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UNITED STATES DEPARTMENT OF LABOR
WOMEN’S BUREAU
Bulletin No. 184

THE OCCURRENCE AND PREVENTION OF
OCCUPATIONAL DISEASES AMONG WOMEN
1935 TO 1938

U'n 3
v>o. 1 ?4

UNITED STATES DEPARTMENT OF LABOR
FRANCES PERKINS, Secretary

WOMEN’S BUREAU
MARY ANDERSON, Director

The Occurrence and Prevention of
Occupational Diseases Among Women
1935 TO 1938

By
MARGARET T. METTERT

5grcs o*.

Bulletin of the Women’s Bureau, No. 184

UNITED STATES
GOVERNMENT PRINTING OFFICE
WASHINGTON : 1941

For 6ale by the Superintendent of Documents, Washington, D. C.

Price 10 cent*

—

CONTENTS
Letter of transmittal
Part I.—Introduction__________________________________________
Summary]]]’’’__________________________________________________ '
Scope
Number of women affected~~~~___
The cost of compensation~~~~
Extent of disability~ ~ _
Age distribution_______________________________________________
Industrial distribution___________________________________
Distribution by disease______________________________________
Evaluation of potential hazards] ] ]
Progress in prevention
Part II.—The occurrence of occupational diseases among women. 1935 to
1938 ________________________________________________ ’
Comparability of data
Occupational diseases tabulated by sex
Extent of data___________________________________________
Number of cases by sex
The cost of compensation
Extent of disability resulting from occupational diseases
Age distribution by sex
Industrial distribution of disease cases
Type of disease
Dermatitis
Synovitis and other diseases resulting from repetitive
activity
Lead poisoning
Volatile-solvent poisoning~~~
Other systemic poisoning.
Chrome ulceration
Respiratory diseases
Contagious diseases
Other occupational diseases of women
Non compensable occupational diseases
Illness among employed women
Part III. Evaluation of the exposure of women to toxic substances and
conditions____________________________________________________
State studies_______________________________________________
Pennsylvania_____ ______________________________________
Illinois”””
Iowa“
Industry studies________________________________________
Pottery manufacturing___________________________________
Asbestos textiles
Shoe industry_____________________________ ____________________
Wood-heel covering
Dry cleaning
The nursing profession
Part IV.—Progress in prevention, 1935 to 1939_____________________
Enactment of occupation-disease compensation laws
Industrial hygiene activity in the United States
Development of independent agencies for the prevention of occu
pational diseases

III

Page
v

1
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8
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39
40
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CONTENTS
TABLES
Page

1. Number of occupational-disease cases in States that tabulate data by
sex, 1935 to 1938
2. Extent of disability of men and women injured by occupational disease,
1935 to 1938-_____________________________________________________
3. Occupational-disease cases of men and of women according to age group,
various periods of 1935-38, by State
12
4. Occupational-disease cases of men and of women according to industry,
6 States, 1935 to 1938
5. Cases of dermatitis among men and women, 1935 to 1938, by State-----6. Industrial distribution of 50,064 women surveyed in Illinois in 1938,
and number and percent of exposures to harmful conditions in in
dustry_______________________________________________________ _____
7. Industrial distribution of 4,388 women surveyed in Iowa in 1938,
number exposed to harmful conditions, and number of such hazards
per woman__
8. Numbers of women to whom health services specified were available in
industries surveyed in Iowa, 1938

9
11

14
15
30
34
36

CHARTS
I. Type and source of statistics tabulated, by period covered and by
State
II. Years for which data of varioustypes are reported, by State_________
III. Harmful sybstances to which employed women are exposed in the
electrical-products and tinware industries in Illinois, by occupation.

6
8
32

ILLUSTRATIONS
Map. Workmen's compensation for industrial diseases—compulsory and
elective coverage in private employments, January 1940facing 1
Figure I. Greenware fettling under controlled conditions over down-draft
ventilationfacing 38
Figure II. Sandblasting tablewarefacing 38
Figure III. Percentage of finishers and fettlers who were found to have
silicosis
39

LETTER OF TRANSMITTAL
United States Department of Labor,
Women’s Bureau,

Washington, February 8, 19fl.
I have the honor to transmit to you a report on the
Occurrence and Prevention of Occupational Diseases Among Women,
1935 to 1938. The situation it shows indicates the continuing need for
watchfulness and constant study of materials and substances used in
industry. Such study is of particular importance at a time when new
processes are developing and new substances being used.
The bulletin follows Nos. 114 and 147 of the Bureau as one of a reg
ular series of reports summarizing State records and special studies in
this field. It is hoped that its publication will further stimulate the
State collection and reporting by sex of data on industrial diseases.
I greatly appreciate the courtesy of the various States in making
available material which in a number of instances was prepared from
unpublished data especially for this use.
The research was done and the report written by Margaret T.
Mettert of the Research Division of the Women’s Bureau.
Respectfully submitted.
Mary Anderson, Director.
Hon. Frances Perkins,
Secretary of Labor.
Madam:

Workmen’s Compensation for Industrial Diseases
COMPULSORY AND ELECTIVE COVERAGE IN PRIVATE EMPLOYMENT, JANUARY 1940

N.DAK.
'MINN.'
3. DAK.

NEBR..

ri-OLcn
[KANS.I

IOKLAHQMA1
|N.M£x~

EXASl

I
I’-;-

I Complete coverage with compulsory compensation law.
-'.'•.'-.'■I Complete coverage with elective compensation law.

Y//////////A Limited coverage with compulsory compensation law.
Limited coverage with elective compensation law.
No industrial disease coverage.

®GB» ,

THE OCCURRENCE AND PREVENTION
OF OCCUPATIONAL DISEASES AMONG
WOMEN, 1935 TO 1938
Part I.—INTRODUCTION
Occupational diseases are giving serious concern to all who are
interested in the health of women in industry and in the industrialinjury problem in general. Practically all industries present some
dangers of health impairment. . Where protective and preventive
measures have been neglected, industrial diseases have proved ex
tremely costly. On the other hand, inclusion under the compensation
laws of injury by disease, combined with adequate programs for inves
tigating reported cases, has made possible reductions in the numbers
affected and reductions in the resulting costs.
There is evidence, that women need special protection from certain
substances in use in industry, in some cases because of the susceptibility
of women to the resulting disease, in others because of the effect of the
substance on the health of children. Such common industrial poisons
include among others lead and various lead compounds, benzol and its
derivatives, and carbon tetrachloride. There is some indication also
that women are constitutionally more susceptible to illness than men
are. The National Health Survey found that for both workers and
nonworkers women experienced an illness rate higher than that for
men.1 2
SUMMARY
Scope.
Nine State agencies furnished information for this report, the third
of a series, as to the numbers of women injured by occupational
diseases. The period covered is the 4 years 1935 to 1938 or some part
of that period. In throe States reports were from State health depart
ments, in four they were from compensation authorities, in two from
divisions of the State labor department. The States are these:
Connecticut.
Illinois.
Massachusetts.

Michigan.
Minnesota.
Missouri.

New York.
Ohio.
Wisconsin.

The reporting of these nine States represents a considerable increase
over the five furnishing data for 1932 to 1934,2 but considering the
great importance of the subject they constitute far too small a propor
tion of all the States.
A number of State health departments have engaged in surveying the
potential disease hazards of industry, and three—Pennsylvania,
Illinois, and Iowa—have given special consideration to the hazards to
which women are exposed. Material from these States and from a
1 U. S. National Institute of Health. Preliminary reports, National Health Survey, Sickness and Medical
Care Series, Bull. 7, Illness Among Employed and Unemployed Workers. 1938. p. 3.
2 Women’s Bureau Bull. No. 147, Summary of State Reports of Occupational Diseases With a Survey
of Preventive Legislation, 1932 to 1934. 1936.

