d , a n d in th is th e e c z e m a c a u se d b y t e t r y l d iffe r s fr o m th a t d u e t o t r in it r o t o lu e n e ’, w h ic h u s u a lly a ffe cts th e fo r e a r m s a n d h a n d s . O p e r a t iv e s m a n ip u la t in g t e t r y l m a y a lso s u ffe r f r o m h e a d a ch e , d ro w s in e s s , a n d la c k o f a p p e tite in v a r y in g d e g r e e s o f in te n s ity . 172 INDUSTRIAL HEALTH AND EFFICIENCY. 343. Prevention .— T h e p r in c ip a l m e a su re s t o b e ta k e n c o n s is t in — (a) A v o id i n g th e e sca p e o f d u s t b y c a r r y in g o u t m a n ip u la t io n s in g la s s c u p b o a r d s w it h a r m h o le s f o r in t r o d u c t io n o f th e h a n d s ; (b) P r o v id i n g lig h t g a u z e v e ils t o p r o t e c t th e fa c e s o f th e w o r k e r s ; ( e ) S u p p ly in g , i f v e ils a re n o t w o r n , som e s im p le p o w d e r (s u c h as a m ix t u r e o f o n e p a r t o f z in c o x id e to t w o p a r t s o f s t a r c h ) f o r a p p ly i n g to th e fa c e b e f o r e b e g in n in g w o r k ; (cl) P r o v id i n g a d e q u a te w a s h in g a c c o m m o d a t io n a n d e n c o u r a g i n g th e use a ft e r w a s h in g o f an a p p lic a t io n f o r th e s k i n ; 1 (e) E x c l u d i n g w o r k e r s w h o s h o w s p e c ia l s u s c e p t ib ilit y o r i d i o syn cra sy. 344. A p a r t fr o m its ten denc}^ t o ca u se e cze m a , t e t r y l sta in s th e s k in a n d h a i r ; in o r d e r t o p r e v e n t th is, o v e r a lls a n d g lo v e s s h o u ld b e w o r n , a n d , w h e re w o m e n a re e m p lo y e d , s u ita b le h e a d c o v e r in g s s h o u ld b e u sed . P IC R IC A C ID . 345. P i c r i c a c id (m e lin it e o r ly d d it e ) is k n o w n c h e m ic a lly as t r in it r o p h e n o l, a n d is m a d e b y th e n it r a t in g a c tio n o f m ix e d a c id s u p o n c a r b o lic a c id . T h e m a n u fa c t u r e , t h o u g h s im p le , e x p o s e s t h o s e e n g a g e d in it t o r is k o f th e in h a la t io n o f n it r o u s fu m e s . W o r k e r s e n g a g e d in th e u se o f p ic r i c a c id , h o w e v e r , a re u s u a lly r e g a r d e d as b e in g e m p lo y e d in a n o n p o is o n o u s o c c u p a t io n . T h o s e h a n d lin g it u s u a lly b e c o m e d u s te d o v e r w it h a fin e y e llo w p o w d e r w h ic h sta in s th e h a ir a n d e x p o s e d s k in s u r fa c e s o f th e b o d y a b r ig h t c a n a r y y e llo w c o lo r . O c c a s io n a lly an ir r it a t in g d e r m a t it is o f a s im p le t y p e is fo u n d o n th e h a n d s a n d fo r e a r m s ; a n d th o s e w h o a re c o m m e n c in g w o r k f o r th e first tim e in p ic r ic a c id m a y h a v e an in it ia l g a s tr itis , w h ic h p a sses o ff in t w o o r th r e e d a y s. S y s te m a tic p o is o n in g , h o w e v e r , is p r a c t ic a lly u n k n o w n a m o n g p ic r ic w o r k e r s , a n d m u c h c o n fu s io n h a s a rise n b e tw e e n th e n e g a tiv e e ffe cts o f p ic r i c a c id a n d th e i ll e ffe c ts o f T N T , sin ce b o t h sta in th e s k in a y e llo w is h c o lo r a n d w o r k e r s a re a p t t o c a ll a ll s h e ll-fillin g w o r k T N T . 346. E x c e p t in r e la tio n to n it r o u s fu m e s , w h ic h a re d e a lt w it h b e lo w , n o. s p e c ia l p r e c a u t io n s a re c a lle d fo r . N IT R O U S FTJMES. 847. T h e p re s e n t d e m a n d f o r e x p lo s iv e s , n e a r ly a ll o f w h ic h a re p r o d u c t s o f n it r a t io n , h a s in t r o d u c e d in c r e a s e d r is k o f e x p o s u r e t o n it r o u s fu m e s , n o t o n ly in n it r a t in g p ro c e s s e s , b u t a lso in th e m a n u fa c t u r e o f n it r ic a c id t o b e u se d in th ese p ro c e s s e s . T h e f a c t o r y d e p a r tm e n t o f th e H o m e O ffice h a v e issu e d th e f o l l o w i n g m e m o r a n d u m : 1 An application found of value to prevent eczema is a mixture of two parts of castor oil to one part of lanolice ; this mixture, which should be rubbed into the skin after washing on leaving work, should be placed in the lavatories for general use. SPECIAL INDUSTRIAL DISEASES. 173 In the manufacture o f nitric acid, and in its use for various purposes, par ticularly in the manufacture o f explosives, danger exists o f accidental escape o f nitrous fumes into the work places. The full effect of inhaling these fumes is not felt immediately, and unless workers are warned of the danger they may continue at work and unwittingly inhale a fatal dose. In such a case the affected person develops an irritating cough, which becomes steadily worse, until, three or four hours after exposure, he becomes seriously ill, suffering from marked dyspnoea and collapse; sometimes these symptoms have come on after leaving work on the way home. The secretion o f mucus now becomes profuse, and vomiting, which helps to clear the air passages, may occur. The congestion o f the bronchioles and alveoli progresses, and, if the case survives for 48 hours definite pneumonic consolidation may develop. More frequently a fatal issue results in about 30 hours, the patient remaining con scious until near the end. Every case exhibiting the initial symptoms does not progress to a fatal ter mination, and recovery has occurred even after marked collapse and dyspnoea. Prevention.— Notices warning those employed o f the danger of remaining in an atmosphere containing nitrous fumes should be posted in every place where there is any possibility o f these fumes escaping. Emergency helm ets 1 o f a pattern which can be easily and quickly put on and provided with a fresh air supply from without should be kept in accessible places near at hand, and the efficiency o f such helmets should be tested at least once a month. R e^ ira tors such as are efficient to intercept dust are useless against gases and must not be used. Treatment.— The follow ing routine may usefully be pursued pending the ar rival o f a medical m a n : Make the patient lie down. Keep him warm. See that he has plenty o f fresh air. I f he is blue in the fa c e : ( i ) Administer oxygen; and (ii) I f he has not been sick, give a drink o f 1 ounce o f salt in 10 ounces of lukewarm water, and repeat the dose until he is s ic k ; (iii) Meanwhile, send for a doctor. Persons even apparently slightly affected must not be allowed to walk home until permitted to do so by the doctor. D E R M A T I T IS . 348. Disease and its causes.— T h e o c c u r r e n c e o f se rio u s d e rm a titis , o r e cze m a , c a u se d b y e x p o s u r e t o tr in it r o t o lu e n e a n d t o t e t r y l h a s a lr e a d y b e e n r e fe r r e d to , a n d s im ila r tr o u b le m a y re su lt fr o m e x p o su re to fu lm in a t e o f m e r c u r y . A p a r t , h o w e v e r , fr o m th ese s p e c ia l su b sta n ce s, e cze m a is lia b le to o c c u r a m o n g m u n it io n w o r k e r s e m p lo y e d in e n g in e e r in g w o r k s w h o c o m e in c o n ta c t w ith c e r ta in flu id s u sed t o lu b r ic a te a n d t o c o o l m e ta ls. T w o fo r m s o f in fla m m a tio n o f th e sk in , w h ic h , h o w e v e r , m a y c o e x is t, re su lt, ( i ) y e llo w p u s tu le s a n d b o ils , a n d ( i i ) m o r e g e n e r a l in fla m m a tio n w h ic h in m a r k e d ca ses d e 1 Such helmets can be procured from Messrs. Siebe, Gorman & Co. (L td .), 187, W est minster Bridge Road, London, S. E. 174 INDUSTRIAL H EALTH AND EFFICIENCY. v e lo p s in t o t y p ic a l w e e p in g ecze m a . P r o b a b ly th e o c c u r r e n c e o f p u s tu le s a n d b o ils is clue t o se b a ce o u s g la n d s a n d h a ir fo llic le s b e c o m in g b lo c k e d a n d in fe c t e d w it h o ily g r im e r u b b e d in b y s o ile d o v e r a lls . T h e m o re g e n e r a l in fla m m a t o r y c o n d it io n s a p p e a r t o b e c a u s e d b y th e d ir e c t a c tio n o f th e flu id s u se d , a c ce n tu a te d b y th e a b r a s iv e e ffe ct o f fin e p a r t ic le s o f m e ta l p r o d u c e d d u r in g m a c h in in g p ro ce ss e s. 349. Prevention .— C le a n o v e r a lls a n d th e p r o v is io n a n d use o f su ita b le w a s h in g a c c o m m o d a t io n w it h h o t w a te r la id o n h a v e p r o v e d to b e th e b e st m e a n s o f p r e v e n tio n . 350. T h e fir s t-a id le a fle t issu ed b y th e f a c t o r y d e p a r tm e n t o f th e H o m e O ffice c o n ta in s th e f o l l o w i n g a d v ic e in r e g a r d t o e c z e m a fr o m lu b r ic a t in g o i l : Dermatitis and eczema from oils and fluids used to lubricate and cool metals can best be prevented by cleanliness of (1 ) the overalls, and (2 ) the skin. All overalls should be washed weekly, and the hands and forearms daily in warm water before leaving the factory. Lanoline and castor oil ointment (equal parts) applied to the skin after washing is a help. When dermatitis and eczema occur washing should be stopped and a doctor seen at once. 351. E x p e r ie n c e h a s s h o w n th a t i f lu b r ic a t in g a n d c o o lin g flu id s a re filte re d fr e e fr o m m e ta l p a r tic le s , a n d i f t h e y c o n t a in a s m a ll a m o u n t o f som e a n tis e p tic , s a y c a r b o lic a c id u p t o 1 p e r c e n t, o r o t h e r c o a l-t a r a n tis e p tic , ca ses o f ecze m a d o n o t o c cu r . A n t is e p t ic lu b r i ca n ts a n d c o o lin g flu id s a re r a p id ly c o m in g in t o g e n e r a l u se in e n g i n e e r in g s h o p s , a n d ca ses o £ e cze m a are less p r e v a le n t th a n fo r m e r ly . SECTION XIV.—CLEANLINESS, VENTILATION, HEATING, AND LIGHTING. FACTORY ENVIRONMENT. 352. T h e F a c t o r y a n d W o r k s h o p A c t , 1901, s e c tio n 1 ( i ) p r o v id e s as f o l l o w s : The follow ing provisions shall apply to every factory as defined by this act, except a domestic fa c to r y : (a ) It must be kept in a cleanly state. (b) It must be kept free from any effluvia arising from any drain, watercloset, privy, urinal, or other nuisance. (e ) It must not be so overcrowded while work is carried on therein as to be dangerous or injurious to the health o f the persons employed therein. ( cl) It must be ventilated in such a manner as to render harmless, so far as is practicable, all the gases, vapors, dust, or other impurities generated in the course o f the manufacturing process or handicraft carried on therein that may be injurious to health. 353. I n su b se q u e n t s e c tio n s th ese v a r io u s r e q u ir e m e n ts a re e la b o r a te d . I t w ill b e c o n v e n ie n t to d e a l w it h th e m se p a r a te ly . CLEANLINESS OE FACTORY. 354. A s h a s a lr e a d y b ee n p o in t e d o u t, th e first p r o v is io n o f th e fa c t o r y a ct is th a t th e w o r k s h o p m u st b e k e p t in “ a c le a n ly s ta te .” S e c t io n 1 (3 ) d e a ls w it h lim e w a s h in g . 355. A h ig h s ta n d a r d o f cle a n lin e s s n o t o n ly is e ss e n tia l f o r h e a lth b u t a lso h a s an im p o r t a n t b e a r in g o n th e s e lf-r e s p e c t o f th e w o r k e r s . T h e d ifficu ltie s in m a in t a in in g su ch a s ta n d a r d a re fr e q u e n t ly s u b s ta n tia l, a n d c o n s ta n t a tte n tio n is n e ce ssa ry . I n th e m a jo r it y o f m u n it io n w o r k s th e c o n d it io n s a re n o t u n s a t is fa c t o r y in th is r e s p e ct, b u t in so m e w o r k s , a n d e s p e c ia lly in th e o ld e r a n d m o r e c r o w d e d o n e s, th e c o n d it io n s le a v e m u c h m o r e to b e d e s ire d . I f d u s t is a llo w e d fr e e ly to a c cu m u la te , its in e v ita b le c ir c u la t io n in th e a ir re p r e s e n ts a m a te r ia l d a n g e r to h e a lth ev e n w h e re it is n o t d e r iv e d fr o m p o is o n o u s su b sta n ce s. 356. Flooring .— (S e c . 8 ( 1 ) . ) I f th e flo o r is t o b e k e p t c le a n it s h o u ld b e h a r d , s m o o th , d u r a b le , a n d im p e r v io u s . W h ile flo o r in g o f c o n c r e te o r s im ila r m a te r ia l m a y b e best f o r th e p a r t s o f a s h o p w h e re th e m a c h in e r y is p la c e d a n d f o r p a s s a g e w a y s , it is n o t th e m a te r ia l m o s t su ita b le f o r w o r k e r s t o sta n d on . I t is a m a tte r o f c o m m o n k n o w le d g e th a t so m e s o ft e r m a te r ia l su ch as w o o d is m u c h le ss fa t i g u i n g t o sta n d o n f o r a n y c o n tin u o u s p e r io d . I t is a lso w a r m e r f o r th e fe e t — a m a tte r o f n o sm a ll im p o r t a n c e in c o ld 175 176 INDUSTRIAL, H EALTH AND EFFICIENCY. w e a th e r . W h e r e th e p ro c e s s e s r e n d e r a w e t flo o r u n a v o id a b le it is e x t r e m e ly d e s ir a b le , h o w e v e r e ffe c tiv e th e d r a in a g e m a y b e , t o p r o v id e lo w w o o d e n p la t fo r m s u p o n w h ic h th e w o r k e r c a n sta n d . GENERAL VENTILATION AND HEATING. 357. T h e p r o v is io n s o f th e fa c t o r y a c t in r e g a r d t o th e se t w o m a tte r s a re as f o l l o w s : Sec. 7 ( i ) . In every room in any factory or workshop sufficient means o f ventilation shall be provided and sufficient ventilation shall be maintained. S e c . 6 ( i ) . In every factory and workshop adequate measures must be taken for securing and maintaining a reasonable temperature in each room in which any person is employed, but the measure so taken must not interfere with the purity o f the air o f any room in which any person is employed. 358. I n t h e ir r e p o r t d a te d 1902 th e d e p a r tm e n ta l c o m m itte e o n th e v e n t ila t io n o f fa c t o r ie s a n d w o r k s h o p s r e c o m m e n d e d th a t— such a standard o f ventilation should be prescribed for all classes o f factories and workshops not otherwise specially dealt with, that the proportion o f carbonic acid in the air at about the breathing level and away from the imme diate influence o f any special source o f contamination, such as a person or light, shall not (except on very foggy days, when no tests should be made, on account o f the vitiated state o f the outside air) rise during daylight, or after dark when only electric light is used, beyond 1 2 volumes o f carbonic acid per 30.000 o f air, and that when gas or oil is used for lighting the proportion shall not exceed 20 volumes after dark or before the first hour after daylight. 359. T h e s ta n d a r d th u s r e c o m m e n d e d h a s g e n e r a lly b e e n a d o p t e d b y th e H o m e O ffice in d e t e r m in in g w h e th e r th e v e n t ila t io n o f a f a c t o r y is su fficie n t w it h in th e m e a n in g o f th e a ct. 360. T h e fa c t o r y a n d w o r k s h o p a c t is c o n c e r n e d o n ly w it h th e m in im u m n e ce s s a r y in o r d in a r y tim e s, b u t p r e s e n t c o n d it io n s a n d c ir c u m s ta n c e s r e n d e r it n e ce s s a r y t o c o n s id e r th e p r o b le m .o f v e n t ila t io n fr o m a s o m e w h a t d iffe r e n t s ta n d p o in t. A t p r e s e n t th e im p o r ta n c e o f p r o p e r a n d e ffe c tiv e m e th o d s o f v e n t ila t io n a re in te n s ifie d b y th e in c r e a s e in th e n u m b e r o f w o r k e r s (m a n y o f w h o m a re n e w t o in d u s t r ia l c o n d it io n s ) , b y th e lo n g h o u r s o f w o r k , a n d b y th e c o n tin u o u s o c c u p a t io n o f th e s h o p s b y d a y a n d b y n ig h t . F r e q u e n t ly th e re is n o in t e r v a l in wTh ic h n a tu r a l v e n t ila t io n c a n r e s to r e a v it ia t e d a tm o s p h e r e , a n d e a c h s h if t su cc e e d s to th e c o n d it io n s o f v e n t ila t io n le ft b y its p r e d e c e s s o r . T h e o b je c t s o f v e n t ila t io n a re t o p r o v id e — (a) A i r w h ic h is p u r e a n d c le a n f o r th e w o r k e r s t o b r e a t h e ; ( i ) A n a tm o s p h e r e w h ic h is s t im u la t in g a n d r e fr e s h in g . 361. A i r w h ic h is e n t ir e ly p u r e f r o m th e c h e m ic a l p o in t o f v ie w m a y a ffo r d an a tm o s p h e r e o f a m o s t d e p r e s s in g c h a r a c te r , w h ic h is h ig h ly d e tr im e n ta l t o p h y s ic a l efficie n cy . I t is n o t e n o u g h t o a im o n ly a t c le a n a ir , as h a s b e e n o ft e n th e c u s to m in th e p a s t, o r o n ly CLEANLINESS, VENTILATION, HEATING, AND LIGHTING. at a s tim u la t in g a tm o s p h e r e . 177 B o t h o b je c t s m u st b e c o n s ta n tly b o r n e m m in d . 362. Clean air.— T h e im p u r it ie s w h ic h a re lia b le to b e a d d e d t o tlie a ir in s id e th e w o r k s h o p a re— (a) C a r b o n ic a c id g iv e n o ff in th e b r e a th o f h u m a n b e in g s , a n d b y fires, g a s lig h ts , o r a n y o t h e r fo r m o f o p e n c o m b u s tio n . C a r b o n ic a c id in th e p e r c e n ta g e fo u n d in r o o m s a n d fa c t o r ie s is h a rm le s s, b u t it a ffo r d s a u s e fu l in d ic a t io n o f th e e fficie n cy o f v e n tila tio n . I f it is efficien t, th e p e r c e n ta g e o f c a r b o n ic a c id w ill n o t m e a s u r a b ly e x c e e d th a t in th e a tm o s p h e r e . T h is is th e id e a l t o b e a im e d at, r a th e r than, th e p r a c t ic e h it h e r t o fo llo w e d o f k e e p in g th e a c id b e lo w 12 p a r t s p e r 10,000 o f a ir in d a y t im e a n d b e lo w 20 a t n ig h t. ( b) V a r io u s ill-d e fin e d v o la t ile su b sta n ce s a r is in g fr o m h u m a n b e in g s , fr o m th e sk in a n d th e a lim e n ta r y c a n a l, e s p e c ia lly w h e n p e r s o n a l c le a n lin e s s is d e fe c t iv e . T h e s e su b sta n ce s a re p r o b a b ly h a r m less in th e m se lv e s, b u t th e y e x c ite a fe e lin g o f d is c o m fo r t o r e r e n o f d is g u s t. (c) B a c t e r ia a r is in g fr o m h u m a n b e in g s fo r m a m o r e d e fin ite a n d m o r e d ir e c t ly h a r m fu l s o r t o f im p u r it y . C o ld s , so re t h r o a t, in flu en za a n d th e lik e a re la r g e ly s p re a d fr o m an in fe c t e d in d iv id u a l to h is n e ig h b o r s b y o r g a n is m s w h ic h are c a r r ie d in th e a ir. T h o u g h th ese d ise a ses m a y b e r e g a r d e d as t r iv ia l in c h a r a c te r , th e re ca n b e n o d o u b t as to th e a m o u n t o f in d u s tr ia l in e fficie n cy w h ic h th e y ca u se. O f d isea ses m o r e se rio u s as r e g a r d s l if e as w e ll as h e a lth , tu b e r c u lo s is o f th e lu n g s is u n d o u b t e d ly fo u n d d is s e m in a te d in a lik e m a n n e r. ( d ) I n d u s tr ia l p ro c e ss e s m a y g iv e rise to v a r ie d im p u r itie s su ch as d u st a n d fu m e s . S o m e a re s im p ly u n p le a s a n t, o th e r s a re d ir e c t ly h a r m fu l. F u lle r r e fe r e n c e t o th ese h a s b ee n m a d e in S e c tio n X I I I . 363. I t is o b v io u s th a t th e k in d o f im p u r it y p re s e n t in a n y p a r tic u la r w o r k s h o p w ill v a r y w id e ly w it h th e p r e v a le n t c o n d itio n s . G iv e n n o r m a l c o n d it io n s , im p u r it ie s ca n b e r e m o v e d b y a n e ffe c tiv e sy ste m o f g e n e r a l v e n tila tio n . 364. Stimulating atmosphere } — A t first s ig h t a w o r k s h o p m a y 1 Whether a workshop has an atmosphere which is satisfactory in this sense may gen erally be judged by the sensations, especially on first entering from the outside air. More accurate information may be obtained by the study of the particular way in which a “ stuffy ” atmosphere may be made “ fresh.” The ordinary thermometer measures the temperature of the a ir ; the wet-bulb thermometer determines the humidity and gives an important measure of the facility with which the body can be cooled by sweating. These instruments, however, give only very imperfect data as to the cooling and skin-stimulating properties of any atmosphere, and it is necessary to have in addition some measure of the rate at which a warm body will lose heat. In the observations made for the committee by Dr. Leonard Ilill, the rate of cooling has been investigated by means of the K ata thermometer (purchasable from J. Hicks, 8 , Hatton Garden, E. C .). A large bulbed spirit thermometer (of standard size) is u sed ; this is heated in hot water, and the rate of cooling measured by taking the time which the meniscus takes to drop from 100° F. to 9 5 ° F. while the instrument is suspended in the atmosphere. This gives the dry reading, and shows the rate of cooling due to radia tion and convection. To take the wet reading the bulb of the K ata thermometer is coy8 0 9 3 5 0— 19^------ 12 178 INDUSTRIAL H EALTH AND EFFICIENCY. h a v e so la r g e a c u b ic c a p a c it y in r e la tio n t o th e n u m b e r o f w o r k p e o p le a n d th e k in d o f p r o c e s s in o p e r a t io n th a t it d o e s n o t r e q u ir e a n y d e fin ite v e n tila tio n . T h is is w h o lly fa lse . I n la r g e s h o p s th e re is a m a ss o f s ta g n a n t a tm o s p h e r e w h ic h is o b v io u s ly d e p r e s s in g a w l r e la x in g , a n d f a ils e n t ir e ly to p r o v id e th e s tim u la t in g e ffe ct o f c o o l a ir in g e n tle m o tio n w h ic h is p r o v o c a t iv e o f th e b e st p h y s ic a l a n d m e n ta l e x e r tio n . T h is e x h ila r a t in g in flu e n ce o f a tm o s p h e r e d e p e n d s e s s e n tia lly u p o n th e c o o lin g o f th e s k in b y m o v in g a ir, a n d is c lo s e ly c o n n e c te d w it h q u e s tio n s o f te m p e r a tu r e a n d h ea t. C o o l a ir is m o r e s t im u la t in g th a n w a r m , a n d m o r e c o n d u c iv e to p h y s ic a l e ffo r t. D a m p w a r m a ir is m o r e r e la x in g th a n d r y a ir at th e sa m e te m p e r a tu r e . T h e s e c o n s id e r a t io n s are f u ll y b o r n e o u t b y d ir e c t e x p e r im e n ta tio n in th e la b o r a t o r y , a n d th e d e s ir e d a tm o s p h e r e is c h a r a c t e r iz e d b y b e in g — (a) C o o l r a th e r th a n h o t ; (b) D r y r a th e r th a n d a m p ; (c) D iv e r s e in its te m p e r a tu r e in d iffe r e n t p a r ts a n d at d iffe r e n t tim e s r a th e r th a n u n ifo r m a n d m o n o t o n o u s ; (d) M o v in g r a th e r th a n s till. 365. T h e e x p la n a t io n o f th e fa m ilia r c o n d it io n s o f su ch an a t m o s p h e r e a p p e a r s t o lie in th e c o o lin g a n d v a r y in g s tim u la tio n o f th e sk in o f th e e x p o s e d p a r ts o f th e b o d y . T h e c o n c e n t r a t io n o f a c u r r e n t o f a ir o n t o o s m a ll a p a r t o f th e b o d y o n ly ca u se s w h a t is c o m m o n ly k n o w n as a d r a u g h t. I t is a c o m m o n e x p e r ie n c e th a t a s lig h t ly o p e n w in d o w ca u ses a d r a u g h t , w h e re a s a w id e ly o p e n w in d o w d o e s n o t. e r e d w it h a d a m p m u s lin g lo v e a n d t h e o p e r a t io n r e p e a te d , g i v i n g t h e r a t e o f c o o lin g w h e n e v a p o r a t io n is a d d e d t o r a d ia t io n a n d c o n v e c t io n . T h e r a t e o f c o o lin g a t b o d y t e m p e r a t u r e is r e c o r d e d b y m e a n s o f a f a c t o r (d e t e r m in e d f o r e a c h K a t a t h e r m o m e t e r ) in m ille c a lo r ie s p e r sq u a r e c e n t im e t e r p e r s e c o n d . T h e n u m b e r o f s e c o n d s o c c u p ie d in t h e f a l l f r o m 1 0 0 ° t o 9 5 ° is d iv id e d in t o t h e f a c t o r . I n a d d it io n t o t h e r e a d in g s o f t h e K a t a t h e r m o m e t e r , t h o s e o f t h e w e t a n d d r y b u lb th e rm o m e te r w ere ta k e n . T h e r e c o r d s s h o w h o w w it h th e s a m e w e t a n d d r y b u lb r e a d in g s , t h e r a t e o f c o o lin g m a y b e s t r i k i n g ly d if f e r e n t. T h e K a t a t h e r m o m e t e r , lik e t h e h u m a n b o d y , n o te s t h e r a t e o f c h a n g e , w h ile t h e t h e r m o m e t e r n o t e s a g iv e n s t a t e o r t h e r e s u lt o f c h a n g e . T h u s t h e K a t a t h e r m o m e t e r t a k e s c o u n t o f th e m o v e m e n t o f th e a ir a n d in d ic a t e s c o n d itio n s o f c o m f o r t . T h e f o llo w i n g e x a m p le s a r e g iv e n in illu s t r a t i o n o f t h e r e s u lt s o b ta in e d . T h e fir s t s o t o f r e a d in g s a r e f o r a b r ig h t , p le a s a n t d a y in M a y , a n d t h e o t h e r f o u r a r e f o r t y p ic a l s h o p s a s a c o n t r a s t o f t y p e s o f “ b a d ” a n d “ g o o d ” sh o p s . A c o m p a r is o n o f t h e fir s t, s e c o n d , a n d t h ir d s e t s o f r e a d in g s s h o w s t h a t w it h t h e s a m e t e m p e r a t u r e w id e ly d iffe r e n t r a t e s o f c o o lin g m a y e x is t . Rate of cooling at body temperature in mille calories per square centimeter per second. (1) (2) (3) (4) (5) B right, pleasant d a y in M a y , out of d o o r s................ Brass foundry (g o o d ) ............................................................ Machine shop (b a d )................................................................ Cartridge annealing and cleaning (b ad) .................. Cartridge and cleaning (g o o d )................... W et b u lb. D ry b u lb . 60 60 61 6 4 .5 54 .5 68 72 72 8 0 .5 6 0 .0 R a d ia tion, con R adia vection, tion , con evapor vection. ation. 27 .2 24 15 17.5 24 .0 7 .5 7.3 4 .6 3 .0 9 .0 Evapo ration. 19.7 16.7 10.4 14,5 15.0 CLEANLINESS, VENTILATION, HEATING, AND LIGHTING. 179 W A Y S AND M EANS. 366. T h e v e n t ila t io n a n d h e a t in g o f e v e r y w o r k s h o p p r o v id e s a s e p a r a te p r o b le m . T h e r e is n o u n ifo r m o r s t e r e o ty p e d m e th o d w h ic h w ill g iv e s a t is fa c t o r y re su lts e v e r y w h e re . T h e m e a n s t o be a d o p te d m u st b e s u b je c t t o lo c a l c o n s id e r a tio n s in e a ch ca se, a n d th e g e n e r a l lin e s a lo n e ca n b e 'in d ic a t e d h e r e : (a) C u b ic c a p a c it y is th e fir s t e ssen tia l. T h o u g h th e m in im u m o f 2 5 0 c u b ic fe e t p e r w o r k e r (4 0 0 d u r in g a n y p e r io d o f o v e r tim e ) p r e s c r ib e d b y s e c tio n 3 ( 1 ) o f th e f a c t o r y a c t is s e ld o m in fr in g e d , th e p r o v is io n o f a d e q u a te v e n t ila t io n m a y b e r e n d e r e d d iffic u lt o w in g t o th e c lo s e p r o x im it y o f th e w o r k e r s t o o n e a n o th e r. T h e y s h o u ld at le a s t b e so a r r a n g e d th a t th e y d o n o t c o u g h o r sn eeze in e a c h o t h e r ’s fa c e s . (b) D e fin ite o p e n in g s c o m m u n ic a t in g w it h th e o u ts id e a ir s h o u ld b e p r o v id e d in e v e r y w o r k s h o p , p r e fe r a b ly o p p o s it e e a ch o th e r . T h e a v e r a g e m a c h in e s h o p a n d a ll s im ila r o n e -s t o r y s h o p s s h o u ld b e p r o v id e d w it h lo u v e r s a lo n g th e le n g t h o f th e r o o f r id g e s , o r , b e tte r , w it h n a r r o w o p e n in g s w h e r e th e r o o f m e ets th e w a ll. S u c h lo u v e r s s h o u ld b e p e r m a n e n tly o p e n , a n d w o u ld g e n e r a lly in su r e th a t th e a tm o s p h e r e w ill a t le a st n o t b e g r o s s ly b a d . (c) S u ch fix e d o p e n in g s d o n o t , h o w e v e r r a llo w o f th e fle x ib ilit y r e q u ir e d t o m e et v a r y in g in te r n a l a n d e x te r n a l c o n d it io n s , a n d s h o u ld b e s u p p le m e n te d b y th e u se o f d o o r s a n d w in d o w s (w h ic h w ill o p e n ) a n d fa n s . F a n s a re s p e c ia lly v a lu a b le t o m e e t e m e r g e n c ie s a n d a b n o r m a l c o n d it io n s a n d p r o v id e f o r th e t h o r o u g h c le a n in g o f th e a ir d u r in g m e a ltim e s . (d) L o c a l so u rce s o f im p u r it y a n d h e a t p r o d u c t io n s h o u ld b e d e a lt w it h b y th e p r o v is io n o f h o o d s , ex h a u sts, e tc. (S e e , a ls o , p a rs . 3 7 2 3 7 9 .) S m o k e a n d fu m e s fr o m n e ig h b o r in g c h im n e y s m a y a ls o r e q u ir e a tte n tio n . 367. A s a r e s u lt o f a d e ta ile d in q u ir y in t o th e c o n d it io n s o f v e n t ila t io n a t an im p o r t a n t fa c t o r y , a m e m b e r o f th e c o m m itte e r e p o r t s : Tlie skylight method o f ventilation is a bad on e; unfortunately it pertains throughout the factory, both in old and new shops* The opening o f a skylight leads to a local draft, and this usually entails its cloture. The skylights, too, take time and trouble to open and shut, and rain comes in when they are open and may rust metal work upon which it falls. F or these reasons the opening o f the skylights is generally neglected, except at the intervals when a special set o f men carry out the duty* Moreover, skylights opened here and there do not ventilate the shop in all its parts. The warm, smelly air rises up against the r o o f and does not escape in parts where no skylights are open. A very great improvement would be made in all these shops if louvers w^ere introduced, run ning continuously along the whole length o f each serration o f the roof. These louvers would allow’ a ceaseless, draftless, and equal ventilation o f every part o f the shops. It is regrettable that the new shops should not have been designed with such louvers, for the efficiency o f their action is demonstrated in many factories. 180 INDUSTRIAL H EALTH AND EFFICIENCY. The smell o f oil and soapsuds can be lessened by strict attention to cleanliness. Similarly, the cleaning o f machines and floors is the first thing to pay attention to in regard to the smell o f the machine shops. In the stress o f present condi tions and lack o f labor cleaning is sure to suffer. Continuous roof louvers would insure ceaseless change o f air and a cooler temperature, and these together would insure much fresher atmosphere. The monotonous smell and lack o f freshness o f the air nervously disturbs the more sensitive men who are working long hours and at a high pitch, men some o f whom have been used to an open-air life and who, acquainted with the popular but erroneous doctrine of ventilation, concern themselves over chemical poisons in the air, the presence ©f which they believe to be indicated by the close smell. In the days o f hot summer weather there is no means provided o f cooling the workers beyond the stirring o f the air produced by the shafting and belts. In some o f the shops the committee saw in action impulsion fans, each placed high up on the wall o f the factory with a sheet o f canvas placed below it and stretching out into the shop so as to act as a baffle. These fans sent a grateful current o f moving air through the shop in hot weather. Such an installation repays itself by the increased efficiency o f the workers. 368. I t is u n n e c e s s a ry t o e m p h a s iz e th e c lo s e c o n n e c t io n w h ic h e x ists b'etw een v e n t ila t io n a n d te m p e r a tu r e . F o r a s h o p t o b e t o o h o t is d is a d v a n ta g e o u s fr o m e v e r y p o in t o f v ie w , b u t th e s t im u la t io n o f t o o c o ld a ir m a y b e m o r e th a n c o u n te r b a la n c e d b y th e p h y s ic a l d e p r e s s io n w h ic h r e su lts, a n d in c o ld w e a th e r e fficie n cy m a y d e te r io r a t e b e c a u se th e w o r k e r b e c o m e s u n c o m fo r t a b ly c h ille d . I n h is m e m o r a n d u m o n T h e C a u s a tio n o f I n d u s t r ia l A c c id e n t s , D r . Y e r n o n sta tes t h a t — At each o f the three shell factories B, C, and D the women’ s accidents greatly increased during cold weather. The men’s accidents increased, though to a less extent, at two o f the three factories, and but for exceptional conditions -would have increased at the third factory likewise. At factory A there was no detect able seasonal change in the number o f accidents, and so there can be very little doubt that if the shell factories had been more adequately heated the whole o f the seasonal increment o f accidents might have been avoided. The data col lected at factory A showT that in order to reduce accidents to a minimum the temperature should be kept at 65 to 69°, but probably not much harm would be done so long as it was not allowed to fall below about 55°. As the temperature falls below 50°, however, there can be little doubt that accidents increase very rapidly. An external temperature at freezing point probably meant an internal temperature o f about 45° at factory C, and a temperature o f 40° or less at cer tain parts o f factory B, and we saw that under such conditions the women’s accidents were, respectively, 48 per cent and 143 per cent greater than when the external temperature was above 47°. 369. D r . V e r n o n a d d s th e o p in io n th a t “ th e o p t im u m te m p e r a tu r e f o r a c c id e n t lim it a t io n is h ig h e r th a n th e o p t im u m f o r o u t p u t .” W h a t is th e b e s t t e m p e r a tu r e d e p e n d s o n . th e c h a r a c te r o f th e w o r k a n d th e h a b it o f th e w o r k e r . S e d e n t a r y w o r k e r s r e q u ir e a w a r m e r a tm o s p h e r e th a n th o s e e n g a g e d in m o r e v io le n t la b o r . I t m a y , h o w e v e r , b e s u g g e s te d th a t w h e n th e a ir is s ta g n a n t th e te m p e r a tu r e s h o u ld n o t e x c e e d a b o u t 6 0 ° F ., t h o u g h it m a y b e s o m e w h a t h ig h e r w h e n th e a ir is in m o tio n . CLEANLINESS, VENTILATION, H EATING, AND LIGHTING. 181 370. M e a n s o f h e a t in g a re u s u a lly r e s tr ic te d b y p r a c t ic a l c o n s id e r a tio n s to so m e sy ste m o f ste a m * h e a tin g o r h o t -w a t e r p i p e s ; th e id e a l fo r m is, n o d o u b t, b y r a d ia n t h e a t, as m a y b e seen fr o m th e e x c e lle n t a n d i n v ig o r a t in g c o n d it io n s w h ic h p r e v a il in m a n y sm ith ie s a n d fo r g e s . G a s-h e a te cl r a d ia t o r s in w h ic h th e b u r n t g a s e sca p e s in t o th e s h o p a re n o t p e r m is s ib le . A p la n b y w h ic h w a r m e d a ir is p u m p e d in t o th e s h o p (c o m m o n ly k n o w n as th e “ p le n u m sy ste m ” ) te n d s to cre a te a n a tm o s p h e r e o f a h ig h ly r e la x in g a n d d e p r e s s in g c h a r a cte r. T h e m e a n s o f v e n t ila t io n s h o u ld b e k e p t s e p a r a te fr o m th a t o f h e a tin g , a n d th e “ p le n u m sy ste m ” s h o u ld o n ly b e u sed to p u m p in c o o l a ir in su m m e r. 371. Maintenance.— T h e m o s t c o m p le t e in s t a lla t io n f o r v e n t ila t io n a n d h e a t in g m a y b e r e n d e r e d in e ffe c tiv e b y in ju d ic io u s m a n a g e m e n t o r fa ilu r e in p r o p e r o r c o n tin u o u s m a in te n a n c e . R a p id c h a n g e s o f c lim a te at d iffe r e n t tim e s o f th e d a y , v a r y in g c ir c u m s ta n c e s o f u se a n d o c c u p a t io n , a ll r e q u ir e a p p r o p r ia t e tre a tm e n t. M is m a n a g e m e n t is fr e q u e n t ly d u e t o th e fa c t th a t it is th e p r e s c r ib e d d u t y o f n o o n e in p a r t ic u la r t o o b s e r v e th e p r e v a ilin g c o n d it io n s a n d t o p u t in o p e r a t io n th e a p p r o p r ia t e a p p lia n c e s f o r th e s u p p ly o f a ir a n d h e a t, a n d th e c o m m itte e a re o f o p in io n th a t s o m e r e s p o n s ib le p e r s o n s h o u ld b e s p e c ia lly d e ta ile d f o r th e p u r p o s e . W h ile it is f o r th e m a n a g e m e n t t o p r o v id e th e m e a n s, it is f o r th e w o r k e r s t o a id in t h e ir u se a n d a p p lic a t io n . T h e e ffe c tiv e m a in te n a n c e o f v e n t ila t io n is th e m o r e im p o r t a n t o w in g t o th e la r g e n u m b e r o f w o m e n n o w e m p lo y e d in m u n it io n w o r k s , s in c e w o m e n a re e s p e c ia lly s u s c e p tib le to th e e ffe cts o f d e fe c t iv e v e n t ila t io n . LOCAL A N D E X H A U S T V E N T IL A T I O N . 372. I n a d d it io n to th e g e n e r a l p r o v is io n s in r e g a r d t o v e n t ila t io n , th e F a c t o r y a n d W o r k s h o p A c t c o n ta in s v a r io u s s p e c ia l p r o v is io n s in r e g a r d t o th e p r o v is io n o f lo c a l o r e x h a u s t v e n t ila t io n in th e ca se o f d a n g e r o u s o r u n h e a lth y in d u s trie s . S e c tio n 74 p r o v id e s — I f in a factory or workshop where grinding, glazing, or polishing on a wheel, or any process is carried on by which dust or any gas, vapor, or other impurity is generated and inhaled by the workers to an injurious extent, it appears to an inspector that such inhalation could be to a great extent prevented by the use o f a fan or other mechanical means, the inspector may direct that a fan or other mechanical means o f a proper construction for preventing such inhalation be provided within a reasonable tim e; and if the same is not provided, main tained, and used, the factory or workshop shall be deemed not to be kept in conform ity with this act. S e c tio n 79 p r o v id e s th a t— Where the secretary o f state is satisfied that any manufacture, machinery, plant, process, or description o f manual labor used in factories or workshops 182 INDUSTRIAL H EALTH AND EFFICIENCY. is dangerous or injurious to health or dangerous to life or limh, either generally or in the case o f women, children, or a**y other class o f persons, he may certify that manufacture, machinery, plant, process, or description o f manual labor to be dangerous, and thereupon the secretary o f state may, subject to the provisions o f this act, make such regulations as appear to him to be reason ably practicable and to meet the necessity o f the case. 373. L o c a l o r e x h a u s t v e n t ila t io n is n o r m a lly r e q u ir e d t o r e m o v e fr o m th e a tm o s p h e r e d u s t, h e a te d fu m e s , o r v o la t ile v a p o r s . T h e e ss e n tia ls t o su ch v e n t ila t io n a re— (a) A d u c t a lo n g w h ic h a flo w o f a ir is m a in ta in e d in a d e fin ite d ir e c t io n . ( b) S u it a b le o p e n in g o r o p e n in g s in th e d u c t, t h r o u g h w h ic h th e d a n g e r o u s su b sta n ce s a re w it h d r a w n . (c) S u it a b le o p e n in g s f o r th e a d m is s io n o f a ir in t o th e w o r k r o o m . 374. N e a r ly e v e r y w o r k p la c e h a s s p e c ia l p r o b le m s in th e s o lv in g o f w h ic h e x p e r t a d v ic e m a y b e n e ce ssa r y . T h e r e a re , h o w e v e r , c e r ta in p r in c ip le s t h a t a r e g e n e r a lly a p p lic a b le t o a ll su ch in sta n ce s. T h e d u c t a lo n g w h ic h a flo w o f a ir is m a in ta in e d s h o u ld b e o f su fficie n t le n g t h a n d size. I t m u s t n o t c o n t a in b e n d s s o s h a r p a s t o im p e d e th e flo w o f a ir. T h e o p e n in g o r o p e n in g s t h r o u g h w h ic h th e a ir e n te r s th e d u c t m u s t n o t b e t o o s m a ll o r t h e y m a y b e c o m e c h o k e d w it h d u st. T h e o p e n in g s s h o u ld h a v e h o o d s s o a r r a n g e d as t o s u r r o u n d so f a r as p o s s ib le th e s e a t o f o r ig in o f th e s u b s ta n ce t o b e r e m o v e d . I n th e ca se o f d u s t fr o m a r e v o lv in g w h e e l, th e h o o d a n d d u c t s h o u ld b e p la c e d so as t o in t e r c e p t th e d u s t w h ic h is t h r o w n t a n g e n t ia lly f r o m th e w h e e l a n d t o c a tc h d u s t w h ic h w o u ld o t h e r w is e f a l l t o th e g r o u n d ; th e d u s t th e n c o m e s u n d e r th e in flu e n c e o f th e a ir c u r r e n t in th e h o o d a n d is d r a w n in t o th e d u c t , w h ile th e a ir c u r r e n t it s e lf is a ssiste d b y th e a ir t h r o w n o ff b y th e w h e e l. W h e r e d u s t is c r e a te d b y m a n u a l la b o r th e o p e r a t iv e s h o u ld s ta n d o r s it f a c in g th e o p e n in g o f th e h o o d so th a t th e c u r r e n t o f a ir d r a w s th e d u s t a w a y f r o m h im . 375. F o r h e a te d fu m e s th e h o o d s h o u ld b e b e ll-m o u t h e d , a n d its lo w e r e n d s h o u ld e n v e lo p a n d e x te n d b e lo w th e p la c e fr o m w h ic h th e fu m e s o r ig in a t e . T h e o p e n in g o f th e h o o d s h o u ld b e a t s u ch a n a n g le as t o p r e v e n t a c c u m u la tio n o f d u s t, o r , in th e ca se o f h e a te d fu m e s , t o p r e v e n t th e e x p a n d in g g a se s fr o m r e b o u n d in g a n d e s c a p in g lik e s m o k e fr o m th e b a d ly c o n s tr u c te d c h im n e y . V o la t ile su b sta n ce s a re d iffic u lt t o lo c a liz e . I f , as is u s u a lly th e ca se w h e n n o x io u s v a p o r s h a v e t o b e d e a lt w it h , th e v a p o r is h e a v ie r th a n a ir, th e o p e n in g s t o th e d u s t m u s t b e a t th e g r o u n d le v e l a n d as n e a r as p r a c t ic a b le t o th e p la c e w h e re th e v a p o r is g iv e n o ff. 376. T h e r e m o v a l o f d u s t o r v o la t ile s u b sta n ce s is g e n e r a lly b est e ffe c te d b y a c u r r e n t o f a ir p r o d u c e d b y m e c h a n ic a l m e a n s. G e n e r a lly s p e a k in g , w h e r e a k ee n d r a u g h t , as f o r th e r e m o v a l o f d u s t, is CLEANLINESS, VENTILATION, H EATING, AND LIGHTING. 183 r e q u ir e d , p re s su re fa n s s h o u ld b e e m p lo y e d , sin ce th ese fa n s , t h o u g h r e q u ir in g m o r e p o w e r t o d r iv e th e m , c a n w o r k a g a in s t c o n s id e r a b le p re s su re a n d s m a lle r d u c ts m a y b e u sed . W h e r e , o n th e o th e r h a n d , la r g e v o lu m e s o f a ir a re t o b e r e m o v e d , v o lu m e fa n s c a n b e m o r e e c o n o m ic a lly e m p lo y e d , b u t w it h su ch fa n s a t te n tio n t o th e s e c tio n a l a rea o f th e d u c ts is o f g r e a t im p o r ta n c e . T h e d u c ts m u s t n e v e r b e c o n s t r ic t e d a t a n y p o i n t ; th e t o t a l a rea o f th e o p e n in g m u s t b e g r e a t e r th a n th a t o f th e fa n , a n d a ll s h a rp b e n d s in th e d u c t m u st b e a v o id e d . F u r t h e r , th e d e liv e r y s id e o f th e fa n m u st n o t b e im p e d e d o r s o p la c e d as t o b e e x p o s e d t o th e a c t io n o f w in d . 377. H e a t e d fu m e s c a n u s u a lly b e r e m o v e d w it h o u t u s in g m e c h a n i c a l p o w e r , p r o v id e d th a t th e d u c t is v e r t ic a l a n d o f a m p le d ia m e te r a n d h e ig h t. D o w n d r a ft s s h o u ld b e g u a r d e d a g a in s t b y th e p r o v i sio n o f w in d c o w ls o r b y o t h e r m e a n s. 378. T h e d is t r ib u t io n a n d size o f o p e n in g s f o r th e a d m is s io n o f a ir t o th e w o r k r o o m is a m a tte r o f esse n tia l im p o r ta n c e . T o o b ta in a n in te r c h a n g e o f a ir a n d so secu re g e n e r a l v e n t ila t io n , th ese o p e n in g s s h o u ld b e p la c e d as fa r as p o s s ib le fr o m th e e x h a u s t o p e n in g s , p r e f e r a b ly on th e o p p o s it e sid e o f th e w o r k r o o m , a n d , t o a v o id d r a ft s , s u ch o p e n in g s s h o u ld c o m p r is e a n a rea th re e tim e s th a t o f th e e x h a u s t o p e n in g s . W h e r e v o la t ile v a p o r s a re b e in g d e a lt w ith , it is s p e c ia lly im p o r t a n t th a t th e o p e n in g s s h o u ld b e a m p le a n d s h o u ld b e a r r a n g e d h ig h u p in th e w o r k r o o m . T h e s u p p ly o f in com in g s a ir m a y .in so m e cases be in s u r e d b y th e u se o f a p re s su re fa n d r iv in g in a ir t h r o u g h w e ll-d is t r ib u t e d o p e n in g s . 370. E x p e r ie n c e s h o w s th a t in s ta lla tio n s w h ic h a re in th e m s e lv e s s a t is fa c t o r y fr e q u e n t ly f a i l t o e ffe ct th e ir p u r p o s e t h r o u g h in su fficie n t a tte n tio n t o th e ir ca re a n d m a in te n a n c e . H o o d s b e c o m e d e ta c h e d fr o m d u c ts , h o le s a re b r o k e n in to th e d u c ts , a n d d u c ts h a v e b ee n fo u n d b lo c k e d w it h e v e r y k in d o f d e b ris . T h e w h o le in s t a lla t io n m a y b e im p a ir e d b y a d u s t -c o lle c t in g a p p a r a t u s w ith e x it s o f in a d e q u a te area. . L IG H T IN G . 380. T h e F a c t o r y a n d W o r k s h o p A c t d o e s n o t c o n t a in a n y p r o v i s io n in r e g a r d t o th e lig h t in g o f fa c t o r ie s . T h e q u e s tio n h a s, h o w e v e r , b e e n e x h a u s t iv e ly d e a lt w ith in th e r e p o r t o f th e d e p a r tm e n ta l c o m m itte e o n lig h t in g in fa c t o r ie s a n d w o r k s h o p s , p u b lis h e d in 1915. T h e essen tia ls o f g o o d lig h t in g a r e s u m m a r iz e d as— ( « ) Adequacy; (h) A reasonable degree o f constancy and uniform ity o f illumination over the necessary area o f w o r k ; (c ) The placing or shading o f lamps so that the light from them does not fall directly on the eyes o f an operative when engaged oil his work or when looking horizontally across the w orkroom ; (d) The placing o f lights so as to avoid the casting o f extraneous shadows on the work. 184 INDUSTRIAL H EALTH AND EFFICIENCY. 381. A n e x p e r t w itn e s s b e fo r e th e c o m m itte e th u s s u m m a r iz e d th e p r in c ip a l e ffe cts o f g o o d l i g h t i n g : (a ) Tlie quality o f work and output both suffer if the illumination is inade quate, particularly in the-case o f delicate operations often called for in munition factories. Adequate illumination assisted the supervision o f workers, with the result that carelessness and errors on the part o f newly trained workers were more readily detected, and instances in which a worker required a rest were noticed more speedily. (b) Inadequate illumination, by adding to the difficulties o f skilled labor, in creases the nervous strain on operators and reacts on their physical condition. ( c) The risk o f accident is in many cases increased by inadequate lighting. (d) In cases where machines do not receive sufficient attention the risk o f breakdowns is increased. (e) It is generally recognized that operators work more cheerfully in welllighted room s; bad lighting, on the other hand, has a depressing effect on the spirits, and thus affects the operator's capacity for work. 382. N a t u r a l lig h t in g is t o b e p r e fe r r e d t o a r tific ia l lig h t in g o n g r o u n d s o f h e a lth as w e ll as o f e c o n o m y . W h e r e it c a n b e p r o v id e d , r o o f lig h t in g is g e n e r a lly s u p e r io r t o la te r a l lig h t in g , e s p e c ia lly i f it ca n b e a r r a n g e d th a t th e lig h t en te rs fr o m th e n o r th . I n a g o o d s y s te m o f r o o f l ig h t in g th e illu m in a t io n is v e r y u n ifo r m . I n m o d e r n fa c t o r ie s w h e r e la te r a l lig h t in g is e m p lo y e d a la r g e p a r t o f th e w a lls a re d e v o te d to w in d o w s , b u t it is e v id e n t th a t th e re is a lim it t o th e w id t h o f th e r o o m b e y o n d w h ic h th e illu m in a t io n fa lls b e lo w w h a t is a d e q u a te . W h a t th is w id t h is w ill d e p e n d p a r t ly u p o n th e n a tu r e o f th e w o r k to b e d o n e in th e s h o p a n d p a r t ly o n th e e x te n t t o w h ic h l ig h t is im p e d e d b y o u ts id e o b s ta cle s su ch as n e ig h b o r in g b u ild in g s o r in s id e o b s ta cle s su ch as m a c h in e r y . 383. T h e e ffe c t o f lig h t - c o lo r e d w a lls a n d w h it e c e ilin g s o n th e g e n e r a l b r ig h tn e s s o f th e r o o m s a n d in fo r m in g a n e ffe c tiv e back-* g r o u n d t o d a r k o b je c t s s h o u ld n o t b e o v e r lo o k e d . S o m e tim e s th e n a tu r a l lig h t in g m a y b e im p r o v e d b y d e fle c tin g v e r t ic a l lig h t in t o th e r o o m b y m e a n s o f r e fle c to r s o r p r is m a t ic g la s s o r b y w h it e n in g th e s u r fa c e o f a n e x te r n a l w a ll o r b u ild in g w h ic h o b s tr u c ts th e lig h t . T h e p o s it io n o f p e r m a n e n t w o r k in g p o in t s s h o u ld b e so a d ju s te d in r e la tio n t o th e w in d o w s a n d to in te r n a l o b s ta cle s o f w h a te v e r k in d as t o se cu re so f a r as p r a c t ic a b le a d e q u a te lig h t f o r e a ch . 384. T h e n e c e s s ity f o r r e g u la r ly c le a n in g th e w in d o w s o n th e in n e r a n d o u te r s u r fa c e s c a n n o t b e t o o s t r o n g ly in s is te d on . N o t o n ly d o d ir t y w in d o w s s e r io u s ly h in d e r d a y lig h t fr o m e n t e r in g th e s h o p , b u t th e d a y lig h t p e r io d o f w o r k is c o n s id e r a b ly s h o r te n e d a n d n e e d le ss e x p e n d itu r e o n a r t ific ia l l ig h t in g in c u r r e d in co n s e q u e n ce . A i r - r a i d r e g u la t io n s h a v e te n d e d t o in c re a s e th is lo ss o f n a tu r a l lig h t . D r . A g n e w , in th e c o u r s e o f h is m e d ic a l in q u ir ie s , in q u ir e d in t o th is q u e s tio n . H e r e p o r t s — The natural lighting in almost every case would be good if the windows were cleaned regularly, but owing to the anti-air-raid darkening regulations the . CLEANLINESS, VENTILATION, HEATING, AND LIGHTING. 185 windows were not cleaned regularly, or if cleaned regularly tlie transmission o f daylight is interfered with by blinds which have become dislodged or have got out o f order and hang loosely about the windows. The advantage o f white washing the walls and keeping the ceilings clean was shown by contrast with some workshops where these processes are sadly neglected. 385. I n th e c o n s t r u c t io n o f s h o p s c a re s h o u ld b e ta k e n t o r e n d e r th e o u ts id e o f w in d o w s e a s ily a cce s sib le f o r c le a n in g . I n m a n y e x is tin g sh o p s a ccess is so d iffic u lt as to m a k e c le a n in g a lm o s t im p o s s ib le . 386. A r t ific ia l lig h t in g is o f s p e c ia l im p o r t a n c e a t th e p re s e n t tim e w h e n n ig h t w o r k is d o n e , a n d w h e n w o m e n a n d b o y s are e m p lo y e d in la r g e n u m b e rs . B a d lig h t in g a ffe cts o u t p u t u n fa v o r a b ly , n o t o n ly b y m a k in g g o o d a n d r a p id w o r k m o r e d ifficu lt b u t b y c a u s in g h e a d a ch e s a n d o th e r e ffe cts o f e y e str a in . T h e d iffic u ltie s o f s u p e r v is io n , w h ic h a re a lw a y s c o n s id e r a b le , are fu r t h e r in c re a s e d i f th e g e n e r a l lig h t in g o f th e w o r k s h ip is in su fficie n t. A t t e n t io n s h o u ld b e p a id to th e lig h t in g o f p a ssa g e s a n d th e im m e d ia te s u r r o u n d in g s o f th e fa c t o r y as w e ll as t o th a t o f th e fa c t o r y it s e lf. 387. I n th e r e p o r t o f th e d e p a r tm e n ta l c o m m itte e s ta n d a r d s o f lig h t in g f o r fa c t o r ie s are s u g g e s te d , a n d t h o u g h th e fig u re s g iv e n .a r e th e m in im a c o n s id e r e d n e ce ssa r y , t h e y m a y a t a n y ra te p r o v e o f a ssista n ce in c o n s id e r in g th e r e la tiv e a m o u n t o f lig h t n e ce s s a r y in d iffe r e n t p a r ts o f th e fa c t o r y . T h e u n it o f illu m in a t io n is th e “ f o o t c a n d le ; ” 1 th a t is, th e illu m in a t io n p r o d u c e d b y a lig h t o f o n e s ta n d a r d c a n d le a t a p o in t o f a s u r fa c e 1 f o o t fr o m th e s o u r ce a n d so p la c e d th a t th e lig h t str ik e s th e s u r fa c e at r ig h t a n g le s. T h u s , 1 c a n d le 1 f o o t fr o m th e s u r fa c e is 1 fo o t -c a n d le , 50 c a n d le s at a d is ta n c e o f 1 fo o t is 50 fo o t -c a n d le s , a n d 50 c a n d le s a t 10 fe e t d is ta n c e is 0.5 f o o t c a n d le .2 L i g h t s h o u ld a lso b e c o n s ta n t a n d u n ifo r m , w it h o u t g la r e a n d w it h o u t ^ castin g e x tr a n e o u s s h a d o w s o n th e p o in t t o b e illu m i n a te d . A r t ific ia l lig h t in g is u s u a lly o b ta in e d b y u se o f c o a l g a s, o ils , o r e le c tr ic lig h t . C a n n e l-c o a l g a s is m o r e illu m in a n t th a n b it u m in o u s -c o a l g a s. T h e c h ie f r e s u lts o f th e b u r n in g o f c o a l g a s a re a n in c re a s e in C 0 2 a n d w a t e r y v a p o r , r a is in g o f te m p e r a tu r e , w ith s o m e p r o d u c t io n o f s u lp h u r o u s a c id a n d o th e r c o n s titu e n t b o d ie s . E a c h c u b ic f o o t o f g a s p o llu t e s th e a tm o s p h e r e t o th e sa m e d e g r e e a s o n e a d u lt p e rs o n . T h e b e st fo r m o f g a s illu m in a t io n is n o w c o m m o n ly o b ta in e d b y th e u se o f an in c a n d e s c e n t-m a n tle b u r n e r p r o p e r ly v e n tila t e d . O il la m p s g iv e fa i r resu lts, b u t r a ise th e te m p e r a tu r e a n d g iv e o ff C 0 2 a n d w a t e r y v a p o r . E le c t r ic lig h t is th e m o s t h y g ie n ic f o r m o f illu m in a t io n . N o o x y g e n is u se d u p , n o C 0 2 o r m o is tu r e is p rod u ced . 1 On th e c a n d le ). 2 O ver le s s c o n t in e n t th e th a n of “ w o r k in g 0 .2 5 E urop e areas ” th e of f o o t -c a n d le ; in a ll m e t e r -c a n d le w ork room s o p en is th e i llu m i n a t i o n p la c e s , r o a d w a y s , u n it at (= = about flo o r le v e l y ard s, or o th e r ^ of s h o u ld a fo o t- be ap proach es not to w o r k p la c e s , 0 . 0 5 (s e e r e p o r t o f d e p a r t m e n t a l c o m m it t e e o n lig h t in g in f a c t o r ie s a n d w o r k sh ops, 1 9 1 5 ). Cd. 8000, SECTION XV.— SANITARY ACCOMMODATION, WASHING FACILITIES, AND CLOAKROOMS. S A N I T A R Y A C C O M M O D A T IO N . 388. S e c t io n 9 o f th e F a c t o r y a n d W o r k s h o p A c t r e q u ir e s th a t— (1) Every factory and workshop must he provided with sufficient and suit able accommodation in the way o f sanitary conveniences, regard being had to the number o f persons employed in or in attendance at the factory or w ork shop, and also where persons o f both sexes are or are intended to be employed or in attendance, with proper separate accommodation for persons o f each sex. ( 2 ) The secretary o f state shall, by special order, determine what is sufficient and suitable accommodation within the meaning o f the section. 389. T h is s e c tio n o n ly a p p lie s to th o s e p a r ts o f th e c o u n t r y in w h ic h th e a n a lo g o u s p r o v is io n s o f s e c tio n 22 o f th e P u b l ic H e a lt h A c t s A m e n d m e n t A c t , 1890, a n d o f s e c tio n 3 8 o f th e P u b l ic H e a lt h ( L o n d o n ) A c t , 1891, d o n o t h a v e e ffe c t. A s p e c ia l o r d e r w a s issu e d b y th e H o m e O ffice in F e b r u a r y , 1903. W h ile th is o r d e r s t r ic t ly o n ly a p p lie s t o ’ th o s e d is t r ic t s in w h ic h th e p r o v is io n s o f th e F a c t o r y A c t h a v e e ffe c t, it m a y b e r e g a r d e d as p r e s c r ib in g th e m in im u m c o n d i t io n s w h ic h a re g e n e r a lly c o n s id e r e d a s su fficie n t a n d s u ita b le . T h e o r d e r in c lu d e s th e f o l l o w i n g p r o v is io n s : (a ) Not less than one sanitary convenience shall be provided fo r every 25 females. (b ) Not less than one sanitary convenience shall be provided for every 25 m en ; provided that— ( i) W here the number o f males exceeds 100 and sufficient urinal accommo dation is also provided, it shall be sufficient i f there is one sanitary convenience fo r every 25 males np to the first 100 and one for every 40 a ft e r ; ( ii) WThere the number o f males exceeds 500, and proper supervision and con trol is exercised by a special officer, one convenience for every 60 men need only be provided in addition to sufficient urinal accommodation. (c ) Tlie accommodation must be so arranged and maintained as to be con veniently accessible at all times to all persons employed. (d) Every sanitary convenience must be kept in a cleanly state, sufficiently ventilated and lighted, and must not communicate with any workroom except through the open air or through an intervening ventilated space. ( e ) Every sanitary convenience must be under cover and so partitioned off as to secure privacy, and if for the use of females must have proper doors and fastenings. ( / ) W here persons o f both sexes are employed, the accommodation for each sex shall be so placed that the interior shall not be visible, even when the door o f a convenience is open, from any place, where persons o f the other sex have to w ork or p a ss; i f the conveniences for one sex adjoin those fo r the other, the approaches must be separate. 186 SANITARY ACCOMMODATION, W ASH ING FACILITIES, ETC. 187 390. I n s o m e n e w fa c t o r ie s o r in is o la t e d s itu a tio n s th e m o s t a p p r o v e d s y s te m o f d r a in a g e a n d c o n s t r u c t io n c a n n o t b e c a r r ie d o u t, a n d r e co u r s e m u st be h a d to p a il c lo s e t s ; in s u ch ca se s th e a c c o m m o d a t io n s h o u ld b e at a h ig h e r ra te in r e la tio n t o th e n u m b e r o f w o r k e r s e m p lo y e d th a n th e ra te set o u t a b o v e u n le s s p r o p e r a r r a n g e m e n ts ca n be m a d e f o r d a ily s c a v e n g in g (o u t o f w o r k in g h o u r s ). 391. W h a t e v e r th e a r r a n g e m e n ts m a d e i t is o f th e u tm o s t im p o r ta n ce th a t a h ig h s ta n d a r d o f c le a n lin e s s s h o u ld b e m a in t a in e d ; e s p e c ia lly at th e p re s e n t tim e th is m u s t b e r e g a r d e d as on e o f th e essen tia ls f o r th e m a in te n a n c e o f th e h e a lth o f w o m e n w o r k e r s , m a n y o f w h o m a re n e w t o in d u s t r ia l c o n d it io n s . I t w ill g e n e r a lly b e f o u n d d e s ir a b le , i f n o t e ss e n tia l, t o a p p o in t so m e o n e t o b e r e s p o n s ib le f o r p r o p e r s u p e r v is io n a n d m a in te n a n c e . A t o n e tim e p r o v is io n f o r w o m e n w a s o ft e n u n s a t is fa c t o r y , la r g e ly , n o d o u b t , o w in g t o th e r a p id in c re a s e in th e ir n u m b e r s a n d t o th e ir e m p lo y m e n t in m a n y fa c t o r ie s f o r th e first tim e . N o w , h o w e v e r , c o n d it io n s a re b e tte r a n d th e n e e d f o r p r o p e r p r o v is io n a n d m a in te n a n c e is g e n e r a lly r e c o g n iz e d . W h ile th e r e h a s p r o b a b ly b e e n a n im p r o v e m e n t a ls o in th e p r o v is io n f o r m e n , it is in s o m e p la c e s s t ill h ig h ly u n s a t is fa c t o r y . T h u s D r . A g n e w r e p o r t s o f th e fa c t o r ie s in o n e d is t r ic t w h ic h h e v is ite d — The appalling condition of the sanitary accommodation calls fo r immediate action. In some cases the provision is insufficient, and almost everywhere the condition o f such conveniences as are provided is so revolting that it is im possible to describe. They are also commonly situated in almost inaccessible places, the approach to which is particularly dangerous at night. C o n d it io n s su ch as th ese s h o u ld o b v io u s ly b e r e fo r m e d at th e first o p p o r t u n it y . W A S H I N G F A C IL IT IE S A N D BA T H S * 392. U n d e r th e F a c t o r y A c t a n d th e r e g u la t io n s o f th e H o m e O ffice a n d M in is t r y o f M u n it io n s th e p r o v is io n o f w a s h in g a c c o m m o d a t io n is o n ly r e q u ir e d w h e re w o r k e r s are e n g a g e d o n p r o c e s s e s in w h ic h p o is o n o u s m a te r ia ls su ch as le a d o r T N T a re m a n ip u la te d . T h o u g h p r o v is io n is m o s t n e e d e d w h e re p o is o n o u s s u b sta n ce s a re u s e d o r w h e re h e a t, d u st, o r d ir t a re p re s e n t t o a n u n u s u a l d e g r e e , th e re is a g e n e r a l a g re e m e n t th a t w a s h in g is b e n e fic ia l t o th e h e a lth a n d effi c ie n c y o f a ll w o r k e r s a n d th a t fa c ilit ie s s h o u ld b e p r o v id e d w h e r e v e r p o s s ib le . A c c o u n t m u st a lso b e ta k e n o f th e e ffe c t u p o n th e s e lfr e s p e c t o f th e w o r k e r , w h o is a b le to le a v e h is e m p lo y m e n t c le a n a n d t id y . T h e r e is th e m u tu a l d is c o m fo r t o f th e a s s o c ia tio n w it h h is f e llo w t r a v e le r s o f a m a n w h o r e tu r n s h o m e s t r a ig h t fr o m w o r k f r o m s o m e d u s ty o r d ir t y e m p lo y m e n t. L a s t ly , th e re is th e r e la tio n o f cle a n lin e s s t o g o o d h e a lth a n d p e r s o n a l e fficie n cy , a r e la tio n w h ic h is s u fficie n tly o b v io u s to m a k e e m p h a sis u n n e c e ssa ry . 188 INDUSTRIAL H EALTH AND EFFICIENCY. 393.* T h e r e is a m p le e v id e n c e o f th e d e sire o f w o r k e r s f o r a m o r e e x te n d e d p r o v is io n . T h u s a r e p r e s e n ta tiv e tr a d e s -u n io n is t sta te d , in e v id e n c e b e fo r e th e c o m m itte e , th a t— Material improvements in the arrangements for washing are desirable. It would be a great help if a worker could have the opportunity for really washing up and putting him self in a condition to go out with his fam ily without having to return home first. Anything in the nature o f evening recreation is rendered almost impossible if a worker has to travel all the w ay home, perhaps right through the city, and get cleaned up before returning to the city .with his family. 394. T h e r e p o r t s u p o n th e m e d ic a l e x a m in a t io n o f in d iv id u a l w o r k ers c o n ta in fr e q u e n t r e fe r e n c e s t o th e d e sire f o r b e tte r fa c ilit ie s . T h u s— In the bullet department there are only nine basins with cold water and nail brushes provided for 130 girls, 30 o f whom handle lead. Soap can nominally be obtained from the forewoman, and towels, conspicuous by their absence, are supposed to be provided biweekly to each o f two sets o f basins. Complaints are made by foremen that towels, etc., are stolen, and the workers complain o f lack of. accommodation. Very little washing is done, I think, although the girls had their hands jet black. In another case washing facilities are quite inadequate, workers in some departments being unable to wash their hands at all before meals, though at most processes they become very dirty. Many state that they clean their hands with oil, though they are not supposed to use oil for this pur pose ; others wash their hands in the water running from their machines. Even those who handle lead do not always wash their hands before meals ; these latter state that five minutes is allowed for washing, and that hot water is provided but no soap or towels. 395. S in c e th is r e p o r t w a s w r it t e n th e re h a s b ee n a m a r k e d a d v a n c e in th e w a s h in g fa c ilit ie s p r o v id e d f o r w o m e n , b u t th e re is s t ill r o o m f o r im p r o v e m e n t. E x p e r ie n c e sh o w s th a t w h e n fa c ilit ie s f o r w a s h in g a re p r o v id e d a n d m a in ta in e d in a d e ce n t sta te t h e y a re u s u a lly u s e d ; th e re ma}^ b e a s h o r t p e r io d o f in e r tia at first, b u t wro r k e r s h a v e n o t o n ly n o in n a te d e s ire t o b e o th e r w is e th a n c le a n , b u t s o o n b r in g in flu e n ce t o b e a r u p o n a n y o f th e ir fe llo w s w h o d o n o t a v a il th e m s e lv e s o f th e fa c ilit ie s o ffe r e d . 396. W h ile th e g e n e r a l p r o v is io n o f b a th s c a n n o t b e r e g a r d e d as a p r a c t ic a l p r o p o s a l, th e re is n o d o u b t th a t e x te n d e d p r o v is io n is h ig h ly d e s ir a b le in th e in te re s t o f h e a lth a n d efficie n cy . P r o v is io n is a t p r e s en t m a in ly lim it e d to a fe w w o r k s c o v e r e d b y th e H o m e O ffice r e g u la tio n s o r w h e re th e p ro c e s s e s in v o lv e str e n u o u s w o r k in a h ig h t e m p e r a tu re . W h e n m e n a re e m p lo y e d u n d e r c o n d it io n o f g r e a t h e a t, b a th s m a y p r o v e an e ffe c tiv e a n tid o te t o m u s c u la r r h e u m a tis m . I t is un* n e ce s s a r y t o e m p h a s iz e t h e b e n e fit a n d r e fr e s h m e n t d e r iv e d f r o m a b a th a ft e r w o r k u n d e r s tr e n u o u s c o n d i t io n s ; w h e re t h e y a re p r o v id e d th e y a re a p p r e c ia te d . T h u s a n e m p lo y e r h a s in fo r m e d th e c o m m itte e th a t-— SANITARY ACCOMMODATION, W A S H IN G . FACILITIES, ETC. 189 Spray baths are provided for the foundrymen, who number about 100. Tickets can be bought at the rate o f 10 for*3d. [6.1 c e n ts ]; this charge includes the use o f towel and soap. Seven minutes out o f working hours are allowed each man in the foundry to wash thoroughly before stopping time. Though the foundry men are not in any way specially selected they use the spray baths greatly, especially in summer. 397. T h e n e e d f o r b a th s is u n d o u b t e d ly a c ce n tu a te d b y th e lim it e d fa c ilit ie s f o r w a s h in g g e n e r a lly a v a ila b le in th e w o r k e r ’s h o m e . A r e p r e s e n ta tiv e o f th e N a t io n a l F e d e r a t io n o f B la s t F u r n a c e m e n h a s in fo r m e d th e c o m m itte e th a t n o t m o r e th a n 5 p e r ce n t o f th e m e m b e r s o f h is u n io n h a v e a h o u s e w it h fiv e o r s ix r o o m s a n d a b a th . “ I n L a n c a s h ir e a n d S o u t h Y o r k s h ir e m a n y a re l iv in g in h ou ses o f th r e e s m a ll r o o m s w it h n o s c u lle r y . C o n s id e r in g th e d ir t y sta te in t o w h ic h th e m e n ’s b o d ie s a n d c lo t h in g g e t w h e n w o r k in g , b a th s s h o u ld b e g e n e r a l.” T h e n e e d f o r b a th s is a lso m u c h fe lt b y w o m e n l iv in g in l o d g in g s , m a n y o f w h o m h a v e c o m e fr o m g o o d h o m e s. I n s o m e d is tr ic ts c o n s id e r a b le u se is m a d e o f p u b lic b a th s. U n fo r t u n a t e ly th e re a re fr e q u e n t ly n o p u b lic b a th s w it h in e a sy a ccess, o r th e y a re n o t o p e n afc h o u r s w h e n t h e y c a n b e u se d b y m u n it io n w o r k e r s . W h ile th e in a d e q u a c y o f th e h o u s in g a c c o m m o d a t io n a v a ila b le f o r h is w o r k e r s is n o t a m a tte r f o r w h ic h th e e m p lo y e r c a n o r d in a r ily b e h e ld r e s p o n sib le , y e t it is o n e w h ic h h e ca n n o t a lto g e th e r n e g le c t in d e t e r m in in g w h a t is n e ce s s a r y t o se cu re th e ir h e a lth a n d efficie n cy . WASHING FACILITIES. 398. Lavatories .— I t is o f th e g r e a te s t im p o r t a n c e th a t a tte n tio n s h o u ld b e p a id t o d e ta ils o f c o n s tr u c tio n . F r e q u e n t ly th e d e ta ils seem t o h a v e b e e n l e f t t o a b u ild in g c o n t r a c t o r w it h n o s p e c ia l k n o w le d g e o f th e h a r d u sa g e t o w h ic h fittin g s a re s u b je c te d u n d e r th e c o n d it io n s o f in d u s t r ia l l i f e ; as a r e s u lt la v a to r ie s , t h o u g h a d e q u a te w h e n n e w , m a y q u ic k ly f a l l in t o d is r e p a ir . S e p a r a te b a sin s, o r g in a lly p r o v id e d w it h p lu g s a tta c h e d b y c h a in s , a re fo u n d w it h th e c h a in s b r o k e n , th e p lu g s lo s t, a n d th e w a ste p ip e s s tu ffe d u p w it h ra g s. W a lls a g a in s t w h ic h b a sin s a re fix e d , u n less p r o t e c t e d b y a n e n a m e le d s u r fa c e , s o o n b e c o m e sp la s h e d w it h s o a p s u d s , a n d p re s e n t an u n in v it in g a s p e c t w h ic h c a n n o t b e e a s ily o r q u ic k ly im p r o v e d . W a s te p ip e s a re o ft e n t o o n a r r o w f o r c o n v e n ie n t c le a n s in g , o r c o n ta in s h a rp b e n d s a n d a n g le s, a n d c o n s e q u e n tly b e c o m e b lo c k e d o r broken . 399. S u fficie n t p r o v is io n m u st b e m a d e f o r d r a in in g th e la v a t o r y flo o r , w h ic h , i f n o t p r o p e r ly c o n s tr u c te d , b e c o m e s u n e v e n a n d th e site o f p o o ls o f d ir t y w a te r . T h e flo o r s s h o u ld b e s m o o th , h a r d , im p e r v io u s , a n d p r o p e r ly s lo p e d a n d g r a d e d . N a ilb r u s h e s a n d s o a p , ev e n t h o u g h fr e q u e n t ly r e n e w e d , d is a p p e a r , a n d th u s in v o lv e a c o n sta n t s o u r c e o f a n n o y a n c e a n d e x p e n se . T h e s e t r o u b le s m a y b e INDUSTRIAL H EALTH AND EFFICIENCY. la r g e ly o v e r c o m e b y a d h e r in g t o c e r t a in p r in c ip le s in c o n s t r u c t io n . T h e in s t a lla t io n s h o u ld b e— (a) A s s im p le as p o s s ib le in c o n s t r u c t io n a n d a r r a n g e m e n t ; ( 5 ) S t r o n g a n d d u r a b le , a b le t o w it h s t a n d c o n s id e r a b le w e a r a n d te a r; ( c) S u ffic ie n t a n d s u ita b le in a c c o m m o d a t io n s o th a t a la r g e n u m b e r c a n w a s h t o g e t h e r o r in a s h o r t t i m e ; 1 Supfib (<*) E c o n o m ic a l in s p a c e ; (e) S o c o n s t r u c t e d th a t it c a n b e e a s ily c le a n e d , a n d c o n t a in a m in im u m o f r e m o v a b le o r d e ta c h a b le a r t ic le s ; ( / ) B a s in s , i f p r o v id e d , s h o u ld n o t b e t o o s m a ll a n d s h o u ld n o t h a v e g r o o v e d r im s ; (g ) P r o v id e d w it h a n a m p le s u p p ly o f w a te r ( h o t a n d c o ld ) ; (h) S o s itu a te d in th e f a c t o r y as t o b e r e a d ily a c c e s s ib le ; a n d (i) W e l l lig h t e d , t h o r o u g h ly v e n t ila t e d , a n d k e p t a t a r e a s o n a b le t e m p e r a tu re . 4 00. a r is e in r e g a r d t o th e u se o f o r d in a r y la v a t o r y b a s in s , t h e y m a y in c e r ta in ca ses b e o v e r c o m e b y u s in g s u ch a w a s h in g t r o u g h as th a t illu s t r a t e d in fig u r e 2. H e r e th e n e c e s s a r y p lu m b in g is r e d u c e d t o a m in im u m ; t h e r e is n o p l u g ; w a s h in g is d o n e u n d e r a s p r a y o f w a t e r ; th e w a s te p ip e o p e n s d ir e c t ly o v e r th e d r a i n ; a n d th e d r a in it s e lf is flu s h w it h th e flo o r , w h ic h is s lo p e d t o w a r d it. T h e t r o u g h s ta n d s in th e c e n te r o f th e 1 T h e s t a n d a r d a d o p t e d u n d e r f a c t o r y r e g u la t i o n s is a s f o l l o w s : T h e w a s h i n g c o n v e n ie n c e s s h o u ld be u n d e r c o y e r a n d m a i n t a i n e d in a c le a n ly s t a t e a n d in g o o d r e p a ir . T h e r e s h o u ld be e i t h e r ( a ) a t r o u g h w i t h a s m o o t h , i m p e r v i o u s s u r f a c e ( f i t t e d w i t h a w a s t e p ip e w i t h o u t p l u g ) , a n d o f s u c h l e n g t h a s t o a l l o w a t l e a s t 2 f e e t f o r p e r s o n s , a n d h a v i n g a c o n s t a n t s u p p ly o f w a t e r f r o m t a p s o r j e t s a b o v e t h e e v e r y fiv e tro u gh a t i n t e r v a l s o f n o t m o r e t h a n 2 f e e t ; o r ( b ) a t le a s t o n e l a v a t o r y b a s in f o r e v e r y fiv e p e r s o n s , f it t e d w i t h a w a s t e p ip e a n d p lu g , o r p la c e d in a t r o u g h h a v i n g a w a s t e p ip e , a n d h a v i n g e it h e r a c o n s t a n t s u p p ly o f h o t a n d c o ld w a t e r o r w a r m w a t e r la i d o n , o r ( i f a c o n s t a n t s u p p ly o f h e a t e d w a tfc r be n o t r e a s o n a b ly p r a c t i c a b l e ) a c o n s t a n t s u p p ly o f c o ld w a t e r la i d o n , a n d a s u p p ly o f h o t w a t e r a l w a y s a t h a n d w h e n r e q u ir e d f o r u s e by p erson s e m p lo y e d . SA N ITARY ACCO M M OD ATION , W A S H IN G FA C ILITIE S, ETC. 191 room* free from the walls, and the wall space can be used for cloak room accommodation, whether hooks or lockers. A useful modificatoin of the water supply is to hare only two spray taps for occasional use and a series of flush holes in both sides of the water pipe, the suppfy to which is controlled by a cock on the far side of the taps. This cock is turned on just before the operatives come to wash at the close of each spell of work. Arrangements can be made for control ling the temperature of the water. Where space is limited, say near the exit of a big engineering shop, a more compact installation may be used. This may take the form of a large circular basin with spray taps radiating from a central supply pipe coming down from above and with an open pipe in the center for carrying off the w^aste water to a drain in the floor, as shown in figure 2. Wherever spray taps are used, advantage is gained by so arranging the height and position of the taps that a douche bath for the head, neck, and arms can be taken if desired. 401. Nailbrushes.— The difficulty occasioned by the disappearance of nailbrushes may be overcome by having large brushes made and fixed in position so that they can drain into the trough. In use the hand is rubbed against such brushes instead of the usual reverse process. In a number of factories stout nailbrushes are provided attached to the washing troughs by chains; and, on the whole, this plan appears to work satisfactorily. 192 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . 402. Soap.—Soap may be supplied economically in small boxes, kept locked and fixed in convenient positions above the trough, say on or near the water pipe; the soap, of the consistency of butter or jelly, is obtained by inserting a finger into a round hole in the bottom of the box. Soap for use in this way can be obtained in powder form,1 which sets to a jelly on the addition of water; by buying soap thus in powder form the cost of carriage is diminished. Alterna tively the soap may be served out as powder placed in a flour dredger chained to the trough. If this latter plan is adopted care must be taken to prevent the holes getting clogged with wet powder. Another plan is to make the powder into blocks and then to cut it into small cubes just sufficient for one “wash.” One point, however, should be borne in mind—the natural oil of the skin and hair may be removed by the use of strong alkaline soaps; if such soaps are used, as may be necessary to cleanse hands soiled with oil and grime in engineering works, then some ointment, glycerine, or lanoline should be employed after washing to restore the suppleness of the skin. Without this precaution the skin may become dry and cracked, and so be unable to resist bacterial infection, when dermatitis results. 403. Towels.—The supply of clean, dry towels should be adequate; for this purpose it is desirable that (a) a towel at least 5 square feet in area should be provided for each worker, and should be renewed or washed daily; or (h) one roller towel fastened in position, at least 15 square feet in area, should be provided for every three workers, and should be renew or washed daily; or should be provided for every nine workers, and should be washed or renewed after every mealtime and at the close of the day’s work.2 The provision of separate towels is preferable, and is made in na tional filling factories, partly because the danger of infection is mini mized, and partly because each worker thus obtains a dry towel. They should be numbered or otherwise separately marked. 404. Mirrors.—A mirror is desirable, especial^ for women. BATHING FACILITIES.* 405. Baths.—For men, the simplest and at the same time the cheap est and most efficacious installation is that of shower or douche baths. In comparison with other types, a shower bath economizes space, time, and water, and possesses the advantage that the stream of water is constantly clean. Moreover, the stimulating effect on the skin of the falling water is greater than is obtained by total immersion. Douche baths have been strongly recommended for use by coal miners, 1 Such soap is prepared by Messrs. Lever Bros., Port Sunlight, Cheshire. 2 These suggestions are identical with the requirements of the Ilome Office order for the manufacture and decoration of pottery. 3 Reference may usefully be made to the report of the departmental committee on washing and drying accommodation at mines. (Cd. G724, 1913.) SA N IT A R Y ACCO M M O DATION , W A S H IN G FA C ILITIE S, ETC. 193 and have been installed with success in many factories (see figs. 3 and 4). For women, ordinary shower baths are unpopular, because of the difficulty of keeping the hair dry or of drying it after bathing; a horizontal spray fixed at the level of the shoulders, or obtained from a movable nozzle or ring on a flexible tube, may meet this ob jection. Such an arrangement may also be found preferable for men. 406. Cubicles.— The cubicles in which the baths are placed should be arranged to secure privacy. In order to reduce the time which each worker spends in the cubicle it may be possible to arrange for the workers to dress and undress in a separate compartment, but at any rate in the case of women some provision for dressing, includ- FIGURE 3.1 ing a seat and pegs, must be provided inside the cubicle. Where this is done the size of the cubicle should not be less than 3 feet wide by 4 feet deep. The walls should ordinarily not be less than 6 feet high. A space should be left between the floor and the walls of the cubicles sufficient to permit of drainage and cleaning. 407. Cleaning.— The building and fittings should be so constructed as to facilitate the maintenance of absolute cleanliness. Square cor ners, ledges, or rough inner surfaces should be avoided. Wood should be used only for seats, and for this purpose hard wood should be em ployed with spaces between the wood for ventilation. The walls and partitions (and this applies also to lavatories and sanitary con veniences) should always have smooth and curved surfaces which 1 From a design by Messrs. Doulton & Co. 80935°— 19------- 13 194 IN D U ST R IA L H E A L T H AN D E F F IC IE N C Y . can be readily washed down and which can not be used for writing on. Enamel tiles and bricks or enamel metal sheets may be used for this purpose; any initial cost thus incurred is soon recouped by sav ing in cleaning and lime-washing. 408. Water.— The water used should, of course, be clean and should not be liable to cause injury to the health of the workers or to yield effluvia. It will generally be found preferable for the temperature of the water to be regulated by an attendant rather than for the tem perature of each bath to be regulated separately by the worker. A temperature of about 100° F. is usual. A thermometer should be placed in a con venient position for noting the tempera ture of the water. 409. Soap and tow els. — A simple and economical method of supplying soap is to provide small tablets sufficient for one bath. A convenient size for towels is 25 by 60 inches. W h en the baths are used by a large number of FIGURE 4.1 workers it may be found convenient and economical to provide a small laundry for washing the towels. MAINTENANCE. 410. The maintenance of any installation provided is as important as its construction. This should be made the definite duty of an appointed officer, who should keep the lavatory clean, control the supply of nailbrushes and soap, and arrange that dry, clean towels are available. Such an officer may also usefully be employed in at tending to the sanitary conveniences, and in supervising the cloak room. While the ultimate responsibility for upkeep must rest with the employer,^ it may be found, at any rate in the case of baths, that the worker can, with advantage, be encouraged to participate in the management by a special committee or otherwise. Since periodic baths are of special benefit to health and efficiency, it is desirable to allow workers time for bathing within working hours. 1 From a photograph taken in a munition factory. SAN ITARY ACCOMMODATION, W A S H IN G FACILITIES, ETC. 195 CLOAKROOMS. 411. The committee are strongly of opinion that the provision of cloakrooms is a matter of great importance to the health and comfort of workers, and especially of women and girls. If, however, full advantage is to be taken of them it is essential that they should be well equipped and adequately maintained. 412. Cloakroom accommodation in order to be satisfactory should comply with the following conditions: (a) It should be conveniently situated not only for the workshop, but should also be close to the canteens, lavatories, and sanitary accommodation. ( b ) It should provide a separate peg or locker for each worker, which should bear the worker’s name or work number. Hanging pegs should be at least 18 inches apart, and 24 inches is desirable; and may be usefully separated by a small partition. I f economy of space is of importance, two horizontal row s of pegs may be provided about a foot apart, the pegs in each row being at least 24 inches apart, and the pegs in the lower rowr being placed midway between those in the upper row. Lockers may be made in metal openwork in preference to wood to allow free circulation of air. Another alternative is to arrange for the suspension, of the clothes from the roof of the building by rods which can be raised to the roof and fastened securely in position. (e) There should be ample space for changing clothes and boots. ( d ) Provision should be made for drying wet outdoor clothes in bad weather as well as the clothes worn for work at certain processes. Steam pipes placed under the hanging pegs or lockers have proved useful for this purpose; care must, however, be taken, otherwise the damp clothes steam and become more objectionable than if spread out in the open air and allowed to dry. Ample space and ventilation are required between the pegs or in the lockers. Where pegs are used the clothing should not hang against a w all or wooden partition, but provision should be made for ventilation behind the clothing by covering the walls with laths or strong wire netting so that the clothes are kept at least an inch from the wall. (e) A high standard of cleanliness should be maintained, and all practicable precautions should be taken against vermin. (/) Cloakrooms should be thoroughly ventilated. (g) Cloakrooms should be in charge of an attendant, and means taken to prevent petty pilfering and theft, SECTION XVI.— SEATS, WEIGHTS, CLOTHING, DRINKING WATER. 413. The committee have not made any detailed laboratory study of methods for eliminating fatigue in regard to industrial machinery, lifting tackle, motion, etc., or of the application of American schemes of “ scientific management5? to factory conditions in this country. They have regarded such studies, important though they are, as lying outside their reference. There are, however, certain matters intimately affecting the health and efficiency of the worker to which some brief reference should be made. SEATS. 414. Fatigue and ill health and consequent loss of time and output are often due among women and girls to prolonged standing. The following extracts from recent reports emphasize the point: Women here are* employed on 30 different processes on lathes, milling and drilling machines, chiefly on shells weighing 130 pounds in the rough and 90 pounds when complete. Certain operations, e. g., nose blending, are difficult and arduous. * * * W hat renders the operations most trying is the lack of seating accommodation. Many of the women and girls complained that they could not sit down even when waiting for work, as no seats were provided and they were not allowed to sit. One chair in the welfare supervisor’s room is supposed to be for girls’ use, but they have never used it. At night this room is locked up and a girl who is taken ill has to sit on a chair in the cloakroom until it is light enough to go home. 415. The Factory Act does not require seats to be provided for workers such as is the case for shop assistants under the Shops Act, 1912, but the secretary of state has now power under the Police, Fac tories, etc. (Miscellaneous Provisions), Act, 1916, section 7, to make an order requiring an employer to make reasonable provisions for u the supply and use of seats in workrooms.” No order 1 has as yetbeen made under this section, but in a general order made in December, 1916, governing the employment of women at night on wool combing a condition was inserted that “ the employer shall provide suitable 1 On Apr. 23, 1918, the Home Office published a draft order requiring the provision of facilities for sitting for all female workers employed in any process in turning or machining shells or shell bodies. 196 NO. I.— FOLDING SEAT TO SCREW TO WAL L OR PARTITION. NO. 2.— SWING SEAT TO SCREW TO LEG OF TABLE, AND WHEN NOT IN USE TO SWING UNDER TABLE. NO. 3.— SWING SEAT WITH IRON PILLAR SUPPORT TO SCREW UNDER TABLE IN AN Y POSITION, AND W H EN NOT IN USE TO SWING UNDER TABLE. 1 TYPES OF PROTECTIVE CLOTHING 197 SEATS, W EIGHTS, CLOTHING, DRINKING WATER. 197 seats for the use of women and © girls at times when their work is not in need of attention.” 41G. Though opportunities for sitting are being provided to an increasing extent there are still a number of employers who hesitate to provide such facilities through fear that they will be abused. Experience, however, can not be regarded as justifying this fear. It should be explained that the object of the provision of seats is not to secure that all work should be done seated, since a sedentary life has its own disadvantages, but rather that means should be provided for varying the position wherever possible and for occasional use when the work necessitates a standing position. There are many types of munition work in which for a considerable proportion of her time the worker is simply standing by watching her machine, which she could do sitting equally well. In almost all the munition work which must be done standing pauses occur while the worker waits for the readjustment of the tool or some slight repair or is held up for material or for some other reason. During such pauses the workers should be allowed to sit. The need for such seats is often felt more at night than by day. Much ingenuity has been shown in providing seats which occupy little space. At the machine it is often practicable to fix a seat or bar at the side of the lathe ; a flap seat attached to the wall or pillar; a leather strap may be hung between the machines or other fixtures; or a suitable form of high stool pro vided for use while at work with or without caster wheels. 417. The intervals between spells of work should be times of real rest and recuperation. This can not be obtained on the wooden forms without backs in canteens or mess rooms, which are too often the only seats provided. Forms with backs or chairs are generally much to be preferred. In addition comfortable chairs for women who may be overtired or faint should be provided, preferably in a rest room adjacent to the surgery. A brief rest under the supervision of the nurse frequently enables a woman or girl to return to work recuper ated for the remainder of the spell. WEIGHTS. 418. Admittedly women and young persons are physically weaker than men. Apart from this they are more liable to strain from the lifting of weights and other analogous operations which involve sudden muscular efforts. The matter is one of special importance at the present time owing to the large number of women now em ployed in munition works and the rapidly increasing extent to which they are being employed to replace men on “ heavy ” operations. The following tables are of interest as conveying some indications of the 198 IN D U ST R IA L H E A L T H AN D E FF IC IE N C Y . amount of the weights handled in certain operations connected with the manufacture of 18-pounder and 4.5-incli and 6-inch shells: Operation. 18-pounderhigh explosive shell, Mark III: Finish recess.............. Turn band................. Faee base to weight... Thread mill................ 4,5-inch high explosive shell,Mark VII: Center......................... Base to length............ Faee t© weight and rough recess base... Approxi Output of mate shells per weight hanlathe per died by hour. operator per hour. 60 48 40 30 Pounds. 1,S07 1,466 1,197 889 60 24 2,840 1,686 18.4 1,012 Operation. Approxi Output of mate shell? per weight han lathe per dled by ~ operator hour. per hour. 4.5-inch high explosiveshell, Mark VII—Contd. Face base................... Turn band................. Thread mill................ 5.6-inch high explosive shell, Mark XII: Cut-off........................ Center......................... Rough face base......... Recenter..................... Turn band................. Thread mill................ Pounds. 2,59? 1,850 1. (>50 3.000 6.000 3.195 6,120 4,014 5,040 419. The framers of the tables give the following explanation in regard to them: The weights on which the entries in coininn 3 are based were obtained by actually weighing each shell before and after each operation in a typical factory. The entries given were obtained by adding the weights of the shell before and after each operation and multiplying by the number of shells turned out per hour. The actual amount of work done in handling these weights depends upon the methods employed. These methods vary in different factories with the opera tion and the type of shell. In some cases the heavier shell are only handled by men, laborers lifting the shell in and out of the lathe for the girls; o;: lifting tackle of one type or another may be provided. Sometimes also there are tables along which the shell may be rolled so as to obviate the necessity for lifting the shell from the floor to the lathe at each operation. A detailed inquiry into the . methods prevailing at individual factories would be necessary in order to calcu late the actual work done in each case. As an illustration: The work done per hour in lifting the shell bodies from the floor to the lathe (assuming no lifting tackle to be provided and the height of the lathe from the floor to be 3.5 feet) for the operations of centering and boring is given below. [Foot-pounds per liour.J Shell. 18-pounder .............................................. ........................................................... ..................... .. Boring. 350 367 902 Centering:. 8 ,8 6 4,<T0 10,500 420. As the result of his inquiries into the causation of industrial accidents Dr. Vernon writes as follows in regard to the incidence of accidents due to strain: At factory A the cuts, burns, and eye accidents were only a fourth to twothirds as numerous in women as in men. This depended on the less risky SEATS, W E IG H T S , C LO T H IN G , D R IN K IN G W ATER. 199 character of their work. The sprains, on the other hand, were 47 to S3 per cent more numerous in the women than in the men, or taking the other acci dents as a standard, one may say that sprains were relatively three times more numerous in the women than in the men. The majority of these sprains were wrist sprains incurred in pushing home the lever which clamped the fuse part in the lathe. Evidently this clamp was designed for men with stronger wrists, and it would be quite easy by lengthening or otherwise altering it to make it more suited to the weaker wrists of the women. Thereby a considerable num ber of these sprains would be prevented, and a by no means negligible amount of wrasted time be saved. In that the work at factories B, C, and D was very similar in character, one would expect to find similar ratios between the women’s and men’s accidents. The sprains were nearly twice as numerous in the women as in the men at factories C and D, where 9.2-inch and 15-inch shells were made and showed a similar excess at factory B where 6-inch shells were made. Hence, it is probable that the liability of women to sprains is inherent and can not be altogether avoided by more suitable mechanical appliances. 421. Apart from the provisions of the employment of children act, 1903, which only apply to children up to the age of 14, there are no legislative provisions imposing restrictions on the weights which may be lifted by workers. The matter was considered by the de partmental committee on accidents, who reported— The danger of internal injuries to women from lifting heavy weights is a matter of great importance. To lay down, however, any detailed and definite provisions on the subject seems impracticable, as so much depends on indi vidual cases and circumstances. The position in which the weight to be lifted lies, the shape of the burden, the manner of carrying it, the place in which it has to be carried, are all important factors. We suggest, however, that there might be some advantage in a general provision with regard to women similar to the provision in section 3 (4) of the employment of children act with regal'd to children. A provision that a woman shall not be employed to lift, carry, or move anything so heavy as to be likely to cause her injury might be useful, chiefly, perhaps, in calling the attention of occupiers to the matter and strengthening the hands of inspectors when dealing with cases in which they judged women liable to injury from this cause. 422. The Home Office, however, in their general order of Septem ber, 1910, prescribed that “ a woman or young person should not be allowed to lift, carry, or move anything so heavy as to. be likely to cause injury to them.” The weight which can safely be lifted de pends not only on the physique of the worker but on the position in which the weight lies, its shape, the manner of carrying it, and the place to which it has to be carried. Again, much depends on the acquisition of knack. Given, however, reasonable conditions and a good physique, women and girls over 18 have been found able to handle weights up to 50 pounds in the ordinary course of work with out difficulty. Such a weight would, of course, be too great for women of less than normal strength, or if the weight is of awkward bulk or has to be raised to a special height. 200 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . 423. I f weights are properly adjusted to physical capacity, experi ence suggests that a woman can frequently perform as much work as a man owing to her capacity for quicker movement and sustained work. In order to prevent strain and to secure the best results attention should be paid to the following among other points: (a) Adaptation of the size and shape of the burden. (b) The provision of labor-saving appliances, such as overhead cranes or inclined planes. (c) The size and shape of boxes, trolleys, or other receptacles and vehicles. (d) Long handles and other methods of reducing leverage. ( e ) Methods of reducing the height through which weights have to be raised—e. g., by the provision of benches for the temporary storing of shells by the machine. (/) Instruction in the knack of lifting weights. (g) Limitation of hours of employment. (A) Careful selection of workers. 424. If adequate attention is paid to these points experience shows that dangers of straining can be very largely obviated. As showing what may be done the following report is of interest: Women are engaged in making and finishing crucibles. The heaviest han dled by one woman alone weighs 57 pounds. Lifting is intermittent, occurring in the intervals of manufacturing work. The girls have been carefully chosen for their good physique and appeared to lift the crucibles with complete ease. TIius of one factory it is reported that “ the forewoman took pains to instruct the girls in the right way of handling the heavy ‘crucibles. She said some re quired considerable instruction howTto carry, as they often began by attempt ing to do the whole work with their forearms and wrists, bringing no other muscles into play and consequently quickly exhausting themselves, but practice soon helped them over this difficulty. If a girl could not acquire the knack of right handling she hurt herself and injured the crucibles and was taken off that work.” PROTECTIVE CLOTHING. 425. For women and girls protective clothing is essential where risk to health is involved from— (a) Dust, dirt, or wet. (b) Acid burns. (c) Dangerous machinery. (d) Work involving climbing. (e) Exposure to excessive heat. (/) Exposure to inclement weather. 426. Protective clothing is desirable for all women and girls. It adds to their smartness and neatness, and so to the general appear ance of the factory. It also aids discipline and promotes esprit de corps. 3 4 TYPES OF PROTECTIVE CLOTHING. 200-1 TYPES OF PROTECTIVE CLOTHING. 7 8 9 10 11 12 TYPES OF PROTECTIVE CLOTHING. 13 14 15 16 17 TYPES OF PROTECTIVE CLOTHING. 18 SEATS, W E IG H TS, C LO TH IN G , D E IN K IN G W ATER. 201 427. There are four main types of costume1— (a) The overall dress, for general factory wear (see illustrations Nos. 1, 6, and 15). (b) The trouser or knicker suit with tunic, for outdoor work, climbing ladders, etc., or for very dirty work (see illustration No. 11). These suits are not suitable for machine workers as the ends of the tunic are apt to catch in the machinery. (c) The boiler suit, for dangerous work where close-fitting clothes are essential for safety (see illustrations Nos. 14 and 18). (d) The impervious apron and bib, worn with either the overall dress or the trouser suit, for protection against wet, oil, acid, or the wear and tear of friction (see illustrations Nos. 5, 7,13, and 16). 428. With the costume a cap should be worn for protection against dust and dirt, for safeguarding the hair from dangerous machinery, and for keeping the head dry out of doors. Accessories, such as globes, veils, clogs, or respirators, are also necessary in the cases of certain processes, especially where there is a risk of fire or of poison ing from dust or fumes. 429. The proper selection of materials is important. Woolen ma terials are less inflammable and more durable than cotton, but for general use cotton materials such as drills, dungaree, or (when thin material is required) jean or linen are suitable. For resistance to moisture good waterproof cloth, oiled or American cloths, are ob tainable. Aprons can be obtained of these materials, also of rubber or leather. Sound acid-resisting materials can be had for aprons, leggings, and clogs, also oil-proof materials for protecting machinists from the lubricating oil which penetrates ordinary clothing. For outdoor wear in wet weather a mackintosh or perhaps preferably a good woolen coat, trousers, and sou’wester hat, with leggings and strong boots are frequently provided. A corduroy suit is also suit able for all weathers, and is very durable. In some cases a mackin tosh coat to wear over the cotton drill trouser suit may be enough. In explosive factories (except national factories) the clothing must be approved by the chief inspector of explosives at the Home Office, who supplies particulars respecting materials and fireproofing. The Min istry of Munitions give advice for other explosive and filling factories. 430. Protective clothing for men and boys is equally important, especially when they are engaged in processes involving exposure to dust, dirt or wet, acids or alkalis. 1 These types of costume are illustrated and described in the Ministry of Munitions Journal for May, 1917, pp. 183, 184, as well as in a special leaflet issued by the ministry with the concurrence of the Home Office ; this leaflet contains particulars of various types of costumes, gloves, boots, etc., which can be purchased through the explosives supply department, 37-41, Old Queen Street, Westminster, S. W. 1. A memorandum on Protective Clothing for Women and Girls has been issued by the Home Office, illustrating different types of costume; a schedule is added stating in detail the type of costume suitable for different types of employment. The memorandum may be purchased through the usual channels. 202 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . 431. Protective clothing should be provided by the employer. The cost of caps and overalls (within a maximum limit of price), at the rate of two to each woman worker, is allowed as a working expense for the purposes of Part II of the munitions of war act, 1915, and the rules thereunder. The employer should also be responsible for wash ing, mending, and renewing the clothing. DRINKING WATER. 432. The committee consider it unnecessary to elaborate the reasons why an adequate supply of good drinking water should always be available in the factory. The following extract from a recent report issued by the United States Public Health Service is of interest: Since so much body water is lost under conditions which provoke free perspira tion, it is important that an ample amount of water be drunk to replenish the tissues thus deprived of their normal water content. Without this, their proper functions will be hampered and health and efficiency can not be expected.* The worker should be furnished with an abundant supply of water, together with drinking facilities which are clean, attractive, and placed so as to be conven iently accessible at all times. The water should never be below 53° F. in tem perature, as the drinking of cold water is likely to cause gastrointestinal dis orders. The jet sanitary fountain is the best drinking facility. Though under ordinary conditions the amount of heat lost in bringing the temperature of water up to that of the body is small, this amount, by judicious drinking, can be in creased, Water should be drunk in small quantities and at frequent intervals, not in large quantities at infrequent intervals.1 433. An order2 has recently been made by the Home Office under the Police, Factories, etc. (Miscellaneous Provisions), Act, 1916, sec tion 7, under which, in all factories and workshops in which 25 or more persons are employed, provision shall be made at suitable points, conveniently accessible at all times to all persons employed, for— (a) An adequate supply of wholesome drinking water from a public main or from some other source of supply approved in writing by the local authority of the district in which the factory or workshop is situated, which shall be either laid on or contained in a suitable vessel; ( b ) (Except where the water is delivered in an upward jet from which the workers can conveniently drink) at least one suitable cup or drinking vessel at each point of supply, with facilities for rinsing it in drinking water. 434. Each drinking water supply shall be clearly marked “ Drink ing water.” All practicable steps shall be taken to preserve the water and vessels from contamination. 1 P u b li c H e a lt h R e p o r t s , is s u e d w e e k ly b y t h e U n it e d S t a t e s P u b l i c H e a lt h ▼ol. x x x i i , N o . 5 0 , D e c . 1 4 , 1 9 1 7 . W a s h i n g t o n : G o v e r n m e n t P r i n t i n g O ffice . * S t a t u t o r y r u le s a n d o r d e r s , 1 9 1 7 , N o . 1 0 6 8 . S e r v ic e ; SECTION XVII.—WELFARE SUPERVISION FOR WOMEN AND GIRLS. THE NEED. 435. The war, and all the novel and strange conditions which it has created, has served to give a new perspective to many social prob lems, and to none more than to the problem of improving and main taining the health of the industrial worker. The problem has many aspects, all of which have a direct or indirect bearing on the em ployee. There is the health of the infant and its mother, of the school child, and of the adolescent and adult worker. Regard must be had to mental good health as well as to physical. Apathy, lassi tude, lack of interest in life may be as detrimental as physical ail ments and defects and may equally involve an irreparable loss of efficiency. There is need not only for improved physical strength and power of endurance, but also for mental alertness, the development of individuality and the capacity for wise citizenship. 436. The committee are satisfied that the interests of employer and employed are in this respect identical. Apart from physical and mental health, the worker can not earn a sufficient livelihood or rightly use and enjoy its proceeds. Equally, the prosperity of indus try is dependent upon the health and efficiency of the worker. Though the employer can not, as a rule, directly control some of the conditions, such as housing, that affect the welfare of his workers, there is yet much that he can do to improve and humanize the con ditions of their employment. (a) Preceding sections will have shown that the provision of a thoroughly satisfactory environment largely depends upon the initia tive of the individual employer. Legislative enactments and statu tory regulations, valuable though they are, can only prescribe minima. They can not take account of the varying circumstances of individual factories. (b) Certain provision, e. g., of canteens, overalls, cloakrooms, lavatories, or first-aid appliances, may be of material benefit. (r) Even though the provision is adequate and sufficient^ constant care and attention on the part of the management are essential for effective maintenance. Though Government inspection can do much, it is necessarily intermittent and can not be sufficient in the presence of apathy or neglect on the part of the employer or workers.. (cl) Regard must be had to the individuality of the workers and to the wide variations that exist in their physical and mental capac ity and in their social circumstances and habits. 203 204 IN DU STRIAL H E A L T H AND E FF IC IE N C Y . ( e) Conditions of work may exist which are prejudicial to the health of certain sections of workers in the factory on account of the heaviness of the work or the conditions under which it is carried on. Partly on these grounds a wage s3^stem, though generally equitable, may cause unexpected hardship to particular individuals. (/) Conditions prejudicial to health may arise through the exist ence of circumstances, causing avoidable irritation or discomfort either to the whole body of workers or to certain sections of them. (g) The surroundings of the worker outside the factory also call for consideration. Account must frequently be taken not only of conditions of housing and transit, but also of circumstances peculiar to the social or family circumstances of individual workers. 437. As has been pointed out in Section II, it is no new phenome non to industrial life in this country for employers to desire the pro motion of the health and w7ell-being of their workers, not only be cause such action may be profitable to themselves as wrell as for their workers, but because they recognize the right of the worker, as a fel low citizen, to be regarded not as a machine, but as a human being possessing an individuality of his OAvn. Under modern industrial conditions the employer usually has neither the time nor, frequently, the experience to give the requisite personal attention to the many and complicated problems affecting the health and welfare of the workers. There has, therefore, been an increasing tendency, notably where women are employed, to appoint an officer specially for the purpose. This officer is generally designated “ welfare supervisor” or “ welfare superintendent.” The idea underlying such appoint ments is not a new one, and it is of interest to note that in the sum maries of the evidence given before the royal commission 0 11 labor, which was appointed in 1892, attention is drawn to the importance of securing a good moral tone among women workers. It is added— In those cases where women overlookers or forewomen can be employed diffi culties of this nature were obviated; hence, when this is possible, it was said to be a very desirable arrangement. Even where this is not possible, however, it was suggested that in all cases where a certain number of women are em ployed there should be a woman in a position of authority to whom all com plaints concerning officials, health, sanitary arrangements, etc., can be brought in the first instance. The very natural dislike of women to approach men on these subjects was constantly brought forward by the witnesses. Were some carefully chosen woman put into this responsible position much of the danger and discomfort which is unavoidable under the present state of things would be removed and some of the chief difficulties connected with the employment of women would also disappear. This system is already adopted in a few of the best-regulated establishments. 438. Previously to the war, however, appointments of welfare supervisors were comparatively rare and wTere practically confined to so-called model factories or particular industries. W ELFARE SUPERVISION FOR W O M E N AND GIRLS. 205 439. For the reasons given in Section IV, the stress and strain of the war have tended greatly to emphasize the importance of atten tion to all matters affecting health and welfare of women and ado lescents. The appointment of the committee in September, 1915, afforded in itself striking evidence of the recognition by the State of the fact that it was a matter of national concern to secure that the personal health and physical efficiency of the worker were so safe guarded as to prevent not only immediate breakdown but permanent injury in the future. The employment of women in new industries, the number of women engaged for the first time in engineering works, their frequent employment in places remote from their own homes, and the increasing occupation of married women and young girls, have raised urgent problems which can not be neglected or overlooked. On the other hand, many of these problems could not be dealt with through the ordinary channels of factory manage ment—at any rate, under war conditions—and special provision was necessary if the true causes of disability and discontent were to be ascertained and removed. 440. Such were the circumstances which led the committee in their memorandum No. 2 (Welfare Supervision),1 which was pre pared in January, 1916, to recommend that welfare supervisors should be appointed in all factories where women were employed. They recognized the risk involved in the rapid appointment of large numbers of persons of varying qualifications for the perform ance of new and largely undefined duties, but the urgency of the need made this inevitable. The policy recommended was that adopted by the welfare department shortly afterwards established at the ministry. The appointments of welfare supervisors have been made compulsory in all factories where TNT is used and have been actively encouraged in all munition factories. In this policy the committee had the cordial cooperation of the Home Office, who only permit women and girls to be employed at night where a wel fare worker or a responsible forewoman has been appointed for their supervision. As the result, several hundreds of women welfare supervisors have been appointed during the past two years. STATUS AND DUTIES OF WELFARE SUPERVISORS. 441. While the opportunities of useful work open to a welfare supervisor may be almost unlimited and can not in all directions be clearly defined, experience shows that it is essential that welfare supervisors should possess a recognized status and equipment and should have certain specified duties,2 and, further, that they should 'C d . 8151. * A p a m p h le t o n D u t ie s o f W e l f a r e S u p e r v is o r s f o r W o m e n h a s b e e n is s u e d b y t h e M in is t r y o f M u n it io n s (s e e A p p e n d i x J ) . C o p ie s c a n b e o b t a in e d o n a p p li c a t io n t o t h e m in is t r y . IN D U ST R IA L H E A L T H A N D E FF IC IE N C Y . be €lirectly responsible to the general manager, should act on in structions received from him and should refer to him direct on all questions of difficulty. 442. Before setting out the various duties which may be assigned to welfare supervisors, it may be well to enter a caution against certain, misunderstandings which are liable to arise as to the aim and purpose of welfare supervision. In the first place, it will per manently succeed only in so far as it receives the support of the employer and employed alike, and it will fail in so far as any en deavor is made to conduct it in a spirit of patronage or superficial philanthropy. Secondly, any scheme of welfare supervision must be based on an adequate w^age system. Without this failure is in evitable. Thirdly, welfare supervision is not intended to and can not replace trades-unionism. Welfare supervisors,, if they are to be successful in removing adverse conditions, must be in sympathy personally with the workers and able to keep the employer informed of their circumstances and desires, both individually and collectively. They must not, however, interfere with the work of the trades-unions; they are* after all, the servants of the employer and can not as such be accepted as the authorized and official representatives of the work ers. even as regards matters which aifect only tlie conditions in the particular factory in which they are employed. Lastly, wTelfare supervision must not be regarded as in any sense a substitute for factory inspection by the State, whose duty it is to secure an agreed minimum of sanitation and safety in all factories equally and to en force a standard of hours and of intervals. 