OCCUPATIONAL DISEASES, 1935 TO 193 8

number of special studies of industries has been summarized in
order to show the disease hazards to which women are exposed and
the need for an integrated disease-prevention program in every State.
Number of women affected.
In the most recent year reported, women’s proportion was greater
among the occupational-disease cases than among all manufacturing
employees in four of the seven States for which such information is
available, as is clear from the following summary. In every State,
however, women’s proportion was less among disease cases than among
workers in all occupations taken together. (See p. 8 for further
analysis.)
Percent women comprised, in—
Disease
cases

Connecticut______________________________ —
Illinois
16
Massachusetts
21
Michigan
New York
21
Ohio
20
Wisconsin_____________________________ _____

15
3
16

ManufacturAll
ing occupations occupations

18
12
21
7
16
10
11

26
22
29
19
26
21
19

The numbers reported reflect State differences in compensation laws
and in the recognition of various diseases as occupational, as well as
employment differences.
The cost of compensation.
Compensation may be large in individual cases of occupational
disease, but the total in every State collecting comparative data is a
very small part of compensation for all injuries. In each of three
States with compensation laws covering all occupational diseases, the
cost of their compensation was less than 5 percent of the compensation
for all industrial injury.
Average compensation for women injured by diseases was less than
that for men in both temporary- and permanent-injury cases, reflecting
the lower wages of women as well as the fact that ordinarily they were
less seriously disabled.
Extent of disability.
Disabilities of women usually were of a temporary nature. How
ever, in one of the four States giving this type of information 12 of the
63 women reported in 1938 suffered injuries of a permanent character
and in two States fatal cases were reported.
Age distribution.
Large proportions of the women injured by disease—from just over
one-half to seven-tenths in the various States—were less than 30 years
old; in fact, from 7 and 8 percent in two States'to 25 and 36 percent
in two others were less than 20 years of age.
Percent of women—

Under SO years Under 20 years

Connecticut__
Illinois_______
Massachusetts.
Minnesota----New York----Ohio-------------Wisconsin____

70
52
63
57
58
56
54

25
8
36
17
13
7
13

PART I.—INTRODUCTION

Industrial distribution.
The largest proportions both of men and of women affected were
in manufacturing occupations, but this proportion generally was
smaller for women than for men. Large proportions in the case of
women are found in almost all States in service, followed in importance
by the trade occupations.
Distribution by disease.
Skin injections (dermatoses) were the most common type of disease
reported to men and women in each State, and, as the following
summary indicates, they comprised an especially large part of the
women’s total.
Percent dermatoses were
of all disease cases
Men

Connecticut_______________
Illinois____________________
Massachusetts____________
Michigan__________________
Minnesota________________
New York________________
Ohio______________________
Wisconsin_________________
1 Not computed; base less than 50.
2 Not available.

56.
37.
69.
27.

6
2
0
4

(2)

47. 2
60. 0
40. 7

Women

74. 6
74. 6
95. 0
(')

72.
57.
66.
65.

8
1
2
1

Reports from Wisconsin show that the working time lost by the
women compensated for dermatoses resulting from their work aver
aged 19 days.
Cases from New York and Ohio records show that serious and even
permanent disability may result from skin infections.
Analysis of the agents resulting in the 734 Ohio cases shows that
cleaning agents rank first in number of cases, followed by chemicals
not specified, then dyes, then vegetables, fruits, and plants. In
every State a great variety of substances were listed, cleaning agents
being the most common except in the canning centers of Wisconsin
and Minnesota, where vegetables and fruits ranked first.
The importance of continued investigation of new processes and
substances has been demonstrated in recent years with the occurrence
of serious skin infections resulting from the use of chlorinated naph
thalene in the manufacture of electrical condensers and wire and cable
insulation. A New York report found 6 serious cases, 4 of them
women, in two plants employing 31 workers.
Repetitive motion over an extended period of time may result in
various abnormal conditions, including tenosynovitis, ganglions, felons,
neuritis, and bursitis. Cases of women were reported in six States,
amounting to from one-tenth to one-third of all women’s occupational
diseases. Repetitive action required by numerous manufacturing
and clerical occupations was the most common source of tenosynovitis
in Ohio reports. Kneeling required by scrubbing and cleaning was
the usual cause of bursitis.
Lead-poisoning cases among women workers were reported in five
States, ancl considerable numbers of men were injured through work
with lead in each of the seven States reporting. Occupations in
which women’s cases occurred included glass decorating, printing,
assembling electrical apparatus, and the manufacture of clocks and
watches, batteries, toys, metal goods, and rubber.
• 306842°—41----- 2

OCCUPATIONAL DISEASES, 1935 TO 1938

Volatile-solvent poisoning cases among women were reported in a
few cases in these States. Reports from a special study of 89 indi
viduals exposed to benzol in Massachusetts included 19 women.
Two of these women died as a result of the exposure to benzol and
14 others showed abnormal blood conditions. The study brought
out the fact that such poisoning is likely to cause a different type of
disease among women from that among men, and that disease may
appear long after exposure has ceased.
Other systemic poisoning cases among women resulted from contact
with radium, hydrofluoric acid, corn, dyes, and gas fumes.
Chrome ulcerations were reported as occurring to women in the
metal-stamping industry of Ohio.
Respiratory diseases, including silicosis, tuberculosis, pneumoconi
osis, and asbestosis were attributed to industrial sources in the case
of several women.
Contagious diseases resulting from the nature of the occupation are
especially common among nurses, though cases are reported among
waitresses, teachers, household employees, and hospital attendants.
Such diseases are likely to be compensated only in States having
compensation laws covering all diseases of industry. They made up
a seventh of all women’s cases in Wisconsin in 1938.
Evaluation of potential hazards.
Three States, Pennsylvania, Illinois, and Iowa, have made special
studies of the exposures of women in the industries of the State.
Evidence is that even in the least industrialized States there are
occupational-disease potentialities for women as well as men that
require constant watchfulness. In many industries organic dusts
constitute the most common hazard to which women are exposed.
Abnormalities of temperature and humidity and repetitive motion
also are among the common hazards to women. Women are exposed
to a great variety of harmful materials, and the indications from these
studies are that in many plants the health of workers is inadequately
safeguarded against such hazards.
Industry studies made by Federal and State agencies in recent
years include a number of important woman-employing industries
and show the extent and effect of exposure of women. These studies
include the manufacture of pottery, asbestos, shoes, and wood heels;
dry cleaning; and the nursing profession.
Progress in prevention.
Compensation laws covering occupational disease doubled in number
in the period 1935 to 1939. In 24 States, the District of Columbia,
three territories, and two groups compensated by the Federal Govern
ment were occupational diseases compensable at the close of 1939:
Arkansas.
California.
Connecticut.
Delaware.
Idaho.
Illinois.
Indiana.
Kentucky.
Maryland.
Massachusetts.

Michigan.
Minnesota.
Missouri.
Nebraska.
New Jersey.
New York.
North Carolina.
North Dakota.
Ohio.
Pennsylvania.

Rhode Island.
West Virginia.
Washington.
Wisconsin.
District of Columbia.
Federal employees.
Longshoremen.
Hawaii.
Philippine Islands.
Puerto Rico.

PART I.--- INTRODUCTION

Three States—Illinois, New York, and Ohio—changed from listing
the diseases covered to an all-inclusive coverage of occupational
diseases.
Industrial-hygiene divisions have been established in more than
half the States and consideration has been given to the need for such
an agency in a number of the others.
Independent agencies, including organizations of employers, organi
zations of employees, and private foundations, have played an
important part in the research and prevention program of recent years.

Part II.—THE OCCURRENCE OF OCCUPATIONAL
DISEASES AMONG WOMEN, 1935 TO 1938
Comparability of data.
For the convenience of agencies interested in the prevention of
occupational diseases among women, this report brings together infor
mation from the States that report separately by sex the occurrence
of such diseases. While the statistical data are not comparable from
State to State, they indicate the exposure of women to harmful
materials and conditions, and they bring out certain pertinent facts
about the age and industrial distribution of the women affected.
To add to the value of the discussion, special studies of the occurrence
of certain diseases have been considered, together with cases tabulated
in State reports.
Chart I is included here for the purpose of emphasizing the lack of
comparability among the States. Not only do some tabulations cover
all reported cases and others only those compensated or compensable,
but some States base their reports on a limited list of diseases and
others receive and tabulate reports of all diseases of industry. The
chart shows, too, that the tabulation was issued in four States by the
authority handling workmen's compensation cases and in three by
the State department of health, while the remaining reports are the
result of investigations by State departments of labor, the division of
industrial safety in one case and the division concerned with women
and children in the other. In one State the health department
tabulated not only the cases reported to that agency but the com
pensated cases not so reported.
Chart

State

I.— Type and source of statistics tabulated, by period covered and
by State
Years in
cluded 1

Connecticut.......... 1935, 1936,
1937, 1938.

Illinois____ ____ _ 1935, 1936,
1937, 1938.

Massachusetts___ Years end
ing Nov.
30, 1935,
1936, 1937,
1938.
Year ending
Michigan........ ...
Nov. 1,
1938.

Cases tabulated

Source

Cases reported to Bureau of Oc
cupational Diseases by physicians
and cases compensated under
blanket compensation law but
not reported.
Cases closed during year (all com
pensation due has been paid).
Blanket law since Oct. 1, 1936.
Brief schedule of diseases prior to
that date. (More than 7 days’
disability.)
Cases investigated by the Division
of Industrial Safety.2

Connecticut Department of Health.
Unpublished data from Bureau
of Occupational Diseases.

Cases reported. All occupational
disease, whether compensable or
not, to be reported. (Scheduled
list of diseases compensable.)

Illinois Department of Labor. Di
vision of Statistics and Research.
Cost of Industrial Accidents for
the years 1935, 1936, 1937, 1938.
Annual reports of the Department
of Labor and Industries, Division
of Industrial Safety, for the years
ending November 30, 1935, 1936,
1937, 1938.
Michigan Department of Health.
One year of occupational-disease
reporting in Michigan.

i Calendar years unless otherwise indicated.
* Not all tabulable cases occurring are separated by sex. The cases investigated by the Division of In
dustrial Safety are about one-third of the total tabulable cases.

OCCURRENCE OF DISEASES AMONG WOMEN

Chart I.—Type and source of statistics tabulated, by period covered and
by State—Continued
State
Minnesota 3
Missouri

Years in
cluded
1935 to 1938,
inclusive,
combined.
1935, 1936,
1937, 1938.

New York-

1936, 1937-

Ohio__

1935, 1936,
1937, 1938.

Wisconsin .

1938.

Cases tabulated

Source

Cases reported. (Scheduled list
of diseases compensable.)

Unpublished data from Minne
sota Industrial Commission, Di
vision of Women and Children.
Annual reports of the Missouri
Workmen’s Compensation Com
mission for the statistical years
1935, 1936, 1937, 1938.

Cases involving medical expense
reported by employers who make
written election to come under
compensation law with regard
to occupational diseases.
Closed cases (cases decided to be
compensable).
Blanket law
since 1935. (More than 7 days'
disability.)
Cases reported by physicians.
All diseases reportable, though
schedule of compensable diseases
in effect 1935 to 1938. Amend
ment of 1939 made all occupa
tional diseases compensable after
7-day waiting period.
Compensable cases settled. (More
than 3 days’ disability.)

Unpublished data from New York
Department of Labor, Disivion
of Statistics and Information.
Ohio Health News. Also unpub
lished reports from Ohio Depart
ment of Heath, Division of Hy
giene.

Industrial Commission of Wiscon
sin, Statistical Department.
(Mimeog.)

3 Information for women only.
haSevP°i ?een includeJin the following analyses because of the small number of employers
electing to be covered by the compensation act with reference to diseases of industry.

Effective occupational-disease prevention, like accident prevention
requires increasing standardization of statistics so that the extent of
progress may be measured.1
OCCUPATIONAL DISEASES TABULATED BY SEX
Extent of data.
The nine States tabulating occupational-disease data by sex during
the period covered by this report comprise almost twice the number
of States (five) that have made such analysis in the past.2 All the
reports are from States having in effect compensation laws that cover
occupational diseases, though many other States require reporting of
such diseases to some. State agency. This demonstrates again the
way m which compensation laws may underline the need for preven
tion Only when these injuries arc paid for by industry does it become
possible to collect data as to their occurrence and to put into effect
methods for preventing recurrence.
Several of the States regularly making a tabulation by sex of the
numbers injured by disease have increased the data available. Chart
II summarizes the types of information tabulated by the nine reporting
States. The increased information reported is indicated by the
following:
Number of States re
porting in the period—

.
...
,
Age of injured_____________________________________
Industry__________
““
__
Type of disease____________________________________________ (
Extent of disability ______________________________
__ """

1985-88

7
6
8
5

and^Bnii.^?o?a87?^Manml^ontindasirlatinjary?tatisUraari,MO*''011 ofIndustriaI Acddent
> See Women’s Bureau Bulls. No. 114, p. 6, and No. 147, p. 2.

1932-84

,
3

j
1820.

OCCUPATIONAL DISEASES, 1935 TO 1938

8
Chart

II.— Years for which data of various types are reported, by State 1
Years for which data are reported

Number
of cases

Type of
disease

Age

Industry

Occupa
tion

Connecticut-

1935
1936
1937
1938

Illinois -

1935
1936
1937
1938

1938

Massachusetts

1935
1936
1937
1938

Cost of
compen
sation

1935
1936
1937
1938
1935
1936
1937

1935
1936
1937

1935
1936
1937
1938

1938

Michigan^.

Extent
of disa
bility

1935-38

Minnesota 3

1935
1936
1937
1938

Missouri4. -

1935
1936
1937
1938

New York,

1936
1937

Ohio______

1935
1936
1937
1938

1937
1938

1935
1936
1937
1938

1935
1936
1937

1938

Wisconsin-

1935
1936
1937
1938

1937
1938
1938

1 For source and cases tabulated see chart I.
2 First year compensation law effective.
3 Information for women only.
. , , , .
,
, „ .
.
,
4 Only for employers electing to be covered by the act. Not included in analyses following, because of
small number.

Number of cases by sex.
Table 1 gives the number of cases of occupational disease reported
by sex and the percentage women form of the total, by State and year.
Lack of data on the hours of exposure makes it difficult to analyze
with any degree of accuracy the statistics showing number of persons
injured by occupational disease. Nevertheless, it is possible to give
a general background for the changes apparent from year to year in
each State. The increase in 1937 in Illinois and New York reflects
the broadened scope of the compensation laws.3
...
.
Occupational disease varies less directly than other injuries with
employment changes, due to the fact that diseases frequently continue
to develop after the exposure has ended. In Ohio the marked increase
from 1936 to 1937 was due not so much to the addition of silicosis to
the list of compensable diseases as to an unusual number of dermatitis
claims and to outbreaks of lead poisoning in three plants. The year
1938 brought a drop from 1937 in total number of cases in each State
giving comparable statistics for earlier years.
The number of women affected is by no means negligible. In Ohio
the proportion of women is practically equal to their proportion in the
3 See p. 44.

See also Women’s Bureau Bull. No. 147, p. 8.

OCCURRENCE OF DISEASES AMONG WOMEN

working population, and in New York and Wisconsin it is not appreci
ably less. In all cases the percentage women form of those injured by
the diseases of industry is much greater than the percentage they form
of the total injured by other causes.
In Michigan, where the proportion of women among these cases is
the lowest in any State, women comprise about one-fifth of the gain
fully employed. There is no accounting for the very small number
and proportion of women affected by occupational disease unless, in
this first year of the law’s application, women’s cases are not so com
pletely reported as men’s. The Michigan bulletin states that report
ing is far from complete and that physicians are unduly guided in their
reporting by the schedule of compensable diseases. Only 3 of the
1,008 acceptable reports did not correspond to this schedule.
Table 1.—Number of occupational-disease cases in States that tabulate data bv sex
1935 to 1938 1
’
Oc cupationa -disease cases
State2

Women

Year 3
Total

Men
Number

Percent
of total

Connecticut- ___

1935
1936
1937
1938

344
401
423
357

305
349
377
305

39
52
46
52

11.3
13.0
10.9
14.6

Illinois____ _____ ____

1935
1936
1937
1938

371
309
539
402

338
291
466
339

33
18
73
63

8.9
5.8
13.5
15.7

Massachusetts

1935
1936
1937
1938

290
229
300
161

242
180
230
128

48
49
70
33

16.6
21.4
23.3
20.5

1938

1,008

965

3.4

Michigan
Minnesota A..