443. What duties are allotted to any particular supervisor will depend to a considerable extent upon the circumstances of the fac tory and upon the age, circumstances, and characteristics of the workers. They will also in some measure vary with the capacity and status of the supervisor. The following include the principal duties which have been successfully undertaken in different factories: 444. (a) Engagement of workers.—The selection of women work ers as regards their general suitability should be undertaken by the welfare supervisor, persons to be employed in a particular depart ment being if necessary subsequently chosen by a foreman or other person responsible for the work from a technical standpoint. When workers are medically examined the supervisor should be informed of any physical conditions likely to affect their w'ork. Whatever their exact duties in these respects may be, supervisors should always have an early opportunity of getting into touch writh a new worker in order from the first to establish those personal relationships upon which the success of her work largely depends. A few words of friendly conversation may be of great assistance in making the new W ELFARE SUPERVISION FOR W O M E N AND GIRLS. 207 workers appreciate the aim and the purpose of the work and in familiarizing them with their strange surroundings. 445. In the case of women and girls it is also important that the supervisors should be consulted as regards the character and general suitability as distinct from the technical qualifications of candidates for appointment as overlookers or forewomen. 446. (b) Records.—A record should be opened for each new worker containing information as to age, physical condition, home circumstances, etc. To this record should be added from time to time details of progress, ill health, broken time, and other matters likely to prove of value. Apart from their immediate purpose, such records may prove of material assistance in determining the suita bility of the worker for other employment after the war. 447. (c) Lost time, sickness, low output, incapacity.—All such cases should be reported to the supervisor, whose duty it should be to investigate the causes, and, where practicable, to take steps to remove them. Experience has shown that abnormally slow" work may be due to laziness, unsuitability or incapacity, and ill health, 448. (d) Wages.—Though the supervisor has no responsibility for fixing the wages, she should receive particulars of the wages earned by all workers, or, at any rate, by all those who fall below a certain level. The amount of the wage may afford a valuable indication of the progress of the worker. Further, low wages mean low output, and it is obviously important that the causes should be ascertained in each case. Low wages may be due to illness, fatigue, slackness, unsuitability of the worker for the job, difficulties of housing and transit, home troubles, and sometimes the inequitable operation of the wage system. 449. (e) Dismissals or withdrawals.—It is a common experience of industrial firms that large numbers of workers leave work for various reasons within the first few months of their employment.1 This leakage represents a serious loss of efficiency, and all cases should be investigated by the supervisor. Departure may be due to ill health, change of residence, or marriage, or it may be due to general dissatisfaction, dislike of work, disappointment over wages, or a simple desire for change. Cases of proposed dismissal in par ticular should be carefully investigated in order to determine the real causes of trouble and to remove possible misunderstandings. 450. (/) Working conditions.— Supervisors should always be inti mately acquainted with the working conditions in the factory (e. g., hours of work, wages, ventilation, heating, seats, lavatories, rest rooms and cloakrooms). Any complaints or representations should be fully and promptly investigated. In some instances the remedy 1 See Appendix D. 208 IN D U ST R IA L H E A L T H AND E FF IC IE N C Y . for defects may lie within their competence. More often it will be their duty to bring them to the notice of the general manager or other officers, according to their nature or importance. These duties are fundamental, and the evidence shows that if wisely performed they do not, as has sometimes been feared, in any way undermine the authority of the foreman or other officials. 451. (g) General discipline.—As a rule the welfare supervisor is only responsible for the good conduct of the workers apart from their technical work; though she is free to visit the shops to super vise general behavior and to speak to individual workers, she is mainly concerned with maintenance of the necessary standard of conduct in the cloakrooms and lavatories, when going to and from the shops, and at meal times. 452. ( h) Night supervision.— Specially close supervision of wo men and girls is needed at night, owing to the strain of the night shift and on moral grounds, and it should form an important duty of the welfare supervisor. Ordinary factory oversight is often more difficult at night than during the day and may become somewhat lax. 453. (i) Home visiting.—Where necessary and desirable, home visiting may be undertaken. Workers who are ill may be visited in order to ascertain that they are properly cared for—a matter often of considerable difficulty in crowded areas. Apart from this, visits may usefully be paid to the parents of the younger girls and the opportunity taken to discuss with them the merits and progress as well as the demerits of their children. Misunderstandings as to wages can be removed. Parents as a rule greatly appreciate periodi cal reports as to progress, conduct, and timekeeping. Minor offenses by girls can sometimes be better dealt with by the parent than through the factory organization. 454. (j) Feeding arrangements.—The supervisor should ascertain that workers are obtaining suitable and nourishing food, and that adequate and convenient facilities are available for its preparation, purchase, or consumption. Where mess rooms or canteens are pro vided by the firm the supervisor will often be charged with their direction. 455. (h) Thrift and benevolent funds.—The supervisor should assist in any scheme for encouraging thrift which may be established through war-savings associations or by other means. The arrange ments, at any rate in the case of the younger workers, are generally most successful when organized in close connection with the payment of wages. They should be such as to attract those who are not -naturally thrifty. The supervisor may also be called upon to assist with the formation of sick and benevolent funds among the workers, and may also be consulted as to applications for help from such funds. W ELFARE SUPERVISION FOR W O M E N AN D GIRLS. 209 The following account has been received of the benevolent fund established at Woolwich Arsenal: This fund was opened in July, 1917. The absolute necessity for the existence of such a fund had for a long time past been one of my many aims. Over and over again I came up against the fact that with a fund to draw on I could do a great deal to help and ease those who were working under me in the arsenal. There are those who, through sickness of themselves or their families, get into financial and often absolutely unavoidable difficulties, as rent must be paid and children fed, even if the mother is laid up and unable to work. To secure this fund a huge fete was organized and when all expenses were paid there was a profit of £1,504 15s. 8}d. [$7,323.04] in hand. This fund does not allow gifts of money, except in exceptional cases; when a worker applies for assistance her case is thoroughly investigated, her home being visited by a supervisor, and a report sent in. I f the case is satisfactory, a loan is granted, which has to be paid back at the rate of 2s. 6d. [60.8 cents] or 5s. [$1.22] per week, without any interest being charged. No return is ex pected until the second pay day after the loan has been granted, and longer time is given if necessary. It is a rule that no claims for lost money or stolen purses or clothing are dealt with, the reason for this being obvious. During the six months, July-December, 963 applications for help have been received; of these 890 were granted assistance; this has meant an outlay of £1,388 8s. li d . [$6,756.87] and of this £319 9s. 8d. [$1,552.41] has been repaid by small install ments. All confinement cases are dealt with separately and not financed out of the benevolent fund at all. The 890 cases assisted included temporary sickness involving absence for a week or more, 233; injury and back pay delayed, 101; surgical appliances, 3 7 ; absence through infection illness in the house, 3 9 ; sending sick children and husbands to convalescent homes and sanatoria, 8 1 ; assistance to new entries, 7 7 ; railway fares for holidays in distant places or in sudden emergencies, 5 6 ; purchase of boots, 43. 456. (I) Training and instruction.—Though supervisors do not usually themselves undertake the instruction of workers, they are frequently responsible for securing the establishment of suitable courses and for encouraging the workers to take advantage of them. At the present time special facilities for attendance at classes are not always easy to provide, though some firms have found it practicable to do so, while others have made arrangements for new workers to be instructed in the technical methods of the work they are to under take and for them to be given a general outline of the aim and pur pose of the work of the factory. Such instruction has proved to be valuable in promoting technical efficiency and in stimulating interest. It also affords an opportunity for determining the kind of employ ment for which the Avorker is likely to be best fitted. 457. ( m) Housing and transit.— Supervisors should acquaint them selves with the facilities for housing available for the workers. It may be necessary to keep lists of suitable lodgings where this duty is not otherwise undertaken. The adequac}^ of means of traveling to and from the factory is a proper subject for the supervisor’s at80035°— 19-------14 210 IN B O ST E IA L H E A L T H A N D EFF IC IE N C Y . teniion, as is also the consideration of local railway or tramway time tables in relation to the hours of changing shifts. 458. (n) Recreation.—Facilities for indoor and outdoor recrea tion are of extreme importance for the health and welfare of the worker. Where existing organizations are insufficient to meet the needs, the supervisor may have to take steps to secure some provision for organized games and evening clubs. Facilities for rest and recreation during intervals of work may prove of much benefit and be greatly appreciated. The conduct of arrangements for recreation should be so far as possible in the hands of the members themselves, and the position of the supervisor should, so far as possible, be one of advising rather than of controlling. 459. (o) Cooperation ivith outside agencies.—For an adequate performance of their duties it is essential that welfare supervisors should possess an intimate knowledge of the agencies—educational, social, industrial—outside the factory which are concerned with th*, life of the worker, 4#0. The duties outlined above, though mainly concerned with matters of health and individual welfare, are to some extent distinct from those usually intrusted to trained nurses or the medical staff engaged to render first-aid or subsequent treatment of accident and sickness. The advantage, however, of bringing the work of the nurse into touch with that of the welfare supervisor is manifest, and in suitable eases the duties of a welfare supervisor of women and girls may be properly undertaken by the nursing staff—increased and, if necessary, reorganized for the purpose. When the numbers are small and full-time service is not required the duties of a welfare supervisor may be undertaken by an existing member of the staff who possesses special qualifications for the work and is given the time and status requisite for their proper performance. 461. The following statements will afford some indication of the present purpose and scope of welfare supervision among women. Thus, a leading munition firm writes: The welfare work has been organized on broad lines and its development left to the individual views of the management and welfare staff concerned in accordance with the special requirements of each factory or department and the nature of its work. Its aim has been to relieve the pressure of industrial life and protectfthe workers’ interests both individually and collectively. Tlte general policy has been to study, adapt, and improve existing conditions o f labor on such practical lines as may be suitable to the requirements of the workers concerned, with a view to future progress and development. The Worth Country workers ^re more independent in spirit and advanced in thought than southerners, and strongly resent any suggestion of patronage or inter ference with their liberties; in consequence, the welfare worker must adapt lierseif to their requirements and not expect them to readily accept her views. T h e qualities most necessary to a successful welfare worker are good heal tlx, W ELFARE SUPERVISION FOR W O M E N AND <HRLS. 211 common sense, justice, loyalty, love of humanity, and a sense o f humor, and any training which has inculcated habits of discipline and application is very desirable, more especially shop training. The management do not allow the welfare workers to deal with any labor or wages questions or rates of pay, as they consider it essential that these should remain in the hands of tin. management. Every female candidate applying for employment at these works is taken on through a labor bureau, who interview every girl and obtain reference as to character. In addition, each girl is examined by a trained nurse prior to being engaged Should the nurse be doubtful about the physical suitability of the candidate, the works doctor is asked to decide. 462. A departmental supervisor at this factory describes her duties as including— Engagement o f labor .— Requisitions from foremen as to number of girla required, type, and class of w ork; interviewing girls recommended by foremen, forewomen, or other workers, and placing those approved in touch with labor bureau; change of work, if unsuitable, arranged with the concurrence o f the foreman concerned; transfers to another department arranged, if desirable, and approved by foremen and supervisors concerned; restarters interviewed and ap proved or sent to doctor or labor bureau for medical report; signing on new starters, impressing them with the reputation of the shop for good work and conduct, and giving them useful h in ts; interviews with labor bureau respecting matters concerning employment or reemployment of women. General .— Reporting to the departmental manager, as and when required, on any questions connected with shop discipline, and seeking his advice if any extreme difficulty or question of principle arises; consulting with shop man agers and taking instructions on all matters concerning shop discipline; inter viewing head foremen, forewomen, and others in reference to various matters concerning the girls, taking care that no action is taken by any supervisor without proper consultation and agreement with the executive authority con cerned ; investigating all serious complaints personally, and keeping in close personal touch with grievances, real or im aginary; receiving reports from and advising subordinate supervisors on matters concerning the shifts for which they are responsible; advising girls on any question, on her own application 01* through the supervisor in charge of her sh ift; interviews with medical officer of works re medical points arising; investigating, consulting, advising, and dealing with all kinds of problems, moral or otherwise, some petty but irritating, others of importance and affecting principle or precedent; visiting any special cases an infirmary or at home. Social.— Attending committees of the girls re entertainments, and where re quired assisting in their organization. Seeking out and recommending cases for rest home or other assistance. Office.— Organization and supervision of various records concerned with the girls, their overalls and other clothing, and of war-savings associations and other thrift funds. Countersigning all requisitions for clothing, cleaning* or other materials from stores. Inspection .— Of shops, cloakrooms, dining rooms, and cookhouses, to see everything is in proper order; of shop supervisors’ registers and records; of ambulance-room records, to see what girls have met with accident or were passed out sick; of medical certificates from absentees; of timekeeping records and lists of absentees. 212 IN D U STRIAL H E A L T H AN D E FF IC IE N C Y . 463. The following statement, received from another important firm, affords some idea of how the work has developed during the war: % Taking up my duties on August 10, 1914, there were 13 girls employed in the factory on aircraft work. At that time the accommodations for girls consisted of 1 spacious cloakroom, 20 hand basins, and 30 lavatories, and this for the first six months became my headquarters, and as we possessed only a small, dingy mess room, which was used by the men, the cloakroom became office, mess room, sewing, and ambulance room. In February, 1915, a small portion of the men’s mess room was partitioned off for the use of the girls, and at the same time a r.oom was taken over and converted into a rest room and surgery, and this proved very valuable indeed, as just at this time we experienced much dif ficulty brought about by dope poisoning; in fact, two girls died as the result of poisoning. Therefore, a strict watch had to be kept on the health of the work ers, helped by doctor’s inspection once a fortnight. In addition, we had by this time another large cloakroom, consising of 4 hand basins and 30 lavatories, fully equipped with the necessary sanitary arrangements. In our new building we now have a cloakroom in every department where girls are employed. This prevents waste of time, and sickness is also prevented, as the girls are not com pelled to leave a heated shop. In September, 1916, a large drawing office was converted as follow s: Rest room, waiting room, surgery, and office. In Janu ary, 1917, the sewing room was enlarged and we are now able to employ girls who may be temporarily unemployed by strikes or breakdown of machinery, and in numerous cases when the girls are indisposed but not ill enough to go off work. Since September, 1917, we have had in use a girls’ recreation room, where they may spend their time when not on d u ty ; that is, mealtimes both ©n day and night shift. In addition, we have a female labor bureau, consisting of waiting room and interviewing room. W e have for the benefit of the workers benevolent and hospital funds, girls’ savings bank or holiday fund, clothing club, and have recently organized a girls’ welfare fund. W ith reference to the social side, there are various organizations— girls’ gymnasium class, tennis and hockey club, football team, home nursing and first-aid classes, and we now have a girls’ ambulance corps trained at the works to render first aid in the shops. These are also on duty during air raids. On January 22, 1917, the new club and mess room was opened with accommodation for approximately 600 girls. There is also accommodation for 300 girls in the Y. W . O. A. A new feature which has been recently introduced— the want of which has been sadly felt— is that help should be given to employees whose wives are laid up owing to illness or child birth. W e have engaged the services of a couple of women whom we send out to do the housework in these cases. 464. Thirdly^nay be quoted the following extracts from an account supplied by a welfare supervisor of “A day of my life as a welfare supervisor ” : One of the chief advantages of a welfare supervisor’s life is its variety. Each hour brings its own difficulties, each day produces fresh problems, and each week opens up new possibilities. The scope of the work is limited only by imagi nation and ability and things accomplished serve as milestones on an endless road of possibilities. This variety makes the task of describing a welfare super visor's day a difficult one. W ELFARE SUPERVISION FOR W O M E N AND GIRLS. 213 A t 9 a. ni. I clock on (we all do this, from the manager downward) and start dealing with letters. These are of all kinds— postcards returned by absentees explaining why they are away from work, letters from other factories asking for the characters of women who have left us, letters from solicitors and the finance department of the Ministry of Munitions about compensation cases, let ters from women and girls asking for work. I read the report left by the assistant supervisor on night duty. Perhaps the shop has been too hot or too cold, there has been a theft in the cloakroom, an operator and a viewer have had a quarrel, a pipe has burst in the lavatory; there are also several complaints that the train from W -----------arrives so late that the women have to run from the station to be at the factory before the gates close, and reach their work in an exhausted condition. * * * The next business is to deal with absentees. Every morning a list of the pre vious day’s absentees is sent from the time office and the cards are taken out of the current index and filed in a special drawer. After three days’ absence each case is either visited or written to, and by the end of seven days we are in a position to know whether the worker is coming back or not. The assistant supervisor goes through the absentees each day and decides which are to be written to and w7hieh visited, and in the first case sends reply postcards asking for an explanation of absence and in the second gives the welfare visitor the cards of those who are to be visited. Before going off every morning the visitor discusses with me points arising out of her visits of the previous day, and in many cases we decide to ask for help from the welfare committee. This com mittee is a kind of benevolent society to which all workers subscribe and which gives grants in cases of necessity, hospital notes when special medical attention is needed, convalescent changes, etc. Choosing labor can be a very skilled work when there is an ample supply to choose from and no great hurry in filling vacancies. Each worker should be just the right type for the work she is put to ; she should be examined medically and her references taken up, or, in the case of young workers, her character from school inquired into. Few labor offices, however, are able to carry out this regime at the present time, and engaging is often reduced to eliminating the least fit. One rejects the old, the infirm, the undersized, the shortsighted, the dirty, the flashy, the anemic, and the corpulent, and the remainder are taken on for the jobs for which they are most suitable. I must explain that ever since I came in at 9 o’clock there has been a constant stream of women from the shop with questions and complaints, and that to write one letter or engage one person without interruptions is quite unusual. Mrs. A wants a job on days as her husband is ill and can not be left at night; Elsie B complains that the charge hand is always “ shouting ” to h er; three viewers state that their rises are due but have not been given; two operators are not satisfied that their w^ages are correct, and the matter has to be thrashed out. In the one case I show the girl that she has calculated wrongly, and that she has been paid correctly; in the other I think the wages office has made a mistake, and I promise to see to it. * * * Although I have not been in the shop, however my assistant has been there off and on all the morning since the shift started at 8 a. m., either in the little works office or walking about the shop. The women know they will find her in the office between 10 and 11 o’clock, and they go to her with difficulties and complaints and to get badges, etc. The forewomen, too, go to her for advice, and she is in close touch with superintendents and foremen, helping them to smooth over the many difficulties arising out of the employment of large num bers of both sexes. When she is not in the office she is walking round the 214 IN D U ST R IA L H E A L T H AN D E FF IC IE N C Y . sliop seeing that the girls are behaving well, wearing their caps, and are not loitering about the cloakrooms and lavatories, also that the latter are well supplied with towels, soap, etc. I take with me into the shop notes of the matters I have to discuss with the superintendent and works manager, and when I have seen them I walk round and note new developments, the drinking fountains for which I have agitated and which are being put up— a new pattern of seat which is being fixed to the machines— a big draught from an opening which might be closed up, and the extra high skies for the slurry pans on the drilling machines which have been made and are giving great satisfaction to the operators. On my way back to the office I call at the ambulance room and see that all is well there. The sister in charge tells me of a woman who has been in with bad varicose veins who should not be standing at her work; she tells me that one of the nurses wants to leave, and warns me that a woman has been in with an old wound which lias broken out again, but which she is claiming to be a fresh injury for which she requires compensation. The ambulance room is in my charge, but it carries on mainly on its own. My assistant comes back before 1.30 so as to be free during the last half of the dinner hour. Sometimes she has arranged a concert, and sometimes the members of the military band or the orchestra bolt their own meal so as to entertain the others, but none of these things happen as often as we would like, as, unfortunately, our canteen does not lend itself to entertainment Occasion ally we have a war-saving or other meeting, but here again we are hampered by the unsuitability of the building. A little before 0 o’clock the matron comes down and speaks to me about towels and soap and overalls, and other domestic details. She acts as a kind o f chief forewoman and frees the assistant supervisors and myself from a good deal of necessary work which does not require careful handling. A t 6.15 p. m. there is a meeting of the sports and recreation committee. H av ing held a most successful dance the night before (which, by the way, kept me up until after 11 o’clock, though I was only a wallflower), we decide to organize a series o f whist drives for the Various sections of the works, followed in each case by a few dances. The football section sends a report on the first half season’s play, and we get a satisfactory account from the choral society of the financial result of their performance of the concert version of “ Merry E nglan d/’ A discussion on finance follows, and it is about 7.30 when we get away. I f this imaginary day is a Tuesday, Wednesday, or Thursday, I am now free to go home, but two nights a week I go back to tlie factory after a hasty dinner and stay until 9 o’clock seeing the new people who are turning in for the night shift and making a final tour of the shop before the night supervisor takes over the work. In conclusion, it may perhaps be of interest to note that the welfare staff consists, besides myself, of two shift supervisors, a matron and a welfare visitor, one adult clerk, a stenographer, and two office girls. In the ambulance room are a sister in charge, two fully trained and two partially trained nurses, and a clerk. The number of women we deal with is just under 3,000. It is only possible to manage with such a small staff of welfare supervisors ©wing to the presence of forewomen. There are eight of these, and they act as kind of liaison officers between the welfare supervisor and tlie works. They are only appointed with my approval, and I find that in many ways there are ad vantages in making use of them instead of increasing the staff of supervisors. W ELFARE SUPERVISION FOR W O M E N AND GIRLS. 215 QUALIFICATIONS AND TRAINING OF W ELFARE SUPERVISORS. 465. The duties of a welfare supervisor are many and difficult; she requires to be possessed of strength of character, tact, and broad mindedness, such as will fit her for responsibility and will command the respect of workers and foremen. She should be of good standing and education, and should possess a good understanding of industrial conditions. Apart from these broad essentials much necessarily de pends upon the conditions of work, the size of the factory, the nature of the management, the type and characteristics of the workers, the nature of the industry, and the conditions under which it is carried on. The duties of the supervisor may have an industrial or an ameliorative bias. Provided only that they possess the requisite qualifications, welfare supervisors can be and are drawn from all classes of the community. It has been suggested that there are five essentials for the work of a welfare supervisor— (a) An intimate knowledge and sympathy with women and girls. This can best be acquired by such methods as teaching in a primary school, life in a settlement, work in a women’s trade-union office, living at the same time in a poor neighborhood. Without this funda mental experience no one should take up welfare work. (b) A careful study of industrial problems which affect women’s labor—such problems as the displacement of men by women, married women’s work, the educational needs of “ young persons,” the home life of women and girls, the working of such acts as the insurance acts and the workmen’s compensation act. (c) A knowledge, both theoretical and practical, of the health of women and girls and how it is affected by speed of output, the kind of commissariat provided, the questions of ventilation and heat ing, and questions of housing accommodation. (d) A knowledge of the technical side of the wTork, indexing, filing, account keeping, domestic arrangements in rest rooms, cloakrooms, the organization of a factory, and the relations between general managers, managers, foremen, and forewomen. (e) A conception of the right relation between the life of the fac tory with all its agencies for good, and the life of the community, the interaction of each upon the other. This involves a serious study of the social structure of the community.1 466. The previous experience and knowledge possessed by persons desiring to become welfare supervisors will necessarily vary. Their experience may be mainly practical or mainly theoretical. Though there will be exceptions, it will generally be desirable that candidates should undergo a special period of training. During the past two 1 I n d u s t r ia l W e l f a r e W o r k , b y M is s H il d a S t r e e t , B r i s t o l. P r i c e , 6d. C a s h m o r e ; G e o . G o r d o n & S o n s , O ld K i n g 216 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . years the universities have provided a number of courses of training of a few weeks’ duration, which have been attended largely by persons already provisionally selected by the Ministry of Munitions as suit able for employment, and in some cases in receipt of special allow ances from the ministry. While these courses have been of practical value in meeting the temporary emergency, they have admittedly been provisional in character. The need for such emergency courses is, however, rapidly passing, and the committee desire to express the oj)inion that longer courses of not less than one year’s duration should at an early date become the established minimum of training. They recognize the difficulty of persuading candidates to equip themselves by longer training as long as emergency courses are still in existence. 467. In considering the scope of courses of training it can not be too strongly emphasized that welfare supervision as it is known to-day is only a phase, and possibly only a temporary phase, of a much wider movement toward industrial betterment. The present time is essen tially one of change and development. The welfare supervisor of the future may not be an officer appointed ad hoc. She may in future be a manageress or forewoman, or hold some technical position in the executive. Account must also be taken of the developments which may arise from the proposed establishment of joint industrial coun cils 1 of employers and workers. Apart from this allowance must be made for the wide variety in the types of post which the supervisor may be called upon to undertake. In any case the essential object must be a right outlook upon her future work; for its absence no knowledge, however large, of technical detail will compensate. The committee are accordingly of opinion that it is essential that any course of training should, while allowing for a special study of wel fare problems, be grounded on a wide study of social questions. Sub ject to this institutions may properly be encouraged to elaborate their courses according to wThat each may conceive to be best for their students, regard being also had to the special bent of the teachers available, and the particular sphere for which they are preparing. The committee generally concur in the recommendations on this sub ject contained in the report made by a committee of university repre sentatives in July, 1917, upon the selection and training of welfare supervisors in factories and workshops.2 This report suggests that the course of training should fall into three main divisions, viz: Lectures and class teaching .— The subjects to be dealt with would include some study of industrial history, the outlines of social economics and local government, modern institutions such as trade-unions or the cooperative move ment, industrial law, including some knowledge of factory legislation, hygiene, 1 S ee in t e r i m r e p o r t .on j o i n t s t a n d i n g i n d u s t r ia l c o u n c i ls b y t h e s u b c o m m it t e e o f t h e r e c o n s t r u c t i o n c o m m i t t e e o n r e la t i o n s b e t w e e n e m p lo y e r s a n d e m p lo y e d . Cd. 8606, 1917. * P u b li s h e d b y P . S . K i n g & S o n ( L t d . ) , O r c h a r d S t r e e t , W e s t m i n s t e r . P r ic e , 3d. W ELFARE SUPERVISION FOR W O M E N AND GIRLS. 217 the health of the individual worker, and workmen’s compensation. Special at tention should be paid to the general organization of a factory, the duties of managers, the principal types of production, and the methods of remuneration, relation of factory organization to problems of continuation-school education. Some, at any rate, of the instruction on the duties of a welfare supervisor should be given by those who are actually engaged in the work. Visits o f observation .— These would have regard to public health, housing, conditions of factory life, poor law, hostels employment exchanges, e tc .; they would be supplementary and explanatory of the lectures. Practical w ork .— A t least half the time of a social student should be spent upon practical work. This should be divided roughly into two sections, the first section aiming at giving the student an acquaintance with normal workingclass life ; in the second the future welfare supervisor should visit a consider able number of factories in which welfare work is carried out, and should, where this can be arranged, work under a welfare supervisor. Finally, it is desirable that wherever possible students should gain some actual experience of life as a wage earner in a factory.1 468. At a recent conference 2 of welfare supervisors a speaker thus described the object of training: Part of the real object of training, combined with association, was to make a standard of work and worker which would endure, and which would be a guaranty of good work in the future. The standard required was not merely one of expert administration, but of breadth of judgment, wise understanding, good sense, and all that general combination of qualities which belonged to the educated man or woman. Efficiency merely would not give the standard. Some professions had got efficiency but not the standard— for instance, nursing. Others had both efficiency and the standard, as the medical and legal profes sions. These had not been obtained by tests, examinations, or difficulty of training, but by pattern and length and character of the training. Some parts of the training might be necessary merely to compel thinking. The shortness of the training made it all the more necessary to include something which would bring out the capacity to think. Perhaps next to good judgment and tact, power to think quickly and sympathetically was most important. Only by contact with the mental struggles of other people could be obtained that sense of the relation of class to class, of the attitude of working people to social usages, their feeling about this or that. Only the study of the most human questions, i. e., mind (psychology), of aim (philosophy), of the struggle to make the best of life (social economics), could give this sense. * * * By training, much of the shortsightedness and narrowness which spoiled social work could be avoided. 469. If the committee are correct in their view that courses of training should be primarily based on a wide study of social prob lems, it may be anticipated that a large part of the course will be suitable for all students who are desirous of taking and are qualified by attainments to take a course of social study; and the committee 1 C o u r s e s o f t h e k in d h e r e c o n t e m p la t e d h a v e b e e n , o r a r e b e in g , o r g a n i z e d b y o r u n d e r t h e a u s p ic e s o f t h e u n i v e r s it i e s o f L o n d o n ( S c h o o l o f E c o n o m i c s ) , B ir m in g h a m , B r i s t o l, B e l f a s t , E d in b u r g h , G la s g o w , L e e d s , L i v e r p o o l , M a n c h e s t e r , S h e ffie ld , a n d e ls e w h e r e . P r o v i s io n i s a ls o s o m e t im e s m a d e f o r s h o r t o r p a r t - t i m e c o u r s e s . P r o s p e c t u s e s o f th e c o u r s e s c a n b e o b t a i n e d f r o m t h e a u t h o r i t ie s o f the- u n i v e r s it i e s c o n c e r n e d . 2 C e n t r a l A s s o c i a t io n o f W e l f a r e W o r k e r s , n o t e s o f a d d r e s s e s g i v e n a t t h e c o n f e r e n c e o n J a n . 1 2 a n d 13 , 1 9 1 8 . P r i c e , I s . 218 IN D U ST R IA L H E A L T H AND E FF IC IE N C Y . would not favor an attempt to limit admission to any part of the course to persons who had been previously selected as likely to prove at the end of the course suitable candidates for the posts as welfare supervisors. Further, while particular candidates will doubtless from time to time be assisted from private funds to undergo a course of training with a view subsequently to taking up employment as a welfare supervisor, perhaps in a particular factory, the committee would be opposed to any scheme of granting financial assistance from public funds to candidates who undertook as a condition of the assistance to take up such an appointment on the completion of the course. Sueh a restriction is only justifiable (except to meet a special and temporary emergency) where the numbers required are large and the prospects of permanent employment are substantially secure. SELECTION OF WELFARE SUPERVISORS. 470. Though the State may properly undertake responsibility for satisfying itself that adequate provision is made for supervision, and may require modification to be made where they are not so satisfied, the State can not in the opinion of the committee itself undertake re sponsibility for actual appointments, if only because it can not pos sess a sufficiently intimate acquaintance with the particular condi tions of individual factories. Apart from this the State would only be justified in itself making appointments if it paid for the super vision provided; and it would appear obvious that welfare super vision—at any rate as it is at present conceived— could not be suc cessfully carried out by a paid agent imposed on the factory from out side. Up to the present the welfare supervisors have been appointed and paid by the employer, and it seems probable that for some time to come at any rate the employer must ordinarily continue to accept ultimate responsibility if only that upon him rests the duty of secur ing that the conditions of employment within his factory are satis factory. It may be anticipated, however, that the workers, whose confidence and support are essential to success, will to an increasing extent seek some voice in the selection. 471. The peculiar conditions which have justified the making of several hundred appointments of women welfare supervisors within the last two years, necessitated that some organization should be established through which empk^ers could obtain information as to suitable candidates. To meet this demand the Ministry of Munitions established a special panel. Though this panel has undoubtedly served a useful purpose, the committee are not satisfied that it is desirable as a permanent arrangement. If admission to such a panel were at all narrowly limited it would probably fail to secure the con fidence and support of employers. Apart from this, the fact that a W ELFARE SUPERVISION FOR W O M E N AN D GIRLS. 219 particular supervisor had been selected from the Government panel might subsequently prove an embarrassment if it became necessary to comment adversely on the provision made for supervision at the factor}^ in question. Any agenc}^ established should in the opinion of the committee be entirely free of all Government control. CONCLUSION. 472. The time has not }^et arrived when any definite judgment can be passed on the developments of welfare supervision during the past two years. Still less can prophecy safely be made as to the future. For permanent success welfare work must gain the confident approval and support of the workers. At present their judgment is in sus pense. The old antagonism of “ capital ” and “ labor ” makes the motive of the employer in appointing a welfare supervisor subject to the suspicion that he is seeking profit at the expense of his workers. Again, there is the natural objection to anything savoring of philan thropy. The demand is for justice not for charity. Fussy inter ference represents another danger. As a prominent employer has pointed out— It would be a great mistake for employers to force themselves into the lives of the men whom they employ. W e must avoid smothering them with our good intentions * * *. The point is that men must have a definite responsibility of their own, and we must not try to interfere with that in any way. 473. Further, there is the fear that the movement, whether deliber ately or not, may be opposed to the development of the aim of tradesunionism. On the other hand, the following remarks of a representa tive trades-unionist at the recent conference already referred to, show a more favorable attitude: Wages and hours, though of primary importance, were not the whole matter. Tone and atmosphere might still be wrong. There was still the relationship between the sexes in a factory to be considered, and also the shameful fact that there were still many men supervisors who wTere in charge of women in every respect. Also, though good wages and good hours always tended to raise the standard of life and manners, the connection was not always immediate. For instance, in the Lancashire cotton trade, where before the war women were best paid, standards of comfort were deplorably low. After all had been done in respect to w^ages and hours there still remained something to do. There would be a great many other matters— for instance, dismissal and en gagement of workers. Engagement was of most far-reaching importance, be cause bound up with the extraordinary difficult question of the slow wTorker, who was often slow because in an unsuitable trade. The welfare worker would after a time be able to select people with the precise qualifications necessary for the particular trade; would probably get rid of, substantially at any rate, the problem of the slow worker. Again there would be questions like the lift ing of heavy weights, the danger of particular processes, etc. The welfare worker would be the intermediary between employer and employee. Any fac tory act, or any observation forced upon employers by the trade-union, could only be a minimum. The conscientious employer would still have to decide IN D U STRIAL H E A L T H AND EFF IC IE N C Y . 220 how far he could go in advance of the minimum and would more and more need the expert advice that a trained welfare superintendent could give him. The supervisory powers which, by degrees, the welfare worker would attain to, were very valuable. Canteens, rest rooms, clean water, overalls, etc., were in valuable, but would mean nothing unless there was somebody to see that each of these things was what it ought to be. In those things was the basis of wel fare work. It was part of the functional management of a great factory. Sidney Webb had appealed for frankness. It should be known that the welfare worker was there for efficiency; she represented the management and not the worker. There was no shame in working on the side of efficiency, and in any system of industry efficiency would be necessary. The welfare worker who came forward in the name of efficiency, and to do what she could for the workers, would incur no misunderstanding or resentment 011 their part. If she were also able to work cordially with trade-unions and direct people to join unions any barrier between her and the workers would be broken down. 474. Considerable interest attaches to the following constructive proposals which were recently put forward in a memorandum1 pre pared by the joint committee of the Woolwich Trades and Labor Council and Woolwich Labor Party: The statement of the duties of welfare supervision contained in memorandum No. 2 (Welfare Supervision) of the health of munition workers committee may be taken as a working basis for the purpose of welfare supervision. The memorandum states that “ the duties here outlined are chiefly concerned with matters of health and individual welfare which are of immediate urgency to-day.” Modification of or addition to these duties will doubtless be brought about by increasing experience, and by the changes which are likely to arise in the industrial system after the war; but we submit that the following con ditions are essential to any scheme of welfare supervision that is to win the full confidence and support of the workers: (1) Welfare supervision must aim primarily at promoting the welfare of the workers, and not at increasing the workers’ output. (2) In the interest of welfare supervision and of the workers, duties which conflict with welfare supervision must not be included in the work of welfare supervisors. (3) Welfare schemes and supervisors must be under a democratic system of control in which the workers shall have equal participation with the employers. (4) The established field of operations of trade-unions and their officials must be clearly and loyally recognized by welfare schemes and supervisors. (5) Welfare supervisors should be drawn, as far as possible, from among the workers. (6) Welfare supervisors should not be appointed without preliminary train ing or experience, such training to include a knowledge of trade-union aims and methods. (7) The remuneration and hours of all assistants in welfare supervision work (e. g., canteen workers) must be of a trade-union standard. (8) If Government control of welfare supervision is maintained after the war, such control must be transferred from the Ministry of Munitions to the Ministry of Labor. We submit further— (9) That there should be the maximum of efficient cooperation among local welfare schemes, especially with regard to small factories. 1 Reprinted in the W oolw ich Pioneer for Feb. 22, 1918. W ELFARE SUPERVISION FOR W O M E N AND GIRLS. 221 (10) That there should be the maximum of efficient cooperation between local welfare schemes and the municipality, especially with regard to health, housing, transit, and recreation. (11) That as welfare supervision will probably become a permanent and ex tending element of the industrial system, there should be held in each in dustrial center, one or more conferences, convened by the trade council, or, where there is also a local labor party, both bodies jointly, for the purpose of considering the aims, scope, and methods of welfare supervision; that such local conferences should be followed by a joint conference of the Trade-union Congress and the National Labor Party. 475. The committee can not escape the conclusion that unwise and unsatisfactory appointments have been made, that friction and mis understandings have been created, and that complaints have at times been considerable in volume and extent. Further, it may be freely granted that many of these complaints were well founded, though their extent and importance must not be overestimated. More is frequently heard of one failure than of many successes. The prob lems at issue can not be solved in a day. If not entirely new, they are for the first time becoming of direct interest and importance to any large section of the industrial community. Allowance, too, must be made for the limited experience of industrial conditions inevitably possessed b j many of the welfare supervisors when first appointed, and also for the difficulties due to the newness of many of the con ceptions of industrial organization involved in the work, and to the absence of any substantial body of experience or tradition to guide welfare supervisors in their work. Failure where it has occurred has quite as often been due to slowness of the management or the workers to understand the aim and purpose of welfare supervision as to the incapacity or unsuitability of the supervisor. On the whole the committee are convinced that it can at least be said that the con ditions of employment of women workers have been substantially and widely improved and that they are as a rule to-day greatly superior to those usually existing in industry before the war. The fact that in spite of the strain of the last three years there has not hitherto been a general breakdown of health is in no small degree due to the work of the welfare supervisors. There can too be no doubt as to the advantage derived from the presence of a person whose special duty it is to give constant attention to many matters which, though often trivial in themselves, are yet vital to the main tenance of a healthy environment. Again, it can not but be of service to the solution of future industrial problems that there should exist a large number of persons who are daily devoting their atten tion to an aspect of these problems which has too frequently been overlooked in the past but which can not safely be neglected. The experience and knowledge now accumulated must certainly prove a notable contribution to the wise handling of many questions vitally 222 IN D U STRIAL H E A L T H AND E FF IC IE N C Y , affecting the future prosperity of the nation. The association1 of welfare supervisors now being established should do valuable work in collecting and focusing information. The committee in fact tire satisfied that the experiment of the last two years has been of inestimable benefit to the nation, and that in one form or another welfare supervision should certainly continue to play an important part in all future schemes for the industrial betterment of the race. 1 The aim of the Central Association of Welfare Supervisors is defined in the constitu tion as being— To promote the well-being of the workers by securing, in the cooperation with em ployer and employed, the best possible conditions of work. To help all efforts, inside and outside of the £actory» to place the industrial relationship on a basis of goodwill awl understanding. Tlie secretary of the association may be addressed at the School of Economics, Clare Market, W. C. 2. District associations are also being formed in London and other industrial areas. The association has upward of GOO members. SECTION xvm.—WLFARE SUPERVISION FOR 'BOYS AND MEN. WELFARE TOB BOYS. THE NEED. 470. The problems involved in the welfare supervision of boys, though in some measure similar to those which arise in the case of women and girls, are in certain respects distinct and call for special consideration and treatment. The employment of boys in engineer ing and other munition works, unlike that of women and girls, is not a new development arising out of the war. Nearly every firm has employed boys before the war. The war has not introduced a new farm of labor for which employers might expect to be asked to provide new conditions, nor, again, has the war introduced difficul ties in regard to boys which did not exist before. The wTar has only magnified the difficulties; it has not created them. High wages in certain occupations, large demands for boy labor, restlessness and the habit of wandering from one employer to another, the trouble of se curing proper control, all these were boy problems during times of peace, but war conditions have emphasized the difficulties, while the need for conserving all possible labor has made their solution a matter of national importance. 477. The first and most essential object of welfare supervision among boys is to bring to bear upon them through the management a definite personal influence. They are at an impressionable age, when the influences to which they are subject wrill largely determine their ultimate outlook upon life. They are not adults; many are as young as 14, some are even younger. They are not old enough to be allowed imguided to control their own destiny. At the same time, existing conditions, such as Irigh wages, the absence of the father or the elder brother, have tended to relax home control. Hours of work frequently prevent attendance at clubs or classes and healthy out door recreation is too seldom available. As might be anticipated under such conditions, the conduct of the boys is the subject of fre quent complaint. From whatever aspect the matter is viewed, it is essential-that the causes of alleged ill behavior and conduct should be ascertained and appreciated. It is only by such means that improve ment can be obtained. 478. While at school boys have been accustomed to a sympathetic discipline and friendly interest. Similar discipline and interest should be present also in the factory, Where these are not assured 223 224 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . it is, as a rule, useless to secure the provision of what may be called the material apparatus of welfare. Facilities alone are inadequate; the boys must be led to avail themselves of the opportunities offered. Experience shows that canteens and mess rooms may be erected, but boys, in many cases, have not used them, preferring to consume 44car ried” food in some corner of the factory. Similarly, washing ap paratus has been supplied, but left neglected or abused; towels have been converted into footballs and soap used as a handy missile. The first-aid arrangements may be excellent, but for minor injuries the boys will not trouble to make use of them. There are, of course, ex ceptions to these statements, but they are not sufficiently numerous to modify the conclusion that what the boys need most is definite per sonal influence. 479. Such personal influence can, in general, only be secured where definite duties with regard to the boys are delegated to some one indi vidual. Collective and indiscriminate responsibility is unsuccessful. The mixed method, usually the practice, of leaving the boys to the control of the manager and foremen has been proved a failure in actual experience. The manager, even when possessing the necessary qualifications, has not the time to carry out the work. The foremen, not infrequently keenly interested in the boys, lack the requisite breadth of outlook and training. Their immediate concern is 44out put,” and they tend to regard only the obvious and often superficial effects as distinguished from the more important but less arresting consequences of any action on their part. To take a single example: Experience has shown that boys are ill suited to stand the monotony of purely repetition work. To keep them long to one operation is to injure output by increasing lost time and frequency of leakage. But the foreman knows that a boy when transferred to a new job lequires time before he becomes expert and that temporary loss of Gutput is the result of transfer. He fails to appreciate that in the absence of such transfers output suffers more seriously. • It is not pos sible, therefore, to count on securing the necessary personal influence from either the manager or the foremen. In small works, employing BO boys or less, where the management are interested in the boys, this personal influence can often be secured without delegation of responsibility to an individual. Occasionally, in large factories, where welfare work has been of long standing and created its own iumosphere, the same may hold good. But such cases are rare, and, i n general, and certainly where welfare work is being introduced, success depends on the presence of a definite individual, termed a wel fare supervisor. 480. As a recent speaker has pointed out— You can not expect a shop manager or the manager of a works to have any particular and peculiar intimate knowledge of one special section of his staff of W ELFARE SUPERVISION FOR BOYS AND M E N . 225 employees. Therefore, it seems to me only natural to demand that the boys’ case shall be stated first of all to the man who understands them, who has made it his special business to know all about them, and to go intimately into a study of their nature. * * * 481. The committee, in their memorandum No. 2 on Welfare Super vision, recommended the appointment of a welfare supervisor wher ever 100 boys are employed, and experience has shown that where there is this number a whole-time officer can be usefully employed. It is, however, only a minority of factories in which so large a num ber is employed, and it is therefore a matter of considerable prac tical importance to devise means for providing for welfare super vision in the numerous factories where only about 30 to 100 boys are employed. Various alternatives have been adopted in practice— (a) A special whole-time officer is appointed and his services shared by two or more firms; (b) A special officer is appointed who gives part of his time to other duties in the factory; ( c ) An existing officer is relieved of part of his other work in order to give time to welfare supervision. (cl) The boys may be placed under the charge of the welfare super visor for women. 482. A problem of great difficulty arises from the practice still prevalent in some districts under which the boys, though normally in the service of the employer, are for all effective purposes in that of the men for whom they work, and who engage them, dismiss them, and pay them. Their work is sometimes casual; the employers know little of their conditions and are inclined to contend that thev have no responsibility for their welfare. It is, however, hoped that in two centers the experiment will shortly be started of a special insti tute for such boys in charge of a welfare supervisor. It is suggested that the institute should act not only as a center of recreation but also as a kind of labor bureau dealing with the difficulties arising out of the casual nature of the employment. THE DUTIES OF THE SUPERVISOR. 483. While the duties1 of a welfare supervisor of boys may use fully include most of the various matters specified in the preceding section for welfare supervisors for women, there are certain aspects which need to be particularly emphasized. It is essential that a wide view should be taken of this sphere and influence. He is con cerned with boys in their critical stage of growth and development, 1 The ministry have issued a memorandum on the duties of a welfare supervisor for boys. Reference may also be made to The Boy in Industry, and Report of a Conference of Boy Welfare Supervisors. All of these documents may be obtained on application to the ministry. S09350— 19------ 15 226 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . and nothing which makes for their well-being should be regarded as alien to his duties. From his presence inside the factory he occupies a unique position for guiding effectually the careers of the boys under his charge, and experience shows that the wider his outlook the stronger his position. The following scheme prepared for a govern ment factory illustrates the point: The boy visitors’ work is directed to improving the boy workers’ moral and material well-being and to reducing the difficulties which slackness, ill disci pline, etc., cause the factory staff. The present abnormal conditions of work, high wages, lack of healthy recrea tion, and in many cases the absence of the father tends to thriftlessness, ill discipline, and other evils. In fairness to the boy it should be said that bad timekeeping, etc., may be the outcome of genuine fatigue, illness, home troubles, or discontent. It is the business of the boy visitor to get at the root of these troubles by personal work amongst the boys and to inform the factory officials of the knowledge which his investigation of the boys’ circumstances, home life, etc., will give him. The boy visitor will, by personal guidance, work toward getting contented, well-disciplined boy workers, and the information he gathers will always be available to assist the staff in the smooth working of the factory. (1) To meet new boys on entry and keep a record of the boys’ progress and career in the factory. (2) To deal with absence and bad timekeepers—first with the boy; then, if necessary, with parents. (3) To see boys before dismissal or leaving, and, if necessary, to see the parents. (4) To investigate shop and police reports and make recommendation thereon. (5) To keep an eye on the feeding arrangements, dining halls, lavatory accom modation, etc., and to report and make suggestions thereon to the welfare super vision department. (6) To inquire into and discuss with the boys their complaints and troubles, and, where necessary, present them on behalf of the boys to the proper authorities. (7) To overlook the general conditions and health of the boys, and, where necessary, arrange for medical inspection. (8) To suggest suitable candidates for convalescent homes after sickness or injury. (9) Where necessary, to visit the homes of the boys who are evidently ill cared for, and report upon the home conditions, etc. To note specially the state of clothing and boots of boy workers. (10) To encourage and arrange recreation, sports, etc., at spare times. (11) To keep in personal touch with the boys by means of individual talks, meeting them at meal times, etc., and advising them in difficulties, encouraging them to thrift and well-doing. (12) To gather information as to boys’ characters and progress and capabili ties for promotion, and for post-war employment. N. B.—The boy visitor has no executive authority and his function is to assist the boy when he is in difficulty or trouble and to place his case in a very tactful way before the foreman or manager. It is emphasized that great tacc is necessary in the relations of the boy visitors as the boys’ friend with the foreman and officials. The boy visitor should clearly show to the officials that W ELFARE SUPERVISION FOR BOYS AND M E N . 227 his work will not in any way reduce their authority but will strengthen it and help to secure efficiency and discipline in the factory. 484. The first essential of success is that the welfare supervisor should gain the confidence not only of the boys and the management but also of the foreman and local trade-unions. He should keep in touch with all other persons and organizations in the district which are concerned with the wellbeing of the boy. He should establish friendly relations with the school authorities and the employment bureaus, also with any club organizations which may be available for providing healthy recreation. In order to encourage the interest and influence of the home, he should be in touch with the parent. Lastly, he should recognize a responsibility for boyhood in general, and not merely for the boy while still in his factory. Boys are con tinually leaving through the unsuitability of the work, reduction of staff, or other causes. He must regard his responsibility as continu ing until the bo}^ has found other occupation. Deterioration, now so common, can only be prevented by recognizing this continued re sponsibility. 485. Recreation.—The boy is in special need of change and variety, and adequate facilities for recreation are accordingly of primary importance. Where it can be arranged for, recreation during the dinner hour is valuable in the form of games indoors or football or cricket on some odd piece of ground adjoining the factory. In the main, however, the boy must rely for recreation on leisure time out side factory hours. Where, as is most frequently the case, local clubs are insufficient to meet the need, special provision should be made. In some centers schemes for the whole district are being organized largely on the initiative of the local welfare officer of the Ministry of Munitions, the organization being in the hands of a local committee, and are supported by contributions from employers on a capitation basis. Such schemes have much to commend them when they can be arranged. More often, however, if recreation is to be provided at all, it must be by one or more employers inde pendently of any local club. Indeed, practically every welfare supervisor has in operation some recreation scheme for his own boys. The provision should include not only indoor games and amusements but also foptball, cricket, and cadet corps. Week-end camps have been organized with success. 486. Training and instruction,—Training and instruction are needed both for the immediate purpose of increasing the boy’s interest in his work and so relieving its monotony, and also for improving his technical efficiency and his capacity for undertaking his future responsibilities as a man and a citizen. It is very desirable that boys on appointment should be instructed in the best method of performing their work, and, if possible, also in its aim and pur 228 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . pose. By such means they would not only become more quickly effi cient but interest may be stimulated and monotony relieved. Boys have normally entered on an occupation in which when men they hope to find a definite career. Their technical training—whether from the point of view of the nation or themselves—is a matter of importance. On the other hand, war conditions and the great increase of repetition work have not proved favorable to such train ing. There has been a tendency to keep the boy on the performance of a single operation. Certain employers, however, to the benefit of both output and the boy's training, have found it possible to vary the work and so provide at least some training. To an increasing extent also facilities are being given for attendance at technical and con tinuation classes, both during the day and in the evening. In such cases boys are generally allowed time off from the factory without loss of pay, and the fees for their instruction are paid by the firm. Thus, one welfare supervisor is able to report: I liave succeeded in getting every apprentice to attend evening technical classes two or three times per week. The managing director was very sympa thetic toward this, and readily granted concessions which enabled me to obtain this splendid result. The boys are allowed to miss a quarter without loss of pay the next morning after attending evening school. When on night shift they go to school and then come on to work, thus missing a quarter. The employment of boys on night shifts is a difficulty we are up against all the time. Many of the other lads are attending evening classes with similar concessions. * * * I am arranging a series of lectures in scientific and general subjects and physics. 487. Thrift.—While the high wages now generally earned have undoubtedly been beneficial to health to the extent that they have brought good food and suitable clothing within the reach of all, they have undoubtedly encouraged some undue indulgence and ex travagance. The possession of a large amount of pocket money is a serious temptation to indulge in thriftlessness and gambling. The need for saving against periods of sickness or other future difficulties is seldom appreciated. It is therefore of urgent importance that saving should be encouraged and its national as well as its personal aspect emphasized. The arrangements should be so organized as to attract the support of those who are not naturally thrifty. The rules should be few and easily understood. The collection of deposits should be made in close connection with the payment of wages, and should ordinarily be in the hands of the welfare supervisor, who, through his acquaintance with the boy and his home, can advise him as to the amount which he can properly put by. Upon the wisdom and tact of the supervisor rather than upon formal regulations should the restriction of improper withdrawals depend. If a boy thinks that he can not get his money out whenever he wants to, he may hesitate to deposit it. W ELFARE SUPERVISION FOR BOYS AND M E N . 229 488. The wide scope and variety of the duties which may be undertaken by a welfare supervisor are well illustrated by the follow ing account by a welfare supervisor of how his time is ordinarily occupied: Arriving at the factory in the morning, the welfare supervisor usually finds several boys waiting to see him in the hope of finding employment. Of these, some have probably been sent by the employment exchange, either in response to previous requests or on the chance of a vacancy existing. A glance at the notification of vacancies in different departments received from the foremen concerned, enables the boys to be roughly classified according to suitability for the jobs for which they may be needed. They are then interviewed sepa rately and questioned closely. * * * His answers give some indication of his mental ability and intelligence, and may prevent a dull boy from being set to work which requires thought, or a bright intelligent boy from being- allocated to a task which could as well be performed by one who is mentally dull. Each boy is required to give some account of his health. * * * If he has not just left school, he is questioned as to his previous employment, the number of •changes he has made since leaving school, his wages and reasons for leav ing. * * * Full particulars of the boys engaged are entered on special record cards which provide also for entries dealing with tlieir careers while at the factory. The supervisor’s attention may now be given to the weekly forms showing the time lost by the boys in the various departments. He probably finds that some have lost several quarters or have been absent during periods ranging from one day to a week. Where he is unaware of any reason, he makes a note so that the matter may be investigated later. Similarly the reports on at tendance received from the local evening continuation or technical schools are dealt with. The supervisor may now make a visit to the various shops, bearing in mind any boys whose timekeeping or irregularity at evening classes call for inquiry. He looks out for boys who have been recently engaged and makes a friendly inquiry as to their progress. Other boys are on the lookout for him, being anxious to make inquiries or complaints which perhaps would seem trivial to the foreman, but which the supervisor knows may be of real importance to a boy. The foreman also may have complaints or suggestions to make. If these matters can not be dealt with speedily on the spot, arrangements are made for special interviews. Such interviews take up a portion of each day. Every case of dismissal or of a boy giving notice is a matter for inquiry on the part of the supervisor, and he is frequently able to adjust matters so that both boy and foreman are satisfied. The weekly visit of the Home Office certifying surgeon calls for the super visor’s presence, especially when boys are examined as to their fitness for night employment. He is in a position, from the knowledge gained at his preliminary interviews with the boys, to draw the doctor's attention to any physical weak ness which, while of little importance in itself, may prove a danger to the boy as a result of his employment* He can arrange for a reexamination of boys whose health seems to be affected by working at night, and keeps a record of all cases where boys are declared unfit for any work other than in the day time, so that arrangements may be made, if necessary, for the transfer of a boy to a department where there is no night employment. On most days the supervisor has visits to make. These may be to local schools or members of care committees, but generally they are visits to the 230 IN D U STRIAL H E A L T H AND E FF IC IE N C Y , boys’ homes, made in order that parents may be consulted and made aware that an interest is taken in the boys, and that the cooperation of the parents with the supervisor is desirable. Matters of health, wages, timekeeping, prog ress, companionship call for such visits which are made, not for the purpose of lodging complaints, but in order that friendly inquiry may help to make things better for the boy and prevent him going astray at a critical period of his life. Experience shows that such visits are welcomed by the parents, while the boys sometimes ask the supervisor to call at their homes in order that the parents’ consent may be given to some change which the boy desires. In cases of accident or sudden illness the foremen send for the supervisor, to whom they leave the responsibility of seeing that proper treatment is given, either in the works ambulance room or, if necessary, at the local hospital. * After the night turn has commenced the supervisor makes another round of the shops, with the same objects in view which called for his earlier visit. H e will also have been sought by some of the boys engaged on night work before they entered the shops. In the evenings the boys’ club calls for the supervisor’s time. Football or cricket committees ask his advice or help; he has to see that the fixture list is kept f u ll; he arranges evening concerts, billiard matches, or contests for* which the club has facilities. It is here that he gets to know the boys well. * * * 489. The following statement recently received from a large muni tion works is also of interest: In the early part of last year a cadet corps for lads between 16 and 18, and a boy scout troop for boys between 14 and 16 were started, and in both cases were restricted to lads employed in the factory; over 100 are enrolled in the former and between 60 and 70 in the latter. Some of these scouts have gone through a primary first-aid course, and several of them are learning the duties of auxiliaries to the fire brigade. They also render every assistance in their power on the occasion of any social or athletic event. W hilst on the subject of boys, we would point out that every boy, on being engaged by our labor bureau to work in. this factory, receives a notice asking him to call at the welfare department to see our welfare supervisor, who takes full particulars of the boy’s circumstances and points out what facilities are suitable in each case, e. g., scouts or cadet corps, technical classes, etc. At the present moment about 300 of our boys, as well as a good many girls, are attending evening classes. These boys are given facilities for getting away in time to attend such classes. Every new boy is medically examined after he has been at work in the fac tory for a fortnight. At the Y. M. C. A. a gymnastic class is held for youths every Friday and Monday evening, and every Sunday afternoon a youths’ red triangle club and tea. CONCLUSION. 490. For the reasons already stated the#need for the welfare super vision of boys has not been so readily recognized as in the case of women and girls, and progress has been slower. Time has been required for securing appreciation of the need by the foreman and the local trades unions as well as by the employer. Apart from this, under existing conditions, it has been a matter of considerable diffi culty to find suitable candidates for posts as they were established, W ELFARE SUPERVISION FOR BOYS AND M E N . 231 though this difficulty has grown somewhat less as the need has become better known.1 Over 150 appointments of welfare supervisors are known to have been made up to the end of April, 1918, and the com mittee have little doubt that the movement is now steadily gaining force.2 As in the case of the welfare supervision of women it is as yet too early to form any final judgment as to the work now being done or as to the lines on which it is likely to develop in the future; The committee have, however, substantial grounds for the view that the work has commenced on sound lines. The need for overcoming initial indifference or opposition has not been without its compen sating advantages, since it has tended to prevent hasty and illconsidered schemes or appointments, and thus to reduce causes for misunderstanding and suspicion. WELFARE SUPERVISION FOR MEN. 491. Though the committee in their memorandum No. 2 on Wel fare Supervision recommended the appointment of a welfare super visor for men wherever 500 were employed, they have always recog nized that the problems involved were much more difficult than in the case of women or boys, and they did not anticipate anything but a gradual development, even had the difficulties in the way of obtain ing suitable men for the work been less insuperable than they are, and must continue to be, so long as the war continues. The whole question is intimately connected with that of the establishment of works councils, and it is interesting to note that so recognized an authority as Mr. Sidney Webb has recently suggested that 3— Such subjects as the cleanliness, ventilation, lighting, and temperature of the work place (upon which maximum efficiency depends much more than man agers commonly realize) ; the hours of beginning and ending w ork ; the inter vals for meals; the dates of holidays; the welfare arrangements, including especially the accommodation for meals; the precautions against accidents; the benevolent funds; the workshop rules, and any arrangements about fines, deductions for breakages or inferior work, or charges made for requisites of work, or for hot water, etc., together with any alleged infringements of work shop rules or district agreements as to wages or hours, might all be consid ered with advantage by such a workshop committee, and brought to the notice of the management at a joint conference. 492. In the immediate future at any rate it appears probable that any welfare work among men will generally grow spontaneously out of the work of the welfare supervision for boys. In several instances already a boy welfare supervisor, usually at the request of the men themselves, has found himself called upon to deal with matters affect 1 For the assistance of employers the ministry have established a panel of suitable candidates. 2 An association of boy welfare supervisors is being formed. The acting chairman is Mr. C. W. Hodder, Messrs. Denny & Co., Dumbarton. s The Works Manager To-Day, by Sidney Webb; Longmans Green & Co., 1917* 232 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . ing tlieir welfare. He naturally sees much of them, and if of the right type soon establishes friendly relations with them. If a men’s recreation club is started, he is likely to be asked to assist in its organization, or he may be selected to act as secretary of a work shop committee or works council. Often he is in charge of the firstaid arrangements, which are available for men as well as for boys. He is not infrequently consulted by men in regard to personal diffi culties, and one welfare supervisor reports that he has had over 200 such inquiries in a few weeks. SECTION XIX.—WELFARE OUTSIDE THE FACTORY. 493. In previous sections the committee have dealt mainly with the health and welfare of munition workers as affected by the con ditions of employment inside the factory, and have only referred incidentally to other conditions of almost equal importance outside the factory, such as housing, transit, and recreation. The demands for labor in munition areas have involved the employment of large numbers of workers at places remote from their own homes, and have thus raised problems of first importance for the physical and moral welfare of the nation, and especially of women and girls. In the earlier stages of the War these problems were mainly left to the energy and initiative of private bodies and of individual firms, who took steps to provide hostels, to find lodgings, and to provide facili ties for recreation. The local advisory committees appointed by the central advisory committee on Women’s War Employment (Indus trial), though primarily established to assist the local employment ex changes in the recruitment and distribution of workers, found them selves concerned with problems of transit, housing, and welfare. Much valuable work was performed through the agency of these various bodies and committees, but their usefulness was frequently limited by the lack of the requisite organization and funds. They were dependent for funds upon voluntary sources, but the localities in which by the action of the Stale the munition workers were con centrated were not always willing to contribute to wliat they often, not unreasonably regarded as a matter of national rather than of local concern. 494. The committee, in their memorandum No. 17 (Health and Welfare of Munition Workers Outside the Factory), which was sub mitted to the ministry in January, 1917, thus summarized the position: By the agency of the State women and girls are being ex ported from their homes and imported into munition areas; by the agency of the State the liberty of the individual to throw up her work and to take her labor elsewhere is restricted. 495. On the State, therefore, the responsibility lies, not only for suitably housing these transported workers but also for securing the safeguards needful for their health and morals, the maintenance of which is essential to the nation. 496. Though the restrictions on the movement of labor have since been removed, the proposition still holds good that it is the duty of 233 234 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . the State to determine the nature and extent of the provision to be made in each area and to take such steps as are requisite for its attainment. Every advantage should be taken of existing facilities and experience possessed by local bodies, whether voluntary or statu tory. In the opinion of the committee the aim should be not to sup plant the work of these bodies, but to supplement and coordinate. In submitting the memorandum to the ministry the committee sug gested that it was necessary not only to provide or aid the provision of hostels, maternity homes, and facilities for recreation, but also to arrange for the appointment of local officers, whose duty it would be to organize outside welfare in all its aspects in their particular locality. It was added that these officers were likely to need assistants for the inspection of lodgings, organization of recreation, and other similar purposes. 497. Though various departments of state—as, for example, the Ministry of Labor and the Home Office—are in various degrees con cerned to secure a proper solution of the problems at issue, it is clear that the primary responsibility must rest upon the Ministry of Munitions as the department responsible for creating the need. In March, 1917, the Ministry of Munitions definitely recognized their responsibility for outside welfare, and through their Welfare Depart ment arranged for the appointment of a number of extramural wel fare officers. At present there are about 20 of these officers, who are stationed in the principal centers of munition work. Their duties to some extent vary according to the needs of each locality, but they are normally concerned with the following matters: (a) Provision for meeting girls and providing them with suitable lodgings; ( b) Registration and supervision of lodgings; ( c) Care of sick and stranded workers; (id) Day nurseries for children of munition workers; ( e) Transit facilities; and (/) Provision of recreation facilities for women and girls and occasionally for men also. 498. As in the case of welfare supervision inside the factory, expe rience shows that these officers have many opportunities for useful work outside their specified duties. There is little doubt as to the valuable effects produced in a locality by the presence of a definite person to whom women and girls can apply for help in a moment of difficulty or emergency. 499. The problems connected with the welfare of the worker out side the factory may be roughly grouped under four heads: (а) The recruitment of suitable workers; (б) Housing accommodation and transit; W ELFARE OUTSIDE T H E FACTORY, 235 ( c ) Sickness and other personal questions; and (d) Leisure. 500. It will be convenient to set out shortly the problems which fall under each of these heads, and to state briefly what is being done, and what, in the opinion of the committee, should be done to meet them. THE RECRUITMENT OF SUITABLE WORKERS. 501. The problems involved in the recruitment of suitable workers and their conveyance to the place of future employment are primarily the concern of the Ministry of Labor. 502. Only normally healthy, clean and wholesome-minded women and girls should be exported.—In some cases women and girls received in lodgings and hostels have been found to be in such a condition of person and clothing that the assistance of the sanitary authority had to be invoked for cleansing or disinfection. In other cases women and girls have been imported who suffer from physical disabilities or are in an unsuitable physical condition. In some instances women of bad character have been associated in lodgings or hostels with respectable women and girls. Such instances, even if not numerous, exert far-reaching effect, and rumors spread quickly through a neigh borhood, losing nothing by repetition, and cause many housewives to close their doors against munition workers as lodgers. 503. The committee accordingly suggest that all women and girls, before being exported, should be examined by a doctor or by a nurse working under his supervision. They are glad to learn that arrange ments to this end have been made by the Ministry of Labor with the help of the Ministry of Munitions. 504. Mothers of infants or of families of young children should not# be exported.—The arrival of mothers in a town accompanied by quite young infants, or three or four young children, having traveled long distances, is by no means uncommon—the mother is attracted, in the absence of the father on active service, by the prospect of high wages in munition works, and brings her baby or children with her. To find lodgings where these are not unwelcome, and where some one will undertake the care of the children while the mother is out at the fac tory, is no easy task. The committee consider that this practice of taking children across country by train to some distant munition area and leaving them to strangers all day or all night should be discour aged, and they suggest that inquiry into such matters should be made at the source of supply by the nurse mentioned above, or by volun tary helpers of experience. 505. No woman or girl should be exported without a sufficiency of clothing or of money.—Women and girls frequently arrive at muni tion centers without luggage or any clothing except what they are 236 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . wearing, and without any money; they are often hungry and thirsty, having had no* food on a long journey. In some cases poverty is the cause, in many others the reason given has been that they had heard that everything necessary, including the first week’s lodging, was provided free. As the first wages are not due for a wreek, and fre quently are not paid until after 10 days or a fortnight (the first week’s, or a few days’ wages being kept back,) the plight of these women and girls in a strange town is not only uncomfortable but a serious danger. 506. The committee accordingly suggest that information should always be given at the employment exchange, verbally and by printed notices, that sufficient change of clothing, as well as money for emer gency expenses on the journey, must be taken. When the need is proved, financial help should be forthcoming from a fund adminis tered locally, safeguards being taken for the refunding of the loan out of wages. The practice already sometimes adopted of giving ad vances pending the first payment of wages might be extended. 507. Travelers across country should be seen off and met at the station.—The need for this protection of those unaccustomed to travel, especially if the distance is great, is well recognized. Where such services have not been organized, serious inconvenience and evil has arisen in many instances. To meet these difficulties, arrangements arc generally made for local agents to see the women and girls off by train, receive them at the station on arrival, and direct them to their employment exchange or lodging. In some cases arrangements have been found necessary for meeting parties in the course of their jour ney, when they have to change stations or trains. The Ministry of Munitions have made an arrangement with the Travelers’ Aid So ciety for meeting workers at junctions, and also on arrival, and con ducting them to their lodgings. Where nccessary, light refreshments are provided. At one junction a special canteen has been established by a local committee. HOUSING ACCOMMODATION AND TRANSIT. 508. Suitable and sufficient board and lodging should be provided for all exported women and girls not otherwise provided for. For this purpose there should be provided— («) Reception or clearing houses; (b) Lodgings; (c) Hostels; and (d) Convenient means of transit. 509. A reception or clearing house should be provided for any women and girls arriving without having secured lodgings, and for whom such can not be found before nightfall, or whose circunibtances W ELFARE OUTSIDE T H E FACTORY. 237 or condition make it difficult to allot lodgings without further inquiry. Such a clearing house has already been provided in some dis tricts, generally with the help of the Ministry of Munitions, and is, indeed, essential in localities where large numbers of women and girls arrive by train from distant places, often late in the day, with out any arrangements having been previously made for lodgings. The house needs to be suitably equipped for receiving all classes. It should be under the charge of a lady superintendent with consider able experience in dealing with women under any emergency; she should preferably have had some nursing training, and be a person of kindly, tactful character. The inmates should have separate cubicles, adequate washing and bathroom accommodation, and facil ities for washing clothing should also be provided. Good plain ap petizing food and a cheerful, warm sitting room are necessary. A homeless woman or girl, full of vague fears at taking up unaccus tomed work, especially in an explosive factory, may spread uneasiness and even alarm among her associates. Depression and fear are con tagious, and have been known to cause many to return home the day after arrival. But cheerfulness and courage are also contagious, and the influence of a lady superintendent or voluntary helpers among new arrivals at a reception hostel is of great value. The stay is gen erally only for a night or two— a week should, unless the case is excep tional, be the maximum—the inmates being found suitable lodging at the earliest moment. At some of these reception hostels arrange ments are made with the factory to refund the cost of board and lodg ings from wages on the first day by consent of the employee. 510. Lodgings with or without board in a family is the readiest and generally the most acceptable arrangement for women and girls. In most centers of munition work some efforts have been made to obtain information as to possible lodgings, visits being paid and lists of lodgings prepared. To begin with voluntary effort was mainly relied on for this purpose working under a voluntary organization or local advisory committee. Experience, however, proved that for an efficient list constant visiting was necessary in order to secure up-todate information as to lodgings actually vacant, and as to those which were suitable in character. Difficulties also sometimes arose from overlapping of different agencies, and in their memorandum No. 17 the committee, while cordially recognizing the value of the work being done, suggested the necessity for a larger and more elaborate organization than could be carried out by voluntary effort, and they urged the desirability of establishing some system of billet ing analogous to that employed for army purposes. During the past 12 months the ministry have established special lodgings committees in 8 of the principal munition districts, and 100 lodging inspectors 238 IN D U STRIAL H E A L T H AND E F F IC IE N C Y . have been employed in dealing with the many problems involved in the satisfactory housing of large numbers of girls in lodgings. 511. On the 24th of May, 1917, the billeting of civilians act, 1917, was passed “ to make provision for the billeting of persons engaged on work of national importance for the purposes of the present war.” A central billeting board was established, consisting of represents tives of the Government departments concerned and of other suita bi > persons. 512. The method by which the board proceeds is to set up a local billeting committee on which are represented the local authorities, the local lodgings committee (if one already exists), the employers, and the workers. An executive officer (who may be a man or woman) is appointed, who with the assistance of investigators makes a house to house canvass of the town and afterwards as an officer of the com mittee adjusts as far as possible any complaints which arise between landlady and tenant. Where the problem is chiefly concerned with men a male officer is appointed; where it is chiefly concerned with women there is usually a woman officer. The local committee has power to fix scales of payment for lodging and accommodations sub ject to the approval of the central board, and to guarantee payment, up to a reasonable extent, of charges incurred by defaulting lodgers. Machinery is in operation for recovering such charges from the defaulter, but in no case has it yet been found necessary to prose cute under the act. No compulsory billeting has yet taken place, and though compulsory powers are contained in the act, they are prob ably unworkable in practice. In the areas referred to them, the amount of accommodation which would be obtained by compulsory billeting is, generally speaking, so slight as to be negligible^ practically all the available lodgings being obtainable by voluntary means when once the payment of rent is guaranteed. A surprising number of voluntary lodgings has been forthcoming even in the most congested areas when once a house to house canvass has been made, and on one side the patriotism and good feeling of the people as a whole has been appealed to, and on. the other they have been secured against loss. In one of the most crowded centers 900, and in another 1,500, additional lodgings were found to be available after such a canvass. In one area, where the importation of additional labor has decreased, it has been found possible, in conjunction with the medical officer of health, to relieve the worst cases of overcrowding. This, of course, is only possible in cases where the supply of billets exceeds the number required to satisfy the demand of imported workers for accommodation. In cases where the Ministry of Munitions has already been employ ing lodgings investigators under the extramural welfare officer a W ELFARE OUTSIDE TH E FACTORY. 239 certain number of these investigators are usually transferred to the billeting board. An arrangement is come to whereby cases of hardship and distress which the billeting officer comes across in lodg ings are referred to the welfare officer for assistance, and she retains one or two of her original staff to assist in dealing with these. The billeting officer and the welfare officer are therefore in close touch in all questions relating to lodging accommodation and are often able to be of considerable use to each other. 513. Hostels.—In most areas, however, the problem is one not of lodgings but of housing. The towns were underhoused before the war, and the importation of large numbers of munition workers has simply served to accentuate a problem which already existed before the war. In a number of areas the Ministry are accordingly assist ing local authorities and private firms to carry out new schemes for increasing the permanent housing accommodation of the locality. But such schemes are not in themselves usually sufficient, and it has been found necessary to supplement them by the provision of tem porary dwellings, hostels, and hutments. Prior to the war hostels were provided by firms for the accommodation of their workers. A number of boarding houses for educated working women and for workingmen were also in existence. In addition, voluntary bodies and private persons had provided hostels intended to afford decent accommodation for girls with low wages; these were of necessity not run on a commercial basis. Conditions arising out of the war have led not only to increased provision by voluntary bodies, but have caused the Ministry of Munitions, acting either directly or through private firms, to erect temporary hutments, providing in some instances for many thousand workers. Such provision is not to be regarded as in any sense a permanent solution of the housing question, but simply as a temporary measure essential for the health, comfort, and efficiency of the workers who have been temporarily imported, not only into manufacturing towns but also into villages and rural districts. The following account of the experiences of a single district represents conditions which are by no means unique: Owing to the great influx of workpeople into this comparatively tiny village, it soon became apparent that housing would have to be arranged. W e therefore centered our efforts on this, with the result that we caused houses to be built on the Garden City principle, and there are now houses standing which were built by our own instigation, to the number of 625 on one estate, and on the other 100. In addition to this, we scoured the neighborhood and rented as many large unoccupied houses as w e could lay our hands on. In this way we are now in possession of over 70 hostels, where we house 1,600 people. The state of affairs at present is such that we have a long waiting list of people who desire to reside in the place. As soon as sanction is obtained ■we shall immediately start building houses, of which quite 1,000 are absolutely necessary. 240 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . 514. For various reasons hostels have not always been popular. The objections most commonly put forward by women and girls and by their trades-unions have included the following: (a) Girls dislike the idea of living in large communities or of spending their leisure hours with the persons with whom they work and with whom they may have no sympathy or social affinity. (b) However well organized a hostel may be, some restrictions on personal liberty are inevitable. (c) Where a hostel is provided by a private firm the girls are sub ject to the control of the firm during the whole 24 hours. If th*ey lose their job they are likely at the same time to lose their place of board and residence. (d) Hostels are not always self-supporting, and girls object to being “ beholden ” to anyone, most of all to the firm by whom they are employed. 515. More recently the numbers seeking admission to the hostels have steadily increased. It is not easy to determine how far this increase is due to a change of attitude in regard to the above points of objection, or, on the other hand, to improvements in the organiza tion and management of the hostel and to the greater difficulties at tending housekeeping in lodgings. In any case there can be no doubt of the essential importance of special care and attention being be stowed on the planning, equipment, and management of hostels. Some detailed suggestions on these points are given in Appendix F and only one or two points need be referred to here. Much depends upon the personality of the superintendent and upon the character of her assistants and staff, who should be carefully chosen and controlled. As much freedom as is compatible with good order should be allowed; the inmates are independent workers not living under any community rule. The bedrooms should be separate self-contained cubicles. The dining and recreation rooms should be bright, airy, and well warmed. In addition the need should be recog nized for rest and companionship of a few friends, and should be met by the provision of a sufficient number of small sitting rooms. The absence of these has doomed otherwise satisfactory hostels to failure, since many women and girls soon tire of organized recreation night after night, and having worked hard in a factory for many hours crave the quiet rest of a room more nearly resembling home. 516. Transit.—The suitability of the lodgings and housing accom modation of a district is closely affected by the existence of reasonable facilities for traveling between the place of residence and the factory. The committee have been greatly impressed with the extent to which health, temper, timekeeping, and output suffer, when to the day’s work is added the discomfort and fatigue of long walks in bad weather or in darkness, the long waits resulting from inconvenient W ELFARE OUTSIDE T H E FACTORY. 241 services, overcrowded railway carriages, trams, and buses. Ad mittedly the problems involved in the conveyance of large numbers of workers at particular times of day are not easy of solution and are increased by difficulties of staff and rolling stock created by the war, but experience conclusively proves that additional and more con veniently timed services can be provided; shelters at tram and omni bus termini have been erected. In some districts special fleets of chara-bancs have been provided. In the darkness of early morning and at night, if no lights are allowed on the railways, workers should not be crowded together in the darkness, and separate compartments for women are desirable. 517. To sum up the evidence collected by the committee and the results of their medical inquiries have emphasized the large extent to which the capacity and efficiency of the worker are affected by unsat isfactory conditions of housing and transit—conditions which fre quently existed before the war, though they have undoubtedly been accentuated since. Sufficient attention does not appear to have been given to the matter in the past, but it is essential that these factors should be taken into account in determining the best conditions of employment in different factories and areas. There can be do doubt (hat provision of better housing accommodation and of more rapid and convenient means of transit would have a beneficial effect on the industrial efficiency of the country. SICKNESS AND OTHER PERSONAL QUESTIONS. 518. Arrangements for sickness.—Large hostels have, as a rule, a small hospital with a nurse. Smaller hostels should be provided with sick rooms to which the patients may be removed if nursing and at tention are needed beyond what the servants can render. But illness, even of quite a temporary character, presents more difficulty among women and girls in lodgings in a strange place. For lodgers living with the family and sharing a room or a bed with other lodgers ill ness is a great misfortune, and may through neglect become very seri ous; it may, if infectious or contagious, be a source of danger to others and cause absence from work of many who are needed at the factory. Home visiting by the factory supervisor and the better or ganization now generally established have undoubtedly served to bring such cases to the notice of welfare officers and to secure suitable treatment. They have also served to bring to light cases of girls who are sufficiently unwell to be out of work for a few days or sometimes longer, but wfyo are not ill enough to require hospital treatment. Here again action is necessary to prevent hardship and distress. In one instance an arrangement has been made with a Government hostel under which a certain number of beds are reserved for these cases and S0935°— 19-------16 242 IN D U STRIAL H E A L T H AN D E FF IC IE N C Y . are filled on the recommendation of the outsicte welfare officer by girls who need rest and good food for a day or two. A certain number of rest homes have been established to which workers can be sent, and special pro-vision for sending them to convalescent homes has also been made. 519*. Stranded workers.—A certain number of girls come to muni tion centers not through the agency of the employment exchange and are either unable to obtain work or have after a short experience proved unsuited to the work and become stranded, often without money enough to return home. Such girls frequently require assist ance to obtain other and more suitable work or to return home. Where girls are dismissed through no fault of their own they are under certain conditions provided through the ministry with repatri ation railway warrants. 520. Maternity cases.—The numerous and urgent problems in volved in the care and treatment of maternity problems have already been discussed in Section IV , and need not be again referred to. The question involved in the provision of day nurseries for the chil dren of munition workers are also discussed in that section. LEISURE. 521. Recreation.—Emphasis has already been laid on the impor tance of recreation in providing the relief from monotony and the change of environment which are essential aids to recovery from fatigue. The question is one of special importance in areas where large numbers of workers have been congregated, and are thus de prived of the means of recreation to which they are accustomed. Especially should the leisure of the week-end be provided for. This important matter can not be left to chance. If opportunities of wholesome amusement* refreshment, and recreation are not provided, the public houses and less desirable places of entertainment may benefit, but everybody else suffers. Until recently there has not been in any munition area a sys tematic attempt to cope with the problems of industrial recreation, or even to coordinate the activities of such organizations as exist. The committee are, however, glad to recognize the increased atten tion now being paid to the subject. The clubs established are very varied in character and provide for men and women, as well as for boys and girls. In addition to the usual games, indoor recreation includes concerts, dances, theatricals, lectures, cinemas, classes of various kinds, including physical exercises, dancing, and dress making. Open-air provision includes games, swimming, and openair camps. Mixed clubs for men and women are increasingly popu lar, and most of the central schemes referred to below contain at W ELFARE OUTSIDE T H E FACTORY. 24$ least one mixed club. The need should not be overlooked for pro viding small clubs easily accessible to tired workers, who desire quiet occupation, and may not wish to journey to more central institutions. In more than one instance, it has been found practicable to arrange for well-to-do residents to offer hospitality in their own houses dur ing Saturday and Sunday to parties of women and girls, and to allow the use of their gardens in summer. Such facilities are greatly appreciated, and may do much to remove class prejudices and mis understandings. Recreation schemes are generally of one of two kinds: Central schemes available for all workers in the district, and factory schemes which are confined to the workers in a particular factory. 522. In a considerable number of areas, central recreation schemes have been set on foot through the cooperation of the civic author ities, existing agencies, the employers, and the workers. It is indeed an essential of the success of any recreation scheme that the workers should take a large share in the management, and that care should be taken to provide what they themselves desire. Arrangements have been made for cooperation with the juvenile organization com mittees, which are being established throughout the country by a central committee under the auspices of the home office. These com mittees are being encouraged to deal with adults as well as juveniles, and so to facilitate the establishment of schemes embracing the whole industrial population of a town. Under certain conditions (see Appendix K ), contributions by employers to recreation schemes may be written off as a working expense. The most detailed central scheme which has yet been worked out is that of Birmingham. There is a finance committee, of wrhich the Lord Mayor is chairman, an executive committee on which are represented various organiza tions and individuals interested in recreation. The city is divided into 14 areas, each of which has its own area committee consisting partly of employees; each committee has a representative on the central executive committee. The finance committee has complete control over all the funds raised and applica tions for funds come to it from the executive committee which is responsible, for weighing the various claims of the different areas or different organizations one against the other. Girls’ and boys’ clubs, recreation halls, playing fields, and open-air concerts are among the activities supported. The following state ment by the welfare supervisor of a local factory affords some indication of the value of the w ork: “ Welfare work in Birmingham is very much helped by the extremely good clubs started by the Civic Recreation League. There is one near our factory to which a large number of our girls go, and I have found it the very greatest help to ms in my work. In this club the girls have drilling, dancing, singing, embroidery, dressmaking, liiiflinery, dramatic, and shorthand classes, and, in summer, ram bles, cycle rides, swimming and tennis in connection with it. I go myself regu larly. A club of this sore is more satisfactory than one belonging and limited to employees of the w orks; it is more of a change for the girls. They can meet friends who go to other factories; with larger numbers it is possible to run it greater variety of classes. I can not speak too strongly of the importance I attach to these clubs, and any success I have had in my work I attribute largely 244 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . to the very pleasant conditions under which I got to know a large number of girls out of work hours at the Civic Recreation League Club. It is neither com fortable nor good discipline to talk to the girls more than is absolutely necessary in work hours, and unless one does talk to them they will never dare to come for help and advice on the many small points that are always cropping up in a large factory. One shop has a ladies’ football club, but I am hoping that next year the Civic Recreation League may have started hockey and netball teams and that the girls will join those instead. I feel most strongly that the ‘ playing of game ’ idea is in many cases lacking, and any possible kind of organized game should be encouraged in every way.” In other centers, instead of one big comprehensive scheme being set on foot at once, a small central club has started as a nucleus, and from that developments have gradually sprung. In one case a girls’ club was first set on foot, a boys' cadet corps speedily followed, and the town in question is now contemplating an ambitious scheme for a people’s palace. A most encouraging sign has been the interest and cooperation of the trades-unionists, both men and w omen, in certain areas as soon as they have realized the elasticity and freedom of the schemes. 