1935-38

114

New York -

1936
1937

984
1,414

805
1,122

179
292

18.2
20.7

Ohio _ _

1935
1936
1937
1938

1,416
1,501
1,730
1,382

1.128
1,253
1,427
1,112

288
248
303
270

20.3
16. 5
17. 5
19.5

W isconsin__

1938

652

546

106

16.3

xveiei U> unari r yj. o; lor type oi case tabulated and source of statistic
1 Exclusive of Missouri; see footnote 4, chart I.
’ Calendar year, except in Massachusetts and Michigan. See chart I
4 If or women only, and over the 4-year period.

The cost of compensation.
Information about the cost of compensating the occupational diseases
of women is available from Illinois and Wisconsin, where only com
pensated cases are tabulated. Such data are published by New York
for all occupational-disease cases, with no breakdown of costs by sex.
This information is discussed in connection with the various diseases
affecting women in the sections following, but the main facts about the
costs of these disabilities may be briefly summarized here.

OCCUPATIONAL DISEASES, 1935 TO 1938

The cost of occupational-disease compensation is a very small
fraction of the total cost of injury compensation, as the following
shows:
Percent cost of compensation
for occupational disease
was of cost of all industrial
injuries

Illinois (1938) 1. 5
New York (1937)- 1.3
Wisconsin (1938) 4.4

Each of these three States has an all-inclusive disease-compensation
law. Every disease for which industry is responsible is covered by
the act, yet cost of coverage is a very minor part of total compensa
tion costs. Those States that fear passage of complete coverage on
the basis of costs should consider the experience of these States.
The total cost of compensating the 106 women to whom awards were
made in Wisconsin in 1938 amounted to $9,510, or less than 6 percent
of all occupational-disease-compensation costs. The average com
pensation paid women was $90, as compared to an average of $293
for male cases. Cost ranged in the 106 women’s cases from $2 in a
chemical-poisoning case and a case of neurasthenia to $3,940 in a
benzol-poisoning case.
Twenty-one of these 106 cases were caused by diseases to which the
general public is exposed and which would not be compensated under
a schedule law, that is, a law in which specific diseases only are covered.
Borne by the individual, the cost frequently might be unbearable;
borne by industry, it is a minor item in the total. These 21 cases and
their costs are as follows:
Disease

Total

Number of
cases

Neurasthenia____
Neuritis_________
Sciatica_________
Chickenpox______
Measles_________
Mumps__________
Scarlet fever_____
Trench mouth___
Tuberculosis_____
Undulant fever__
Sore throat______
Systemic infection
Heat prostration. _

Compensation
paid

$2,947

1
1
1
1

3
3
4

1
1
1
1
1
2

2
18
5
51
67
112
325
144
983
994
114
31
101

In Illinois a correlation of extent of disability with cost of com
pensation shows that in 1938 the average cost of compensating
diseases resulting in only temporary disability was about $92 for men,
$55 for women. In permanent partial cases, compensation for men
averaged $487, for women $213. Women whose injuries were tem
porary were disabled an average of 12 weeks as compared with 8
weeks for men’s temporary cases; cases having permanent effects
disabled women 21 weeks as compared to 38 weeks in male cases.

OCCURRENCE OF DISEASES AMONG WOMEN

These data may be summarized as follows:
Men

Women

Fatal and
Fatal and
permanent Permanent
Temporary permanent Permanent Temporary
partial
partial
total
total
Number of cases _
Average compensation____
Average weeks' disability___

17
$1, 682.8

147
$487.1
37.5

175
$91.9
7.7

12
$212.8
20.5

—

51
$55.1
11.5

The cost of certain occupational diseases has provided the stimulant
necessary to prevention. Wisconsin found that the high cost of
silicosis m iron mines, foundries, and granite works provided a tre
mendous urge toward prevention. The possibility of complete elimi
nation of the disease even in these most hazardous industries is
apparent. Industry is investing large sums to bring the dust count
oelow the point of dangerous concentration, and Wisconsin statistics
show a steadily declining number of silicosis cases as a result.4
Extent of disability resulting from occupational diseases.
There are few data on the final results of cases occurring. The
summary following (table 2) indicates the reporting of extent of
disability resulting from these diseases in the 4 years.
No fatality was reported for women in either Illinois or Wisconsin
m 1938. Massachusetts reported one fatality among women in that
year—a girl who had been working with a benzol cement for about
G months m a plant making crepe soles for shoes and who died as a
result of the benzol exposure.5 In Minnesota a woman employed in
canning died of corn poisoning. Illinois closed 12 cases involving
permanent disability to women, about a fifth of all women’s cases
closed m 1938. Wisconsin reported 2 cases of permanent disability
among the 106 women affected by diseases in the year.
Table 2.—Extent of disability of men and women injured by occupational disease
1
19S5 to 1938 i
1935

1937

1936

1938

State and sex
Total Fatal

Illinois:
Men..

....

Massachusetts:
Men. _
Women_____
Minnesota:3
Women..
Wisconsin:
Men___
.
Women______

All
All
All
other Total Fatal other Total Fatal other Total Fatal

338
33

26
0

312
33

291
18

12
3

279
15

466
73

8
0

458
73

339
63

217
30

242
48

5
0

237
48

180
49

9
1

171
48

230
70

14
0

216
70

128
33

9
1

Per Tem
ma
po
nent rary

147
12

175
51

11 9
2

3 114

113

546
106

313
20

16
2

517
104

1 For source of data see chart I.
1 Includes permanent total.
3 Reported in 1938 for 4 years combined but only for women.
* Safety Engineering. August 1936, pp. 82 and 83.
30, 1938^pphl13atnSdTI2Gartment °f Lab°r aDd Industrios- Annual Report for the Year Ending November
306842°—41---- 3

OCCUPATIONAL DISEASES, 193 5 TO 193 8

Age distribution by sex.
Cases of women are reported in every age group from less than 20
up to 60 years, and in three States there were cases reported of women
past the age of 60. Nevertheless, the outstanding fact about the ages
of women having industrial diseases is their concentration in the age
groups under 30, due primarily to the fact that larger proportions of
employed women than of employed men are so young. In the various
reporting States from 52 to 70 percent of the women with industrial
diseases were less than 30 years old, though roughly half the employed
women in each State were in such age group. The comparable pro
portions of men having industrial illnesses ranged from 32 to 42 per
cent. However, the degree to which women are remaining in industry
is to some extent reflected in the numbers of older women who suffer
from occupational diseases.
A marked difference exists between men and women in the propor
tion of cases less than 20 years old, again attributable largely to the
fact that youth characterizes employed females more generally than
employed males. In the four States reporting for both men and
women, the percentages under 20 were as follows: 6
Men

Women

2
2
9
5

25
8
36
7

Connecticut----------------- -------------------------------------Illinois Massachusetts----------------------------------------------------Ohio___
— ----------------------------------------------------------

The evidence points to the need of special efforts toward the preven
tion of disease among young employees.
Table 3 details the State figures by age group.
Table 3.—Occupational-disease cases of men and of women according to age group,
various periods of 1935—38, by State 1

Connecticut
(4 years ended
Dec. 31, 1938)

New
Massachu Minne
York 3 Ohio (2 years Wis
sota 3
setts 2 (3
(2
years ended Dec. consin3
(4
years
years ended ended
ended
31, 1938)
(1938)
Nov. 30,
Dec.
31,
Dec.
31,
1937)
1938)
1937)