523. Central schemes are, on the whole, to be preferred where they can be established, but in many cases, owing to the isolated position of the factory, the lack of local initiative or other causes, provision for recreation can only, or, at any rate, can most conveniently be made in connection with a particular firm. It forms, indeed, a natural develop ment of the w^ork of the welfare supervisor, and the committee are convinced that their activities have proved of the highest value and have been widely appreciated. Factory schemes are, however, liable to be objected to by the workers on the ground that they represent an endeavor on the part of the employer to bind them to the firm, or be cause they object to being tied to the works during their leisure time. Apart from this, a proportion of the employees may live at such a dis tance from the factory that they are unable to avail themselves of factory clubs. In such cases employers have sometimes found it desirable also to contribute to central schemes if they exist. 524. The following account has been received from a firm whose works are situated in an isolated position: On the social side everything possible is being done to interest and amuse our employees after working hours. W e have a good works orchestra, and our brass band is being organized, as theie is plenty of talent in the factory. This neigh borhood suffered a very severe blow when the theater was burnt down. W e are compelled to fall back upon a cinema annex (which is merely a large drafty marquee) and our Y. M. C. A. hut as the only available buildings outside the factory in which to hold entertainments. Our two mess rooms are in constant demand for socials and dances and whist drives, wThich are held almost every Saturday night, the proceeds from which are always devoted to some charitable object, such as the entertainment of wounded soldiers and sailors, etc. The employees support most generously any collection lists which are sent round the factory for charitable purposes. W e had a four weeks’ collection for Christmas parcels for soldiers and sailors on active service which realized over £600 [$2,919.90]. W e also raised over £400 [$1,946.60] for the Victoria buffet fund, and at the end of last year £438 [$2,131.53] was collected to entertain the wives and children of men from the neighborhood who have gone to the front. This enabled us to entertain 1,800 mothers and children on the two consecutive W ELFARE OUTSIDE T H E FACTORY. 245 Saturdays— January 26 and February 2. A visit from the Coldstream Guards Band was very much enjoyed by our workers a few weeks ago, and a novelty in the form of a recital by Mark Hambourg and the Gresham Singers last Sunday afternoon was highly appreciated by some 600 of our employees. A t the Y. M. O. A. hut we have a concert every Thursday evening and a lecture every Tuesday evening and a mid-day lecture every Wednesday. Club .— W ith regard to sports, our athletic club was thoroughly reorganized last spring. The following sections are now in full swing: Cricket, football, harriers, hockey, gymnastics, wrestling and boxing, and rifle club. W e also hope to start in the near future bowls, tennis, quoits, and a swimming club. Ladies and boys are included in these sections as well as men. For instance, the rifle club has a membership of 490 men, 53 ladies, and 51 boys, and the football section 492 men and 60 boys. W e also run a ladies’ football team. There are also about 80 lady members of the hockey section. Altogether we have about 1,400 members of the athletic club. W e are at present running an association football league in the factory in which 18 teams are competing. A new sports ground has just been acquired, and we should in the near future be fully equipped with good playing grounds for the various branches of sport. Throughout, our chief difficulty has been the securing of sufficient grounds for play. The above-mentioned grounds are a desirable estate situate close to the eliiirch, comprising about 45 acres in all, with a large private residence; the latter we intend fitting up as a maternity home (should we obtain the necessary grant from the ministry). The circumstances surrounding the purchase of this ground are extremely gratifying, inasmuch as we have the assurance of the workers here that the whole of the money will eventually be contributed by themselves. Not only is the proposition one of welfare from an athletic point of view, but a good housing venture, as it is proposed to build in due course. Magazine .— In July last we started the works magazine, wTith the double object of (1) saving paper and labor by avoiding the printing and circulation of notices on every variety of topic throughout the factory; and (2) giving the employees some idea of wThat is going on in their midst and to keep before them the facilities that are offered them for recreation, etc. The magazine seems to be answering its double purpose very satisfactorily; 8,600 copies of the special Christmas number were sold, and the sales in an ordinary month are now between 7,000 and 8,000 copies. An abundance of subject matter is contributed from all parts of the factory, and the advent of the magazine is eagerly looked forward to each month, proving the need of such a channel to break down (lass prejudice and build up cooperation. 525. The following statement gives some account of wThat is being done for the women workers at Woolwich Arsenal: About 18 months ago, bearing in mind that many of the women and girls employed in the Royal Arsenal were living in hostels or lodgings away from home, I drewr up and inaugurated a scheme to provide for them social and educational facilities out of arsenal hours. The result has more than passed my expectations, as during the above-named period some hundreds of the women workers have availed themselves of the opportunities offered. As many of the workers are engaged in processes necessitating a sitting position while at work, it seemed to me that provision should be made to counteract any ill effects that might accrue from long hours of sedentary work; therefore I ar ranged that gymnastics, physical exercises, Morris and country dancing be included in the scheme. During the summer months swimming is also included. I am sure that it is far better for women and girls to perform health-giving exercises under wise and trained supervision than for them to walk about the 246 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . darkened streets of the neighborhood aimlessly. Many workers are engaged in purely mechanical processes* and for these I felt that opportunity should be given for them to use their reasoning powers and to develop their intelligence. Therefore I arranged for classes in dramatic literature and elocution, thus giving students a taste for good reading. A large proportion of the women being engaged on more or less dangerous work, I felt it would be wise for them to have some knowledge of first aid, home nursing* etc. These classes are most popular and have attracted large numbers, many of whom presented themselves for special examination and were granted certificates of proficiency by the London County Council. T desired to launch my scheme without incurring expense or increased lia bility on the part of the Ministry of Munitions. I applied to the London County Council for the loan of a neighboring school and met with a ready response. On guaranteeing a sufficient number of students, the council offered to provide and remunerate instructors and instructoresses, and even appointed a responsible mistress to take charge of both the teaching staff and students and to keep in close touch with me as regards the carrying out effectively the details of my scheme. A charge of Is. [24.3 cents] per student per subject is made for each session. In order that the hours of work at the arsenal are not fn any way interfered with I arranged that classes should sit both shifts, the hours of instruction being from 5 to 6 for the night shift, and from S.15 to 9.15 for the day shift. The curriculum includes such subjects as gymnastics, physical exercises, Morris and country dancing, singing, dress and blouse mak ing. etc. I may add here that the men employed in the arsenal are permitted to join the singing, and the addition of their voices enables the class to enjoy the rehearsal of four-part glees, choruses, etc. This class also has rehearsed Elgar’s Banner of St. George and assisted in the chorus of the mystery play Eager Heart. At varying times the students arrange social gatherings on Saturday even ings ; each member of the class is allowed to invite a nonmember, and the girls are specially encouraged to introduce their male friends. In addition to the monthly socials, twice at least during the season, the members of the gym nastic classes give displays at the town hall and in this wTay further recruits from the arsenal to the classes are obtained. The literature class also con tributes a public performance, producing scenes from standard plays and authors. But though a large number can and do attend these classes, there is a far larger number wTho have no time for recreation except on Sundays. I there fore, in cooperation with Mr. Howard Jones, organized Sunday concerts at the Woolwich Town Hall, for which we obtain the best talent possible, and at which we endeavor to reach a very high standard and tone. These concerts have done untold good; but now that the factories are closing half days on Saturdays, I am proposing to drop the Sunday during the summer months and organize Saturday afternoon outings into the country. Several hockey and football clubs have been organized throughout the winter under the supervision of some of my staff. The members of the various classes and clubs from time to time have given performances for the entertainment ©f wounded soldiers. Another outcome of the scheme has been the inauguration during the winter season of a series of dunces under welfare supervision. 526. What may be clone on a smaller scale by an energetic welfare supervisor is illustrated by the following account: W e are in need of recreation room s; we have to use our dining rooms for alt recreation schemes. In these dining rooms we have a cinema box and stages W ELFARE o u t s id e the factory. 24-7 W e liave concerts, dances, or whist drives all through the winter months every Saturday night. The girls’ club runs a gymnasium class on Wednesday even ings and a dance every Monday, to which men and nonmembers are allowed to come on payment of 3d. 527. I n 1915 th e M a h a r a ja h S cin clia o f G w a lio r g e n e r o u s ly g a v e a su m o f £ 6 ,0 0 0 f o r m u n it io n w o r k e r s . U p t o th e p re s e n t a b o u t th r e e q u a rte rs o f th is su m h a s b e e n d is tr ib u te d b y th e w e lfa r e d e p a r tm e n t o f th e M in is t r y o f M u n it io n s o n th e d e v e lo p m e n t o f sch e m e s f o r r e c r e a tio n , in c lu d in g le ctu r e s a n d c o n c e r ts in c lu b s a n d ca n te e n s , p ia n o s , la n te rn slid e s , b o o k s o r p ic t u r e s f o r c lu b s , o r g a n iz a t io n o f r e c r e a tio n , a n d a h o lid a y c a m p f o r b o y s . 528. Facilities fo r divine ivorship , r e lig io u s in s tr u c tio n , a n d s p ir itu a l m in is t r a t io n a c c o r d in g t o th e c o n v ic t io n s o f th e v a r io u s d e n o m i n a tio n s a re n o less w o r t h y o f c o n s id e r a t io n f o r m u n it io n w o r k e r s th a n f o r th e A r m y a n d N a v y . T h e e x is tin g lo c a l p r o v is io n m a y n o t a l w a y s b e a d e q u a te o r c o n v e n ie n t ly situ a te d . 529. Public order .— T o b r in g la r g e n u m b e r s o f y o u n g p e o p le in t o a n y lo c a lit y m u st in c re a s e th e d iffic u lty o f m a in t a in in g p u b lic o r d e r a n d g o o d b e h a v io r at a ll tim e s. J u s t as in u n iv e r s it y t o w n s th e r e a re p r o c t o r s a n d in m ilit a r y ce n te rs th e re a re m ilit a r y p o lic e , s o w h e r e la r g e n u m b e rs o f w o m e n a n d g ir ls a re a sse m b le d f o r m u n it io n w o r k w o m e n p o lic e a n d p a t r o ls a re r e q u ir e d . S p e c ia l d a n g e r s b eset y o u n g w o m e n a w a y fr o m h o m e a n d fr ie n d s ; th e im p o s s ib ilit y o f e x c lu d in g a lt o g e t h e r fr o m th o se w h o flo c k in t o m u n it io n area s som e w o m e n o f b a d c h a r a c te r , th e n e ce s s ity f o r s u b d u in g th e lig h t in g o f streets a n d c o u r t s a n d o p e n sp a ce s, a n d th e c h a n g e o f s h ift s a t th e fa c t o r y e a r ly a n d la te — a ll c o n tr ib u te t o c o n d it io n s o f d iffic u lty f o r w h ic h t r a in e d w o m e n a re w e ll a d a p te d . A la r g e n u m b e r o f w o m e n p o lic e a re e m p lo y e d b y th e M in is t r y o f M u n it io n s in s id e fa c t o r ie s ; in o n e a rea e ig h t a re e m p lo y e d b y th e m in is t r y in th e t o w n it s e lf. I n m a n y to w n s w o m e n p o lic e a re n o w w o r k in g s u c c e s s fu lly u n d e r th e c h i e f c o n s t a b le ; th e y a re u n ifo r m e d a n d t r a in e d as r e c o g n iz e d m e m b e r s o f th e fo r c e , a n d in som e to w n s th e y are “ s w o r n in .” W o m e n p a t r o ls h a v e b e e n fo u n d v e r y u s e fu l w o r k in g in c o o p e r a t io n w it h th e p o lic e . T h e y a re m o r e e s p e c ia lly h e lp fu l in d e a lin g w it h y o u n g g ir ls w h o s e t h o u g h t lessn ess m a y b e p la c in g th e m in th e w a y o f te m p t a t io n . I n th e r e p o r t o f I I . M . in s p e c to r o f c o n s ta b u la r y , H o m e O ffice, 1918, it is sta te d th a t 7 c o u n tie s a n d 24 c itie s s h o w w o m e n as p a r t o f th e a c tu a l s tr e n g th o f th e p o lic e fo r c e . T h e in s p e c t o r m e n tio n s in h is r e p o r t th e d u tie s a llo tte d t o w o m e n p o lic e . A m o n g th e m “ th e m a in te n a n c e o f p u b lic d e c o r u m a m o n g g ir ls u p o n w h o m th e p re s e n ce a n d a d v ic e o f w o m e n in a u t h o r it y h a s a m o r e r e s t r a in in g in flu e n ce th a n th o se o f a m an.*' H e a ls o c o m m e n ts on th e g o o d w o r k d o n e b y w o m e n p a t r o ls , a n d w r it e s : “ T h e su ccess o f th e w o m e n p a t r o ls w ill, to m y m in d , p r o v id e s t r o n g a r g u m e n t f o r th e e m p lo y m e n t o f w o m e n in th e r e g u la r p o lic e f o r c e .” 248 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . 530. The encouragement o f sobriety among the population is an im p o r t a n t b r a n c h o f th e w e lfa r e w o r k ; q u e s tio n s as t o th e n u m b e r a n d th e sta tu s o f th e p u b lic h o u se s in m u n it io n a rea s, th e h o u r s d u r i n g w h ic h d r in k m a y b e s o ld , a n d o th e r m a tte r s o f a lik e n a tu re* a rise f o r c o n s id e r a t io n a n d a c tio n in a c c o r d a n c e w it h th e n e e d s o f e a ch lo c a lit y . 531. M u c h h a s b e e n d o n e t o im p r o v e th e h e a lth a n d in c re a s e th e e fficie n cy o f th e m u n it io n w o r k e r b y th e r e d u c t io n in e x c e s s iv e d r in k in g w h ic h h a s b ee n b r o u g h t a b o u t t h r o u g h th e r e s t r ic t iv e m e a su re s o f th e c e n tr a l c o n t r o l b o a r d (liq u o r tra ffic ) u n d e r th e c h a ir m a n s h ip o f L o r d D ’A b e r n o n a n d o f w h ic h th e c o m m it t e e ’s c h a ir m a n ( S i r G e o r g e N e w m a n ) is a m e m b e r . T h e s ta tis tic a l e v id e n c e w h ic h is a t p re s e n t a v a ila b le w it h r e g a r d t o th e e ffe ct o f th ese m e a su re s d e a ls w it h th e g e n e r a l p o p u la t io n , a n d d o e s n o t in c lu d e d a ta h a v in g s p e c ific r e fe r e n c e t o m u n it io n w o r k e r s as a d is t in c t cla ss. I t m a y , h o w e v e r , b e a ssu m e d w it h o u t q u e s tio n th a t a n y g e n e r a l m o v e m e n t in th e p r e v a le n c e o f a lc o h o lis m m u s t n e c e s s a r ily a ffe c t th e in d u s t r ia l cla sse s as m u c h as, i f n o t, in d e e d , m o r e th a n th e o th e r s e c tio n s o f th e c o m m u n it y ; so th a t, i f th e re h a s b e e n a n y c o n s id e r a b le d e cr e a se in a lc o h o lic m o r t a lit y a n d a lc o h o lic d ise a se in th e p o p u la t io n a t la r g e , it is c le a r t h a t th e re m u st h a v e b e e n a c o r r e s p o n d in g , o r ev en g r e a t e r e ffe c t o f th e sa m e s o r t in th e ca se o f m u n it io n w o r k e r s . A n d th e s ta tis tic a l e v id e n c e th a t su ch a d e cr e a s e o f a lc o h o lis m h a s, in fa c t , o c c u r r e d is d e fin ite a n d c o n v in c in g . T h u s , t a k in g th e fig u re s f o r th e p r e w a r y e a r 1913 as th e b a s is o f c o m p a r is o n , th e r e tu r n s o f th e r e g is t r a r g e n e r a l s h o w th a t th e m o r t a lit y fr o m c h r o n ic a lc o h o lis m , w h ic h in 1 914 s h o w e d a s lig h t d e cr e a s e in tlie ca se o f fe m a le s a n d a s lig h t in c r e a s e in th e ca se o f m a le s, f e l l in th e f o l l o w i n g y e a r b y 22 p e r c e n t in m e n a n d b y 19 p e r c e n t in w o m e n , a n d in 1916, w h e n th e r e s t r ic t iv e o r d e r s o f th e c o n t r o l b o a r d w e r e in o p e r a t io n o v e r th e g r e a te r p a r t o f th e c o u n t r y th e n u m b e r o f d e a th s f r o m th is ca u se d r o p p e d b y n o less th a n 44 p e r c e n t a n d 54 p e r c e n t in m a le s a n d fe m a le s , r e s p e c t iv e ly . T h is d o w n w a r d m o v e m e n t c o n t in u e d in 1917, th e fig u re s f o r th e 12 m o n th s b e in g 67.8 p e r c e n t b e lo w th e 1913 s ta n d a r d in th e ca se o f m e n , a n d 69.1 p e r c e n t in th e ca se o f w o m e n . D e a t h s fr o m c ir r h o s is o f th e liv e r s h o w a s im ila r d e cr e a se , t h o u g h s m a lle r in d e g r e e , as w o u ld n a t u r a lly b e a n t ic ip a t e d , h a v in g r e g a r d t o th e c h r o n ic n a tu r e o f th is a ffe c tio n a n d th e lim it e d e x te n t t o w h ic h its p r o g r e s s c a n b e d e la y e d ev en b y r ig o r o u s a b s tin e n ce f r o m a lc o h o l. 532. S t a t is t ic a l d a ta o f a c o m p a r a b le c h a r a c te r r e fe r r in g t o a lc o h o lic d ise a se a re u n fo r t u n a t e ly v e r y s c a n ty , b u t, so f a r as th e y a re a v a ila b le , t h e y f u ll y a g r e e w it h th e m o r t a lit y r e tu r n s o f th e r e g is t r a r g e n e r a l in s h o w in g a m a r k e d a n d p r o g r e s s iv e d e cr e a se o f a lc o h o lis m d u r in g th e la st th re e y e a rs . T h u s , in c e r ta in lo c a lit ie s w h e re it h a s b e e n p o s s ib le t o o b ta in r e c o r d s o f th e ca ses o f d e lir iu m tre m e n s o v e r W ELFARE OUTSIDE T H E FACTORY. 2 49 a te r m o f y e a rs , it h a s b e e n fo u n d tlia t tlie p r e v a le n c e o f tliis u n e q u iv o c a lly a lc o h o lic d is o r d e r h a s fa lle n b y as m u c h as 81 p e r ce n t b e tw e e n 1914 a n d 1917. I n L iv e r p o o l, f o r e x a m p le , th e ca ses r e c o r d e d in e a c h y e a r w it h in th is p e r io d n u m b e r e d as f o l l o w s : 1914, 511 (8 6 6 m a le s, 145 f e m a l e s ) ; 1915, 421 (2 6 3 m a le s, 158 f e m a l e s ) ; 1916, 205 (1 2 8 m a le s, 77 fe m a le s ) ; 1917, 99 (7 1 m a le s, 28 fe m a le s ). O fficia l s ta tis tics o f a lc o h o lic m o r t a lit y a n d a lc o h o lic d ise a se d o n o t, o f co u rse , fu r n is h a n y m e a su re o f th e a b so lu te a m o u n t o f ill-h e a lt h a n d in e fficie n cy d u e t o e x ce s s iv e d r in k in g ; b u t th is fa c t d o e s n o t d e tr a c t fr o m t h e ir v a lu e as in d ic a t in g b y th e ir flu c tu a tio n s th e g e n e r a l m o v e m e n t o f a lc o h o lis m , a n d its r e a c t io n to th e in flu e n ce s w h ic h te n d to in c re a s e o r d im in is h its p r e v a le n c e . R e g a r d e d fr o m t h is p o in t o f v ie w , th e s ta tis tic s q u o te d a b o v e j u s t if y th e in fe r e n c e th a t th e u n p r e c e d e n te d r e d u c t io n in th e d e a th ra te fr o m a lc o h o lis m a n d in th e in c id e n c e o f th e g r a v e r fo r m s o f a lc o h o lic d ise a se s in ce th e e n fo r c e m e n t o f th e r e s t r ic t iv e m e a su res o f th e c o n t r o l b o a r d , is a s ig n a n d in d e x o f a c o r r e s p o n d in g d e cre a se in th e less s e r io u s a n d less o b v io u s e ffe cts o f in te m p e r a n c e o n th e h e a lth a n d w o r k in g e n e r g ie s o f ’ th e m u n it io n w o r k e r . A n d th is in fe r e n c e is f u ll y b o r n e o u t b y th e t e s tim o n y o f e m p lo y e r s o f la b o r a n d b y th e e v id e n c e o f c o m p e te n t o b s e rv e r s w h o h a v e h a d o p p o r t u n it ie s o f in v e s t ig a t in g th e e ffe c t o f liq u o r c o n t r o l o n th e c o n d it io n o f th e in d u s t r ia l w o r k e r a n d h is o u tp u t. T h e liq u o r b o a r d n o t o n ly r e d u c e d th e h o u r s o f sa le, b u t c o n c e n tr a te d th e m at th e w o r k m e n ’s m e a l tim e s a n d a lso im p o s e d r e s tr ic tio n s u p o n th e sa le o f s p ir its , c r e d it sales, a n d th e h a b it o f t r e a t in g .1 1 See first [Cd. 8 1 1 7 ], second [Cd. 8 2 4 3 ], third [Cd. 8 5 5 8 ], and fourth [Cd. 9 0 5 5 ] rep orts of the central control board (liquor traffic). SE CTIO N X X .— S U M M A R Y OF CO N CLU SIO N S. 533. T lie c o m m itte e c o n s id e r th a t it is b o t h d e s ir a b le a n d c o n v e n ie n t th a t t h e y s h o u ld c o n c lu d e t h e ir fin a l r e p o r t b y s h o r t ly s u m m a r iz in g th e v a r io u s p r in c ip le s e n u n c ia te d , th e c o n c lu s io n s a r r iv e d a t, a n d tlie r e c o m m e n d a t io n s m a d e in th e v a r io u s s e c tio n s o f th e r e p o r t . W h ile th e r e c a n b e n o d o u b t th a t sin ce th e a p p o in t m e n t o f th e c o m m itte e in S e p te m b e r , 1915, th e issu e o f th e ir m e m o r a n d a , th e a c t io n o f th e c e n tr a l d e p a r tm e n ts c o n c e r n e d , a n d th e tr e n d o f o p i n io n a m o n g e m p lo y e r s , w o r k e r s , a n d th e p u b lic g e n e r a lly h a v e c o m b in e d t o se cu re a v e r y s u b s ta n tia l im p r o v e m e n t in th e c o n d it io n s o f e m p lo y m e n t , it w o u ld b e a v e r y g r a v e m is ta k e t o a ssu m e th a t a ll is n o w w e ll, o r th a t fu r t h e r c a r e a n d a tte n tio n a re n o t s till e ss e n tia l i f a se rio u s b r e a k d o w n o f in d u s t r y is t o b e a v o id e d . F u r t h e r , w h ile th e c o m m itte e h a v e o f n e ce s s ity b een p r im a r ily c o n c e r n e d w it h th e h e a lth a n d p h y s ic a l e fficie n cy o f th e m u n it io n w o r k e r u n d e r -t h e a b n o r m a l c o n d it io n s c r e a te d b y th e w a r , th e y a re s t r o n g ly o f o p in io n th a t th e p r in c ip le s u n d e r ly in g r ig h t a c tio n a t th e p re s e n t tim e a re p e r m a n e n t a n d n o t m e r e ly t r a n s it o r y in im p o r t a n c e , a n d s h o u ld b e a c c e p te d a ls o as fu n d a m e n t a l t o a ll sch e m e s f o r in d u s t r ia l h e a lth a n d b e tte r m e n t a ft e r th e w a r. O n e o f th e v it a l a n d p r e s s in g p r o b le m s b e f o r e th e c o u n t r y a t th e p r e s e n t m o m e n t a n d in th e im m e d ia t e fu t u r e is th e q u e s tio n o f th e h e a lth a n d c o n te n tm e n t, th e c a p a c it y , sta tu s, a n d e ffic ie n c y o f th e in d u s t r ia l w o r k e r , w h o s e c o n t r ib u t io n t o th e c o m m o n w e a lth is o f e v e r -g r o w in g im p o r ta n c e . F o r c o n v e n ie n c e o f r e fe r e n c e th e s u m m a r y fo llo w s th e o r d e r o f th e s e c tio n s o f th e r e p o r t . I.—INTRODUCTORY. (i) S in c e th e c o m m itte e w e r e a p p o in t e d in S e p te m b e r , 1915, th e re h a s b e c o m e a p p a r e n t a n in c re a s e d a p p r e c ia t io n o f th e im p o r t a n c e o f th e w h o le q u e s tio n o f in d u s t r ia l h y g ie n e ; th e re is n o d o u b t th a t th e e n v ir o n m e n t a n d c o n d it io n s o f e m p lo y m e n t o f , th e w o r k e r a re v a s t ly b e tte r th a n th e y w e r e , t h o u g h th e re is s t ill m u c h n e e d f o r fu r t h e r im p r o v e m e n t . A p a r t fr o m th e q u ic k e n in g o f th e n a t io n a l c o n s cio u s n e s s a n d sen se o f r e s p o n s ib ilit y r e s u lt in g fr o m th e w a r , th is d e v e lo p m e n t m a y b e a ttr ib u te d to th re e m a in ca u se s, th e w id e s p r e a d a d o p t io n o f th e r e c o m m e n d a tio n s c o n t a in e d in th e c o m m it t e e ’s m e m o r a n d a a n d r e p o r ts , th e e s ta b lis h m e n t o f a h e a lth a n d w e lfa r e s e c t io n at th e M in is t r y o f M u n it io n s a n d th e in c r e a s e d p o w e r s f o r se250 SU M M A R Y OF CONCLUSIONS. 251 c u r in g tlie w e lfa r e o f w o r k e r s c o n fe r r e d u p o n th e H o m e O ffice b y th e p o lic e , fa c t o r ie s , etc. (m is c e lla n e o u s p r o v is io n s ) , a ct, 1916. (S e o p a r a g r a p h s 1 -1 0 .) II.—PRELIMINARY AND HISTORICAL SURVEY. ( i i ) T h e p r o b le m s c o n c e r n e d w it h th e w e ll-b e in g o f th e w o r k e r a re n o t n e w , t h o u g h th e y h a v e b e e n a c c e n tu a te d b y th e w a r . E v e r s in c e th e firs t b e g in n in g s o f th e m o d e r n fa c t o r y s y s te m th e s e p r o b lem s h a v e r e c e iv e d in c r e a s in g a tte n tio n f r o m th e S ta te , th e e m p lo y e r , a n d fr o m th e w o r k e r s th e m se lv e s. M a n y o f th e q u e s tio n s c o n s id e r e d in th is r e p o r t a re in t im a t e ly c o n n e c te d w it h w id e r s o c ia l a n d in d u s t r ia l q u e stio n s w h ic h f a l l o u ts id e th e te r m s o f r e fe r e n c e o f th e c o m m itte e . ( i i i ) T h e w o r k o f tlie c o m m itte e h a s b e e n g r e a t ly e m b a ra ss e d b y th e lim it e d e x te n t t o w h ic h in th e p a s t s c ie n tific in v e s t ig a t io n h a s b e e n m a d e in t o th e v a r io u s p r o b le m s a ffe c t in g in d u s t r ia l e fficie n cy . I n q u ir ie s in t o th e e ffe c t o f in d u s t r y u p o n h e a lth h a v e b e e n la r g e ly lim it e d t o s p e c ia l in q u ir ie s c o n d u c t e d in t o p a r t ic u la r “ d a n g e r o u s ” tra d e s . T h e r e h a s e x is te d n o p e r m a n e n t o fficia l b o d y c h a r g e d w it h th e d u t y o f c o n t in u in g th ese in q u ir ie s o r o f in v e s t ig a t in g th e e ffe c t u p o n h e a lth o f in d u s tr ie s w h ic h , t h o u g h n o t t e c h n ic a lly u d a n g e r o u s ,” m a y s till e x e r c is e a p o t e n t in flu e n ce u p o n h e a lth a n d p h y s ic a l effi c ie n c y . R e s e a r c h is g r e a t ly n e e d e d in t o th e r e la tio n s h ip o f o c c u p a t io n t o fa t ig u e , in v a lid it y , a n d m o r t a lit y . I t is o n ly w it h in th e la s t 2 0 y e a r s th a t m e d ic a l o ffice rs h a v e b e e n a p p o in t e d t o th e f a c t o r y d e p a r tm e n t o f th e H o m e O ffice, a n d th e lim it e d n u m b e r o f th o s e officers h a s m a d e it in e v it a b le th a t t h e ir a c t iv it ie s s h o u ld b e la r g e ly c o n fin e d t o q u e s tio n s o f im m e d ia te a d m in is t r a t iv e im p o r t a n c e . I t is g r e a t ly t o b e h o p e d th a t p e r m a n e n t p r o v is io n w ill b e m a d e f o r a w id e r a n d m o r e c o n tin u o u s in v e s t ig a t io n o f th e in flu e n ce s o f in d u s t r y u p o n h e a lth th a n h a s h it h e r t o b ee n p r a c t ic a b le . (S e e p a r a g r a p h s 1 1 -5 0 .) III.—THE RELATION OF FATIGUE AND ILL HEALTH TO INDUSTRIAL EFFICIENCY. ( i v ) T h e s u b je c t o f in d u s t r ia l e fficie n cy in r e la tio n to h e a lth a n d fa t ig u e is in la r g e d e g r e e o n e o f p r e v e n t iv e m e d ic in e , a q u e s tio n o f p h y s io lo g y a n d p s y c h o lo g y , o f s o c io lo g y a n d in d u s t r ia l h y g ie n e . ( v ) F a t ig u e is th e su m o f th e re su lts o f a c t iv it y w h ic h show T t h e m se lv e s in a d im in is h e d c a p a c it y f o r d o in g w o r k . F a t ig u e m a y s p r in g fr o m th e m a in ta in e d u se o f in t e llig e n c e , th e m a in te n a n c e o f s te a d y a tte n tio n , o r th e c o n t in u e d u se o f s p e c ia l sen ses. W h e n th e w o r k is m o n o to n o u s fa t ig u e m a y a p p e a r in th e p s y c h ic a l fie ld ; m o n o t o n y m a y d im in is h c a p a c it y f o r w o r k ; o n th e o th e r h a n d “ in t e r e s t ” m a y in c re a s e it. 252 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . ( v i ) F a t ig u e s h o u ld b e d e te c te d a n d its ca u se s d e a lt 'w it h w h ile it is s till la te n t a n d b e f o r e it b e c o m e s e x ce ssiv e . T h e tests o f fa t ig u e a re d im in is h e d o u tp u t, th e fa ilu r e o f c o n c e n t r a t io n a s s h o w n in in c re a s e d a c c id e n ts a n d s p o ile d w o r k , sta len ess, ill h e a lth , a n d lo s t tim e . ( v i i ) W it h o u t h e a lth th e r e is n o e n e r g y ; w it h o u t e n e r g y th e re is n o o u tp u t. M o r e im p o r t a n t th a n o u t p u t is th e v ig o r , s tr e n g th , a n d v it a lit y o f th e n a tio n . T h e c o n d it io n s e ss e n tia l t o th e m a in te n a n c e o f h e a lth a re, first, p e r s o n a l c o n d it io n s o r th o s e fa v o r a b le t o th e b o d y it s e lf (e. g ., fo o d , fr e s h a ir, e x e r cis e , w a r m th , a n d a d e q u a te r e s t ), a n d , s e c o n d ly , a s a t is fa c t o r y e n v ir o n m e n t (e . g ., a s a fe a n d s a n ita r y f a c t o r y , s u ita b le h o u r s o f w o r k , g o o d h o u s in g a c c o m m o d a t io n , a n d c o n v e n ie n t m e a n s o f t r a n s it ). (S e e p a r a g r a p h s 5 1 -8 2 .) IV.— THE INDUSTRIAL EMPLOYMENT OF WOMEN. ( v i i i ) I n c o n s id e r in g c o n d it io n s o f e m p lo y m e n t o f w o m e n as c o m p a r e d w ith th o s e o f m e n a c c o u n t m u st b e ta k e n n o t o n ly o f p h y s io lo g i c a l d iffe r e n c e s b u t a ls o o f th o se c o n t r ib u t io n s w h ic h w o m e n a lo n e ca n m a k e to th e w e lfa r e o f th e c o m m u n it y . C e r ta in a ilm e n ts a n d fo r m s o f p h y s ic a l d is a b ilit y to w h ic h w o m e n a re lia b le are r e a d ily c a u se d , o r a t lea st a c c e n tu a te d , b y la c k o f a tte n tio n t o t h e ir s p e c ia l n eed s. ( i x ) U p to th e p re s e n t th e re h a s b ee n n o m a r k e d b r e a k d o w n in th e h e a lth o f w o m e n in in d u s tr y . I t is p r o b a b le , h o w e v e r , th a t th e s tr a in h a s b e e n g r e a t e r th a n is at p re s e n t a p p a r e n t, h a v in g b e e n h it h e r t o c o u n te r a c te d o r d is g u is e d b y c e r ta in fa c t o r s , su ch as im p r o v e d f o o d a n d b e tte r fa c t o r y e n v ir o n m e n t, w e lfa r e s u p e r v is io n , a n d th e d r o p p in g o u t o f th e p h y s ic a lly w e a k e r. U n d o u b t e d ly m a n y w o m e n a re o n ly a b le t o k e e p w o r k in g b y a to t a l a b a n d o n m e n t o f a ll r e c r e a tio n o r s o c ia l in te rc o u rs e . ( x ) C e r ta in c o n d it io n s o f e m p lo y m e n t a re e ss e n tia l i f th e r is k o f fu t u r e b r e a k d o w n is t o b e a v o id e d , in c lu d in g s h o r t h o u r s o f w o r k c o n v e n ie n t ly a r r a n g e d , m e d ic a l s u p e r v is io n (in c lu d in g re st r o o m s , firs t a id , e t c .) , c a r e fu l s e le c tio n o f w o r k e r s , g o o d f o o d , a fa v o r a b le fa c t o r y e n v ir o n m e n t , s y m p a th e tic m a n a g e m e n t a n d s u p e r v is io n . ( x i ) I n th e ca se o f m a r r ie d w o m e n , to th e s tr a in o f t h e ir w o r k m u st g e n e r a lly b e a d d e d th e s tr a in in v o lv e d in h o u s e w o r k , as w e ll as in f a m ily w o r r ie s a n d a n x ie tie s. C o n s e q u e n tly t h e y a re less a b le t o b e a r th e s tr a in o f e m p lo y m e n t, a n d s p e c ia l a tte n tio n is n e ce s s a r y to th e c o n d it io n s o f th e ir w o r k , p a r t ic u la r ly in r e la tio n t o th e p e r io d o f p r e g n a n c y a n d th e c a re o f y o u n g c h ild r e n . A n y g e n e r a l p r o h ib it io n o f th e ir e m p lo y m e n t is im p r a c t ic a b le , b u t it s h o u ld b e c o n fin e d so f a r as p o s s ib le t o u lig h t ” w o r k , a n d th e p o s s ib ilit y m ig h t b e c o n s id e r e d o f a llo w in g th e m s o m e r e la x a t io n a t th e b e g in n in g a n d e n d o f th e d a y a n d a lso d u r in g th e d in n e r in te r v a l, as is s o m e tim e s d o n e in c e rta in in d u s t r ia l d is t r ic t s a n d a lso in F r a n c e . T h e c o m m itte e d e - S U M M A R Y OF CONCLUSIONS. 253 s ire t o d r a w s p e c ia l a tte n tio n t o th e c o n c lu s io n s o f th e ir m e d ic a l in v e s tig a to r s . (S e e p a r a g r a p h s 8 3 -1 1 5 .) V.—IIOURS OF LABOR. ( x i i ) A t th e b e g in n in g o f th e w a r th e re e x is te d a m a r k e d d iv e r g e n c e o f o p in io n as to th e le n g t h o f h o u r s th a t m e n c o u ld p r o fit a b ly w o r k , b u t th e re w a s a w id e s p r e a d b e lie f th a t lo n g h o u r s p r o d u c e d a la r g e r o u tp u t, t h o u g h n o t n e c e s s a r ily p r o p o r t io n a t e ly so. M e n , a n d e s p e c ia lly th e m o r e h ig h ly s k ille d w o r k e r s , w e r e fr e q u e n t ly e m p lo y e d f o r as m u c h as 90 h o u r s a w e e k . I n J a n u a r y , 1916, th e c o m m itte e p r o v i s io n a lly r e c o m m e n d e d th a t th e a v e ra g e w e e k ly h o u r s o f e m p lo y m e n t o f m e n s h o u ld b e lim it e d t o 6 5 -6 7 ; th a t is t o sa y , a 1 3 -1 4 h o u r w o r k in g day. ( x i i i ) I n th e e a r lie r sta g e s o f th e w a r m a n y w o m e n w e r e e m p lo y e d ' f o r o v e r 70 h o u r s a w e e k , b u t th e re w a s a m u c h s m a lle r d iv e r g e n c e o f o p in io n as t o th e le n g t h o f h o u r s w h ic h w a s p r o d u c t iv e o f th e g r e a te s t o u tp u t, a n d th e c o m m itte e in J a n u a r y , 1916, p r o v is io n a lly r e c o m m e n d e d th a t th e h o u r s o f w o m e n s h o u ld b e r e s tr ic te d w it h in th e lim it o f 60 p r e s c r ib e d b y th e F a c t o r y a n d W o r k s h o p s A c t , 1901, a n d th a t th e e m p lo y m e n t at n ig h t o f g ir ls u n d e r 18 s h o u ld b e lim it e d so fa r as povssible. ( x i v ) I n v ie w o f th e e x te n t to w h ic h b o y s a re e m p lo y e d to h e lp m e n , th e c o m m itte e in J a n u a r y , 1916, p r o v is io n a lly r e c o m m e n d e d th a t th e y s h o u ld b e a llo w e d to w o r k f o r th e sa m e h o u r s a s m e n , B u t it w a s u r g e d th a t, so f a r as p o s s ib le , b o y s u n d e r 16 s h o u ld n o t b e e m p lo y e d f o r m o r e th a n 60 h o u r s o r at n ig h t. ( x v ) T h e s c ie n tific d a ta c o lle c t e d f o r th e c o m m itte e a n d th e e x p e r i e n ce g a in e d d u r in g th e p a s t t w o y e a rs c o m b in e t o s u p p o r t th e v ie w th a t th e le n g th o f h o u r s o f e m p lo y m e n t p r o v is io n a lly r e c o m m e n d e d t w o y e a rs a g o a re n o w t o o lo n g a n d ca n b e r e d u c e d w it h o u t lo s s o f o u tp u t. ( x v i ) B y e c o n o m iz in g tim e , a p a r t fr o m a n y in c re a s e d r a p id it y o f w o r k in g , th e h o u r ly ra te o f o u t p u t ca n b e c o n s id e r a b ly in c re a s e d . ( x v i i ) T h o u g h h o u r s o f w o r k h a v e b e e n m u c h r e d u c e d d u r in g th e p a s t t w o y e a rs , th e tim e is r ip e f o r fu r t h e r s u b s ta n tia l r e d u c tio n s . W h a t th e e x te n t o f th e r e d u c t io n s h o u ld b e in a n y p a r t ic u la r ca se ca n o n ly b e d e te r m in e d a ft e r c o n s id e r in g a n u m b e r o f fa c t o r s , su ch as th e p h y s ic a l o r m e n ta l s tr a in o f th e w o r k , th e e x te n t t o w h ic h th e p a c e o f th e w o r k is g o v e r n e d b y th e m a c h in e , th e fa c t o r y e n v ir o n m e n t, th e p h y s ic a l c a p a c it y , th e a g e, sex , a n d e x p e r ie n c e o f th e w o r k e r , th e s u it a b ility o f th e f o o d ta k e n b y th e w o r k e r , th e a r r a n g e m e n t o f h o u r s o f w o r k , a n d c o n d it io n s o u ts id e th e f a c t o r y (e. g ., h o u s in g a n d t r a n s it ). (S e e p a r a g r a p h s 1 1 6 -1 6 2 .) 254 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . VI.— SHIFTS, BBEAXS, SPELLS, PAUSES, AND HOLIDAYS. ( x v i i i ) P r o v id e d th a t th e w e e k ly h o u r s o f e m p lo y m e n t a re r e a s o n a b le, it f o llo w s in p r a c t ic e th a t th e d a ily h o u r s o f e m p lo y m e n t w ill a lso be c o n fin e d w it h in m o d e r a t e lim its . ( x i x ) T h e d a ily e m p lo y m e n t o f w o r k e r s is o r g a n iz e d , e it h e r in s in g le s h ift s , o r in d o u b le s h ift s , o r in th r e e s h ifts . F r o m th e p o in t o f v ie w o f o u t p u t s in g le s h ift s a re o p e n t o o b je c t io n o w in g t o th e la r g e n u m b e r o f h o u r s d u r in g w h ic h th e m a c h in e r y lie s id le . D o u b le s h ift s a re th e f o r m o f e m p lo y m e n t m o s t c o m m o n ly a d o p te d . T h o u g h n ig h t w o r k is o p e n t o s e r io u s o b je c t io n , a t a n y r a te f o r w o m e n a n d a d o le s c e n ts , d o u b le s h ift s u n d e r r e a s o n a b le c o n d it io n s a r e u n d o u b t e d ly p r o d u c t iv e o f in c r e a s e d o u t p u t , s in c e t h e y e n a b le th e m a c h in e r y t o b e e m p lo y e d f o r th e g r e a te r p a r t o f th e 24 h o u rs . ( x x ) W h e r e v e r p o s s ib le a n in t e r v a l s h o u ld b e l e f t b e tw e e n th e t w o s h ifts . T h e s h o r te r h o u r s o f e m p lo y m e n t in v o lv e d a r e w id e ly r e c o g n iz e d t o b e a d v a n ta g e o u s fr o m th e p o in t o f v ie w b o t h o f th e h e a lt h o f th e w o r k e r a n d o f o u t p u t . A p a r t fr o m th is , o p p o r t u n it y is a ffo r d e d f o r c le a n in g a n d v e n t ila t in g th e sh o p s. ( x x i ) T h e t h r e e -s h ift s}rstem , e s p e c ia lly f o r w o m e n , h a s m u c h t o c o m m e n d it w h e r e it can* b e o r g a n iz e d . T h e d iffic u ltie s in v o lv e d a rise in c o m b in in g th e h o u r s o f m e n a n d w o m e n w o r k e r s , f r o m th e s h o r tn e ss o f m e a l in t e r v a ls , fr o m th e w o r k e r s ’ fe a r th a t s h o r te r h o u r s w ill m e a n s m a lle r w a g e s , a n d fr o m th e b e n e fit o f th e s h o r t e r h o u r s b e in g lo s t t h r o u g h m isu se o f le is u r e tim e o r b y its d e v o t io n t o h o u s e w o r k d u tie s . T h e n u m e r o u s in s ta n c e s in w h ic h th e t h r e e -s liift s y s te m h a s b e e n s u c c e s s fu lly o r g a n iz e d s h o w th a t th ese d iffic u ltie s a re o r d in a r ily s u r m o u n ta b le . ( x x i i ) T h e o r d in a r y d a ily h o u r s o f w o r k a re o r g a n iz e d e ith e r u n d e r th e “ t w o -b r e a k ” s y s te m o r th e a o n e -b r e a k ” sy ste m . U n d e r th e fo r m e r sy ste m w o r k u s u a lly c o m m e n c e s a t 6 a. m ., a n d th e n o r m a l b r e a k s are h a lf h o u r f o r b r e a k fa s t a n d o n e h o u r f o r d in n e r . U n d e r th e la tte r sy ste m th e w o r k c o m m e n c e s a ft e r b r e a k fa s t , at 7 o r 8 a. m .. a n d th e re is fr e q u e n t ly o n ly a s in g le b r e a k o f o n e h o u r f o r d in n e r , t h o u g h a b r e a k f o r tea is s o m e tim e s n e ce ssita te d b y th e h o u r s o f w o r k . ( x x i i i ) T h e e v id e n c e s u g g e s ts th a t w o r k b e fo r e b r e a k fa s t is a m ista k e . O n ly th e m in o r it y o f w o r k e r s ca n p u t in t h e ir b est w o r k b e fo r e h a v in g a p r o p e r m e a l in th e m o r n in g . T h e tim e lo s t o fte u ca u se s se r io u s d is o r g a n iz a t io n , a n d e v e n w h e r e th e d is c o n t in u a n c e o f w o r k b e fo r e b r e a k fa s t in v o lv e s a s m a ll r e d u c t io n in th e n o m in a l h o u r s o f e m p lo y m e n t th e lo ss is g e n e r a lly m o r e th a n m a d e g o o d b y th e r e d u c t io n in th e tim e lo st. ( x x i v ) M a n y w o m e n a n d y o u n g p e r s o n s c a n n o t p r o fit a b ly b e e m p lo y e d f o r th e fu ll s p e ll o f fiv e h o u r s o n c o n t in u o u s w o r k a llo w e d b y th e fa c t o r y a ct. SU M M A R Y OF CONCLUSIONS. 255 (xxv) Even where the spell is somewhat less than five hours, em ployers frequently allow- short intervals for refreshment in the after noon and also in the morning. These pauses not only provide an opportunity for refreshment, but a period of rest and recovery from fatigue and a break in the monotony of work. ( x x v i ) A l l w o r k e r s e n g a g e d o n a c tiv e w o r k ta k e v o lu n t a r y rest p e r io d s , g e n e r a lly q u ite u n s y s te m a tic a lly . I t is d e s ir a b le th a t th ese rests s h o u ld .b e r e p la c e d b y a u th o r iz e d rest p a u se s s y s te m a tic a lly d e te r m in e d . ( x x v i i ) A l l w o r k e r s s h o u ld b e a llo w e d p e r io d ic h o lid a y s — p r e f e r a b ly o f se v e ra l d a y s ’ d u r a tio n . T h e y a re e q u a lly im p o r t a n t f o r th e m a n a g e m e n t a n d fo r e m e n . T h e y a ls o a ffo r d an o p p o r t u n it y f o r r e p a ir s to p la n t a n d m a c h in e r y . (S e e p a r a g r a p h s 1 G 3 -1 8 9 .) VII.—SUNDAY LABOR AND NIGHT WORK. (xxviii) A t the commencement of the W ar Sunday labor, espe cially for men, was widely adopted in the hope of increasing output. The evidence, however, proves conclusively that Sunday labor is unpopular, uneconomical, and not productive of increased output. ( x x i x ) I n a c c o r d a n c e w it h an e a r ly r e c o m m e n d a tio n o f th e c o m m itte e , S u n d a y la b o r is n o w a lm o s t e n t ir e ly c o n fin e d to s u d d e n e m e rg e n cie s , r e p a ir s , a t t e n d in g fu r n a c e s , a n d c e r ta in c o n t in u o u s p ro ce ss e s. C o n s ta n t s c r u t in y is, h o w e v e r , n e ce s s a r y in o r d e r t o se c u re th a t su ch e x c e p t io n s as c o n tin u e are c o n fin e d w it h in th e n a r r o w e s t lim its . W h e r e S u n d a y la b o r b e c o m e s n e ce ssa r y , a r r a n g e m e n ts s h o u ld b e m a d e b y a sy ste m o f r e lie f s h ift s th a t n o in d iv id u a l w o r k e r is e m p lo y e d m o r e th a n s ix d a y s in th e w eek . ( x x x ) E v e n f o r m e n n ig h t w o r k is o p e n t o s e r io u s o b je c t io n . I t is u n e c o n o m ic a l o w in g t o th e h ig h e r c h a r g e s f o r w a g e s , lig h t in g , a n d h e a tin g . L i g h t i n g is g e n e r a lly in fe r io r a n d s u p e r v is io n m o r e d iffi c u lt. A d e q u a te sleep b y d a y is d iffic u lt, o w in g t o d is lo c a t io n o f o r d i n a r y h a b its o r fr o m s o c ia l ca u ses. S o c ia l in te r c o u r s e a n d r e c r e a t io n c a n h a r d ly b e o b ta in e d e x c e p t b y an u n d u e c u r ta ilm e n t o f sleep . C o n tin u a n c e o f e d u c a tio n is g e n e r a lly im p r a c t ic a b le . F in a lly , it is u n n a tu r a l t o tu r n n ig h t in t o d a y . ( x x x i ) N ig h t w o r k f o r w o m e n a n d g ir ls h a s b e e n ille g a l f o r o v e r 50 y e a rs. A lt h o u g h in e v it a b le f o r a d u lt w o m e n u n d e r e x is tin g c o n d itio n s , it s h o u ld b e s t o p p e d as s o o n as it cea ses t o b e e ssen tia l. N ig h t w o r k f o r g ir ls u n d e r 1G h a s n o w b ee n e n t ir e ly s t o p p e d ; f o r g ir ls b e tw e e n 1G a n d 18 it h a s b e e n la r g e ly c u r t a ile d a n d s h o u ld b e e n d e d as s o o n as p o s s ib le . ( x x x i i ) N ig h t w o r k f o r b o 3^s is o n ly le g a l in c e r ta in c o n tin u o u s p ro ce ss e s. I t h a s a lr e a d y b ee n c u r t a ile d f o r b o y s u n d e r 1G, a n d s h o u ld b e a lt o g e t h e r s t o p p e d . T h e c o m m itte e f u l l y in d o r s e th e 256 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . a r g u m e n ts a g a in s t th e e m p lo y m e n t .o f a n y b o y s u n d e r 18 a t n ig h t w h ic h w e r e p u t f o r w a r d in th e r e p o r t o f th e d e p a r tm e n ta l c o m m itte e <m th e N ig h t E m p lo y m e n t o f M a le Y o u n g P e r s o n s in F a c t o r ie s a n d W o r k S h ops. ( x x x i i i ) T h e r e is n o u n ifo r m it y o f p r a c t ic e as t o h o w lo n g a w o r k e r s h o u ld r e m a in o n th e n ig h t s h ift at a n y o n e tim e . A w e e k is th e c o m m o n e s t p e r io d , b u t m u ch d e p e n d s o n th e s o c ia l c o n d it io n s u n d e r w h ic h h e liv e s . I n v e s t ig a t io n s s u g g e s t th a t c o n t in u o u s n ig h t w o r k is p r o d u c t iv e o f less o u t p u t th a n th e sy ste m u n d e r w h ic h a w o r k e r is e n g a g e d o n d a y a n d n ig h t s h ift s a lte r n a te ly . T h e r e is n o e v id e n c e th a t th e o u t p u t o f a c o n tin u o u s d a y s h ift b a la n ce s th is in fe r io r it y . (S e e p a r a g r a p h s 1 9 0 -2 1 1 .) VIII — LOST TIME AND INCENTIVE. ( x x x i v ) T im e m a y b e lo s t t h r o u g h th e fa ilu r e o f th e w o r k e r t o a tte n d th e f a c t o r y r e g u la r ly , o r it m a y b e lo s t at th e fa c t o r y b y s la c k n ess a t th e b e g in n in g o r e n d o f th e s p e ll, u n r e g u la te d r e s t p a u se s, o r la c k o f m a te r ia l. ( x x x v ) T h e ca u se s o f lo s t tim e (a s o r d in a r ily u n d e r s t o o d ) m a y b e b r o a d ly d iv id e d in t o th o s e th a t a re m a in ly in h e r e n t (e . g ., s ick n e s s a n d a c c id e n ts e x te r n a l t o th e fa c t o r y , b a d c o n d it io n s o f h o u s in g a n d tr a n s it, b a d w e a th e r , d o m e s tic d u tie s , o r la c k o f m a t e r ia l) , a n d th o s e w h ic h a re m a in ly c o n t r o lla b le (e. g ., sick n e s s a n d a c c id e n ts o f f a c t o r y o r ig in , d r in k , in d iffe r e n c e , d is c o n te n t, o v e r tim e a n d S u n d a y w o r k , la c k o f w o r k ) . ( x x x v i ) T h e p r o p o r t io n o f lo s t tim e d u e t o sick n e s s is g e n e r a lly g r e a t ly u n d e r e s tim a te d . ( x x x v i i ) T h e ca u se s o f lo s t tim e s h o u ld b e c a r e fu lly a s c e r ta in e d a n d r e m e d ie s s o u g h t. ( x x x v i i i ) I n c e n t iv e s t o w o r k in c lu d e p a t r io t is m , a g o o d f a c t o r y e n v ir o n m e n t, s o c ia l a m e n itie s, in s t r u c t io n o f th e n e w w o r k e r , s u ita b le a n d su fficien t r e s t p a u se s, a n d w a g e s. ( x x x i x ) W a g e s a re p r o b a b ly th e m o s t im p o r t a n t in c e n tiv e . N o w a g e sy ste m ca n a ffo r d an e ffe c tiv e in c e n t iv e u n le ss th e re is a h e a lt h y b o d y o f w o r k e r s . T h e sy ste m m u s t b e e a s ily u n d e r s t o o d a n d p r o p e r ly a d ju s te d . T h e in c e n t iv e fa ils i f th e w o r k e r s c a n o b t a in t o o e a s ily th e m o n e y r e q u ir e d t o m e e t th e ir s o c ia l a s p ir a tio n s , o r i f th e h o u r s o f w o r k p r e v e n t th e ir s p e n d in g th e m o n e y e a r n e d . (S e e p a r a g r a p h s 2 1 2 -2 1 9 .) IX.—FOOD AND CANTEENS. ( x l ) T h e r e q u ir e m e n ts o f th e b o d y f o r f o o d a re la r g e ly a ffe c te d b y th e a m o u n t o f p h y s ic a l e n e r g y e x p e n d e d in d a ily w o r k a n d b y th e e n v ir o n m e n t o f th e w o r k e r . G r o w in g b o y s a n d g ir ls r e q u ir e r e la SU M M A R Y OF CONCLUSIONS. 257 t iv e ly m o r e f o o d tlia n a d u lts. F o r th e m a in te n a n c e o f in d u s t r ia l efficie n cy th e w o r k e r m u st h a v e f o o d w h ic h is a d e q u a te in a m o u n t, n u tr itio u s , fr e s h , d ig e s t ib le , a n d a p p e tiz in g . ( x l i ) A p a r t fr o m an j q u e stio n o f s h o r t a g e o f f o o d s u p p lie s m a n y w o r k e r s d o n o t o b t a in s u ita b le f o o d o w in g t o d o m e s tic d ifficu ltie s, d is ta n c e o f th e h o m e fr o m th e fa c t o r y , n ig h t w o r k , a n d ig n o r a n c e o f th e n e e d (in th e ca se o f w o m e n ). ( x l i i ) C a r r ie d f o o d is u n s a t is fa c t o r y o w in g t o th e lim it a t io n in th e k in d s o f f o o d s u ita b le . F u r t h e r , th e f o o d is n e c e s s a r ily c o ld a n d m a y d e te r io r a te e a s ily . M e a n s o f h e a t in g u p f o o d a re u s e fu l, b u t a re in a d e q u a te b e c a u se su ch f o o d lo s e s n u t r it iv e v a lu e . T h e h e a t in g u p o f a n y la r g e n u m b e r o f m e a ls is d iffic u lt t o d o s a t is fa c t o r ily . ( x l i i i ) T h e o n ly s a t is fa c t o r y s o lu t io n o f th e p r o b le m o f p r o v id in g s u ita b le f o o d a t lo w p r ic e s f o r la r g e n u m b e rs a t c o n v e n ie n t tim e s lie s in th e e s ta b lis h m e n t o f -in d u s tr ia l ca n te en s. A p a r t fr o m th e s u it a b ility o f th e f o o d p r o v id e d th e essen tia ls f o r su ccess o f a ca n te e n in c lu d e a c c e s s ib ilit y , th e c o n v e n ie n c e a n d a ttra ctiv e n e s s o f th e p re m is e s , p r o m p t s e r v ic e , c o n v e n ie n t h o u r s o f o p e n in g , a n d a s y s te m o f m a n a g e m e n t a c c e p ta b le t o th e w o r k e r s . ( x l i v ) A t th e e n d o f 1917 th e re w e r e a b o u t 840 ca n te e n s in m u n i t io n w o r k s a n d d o c k s . T h e c o m m itte e a re s t r o n g ly im p r e s s e d w it h th e v a lu e o f th e fa c ilit ie s th u s a ffo r d e d , a n d a re c o n v in c e d th a t th e y h a v e v e r y m a t e r ia lly c o n t r ib u t e d t o th e m a in te n a n c e o f th e h e a lth o f th e w o r k e r , t o th e p r e v e n t io n o f a s e r io u s b r e a k d o w n u n d e r th e s tr a in im p o s e d b y w a r c o n d it io n s , a n d t o in c re a s e d efficie n cy a n d e n e r g y a n d c o r r e s p o n d in g o u tp u t. T h o u g h th e n e e d f o r ca n te e n s h a s b e e n a c c e n tu a te d b y w a r c o n d it io n s , it is in a la r g e m e a su re a p e r m a n e n t on e. (S e e p a r a g r a p h s 2 2 0 -2 6 1 .) X.— SICKNESS AND ILL HEALTH. ( x l v ) A n u n d u e p r o p o r t io n o f sick n e s s in a n y g r o u p o f w o r k e r s u s u a lly re p r e s e n ts a m o n g s t th o s e n o t a c t u a lly s ick le sse n e d v ig o r a n d a c t iv it y w h ic h c a n n o t f a i l t o r e d u c e o u tp u t. ( x l v i ) C o n d it io n s o f in d u s t r ia l o c c u p a t io n m a y a ffe c t h e a lth b y r e a so n o f lo n g h o u r s o f w o r k , c r a m p e d a n d c o n s tr a in e d a ttitu d e s , p r o lo n g e d o r e x c e s s iv e m u s c u la r s tr a in , b a d v e n t ila t io n a n d lig h t in g , d u s t a n d fu m e s . T o th e in flu e n ce s o f o c c u p a t io n u p o n h e a lth m u st b e a d d e d th e p r e d is p o s it io n t o d ise a se a r is in g fr o m th e a b se n ce o f p e r s o n a l h y g ie n e . ( x l v i i ) M e d ic a l in q u ir ie s s u g g e s t t h a t th e p r in c ip a l fo r m s o f m in o r i ll h e a lth t o b e fo u n d a m o n g s t m a le w o r k e r s a re h e a d a c h e , fo o t a c lie , m u s c u la r p a in s , sle e p in e ss o n th e n ig h t s h ift , a n d n e r v o u s s y m p t o m s ; a m o n g s t w o m e n w o r k e r s in d ig e s t io n , h e a d a c h e , a n e m ia , a n d m u s c u la r p a in s . 80935°— 19-------17 258 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . ( x l v i i i ) K e c o r d s o f sick n ess, b r o k e n tim e o r d im in is h e d o u t p u t s h o u ld b e c a r e f u lly k e p t a n d s c r u tin iz e d . F o r a c o r r e c t a p p r e c ia t io n o f t h e ir s ig n ific a n c e a c co u n t m u st b e ta k e n o f v a r io u s ca u ses o f flu c tu a tio n j. su ch a s c lim a t ic c o n d it io n s , a p p r o a c h in g o r r e ce n t h o l i d a y * , p a t r io t ic e n th u sia sm , lo n g h o u r s , a n d S u n d a y la b o r . ( x l i x ) A n y s o u n d sy ste m f o r d e a lin g w it h in d u s t r ia l d ise a se m u st b e b a se d o n th e p r in c ip le s , first, th a t p r e v e n t io n is b e tte r th a n c u r e , a n d , s e c o n d ly , th a t th e tre a tm e n t, t o b e im p o s e d e ffe c t iv e ly , m u^t d e a l w it h th e b e g in n in g s o f th e d ise a se. I t f o l l o w s th a t th e p r e lim in a r y s a fe g u a r d s h o u ld b o t o e x te n d t o a ll w o r k e r s th e p r e lim i n a r y m e d ic a l e x a m in a t io n a lr e a d y p r o v id e d f o r in c e r ta in m u n i tio n w o r k s a n d e s p e c ia lly in th o se w h e re d a n g e r o u s su b sta n ce s a r e m a n ip u la te d . S u c h an e x a m in a t io n is e s p e c ia lly n e ce s s a r y at th e p re s e n t tim e o w in g t o th e s tr a in in v o lv e d b y p r e s e n t c o n d it io n s o f e m p lo y m e n t a n d o w in g t o th e la r g e n u m b e r o f p e r s o n s w h o a re t a k in g u p in d u s t r ia l e m p lo y m e n t f o r th e firs t t im e ; b u t su ch e x a m in a tio n s a re lik e ly to b e a lw a y s d e s ir a b le w h e r e th e w o r k in v o lv e s s p e c ia l s tr a in a n d p a r t ic u la r ly so in th e ca se o f w o m e n . T h e r e is a s im ila r n eed f o r th e p e r io d ic r e e x a m in a t io n o f su ch w o r k e r s , (1 ) T h e p re s e n t p r o v is io n s o f th e fa c t o r y a ct f o r th e c e r t ific a t io n o f th e p h y s ic a l fitn ess f o r e m p lo y m e n t o f c h ild r e n a n d y o u n g p erson s, c a n h a r d ly b e r e g a r d e d as a d e q u a te . T h e f a c t o r y ’s c e r t i f y in g s u r g e o n h a s s e ld o m a n y p r e v io u s k n o w le d g e o f th e ease. T h e v a lu e o f h is c e r tific a te w o u ld b e g r e a t ly in c r e a s e d i f it w e r e o n ly g iv e n a ft e r c o n s id e r a t io n o f th e m e d ic a l r e c o r d s in th e p o s s e s s io n o f th e s c h o o l m e d ic a l s e r v ic e , a n d c lo s e r c o o p e r a t io n a p p e a r s t o b e d e s ir a b le . A t p re s e n t th ese r e c o r d s a re s e ld o m a v a ila b le . P r o v is io n is n o w s e ld o m m a d e f o r p e r io d ic r e e x a m in a tio n , b u t it is e x tr e m e ly d e s ir a b le h a v in g r e g a r d to th e e ffe c t o f e n tr y in t o in d u s t r ia l life . T h e d e p a r tm e n ta l c o m m itte e o n th e n ig h t e m p lo y m e n t o f m a le y o u n g p e r s o n s e m p h a s iz e d th e n e e d f o r p e r io d ic e x a m in a t io n s o n c e a t le a st in e v e r y s ix m o n th s , a n d r e c o m m e n d e d th a t r e c o r d s o f th e r e su lts s h o u ld b e k e p t. ( l i ) T h e s e c o n d p r e v e n t iv e m e a su re is t o r e d u c e t o a m in im u m u n fa v o r a b le c o n d it io n s o f e n v ir o n m e n t. T h ir d ly ^ a r ra n g e m e n ts s h o u ld b e m a d e f o r a d e q u a te m e d ic a l a n d n u r s in g schem es^ M e d ic a l a tte n d a n c e is u s u a lly o b t a in a b le u n d e r th e n a t io n a l in s u r a n c e s y s te m , b u t n u r s in g c a n o n ly b e o b t a in e d b y th e e m p lo y m e n t o f o n e o r m o r e t r a in e d n u rse s t o u n d e r ta k e d u tie s in th e f a c t o r y b y n ig h t as w e ll as b y d a y . T h e d u tie s o f th e n u rse w o u ld in c lu d e s u p e r v is io n o f th e h e a lth o f th e w o r k e r s a n d e s p e c ia lly o f th o s e t e m p o r a r ily in d is p o s e d , f o l l o w i n g u p ca ses o f sick n e s s a n d t a k in g c h a r g e o f firs ta id tre a tm e n t o f in ju r ie s . S u c h a r r a n g e m e n ts h a v e b e e n in s titu te d in m a n y m u n it io n fa c t o r ie s , e s p e c ia lly w h e re w o m e n a re e m p lo y e d , a n d h a v e p r o v e d o f g r e a t v a lu e t o e m p lo y e r s a n d e m p lo y e d a lik e . (S e e p a r a g r a p h s 2 6 2 -2 7 9 .) S U M M A R Y OF CONCLUSIONS* 259 XI.—INJURIES AND ACCIDENTS. ( l i i ) A g r a v e a m o u n t o f d is a b le m e n t is c a u s e d b y a c c id e n t s su ch as fr a c t u r e s , o p e n w o u n d s , a n d in ju r e d lim b s , b u t p r o b a b ly a n e v e n la r g e r a m o u n t o f in t e r r u p t io n t o w o r k is c a u s e d b y s lig h t e r in ju r ie s , s u ch as s c ra tc h e s a n d b u rn s , w h ic h m a y , h o w e v e r , b e c o m e s e r io u s it n e g le c te d . T h e p r in c ip a l ca u se s o f a c c id e n ts a re s p e e d o f w o r k in g , fa t ig u e , p s y c h ic a l in flu e n ce s , n u t r it io n , a n d a lc o h o lic c o n s u m p t io n , l ig h t in g , a n d te m p e r a tu re . ( l i i i ) A la r g e n u m b e r o f a c c id e n ts a re p r e v e n ta b le , a n d it is t o th e in te re s ts o f a ll p a r tie s th a t th e n u m b e r s h o u ld b e r e d u c e d . H o w e v e r c o m p le te th e in s t a lla t io n f o r s e c u r in g th e s a fe t y o f w o rk e rs* su ccess m u st la r g e ly d e p e n d u p o n t h e in t e llig e n t c o o p e r a t io n o f w o r k e r s a n d fo r e m e n , a n d th e ir h e lp s h o u ld b e se c u re d in s t u d y in g ca u se s a n d m e th o d s o f p r e v e n t io n . ( l i v ) H o w e v e r e ffe c t iv e m a y b e th e m e th o d s o f p r e v e n t io n a d o p te d , som e a c c id e n ts w ill o c cu r . I t is a c c o r d in g ly im p o r t a n t th a t in e a ch s h o p th e r e s h o u ld b e o n e o r t w o w o r k e r s tr a in e d t o r e n d e r fir s t a id in ca se o f a c cid e n ts . L e a fle ts o f in s t r u c t io n a n d a d v ic e s h o u ld b e issu ed . ( l v ) T h o u g h in m a n y fa c t o r ie s g o o d p r o v is io n h a s b e e n m a d e f o r th e tre a tm e n t o f a c c id e n ts , g r e a t im p r o v e m e n ts s h o u ld resu lt f r o m th e r e ce n t H o m e O ffice o r d e r r e q u ir in g e m p lo y e r s in c e r t a in in d u s trie s t o p r o v id e a n d m a in t a in — (a) F ir s t -a id p o s ts o r lo c a l d r e s s in g s ta tio n s f o r e v e r y 15 0 w ork ers; and (Z>) A n a m b u la n c e r o o m o r c e n tr a l d r e s s in g s ta tio n w h e r e v e r th e t o t a l n u m b e r o f e m p lo y e e s is 500 o r m o re . T h e r o o m is t o b e in c h a r g e o f a n u rse o r o t h e r p e r s o n tr a in e d in fir s t -a id w o r k . R e c o r d s o f a ll cases tr e a te d are t o b e k e p t. P r o v is io n is a lso t o b e m a d e f o r th e c o n v e y a n c e t o h o s p it a l o f th e m o r e s e r io u s cases. (S e e p a r a g r a p h s 2 8 0 -2 9 8 .) # X II.—EYE INJURIES. (I v i) I n ju r ie s t o a n d d ise a se d c o n d it io n s o f th e ey e a re a w id e s p r e a d ca u se o f in e fficie n cy . T h e p r in c ip a l ca u se s a re a c c id e n ts f r o m fly in g p a r t ic le s a n d im p a c t e d b o d ie s a r is in g fr o m g r in d in g a n d s im ila r o p e r a t io n s , in ju r ie s d u e to e x p o s u r e t o in te n se h e a t a n d e y e s tr a in fr o m i n fe r io r lig h t in g , u n c o r r e c t e d e r r o r s o f r e fr a c t io n , o r o th e r cau ses. ( l v i i ) T h e p r in c ip a l m e a su res o f p r e v e n t io n a re th e p r o v is io n o f e y e g u a r d s o r g o g g le s , g o o d lig h t in g , e x a m in a t io n o f e y e s ig h t, a n d th e p r o v is io n o f su ita b le s p e cta cle s. A c c id e n t s i f n e g le c te d m a y e a s ily ca u se s e r io u s in c a p a c it y , a n d t h e y s h o u ld r e ce iv e im m e d ia te a tte n tio n fr o m a d o c t o r , o r , f a ilin g h im , a q u a lifie d n u rse. (S e e p a r a g r a p h s 2 9 9 -3 1 4 .) IN D U ST R IA L H E A L T H AND E FF IC IE N C Y . 2G 0 X III.—SPECIAL INDUSTRIAL DISEASES. ( l v i i i ) F r o m th e p o in t o f v ie w o f m u n it io n w o r k T N T is m u c h th e m o s t im p o r t a n t o f th e “ d a n g e r o u s ” o c c u p a t io n s , b o t h o n a c c o u n t o f th e s e r io u s e ffe c ts w h ic h m a y r e s u lt a n d th e la r g e n u m b e r s o f w o r k e r s em p loj^ ed . I t m a y b e a b s o r b e d t h r o u g h th e s k in o r t h r o u g h th e d ig e s t iv e tr a c t o r b y th e in h a la t io n o f fu m e s o r d u st. P o is o n in g n o i m a l ly ta k e s o n e o r m o r e o f th e f o l l o w i n g f o r m s : D e r m a t itis , d ig e s t iv e tro u b le s , b lo o d c h a n g e s , a n d liv e r d e g e n e r a tio n (t o x ic j a u n d i c e ) . T h e o c c u r r e n c e o f p o is o n in g d e p e n d s t o so m e e x te n t u p o n p e r s o n a l id io s y n cra s y . T h e g r e a t m a jo r it y o f w o r k e r s a re in s u s c e p tib le , a n d r e m a in s o , b u t a fe w a re a ffe c te d , b u t n o t a lw a y s th o s e w h o , o w i n g t o i ll h e a lth a n d m a ln u t r it io n , m ig h t b e e x p e c t e d t o b e s p e c ia lly lia b le . ( l i x ) T h e c o n d it io n s o f e m p lo y m e n t in th e m a n u fa c t u r e o f T N T a re g o v e r n e d b y a H o m e O ffice o r d e r , w h ile its use a n d m a n ip u la t io n a re g o v e r n e d b y R e g u la t io n s o f th e M in is t r y . T h e p r in c ip a l m e a n s o f p r e v e n t io n a d o p te d a r e : T h e r e d u c t io n t o a m in im u m o f d u s t a n d fu m e s , c o n s ta n t m e d ic a l s u p e r v is io n , lim it a t io n o f th e p e r io d o f e x p o s u r e , p r o v is io n o f a m p le a n d s u ita b le fo o d , s p e c ia l w o r k in g c o s tu m e s a n d su ita b le c lo a k r o o m s , a n d w a s h in g fa c ilit ie s . (lx) Other substances in the manufacture and use of which special precautions are necessary include lead, fulminate of mercury, tetryl, aeroplane dope, picric acid, poisonous gases, and nitrous fumes. The preventive measures adopted are on similar lines to those for TNT. (See paragraphs 315-351.) XIV.— CLEANLINESS, VENTILATION, HEATING, AND LIGHTING. ( l x i ) A h ig h s ta n d a r d o f c le a n lin e s s is e ss e n tia l n o t o n ly f o r h e a lth b u t b eca u se it h a s a n im p o r t a n t b e a r in g o n th e s e lf-r e s p e c t o f th e w ork er. ( l x i i ) F l o o r i n g s h o u ld b e s m o o th , h a r d , d u r a b le , a n d im p e r v io u s . W o o d e n flo o r in g s h o u ld b e p r o v id e d f o r s t a n d in g o n , as c a u s in g less fa t ig u e a n d b e in g m o r e c o n d u c iv e t o w a r m th a n d d r y n e s s o f th e fe e t. ( l x i i i ) T h e o b je c t o f v e n t ila t io n is t o p r o v id e a ir w h ic h is p u r e , c le a n , s t im u la t in g , a n d r e fr e s h in g . T h e a ir s h o u ld b e c o o l a n d d r y , n o t m o n o to n o u s in te m p e r a tu r e , a n d m o v in g r a th e r th a n sta g n a n t. T h e p r in c ip a l im p u r it ie s a re c a r b o n ic a c id ( p r in c ip a lly im p o r t a n t as a ffo r d in g a n in d ic a t io n o f th e e fficie n cy o f v e n t i l a t io n ) , v o la t ile s u b s ta n ce s g iv e n o ff fr o m th e sk in a n d a lim e n ta r y c a n a l o f h u m a n b e in g s, b a c te r ia , d u st, a n d fu m e s . ( l x i v ) T h e v e n t ila t io n a n d h e a t in g o f e v e r y w o r k s h o p p re s e n ts a se p a r a te p r o b le m . T h e r e s h o u ld b e a d e q u a te c u b ic c a p a c it y , lo u v e r s o r o th e r d e fin ite o p e n in g s in t o th e o u ts id e a ir , s u p p le m e n te d b y th e u se o f d o o r s , w in d o w s , a n d fa n s . SU M M A R Y OF CONCLUSIONS. 261 ( I x v ) W h a t is th e b e s t te m p e r a tu r e d e p e n d s o n th e w o r k a n d h a b its o f th e w o r k e r . S e d e n t a r y w o r k e r s m a y r e q u ir e a t e m p e r a tu r e o f a b o u t 6 0 ° F., t h o u g h it m a y b e s o m e w h a t h ig h e r i f th e a ir is in m o tio n . (Ixvi) Some one person should be made responsible for securing the proper use and maintenance of any installation for ventilation and heating. (lxvii) Lighting should be adequate, reasonably uniform, shaded from the eyes of the worker, and should not cause extraneous shad ows. Windows should be cleaned regularly. (See paragraphs 3 5 2 - 3 8 7 .- XV.—SANITATION, WASHING, AND CLOAK ROOMS. (lxviii) For the proper maintenance of health it is essential that the sanitary accommodation should be adequate, conveniently ar ranged, and kept thoroughly clean. ( l x i x ) W a s h in g is b e n e fic ia l t o th e h e a lth , efficie n cy , a n d s e lfre s p e ct o f th e w o r k e r , a n d th e re is a g r o w in g d e m a n d f o r th e p r o v i s io n o f fa c ilit ie s . T h e in s t a lla t io n m u st b e a d e q u a te in a m o u n t, r e a d ily a cce s sib le , a n d e a s ily m a in ta in e d . W a s h in g t r o u g h s a re g e n e r a lly t o b e p r e fe r r e d t o s e p a ra te b a sin s. A n a m p le s u p p ly o f h o t a n d c o ld w a te r , n a ilb r u s h e s , s o a p , a n d to w e ls a re o th e r essen tia ls. (lxx) The provision of baths is recommended where workers are employed on hot or dusty processes. In such cases they may prove an effective antidote to muscular rheumatism. ( l x x i ) C lo a k r o o m s a re n e ce s s a r y f o r h e a lth , e s p e c ia lly o f w o m e n a n d g ir ls . T h e y s h o u ld b e clo s e t o th e ca n te en s, la v a t o r y , a n d s a n i t a r y a c c o m m o d a t io n . S e p a r a te lo c k e r s s h o u ld b e p r o v id e d f o r e a ch w o r k e r . T h e r e s h o u ld b e a m p le a c c o m m o d a t io n f o r c h a n g in g c lo th e s a n d b o o ts a n d f o r th e d r y in g o f c lo th e s . T h e y s h o u ld b e k e p t t h o r o u g h ly c le a n a n d v e n tila te d . M e a n s s h o u ld b e ta k e n to p r e v e n t p e t t y p il f e r i n g o r t h e ft . (S e e p a r a g r a p h s 3 8 8 -4 1 2 .) XVI.— SEATS, WEIGHTS, CLOTHING, AND DRINKING WATER. ( l x x i i ) P r o t e c t iv e c lo t h in g , t h o u g h e ss e n tia l f o r c e r ta in ty p e s o f e m p lo y m e n t (e. g ., th o s e i n v o lv in g d ir t , d u st, d a m p , h e a t, o r d a n g e r o u s m a c h in e r y ), is d e s ir a b le f o r a ll w o r k e r s , a n d e s p e c ia lly f o r w o m e n a n d g ir ls . I t a d d s t o t h e ir sm a rtn e ss a n d n ea tn ess, a n d a lso a id s d is c i p lin e a n d e s p r it d e c o r p s . ( l x x i i i ) W h a t e v e r th e n a tu r e o f t h e ir e m p lo y m e n t, w o r k e r s sh o u ld h a v e o p p o r t u n it ie s o f s it t in g d o w n f r o m tim e to tim e . C o m fo r t a b le sea ts s h o u ld a lso b e p r o v id e d f o r u se d u r in g m e a l h o u r s , a n d f o r w o r k e r s w h o a re t e m p o r a r ily in d is p o s e d . 262 IN D U ST R IA L H E A L T H AND E FF IC IE N C Y . ( l x x i v ) A p a r t f r o m th e ir in fe r io r p h y s ic a l s tr e n g th , w o m e n are m o r e lia b le th a n m e n t o s tr a in fr o m s u d d e n m u s c u la r e ffo r t. T o o b v i ate th is , a tte n tio n s h o u ld b e p a id to th e size a n d s h a p e o f b u r d e n s , r e c e p ta c le s a n d v e h ic le s , la b o r -s a v in g c o n tr iv a n c e s , t o th e k n a c k o f l if t i n g , a n d t o h o u r s o f e m p lo y m e n t. ( l x x v ) T h e c o m m itte e f u ll y in d o r s e th e p o l ic y u n d e r ly in g th e o r d e r r e c e n t ly m a d e b y th e H o m e O ffice r e q u ir in g th e p r o v is io n o f a d e q u a te fa c ilit ie s f o r o b t a in in g d r in k in g w a te r in a ll fa c t o r ie s . (S e e p a r a g r a p h s 4 1 3 —1 34.) XVII.—WELFARE SUPERVISION FOR WOMEN AND GIRLS. ( l x x v i ) U n d e r m o d e r n in d u s t r ia l c o n d it io n s th e e m p lo y e r u s u a lly h a s n e ith e r th e tim e n o r , fr e q u e n t ly , th e e x p e r ie n c e t o g iv e th e r e q u is ite a tte n tio n t o m a n y o f th e s p e c ia l p r o b le m s a ffe c t in g th e h e a lth a n d w e lfa r e o f w o m e n w o r k e r s . T h e r e h a s, t h e r e fo r e , b e e n an i n c r e a s in g t e n d e n c y t o a p p o in t a s p e c ia l officer f o r th e p u r p o s e , w h o is g e n e r a lly c a lle d a “ w e lfa r e s u p e r v is o r ” o r “ w e lfa r e s u p e r in te n d e n t .” ( I x x v i i) T h e stress o f w a r c o n d it io n s , th e w id e s p r e a d in t r o d u c t io n o f w o m e n in t o in d u s t r y , a n d th e in c re a s e d e m p lo y m e n t o f m a r r ie d w o m e n a n d y o u n g g ir ls g r e a t ly in c r e a s e d th e n e e d f o r a d e q u a te s u p e r v is io n a n d le d th e c o m m itte e t o r e c o m m e n d in J a n u a r y , 1 9 1 G, th e a p p o in t m e n t o f w e lfa r e s u p e r v is o r s in a ll fa c t o r ie s w h e re w o m e n w e r e e m p lo y e d . ( I x x v i ii ) T h e w e lfa r e s u p e r v is o r s h o u ld h a v e a c le a r ly d e fin e d sta tu s a n d d e fin ite d u tie s, a n d s h o u ld b e d ir e c t ly r e s p o n s ib le to th e m a n a g e r . W h a t h e r e x a c t d u tie s m a y b e w ill, t o som e e x te n t, d e p e n d u p o n th e c ir c u m s ta n c e s o f th e fa c t o r y a n d h e r o w n c a p a c it y . E x p e r ie n c e , h o w e v e r , s h o w s th a t h e r d u tie s m a y p r o p e r ly in c lu d e th e e n g a g e m e n t o f w o r k e r s (s o fa r as t h e ir g e n e r a l s u it a b ility is c o n c e r n e d ) ; k e e p in g o f r e c o r d s o f in d iv id u a l w o r k e r s ; in v e s t ig a t io n o f ca ses o f lo s t tim e , sick n e ss, lo w o u tp u t, o r w a g e s , in c a p a c it y , d is m issa ls o r w it h d r a w a ls , w o r k in g c o n d it io n s , h o m e v is it in g , fe e d in g a r r a n g e m e n ts , t r a in in g a n d in s t r u c t io n , h o u s in g , tr a n s it, a n d r e c r e a tio n . T h e y s h o u ld n o t in t e r fe r e w it h th e w o r k o f tr a d e s -u n io n s . ( l x x i x ) T h e w e lfa r e s u p e r v is o r m u st b e o f g o o d s t a n d in g a n d e d u c a t io n , a n d m u st p o sse ss s tr e n g th o f c h a r a c te r , ta c t, a n d b r o a d m in d ed n e ss, su ch as w il l se cu re th e c o n fid e n c e o f th e m a n a g e m e n t as w 'ell as o f th e w o r k e r s ; p r o v id e d o n ly th a t th e y a re p o sse sse d o f th e r e q u is ite q u a lific a tio n s , t h e y c a n b e a n d a re d r a w n fr o m a ll cla sses o f th e c o m m u n it y . ( l x x x ) I t is, as a r u le , d e s ir a b le th a t w e lfa r e s u p e r v is o r s s h o u ld h a v e u n d e r g o n e a p r e lim in a r y co u r s e o f t r a in in g o f n o t le ss th a n o n e y e a r s d u r a t io n , w h ic h s h o u ld , w h ile a llo w in g o f a s p e c ia l s t u d y o f w e lfa r e p r o b le m s , b e g r o u n d e d on a w id e s tu d y o f s o c ia l q u e stio n s. SU M M A R Y OF CONCLUSIONS. 263 A la r g e p a r t o f th e tim e s h o u ld b e d e v o te d t o p r a c t ic a l w o r k . N e ith e r a d m is s io n t o th e c o u r s e n o r fin a n c ia l a ssista n ce s h o u ld b e c o n d it io n a l o n th e stu d e n t s u b s e q u e n tly t a k in g u p w e lfa r e w o r k . ( I x x x i ) W e l f a r e s u p e r v is o r s s h o u ld n o t b e a p p o in t e d b y th e S ta te . T h e y w ill p r o b a b ly c o n tin u e f o r so m e tim e to c o m e at a n y ra te to b e a p p o in t e d b y th e e m p lo y e r , as th e p e r s o n r e s p o n s ib le f o r th e m a in te n a n ce o f s a t is fa c t o r y c o n d it io n s o f e m p lo y m e n t, t h o u g h th e w o r k e r s a re lik e ly to a n in c r e a s in g e x te n t to seek som e v o ic e in th e s e le c tio n . T h o u g h th e e s ta b lis h m e n t b y th e M in is t r y o f M u n it io n s o f a p a n e l o f c a n d id a te s h a s b e e n ju s tifie d as a t e m p o r a r y e x p e d ie n t, it is n o t d e s ira b le th a t a n y d e p a r tm e n t o f S ta te s h o u ld d o so as a p e r m a n e n t a r ra n g e m e n t. ( l x x x i i ) T h e tim e h a s n o t y e t c o m e w h e n a d e fin ite ju d g m e n t c a n b e p a sse d o n th e d e v e lo p m e n t o f w e lfa r e w o r k d u r in g th e p a s t tw o y e a rs , s till less is it p o s s ib le t o p r o p h e s y as t o fu t u r e lin e s o f d e v e lo p m e n t. T h e c o n fid e n t s u p p o r t o f th e w o r k e r s h a s y e t to b e o b ta in e d . U n d o u b t e d ly u n w is e a p p o in t m e n t s h a v e b ee n m a d e ; c o m p la in t s h a v e b ee n c o n s id e r a b le a n d o ft e n w e ll fo u n d e d , t h o u g h t h e ir im p o r t a n c e m a y h a v e b ee n o v e r e m p h a s iz e d . O n th e o t h e r h a n d , s o m e m is ta k e s w e r e in e v ita b le in th e in it ia t io n o f w h a t w a s la r g e ly a n e w e n te r p r is e in in d u s t r ia l o r g a n iz a t io n . T h e c o n d it io n s o f e m p lo y m e n t o f w o m e n h a v e v a s t ly im p r o v e d . I t h a s b een a n d is lik e ly t o b e o f m a te r ia l a d v a n t a g e th a t th e r e s h o u ld e x is t a b o d y o f p e r s o n s s p e c ia lly c o n c e r n e d t o p r o m o t e th e h e a lth a n d w e ll-b e in g o f th e w o r k e r . (S e e p a r a g r a p h s 4 3 5 -4 7 5 .) XVIII.—WELFARE SUPERVISION FOR BOYS AND MEN. ( l x x x i i i ) T h e p r o b le m s in v o lv e d in th e w e lfa r e s u p e r v is io n o f b o y s a re n o t n e w t h o u g h t h e y h a v e b een a c ce n tu a te d b y th e w a r. T h e e ss e n tia l r e m e d y is p e r s o n a l in flu e n ce . T h e in flu e n ce s t o w h ic h t h e y a re s u b je c t w ill la r g e ly a ffe ct t h e ir p e rm a n e n t o u t lo o k o n life . H i g h w a g e s , re stlessn ess, la c k o f c o n t r o l, a ll h a v e d e m o r a liz in g in flu e n ce s, w h ic h s p e c ia lly n e e d c o n t r o l a t th e p re s e n t tim e. ( l x x x i v ) P e r s o n a l in flu e n ce t o b e e ffe c tiv e m u s t o r d in a r ily b e e x e r c is e d b y s o m e o n e in d iv id u a l, a n d th e c o m m itte e in J a n u a r y , 1910, r e c o m m e n d e d th e a p p o in t m e n t o f w e lfa r e s u p e r v is o r s w h e r e v e r 100 b o y s a re e m p lo y e d . E x p e r ie n c e h a s s h o w n th a t f o r th is n u m b e r o f b o y s a fu ll-t im e a p p o in t m e n t is d e s ira b le . W h e r e , as is m o r e o ft e n t h e ca se , a s m a lle r n u m b e r a re e m p lo y e d , a p a r t -t im e a r r a n g e m e n t is u su a l. ( l x x x v ) T h e d u tie s o f a w e lfa r e s u p e r v is o r f o r b o y s m a y u s e fu lly in c lu d e m o s t o f th o s e s p e c ifie d in th e ca se o f w o m e n , b u t n o t h in g w h ic h m a k e s f o r t h e ir w e ll-b e in g s h o u ld b e a lie n t o h is d u tie s. T h e w id e r h is o u t lo o k th e s t r o n g e r is lik e ly t o b e h is p o s it io n . I t is 264 IN D U STRIAL H E A L T H AND E F F IC IE N C Y . s p e c ia lly d e s ir a b le th a t h e s h o u ld k e e p in t o u c h w it h a ll o th e r p e r so n s a n d b o d ie s in th e d is t r ic t w h o a re c o n c e r n e d w it h th e w e ll-b e in g o f b o y s . R e c r e a t io n , t r a in in g , a n d in s t r u c t io n a re m a tte r s c a llin g f o r s p e c ia l c o n c e r n . ( l x x x v i ) T h e n e e d f o r th e w e lfa r e suj^er v is io n o f b o y s h a s n o t b e e n so r e a d ily a p p r e c ia t e d as in th e ca se o f w o m e n a n d g ir ls , a n d tim e h a s b ee n r e q u ir e d f o r o b t a in in g th e s u p p o r t o f th e fo r e m e n a n d th e lo c a l t r a d e -u n io n s as w e ll as o f th e e m p lo y e r . T h e s e in it ia l d iffic u ltie s h a v e , h o w e v e r , n o t b e e n w it h o u t t h e ir a d v a n ta g e s in p r e v e n t in g h a s ty o r ill-c o n s id e r e d sch e m es, a n d w h ile it is as y e t t o o e a r ly t o f o r m a n y fin a l ju d g m e n t th e w o r k a p p e a r s t o h a v e s ta r te d o n s o u n d lin es. ( i x x x v i i ) T h e p r o b le m s o f th e w e lfa r e s u p e r v is io n o f m e n a re m u c h m o r e d ifficu lt, a n d o n ly g r a d u a l d e v e lo p m e n t is t o b e a n t ic i p a te d . T h e w h o le q u e s tio n is in t im a t e ly c o n c e r n e d w it h th e g r o w t h s o f w o r k s c o u n c ils n o w b e in g so w id e ly d is c u s s e d . I n th e im m e d ia t e fu t u r e at a n y r a te a n y w e lfa r e w o r k a m o n g m e n is lik e ly t o g r o w s p o n t a n e o u s ly o u t o f th a t f o r b o y s . (S e e p a r a g r a p h s 4 7 6 -4 9 2 .) XIX.—WELFARE OUTSIDE THE FACTORY. ( l x x x v i i i ) T h e S ta te b e in g r e s p o n s ib le f o r th e e m p lo y m e n t o f la r g e b o d ie s o f w o r k e r s , a n d e s p e c ia lly w o m e n , in p la c e s r e m o te f r o m t h e ir o w n h o m e s , h a s a s p e c ia l r e s p o n s ib ilit y f o r t h e ir w e lfa r e o u t s id e th e fa c t o r y . T h e M in is t r y o f M u n it io n s h a v e p la c e d in th e p r in c ip a l m u n it io n a re a s a n u m b e r o f officers s p e c ia lly c h a r g e d w it h th e d u t y o f lo o k in g a ft e r th e h e a lth o f th e w o r k e r o u t s id e th e f a c t o r y ; th e y d e a l w it h su ch m a tte r s as h o u s in g a n d tr a n s it, sick n e s s, a n d r e c r e a tio n . ( l x x x i x ) I t is o f th e u tm o s t im p o r t a n c e th a t o n ly h e a lth y , c le a n , a n d w h o le s o m e -m in d e d w o m e n s h o u ld b e e x p o r t e d . M o t h e r s w it h y o u n g c h ild r e n s h o u ld n o t b e e x p o r t e d . N o w o m a n o r g i r l s h o u ld b e e x p o r t e d w it h o u t a su fficie n cy o f m o n e y a n d c lo t h in g . T r a v e le r s a c ro s s c o u n t r y s h o u ld b e seen o ff a n d m et. ( x c ) I n a ll la r g e c e n te rs c le a r in g h o s te ls s h o u ld b e p r o v id e d , in w h ic h w o m e n c a n b e h o u s e d u n til o th e r a c c o m m o d a t io n c a n b e f o u n d f o r th e m . ( x c i ) L o d g in g s w it h o r w it h o u t b o a r d in a f a m ily is g e n e r a lly th e r e a d ie s t a n d m o s t a c c e p ta b le m e a n s o f h o u s in g w o m e n a n d g ir ls . A n o r g a n iz e d sy ste m is r e q u ir e d f o r p r o v id i n g s u ita b le lo d g in g s a n d k e e p in g th e m u n d e r s u p e r v is io n . I n th e m o r e im p o r t a n t a rea s t h is w o r k is g e n e r a lly u n d e r ta k e n t h r o u g h officers o f th e M in is t r y o f M u n it io n s , o r b y lo c a l b ille t in g c o m m itte e s e s ta b lis h e d b y th e c e n t r a l SU M M A R Y OF CONCLUSIONS. 265 b ille t in g b o a r d u n d e r th e b ille t in g a ct. U n d e r th a t- a c t p a y m e n ts f o r r e n t a n d b o a r d c a n b e g u a r a n te e d . N o u se h a s h it h e r t o b e e n m a d e o f th e p o w e r o f c o m p u ls o r y b ille t in g , a n d it is d o u b t fu l h o w f a r it is w o r k a b le in p r a c tic e . ( x c i i ) I n m o s t a rea s th e p r o b le m , h o w e v e r , is o n e n o t o f lo d g in g s b u t o f h o u s in g , a n d e x is te d b e fo r e th e w a r. A s s is ta n c e h a s b e e n g iv e n in so m e a rea s t o lo c a l a u th o r itie s f o r th e p r o v is io n o f a d d it io n a l p e r m a n e n t a c c o m m o d a t io n , b u t in th e m a in th e r e q u is ite h o u s in g h a s h a d to b e p r o v id e d b y th e e s ta b lis h m e n t o f h o s te ls a n d h u tm e n ts . ( x c i i i ) H o s t e ls h a v e n o t alwTa y s b e e n p o p u la r . O b je c t io n h a s b een ta k e n t o l iv in g in la r g e in s titu tio n s o r u n d e r th e c o n t r o l o f th e e m p lo y e r ; a ls o t o th e r e s tr ic tio n s o n in d iv id u a l lib e r t y w h ic h are in v o lv e d . S o m e wro r k e r s o n ly u se th e m o n a c c o u n t o f th e la c k o f o t h e r d e ce n t a c c o m m o d a t io n s a n d th e d iffic u lty o f h o u s e k e e p in g u n d e r p re s e n t c o n d it io n s . I t is o f p a r t ic u la r im p o r t a n c e th a t th e p la n n in g a n d m a n a g e m e n t o f h o s te ls s h o u ld b e t h o r o u g h ly s a t is fa c t o r y . I n A p p e n d ix F d e t a ile d s u g g e s tio n s a re g iv e n . ( x c i v ) S ick n e s s , h o w e v e r t e m p o r a r y , a m o n g g ir ls in lo d g in g s in v o lv e s m u ch h a r d s h ip , a n d m a y b e c o m e s e r io u s i f n e g le c te d , a n d s p e c ia l ste p s s h o u ld b e ta k e n t o d e a l w ith it. A c t io n is a lso n e ce s s a r y in th e ca se o f g ir ls t h r o w n o u t o f w o r k o r o th e r w is e s tr a n d e d , o ft e n t h r o u g h n o fa u lt o f t h e ir o w n . ( x c v ) R e c r e a t io n is an e ss e n tia l a id to r e c o v e r y fr o m fa t ig u e , a n d a d e q u a te p r o v is io n f o r it s h o u ld b e m a d e , e s p e c ia lly in th o s e a re a s w h e re la r g e n u m b e rs o f im p o r t e d w o r k e r s a re e m p lo y e d . M u c h a tte n tio n is n o w b e in g g iv e n t o th e s u b je c t a n d fa c ilit ie s a re s t e a d ily in c r e a s in g . W h e r e t h e y c a n b e o r g a n iz e d c e n tr a l sch e m es a v a ila b le f o r a ll w o r k e r s in th e d is t r ic t a re to b e p r e fe r r e d . M o r e o ft e n , h o w e v e r, p r o v is io n d e p e n d s u p o n th e in it ia t iv e o f an in d iv id u a l firm tind its w o r k e r s , a n d m o s t w e lfa r e s u p e r v is o r s a re c o n c e r n e d w ith sch e m es f o r r e c r e a tio n . ( x c v i ) T h e m a in te n a n c e o f p u b lic o r d e r , n o t a b ly in c e n te rs w h e re la r g e n u m b e rs o f g ir ls a re a sse m b le d , h a s le d t o th e e m p lo y m e n t o f w o m e n p o lic e a n d p a tr o ls . T h e y h a v e d o n e v a lu a b le se r v ic e , b o t h in s id e th e f a c t o r y a n d o u ts id e th e f a c t o r y : a lso in a s s is tin g th e r e g u la r p o lic e . ( x c v i i ) M u c h h a s b ee n d o n e to im p r o v e th e h e a lth a n d in c re a s e th e efficie n cy o f th e m u n it io n w o r k e r b y th e r e d u c t io n in e x ce s s iv e d r in k in g w h ic h h a s b e e n b r o u g h t a b o u t t h r o u g h th e r e s tr ic tiv e m e a s u re s o f th e c e n tr a l c o n t r o l b o a r d (liq u o r t r a ffic ). (S e e p a r a g r a p h s 493-532.) 534. The committee desire to place on record their warm appre ciation of the unfailing courtesy, the devotion to duty, and the ability 266 IN D U ST R IA L H E A L T H AND E FF IC IE N C Y . o f th e ir s e c r e ta r y , t o w h o m th e y o ffe r th e ir b e s t th a n k s f o r th e a s s is t a n c e h e h a s r e n d e r e d th e m in th e p e r fo r m a n c e o f th e ir ta sk . (S ig n e d ) G eorge N e w m a n , Chairman . E . H . P e l h a m , Secretary . A p r il , 1918. T h o m a s B a rlo w . G erald B e l l iio u s e . A . E . B oycott . J . E . Clynes. E dgar L . C o l l is . W . M . F letcher. L eo n a r d H il l . S a m u e l O sb o r n . E ose E . S q u ir e . M ay T e n n a n t . A P P E N D IX A .— L IS T O F P E R S O N S W H O G A V E E V ID E N C E O R O T H E R W IS E A S S IS T E D T H E C O M M IT T E E . (a) The persons giving evidence before the committee included the following, many of whom have also assisted the committee in other ways: London : Mr. F. S. Button, Mr. A. B. Swales, Amalgamated Society of Engi neers; Mr. Ii. J. A. Pearson. Messrs Vickers (L td .), E r ith ; Mr. H . S. Adams, Messrs. The Projectile Co. (1902) (Ltd.) ; Capt. Pasley, Messrs. Eley Bros. (L td .). Birmingham: Mr. J. E. Harston, H . M. I., deputy superintending factory inspector for the Birmingham district; Miss Hilda Martindale, H. M. I., His Majesty's senior lady inspector of factories under the Home Office for the Midland division; Mr. George Ryder, Amalgamated Society of Engineers; Mr. George Wilkinson, Amalgamated Society of Tool M akers ; Councilor John Beard, Mr. John Wliiston, Mr. J. E. Grobey, Workers’ Union. Sheffield: Mr. W illiam Ireson, Messrs. Thomas Firth & Sons ( L t d .) ; Mr. G. H. Wilkinson, chief assistant overseer of the townships of Sheffield and Eccleshall; Mr. W illiam Marshall, Messrs. Vickers (L td .), Sheffield; Mr. A. J. Bailey, National Amalgamated Union of L abor; Mr. Green and Mr. R. E. Jones, Amalgamated Society of Engineers; Mr. M. Humberstone, National Steel W ork ers’ Association, Engineering and Labor League; Mr. A. R. Fearnley, general manager, Sheffield Corporation Tramways. Neweastle-on-Tyne: Mr. Thomas Bowmaker, Amalgamated Society of Engi neers ; Mr. E. Gilbert, Blacksmiths’ Society; Mr. I. D. Hebron, Pattern Makers’ Society; Mr. J. Wile, Brass Founders’ and Turners’ Society; Mr. D. S. Marjoribanks, Messrs. Armstrong, Whitworth & C o .; Miss E. Sadler, His M ajesty's senior lady inspector of factories; Mrs. Fawcett, National Federation of Women W ork ers; Mr. G. B. Hunter, Messrs. Swan, Hunter & Wigliam Richardson (L td .). Glasgow: Sir W . W eir, formerly director of munitions for Scotland ; Mr. Harold D. Jackson, Messrs. Barr & Stroud (Ltd.) ; Mr. H . J. Wilson, His Majesty's inspector of factories; Dr. Alexander Scott, medical referee for indus trial diseases for the west of Scotland district, workmen’s compensation act, 190G; Mr. G. Moore, Mr. W alter Hicks, Mr. R. Polgrean, representative munition workers. Representatives of women w orkers: Miss Lois Young, secretary National Federation of Women W orkers; Mrs. Gibb, Miss Fanny Workman, Miss Anna Howatt, Miss Nellie McGregor, workers; Miss Vines, His M ajesty’s senior lady inspector of factories for Scotland. Woolwich arsenal: Royal gun factory department— Messrs. Cardwell, Keir, Mills, Savage, Stratton ; mechanical and inspection department— Messrs. Ilsley, Taylor, B lake; royal laboratory— Messrs. Pendtey, Falconer, Franks. Cage, H i ll; royal carriage department— Messrs. Thompson, Leighton, Wallis. Manchester: Mr. Robert H. Coates. United Machine Workers’ Association; Miss A. Tracey, His Majesty’s senior lady inspector of factories; representatives of the National Union of Gas Workers and General Laborers— Messrs. Eccles, J. Cummings, masterman; Mrs. Annot E. Robinson, women’s war interests com mittee; Mr. Edward Hopkinson, Messrs. Mather & P latt; Mr. M. A. Mcl^ean, the British Westinghouse Electric & Manufacturing C o .; Mr. E. Reid, Sir W illiam Armstrong, Whitworth & Co. 267 268 IN D U STBIAL H E A L T H AK D E FF IC IE N C Y . Coventry: Mr. C. Greenway, Amalgamated Society of Engineers; Mr. W . T . Smith, Toolmakers’ Society. Representative of the trades council— Mr. Chater, secretary. Representative of the workers’ Union— Mr. Morris. Representa tives of the Coventry branch of the National Federation of Women Workers— Mrs. Lewis, Mrs. H. E. Givens. Representatives of the Women’s Cooperative Guild and the women’s hostel committee— Mrs. -Collington, hostel committee; Miss Selina Dix, president women’s hostel committee; Averal C. W ilks, Mrs. Eleanor Kirkman Gray, Annie E. Corrie, women’s hostel committee; Mrs. Mary A. Keene, president Women’s Cooperative Guild, poor-law guardian; Mrs. Mary Biggs, Emily Clialker, hostel committee and poor-law guardian; Hon. Mrs. Baillie, chairman voluntary committee on supply of labor; Mr. A. W all, Coventry Labor Exchange. Dr. T. M. Legge, Home Office; Mr. Leon Gaster, honorable secretary Illuminating Engineering Society; Mr. John Hodge, M. P., secretary British Steel Smelters, Mill, Iron, Tinplate, and Kindred T rad es; Mr. C. E. B. Russell, chief inspector of reformatory and industrial schools; Dr. E. F. Armstrong, D. Sc., technical adviser and managing director of Messrs. Crossfield & Co., and of William Gossett & Son ; Mr. T. North, super intendent, Vickers & Co., Crayford; Mr. J. J. Mallon, Miss Macartliur, Na tional Federation of Women W orkers; Mr. P. B. Brown, director and gen eral manager of Messrs. Hadfields (L td .), Sheffield; Right Hon. Sir W . Mather, Messrs. Mather & Platt. Representatives of the following bodies concerned with the welfare of women and girls— Women Police Service, National Associa tion for Women’s Lodging Homes, National Association for Women’s Lodging Houses, Young Women’s Christian Association, Church Army, Salvation Army, Catholic Women’s League, League of Honor, National People's Palace Asso ciation. ( b ) Persons who assisted in the medical inquiries conducted by the committee included the following: ( 0 Medical officers: Dr. Ethel Stacey; Dr. Beatrice W eb b ; Dr. Ethel W il liam s; Dr. Mabel Campbell; Dr. L. M. Chesney; Dr. Margaret Thackrali; Dr. Mary Phillips; Dr. Rhoda Adam son; Dr. Lilian Wilson, board of education; Dr. John B radley; Dr. Ada Whitlock, Home Office. ( ii) Inspectors and others: Mr. P. A. H eath; Miss E. G. W oodgate; Miss C. M. Thompson; Miss E. M. Gardner; Miss H o w a tt; Miss W orkm an ; Mrs. George Young; Mrs. Osborne, M. S c .; Miss Gordon; Mrs. Bankes; Miss M iller; Miss Irene Whitworth, Home Office; Miss H. C. Escreet, Home Office; Miss Isabel Taylor, Home Office; Miss Elizabeth Macleod, Home Office; Miss Carbutt, Home Office; Mrs. C. D. Rackliam, Home Office; Miss E. G. Colies, board of education; Miss G. M. Broughton, Ministry of Munitions; Miss Hilda Walton, Ministry of Munitions. (c) Amongst other persons who have by the submission of memo randa or by other means, placed their special knowledge at the dis posal of the committee were: Lord Leverhulme; Mr. B. Seebohm Rowntree; Mr. A. H. Self and Miss Lilian Barker, C. B. E., Woolwich A rsen al; Mr. A. Maitland Ramsey, opthalmic surgeon, Glasgow; Dr. Elizabeth Butler, National Filling Factory, Georgetown; Miss Hilda Caslimore, Bristol University Settlement; and Miss Elizabeth Macadam, University of Liverpool; Mr. R. A. Bray, Viscount Dunluce, and Miss G. E. Hadow, Ministry of Munitions; Mr. A. F. Agar and Mr. P. R. Higgins, canteen committee of liquor board. A P P E N D IX B ( I ) .— A F U R T H E R IN Q U IR Y IN T O T H E H E A L T H O P W O M E N M U N IT IO N W O R K E R S . BY MISS JANET M . CAMPBELL, M. D., M. S. (A SENIOK MEDICAL OFFICER OF THE BOARD OF EDUCATION.) In accordance with the instructions of the health of munition workers’ committee, an inquiry was arranged in the autumn of 1917 to follow up the medical investigation of the health of woman munition workers which had been made in 1915 and 1916, and with a view to ascertaining in a general way the effect of continued munition work upon the health and physique of women. The inquiry was carried out by Dr. Lilian Wilson (one of the medical officers of the board of education), Dr. Mary Phillips and Dr. Ehoda Adamson, assisted by Miss E. G. Colles (board of edu cation), Miss Hilda Walton (welfare department, Ministry of Mu nitions), Mrs. George Young and Mrs. Osborne, M. Sc. The fac tory conditions were reported on by His Majesty’s factory inspec tors, Miss Irene Whitworth, Miss H. C. Escreet, Miss Isabel Tay lor, Miss Elizabeth Macleod and Miss Carbutt. Miss Gordon, Mrs. Bankes and Miss Miller of the welfare department gave assistance in following up workers who had left the factory. Every endeavor was made to secure comparable results, and the following report has been compiled from the accounts written by the investigators. GENERAL ARRANGEMENTS. The inquiry was made at eight factories at which the general conditions may be regarded as reasonably typical. Five of them were chosen on account of the heavy nature of the work done by the women. At all the factories the management and welfare staff were most courteous and considerate and gave every facility for the inquiry. The women examined were chosen at random and were not se lected on account of physical weakness or strength. As a general rule, only women who had worked for at least nine months were seen. A considerable number was drawn from heavy operations likely to cause strain or fatigue, and from operations at which women had only recently been tried. The proportion of married women seen was also intentionally high. No compulsion was exer cised and women were free to refuse to be examined if they wished. The numbers examined were as follows: Factory No. 1 (northeast coast)________________________________ Factory No. 2 (M idlands)______________________________________ Factory No. 3 (Yorkshire)-------------------------------------------------------- 269 193 264 110 270 IN D U ST R IA L H E A L T H AND E FF IC IE N C Y . Factory Factory Factory Factory Factory No. No. No. No. No. 4 5 6 7 S 157 199 (London) (Yorkshire) (M idlands)____ (near London) (near London) 1,1S3 Total DESCRIPTION OF W O R K U NDERTAKEN B Y THE FACTORIES* Factory No. 1 (Northeast Coast). Workers were selected from nine departments doing heavy work and including the following processes: Six-inch shell, all machine processes. Eighteen-pounder shell, a few of the heavier machine processes, copper bend in g gauging, filling with shrapnel. Making fuses, most machine processes. Cartridge cases, shoveling coke in brass casting shop, oiling machinery and wheeling bogeys in rolling mill on acid tanks in annealing shop* automatic presses, all heavy machine processes. Traffic department, unloading and loading wagons— IS-pounder shell only. Factory No. 2 (Midlands). Shells.—Women are employed on practically all processes of man ufacture of 9.2 and 6 inch shells in various stages of heaviness. They are also employed on overhead cranes and as slingers. Guns.—About 60 women are employed as assistant operators to men on machines in this section. The work is less heavy than that of the shells, as the articles manufactured are very large and the work consists of machine minding pure and simple. Some of the operations take as long as 10 hours. Factory No. 3 (Yorkshire). The main part of the factory is used for the manufacture of 4.5inch and 60-pounder shells. A small part is used for the manu facture of gun parts. The great majority of the workers concerned in the output of shells can be divided into three classes— machine operators, laborers, and inspectors. The factory is arranged in such a way that so far as possible the first process starts from the right-hand side of the factory, on which the rolling way for billets is situated, and the shells are then worked gradually along toward the left. W ith the exception of the initial process of centering, the machine operator is not concerned with the transit of shells, and her heavy work consists in lifting the shells in and out of the machine and in the necessary “ tightening up ” of the machine. No lifting tackle is provided for the 4.5 shells, but it is pro vided for the 60-pound shells up to the process of fnse-hole boring, when the shell is reduced in weight to 53 pounds 4 ounces. The centering is done on rather a different system. All the laboring and machine work is done by a A PPEN D IX B (I). 271 sang of four women to each machine, so that in addition to lifting the shell into the machine they load up the trolleys and pull them toward the tables and unload them at the tables. The primary work of the laborers is the moving of shells from one process to another. This is done by means of trolleys onto which the shells are loaded. In the early processes the trolleys and the tables onto which the shells go are about the same height so that in most cases the shells can be rolled mi and oil the trolleys instead of being lifted. This considerably lightens the work, but tlie trolley loads seem in many cases to be unnecessarily heavy. As tlie shells proceed down the shop and gradually become lighter, the trolleys in many cases are lower, and shells, owing to lack of table space, are stacked on the floor, so that they have to be lifted up constantly from the floor to tables about 3 feet high. By this time the 4.5 shells have been reduced in weight, to under 30 pounds, hut the 60-pound shells still weigh about 50 pounds. Factory No. 4 (London). Women are employed on about 30 different processes, on lathes, milling and drilling machines, examining, cleaning, and checking, and also in the tool room. Although the majority of the w-ork entails handling 6-inch shells which weigh 130 pounds in the rough and nearly 90 pounds in the complete state, practically all the heavy handling is done by men, and the placing of the shells in the machines is done by sliding them down a sloping plane so that there is no particular strain placed on the workers when they are actually han dling the shells. Factory No. 5 (Yorkshire). Factory (a) is engaged in the manufacture of 9.2-inch shells, and women are machine operators on most operations. Owing to the size of the shell (the initial weight of the forging is about 440 pounds) women were not employed as laborers or shell movers in this factory until recently. Now, since the introduction of the rolling bench and hydraulic cranes, the men laborers have been extensively replaced by women who assist in craning up the shells with the women operators. Some women do their own craning in. As a result of the introduction of the aforementioned rolling bench system the energy required for laboring has been considerably reduced and the shells have merely to be craned from the bench to the machine, instead of, as formerly, from the ground. Men fix practically all the shells into the machines and all through skilled men act as tool setters. In Factory (5) 6-inch shells are made. Women are at work on practically all the operations to which the shell is submitted and these vary very considerably in time occupied per shell, and in the skill required. The forging at its heaviest stage weighs about 130 pounds, and before it leaves the shop its wreight has been reduced to about 86 pounds. The machine operator fixes her own shells in the lathe, and the methods of fixing vary very considerably from automatic clamps 272 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . to chucks, the fastening of which requires a series of violent jerks at the end of a long crowbar. Factory No. 6 (Midlands). The women are engaged in making fuses. The work is light in character and in itself involves little or no physical strain. Factory No. 7 ( near London). The firm is now mainly engaged on gaines and gaine caps, having only a small number of 12 and 14 pound shells in hand to finish a contract. Therefore practically all the work is light. The women are employed on turning the shells throughout after the first two operations (cutting off and roughing out); melting and centering fuse plugs; parting off, drilling, screwing, and forming gaines; boring, screwing, and forming caps; besides lacquering and inspec tion. Factory No. S ( near London). The firm makes and assembles ball bearings wThich consist of “ races ” and balls or rollers, and in some cases of “ cages ” and balls, and vary in size from those having a bore of 5 millimeters to the large ones with a 12-inch bore, whilst the balls vary from one-sixteenth of an inch to 4| inches in diameter. The women are engaged in making and assembling the small ones throughout, but only on some lathe, processes and on viewing parts of the larger ones. They are em ployed on the automatic and semiautomatic machines, grinding on the presses, viewing, gauging, ball viewing, assembling, testing, and packing. It is all unskilled or semiskilled work and does not entail any heavy lifting, but is monotonous and in certain cases demands great concentration. HOURS OF W ORK . Most of the work is done on the two-shift system. below : Typical hours are given Factory No. 1 ( northeast coast). Day. — 7 a. m. to 6.30 p. m. Monday to Friday, 7 a. m. to 12.30 p. m Saturday; 12 m to 1 p. m., 4 to 4.30 p. m. (10 minutes for te a )— total, 55 hours. Niglit.—7 p. m. to 6.30 a. m. Sunday to F rid ay ; meals, 11 to 12 p. m., 2.30 to 3 a. m. (10 minutes for tea )— total, 60 hours. meals, Factory No. 7 ( near London). Da y .— 7 a. 10 to 10.10 a. m. to 7 p. m. Monday to Friday, 7 to 12 a. m. Saturday; meals, m., 12 to 1 p m., 4 to 4.20 p. m.— total, 57£ hours. 273 APPENDIX B ( I ) . Night .— 7 p. m. to 7 a ra. Monday to F riday; meals, 10 to 11 p. m., 3.30 to 4 a. m.— total, 52^ hours. F actory No. 8 ( n e a r L o n d o n ) . D a y .— 7 a. m. to 6 p. ra. Monday to Friday, 7 to 12 a. m. Saturday; meals, 8.30 to 8.45 a. m., 12 to 1 p. m., 3 to 3.15 p. m.— total, 52| hours. Night .— 7 p. m. to 6 a. m. Monday to F riday; meals, 10.30 to 11 p. m., 3 to 3.30 a. m.— total, 50 hours. At Factory No. 2 (Midlands) the work is arranged on both two and three shift systems. Broadly speaking, the supervisors (e. g., fore men, tool setters, etc.) work two shifts, the day shift 11 hours, the night shift 13 hours, with mealtimes of 1 hour and 1^ hours, re spectively. The actual operators work on a three-shift system, the shifts being slightly uneven, and a mealtime of half an hour being given in each case. Where men and women work together on a lathe the women work the same hours as the men. At Factory No. 3 (Yorkshire) practically all women work on the three-shift system: Morning shift .— Monday to Friday, 7 a. m. to 2.30 p. m .; meals, 10 to 10.30 a. m. Saturday, 7 a. m. to 5 p. m .; meals, 1 hour. Weekly total, 44 hours. Afternoon shift .— Monday to Friday, 2.30 to 10 p. m .; meals, 6 to 6.30 p. m. Weekly total, 35 hours. Night shift .— Monday to Friday, 10 p. m. to 7 a. m .; meals, 2.30 to 3 a. m., and about 10 minutes for tea at 11.40 p. m. Weekly total, 42£ hours. At Factory No. 5 (Yorkshire) until June, 1917, women in factory (a) were working on 8-hour shifts with a half hour meal break, the men being on 12-hour shifts—so that each set of men worked with two sets of women each day. In June, 1917, a change over was made—■ the hours then being 10 hours’ shift for day and 11J for night work. Work starts at 8 p. m. on Sunday and finishes at noon on Saturday. It is noticeable that the night shift is of longer duration than the day shift, and the work in addition includes a long Sunday night. No reason has been discovered as to the object of having longer night work than day other than that this scheme of hours fits in with the existing train service, for this factory is situated some four miles out of the city in almost rural surroundings. It is not unlikely that the train service could readily be modified to suit the convenience of the large numbers of daily workers if it were proved desirable to equalize the length of shift. There can be little doubt that from an efficiency point of view it is desirable, where other than automatic work is being done, that the shifts should be of equal duration, as the worker must be tuned to a certain speed dependent on length of shift, and a varia tion in ^duration of shift weekly must necessitate some loss of effi ciency. 80935°— 19-------18 274 IN D U ST R IA L H E A L T H AN D E F F IC IE N C Y . In factory (b) the hours are as follows: Shift. Time. Meals. Longest Total hours period without worked break. per week. DAY. Week day........................ 6 a. m . to 6 p. m . . 9 to 9.30 a. m .; 1 to 2 p. m .; unofficial break, 3.45 to 4 p. m . Saturday . . . . . . . . . 6 a. m . to 1 p . m . . 9 to 9.30 a. m ...................... ...................... 3a 3i NIGIIT. Sunday-Friday.............. 6 p .m . to 6 a. m ... 9 to 10 p. m .; 1.15 to 1.45 a. m .; unoffi cial break, 3.45 to 4 a. m . 3i G3 Just at the time of the investigation the question of shortening the hours had been considered and practically decided on, when it was announced that the matter had been postponed. In order to fit in the working time of the men on two shifts with that of the women on three, the working hours of the women on the new shifts were to be 74-, 7-J, and 6-J. This reduction of hours to 6^ naturally caused many of the women to feel that they would not be able to earn a “ living wage.” An endeavor wTas made to ascertain the views of the women them selves on the question of the two and three shift systems. The main objection to the eight-hour shift seems to be that less money can be earned. On the other hand, the short shift is obviously more con venient for women with children and home duties and provides a reasonable opportunity for rest and recreation. The factory No. 2 (Midlands) report states “ the general impression was gathered that married women prefer shorter hours, as they like to undertake the management of their own homes without outside assistance. The unmar ried women, on the other hand, evidently feel that they ought to be helping in home work when they are not at the factory, and prefer the increased pay of the longer shift to indefinite unpaid home duties. One point raised against short shifts wras that on two out of three shifts workers were always about at 10 p. m. either ceasing afternoon work or starting on the night shift, and writh decreased lighting and lonely roads some found the journey a considerable strain to their nerves. On the whole, it appeared that there is less disturbance to home life if the shorter shift is in use, but the question of strain for individual women needs careful consideration, as the 8-hour factory shift, in addition to heavy household wTork, involves a heavier day’s toil than factory work alone through a 12-hour shift when it is obviously impossible to undertake home duties.” The report on factory No. 1 (northeast coast) states : “ On the point of shorter shifts (e. g., the substitution of eight-hour shifts I gathered that many shop managers would welcome it and would expect to obtain the same output in two eight-hour shifts as they do at present, but that the many difficulties in the way include (1) the strong opposition of the men fitters and tool setters ; (2) the objection of the women themselves, who are in most shops on the premium- APPEN D IX B (I). 