Illinois
(1938)

Age group

Men
Total___

1, 336

Wom Men Wom Men Wom Women Women
en
en
en
189

339

966
4 370

132
4 57

42
297

1
62

2.1
Under 20 years-----20 to 29 years--------- 31.1
«23. 8
30 to 39 years
40 to 49 years
_ - M3.0

24.6
45.6
«21.1
6 8.8

2.0
30.0
27.9
19.9
15.5
4.7

8.1
43.5
22.6
19.4
6.5

Not reporting age. _
Total reporting age^

Wom Wom
en
en

165

113

471

2,539

573

106

531

165

17
96

35
436

121
2,418

30
543

3
103

9.4
31.8
22.6
20.5
9.2
6.4

35.8
27.3
23.0
11.5
2.4

16.7
40.6
23.9
14.6
7 4. 2

12.8
45.2
21.3
15.6
4.4
.7

5.2
37.1
22.5
18.7
11.7
4.9

7.0
49.0
22.1
16.0
4.6
1.3

12.6
41.8
21.4
16.5
6.8
1.0

531

1 For source of statistics see chart I.
2 Age groups: Under 21; 21 to 30; 31 to 40; 41 to 50; 51 to 60; 61 and over.
3 Comparable data for men not available.
4 Age data available only for cases reported by physicians.
3 Age group is 30 to 40.
6 Age group is 41 and over.
: Age group is 50 and over.
8 In Massachusetts, includes 20 years.

Men

OCCURRENCE OF DISEASES AMONG WOMEN

Industrial distribution of disease cases.
Manufacturing is the source of an appreciably larger proportion of
the industrial-disease cases of men than of those of women. The
service industries and trade ordinarily are more important among
women than among men.
Within the manufacturing group the marked differences among
btates follow to some extent the differences in mechanical develop
ment. It is not surprising to find that in Massachusetts two in
every five women reporting disability caused by disease were engaged
m the manufacture of shoes and other leather products, nor to find
blew York textile and clothing industries reporting more cases of
women than any other manufacturing group. A third of all women
reported m Minnesota worked in the processing of foods, chiefly in
canneries. This industry accounted, too, for the largest group of
Wisconsin women who suffered from diseases of industry. Metals
machinery and vehicle manufacture, ranked first in number of cases
ol both men and women in Connecticut and Ohio.
In the period before 1935 chemical manufacture, particularly the
making ol ammunition, accounted for over a fifth of the women’s
cases m Connecticut.7 In the years since 1934 this industry has not
had a single case among its women workers, an example of the results
that may be expected to follow complete reporting and a preventive
program. Similarly, over a period of 20 years the application of
high standards of reporting and prevention has made itself felt in a
reduction ol diseases occurring in the Ohio rubber industry.8
Of the service industries, hotels and restaurants account for most
cases m tour States; beauty parlors report a larger number of women’s
cases m Connecticut.
The later discussion of the types of disease affecting working women
as a result of their occupations will show more detail as to the indus
tries m which these diseases occur.
«WoSS's Bureau Bull' No m
w omen s Bureau Bull. No. 114.

sST*’ oft?tate RfPorts of Occupational Diseases, 1932 to 1934, p. a
Stale Reporting of Occupational Disease, pp. 58 and 59.
P

Table 4.—Occupational-disease cases of men and of women according to industry, 6 States, 1935 to 1938 1

Industry

Connecticut
(1935-38, 4 years)

Massachusetts
(1935-37, 3 years)

Men

Women

Minnesota 2 New York 2
(1935-38,
(1936-37,
4 years)
2 years)

Women

Ohio
(1935-38, 4 years)
Men

Wisconsin
(1938 only)

Women

Men

Women

Total reporting.

_______________

1.237 100.0

176 100.0

595 100.0

157 100.0

1,146

92.6

137

580

97.5

153

1.8
4. 2
.8
15.8
6.5
2.8
35.2
1.5

3.4

4
18
15
39
1

2.3
10.2
8.5
22.2
.6

6
25
1
20
18
21
113
23

1.0
4. 2
.2
3.4
3.0
3.5
19.0
3.9

2
3

Electrical apparatus and supplies
Food, beverages, and tobacco.._____ ____
Metals, machinery and vehicles________
Paper, printing, and publishing

22
52
10
196
80
35
435
18

Shoes and other leather . _. ____
___
Textiles and clothing.........
. ___ _ ___
Miscellaneous manufacturing

23
4
239
32

1.9
.3
19.3
2.6

15
1
21
17

8. 5
.6
11.9
9.7

26
164
127
36

3.6

15.3

28
14

2.3
1.1

11
1
7
4

6.2
.6
4.0
2.3

2.3

10
1

.8
.1

2.8

Manufacturing and mechanical.

Service industries

__________ ___ ___ ___

Laundries and dry cleaners

77.8

Professional and serniprofessional__
Trade

___

...

____

__ . ............. .

6.2

1 For sources of information see chart I.

114 100.0
55.3

227

1.3
1.9

11
4

2. 3
.8

18
13
13
1

11.5
8.3
8.3
.6

1
37
3
3

.9
32. 5
2.6
2.6

16
45
19
17

3.4
9.6
4.0
3.6

4. 4
27.6
21.3
6.1

5
60
28
10

3.2
38.2
17.8
6.4

16
2

14.0
1.8 .

2
39
58
16

1.9

24.6

7.9

15
1

13.2
.9

8
3

1.3
.5

1.9

106

100.0

340

62.3

50.9

3.3
8.0
18.3
7.1
2.9
11.0
4.0
6.0
5.2

12
18
98
2
52
77
14

2. 2
3.3
17.9
.4
9.5
14.1
2.6

3
30
4
2

2.8
28.3
3.8
1.9

i
24
7
35

.2
4.4
1.3
6.4

1
4
6
4

.9
3.8
5.7
3.8

179

16.2

4.9

20.8

23
11
84
20

2.1
1.0
7.6
1.8

1
10
1

1.1

3.7

1.1
.3
.9
.9

11
22

1.0
2.0

4.0
.5
1.7

8.1

86.6

790

71.4

5.1
5.5
4.5
5.1
6.1
38. 5
3.5
1.6
8.0
1.1
2.0
5.5

14
50

1.3
4.5

.4
8.3
12.3
3.4

247
269
222
250
300
1.877
172
80
390
53
96
268

37
88
202
78
32
122
44
66
57

170

36.1

192

3.9

8.3
3.4
13.4
2.3
7.6
1.1

4
10
79
44

.1
.2
1.6
.9

2.6

39
16
63
11
36
5

4.4

2
17

.4
3.6

1.8

6.2

55
15
43
45

14.0

19
7

4.0
1.5

196
25
85

546 100.0

471 100.0 4,880 100.0 1,106 100.0

97.5' ’

48.2 4, 224

2 Corresponding data for men not available.

4.7

.2
1.8
.2

11
3

10. 4
2.8

2.7

2.8

19
1
]
5
101
35
17

3. 5
.2
.2
.9
18. 5
6.4
3.1

2
4

1.9
3.8

13. 2

9.4

OCCUPATIONAL DISEASES, 1935 TO 1938

Num Per Num Per Num Per Num Per Num Per Num Per Num Per Num Per Num Per Num Per
ber cent ber cent ber cent ber cent ber cent ber cent ber cent ber cent ber cent ber
cent

OCCURRENCE OF DISEASES AMONG WOMEN

Type of disease.
Some analysis of industrial diseases affecting women has been made
by each of the 8 States under discussion. Such information for women
in Illinois was published first in 1938, and that for women in New York
was made more complete in the period of this study.
Dermatitis.—As a class, skin infections exceed in every State any
other group of diseases, though differences both in reporting and in
industry cause great variation among the States in the incidence of
particular diseases. Some skin infections cause serious discomfort
and a few result in permanent injury, though many are mild. As
table 5 shows, skin infections caused nearly three-fifths of the women’s
occupational-disease cases in New York, two-thirds in Wisconsin and
Ohio, practically three-fourths in Minnesota, Illinois, and Connecti
cut, and almost all (95 percent) of the women’s cases investigated in
Massachusetts.9 The proportion of men’s cases that were classed as
dermatitis was much less, varying from little over a fourth in Michigan
to about seven-tenths in Massachusetts. The difference between
men and women in percentage affected was least in Ohio.
Table 5.—Cases of dermatitis among men and women, 1935 to 1938, by State 1
Women’s cases