275 bonus system, and who would object to the lower wage (this objection does not hold in the piecework shops) ; and (3) the reorganization of the transit arrange ments which in a factory of this size would be a big problem. Many women themselves told me that they could easily produce the same output in an eighthour shift. In all cases there appeared to be considerable waiting about for work owing to the work not coming through quickly enough from the men on the previous process. In one shop at least the daily output is limited, and when the girls have finished they hang about the shop sometimes for an hour or an hour and a half— being on the premium-bonus system (which is based partly on a time wage) they have to put in their hours at the shop. In no shop on the premium-bonus system did it appear to me that much work was done during the last hour of the shift.” At factory No. 5 (Yorkshire) : “ The general impression gathered from the women in factory (b) is that the large majority would be glad to return to the eight-hour shift, even though their weekly earnings were reduced. A minority, composed of very strong women who had reached middle age after hard-working lives and the younger single women with no home ties, are satis fied with the 12 hours, and feel quite able to continue at this rate and to earn their present rate of pay. There were on 12-hour shifts, many who openly won dered how long they could continue to work under present conditions, and a few definitely intended to give up munition work this winter, as they felt the long hours were ruining their health. “ The general impression gathered from the women in factory ( a) is that there is a greater appearance of wrell-being and satisfaction with the work and hours. The weekly earnings for each process appear a little higher than those earned in corresponding processes in 6-inch shells.” N ig h t S h if t s . A s a r u le d a y a n d n ig h t s h ift s w e re w o r k e d a lte rn a te w eek s. A t fa c t o r ie s 7 a n d 8, h o w e v e r , o n ly a p r o p o r t io n o f th e w o r k e r s w e r e r e q u ir e d f o r n ig h t w o r k a n d th e re w a s n o r e g u la r a lte rn a tio n . At factory No. 8 (near London) 16 permanent night-shift workers were examined. Nine were classified as A and six as B. Workers in class A had worked continuously on night for periods varying from 3^ to 11 months, the average time being months. The average time of the remainder was also 4 i months. The nutrition and general health of the night workers examined (and they were picked at random) was much better than that of the day workers. This is probably because it is only the stronger girls and women who “ can stick it.” There is no regular alternation of day and night work, and if a worker agrees to go on night she is left on until she “ knocks up.” It was said that numbers of girls had had to give up night work because they could not stand it. Several had left because they were not allowed to change to day work. The night workers examined wrere satisfactory. Their feeding is better on night shift, as they have two good hot meals, one before coming out in the evening and a good breakfast. The breakfast of the day workers is nothing but tea, bread, and butter, as they have to leave so early that there is no one to prepare a meal for them. The majority of the night workers apparently pre ferred night because of the long week end. They work five nights and rest from Saturday morning till Monday night. Even those who complained that they were tired at the end of the w^eek said that they got rested during the week end. 276 IN D U STRIAL H E A L T H AN D EFFICIENCY* At factory No. 7 (near London), where there is also no regular alternation pi day and night work, 19 workers on different processes were examined. Twelve were classed as A and seven as B. The average time worked continu ously on night was 13.5 months in class A and 15 months in class B. O n th e w h o le n ig h t itfork w a s n o t u n p o p u la r a m o n g th e w o m e n , p a r t ly b e ca u se o f th e h ig h e r w a g e s e a r n e d , p a r t ly b e c a u s e th e y f o u n d m o r e o p p o r t u n it ie s f o r s h o p p in g a n d p e r s o n a l a ffa ir s . M o s t w o r k e r s f o u n d n o d iffic u lty in s le e p in g d u r in g th e d a y , t h o u g h m a n y , f o r re a so n s w h ic h w e r e n o t o ft e n u n a v o id a b le , d id n o t a llo w th e m s e lv e s su fficien t tim e f o r sle e p . W o r k o n S u n d a y n ig h t w a s d is lik e d , fe w w o m e n c a r e d t o s p e n d S u n d a y in b e d a n d m a n y u s e d t h is d a y f o r h e a v y d o m e s t ic w o r k f o r w h ic h th e y h a d n o o p p o r t u n it y d u r in g th e w eek. SEATS. A lt h o u g h in s o m e ca ses sea ts h a d b e e n p r o v id e d f o r u se w h e n w o r k e r s h a v e p r o p e r o p p o r t u n it y f o r r e s tin g , th is w a s b y n o m e a n s g e n e r a l. F o r e x a m p le — The report on factory No. 1 (northeast coast) states: “ There is a great grievance in certain shops. Sitting is generally not allowed and in many cases this appears to cause quite unnecessary fatigue to the workers. There is no provision of stools or benches except for certain drilling machines and benches where the work must be done sitting. No stools are provided for workers on such processes as rough turning (6-inch shell and 18-pounder shell) and on cer tain automatic machines where the worker might often sit for some minutes at a time.” The report on factory No. 4 (London) calls attention to the lack of seating accommodation. At factory No. 7 it is stated that “ only the viewers and lacquering girls have stools; in none of the other shops is provision made for sitting, though I noted many times when workers were waiting either for the tool setter or material.” Many women complained that they could not sit down while wait ing for work as no seats were provided and they were not allowed to sit. In this factory the proportion of tired and swollen feet was noticeable. On the other hand, the report on factory No. 8 states: “ In nearly every department seats were provided for the workers; some had metal backs for support, while some were merely stools.” # T h e p r o v is io n o f sea ts a n d th e u se m a d e o f th e m u n fo r t u n a t e ly o ft e n a p p e a r s t o d e p e n d t o o m u c h o n th e c a p r ic e o r p r e ju d ic e s o f in d iv id u a l m a n a g e r s a n d fo r e m e n , w h o d o n o t y e t r e a liz e th a t, i f s u it a b ly u s e d , sea ts r e d u c e fa t ig u e a n d d o n o t e n c o u r a g e h a b it s o f id le n e s s a n d sla ck n e ss. S e a ts a re p a r t ic u la r ly n e e d e d w h e r e th e o p e r a t io n s a re l o n g a n d c a n n o t b e a c c e le r a te d , w h e r e w a it in g is a p t t o o c c u r f o r m a t e r ia l o r a ssista n ce a n d w h e r e th e t w o -s h ift s y s te m is fo llo w e d . NUTHITION. C a n te e n s h a d b e e n e s ta b lis h e d in c o n n e c t io n w it h a ll th e fa c t o r ie s v is it e d a n d o n th e w h o le w e r e s u ita b le a n d c o n v e n ie n t, t h o u g h n o t APPEN D IX B (I)• •277 a lw a y s as p o p u la r w it h th e w o m e n as h a d b e e n h o p e d . I n s p ite o f th e p r o v is io n o f c h e a p , a p p e t iz in g d in n e r s , m a n y w o m e n s till p r e f e r t o b r in g th e m a in p o r t io n o f th e ir f o o d fr o m h o m e , m e r e ly s u p p le m e n t in g th is w it h “ e x tr a s ” o r tea f r o m th e c a n te e n .1 O n a n e ig h t h o u r s h ift a d is in c lin a t io n t o p u r c h a s e a f u l l m e a l is u n d e r s ta n d a b le . T h e s h ift is r e la tiv e ly s h o r t a n d a llo w s tim e f o r m e a ls a t h o m e , w h ile th e fa c t o r y m e a l tim e is o n ly h a lf a n h o u r a n d d o e s n o t c o r r e s p o n d w it h a n y o f th e o r d in a r y p r in c ip a l m e a ls o f th e d a y . At factory No. 2 (M idlands), for example, only 20 of tlie workers stated that they used tlie canteen entirely, getting their dinners there. The remainder took their solid meals at home, and brought sandwiches, cake, and bread and butter to the factory, getting “ what they fancied,” in the canteen, and making tea there. This incomplete use of the canteen may be attributable to the short meal times to which workers have grown accustomed on the three shifts, and to the consequent difficulty of serving rapidly enough to allow proper time to eat. Factory No. 5 (Yorkshire). At factory (a) the girls take all their meals in the canteen— a fair proportion actually buying all their food there; that is to say, on day shift they buy good breakfasts and good dinners, whilst the re mainder bring their food from home, often prepared dishes which they can warm up in the canteen and which they supplement with small purchases at the tanteen. On night shift the usual plan is to have substantial food before leaving home, many having a good meat meal often with the members of the household who have returned from day work. They make this their main meal and purchase light suppers and breakfasts during the night or bring light meals with them. The women have certainly learned the lesson, and act on it, that they can not continuously work at their strenuous occupations unless they get adequate food. Occasionally one would say “ we are really doing men’s work, we can not expect to do it on bits of thing that would keep us going at home, we have to have real meals.” These inquiries were made at the time when the great difficulties in obtaining certain provisions arose and many of them told of the hardships which were being experienced by themselves or their mothers in obtaining food. It was common at this time for the women to leave work in the early morning after the H i hours of night shift, with perhaps two hours’ traveling in addition, and line up in the food queues in order to obtain supplies. In many cases this resulted in the w^omen not getting home until midday, so that their rest was hopelessly interferred with. A t this time, too, the weather was very cold, heavy snow having fallen. The women on the heavy work in factory ( b ) have also realized that they require substantial food, if they are to carry out their duties continuously. Of the women interviewed the following analysis gives roughly the system in food taking: 124 good meals every day at home. 24 bay good meals at canteen. 64 buy some light food at canteen. 45 buy no food at canteen. An interesting comparison between the two factories is to be noted. The average wages are lower in factory (b) though the hours are longer. A rela tively small proportion is buying full meals at the canteen and a relatively 1 S in ce the in q u iry w as m ade th e d ifficulties o f sh o p p in g h a ve becom e g re a tly a cce n tu a ted and the dem an ds fo r fo o d a t ca n teen s has co r re sp o n d in g ly in creased . 278 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . large proportion buys nothing at all at the canteen. Apparently the higher wages insure a greater expenditure on food by these workers on heavy opera tions. O n th e 1 2 -h o u r s h if t a n d at n ig h t s th e p r a c t ic e o f b u y in g a f u ll m e a l seem s t o b e in c r e a s in g , a n d in s o m e ca ses i f m o r e w e r e d o n e t o m e e t th e w is h e s a n d ta stes o f th e w o r k e r s th e m e a ls w o u ld p r o b a b ly b e c o m e m u c h m o r e p o p u la r . I t is n o t an e a s y ta s k a lw a y s t o s a t is fy a n d m e e t th e lik e s a n d d is lik e s o f f a c t o r y w o r k e r s u n u s e d t o r e s ta u r a n t m e a ls a n d v e r y r e a d y t o c r it ic iz e , b u t a t th e sa m e tim e th e re is r o o m f o r im p r o v e m e n t in ca n te e n m a n a g e m e n t. For example, one factory has a canteen to seat 4,000. It is run by an outside caterer so badly that very few will use it. The supervisor offered to take it over, but was refused. The caterer has been reprimanded, and it is hoped the management will be improved. A t factory No. 4 (London) the canteen is too small to hold the workers, the food is only fairly good, the service is inadequate, especially at night, and the tea is particularly bad and strong. I n o th e r cases, a lt h o u g h th e f o o d a t th e c a n te e n is g o o d , th e w o r k e r s , t h r o u g h fo r c e o f h a b it, p r e f e r t o ta k e th e ir m e a ls in th e s h o p s . T h is is u n s a t is fa c t o r y fr o m e v e r y p o in t o f v ie w , b u t it seem s p r a c t ic a lly im p o s s ib le a lw a y s t o e x c lu d e th e m fr o m th e s h o p s in c e r ta in fa c t o r ie s . T y p i c a l p r ic e s a re as f o l l o w s : (1 ) Meat and vegetables Soup ____ ___ ____ Pudding - (This is considered too dear for some girls.) (2 ) Boiled beef and vegetables _ _ ________ _ Steamed pudding ___ _ _____ Custard -------- ---------_ _ Rice pudding _ Soup with dumpling Bread and cheese (The food appeared well cooked and of good quality.) _________ (3 ) Tripe and onions Savory (a kind of rissole) Fish _ P u d d in g ____ (The quality of the food seemed good, but the dinner is not often purchased, although there is a big trade in meat pies, cakes, beverages, chocolate, etc.) d. 9 2 3 Cents. [18. 3] [ 4 .1 ] [ 0 .1 ] 6 2 1 1 2 [12. 2] [ 4 .1 ] [ 2 .0 ] [ 2 .0 ] [ 4 .1 ] [ 1 .0 ] i 4 2 5 3 [ 8 .1 ] [ 4 .1 ] [1 0.1 ] [ G .l] T h e n u t r it io n o f th e w o r k e r s w a s g e n e r a lly s a t is fa c t o r y , e x c e p t in th e ca se o f f a c t o r y N o . 8, w h e r e “ th e n u t r it io n w a s v e r y p o o r a n d th e d ie t u n s u ita b le a n d in su fficie n t f o r w o m e n w o r k in g l o n g h o u rs . B r e a d a n d b u tte r a n d tea fo r m e d t o o la r g e a p a r t o f th e d ie ta r y , a n d 41 o u t o f 114 e x a m in e d w e r e c o n s id e r e d t o b e s u ffe r in g f r o m u n d e r fe e d in g .” T h is m a ln u t r it io n is d u e m a in ly to lo n g e s ta b lis h e d h a b it 279 APPENDIX B ( I ) . a n d c a n n o t b e a s c r ib e d t o w a r c o n d it io n s . I t m a y b e h o p e d th a t th e w e ll-m a n a g e d c a n te e n , w h ic h th e fir m h a v e n o w p r o v id e d , w ill e n c o u r a g e a b e tte r a n d m o r e su b s ta n tia l d ie ta r y . T R A N S IT . C o n v e n ie n c e o f tr a n s it v a r ie s g r e a t ly . A t f a c t o r y N o . 1 (n o r th e a s t c o a s t) th e d iffic u ltie s o f tr a n s it s till fo r m a n u n s o lv e d p r o b le m . O f 193 w o r k e r s e x a m in e d 39 w a lk to w o r k , 64 t r a v e l b y tr a in , 2 b y th e fa c t o r y b u s, 1 b y b o a t, 1 c y c l e s ; th e r e m a in d e r t r a v e l b y tra m . T h e jo u r n e y o c c u p ie s 1 h o u r o r m o r e in 41 ca ses, 2 h o u r s a n d m o r e in 19 ca ses, 3 h o u r s in 3 ca ses, 4 h o u r s in 1. T h e t r a in s e r v ic e is sta te d t o h a v e im p r o v e d , b u t th e tr a m s e r v ic e is s t ill w h o lly in a d e q u a te a n d u n s a t is fa c t o r y . T h e la r g e m a jo r it y o f w o r k e r s , m e n a n d w o m e n , is o b lig e d t o u se th e tra m s , a n d th e e x tr e m e o v e r c r o w d in g a n d b a d a ir a re c e r t a in ly r e s p o n s ib le f o r m u c h o f th e tir e d n e s s a m on g : th e w o m e n . T h e c r o w d in g in it s e lf m a y b e d a n g e r o u s , a n d o n e g i r l e x a m in e d h a d r e c e n t ly b e e n s e r io u s ly c r u s h e d a n d in ju r e d in th e a tte m p t t o fin d a p la c e . A t fa c t o r y N o . 2 (M id la n d s ) a c o n s id e r a b le n u m b e r o f wro r k e r s (1 1 8 ) are a b le t o w a lk o r c y c le to a n d f r o m th e f a c t o r y i f t h e y wTish . T h e r e m a in d e r c o m e b y b u s o r tr a in . T h ir t y -e ig h t w o r k e r s c o m p la in e d o f d iffic u lty in t r a n s it o r m e n tio n e d c o n d it io n s w h ic h in v o lv e d c o n s id e r a b le a d d it io n t o t h e ir h o u r s o f w o r k in g e t t in g t o , a n d f r o m th e fa c t o r y . T h e d e cr e a s e d s e r v ic e o f tr a in s p r o v e s m o s t in c o n v e n ie n t in c e r t a in c a s e s ; w o r k e r s w h o a r r iv e b y t r a in m a y h a v e t o wxa it a n h o u r a t th e fa c t o r y b e fo r e th e ir s h ift b e g in s . I n o n e in s ta n c e a w o r k e r o n th e a ft e r n o o n s h ift (2 .3 0 to 10 p . m .) a r r iv e d r e g u la r ly a t h e r h o m e a t 12.30 a. m ., a n d f o r th e m o r n in g s h if t (7 a. m . t o 2.30 p . m .) sh e r o s e a t 4 a. m . T h e tr a m s e r v ic e v a rie s . M a n y o f th e w o r k e r s h a v e n o c o m p la in t t o m a k e , b u t o n s o m e lin e s c a rs a re c r o w d e d , a n d w o m e n s ta n d h a b it u a lly , t r a v e lin g an h o u r e a ch w a y . A t fa c t o r y N o . 3 (Y o r k s h ir e ) p r a c t ic a lly a ll th e w o r k e r s c a m e b y car or t r a in : 15 m in 15-30 utes and under. minutes. A ........................................................................ B ........................................................................ C......................................................................... 4 4 Total (116)............................................. S 30minutes-1 hour. 1 hour and over. 25 18 4 32 24 2 2 47 58 3 Tram or train. Walk. 4 5 59 4J. 9 107 1 C e r ta in tra m s w e re s a id to b e c r o w d e d , a n d th e w o m e n c o m p la in e d o f th e c o ld a n d fa t ig u e o f w a it in g in q u eu es at th e e n d o f th e d a y ’s w ork. 280 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . A t f a c t o r y N o . 4 ( L o n d o n ) 114 o u t o f 157 w e r e a b le t o w a lk h o m e ; 138 ta k e less th a n 10 m in u te s f o r th e jo u r n e y a n d o n ly t w o m o r e th a n an h ou r. 15 m in 15-30 utes and minutes. under. A ........................................................................ Total (157)........... .................................. 30 minutes-1 hour. 1 hour and over. Walk. Bus or train. 64 16 2 37 18 1 10 6 1 1 1 *3 28 3 29 13 1 82 ; 56 17 2 114 43 A t f a c t o r y N o . 8 (n e a r L o n d o n ) 90 o u t o f 114 w a lk h o m e , a n d in 88 ca ses th e jo u r n e y o c c u p ie s less th a n 30 m in u te s . T h e firm h a s a r r a n g e d f o r a s p e c ia l tr a in m o r n in g a n d e v e n in g , a n d s h o u ld a n y fa r e e x ce e d 4s. [9 7 .3 c e n ts ] w e e k ly th e firm p a y s th e ex cess. LOST T IM E . N o a tte m p t w a s m a d e in th e c o u r s e o f th is in q u ir y t o o b ta in a c c u r a te d a ta in r e g a r d t o lo s t tim e a n d its cau ses. I n th e ca se o f w o m e n w o r k in g lo n g h o u r s th e re a re c le a r ly n u m e ro u s m o r e o r less le g itim a te r e a s o n s f o r b r o k e n tim e in a d d it io n to t e m p o r a r y ill h e a lth . T h e r e is, f o r e x a m p le , g e n u in e fa t ig u e a n d th e n o t u n n a tu r a l d e s ire f o r an o c c a s io n a l “ d a y o ff .” T h e r e a re a ls o d o m e s tic d u tie s o r e m e r g e n c ie s in r e g a r d t o th e h o m e o r c h ild r e n w h ic h , in th e ca se o f m a r r ie d w o m e n , a lm o s t n e c e s s a r ily e x e r t a p r io r c la im t o th e fa c t o r y . At factory No. 1 (northeast coast), for example, the report states: “ I gath ered on all hands that most workers deliberately stay away from work one day a week or a fortnight; this is sometimes for domestic reasons, but often because they feel the need of a day’s rest. The timekeeping records are consequently bad. In two shops where the timekeeping is much better I found that this was due to the strict discipline; any girl who stays away for a week, except it be on sick leave, loses her machine— she is put on some time work, such as laboring, and has to wait her turn to get a machine again. It is interesting that these were the only shops in which I had emphatic complaints from the girls as to the length of hours. Roughly speaking and simply from the general statements given, the timekeeping in these two shops was 50-75 per cent better than in the other shops.” At factory No. 5 (Yorkshire), the information given by the workers them selves indicated that the lost time at factory (a) was low. There was in gen eral a high sense of duty in this respect, great pride being taken in the posses sion of a “ clean slate,” both in respect of absence and lateness. Occasionally a woman stopped aw7ay as she was “ just done up ” or “ dead beat ” and felt that she must rest. The records of time lost during the last six months (since the introduction of longer hours) compared with the records for the previous two months when the women were on eight-hour shifts, show a rise in the total percentage of time lost which must be due largely to increased fatigue. APPENDIX B (I). 281- In factory (b) there is the same pride in many of the women in having “ no broken time ” to show. The machine operator who is fond of her work dislikes very much to stay away, for she is always anxious lest she should have “ her machine taken away.” Some cases were noted of women who took “ breakfast time,” because they felt “ too done up ” to come, but felt that the three hours extra rest they would obtain would set them up for the rest of the week. W E L F A R E S U PE R V IS IO N . I n a ll fa c t o r ie s v is it e d w e lfa r e s u p e r in te n d e n ts h a d b ee n a p p o in t e d w h o w e r e c h a r g e d w it h th e g e n e r a l o v e r s ig h t o f th e p h y s ic a l w e ll b e in g o f th e w o r k e r s . At factory No. 1 (northeast coast) the lady superintendent has a large staff of supervisors allocated to the different shops. Each supervisor has under her at least one assistant supervisor and an adequate number of attendants for cloakrooms, cookhouses, etc. The workers say that conditions have much im proved since the appointment of these officers and evidently regard them as valuable acquisitions. Welfare supervisors have nothing to do with the manage ment of the canteens, and the ambulance arrangements are in charge of the firm’s medical officer. The ambulance rooms are staffed by nurses and first-aid attendants who have no relation to the welfare supervisors. At factory No. 2 (Midlands) a welfare supervisor with three shift supervisors under her is in charge of the welfare work. The department is a branch of the labor department of the factory and the welfare supervisor is consulted by the management on questions concerning women. There are two surgeries in charge of nurses which can be used as rest rooms, if required. At factory No. 3 (Yorkshire) there is a welfare staff of 19. This includes the head welfare superintendent, 15 supervisors in the works, 1 in the record office, and 1 for engaging the workers. The vaftous processes are divided into five sections and each of the 15 supervisors has her own section under her control on each shift. She has a desk in the middle of her section and is therefore always accessible to the women. Of late a large number of athletic and social societies have been instituted in connection with the factory, and a welfare com mittee, which brings matters to the notice of the management, has also been formed. Various classes are also soon to be started in cooperation with the local education authority. An extremely well-equipped surgery with a separate department for men and women is in charge of the firm’s medical officer and staffed by nurses. At factory No. 5 (Yorkshire) the care of the workers at factory ( a) is in charge of a well-developed welfare department under the control of a lady supervisor and assistant supervisor. In each shop there is a shop supervisor who takes a personal interest in the women. A night matron has charge of the welfare of the girls during the night shift. A good spirit of comradeship has been developed amongst the women due to the energy of the welfare department. Games, football, and cricket on Saturdays and sports meetings are participated in by the women with great enjoyment. The welfare work at factory (b) is un der the direction of a lady supervisor and assistants, and working in the shops under the direction of the lady supervisor are the shops supervisors. At both factories all the wTomen who are engaged are required to undergo a medical examination by a woman medical officer within the first week or two r.fter engagement. Practically all the women who are employed have been examined, or will have been, in a very short time. Recommendations of the medical officer as to transference of women to light work are attended to by 282 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . the lady supervisor and any other recommendations made by the medical offi cer are followed up by the welfare department. At factory No. 7 (near London) the welfare superintendent does not engage or dismiss workers but interviews them after the assistant manager has taken them on. She is responsible for first aid and supervises the mess room. She engages mess-room and lavatory attendants. For first aid the supervisor has a well-fitted Red Cross box in her surgery for the treatment of minor injuries. Serious cases can be taken to the hospital close at hand. In her absence a lavatory attendant applies bandges, etc. At factory No. 8 (near London) two welfare supervisors have been appointed, but they have not as yet any very effective grip of their work. The canteen is not under their control and the first-aid arrangements are separately man aged. The present ambulance room is only temporary. It is well equipped, but there is no waiting room. Different hours are arranged for men and women. Three nurses take spells of eight hours each. GENERAL HYGIENE. A p a r t fr o m th e lo n g h o u r s u s u a lly w o r k e d a n d d iffic u ltie s o f t r a n s it in som e ca ses, th e g e n e r a l a r r a n g e m e n ts f o r th e h e a lth a n d c o m f o r t o f th e w o r k e r s a p p e a r r e a s o n a b ly g o o d in m o s t cases. T h e c o n d it io n s o f th e s h o p s as r e g a r d s v e n t ila t io n , h e a t in g , lig h t in g , r e m o v a l o f fu m e s , e tc., h a v e o ft e n b e e n m u c h im p r o v e d , a n d s p e c ia l c o n t r iv a n c e s h a v e b e e n d e s ig n e d t o ease th e s tr a in o f h e a v y w o r k . T h e c lo a k r o o m s , la v a t o r ie s , e tc., a re u s u a lly f a i r l y s a t is fa c t o r y , t h o u g h th e re is o ft e n n o p r o v is io n f o r d r y in g w e t g a r m e n ts . O v e r a lls o f a s u ita b le p a tte r n a re n o w g e n e r a lly p r o v id e d , t o g e t h e r w it h s p e c ia l m e a n s o f p r o t e c t io n {c lo g s , w a t e r p r o o f a p r o n s , e t c .) f o r w o m e n c a r r y in g o u t w e t o r d ir t y o p e r a tio n s . R e s t r o o m s f o r w o r k e rs t e m p o r a r ily in d is p o s e d a re u s u a lly a v a ila b le , a lt h o u g h t h e y a re p r o b a b ly n o t m a d e f u ll u se o f . I n th e p e r s o n o f th e w e lfa r e s u p e r v is o r a n officer e x is ts t o w h o m w o m e n m a y b r in g p e r s o n a l c o m p la in t s o r r e q u e sts f o r a d v ic e o r h e lp . T h e o r g a n iz a t io n is b y n o m e a n s p e r fe c t , b u t it r e p r e s e n ts a n im m e n se a d v a n c e o n th e c o n d it io n s w h ic h o b ta in e d t w o o r th r e e y e a r s a g o . A n e n d e a v o r is o ft e n m a d e b y th e f a c t o r y t o a r r a n g e lo d g in g s f o r w o r k e r s . I t is f o u n d th a t w o m e n u s u a lly p r e f e r t o liv e a t h o m e , e v e n t h o u g h th is e n ta ils a lo n g d a ily jo u r n e y , th a n in lo d g in g s c lo s e at h and. At factory No. 8 (near London) as the number of women employed increased and it became necessary to draw workers from a distance the housing ques tion became urgent. The firm persuaded the local authorities to make a can vass in the town and find out the householders willing to take lodgers and the prices they would charge. The names are kept on a card register and given to workers who require rooms. Unfortunately the register has not been kept up to date. The firm has also provided two small houses to be used as recep tion houses, one for men and one for women. These are placed under the management of the canteen supervisor, and workers may remain for three nights while looking for permanent lodgings. A woman cleans both houses and cooks, the charge being 2s. 6d. [60.8] per day. The houses are well kept, APPEN D IX B 283 (I). are furnished with single beds, not more than two in a room, and chests of drawers. Each house has a bath with hot water. KEDICAL EXAMINATION. T h e a r ra n g e m e n ts w e r e g e n e r a lly s im ila r t o th o s e o f th e p r e v io u s in q u ir y . E a c h w o m a n w e n t firs t t o th e a ssista n t in v e s t ig a t o r , w h o a sk e d v a r io u s q u e s tio n s in r e g a r d t o g e n e r a l a n d s o c ia l c o n d it io n s , a n d th e n to th e d o c t o r w h o m a d e th e m e d ic a l e x a m in a tio n s . E x c e p t at fa c t o r y N o . 5 ( Y o r k s h i r e ) , w h e re th e m e d ic a l o fficer w a s p e r s o n a lly k n o w n t o m a n y o f th e w o m e n , t h is e x a m in a tio n w a s n e c e s s a r ily s o m e w h a t c u r s o r y in n a tu r e , p a r t ly b e ca u se vo f th e c ir c u m sta n ce s u n d e r w h ic h th e in q u ir y w a s c o n d u c t e d , b u t m a in ly b e c a u s e it w a s e ss e n tia l t o a v o id a la r m in g o r ir r it a t in g p r e s u m a b ly h e a lt h y w o m e n b y r e q u ir in g m u c h u n d r e s s in g o r b y m a k in g a s e a r c h in g e x a m in a tio n . T h e in q u ir y w a s v o lu n t a r y a n d its r e s u lts d e p e n d e d e n t ir e ly o n th e su cce ss w it h w h ic h th e in v e s t ig a t o r s w e r e a b le t o o v e r c o m e th e sh y n e ss o r e v e n s u s p ic io n o f th e w o m e n . F o r e x a m p le , in so m e fa c t o r ie s w h e r e n u m e r o u s d is m is s a ls h a p p e n e d t o b e t a k in g p la c e , th e A vorkers n a t u r a lly s u p p o s e d th a t th e in q u ir y m ig h t b e in te n d e d to w e e d o u t th e m o s t u n fit. I n a n o th e r fa c t o r y in a t o w n w h e r e th e m e d ic a l o fficer o f h e a lth h a d r e c e n t ly p u b lis h e d a r e p o r t o n ill h e a lth a n d e s p e c ia lly a c h e s t t r o u b le ” a m o n g m u n it io n w o r k ers, a n u m b e r o f th o s e w h o w e r e n o t in th e b e s t o f h e a lth r e fu s e d t o be e x a m in e d as th e y fe a r e d su b se q u e n t a c tio n . N o d e t a ile d e x a m in a tio n o f th e c h e s t w a s m a d e as a r o u tin e . T h e d o c t o r s e n d e a v o r e d t o e lic it th e m e d ic a l h is t o r y b y s y m p a th e tic in q u irie s . A s b e fo r e , th e w o r k e r s w e r e c la ss ifie d in t o th re e g r o u p s , A , B , a n d C . A d e n o te s a p p a r e n t g o o d h e a lt h ; B d e n o te s so m e s ig n s o f fa t ig u e o r ill h e a lt h ; C d e n o te s m a r k e d fa t ig u e o r i ll h e a lth . N um ber of w ork ers e x am ined. E n gland. F a ctory F a ctory F a ctory F a ctory F a ctory F a ctory F a ctory l actory N o. N o. N o. N o. N o. N o. N o. N o. 1 ............................................... 2 .......................................... 3 .......................................... 4 .......................................... 5 .......................................... 6 .......................................... 7 . ...................................... 8 .......................................... A (h ealth y ). Num ber. P er centage. B (slight fatigu e). C (m a rk ed fatigu e). N um ber. P er centage. N um ber. P er centage. 193 284 116 157 199 73 67 114 no 199 63 112 77 45 35 51 56.9 75.3 54.3 71.3 38.6 61.6 52.2 44.7 70 53 46 41 114 19 30 52 36.2 20.07 39.6 26.1 57.2 26.02 44.7 45.6 13 12 7 4 8 9 2 11 1,183 692 58.4 425 35.8 66 | 6.7 4.5 6. 03 2. 5 4.02 12.3 2.9 9.6 5.5 CAUSES OF FATIGUE IN WOMEN WORKERS. T h e cases c la ss ifie d as “ C ” w e re th o se r e g a r d e d b y th e m e d ic a l officer as d e fin ite ly u n fit f o r th e w o r k th e y w e re d o in g . I n so m e in sta n ce s th e p h y s ic a l c o n d it io n a p p e a re d d u e to th e n a tu re o f th e 284 IN D U STRIAL H E A L T H AND EFF IC IE N C Y . w o r k a lo n e , b lit in m o s t t o h e a v y w o r k c o m b in e d w it h d o m e s tic d u tie s a n d p e r h a p s m e n ta l a n x ie ty . T h e cases c la s s ifie d as u B ” w e r e th o s e in w h ic h s ig n s o f w e a r i n ess a n d th e b e g in n in g s o f ill h e a lth w e r e o b v io u s t o th e e x a m in e r . N o s c ie n tific tests o f fa t ig u e w e r e a p p lie d . T h e o p in io n fo r m e d w a s b a s e d u p o n a p p e a r a n c e , s ig n s o r s y m p t o m s o f i ll h e a lth , p h y s ic a l a n d s o c ia l h is t o r y , etc. A t tim e s o b v io u s ly t ir e d w o m e n w e r e lo a t h t o a d m it a n y s ig n s o f fa t ig u e , f o r e x a m p le , a t N o t t in g h a m , as t h e y fe a r e d d ism iss a l. T ir e d n e s s a n d “ n e rv o u s n e s s ” w e r e c o m m o n c o m p la in t s a m o n g th e se w o m e n . A t f a c t o r y N o . 1 (n o r th e a s t c o a s t ) w h e r e a ll th e w o r k e r s h a d b e e n w o r k in g f o r a t le a st a y e a r , a n d m a n y f o r o v e r t w o y e a rs , a n u m b e r o f w o r k e r s sta te d th a t o n e o f th e firs t s ig n s o f fa t ig u e n o t ic e d b y th e m s e lv e s is th a t th e y “ d r e a d th e b e lt .” S le e p le ssn e s s a n d restlessn ess w e r e r e la tiv e ly c o m m o n ; in d ig e s t io n , lo ss o f a p p e tite , h e a d a ch e , e tc., w e r e o ft e n a s s o cia te d w it h th e t ir e d n ess. S o m e h a d d e fin ite ly lo s t w e ig h t , m a n y lo o k e d p a le , th in , a n d w orn. A m o n g th e s p e c ia l ca u se s o f fa t ig u e m a y b e m e n tio n e d h e a v y w o r k , e s p e c ia lly w h e n a s s o cia te d w it h lo n g h o u r s , a g e a n d g e n e r a l u n s u it a b ilit y f o r p a r t ic u la r w o r k , le n g t h o f s e r v ic e , in su fficie n t a t te n t io n t o “ w e lfa r e ” in s id e th e fa c t o r y , h o m e d u tie s , m e n ta l a n x ie ty , tr a n s it, d ie ta r y , e tc. S o m e o f th ese h a v e b e e n r e fe r r e d t o a lr e a d y ; o th e r s m a y n o w b e c o n s id e r e d in s o m e d e ta il. & (a ) H eavy W ork and L ong H ou rs. A s an e x a m p le o f fa t ig u e d u e t o th e se ca u ses, th e re su lts o f an e x a m in a t io n o f 199 w o m e n a t L e e d s m a y b e m e n tio n e d . A t factory No. 5 (Yorkshire) of 146 women employed on 6-inch shells the medical officer reported that 51 were physically lit and able and willing to continue at the present pressure of work. Of these the greater number were women living in lodgings or in homes where they had no work to do after their munition s h ift; a few had spent many years as charwomen, working hard for little remuneration, and these looked upon the regular long hours of munition work as a well-paid rest. Of the remainder 95 women showed signs of fatigue varying from those who were moderately tired and unable to spare any energy for recreation to those who were completely exhausted and unfit for recreation or work. O f these, seven were entirely broken down in health. The most noticeable point about these women was a general appearance of weariness and loss of tone. There seemed to be a general want of alertness, as though it needed a definite effort of concentration before they could bring their minds to bear upon any given question. Many had the appearance of a rapid loss of weight, and those who did not know’ their weight could remem ber that their clothing had to be definitely taken in to make it fit the present waist measurement. Women suffered from loss of appetite, with fullness and epigastric pain after food, having the appearance of atonic dyspepsia in varying degrees. A few suffered from cough, the result of bronchitis, which was started or aggravated by work in a munition factory. Many showed signs of cardiac insufficiency, APPEN DIX B 285 (I ). a with weak heart sounds, irregular in time and force, while few had definite cardiac dilatation. Some of these women were dyspnceic while at rest, and more were definitely so on moderate exertion. The evidence of nervous fatigue varied from staleness, with loss of interest in or inclination for amusement or work in the milder cases, up to exhaustion of a marked degree, with nervousness, loss of control of temper, and depres sion in the more marked cases. The loss of voice occurring in women, especially 011 tlie night shift, appears to be the outcome of exhaustion and loss of tone. The general impression gained from these women (working on 12-hour shifts) suggests that they are not physically fit to continue indefinitely on these long hours. Some will voluntarily leave at an early date, and others from economic necessity will continue to work above their strength and will become per manently damaged members of society. The ones who will remain at work at all costs are those who have many dependents. These threaten to become prematurely old, losing all the joy of life and continually haunted by the fear of a breakdown in health. As regards the examination of 58 women working on 9.2-inch shells (10hour day and Ill-h o u r night shifts) they can not by any effort lift them from place to place as they do in the case of the 6-inch shells. The chucks of the machines are tightened by men, and the result is that though the shells are heavier and the machines larger the women actually carry out lighter work than they do when working on 6-inch shells. Of those examined, 23 were physically fit, and again those were usually women with few home duties. The remaining 27 showed signs of varying degrees of fatigue. But their fatigue, generally speaking, was not so obvious as the fatigue of those on the lighter shells. At factory No. 2 (Midlands) where the women are engaged on 9.2-inch and 6-inch shells (eight-hour shifts usually), it appears that the processes which caused most strain were those of boring, drilling, and rough-turn body. The latter involves an upward jerk to tighten the shell in the machine, which the majority of women find fatiguing, especially on night work or during men struation. On the other hand, seven 3Toung women and four elder workers of an especially wiry type had suffered 110 inconvenience of any kind beyond a temporary muscular stiffness. At factory No. 3 (Yorkshire) the women are engaged on 4.5 and 5 inch shells (eight-hour shifts) ; 24 workers on the rough-turn body process were examined for the purpose of comparison with findings at other factories where similar work is undertaken. It was observed at factory No. 2 (Midlands) that robust young women suffered little inconvenience at this work beyond tem porary stiffness, but that there was a tendency to cause pelvic disorder in elderly married women with weak abdominal muscles. Here it appeared usual to employ younger women. Seventeen out of 24 examined at this factory were under 24 years of age and only two women were 30 years old. Some of the more delicate workers had found this work too heavy and had been trans ferred to other operations. There were four cases of dysmenorrhea, seven of irregularity of menstruation, where it was said that the complaint had arisen or had become worse since working at the factory. I t is e v id e n t ly m o s t d e s ir a b le t h a t w o r k e r s s h o u ld b e c a r e fu lly se le c te d f o r h e a v y w o r k , su ch as r o u g h -t u r n b o d y , r ip p in g , a n d c e n te r in g , i f u n d u e fa t ig u e o r p h y s ic a l in ju r y is t o b e a v o id e d . T h e le n g th o f th e s h ift s is c le a r ly o f g r e a t im p o r t a n c e . 286 IN D U STRIAL H E A L T H AND E FF IC IE N C Y . (b) A ge an d G e n e ra l U n s u ita b ility fo r W o r k . O t h e r th in g s e q u a l, w o r k e r s u n d e r 18 a n d th o s e o f m id d le a g e m a y n a t u r a lly b e e x p e c t e d to s h o w fa t ig u e m o r e r e a d ily th a n th o s e in th e p r im e o f life . Young workers.— A t th e p r e v io u s in q u ir y c o n s id e r a b le fa t ig u e w a s m a n ife s t e d b y g ir ls u n d e r 18 w h o w e r e w o r k in g e x c e p t io n a lly lo n g h o u r s u n d e r s o m e w h a t u n fa v o r a b le c o n d it io n s . ' A la r g e n u m b e r w a s n o t e x a m in e d in th e c o u r s e o f th e p re s e n t in v e s t ig a t io n , b u t in th e fa c t o r y w h e r e th ese fin d in g s w e r e n o te d th e c o n d it io n s o f w o r k a n d c o m fo r t h a v e b e e n g r e a t ly im p r o v e d a n d th e fa t ig u e h a s d im in is h e d a c c o r d in g ly . At factory No. 7 (near London) nine workers under 18 were examined, eight were classified A and one as B. Their general condition was satisfactory. One strong girl of 16 is in the foundry sand placing, another girl of 17 has already worked three years at munitions. Middle-aged workers m a y b e d iv id e d b r o a d ly in t o t w o d iv is io n s : (1 ) T h e th in , w ir y w o m e n w h o h a v e w o r k e d a ll t h e ir liv e s a n d sta n d h e a v y w o r k m o r e e a s ily th a n m a n y y o u n g e r a n d a p p a r e n t ly s tr o n g e r w o m e n ; a n d ( 2 ) th e w o m e n w h o m a y a p p e a r s t r o n g a n d wTe ll-n o u r is h e d , b u t w h o s e a b d o m in a l m u scle s a re la x a n d fla b b y f r o m la c k o f e x e r cise , fr e q u e n t c h ild b e a r in g , etc. T h e la tte r t y p e is a p t to su ffe r u n d u ly fr o m fa t ig u e o r in te r n a l in ju r y w h e n o n h e a v y m a c h in e w o r k o r o n o p e r a tio n s w h ic h e n ta il je r k s o r th e l i f t i n g o f h e a v y w e ig h ts . (c ) L e n g t h of S e r v ic e . I t is o n ly t o b e e x p e c te d th a t w o r k e r s e m p lo y e d f o r l o n g p e r io d s u n d e r a r d u o u s c o n d it io n s w ill te n d t o s h o w in c r e a s in g s ig n s o f s la c k n ess a n d fa t ig u e . T h e r e e x a m in a tio n o f w o r k e r s at fa c t o r y N o . 6 (M id la n d s ) w h o h a d a lr e a d y b e e n e x a m in e d t w ic e b e f o r e is o f in te re s t in th is c o n n e c tio n , a lt h o u g h th e n u m b e rs a re sm a ll. January, 1916. .Tulv, 1916. O ctober, 1917. A ............................................................................................................................................. V,............................................................................................................................................... Per cent. 38 49 13 Per cent. 52.6 33.7 13.7 Per ccnt. 56 T otal e x a m i n e d ..................................................................................................... 100 c .............................. ..................................... 80 22 22 27 T h e fig u re s in d ic a te th a t w o m e n s h o w in g s lig h t s ig n s o f fa t ig u e in 1916 a re n o w f e e lin g in c re a s e d s tra in . ( d ) I n s u ffic ie n t A tte n tio n t o W e lfa r e . I t is o b v io u s th a t d is c o m f o r t in s id e th e f a c t o r y — f o r e x a m p le , d a m p flo o r s , n o sea ts, c o ld r o o m s a n d la c k o f v e n tila tio n , u n s a t is fa c t o r y a r r a n g e m e n ts f o r m e a ls, etc.— w ill te n d to ca u se a v o id a b le fa t ig u e a n d m in o r a ilm e n ts . APPENDIX B ( I ) . 287 At factory No. 4 (London), for example, many of the women who complained of special “ tiredness ” on the night shift stated that they brought their own food instead of purchasing a hot meal from the canteen. The night service of this particular canteen was evidently so bad that workers had often given up the attempt to obtain food within a reasonable time. The conditions of factory ( b ) at factory No. 5 (Yorkshire), where a large number of women appeared definitely fatigued, is another case in point. In the shell shop there is considerable congestion. The number of machines installed is probably much too high, leaving the alleyways too narrow, with the result that the continual passing up and down of the bogies with and without shells, bookers, gaugers, laborers, sweepers, barrows, etc., causes an unpleasant overcrowding. The factor most to be criticized in the building is the existence of wooden galleries, which are used as a fuze department and in which approxi mately 400 people are constantly at work. The presence of these galleries re moves all feeling of air space and gives a depressing overcrowded sensation in the shops. The hanging of clothes in the shops, the absence of provision in cloakrooms and elsewhere for shoes and garments which are changed by the girls, contributes to the sense of congestion. Large gates at the one end swing open to admit truck loads of forgings. Until recently these gates opened directly on to the machines in this part of the shop, giving rise to pronounced fluctuations in temperature and in the cold weather to great discomfort of the workers. But recently a high screen has been erected which should be some protection against the sudden changes of temperature. As to the general cleanliness, sweepers are continually at work, but the crowded state prevents the work being carried out as well as might be. The splashing of the cooling liquor from the machines leads to an unwholesome dampness of the floor; sawdust is sprinkled to absorb the wet and standing boards are provided, but too much wet remains lying about. (c) H ome D uties , E tc . T h e r e la tiv e ly la r g e n u m b e r o f m a r r ie d w o m e n n o w e m p lo y e d i n crea ses th e a m o u n t o f fa t ig u e lik e ly t o b e o b s e r v e d a m o n g th e w o r k ers. A c e rta in p r o p o r t io n o f th ese w o m e n a re th e r e c e n t ly m a r r ie d w iv e s o f s o ld ie r s a n d h a v e n o c h ild r e n o r d o m e s tic r e s p o n s ib ilitie s . T h e m a jo r it y , h o w e v e r , a re o ld e r w o m e n w it h c h ild r e n a n d h o m e s o f th e ir o w n . At factory No. 2 (M idland), 105 out of 264 women were married, 56 had young children, and about half of these were doing heavy housework. Fourteen women had sick husbands at home, in some cases needing special diet. As a rule the children were left with neighbors or were sometimes taken charge of by other relatives. At factory No. 3 (Yorkshire), 48 out of 116 women were married; 37 had chil dren at home. Of the latter, 20 were classed as A, 15 as B, and 2 as C ; 18 had heavy housework and 26 lighter home duties. Of the 18, 7 were classified as A, 8 as B, and 3 as G, while of those with lighter housework 18 were A, 7 B, and 1 was C. A t factory No. 8 (near London) only 16 out of 114 women were married. Eight had children at home and 5 were doing considerable housework. Two of these were classified as A, 2 as B, and 1 as C. At factory No. 4 (London), 53 out of 157 women were married; 26 had chil dren at home and of these 21 were classified as A, 4 as B. and 1 as C. Of 26 IN D U ST R IA L H E A L T H AND E FF IC IE N C Y . 288 married women who had considerable housework, 18 were classified as A, 7 as B, and 1 as C. It may be added that there was little evidence of fatigue in this factory. M a r r ie d w o m e n a re o ft e n f u l l y c o m p e te n t p h y s ic a lly t o c a r r y o u t d u tie s a t th e fa c t o r y . I t is o n ly w h e n th ese d u tie s a r e s u p p le m e n te d bjr h o m e w o r k a ft e r l o n g h o u r s o f fa c t o r y w o r k , b y th e d iffic u lty o f m a k in g p r o p e r a r r a n g e m e n ts f o r th e c h ild r e n d u r in g t h e ir a b se n ce , b y th e e v e r -in c r e a s in g d iffic u lty o f s h o p p in g d u r in g th e lim it e d in t e r v a l, a n d o ft e n b y w o r r y o r a n x ie t y in r e g a r d t o h u s b a n d o r r e la tiv e s a t th e f r o n t t h a t th e b u r d e n b e c o m e s t o o h e a v y t o b e a r w it h o u t m e n ta l o r p h y s ic a l d a m a g e . I f m a r r ie d w o m e n m u st b e e m p lo y e d , e ith e r b e ca u se th e y n e e d m o n e y t o s u p p o r t th e m s e lv e s o r t h e ir fa m ilie s o r b e c a u s e th e G o v e r n m e n t n e e d s th e ir la b o r , s o m e s p e c ia l a r r a n g e m e n t o u g h t t o b e p o s s ib le b y w h ic h th e y c o u ld b e r e lie v e d o f a p o r t io n o f th e w o r k w h ic h n o w d e v o lv e s u p o n th em . G E N E R A L A IL M E N T S . T A B L E OF C H IE F D E FE C TS D E T E C T E D . • Total Fac Fac FacFac Fac Fac Fac Fac tory 1. tory 2. tory 3. tary 4. tory 5. tory 6. tory 7. tory 8. per cent. Number examined................................ 193 Percentage of defects noted................. 100 Digestive system: Indigestion (pain, flatulence, etc.). 23 14.5 Constipation.................................... Teeth: 31 Several carious.......................... . 8 Oral sepsis........................................ 32 Artificial teeth................................ Nervous system (tired, nervous, irri table).................................................... 30 Headache (frequent)............................. 42 13 Anem ia.................................................... 10 Aching and swollen feet...................... Muscular pains (including rheuma 14.5 tism) .................................................... Nose and throat (pharyngitis, un 5.7 healthy tonsils, etc.).......................... 6 Eve strain, etc....................................... Disorders of menstruation................... 35 264 100 116 100 157 100 199 100 46 100 67 100 114 100 1,156 100 15.5 7 25.5 9.5 16.5 14.5 24.5 16 13 26 31 16.5 37.5 12 23.5 12.5 26.5 10.5 15.5 20 13.5 20.5 29 5 12.5 32 20.5 36.5 17 8.5 10.5 24 7.5 18 29 3.5 10.5 27.5 10.5 21.5 13 13.5 12 5.5 20 33.5 23 4 18 24 14.5 3 26.5 19 22.5 21 15 28 15 15 59.5 22 19.5 17.5 41 50 9.5 20 28.5 20 9.5 28 14 12.5 10.5 15 37 22.5 17.5 29.5 7.5 8.5 26. 8 2 2.5 17.5 20 3.5 22.5 27.5 7.5 18.5 5 25 14 3 5.5 19.5 4 2 17 28 D igestive disorders .— L o s s o f a p p e tit e a n d p a in a ft e r f o o d w e r e th e m o s t c o m m o n s y m p to m s . C o n s t ip a t io n w a s c o m p a r a t iv e ly s e ld o m c o m p la in e d o f . T h is w a s p a r t ly d u e , n o d o u b t , t o th e fa c t th a t a p e r i e n ts (s a lts o r seicllitz p o w d e r s ) a r e o ft e n ta k e n as a r o u tin e . At factory No. 7 (near London) 21 out of 67 complained of indigestion, and here bad cooking and catering seemed the main cause. Bread and butter and tea formed far too large a portion of the dietary. At factory No. 8 (near London) 43 cases of indigestion were noted among 114 examined. This was not due to bad teeth, but seemed caused partly by hurrying over meals before a long bicycle ride, by bad cooking and an inadequate dietary and partly by fatigue. Forty-one girls were noted as underfed. Decayed teeth and oral sepsis w e r e c o m m o n , e s p e c ia lly in s o m e f a c to r ie s , t h o u g h as f a r as th e w o r k e r s ’ o w n sta te m e n ts w e n t t h e y a p APPEN D IX B (I). 289 p e a r e d t o h a v e lit t le d ir e c t e ffe c t u p o n th e d ig e s t iv e sy stem . S o o n e r o r la te r th e y a r e b o u n d t o a ffe c t th e h e a lth a d v e r s e ly a n d a re in d e e d r e s p o n s ib le f o r m a la is e , h e a d a ch e s , e tc., w it h w h ic h th e w o r k e r s d o n o t a s s o cia te th e m . At factory No. 6 (Midlands) some of tlie youngest workers had excellent sets of teeth and had been educated in good habits of dental hygiene, thus illustrating the effect of the school medical service which in Birmingham pays special atten tion to the care of the teeth. At factory No. 4 (London) “ the women are paying increased attention to den tal hygiene. During last year several had visited the dentist and had carious teeth out and plates in.” At factory No. 2 (Midlands) “ the teeth were usually extremely bad, dental hygiene seemed unknown and pyorrhea occurred in most of the women over 30 years of age. Considerable Reluctance was shown at the prospect of a visit to the dentist and conservative treatment was rarely sought in time even by young girls of otherwise good appearance. There was a general impression that stop ping always hurt more than having a tooth out and as a result no treatment was sought.” At factory No. 8 (near London) the teeth were exceptionally good. Only 33 out of 114 had carious teeth, and it was noticed that those who had bad teeth lived out of the district. Headache is p r o b a b ly o ft e n m e r e ly a s y m p t o m o f g e n e r a l tir e d n e s s a n d m a y b e c a u se d o r a g g r a v a t e d b y n o is e in th e f a c t o r y a n d b a d c o n d it io n s o f tr a n s it (e. g ., N e w c a s t le ), in su fficie n t fr e s h a ir a n d e x e r cis e . I n o th e r ca ses it a p p e a r e d t o b e a s s o cia te d w it h a n e m ia o r w it h d ig e s tiv e d is tu r b a n c e s . A t factory No. 7 (near London), where the factory is old and crowded with machines, 40 out of 67 complained of headache, many attributing it to the noise of the machinery; the long hours and constant standing also made them “ so tired and headachey.” A t factory No. 8 (near London) 47 out of 114 complained of headache, and it was often attributed to noise. For the most part the girls were unused to fac tory life. The high temperature at which the work has to be carried out in some of the rooms is also responsible for headache. Anemia w a s s e ld o m m a r k e d in t y p e a n d u s u a lly n o s p e c ia l tr e a t m e n t w a s b e in g o b ta in e d . A t fa c t o r y N o . 4 ( L o n d o n ) , f o r e x a m p le (w h e r e lit t le fa t ig u e w a s o b s e r v e d ), o n ly 3 w e ll-m a r k e d ca ses w e r e o b s e r v e d , a n d 20 s lig h t on es, a m o n g 157 w o m e n . A t fa c t o r y N o . 5 ( Y o r k s h ir e ) , o n th e c o n t r a r y , w h e r e th e re w a s m u c h fa t ig u e , 45 eases w e r e n o t e d a m o n g 199 w o m e n . A n e x c e p t io n w a s a lso n o t e d a t f a c t o r y N o . 8 w h e r e 57 o u t o f 114 g ir ls s u ffe r e d w it h a n e m ia , w h ic h in 19 ca ses w a s se v e re w it h d y s p n e a a n d h e m ic m u rm u r s . M a n y o f th e se g ir ls w e re u n d e r 18, th e ir d ie t w a s u n s a t is fa c t o r y , a n d th e c o n d it io n s o f t h e ir w o r k in h o t, s t u ffy r o o m s w o u ld n a t u r a lly p r e d is p o s e t o a n e m ia . Muscular pains and swollen fe e t .— M u s c u la r p a in s , a c h in g b a c k , s h o u ld e r s a n d a rm s w e r e o ft e n e x p e r ie n c e d a t th e c o m m e n c e m e n t o f • 80935°— 19-------19 290 IN D U ST R IA L H E A L T H AND E FF IC IE N C Y . fa c t o r y l if e , a n d a ft e r w a r d s t e n d e d t o d is a p p e a r as th e w o r k e r b e c a m e a c c u s t o m e d t o th e p h y s ic a l e x e r cis e . I n o t h e r ca ses, h o w e v e r , w h e r e th e w o r k w a s h e a v y a n d th e w o r k e r n o t r o b u s t, m u s c u la r p a in s w e r e fr e q u e n t ly c o m p la in e d o f t o w a r d th e e n d o f th e s h if t a n d e s p e c ia lly a ft e r n ig h t w o r k . T h e p r e v a le n c e o f s w o lle n o r a c h in g fe e t a p p e a r s t o d e p e n d a g o o d d e a l o n th e c o n d it io n s o f w o r k a n d e s p e c ia lly o n th e n a tu r e o f th e flo o r a n d th e p r o v is io n o f seats. At factory No. 7 (near London), for example, the heating of the factory w as not good and the floors were complained of as uneven and wet, making the feet very sore. Muscular pains and swollen, aching feet were common. At factory No. 5 (Yorkshire) many women in factory (5 ) complained of sore or swollen feet which they attributed to standing on a concrete floor; the condi tion was sometimes improved by the wearing of clogs or standing on a board. Varicose veins were relatively common among the older workers and often asso ciated with aching legs and feet and swollen ankles. G ynecological C o n d itio n s . D is o r d e r s o f m e n s tr u a tio n o c c u r r e d w ith s o m e fr e q u e n c y a n d a p p e a r e d to b e a s s o cia te d p a r t ic u la r ly w it h h e a v y w o r k , e s p e c ia lly i f o th e r ca u ses o f fa t ig u e w e r e p re s e n t. T h e y u s u a lly t o o k th e f o r m o f d y s m e n o r r h e a , w h ic h in s o m e cases h a d a p p e a r e d s in c e f a c t o r y w o r k h a d c o m m e n c e d , m e n o r r h a g ia o r in c r e a s e d fr e q u e n c y . T h e d y s m e n o r r h e a d id n o t seem as a r u le t o b e se v ere in t y p e , b u t th e p a in w a s su fficien t t o ca u se c o n s id e r a b le tir e d n e s s a n d m a la is e ev e n w h e n it d id n o t e n ta il a b se n ce fr o m w o r k . At factory No. 1 (northeast coast) 58 out of 185 complained of dysmenorrhea, for which 15 lost time every month, 10 suffered from menorrhagia. Serious complaints having been made of the bad effect of the work in a particular shop on menstruation, 11 girls about whom the supervisor was concerned were specially examined in this respect. Of these 4 cases were normal, 6 had dysmenorrhea, 2 suffered from menorrhagia. In 2 cases the girls were obliged to lose time, but in only 1 case had the symptoms appeared since the work was commenced. The medical officer came to the conclusion that there was no special cause for alarm and that the conditions were fairly typical of the factory as a whole. At factory No. 2 (Midlands) 80 out of 264 suffered from dysmenorrhea and 9 from frequency. An inquiry among 34 women engaged on the rough turn-body process showed that considerable pelvic discomfort occurred in those women whose pelvic and abdominal muscles were weakened either through pregnancy, overfatigue, or lack of muscular power. In 6 of the cases women had observed Irregularity of menstruation, in 8 there was some degree of menorrhagia, 3 cases of prolapsus uteri had occurred and 3 suffered from some weakness of the bladder. Dysmenorrhea had increased in 3 cases; 1 woman had undergone spontaneous extrusion of a fibroid while engaged on this process and was feeling considerably better in health. At factory No. 3 (Yorkshire) 23 out of 116 women suffered from dysmenor rhea, and in about half the number of cases the pain was sufficiently severe to APPEN D IX B (I). 291 necessitate absence from the factory. Eleven severe cases and five slighter ones were stated to have arisen from or to have been aggravated by factory work. Two women complained of menorrhagia and seven of increased frequency. A t factory No. 4 (London) 39 women out of 157 suffered from menstrual dis orders, 12 losing time every month. In 1 case improvement had taken place since working at the factory, in 6 cases the reverse. At factory No. 5 (Yorkshire) of 146 women engaged on 6-inch shells menstrua tion was unchanged in 88 cases, decreased in 12, and increased in 5 cases. In the last group the loss was so excessive as practically to amount to actual flood ing. These latter cases were women who had borne children and were working on processes involving heavy lifting, such as tightening the chuck of machines. A few complained of backache and bearing down sensation, amounting to definite prolapse in 1 case. These were directly attributable to overstrain and gave a fairly typical picture of endometritis following hard work and want of rest. O f 53 women engaged on 9-inch shells menstruation was increased in 9 cases and diminished in 10. There was no history of severe flooding. A t factory No. 7 (near London) 20 out of 67 girls complained of dysmenorrhea and 2 of menorrhagia; 7 lost time every month. At factory No. 8 (near London) 31 out of 114 suffered from dysmenorrhea, of whom 19 lost time every m onth; 2 stated that they were worse since coming to the factory. V e r y fe w w o m e n w h o s u ffe r e d fr o m d y s m e n o r r h e a h a d e v e r c o n s u lte d a d o c t o r . T h e y a p p e a r e d to c o n s id e r it a n e ce ssa r y e v il t o b e p u t u p w it h a n d m a d e th e b est o f . M a n y w o m e n w e r e s u r p r is e d th a t i t s h o u ld b e r e g a r d e d as a n a b n o r m a l c o n d it io n f o r w h ic h m e d ic a l a d v ic e a n d tr e a tm e n t s h o u ld b e s o u g h t. T h e r e see m ed in d e e d a g r e a t d is in c lin a t io n t o c o n s u lt t h e ir d o c t o r s , a n d “ h e ’s n o tim e f o r su ch t h i n g s ” w a s a c o m m o n r e p ly t o th e q u e s tio n as t o w h e th e r a d v ic e h a d b e e n o b ta in e d . A t fa c t o r y N o . 