Men’s cases
State
N umber

Connecticut ___
...
Illinois -........ ....... ... _.
Massachusetts _ .
Michigan

__ .

New York ________________________
Ohio __ ___
Wisconsin____ _____ ____ ____ ___

Percent of
men’s occu
pational-dis
ease cases

756
126
538
264

56.6
37.2
69.0
27.4

910
2. 952
222

47.2
60.0
40.7

1 For source and years covered see chart I. Illinois covers only 1938.

Number

141
47
190
29
83
269
734
69

Percent of
women’s oc
cupationaldisease cases

(*)

Percent of
all derma
titis cases

74.6
74.6
95.0

15.7
27.2
26. 1
9.9

72.8
57.1
66.2
65.1

22.8
19.9
23.7

2 Not computed; base less than 50.

Cases .reported in Wisconsin are those that resulted in more than 3
days of disability. The data show that in 1938 the average cost of
compensation for women with industrial dermatitis was $33, with an
additional $26 for medical care. Women lost from work, on the
average, slightly over 3 weeks. Altogether the 69 women who were
compensated for skin infections in this State lost 1,309 working
days and cost in compensation and medical care $4,073. The
average time lost and the average cost of medical aid were respectively
one-third more and almost one-half more in the case of men than of
women, but the cost of men’s compensation was more than twice
that of women’s compensation, due to men’s higher weekly earnings.
These Wisconsin data may be summarized as follows:8
Men

Number of cases
Number of working days’ time loss 1
Average
Cost of compensation_____________
Average
Cost of medical aid $8, 448
Average

222
5, 586
25
$15, 114
$68
$38

Women

69
1, 309
19
$2, 273
$33
$1, 800
$26

1 6 days’ loss per week of disability.
8 Dermatitis eases were 56 percent of all occupational-disease cases tabulated by the Department of In
dustrial Accidents, for which the data were not tabulated separately for women. (Cases tabulated were all
occurring cases with disability lasting 1 day or shift.)

OCCUPATIONAL DISEASES, 1935 TO 1938

Cases reported in New York are only those that resulted in more
than 7 days of disability. Skin diseases were costly in New York,
and in 1937 the average compensation cost, not tabulated by sex, was
$170; a total of $129,248 was spent in compensation for these diseases
during that year.10
While many industrial diseases are the result of a specific hazard
found only in certain processes and occupations, dermatitis occurs in
most industries and may result from a great variety of contacts. An
analysis of the 734 women’s dermatitis cases reported in Ohio in the
4-year period shows the variety of hazards resulting in such infections.
The largest number of cases resulted from the use of cleaning agents,
followed by miscellaneous chemicals. The women affected were from
every industry reported and no occupational group could claim to be
entirely free from such hazards;11 the occupations of those affected
ranged from the operatives and laborers in manufacturing and service
industries to skilled workers, saleswomen, and clerical and professional
workers. The following are the causes reported in the 734 dermatitis
cases occurring to Ohio women in the 4 years covered:
Cleaning agents _. ----------------------Chemicals not specified---------------Dyes------------Vegetables, fruits, and plants------Oils and greases 48
Rubber 35
Bakelite and formica-------------------Dusts not specified_________
Textiles, clothing, and furs----------Formaldehyde--------- ------------------Volatile petroleum products---------Glue 13
Ink 13

92
73
58
53
31
22
22
14
13

Metals not specified 12
Leather 11
Chrome 10
Cement
6
Enamel
6
Money.'—
Turpentine
6
Sulphur-----------Lacquers and thinners-----------------Various (infections)______________
Irritants not specified 42
All other 1 132

6
5
5
6

i Less than 5 eases resulting from any one specified hazard.

Reports from New York show that there, too, cleaning preparations
caused the largest number of dermatoses, three-tenths of the total.
The preparation of foods or their handling ranked second, and work
involving the use of gasoline, kerosene, oils, and grease was third.
The most costly of New York’s occupational skin diseases compen
sated in 1937 were those caused by contact with dyed furs or other
materials containing benzol, anilin, or derivatives of benzene. These
averaged $521 a case and included one permanent partial disability
to a fur worker who became unable to handle dyed furs, and one
permanent partial case in which dermatitis finally resulted in amputa
tion of the end of a finger. The first of these cases would not have
been compensable under the New York schedule of diseases in effect
before the all-inclusive act of 1935 was passed.12
_
To illustrate the way in which cleaning agents may result in such
disability, cases may be cited from recent Ohio and New York
experience:
A woman employee of an Ohio drug company was granted compensation for
disability due to her employment as soda-fountain attendant. She was required
to wash dishes and glasses in water containing a softener and a chemical required
for sterilization. She burned her right hand on a coffee urn and, after receiving
first aid, continued to work. She developed a skin condition diagnosed as a
10 New York Industrial Bulletin, February 1039, p. 70.
u See Women’s Bureau Bull. No. 147, Summary of State Reports of Occupational Diseases, 1932 to 1934,
for an occupational classification of women reported as having industrial dermatitis,,
u New York Industrial Bulletin, February 1939, p. 70.

OCCURRENCE OF DISEASES AMONG WOMEN

chronic dermatitis and was compelled to quit her work on account of recurrent
attacks.13
15 14
A kitchen maid in a New York City hospital became disabled by dermatitis
of both hands due to using cleansing agents and an antiseptic. Compensation
covering periods of total and partial disability amounted to $492.31. A suscepti
bility to recurrence prohibited her employment in any type of work that involved
contact with soaps, alkalies, and so forth. As she was unable to earn her full
wages in another occupation, the board made further award on the basis of her
inability to perform her usual work.14
.

As in Ohio and New York, contact with cleaning agents caused the
largest number of skin infections classed as occupational diseases of
women in Connecticut. Oil followed, and other agents, in order of
their importance, included solvents, organic dusts, rubber, and acids.
The group of materials causing the largest number of dermatitis
cases to women in Wisconsin was food, principally vegetables. The
chief group of women were reported as factory laborers; next in point
of numbers were the fruit and vegetable sorters and trimmers.
In Minnesota, cannery employees were important among the women
reporting skin diseases. In practically every case liability for resulting
disability was denied because of the limited schedule of compensable
diseases. Workers handling the raw products in fruit and vegetable
canneries have so commonly been affected by skin infections that a
number of dermatitis studies have centered on this important womanemploying industry. The City Health Department of Baltimore,
Md., has investigated the occurrence of dermatitis among women
packing spinach, peas, and tomatoes in canning plants in the city.
In the season following the reporting of a number of cases in a vegetable
cannery, a policy was put into effect to prevent recurrence. In spite
of the preemployment examinations and supervised regular washing
of hands and faces, almost a fifth of the packers were affected by
dermatitis. On the theory that a type of fungus might be the causa
tive factor, as it had been determined to be among fruit packers of
the Northwest, the health authorities requested managers of all
Baltimore plants to require their employees to use a solution of
thymol and oil of cinnamon after washing. The results indicated
this to bo effective. Of the 1,812 workers trimming and packing
spinach in 10 plants, 20 cases (19 of them women) were reported, 14
from one plant. Investigation of this plant showed laxity in carry
ing out the preventive measures. Time lost in these 20 cases varied
from a few days to several weeks.15
Conditions of heat and moisture and the skin abrasions caused by
sharp-edged cans add to the hazard of contact with the sensitizing
agent. Provision of rubber gloves for employees handling the raw
product has been a solution to the problem in many canneries.16
The use of chlorinated naphthalenes in the manufacture of wire
insulation and electrical condensers has been found in recent years
to result in serious skin conditions as well as systemic disease. Reports
of dermatitis from this source come from Connecticut, New York,
and from a special study in Pennsylvania. In this 4-year period
Connecticut reported 27 cases of dermatitis and 1 of systemic poison
ing from the use of chlorinated naphthalene in cable and wire-insula
tion manufacture. Following the death in 1936 of three workmen
13 Ohio Industrial Commission Monitor, October 1939, p. 153.
14 New York Industrial Bulletin, October 1938, p. 481.
15 Journal of Industrial Hygiene and Toxicology, May 1935, pp. 111-113.
i« National Youth Administration of Indiana. The Vegetable Canning Industry. July 1938. p. 37.

OCCUPATIONAL DISEASES, 1935 TO 193S

employed in the insulation of wire in Pennsylvania, the State De
partment of Labor and Industry made a study of 101 persons exposed
to the compounds in wire-insulating companies. Of this number, 78
percent were found to be affected with the dermatitis. This investi
gation showed that it is possible for a worker with this type of derma
titis to transfer it to members of his family. In one case a worker,
his wife, and two children all were affected.17
The occurrence of similar tragedies in New York State, including
the death of a 17-year-old girl employed in the manufacture of electrical
condensers,18 caused the department of labor in that State to make
a survey of the 22 plants using these materials. Three manufactured
insulated wire, the others made electrical condensers. A careful
examination of 31 workers in two electrical-condenser plants found
6 workers, 4 of whom were women, with very serious cases. An
investigation in one plant of the case of a girl, not included among
these 31, who contracted a severe skin eruption revealed the fact
that at the site of the eruption on the cheek a furunculosis of the inner
cheek had developed, which due to secondary infection from scratching
went on to septicemia and resulted in her death.
In another such case in New York, a young girl employed in the
manufacture of electrical condensers and using chlorinated naphtha
lene suffered a permanent facial disfigurement as a result of scartissue formation. The deeper layers of the skin were involved.
Serious results also are found to follow secondary infections of an
existing dermatitis.19
The finishing departments of these plants are responsible for most
cases of skin eruptions. In the dipping, pouring, and soldering
operations fumes are given off in small amounts from many different
points in the workroom. The New York Department of Labor has
detailed general principles for ventilation to be applied to the various
processes, and makes recommendations with regard to personal hygiene
including provision by the employer of highly starched uniforms,
underwear, caps, and gloves, laundered daily; provision of two lockers,
one for street clothes, the other for uniforms; sanitary eating facilities
removed from workrooms; regular wash periods on company time;
provision of abundant hot water, cold cream, soap, individual towels,
and protective lotion.19
Synovitis and other diseases resulting from repetitive activity.—
Repeated motion is among the hazards affecting women in the reports
of Connecticut, Illinois, Michigan, New York, Ohio, and Wisconsin.
It is evident that these cases may result from a great variety of
occupational activity where continuous repetitive movement, pres
sure, or vibration is present. The continuous use of hand tools is a
common cause of synovitis and neuritis of hand, wrist, or arm. So
also is constant operation of machinery, or operations requiring
continuous gripping or pulling of work and repetitive hand operations
such as are required in packing, wrapping packages, folding, typing,
and so forth. Continuous tightening of bolts in one case and continu
ous striking of a rod of a screw machine with the hand in another case
Pennsylvania. Department of Labor and Industry. Bull. No. 43, A Preliminary Report of the
Dermatological and Systemic Effects of Exposure to Hexachloro-Naphthalene and Chloro-Diphenyl.
March 16, 1936.
18 J ournal of Industrial Hygiene and Toxicology, February 1939, pp. 32-35.
19 New York Industrial Bulletin, August and September 1938, pp. 358, 360, 361, 425, 426, and 427.

OCCURRENCE OF DISEASES AMONG WOMEN

caused two costly permanent-disability cases in New York State in
1937. In general, however, these disease cases were not so serious as
those resulting from exposure to injurious substances.20
Many cases resulting from repetitive action or friction compensable
as occupational disease in these States are tabulated and compensated
as accidental injury in other States. There is difficulty even in these
States in drawing a line between accidental injury and disease. In
New York in 1937, for example, there were compensated as accidents
over 100 cases of blisters and abrasions from continuous handling
and 379 injuries due to the position in which employees had to work.
In the most recent year reported, the proportion of all women’s
cases that resulted from repeated motion was as follows:
Number of
cases

Connecticut (1938)
Illinois (1938)____
Michigan (1938).
New York (1937)..
Ohio (1938)_______
Wisconsin (1938)..

9
7
4
98
46
11

Percent of all
women's occupationaldisease cases

17.
11.
11.
33.
17.
10.

3
1
8
6
0
4

Illinois reports in 1938 two women with permanent partial disa
bility resulting from these illnesses. In that State the average woman
suffering as a result of repeated motion lost 34 days from work, as
compared to 16 days lost by men from the same cause. The average
cost of compensation for women was $70; the cost was $133 in each
of the two permanent partial cases.
The 11 cases compensated in Wisconsin included 5 with synovitis—
4 in manufacturing and 1 a bookkeeper. Two women—1 a steno
grapher, the other a hosiery knitter—had ganglions; another hosiery
knitter suffered from a felon; a woman with neuritis was a spray
painter; a charwoman had bursitis; and a cook had a muscular infec
tion as a result of her work. The neuritis case resulted in a permanent
partial disability.
Of the 98 women compensated in New York in 1937 for diseases
resulting from hazards of this nature, two-thirds were in manufactur
ing, an eighth were in domestic and personal service, and a twelfth
were clerical workers.
In the 4 years 1935 to 1938 Ohio reported 197 cases of tenosynovitis
and 12 of bursitis affecting employed women as a result of the work
in which they were engaged. Tin; great majority of the 197 women
with tenosynovitis were in manufacturing, as the following summary
shows:
Manufacturing 170
Paper products and printing 46
Shade roller 14, wrapper 7, assembler 4, packer 4, taping or sticking
shades 4, other 1 13.
Rubber and its products 37
Rubber worker 20, package wrapper 3, other 1 14.
Metal products 28
Assorter of tin plates 12, other 1 16.
Food and beverages 17
Packer (various products) 7, polishing and inspecting whiskey bottles 4,
other 1 6.
1 Not over 2 cases reported in any one occupation.
20 Ibid., February 1939, pp. 70 and 71.
306342°—41---- 4

OCCUPATIONAL DISEASES, 1933 TO 1938

Textiles 12
Worker on textile bags 4, other 1 8.
Automobiles and parts
7
Machine operators 3, other 1 4.
Electrical goods 1--------------------------------------------------------------------------------------Shoes 1
Miscellaneous manufacture 1

6
3
14

Trade 11
Saleswomen 6, other 1 5.
Clerical 10
Stenographer and typist 7, other 1 3.
Service 1_____________________________________
Not reported;________________________________________________________

5
1

1 Not over 2 cases reported in any one occupation.

Ten of the twelve Ohio women with bursitis were employed in
domestic and personal service, as cleaners, scrubwomen, or general
maids, and the affliction was caused by kneeling to scrub floors.
The other two women were employed in trade as saleswomen.
Lead poisoning.—Lead is the most common poisonous material
used in modern industry. Dr. Elston L. Belknap, a well-known
industrial physician in Wisconsin,21 states that it is used in more than
150 industries. He lists the following 10 occupation groups as the
commonest source of severe lead-poisoning cases: Storage-battery
manufacture, cutting of lead-painted metal with oxyacetylene torches,
use of machine abrasive wheels in smoothing welded auto bodies,
spraying of lead arsenate in farm work, hand soldering in canning,
spray-gun painting, burning off old painted surfaces with blow torch,
printing (remelting type metal), sawing brass or tending brass fur
naces, small battery-repair shops and junk yards where batteries are
broken up. Dr. Belknap stresses the need for continuous inspection
of industrial processes in which lead in any form is used. Potteries,
once an industry with a high rate of disability from lead poisoning,
have practically eradicated this hazard,22 but other industries and
processes have developed with hazards as pronounced.
The need for extraordinary vigilance is illustrated by the great
increase in cases reported to the Ohio Department of Health in 1937,
and the results of such vigilance are evident in the decrease in num
ber of cases reported in 1938. The increase in 1937 was due to
unusual outbreaks in three plants. All but 1 of the 26 women affected
in that year worked in the manufacture of glassware; 1 woman was
employed to set the ware on a spray machine, the others in glass
manufacturing were decorators. The one woman not in glasswork
was employed in the printing industry. In the glass plant, lead
color was used in a powder form and lead poisoning resulted from
inhalation of this powder.
Of the 36 women’s cases in Ohio in the 2 years 1937 and 1938
(8 percent of all lead-poisoning cases), 29 reported age as well as
industry and occupation. The following summary shows that the
majority of these 29 women were less than 31 years old:
Under 25_________________________________________
25 to 30________________________________
31 to 35
36 to 40
41 to 45
46 to 50___________

9
8
3
1
7
1

si Belknap, Elston L., M. D. Common Poisons in Industry. Public Health Nursing, August 1938.
»Ibid., p. 66.