3 ( Y o r k s h ir e ) “ th e re w a s a t e n d e n c y f o r m o th e r s o r e ld e r ly w o m e n r e la tiv e s t o p r e s c r ib e g in a s a s p e c ific r e m e d y , a n d t h o u g h th e y o u n g e r w o m e n d is lik e d its ta ste at first its u se m ig h t e a s ily le a d to a lc o h o lis m in la te r y e a rs . I n so m e ca ses th e m e d ic a l tre a tm e n t o b t a in e d a p p e a r e d to b e p a llia t iv e r a th e r th a n c u r a t iv e , p o w d e r s a n d lin im e n t b e in g g iv e n .” O t h e r g y n e c o lo g ic a l c o n d it io n s w h ic h w e r e n o te d (in a d d it io n t o b a c k a c h e a n d s y m p t o m s p o s s ib ly d u e t o c h r o n ic p e lv ic t r o u b le ) w e r e p r o la p s u s u te r i a n d m is c a r r ia g e . B o t h th ese c o n d it io n s m a y b e ca u se d p a r t ly o r e n t ir e ly b y th e h e a v y w o r k , b u t w it h o u t d e t a ile d in q u ir y it is d iffic u lt to a ttr ib u te th e ca u se s o le ly t o fa c t o r y w o r k , w h e n th e w o m a n m a y a lso b e u n d e r t a k in g h e a v y o r u n su ita b le w o r k a t hom e. ADDENDA. I n th e c o u r s e o f th e in q u ir y th e a t te n tio n o f th e m e d ic a l officers w a s d ir e c t e d to t w o p ro c e s s e s w h ic h f o r d iffe r e n t re a so n s p r e s e n te d fe a tu r e s o f s p e c ia l in te re s t, n a m e ly , (a ) c o p p e r b a n d t u r n in g ; (b ) c o n t in u o u s w o r k in a r tific ia l l i g h t ; ( c ) f o l l o w i n g u p w o r k e r s w h o h a v e le f t th e fa c t o r y . 292 IN D U ST R IA L H E A L T H AN D E FF IC IE N C Y . ( a) Coppeb B a n d T u r n in g . D u r in g th is p r o c e s s w o r k e r s a re a p t t o in h a le m e ta llic d u st o r fu m e s , a n d s y m p to m s s u g g e s t in g ir r it a n t p o is o n in g w e r e n o te d in a n u m b e r o f cases. At factory No. 1 (Northeast coast) there was an unusual amount of digestive disturbance among the workers in copper and brass. The girls themselves have a fixed idea that the copper “ gets on their stomach ” or “ on their chest.” They complained of dust in the mouth like verdigris, and purgatives are taken regularly to counteract this. In 11 cases inflammation of the gums and nausea and vomiting were noted, while diarrhea and vomiting occurred in 4. At factory No. 2 (Midlands) 28 women on copper band turning were ex amined, and, generally speaking, the wTork was popular, but a fairly large number appear to have had symptoms suggestive of mild poisoning, possibly due to the inhalation of impurities in copper dust. About 18 were aware of a metallic taste in their mouths, 10 had noticed dryness of the throat, and about 7 suffered at intervals from nausea, indigestion, and diarrhea. Actual vomiting occurred in 4 cases. Other who did not complain of nausea suffered from nose bleeding with occasional loss of voice, especially after night) duty. A certain amount of eye strain was noticed from the dazzling reflection of the rotating copper band. It was observed that about 10 of the workers who complained of a metallic taste with digestive disturbance or nose bleeding had extremely bad teeth with marked oral sepsis. Conversely 10 women with clean and well-kept teeth had remained healthy at this work. Only two employees were examined who had good teeth but yet showed some symptoms on this process; and one of these stated that her sister had been away for some weeks with “ copper poisoning ” so that allowance may be made for personal susceptibility. At factory No. 3 (Yorkshire) an examination of 26 women showed that at least 20 of the workers were conscious of a metallic taste with dryness and pricking of the throat, especially after night duty. Nausea was present in 16 and 4 had occasional attacks of vomiting and diarrhea. Nose bleeding occurred in two wTorkers. Fatigue of the eyes and headache were observed in a large number of cases from the glare of artificial light on the rotating copper band. These symptoms suggest that women are occasionally suffering from mild attacks of irritant poisoning due to impurity in the copper dust, and it seems possible that arsenic may be the exciting cause. This is supported by a conversation with the manager, who stated that arsenic is frequently found as an impurity in the copper and that the amount varies at different tim es; occasionally the copper bands are unduly soft and more dust is produced in rotation. In favor of arsenic is the apparent connection between the condition of the teeth and the susceptibility of the worker, thus pointing to the existence of a volatile irritant. Forty per cent of the workers who showed symptoms had several carious teeth, often with marked oral sepsis. Conversely, five workers with good, well-kept teeth had remained quite healthy, and three women with excellent teeth who had attacks of vomiting or colic admitted that they never used a toothbrush. The known variation in susceptibility of persons to the influence of irritants such as arsenic should also be taken into account. At factory No. 5 (Yorkshire) the work of the copper-band turners is highly paid and not so exacting physically as in the case of some other operations. It involves deftness and close visual attention and the girls employed are picked at the outset. In the summer of 1917 it was recognized by the medical officer A P P E F D IX B (I). 293 o f the factory that the girls working in brass and copper were suffering to a certain extent from copper absorption as shown by a taste of copper in the mouth, sore dry throat and nose, pain after food, colic, constipation, and in some cases a green line of the gums corresponding to the lead line produced in cases of plumbism. At that time the worst cases were recommended for transfer to other work, washing before meals encouraged, saline drinks supplied in the ambulance room, and a half pint of milk per shift given to each worker. After this line of treatment the conditions improved greatly, so that the girls ex amined for the purpose of this inquiry showed no very marked evidence of injurious results. In 10 girls examined there were 6 cases of irritation, as shown by a copper taste in the mouth, and sore nose and throat, 3 cases o f mild absorption; 1 girl had no evidence of injurious effects. T h e s e fin d in g s p o in t t o th e d e s ir a b ilit y o f s p e c ia l a tte n tio n b e in g d e v o t e d t o w o r k e r s in th is p ro c e s s . A l l p o s s ib le m e a n s s h o u ld b e ta k e n f o r p r e v e n t in g th e in h a la t io n o f ir r it a n t d u st, a n d th e w o m e n so e m p lo y e d s h o u ld b e u n d e r th e o b s e r v a t io n o f th e w e lfa r e sta ff, w h o s h o u ld a t o n c e r e p o r t s y m p t o m s s u g g e s tiv e o f p o is o n in g t o th e m e d i c a l officer. A t t e n t io n s h o u ld b e p a id t o d e n ta l' h y g ie n e a n d p e r s o n a l c le a n lin e s s s h o u ld b e e n c o u r a g e d . (b) C o n tin u o u s W o e k in A r t i f i c i a l L ig h t . B a ll v ie w in g is a m o s t t r y in g t y p e o f w o r k as it h a s t o b e d o n e in s t r o n g e le c t r ic lig h t , e x c e p t in th e ca se o f l a p p in g v ie w in g w h e r e d iffu s e d lig h t is u sed . F o r th is p r o c e s s th e w o m e n a n d y o u n g p e r s o n a h a v e t o w o r k in a r o o m w h e n c e d a y lig h t is e x c lu d e d b y s h u t t e r s ; s t r o n g a r c la m p s , h a n g in g lo w o v e r o c t a g o n a l ta b le s a n d s h a d e d b y c a r t r id g e p a p e r , t h r o w a d iffu s e d l ig h t o n t o t r a y s c o n t a in in g a c e r ta in n u m b e r o f b a lls ( v a r y in g a c c o r d in g t o s iz e ). E a c h w o r k e r k e e p s h e r t r a y c o n t in u a lly r o t a t in g w h ile sh e w a tc h e s in t e n t ly f o r a n y fla w , r e m o v in g a n y d e fe c t iv e b a ll sh e m a y fin d . I n o r d e r t o d e te c t a n y fla tte n e d s u r fa c e s th e b a lls a re e x a m in e d a g a in in t h e “ t w ilig h t ” r o o m , s im ila r ly s h u tte re d , b u t w it h th e o r d in a r y e le c t r ic lig h t so d im m e d th a t th e r o o m is in a sta te o f s e m io b s c u r ity , in w h ic h th e ir r e g u la r it ie s a re s a id t o b e m o r e q u ic k ly seen . T h e w o r k is v e r y lig h t a n d r e q u ir e s n o p h y s ic a l s tr e n g th . I t th ere * f o r e a ttr a c ts g ir ls w h o a re p e r h a p s u n fit f o r o r d in a r y f a c t o r y e m p lo y m e n t . T h e w o r k e r s s a y th a t t h e ir e y e s a ch e a n d t h e y h a v e h e a d a c h e s f o r th e firs t w e e k , b u t a ft e r th a t t h e y b e c o m e a c c u s to m e d t o th e lig h t . A t f a c t o r y N o . 8 s o m e w o m e n h a d b e e n w o r k in g f o r s e v e r a l y e a r s in d iffu s e d lig h t a n d a p p e a r e d w e ll. T h e p a u se s in th is w o r k a re fr e q u e n t. T h e r e a re t w o a d d it io n a l b r e a k s a t 10.45 a n d 2 .15 a n d th e w o r k is n o t c o n t in u o u s f o r m o r e th a n h o u rs . D u r in g th e s e b r e a k s th e g ir ls a re sen t o u t o n t o a r o o f p la y g r o u n d f o r e x e r c is e a n d r e c r e a tio n , A t f a c t o r y N o . 8 (n e a r L o n d o n ) th e re w e r e se v e n g ir ls in th e 44t w i l i g h t ” r o o m a n d fiv e w e r e e x a m in e d . A l l fiv e s u ffe r e d f r o m 294 IN D U ST R IA L H E A L T H AJtfD E FF IC IE N C Y . 'e n la r g e d c e r v ic a l g la n d s w h ic h w e r e p r e s u m a b ly t u b e r c u la r , t w o h a d s c a r s o f o ld a b scesse s, a n d o n e h a d h a d fo u r o p e r a t io n s f o r th e r e m o v a l o f g la n d s . I n th e la t t e r ca se th e la s t o p e r a t io n h a d b e e n d o n e th re e w e e k s p r e v io u s ly , a n d th e w o r k e r , w h o su ffe rs f r o m in d ig e s t io n a n d is s u b je c t t o fa in t in g , h a d a lr e a d y b e e n b a c k a t th e f a c t o r y f o r a w eek . N in e te e n g ir ls w e r e e x a m in e d w h o w o r k in d iffu s e d a r t ific ia l lig h t . O f th ese 6 h a d e n la r g e d c e r v ic a l g la n d s , 7 w e r e a n e m ic, a n d 7 h a d e y e a ffe ctio n s . O f th e 2 4 w o r k e r s 7 w e r e c la s s ifie d as A , 13 as B , a n d 4 as C . T h e p r e s e n c e o f so m a n y e n la r g e d a n d p o s s ib ly tu b e r c u lo u s g la n d s , n o t a c o m m o n c o m p la in t a m o n g m u n it io n w o r k e r s , a s s o c ia te d w ith , c o n t in u e d w o r k in th e a b se n ce o f s u n lig h t is w o r t h y o f n o t ic e . I t s u g g e s ts th a t c o n t in u e d e m p lo y m e n t in a r t ific ia l lig h t is u n d e s ir a b le a n d th a t th e re s h o u ld b e so m e a r r a n g e m e n t b y w h ic h a lte r n a t io n o f e m p lo y m e n t c o u ld b e p r o v id e d f o r w o r k e r s in th is p ro c e s s . (c) F ollow ing u p of W orkers who have L eft the F actory . I t is c le a r th a t th e e x a m in a t io n o f w o m e n a c t u a lly e m p lo y e d a t a n y g iv e n m o m e n t in th e fa c t o r ie s w ill n o t r e v e a l a c o m p le t e p ic tu r e o f th e e ffe c t th e w o r k is h a v in g u p o n h e a lth a n d p h y s iq u e . T h o s e w h o h a v e b e e n a b le t o r e m a in f o r a y e a r o r m o r e in c o n t in u o u s e m p lo y m e n t w it h o u t a b r e a k d o w n a re to som e e x t e n t t h e re su lts o f a p h y s io lo g ic a l s e le c tio n a n d r e p r e s e n t th e m o s t p h y s ic a lly fit a m o n g th e w o m e n w o r k e r s . A n e x a m in a t io n o f t h is k in d ta k e s n o a c c o u n t o f th e w o m e n w h o h a v e d r o p p e d o u t o f e m p lo y m e n t b e c a u s e t h e y w e r e u n a b le t o s u p p o r t th e s tr a in o f lo n g h o u r s , n ig h t s h ift s , o r h e a v y w o r k . I t is n o t a n ea sy ta sk t o tr a c e w o r k e r s w h o h a v e l e f t th e f a c t o r y , e s p e c ia lly w h e n th e w o r k e r s a re d r a w n f r o m a w id e a rea . L a c k o f tim e a n d o p p o r t u n it y h a v e p r e v e n te d a n y e x te n s iv e in q u ir ie s b e i n g m a d e in th is d ir e c t io n . A t th e sa m e tim e i t w a s t h o u g h t t h a t e v e n lim it e d in v e s t ig a t io n s m ig h t b e w o r t h m a k in g a n d th e f o l l o w in g re su lts a re t h e r e fo r e g iv e n . F a c t o r y N o . 2 (M id la n d s ) : H o m e v is its p a id t o 56 w o r k e r s w h o h a d r e c e n t ly l e f t s h o w e d th a t w o m e n lik e d th e f a c t o r y a n d w e r e u s u a lly s o r r y t o le a v e . T h e ca u se o f a b se n ce as e n te r e d in th e r e c o r d s o f th e w e lfa r e s u p e r in te n d e n t a g r e e d c lo s e ly w it h th e re s u lts o f p r i v a te in q u ir y in th e h o m e s o f w o r k e r s . T h e f o l l o w i n g t a b le s h o w s ca u se s o f l e a v i n g : Cases. 18 Left for other work_______________ 11 Care of children or home duties__ 8 Long h ou rs_________________________ 8 Left district____ ____ __ ___ ______ _ 7 111 health___________________________ Cases. Long distance from work_. Not traced__________________ Total. 2 2 56 APPEN D IX B (I)• 295 C a se s o f i ll h e a lth in c lu d e d f o u r w o m e n w h o l e f t f o r a p p r o a c h in g c o n fin e m e n ts a n d o n e w o m a n w h o g a v e u p fa c t o r y w o r k o w in g t o se v e re h e m o r r h a g e d u r in g th e m e n o p a u s e . O n e s in g le w o m a n w h o w o r k e d u n t il th r e e w e e k s b e fo r e th e b ir t h o f h e r c h ild h a d a d iffic u lt c o n fin e m e n t a n d th e c h ild w a s s a id t o b e v e r y d e lic a te . T h is w a s a ttr ib u te d b y th e d o c t o r in c h a r g e to th e p r o lo n g e d w o r k d u r in g p r e g n a n c y . T h e m o th e r w a s a t a n u r s in g h o m e f o r f o u r w eek s, b u t h a s n o w r e c o v e r e d a n d is w o r k in g o n m u n it io n s e lse w h e re . A n o t h e r m a r r ie d w o m a n w a s a m a c h in e o p e r a t o r a n d w o r k e d a t h e r la th e u n til th e d a y o f h e r c o n fin e m e n t w h e n sh e h a d a 7 -m o n th s s t illb o r n c h ild . A m o n g th e w o m e n w h o le ft f o r o th e r w o r k a re in c lu d e d c e r ta in cases w h o g a v e in n o t ic e to se cu re e m p lo y m e n t e lse w h e r e f e a r in g d is m is s a l o w in g t o s h o r ta g e o f w o r k . T h e e ig h t cases w h o fo u n d h o u r s lo n g w e r e u n a b le t o s ta n d th e fa t ig u e o f th e 1 2 -h o u r s h ift . F a c t o r y N o . 6 (M id la n d s ) : V is it s w e r e p a id to 37 w o r k e r s w h o h a d b ee n e x a m in e d a t th e p r e v io u s in q u ir y b u t w h o w e r e n o t a v a il a b le f o r in s p e c t io n b y th e m e d ic a l o fficer o n th is o c c a s io n . T h e r e su lts s h o w e d th a t o n ly t w o w o r k e r s l e f t a c t u a lly o n a c c o u n t o f i l l n ess. F a c t o r y N o . 4 ( L o n d o n ) : V is it s w e r e p a id b y th e m e d ic a l office r t o 14 ca ses w h o w e r e s a id to h a v e le ft th e f a c t o r y o n th e g r o u n d s o f i ll h e a lth . T h e re su lts w e re as f o l l o w s : 1. Aged 18. Normal pregnancy; no complications. 2. Aged 20. Normal pregnancy, together with a mastoid abscess not attrib utable to factory conditions. 3. Aged 22. Left on account of slackness of work; in good health. 4. Aged 26. On base-facing process. Miscarriage at four months attributed to pulling levers. Work probably too heavy. Normal health at present. 5. Aged 38. Engaged in sweeping floors. Left on account of hemorrhage from piles. E^ound work too heavy. At present thin, w orn; subject to bron chitis. 6. Aged 22. Worked on base plates. Constantly got steel splinters in her eyes— wore no goggles. Left on this account. Is in normal health now. 7. Aged 19. Left on account of slackness of work. Is in good health. W ork ing at a tailor shop. 8. Worked as a checker. Sight was poor and could not do work properly. Left on this account. Thin, delicate girl. 9. Aged 38. Found standing tiring and got varicose veins. Left on this account. 10. Aged 25. Found work too hard— refused to be medically examined. 11. Aged 18. Left because she could not stand the night work. Is anemic, blit now works at a tailor’s. 12. Aged 28. Worked on base plates at first and then on boring. The latter operation caused menorrhagia. She became very tired and worn out, especially as she did her own housework, including washing. Is at present strong and well, and menstruation is normal. 13. Left on account of night work. Is now a guard on a tram ; strong, healthy, and well. 14. Left on account o£ pregnancy; normal confinement. Quite well now. , 296 IN D U STRIAL H E A L T H AND E F F IC IE N C Y . F a c t o r y N o . 8 (n e a r L o n d o n ) : T h e t o t a l n u m b e r ( a c c o r d in g t o th e fir m ’s r e c o r d s ) o f w o r k e r s w h o h a v e l e f t s in c e A u g u s t 1, 1917, i. e., d u r in g f o u r m o n th s , w a s 131. T h e f o l l o w i n g re a so n s f o r le a v in g w ere g iv e n : 1. 2. 3. 4. Ill health_______________________ U n kn ow n _______________________ Bad timekeeping________________ Other disciplinary reasons____ 34 7 13 20 5. 6. 7. 8. Own accord_____________________ _IS Home duties____________________ _11 Not suitable___ _________________ _15 Leaving town or to be married- 16 A n e n d e a v o r w a s m a d e t o v is it th e w h o le o f th ese w o r k e r s t o a s c e r ta in w h e th e r th e re a so n s g iv e n t o th e fir m c o r r e s p o n d e d g e n e r a lly w it h th e re a so n s g iv e n o n in q u ir y . T h e re su lts o f 102 v is its w e r e as fo llo w s : Visited at addresses recorded (reasons for leaving) — (a ) Effective: 1. Ill health______________ 2. Maternity cases_______ 3. To be married_________ 4. Home duties___________ 5. Still wTorking at same fa c to r y ______________ 6. Dismissed ____________ Total_______________ 1 5 (&) Ineffective: 1. No information______ 2. Left addresses— forms sent in, 1 2 ; no forms, 17____________ 3. Not traced or out — forms sent in, 8 ; no forms, 5______________ 57 Total_______________ 34 3 7 7 3 29 13 45 J t is o f in te re s t to n o te th e p re s e n t o c c u p a t io n s o f 17 o f th e w o m e n v is it e d — Laundry____________________________ ___ 2 S h op________________________________ ___ 2 Flour m ills ____________________________ 1 Gas works__________________________ ___ 1 Work at same factory________________ 1 Munition work_____________________ ___ 4 Work in recruiting office__________ ___ 1 Domestic service_______________ _______ 5 F a c t o r y N o . 7 (n e a r L o n d o n ) : T h e t o t a l n u m b e r (a c c o r d in g t o th e fir m ’s r e c o r d s ) o f w o r k e r s w h o h a v e l e f t s in c e A u g u s t 1, 1917, i. e.. d u r in g fo u r m o n th s , w a s 42. T h e f o l l o w i n g re a s o n s f o r le a v in g w e r e g iv e n : 1. 2. 3. 4. 5. Ill health_______________________ Prolonged absence______________ Bad timekeeping_______________ Other disciplinary reasons_____ Own accord_____________________ 9 3 4 4 13 6. Not required (probably owing to slackness)_________________ ___C 7. Not suitable_____________________ ___1 8. Left town_______________________ ___2 V is it s w e r e p a id t o th e h o m e s o f th e w o r k e r s w it h th e f o l l o w i n g r e s u lts in 14 c a s e s : Visited at addresses recorded (reasons for leaving) — Effective: 1. Ill health______________________0 2. Maternity cases___________ ___2 3. To better position_________ 1 4. Dismissed______________________ 1 Effective— Continued. 5. Still at same factory_______ T o ta l. 1 14 APPEN D IX B (I). 297 Eight of the women visited are now employed as follow s: Sh op _______________ :_______________ Ticket collecting__________________ Waiting at aeroplane canteen___ Work at same factory___ Work at munition factory. 1 1 W . A. A. C. baker. Domestic service. 1 1 1 Total. 8 1 2 I n o n ly a fe w ca ses w a s it p r a c t ic a b le f o r th e w o m e n to b e e x a m in e d b y a d o c t o r , so , u n fo r t u n a t e ly , fe w d e ta ils a re a v a ila b le as t o th e p re c is e a ilm e n ts o f th o s e w7h o le f t w o r k b e c a u s e o f ill h e a lth . A s fa r as th e y g o , th ese fin d in g s d o n o t s u g g e s t th a t an u n d u ly la r g e p r o p o r t io n o f w7o m e n is le a v in g th e fa c t o r ie s o n a c c o u n t o f p h y s ic a l b r e a k d o w n . T h e n u m b e rs a re h ig h e s t a t fa c t o r y N o . 8, w h e re 34 o u t o f 57 in t e r v ie w e d h a d le f t f o r r e a s o n s o f h e a lth . T h e p h y s iq u e o f th e w o m e n at th is fa c t o r y , h o w e v e r , w a s d e c id e d ly b e lo w th e a v e r a g e o f w o r k e r s e x a m in e d , a n d a la r g e n u m b e r o f w o m e n a p p e a r e d t o b e u n d e r n o u r is h e d . S u c h w o r k e r s m ig h t b e e x p e c t e d t o b e u n a b le t o sta n d th e s tr a in o f m u n it io n wTo r k a n d a ll th a t it e n ta ils, e v e n w h e n th e w o r k is lig h t in c h a r a c te r . J a n e t M . C a m p b e ll, M . D , F e b r u a r y , 1918, A P P E N D IX B ( I I ) .— G E N E R A L F IN D IN G S O F IN Q U IR IE S IN T O T H E H E A L T H O F W O M E N M U N IT IO N W O R K E R S . B Y M I S S J A N E T M . C A M P B E L L , M . D ., M . S . T h e r a p id m u lt ip lic a t io n a n d g r o w t h o f m u n it io n fa c t o r ie s s in c e th e c o m m e n c e m e n t o f th e w a r h a v e b e e n a s s o cia te d w it h c o r r e s p o n d in g ly w id e a n d u r g e n t d e m a n d s u p o n w o m e n t o e n te r in d u s t r ia l life . T h e r e h a s b e e n a m p le r e s p o n s e n o t o n ly f r o m w o m e n a lr e a d y a c c u s to m e d t o f a c t o r y w o r k b u t fr o m la r g e n u m b e r s o f o th e r s w h o e n te r e d u p o n su ch e m p lo y m e n t f o r th e first tim e . L a t t e r ly m a n y p la c e s h a v e b e e n fille d b y m a r r ie d w o m e n , so m e o f w h o m o ffe r e d th e m s e lv e s b e ca u se o f th e u r g e n t n a t io n a l n e e d , b u t m o s t p e r h a p s b e ca u se t h e y w e r e u n a b le o th e r w is e t o s u p p o r t th e m s e lv e s a n d t h e ir c h ild r e n . T h e e x is t in g c o n d it io n s o f e m p lo y m e n t a re in m a n y r e sp e c ts a b n o r m a l, b u t i t is im p o r t a n t t o c o n s id e r th e ir e ffe cts o n th e h e a lth o f th e w o m e n w it h a v ie w t o p re s e n t a n d fu t u r e g u id a n c e . I t w a s f o r th e p u r p o s e o f o b t a in in g so m e r e lia b le d a ta a n d fir s t-h a n d e v id e n c e o f th e e ffe c t o f e m p lo y m e n t u p o n th e in d iv id u a l w o m a n t h a t th e h e a lth o f m u n it io n w o r k e r s c o m m itte e m a d e a r r a n g e m e n ts f o r t w o m e d ic a l in q u ir ie s w h ic h w ere c a r r ie d o u t in v a r io u s fa c t o r ie s in 1915, 1916, a n d in 1917. I n th e first in q u ir y 1,326 w o m e n w e r e e x a m in e d in 11 t y p ic a l e n g i n e e r in g fa c t o r ie s . I n m o s t ca ses th e w o r k w a s f a i r l y lig h t in c h a r a c te r, n o t h in g h e a v ie r th a n 4 .5 -in c h sh e lls b e in g h a n d le d . T h e h o u r s o f w o r k w e re o ft e n e x ce ssiv e . I n o n e ca se w o m e n w e r e e m p lo y e d 77 h o u r s w e e k ly , a n d h e re 15.5 p e r c e n t s h o w e d e v id e n c e o f se v e re fa t ig u e . I n o th e r ca ses th e h o u r s , e x c lu d in g m e a ls, w e r e 68|, 63, 67, a n d 69 a w eek . S u n d a y w o r k w a s g e n e r a l. O n th e w h o le th e w o m e n r e a liz e d th e n e e d f o r an a d e q u a te d ie t a r y a n d u s u a lly h a d s u b s ta n tia l m e a ls, b u t th e c a n te e n a n d m e s s -r o o m a c c o m m o d a t io n a t th e fa c t o r ie s w a s w h o lly in su fficie n t a n d s o m e tim e s n o n e x is te n t, w e lfa r e s u p e r v is io n w a s lit t le d e v e lo p e d , a n d th e a r ra n g e m e n ts f o r th e p e r s o n a l h y g ie n e a n d c o n v e n ie n c e o f th e w o r k e r s o ft e n l e f t m u c h t o b e d e s ir e d .1 I n th e s e c o n d in q u ir y 1,183 w o m e n w e r e e x a m in e d in e ig h t t y p ic a l fa c t o r ie s . P r a c t ic a lly a ll th e w o m e n h a d b ee n e n g a g e d in m u n it io n wTo r k f o r a t le a st n in e m o n th s , a n d m o s t o f th e m f o r lo n g e r . T h o s e e x a m in e d in c lu d e d a la r g e p r o p o r t io n o f m a r r ie d w o m e n w it h d o * A re p o rt on th is in q u iry w as pub lish ed in th e In te rim R e p o r t o f th e M u n ition W o rk e rs C om m ittee on In d u s tria l E fficien cy a n d F a tig u e , 1917. 298 H e a lth APPEN D IX B (II). 299 m e s tic r e s p o n s ib ilitie s , a n d th e d iffic u ltie s o f s h o p p in g a n d p r o v id in g f o o d w e r e b e g in n in g t o b e s e v e r e ly f e l t in so m e d is tr ic ts . M a n y w o m e n w e r e e m p lo y e d o n h e a v y w o r k ( 5 , 6, a n d 9.2 in c h s h e lls ). T h e g e n e r a l c o n d it io n s o f e m p lo y m e n t h a d c o n s id e r a b ly im p r o v e d . T h e h o u r s h a d b e e n s h o r te n e d , th e re w a s n o o v e r tim e o r S u n d a y la b o r (e x c e p t S u n d a y n ig h t in som e c a s e s ) ; g o o d c a n te e n s w e r e a v a il a b le f o r m e a ls, a n d th e “ w e lfa r e ” o f th e w o r k e r s w a s c a r e f u lly o r g a n iz e d . T h e c o n d it io n s o f w o r k d e se rv e a b r ie f r e c a p it u la t io n . CHARACTER OF THE WORK. I n th e e a r lie r d a y s o f t h e w a r w o m e n w e r e o n ly e m p lo y e d o n th e lig h t e r p ro c e s s e s o f m u n it io n w o r k a n d in th e m a k in g o f s m a lle r s h e lls u p t o 3 -in c h sh e lls . T h e n a ft e r so m e h e s it a t io n t h e y w e r e a llo w e d t o b e g in w o r k o n 4 .5 -in c h sh e lls , w h ic h w e ig h 48 p o u n d s in th e r o u g h a n d a b o u t 2 7 J p o u n d s in th e c o m p le t e sta te. F o r th e se a n d h e a v ie r sh e lls t h e y n o w c a r r y o u t a ll th e d iffe r e n t p ro c e ss e s, w h ic h in c lu d e w o r k in g o n la th e s, m illin g a n d d r i ll i n g m a c h in e s , e x a m in in g , c le a n in g , c h e c k in g , a n d a lso lo a d in g a n d u n lo a d in g w a g o n s . T h e y a re e m p lo y e d as c r a n e d r iv e r s a n d s lin g e rs . N o l i f t i n g t a c k le is p r o v id e d f o r th e 4 .5 -in c h sh ells, a n d th e t o t a l w e ig h t o f s h e ll h a n d le d d a ily is c o n s id e r a b le . F o r 5 a n d 6 in c h sh e lls l i f t i n g t a c k le is u s u a lly a v a ila b le , b u t is n o t a lw a y s u se d b y th e w o m e n , w h o so m e tim e s fin d it q u ic k e r t o l i f t th e s h e ll th a n t o a d ju s t th e ta c k le . T h e 6 -in c h sh e lls w e ig h a b o u t 130 p o u n d s in th e r o u g h a n d 90 p o u n d s w h e n fin is h e d , so th a t th e w o m e n a re ju s t a b le to l i f t th e m . F o r th is r e a s o n th is t y p e o f sh e ll is p e r h a p s th e m o s t lik e ly t o ca u se o v e r s tr a in a n d fa t ig u e , a lt h o u g h m u c h h a s b ee n d o n e in m a n y fa c t o r ie s t o r e d u c e th e s tr a in o f m a n ip u la t io n b y a r r a n g in g r o ll i n g w a y s , t r o lle y s o f th e r ig h t h e ig h t, etc., a n d g i v in g th e m a c h in e o p e r a t o r s th e a ssista n ce o f la b o r e r s t o l i f t th e sh e lls in t o th e m a c h in e s . T h e 9 -in c h a n d a ll h e a v ie r s h e lls c a n n o t b e h a n d le d e x c e p t b y t a c k le , a n d th e r is k o f s tr a in fr o m l i f t i n g is m u ch r e d u c e d , t h o u g h th e m a c h in e s th e m s e lv e s a re o ft e n h e a v y t o w o r k .1 W o m e n e n g a g e d in lo a d in g a n d u n lo a d in g sh e lls a re u s u a lly o r g a n iz e d in g a n g s a n d g iv e n d u e re st b e tw e e n e a ch s p e ll o f w o r k . M u c h ca n b e d o n e t o m in im iz e e n e r g y b y p r e v e n t in g u n n e c e s s a ry l if t i n g , as fr o m th e g r o u n d o r a lo w t r o lle y t o a h ig h b e n c h o r w a g o n a b o v e . F o r g e w o r k , f o r e x a m p le , l i f t i n g sh e lls o u t o f th e fu r n a c e o r c a r r y in g th e m o u t o f th e f o r g e p re s s, is d o n e b y a fe w w o m e n . A t 1 T h e n u m ber o f sh ells a n d con seq u en tly th e w e ig h t h a n d led by in d iv id u a l w om en v a ries g re a tly o n th e d ifferen t op era tion s. In ord er to giv e som e in d ica tio n the a vera g e in d iv id u a l ou tp u t p er 1 2-h ou r s h ift a t one fa c t o r y en g ag ed In 6 -in ch sh ells m ay be cite d fo r th e d ifferen t p rocesses : R ip p in g , 79 ; rou g h tu rn in g , 35 ; rou gh and base b orin g , 3 7 ; finish and cou n ter b orin g , 2 5 ; fa c e base, 8 2 ; co u n te r b o rin g and chase, 50 ; rou gh profile, 1 2 0 ; finish tu rn , 4 3 ; g r o o v in g , 1 1 0 ; w a v in g , 2 1 8 ; ro u g h recess, 1 1 4 ; finish recess, 5 8 ; co p p e r ban d tu rn in g, 130. 300 IN D U ST R IA L H E A L T H AND E FF IC IE N C Y . o n e fa c t o r y th e la r g e r s h e lls so h a n d le d w e ig h e d 96 p o u n d s a n d th e s m a lle r o n e s 45 p o u n d s . W o m e n t o o k tu r n s in l i f t i n g a n d c h a n g e d a ft e r e v e r y 2 0 -3 0 sh ells. I t is a s to n is h in g how~ d e ft w o m e n b e c o m e in d e a lin g w it h h e a v y w e ig h t s , a n d th e y o ft e n ta k e g r e a t p r id e in th e ir m u s c u la r s tr e n g t h a n d d e x t e r it y . B u t c le a r ly it is m o s t im p o r t a n t fir s t t o se le c t th e w o r k e r s p r o p e r ly a n d n e x t t o w a t c h th a t t h e y d o n o t a tte m p t t o o m u c h in t h e ir e a g e rn e ss t o d o w e ll. THE LONG HOURS OF WORK. E v e n t h o u g h th e e x c e s s iv e h o u r s w o r k e d a t th e b e g in n in g o f th e W a r h a v e n o w b e e n r e d u c e d , it is s t ill p e r m is s ib le f o r w o m e n t o w o r k 60 h o u r s a w e e k , ir r e s p e c tiv e o f p a u se s a n d m e a ltim e s . T h is u s u a lly m e a n s in p r a c t ic e t w o 1 2 -h o u r s h ift s w it h n o S u n d a y d a y w o r k . I n m a n y fa c t o r ie s w o r k in g th e t w o -s h ift sy ste m th e h o u r s a r e s o m e w h a t less th a n th is (5 5 o r 5 7 | ) a n d a h a lf h o lid a y is g iv e n o n S a t u r d a y . A 1 2 -h o u r s h if t m e a n s in p r a c t ic e 1 3 -1 4 h o u r s a w a y f r o m h o m e . T h e w h o le o f th e r e m a in in g tim e o u g h t t o b e o c c u p ie d w it h m e a ls a n d sle e p i f th e w o m e n a r e t o h a v e su fficien t r e s t t o o v e r c o m e fa t ig u e . B u t t h o u g h m a n y o f th e y o u n g e r w o m e n a re f a i r l y fr e e f r o m d o m e s t i c r e s p o n s ib ilit ie s m o s t o f th e o ld e r o n e s a re b u r d e n e d w it h th e c a re o f h o u se o r c h ild r e n a ft e r w o r k in g h o u rs . T h e ir “ le is u r e ” is o c c u p ie d w it h s h o p p in g , m e n d in g , c le a n in g , a n d o th e r d u tie s. T h e tim e f o r sle e p is p e r ilo u s ly r e d u c e d a n d r e c r e a tio n is im p o s s ib le . E v e n S u n d a y , w h ic h s h o u ld b r in g r e lie f, m u s t o ft e n b e s p e n t in d o in g th e w e e k ly w a s h in g , b a k in g , o r c le a n in g , a n d i f su ch a d a y is fo l l o w e d b y a n ig h t s h if t it is s m a ll w o n d e r i f th e o u t p u t o f w o r k is n o t as g o o d as it m ig h t b e. E v e n g ir ls w h o h a v e fe w o r n o h o m e d u tie s o n ly o b t a in th e t im e th e y d e s ire , a n d in d e e d r e q u ir e , f o r e x e r c is e in th e fr e s h a ir , r e c r e a t io n , a n d a m u se m e n t a t th e e x p e n s e o f m u c h -n e e d e d sle e p . I t m a y h a v e b e e n n e ce s s a r y a n d e v e n d e s ir a b le a t th e b e g in n in g o f th e W a r t o im p o s e th e se l o n g w o r k in g h o u rs . F o r a tim e i t w a s p o s s ib le , b y g i v in g u p m a n y t h in g s th a t m a k e l i f e w o r t h w h ile , f o r w o m e n t o sta n d th e p h y s ic a l s tr a in r e a s o n a b ly w e ll, b u t a ft e r m o r e th a n th re e y e a r s o f w a r d o m e s tic c o n d it io n s h a v e b e c o m e m o r e a r d u o u s , s ta le n ess a n d fa t ig u e a re b e in g e x p e r ie n c e d b y m a n y w o m e n w h o h a v e w o r k e d c h e e r fu lly u n t il n o w , a n d th e q u e s tio n w h e th e r , h a v in g r e g a r d t o th e p re s e n t a n d fu t u r e h e a lth o f th e w o m e n , th ese l o n g h o u r s c a n r ig h t ly b e c o n t in u e d b e c o m e s e v e r m o r e u r g e n t. T o p u t th e ca se at its lo w e s t i t is n o t e c o n o m ic a lly s o u n d t o e x h a u s t a n d c a st a sid e w o m e n w h o h a v e b e c o m e e x p e r ie n c e d a n d c a p a b le w o r k e r s . E v e n i f th e r e w e r e n o d is a d v a n ta g e s in c o n s t a n t ly t r a in in g n e w r e la y s o f w o r k e r s , it s h o u ld b e r e m e m b e r e d t h a t th e b e s t o f th e a v a ila b le w o m e n h a v e p r o b a b ly a lr e a d y b e e n a ttr a c te d to th e m u n it io n f a c APPEN D IX B (II). 301 t o r ie s , a n d i f t h e y b e c o m e p h y s ic a lly u n fit t h e y c a n o n ly b e r e p la c e d b y th e less efficient* S o m e fa c t o r ie s , r e c o g n iz in g th e n e e d o f t h e ir w o r k e r s f o r p r o p e r r e s t a n d r e c r e a t io n a n d f o r a t le a s t a m in im u m o f tim e t o d e v o te t o th e ir o w n a ffa ir s , a re w o r k in g a t h r e e -s h ift s y s te m o f a b o u t 8 h o u r s ea ch . T h is in v o lv e s a w e e k ly to t a l o f 3 5 -4 4 h o u rs . I n s o m e r e s p e c ts th e h o u r s o f w o r k a re n o t a lt o g e t h e r c o n v e n ie n t, b u t th e m a in o b je c t io n o n th e p a r t o f th e w o r k e r s t o th e s h o r te r s h if t is th e r e d u c t io n in th e ir p o s s ib le e a r n in g s . F r o m th e f a c t o r y ’s p o in t o f v ie w th e r e is th e d iffic u lty o f p r o v id i n g w o m e n f o r th r e e s h ift s in s te a d o f t w o a n d o f s u it in g th e h o u r s w o r k e d b y th e w o m e n t o th o s e w o r k e d b y th e m en. I f it is c o n s id e r e d im p o s s ib le t o e ffe c t a g e n e r a l r e d u c t io n o f w o r k in g h o u r s f o r w o m e n , i t m ig h t a t le a st b e p r a c t ic a b le t o a r r a n g e f o r s h o r te r h o u r s f o r c e r ta in g r o u p s , f o r e x a m p le : (a) A l l w o m e n e n g a g e d in h e a v y w o r k s h o u ld n o t w o r k lo n g e r th a n e ig h t -h o u r s h ift s . A su fficien t m in im u m wTa g e w o u ld b e n e ce s s a r y , as m a n y o f th e o p e r a t io n s a re le n g t h y a n d c a n n o t b e m u c h a c c e le r a te d b y th e s k ill o f th e w o r k e r . (b ) T h e h o u r s f o r lig h t w o r k , th e o u t p u t o f w h ic h c a n b e in c r e a s e d b y s k ill a n d in d u s t r y , m ig h t b e r e d u c e d e ith e r b y w o r k in g t w o s h ift s o f , s a y , 9 o r 10 h o u r s in le n g t h (e . g ., b e g in n in g a ft e r b r e a k fa s t in s te a d o f b e f o r e ) o r th re e s h ift s o f 8 h o u r s e a ch . I t m ig h t e v e n b e p o s s ib le in so m e ca ses t o w o r k t w o 8 -h o u r s h ift s a n d a b a n d o n th e n ig h t s h if t w it h o u t m a t e r ia lly a ffe c t in g o u tp u t. P r o p o s a ls h a v e b e e n m a d e a t tim e s f o r r e d u c in g th e h o u r s o f w o r k f o r m a r r ie d w o m e n , a llo w in g th e m t o c o m e la te r , le a v e e a r lie r , o r w o r k h a l f s h ifts . S u c h a r r a n g e m e n ts w o u ld n o t see m t o b e p r a c t i ca b le , a t a n y r a te , o n a g e n e r a l sca le fr o m th e p o in t o f v ie w o f th e fa c t o r y , a n d th e o n ly tr u e r e m e d y lie s in a g e n e r a l s h o r t e n in g o f h o u r s , so, th a t as lo n g as w o m e n h a v in g o t h e r d u tie s m u st b e e m p lo y e d , th e y m a y h a v e r e a s o n a b le tim e in w h ic h to p e r f o r m th e m . I t h a s b e e n s h o w n so r e p e a t e d ly th a t u n d u ly lo n g h o u r s d o n o t y ie ld a c o r r e s p o n d in g ly la r g e o u tp u t, th a t it seem s n o t u n r e a s o n a b le , f o r th e sa k e o f th e h e a lth o f th e w o m e n , t o a sk u r g e n t ly f o r a fu r t h e r r e c o n s id e r a t io n o f th is m a tte r , e v e n t h o u g h a r e d u c t io n in h o u r s o f w o r k w o u ld in v o lv e d iffic u lt q u e stio n s o f fa c t o r y r e o r g a n iz a t io n , w a g e s , a n d a d ju s tm e n t w it h th e h o u r s o f m e n w o r k e r s . NUTRITION. W o m e n a re n o w b e g in n in g to r e a liz e th a t a h e a v y d a y ’s w o r k in a f a c t o r y u n d e r d is c ip lin e a n d in to u c h w it h th e r h y t h m o f m a c h in e r y , r e q u ir e s a b e t t e r a n d m o r e s u b s ta n tia l d ie ta r y th a n m is c e lla n e o u s w o r k a t h o m e . M o s t w o r k in g w o m e n h a v e n e v e r a c q u ir e d th e h a b it 302 IN D U STRIAL H E A L T H A N D E FF IC IE N C Y . o f t a k in g s o lid a n d r e g u la r m e a ls, p a r t ly b e c a u s e w h e n f o o d is n o t a b u n d a n t th e w o m a n g o e s s h o r t r a th e r th a n th e m a n , p a r t ly b e c a u s e w o m e n , a s a w h o le , h a v e n e v e r c o m m a n d e d s u fficie n tly g o o d w a g e s t o e n a b le th e m t o p u r c h a s e a d e q u a te f o o d , as w e ll a s th e v a r io u s o t h e r a r tic le s , n e ce ssitie s, o r lu x u r ie s w h ic h t h e y a ls o d e s ire . T h e b r e a d a n d b u tte r a n d te a d ie t a r y is p r a c t ic a lly a t h in g o f th e p a s t as f a r as m u n it io n w o r k e r s a r e c o n c e r n e d , t h o u g h th e e v id e n c e f r o m o n e f a c t o r y v is it e d in d ic a t e s c le a r ly th e d is a d v a n t a g e s t o h e a lth o f u n s u ita b le f o o d . T h is is d u e t o th e h ig h e r w a g e s , w h ic h a llo w b e t t e r f o o d t o b e b o u g h t , t o th e in c r e a s e d a p p e tit e a n d d e s ir e f o r s o lid f o o d f o l l o w i n g u p o n r e g u la r w o r k u n d e r f a i r l y g o o d c o n d it io n s o f h y g ie n e , a n d t o th e g r o w i n g ta ste f o r th e s u b s ta n tia l m id d le -d a y m e a l in p la c e o f s a n d w ic h e s b r o u g h t f r o m h o m e a n d s u p p le m e n te d b y sw e e ts, p a s t r y , t in n e d p in e a p p le , etc., fr o m th e ca n te e n . T h e in c re a s e in th e n u m b e r o f w e ll-e q u ip p e d a n d m a n a g e d ca n te e n s , a n d th e d a ily o b je c t le s s o n o f c h e a p , a p p e t iz in g m e a ls, n ic e ly s e r v e d , a r e g r a d u a lly p r o m o t in g a h a b it o f e a t in g w e ll, w h ic h h a s, u n d o u b t e d ly , s a v e d m a n y w o m e n f r o m u n n e c e s s a ry fa t ig u e a n d p h y s ic a l d is a b ilit y , o r b r e a k d o w n . S w e e ts, p a s t r y , e tc., a r e p o p u la r , as t h e y a lw a y s w ill b e. T a k e n m e x ce s s b y th e m s e lv e s a n d in s te a d o f p r o p e r f o o d , th e y a re u n w h o le s o m e in m a n y w a y s . I t is q u ite a n o th e r m a tte r w h e n t h e y a re ea te n as p a r t o f a fu ll, w e ll-p r o p o r t io n e d d ie ta r y . T h e c u s to m o f d r in k in g te a fr e q u e n t ly is w id e s p r e a d , b u t as th e te a is a lm o s t a lw a y s fr e s h ly m a d e , it p r o b a b ly d o e s lit t le , i f a n y , h a r m , a n d i t fo r m s th e b e s t a n d m o s t a c c e p ta b le s tim u la n t f o r th e t ir e d w o r k e r . TRANSIT AND HOUSING DIFFICULTIES. T r a n s it a n d h o u s in g d iffic u ltie s h a v e p r e s s e d h a r d ly u p o n w o m e n , a n d m u c h o f t h e ir fa t ig u e is c e r t a in ly d u e t o c o n d it io n s in c id e n t a l t o th e f a c t o r y l i f e r a th e r th a n t o th e n a tu r e o f th e w o r k it s e lf. T h e w a it i n g in a ll w e a th e r s f o r th e o ft e n c r o w d e d t r a m o r tr a in , th e s t r u g g le f o r a p la c e , th e fr e q u e n t o b lig a t io n t o s ta n d f o r p a r t o r th e w h o le o f th e jo u r n e y , is f a t i g u i n g t o m e n , b u t u s u a lly f a r m o r e so t o w o m e n . M o s t m e n h a v e fe w , i f a n y , d u tie s o n c e t h e y a re fr e e o f th e fa c t o r y . P r a c t ic a lly a ll w o m e n r e t u r n h o m e t o s o m e w o r k , w h ic h v a r ie s f r o m t h e ir p e r s o n a l w a s h in g a n d m e n d in g t o th e c a r e o f a h o u s e a n d fa m ily . I t is th is c o m b in a tio n o f h o m e a n d f a c t o r y d u tie s w h ic h b e a r s so h a r d ly o n th e w o m e n . THE IMPORTANCE OF WELFARE WORK. A l l a v a ila b le e v id e n c e g o e s t o s h o w th e v a lu e o f w e lfa r e s u p e r v is io n w h e n s u it a b ly o r g a n iz e d , a t a n y r a te , as f a r as g i r ls a n d w o m e n a r e 303 APPENDIX B ( I I ) . c o n c e r n e d . I t is v a lu a b le , n o t s o m u c h fr o m th e p o in t o f v ie w o f in c r e a s in g o u t p u t , t h o u g h t h is u s u a lly f o llo w s w h e n w o r k e r s a r e h e a lt h y a n d c o n te n te d a n d th e f a c t o r y e n v ir o n m e n t s a t is fa c t o r y , b u t p r im a r ily in o r d e r t o r a is e th e s ta n d a r d o f h e a lth , c o n te n tm e n t, a n d h a p p in e s s as a w h o le . W o m e n h a v e b e c o m e so a c c u s to m e d t o w o r k f o r lo w w a g e s a n d u n d e r b a d c o n d it io n s th a t t h e y a re o n ly b e g in n in g t o le a r n w h a t is n e e d fu l f o r t h e ir m e n ta l a n d p h y s ic a l h e a lth . S o m e o n e , th e r e fo r e , is r e q u ir e d t o s u p e r v is e o n t h e ir b e h a lf c o n d it io n s w h ic h d o n o t b e lo n g to th e a c tu a l te c h n ic a l w o r k , f o r e x a m p le , t o m a k e su re th a t th e la v a t o r y a n d s a n ita r y a c c o m m o d a t io n is c o n v e n ie n t f o r th e w o m e n a n d is p r o p e r ly u se d a n d s u p e r v is e d ; t o see th a t th e re a r e o p p o r tu n itie s f o r d r y in g w e t c lo t h i n g ; t o w a t c h th a t m in o r a c c id e n ts a n d in ju r ie s r e ce iv e p r o m p t a n d c o n t in u e d t r e a t m e n t ; t o in s u r e f u ll a n d su ita b le u se b e in g m a d e o f th e r e st r o o m f o r t e m p o r a r y illn e s s ; t o e n c o u r a g e w h o le s o m e ou tsi,d e in te re s ts a n d r e c r e a tio n , su ch as g a m e s , g y m n a s tic s , d a n c in g , cla sses, c lu b s , e t c .; in s h o r t, t o m a k e th e w e ll b e in g o f th e w o m e n h e r c h ie f c a re a n d t o e s ta b lis h s u ch f r ie n d ly r e la t io n s w it h th e m t h a t th e y w ill n o t h e sita te t o seek f r o m h e r h e lp , a d v ic e , o r g u id a n c e . W h e t h e r th e w e lfa r e s u p e r v is o r s h o u ld r e m a in a n ad hoc officer, as is c o m m o n a t p r e s e n t, is r e la tiv e ly u n im p o r t a n t , p r o v id e d h e r c h ie f fu n c t io n is n o t in a n y w a y o v e r s h a d o w e d o r lo s t s ig h t o f . MEDICAL FINDINGS. T h e m e d ic a l e x a m in a t io n c o u ld n o t b e m a d e as c o m p le t e a n d e x h a u s tiv e as m ig h t h a v e b ee n w is h e d , p a r t ly b e c a u s e s u ita b le a c c o m m o d a t io n w a s n o t a lw a y s a v a ila b le , p a r t ly b e ca u se th e tim e w a s lim it e d (w o m e n w e r e s u m m o n e d f r o m th e ir w o r k ) , b u t c h ie fly b e ca u se p r e s u m a b ly h e a lt h y w o m e n a re n a t u r a lly s h y o f s e a r c h in g m e d ic a l e x a m in a tio n s . I n e s tim a tin g th e p h y s ic a l c o n d it io n a n d th e a m o u n t o f fa t ig u e , r e lia n c e h a d t o b e p la c e d t o a la r g e e x te n t o n sta te m e n ts a n d d e s c r ip t io n s o f s y m p t o m s v o lu n te e r e d b y th e w o m e n . T h e h e a rt, lu n g s , a n d a b d o m e n c o u ld n o t b e f u l l y e x a m in e d as a r o u tin e . A s in th e p r e v io u s in q u ir y , th e w o r k e r s w e r e c la ss ifie d in t o th re e g r o u p s — A , B , a n d C — a n d it w ill b e in t e r e s tin g t o o b s e r v e th e r e su lts o f th e t w o in q u ir ie s , w h ic h , in s p ite o f th e d iffe r e n t c o n d it io n s o f th e e x a m in a t io n , a re s u r p r is in g ly s im ila r . • Inquiry No. 1 .................. . ........ ........................................... Inquiry No. 2 ...................... .................................... Number of workers examined. 1,320 1,183 Class A (healthy). Class B (some fatigue or ill health). Class C (marked fatigue or ill health). Per cent. Per cent. Per cent. 763=57.5 692= 58.5 451=34.0 425= 35.8 112=8.5 66= 5.7 304 IN D U ST R IA L H E A L T H AND E FF IC IE N C Y . FATIGUE. T h e s e ta b le s in d ic a t e g e n e r a lly th e a m o u n t a n d d e g r e e o f fa t ig u e o b s e r v e d a m o n g t y p ic a l w o r k e r s c h o s e n a t r a n d o m . T h e f o l l o w i n g p o in t s c le a r ly e m e r g e : ( 1 ) T h e p r o p o r t io n o f s e r io u s fa t ig u e a m o u n t in g t o m a r k e d i l l h e a lth a n d in c a p a c it y f o r w o r k is r e la t iv e ly s m a ll, a p p r o x im a t e ly 5 t o 6 p e r c e n t o f th e ca ses e x a m in e d . ( 2 ) T h e r e is a c o n s id e r a b le a m o u n t o f s lig h t fa t ig u e , w h ic h v a r ie s f r o m 2 0 t o 57 p e r ce n t. ( 3 ) T h e t o t a l p r o p o r t io n o f w o m e n e x h ib it in g d e fin ite s ig n s o f fa t ig u e is a b o u t 40 p e r c e n t o f a ll ca ses. T h is p r o p o r t io n , n a m e ly , 40 p e r c e n t, d o e s n o t , h o w e v e r , r e p r e s e n t th e f u l l b u r d e n o f fa t ig u e , f o r th e f o l l o w i n g r e a s o n s : (a) M u c h e a r ly fa t ig u e is la te n t a n d o b je c t iv e ly u n r e c o g n iz a b le . (b ) T h e w o m e n m o s t s e r io u s ly a ffe c te d t e n d t o d r o p o u t o f f a c t o r y l i f e b e fo r e th e y h a v e s e r v e d f o r a n y l o n g p e r io d . ( c ) W o m e n k n o w in g th e m s e lv e s t o be fa t ig u e d d id n o t v o lu n t e e r f o r e x a m in a tio n . (d) T h e e x a m in a t io n w a s n e c e s s a r ily s u p e r fic ia l a n d o n ly s u ch as c o u ld d e te c t d e fin ite a n d r e la t iv e ly w e ll-m a r k e d fa t ig u e . (a) Latent or undetected fatigue .— F a t ig u e , a p a r t f r o m r e d u c e d c a p a c it y a n d d im in is h e d o u t p u t , is a lw a y s d iffic u lt t o m e a su r e , a n d p a r t ic u la r ly so w h e n th e in v e s t ig a t o r is d e p e n d e n t u p o n th e sta te m e n ts o f wTo r k e r s w h o m a y b e in te r e s te d in e x a g g e r a t in g o r m in i m iz in g th e e ffe cts o n th e ir w o r k . A t ir e d w o m a n w h o fe a r s in a n y w a y t o p r e ju d ic e h e r p o s it io n a t th e f a c t o r y m a y m a k e a p o in t o f a p p e a r in g b r ig h t a n d c h e e r fu l t o th e m e d ic a l office r a n d g iv e a n e x c e lle n t a c c o u n t o f h e r h e a lth . A lt h o u g h f r o m h e r n u t r it io n , c o m p le x io n , a n d g e n e r a l a p p e a r a n c e th e d o c t o r m a y b e d is in c lin e d t o a c c e p t h e r sta te m e n ts as a c cu ra te , it is a lm o s t im p o s s ib le in a s h o r t in t e r v ie w t o e lic it th e w h o le tr u th . A g a in , th e b e g in n in g s o f fa t ig u e m a y s h o w th e m s e lv e s in Avays u n r e c o g n iz e d b y th e w o r k e r s . A g r e a t e r n u m b e r o f a c c id e n ts , m o r e s p o ilt w o r k , d im in is h e d o u t p u t o ft e n p a ss u n n o t ic e d b e c a u se u n r e c o r d e d , a n d e v e n w h e n fa t ig u e b e c o m e s o b je c t iv e a n d p a t h o lo g ic a l m a n y o f th e p h y s ic a l s y m p t o m s , su ch as h e a d a c h e , in d ig e s t io n , sleep lessn ess, ir r it a b ilit y , e tc ., a re d is r e g a r d e d o r m a d e l ig h t o f b e ca u se th e y h a v e o ft e n b e e n e x p e r ie n c e d b e fo r e , a n d a r e ta k e n as a m a tte r o f co u r s e . W o r k i n g w o m e n a re so a c c u s to m e d t o b e in g w e a r y a n d o v e r tir e d th a t t h e y fr e q u e n t ly a c c e p t p a t ie n t ly a c o n d it io n o f p h y s ic a l m a la is e w h ic h w7o u ld b e th e s u b je c t o f d e fin ite c o m p la in t b y w o m e n in b e tte r c ir cu m s ta n ce s . ( b) Disappearance o f women most affected .— T h e fa c t th a t a w o m a n is a b le to w o r k r e g u la r ly f o r m a n y m o n th s is in it s e lf e v id e n c e o f g o o d p h y s iq u e . T h e less r o b u s t w o m e n , w h o a re u n a b le t o sta n d APPEN D IX B (II). th e s tr a in , t e n d e ith e r t o le a v e v o lu n t a r ily tim e k e e p in g . N o a c c u r a te e stim a te o f th e d it io n s o f w o r k c a n b e m a d e u n le ss th e p h y s ic a l g r o u n d s a re e x a m in e d as w e ll as 305 o r t o b e d is m is s e d f o r b a d fa t ig u e c a u s e d b y th e c o n w om en w h o d rop out on th o s e w h o r e m a in . (c) W om en knowing themselves to be fatigued a re lik e ly t o h a v e r e fu s e d t o p r e s e n t th e m s e lv e s f o r e x a m in a t io n , e s p e c ia lly in fa c t o r ie s w h e r e d is m is s a ls w e r e t a k in g p la c e o r k n o w n t o b e p e n d in g , f o r fe a r t h a t th e d e te c tio n o f p h y s ic a l d is a b ilit y m ig h t , i f r e p o r t e d t o th e m a n a g e m e n t, r e s u lt in t h e ir d is c h a r g e . T h e e x a m in a t io n w a s, in p o in t o f fa c t , w h o lly c o n fid e n tia l, b u t n o c o m p u ls io n w a s e x e r c is e d , a n d a n y w o m a n a p p r o a c h e d w a s fr e e t o d e c lin e t o see th e d o c t o r . (d) T h e n e c e s s a r ily superficial character o f the examination m a d e it im p o s s ib le t o d e te c t a n y t h in g b u t f a i r l y w e ll m a r k e d fa t ig u e . N o s p e c ia l tests w e r e e m p lo y e d , a n d th e re w a s n o o p p o r t u n it y o f e x a m in in g th e r e c o r d s o f in d iv id u a l w o r k e r s as r e g a r d s lo s t tim e , a c c i d e n ts , e tc ., e v e n h a d s u c h r e c o r d s a lw a y s b e e n a v a ila b le . F a t ig u e in its e a r lie s t s ta g e s is t h e r e fo r e n o t r e c o r d e d . T h u s it is c le a r t h a t th e a m o u n t o f fa t ig u e r e v e a le d b y th e in q u ir y is less, a n d p o s s ib ly m u c h less, in a m o u n t a n d d e g r e e th a n th e a c tu a l fa t ig u e e x p e r ie n c e d b y th e w o r k e r s as a w h o le . O n th e o th e r h a n d , th e r e a re v a r io u s re a so n s w h y th e fa t ig u e s h o u ld n o t b e so g r e a t as m ig h t b e a n t ic ip a t e d f r o m a m e re r e c it a l o f h o u r s a n d p ro c e s s e s . F o r e x a m p le : (a) The interest o f the w ork .— I n t e r e s t in g w o r k is less fa t i g u i n g t h a n d u ll a n d m o n o to n o u s w o r k . W o m e n h a v e ta k e n e x t r e m e ly k in d ly t o m a c h in e w o r k . T h e fo r m e r ta ilo re s s e s , m ill h a n d s , d o m e s t ic se r v a n ts, c h a r w o m e n , e tc., fin d e n g in e e r in g w o r k u n e x p e c t e d ly c o n g e n ia l a n d t h e y e n jo y it f o r its in t r in s ic in te re s t a p a r t f r o m a d d e d in c e n tiv e s su ch as h ig h w a g e s , r e s p o n s ib ilit y , etc. ( b ) Patriotism a n d a d e s ire t o “ d o t h e ir b i t 55 h a v e a lso h a d c o n s id e r a b le e ffe c t in m a in t a in in g in te re s t a n d k ee n n ess. T h e w o m e n a r e g la d t o fe e l th a t th e y a re r e le a s in g m e n f o r o t h e r s e r v ic e a n d a re a n x io u s t o p la y a n e ffe c tiv e p a r t in th e d e fe n s e o f th e ir c o u n t r y . (c) The higher wages o b t a in e d a re in th e m s e lv e s an in c e n tiv e t o g o o d a n d r e g u la r w o r k , b u t t h e y h a v e im p o r t a n t s e c o n d a r y re s u lts in th a t th e y le a d t o a h ig h e r s ta n d a r d o f liv in g , b e tte r f o o d a n d c lo t h in g , a n d s o t o im p r o v e d n u t r it io n a n d a g r e a t e r p o w e r o f re sist a n ce t o fa t ig u e a n d d isea se. (d) Previous harder work h a d b e e n c a r r ie d o u t b y m a n y o f th e w o m e n u n d e r less g o o d c o n d it io n s . S u c h w o m e n a re a c c u s to m e d t o lo n g h o u r s ; th e y d e r iv e b e n e fit fr o m a n im p r o v e d e n v ir o n m e n t, a n d t h e ir h e a lth is lik e ly t o b e c o m e b e tte r r a th e r th a n w o r se . (e) The immense advance o f to elf are supervision .— T h e a tte n tio n n o w g iv e n b y th e m a n a g e m e n t t o th e h e a lth a n d w e lfa r e o f th e 80935°— 19-------20 306 IN D U STRIAL H E A L T H AND E F F IC IE N C Y . w o r k e r s w a s a lm o s t u n k n o w n in o r d in a r y fa c t o r ie s b e f o r e th e w a r. T h e d e v e lo p m e n t o f w e lfa r e s u p e r v is io n in th e b r o a d e s t sen se h a s le d t o a s to n is h in g im p r o v e m e n t s in th e c ir c u m s ta n c e s o f th e w o r k a n d h a s p r e v e n te d th e e s ta b lis h m e n t o r c o n tin u a n c e in m a n y fa c t o r ie s o f c o n d it io n s lik e ly t o b e h a r m fu l t o th e w o r k e r s . F o r in s ta n c e , h o u r s o f w o r k h a v e b e e n s h o r te n e d , th e r e is p r a c t ic a lly n o S u n d a y d a y w o r k , a n d o v e r tim e h a s b e e n la r g e ly a b o lis h e d . I t is r e a liz e d w it h in c r e a s in g c le a rn e ss th a t w o m e n c a n n o t p r o fit a b ly w o r k f o r fiv e h o u r s w it h o u t a b r e a k , a n d th e s p e lls o f w o r k h a v e t h e r e fo r e b e e n s h o r te n e d in m a n y ca ses, a n d u n o fficia l “ b r e a k s ” o f 10 m in u te s o r so l o r tea h a v e b e e n f o u n d t o a ssist th e w o r k e r s w it h o u t r e d u c in g o u tp u t. T h e g r e a t ly e x t e n d e d p r o v is io n o f ca n te e n s a n d m ess r o o m s o n a sca le n e v e r b e fo r e c o n t e m p la t e d h a s n o t o n ly m a d e c h e a p , w e ll-c o o k e d f o o d e a s ily a c ce s s ib le t o th e w o r k e r s , b u t h a s e n a b le d th o s e w h o r e m a in e d a t th e fa c t o r y t o s p e n d th e ir m e a ltim e s u n d e r c o n d it io n s o f r e a s o n a b le c o m f o r t a n d r e s tfu ln e s s . T h e im p r o v e m e n t in ca n te e n a c c o m m o d a t io n is s t ill g o in g fo r w a r d , a n d in v ie w o f th e d iffic u ltie s o f s h o p p in g , e tc., it is lik e ly t o b e c o m e e v e n m o r e w e lc o m e a n d n e e d fu l. B e s t r o o m s f o r w o m e n w o r k e r s a re n o w p r o v id e d in m o s t fa c t o r ie s , t h o u g h t h e ir p r o p e r u se is n o t a lw a y s fu lt y a p p r e c ia t e d b y th e fa c t o r y sta ff. M a lin g e r in g m u s t, o f co u r s e , b e g u a r d e d a g a in s t m a in ly b y e ffe c t iv e s u p e r v is io n , b u t an h o u r o r t w o ’s rest in a c o m fo r t a b le r o o m m a y e n a b le m a n y w o m e n t e m p o r a r ily u n fit f o r w o r k to r e tu r n t o th e s h o p a n d c o n t in u e t o w o r k s a t is fa c t o r ily in s te a d o f e x p e r ie n c in g p h y s ic a l d is c o m f o r t o r m a la is e d u r in g th e w h o le p e r io d a n d d o in g b a d w o r k in co n s e q u e n ce . W e ll-e q u ip p e d s u rg e r ie s f o r th e tr e a tm e n t o f m in o r a c c id e n ts a n d a ilm e n ts h a v e r e p la c e d th e R e d C r o s s b o x e s k e p t in th e w o r k s h o p . P r o m p t a n d c o n t in u e d tre a tm e n t h a s p r e v e n t e d m a n y s lig h t w o u n d s f r o m b e c o m in g s e r io u s a n d h a s s a v e d m u c h p h y s ic a l d is tr e s s t o th e w o r k e r s . G r e a t a tte n tio n h a s b e e n g iv e n t o th e p r o v i s io n o f s u ita b le a n d c o m fo r t a b le p r o t e c t iv e c lo t h in g , in c lu d in g g o g g le s , c a p s , fo o t w e a r , e tc., w it h g o o d re su lts o n th e h e a lth o f th e w o r k e r s . T h is is p a r t ic u la r ly im p o r t a n t w h e r e o r d in a r y c lo t h in g is a p t t o c a tc h in m a c h in e r y o r b e c o m e w e t o r s o ile d d u r in g th e w o r k , w h e r e th e lia b ilit