OCCURRENCE OF DISEASES AMONG WOMEN

The unusual number of men reported as having lead poisoning in
Ohio in 1937 resulted from the inhalation of dust in the manufacture
of automobile and truck bodies. The dust was caused by the grind
ing of metallic lead used for filling cracks and seams in the metal
bodies. In each case the cause was found and preventive methods
were applied.23 In the year following, the total number of cases
reported by physicians had fallen from 195 to 55.
Ohio reports in the 2 years 1937 and 1938 the ages of men as well as
of women injured by lead poisoning, together with the industry in
which they were at work. Of the 213 men reported, over a third were
in the manufacture of vehicles, their parts and accessories, and these
men were not youthful workers: Four-fifths were 30 or older, well
over half being 40 or over. In the manufacture of electrical apparatus
and supplies, the industry with the third largest number of cases, the
workers affected were in most instances young men: 14 of the 25 were
under 30, and 2 were less than 20 years old. In the printing industry
a boy of 16 was reported as having lead poisoning.
Cases of lead poisoning among women were relatively few in each
of the 7 reporting States, as the following list shows:
Men

Connecticut (4 years) 36
Illinois (1938)
Massachusetts (4 years) 77
Michigan (1938).!__________________________________
New York (2 years, 1936 and 1937) 125
Ohio (4 years) 428
Wisconsin (1938)_______________________________

65
83

Women

7
2
1
3
36

In Connecticut five of the seven women affected were employed as
assemblers in the manufacture of electrical apparatus; the other cases
occurred in clock and watch and in metal-goods manufacture. Three
of the five for whom age was reported were less than 20 years old, the
other two, 20 and under 30 years.
One of the three women compensated for lead poisoning in New
York was a mixer in the manufacture of batteries, another worked as
lay-up girl in rubber manufacture, and the third was a bookkeeper.
Construction ranked first in number of men having lead poisoning,
with metal and metal-products manufacture second.24
In Massachusetts a young girl working as a sander in a toy factory
suffered a brief period of incapacity from lead poisoning caused by
fumes and dust from her work. She was transferred from this tvpe
of work.
Of the cases of men reported in the four States giving occupa
tions of the injured, a greater number had been employed as painters
in various industries than in any other single occupation. In Massa
chusetts as in Ohio there was an outbreak of lead-poisoning cases in
automobile assembling. In Massachusetts this occurred in 1935.
One establishment employing 60 men at grinding and smoothing
soldered metal bodies with emery wheels and circular disks covered
with carborundum powder had 18 cases of lead poisoning in the year.
One and a half pounds of molten-lead solder was applied to each car
body, and the operators worked at grinding the lead-coated seams
n Ohio Industrial Commission Monitor, June 1938, p 84
24 New York Industrial Bulletin, July 1937 and February 1939.

OCCUPATIONAL DISEASES, 1935 TO 1938

and joints. Through the installation of an effective ventilating
system the hazard was eliminated.25
Illinois, New York, and Wisconsin, reporting on the costs of medical
care and compensation, find lead-poisoning cases among the most
expensive occupational diseases. In Illinois the compensation of the
two women affected averaged $475, over $100 more than for any other
type of disease affecting women. Both of these cases resulted in
permanent partial disability. For men in this State the average
compensation was less than that for women and only slightly higher
than their average for all diseases. The cost was exceeded by several
other industrial poisons and by dust diseases. In Illinois lead poison
ing resulted in 4 of the 17 deaths and permanent total cases and 26 of
the 159 permanent partial cases.
In New York the 128 cases of lead poisoning occurring in 1936 and
1937 were the most costly group of occupational diseases in each year,
with an average award of nearly $1,500 a case. The disability result
ing may be summarized as follows: 26
Total oases

128

Fatal____________
Permanent total._
Permanent partial
Temporary______

5
112

The 10 compensable cases in Wisconsin in 1938 had an average loss
of 863 working days’ time and received an average indemnity of
$1,420, in contrast to 172 days’ loss of time and $260 indemnity for all
occupational diseases combined.
Volatile-solvent ■poisoning.—The volatile solvents, increasingly com
mon in industry, have been the subject of investigation in several
States in recent years. The conclusion has been reached that no
volatile solvent is safe in high concentration, and that even the
“safest” solvent requires watching.27 In the consideration of benzol,
a solvent that is notoriously unsafe, Massachusetts investigators have
come to the conclusion that the only really safe concentration is zero.
Over a period of 4 years medical officers of Massachusetts have made
a special study of 89 individuals, including 19 women, exposed to
benzol fumes.28 The results, based on investigation of the industrial
background as well as the chemical and pathological aspects of benzol
poisoning, differ in certain important points from commonly accepted
principles about this disease. It has been generally assumed that
young women are more susceptible to poisoning than men. This
study indicates, however, that exposed males tend to develop hyper
plastic bone marrow, a form of the disease not yet generally recog
nized, while females have a tendency to develop aplastic bone marrow.
Among the 4 women for whom a study of the pathology of the disease
was made were the only 2 cases with aplastic marrows in the face of
prolonged exposure (4 and 5 years). All these 4 cases showed aplasia.
Ten of the twelve males for whom the pathology of chronic benzol
u Massachusetts. Annual Report of the Department of Labor and Industries, year ending November
30, 1935, p. 20.
26 New York Industrial Bulletin, July 1937, February 1939.
.
. ,„,Q
j7 Belknap Elston L , M. D. Common Poisons in Industry. Public Health Nursing, August 1938.
28 Journal of Industrial Hygiene and Toxicology, October 1939, pp. 321-393. Chrome Exposure to Benzene.

OCCURRENCE OF DISEASES AMONG WOMEN

poisoning was studied showed hyperplasia, and only 2 aplasia. It is
true, however, that females can react to prolonged exposure with
extreme hyperplasia. It is also true that because of the effect of
benzol on the liver, pregnant women especially need protection, since
the liver in pregnancy is peculiarly sensitive to injury.20
Most important, perhaps, was the discovery that the first symptoms
of chronic poisoning may appear long after exposure has ceased. Two
cases established this point. No signs of benzol poisoning were evi
dent until the onset of what would otherwise have been a minor infec
tion, when the injured bone marrow showed the effects of exposure.
The author points out that workmen’s compensation should be
extended to include cases arising long after exposure is stopped.
Concentration of fumes is not the whole story in consideration of
exposure of workers. Individual susceptibility and duration of exposure
are of great importance. Individual susceptibility is highly varied
and complex, so that one individual may be poisoned, another not,
though exposed to the same concentration of fumes and other factors
being equal.
The 19 cases of women studied, with the length of exposure, occupa
tion (most of them were employed in the manufacture of crepe rubber
soles for shoes), age, and the blood picture resulting from the exposure,
are listed in the following:
Age
18
19
20
37
32
29
18
30
21
18
22
21
23
18
20
20
24
36
63

Work
Cementing_______________
____do________ __________
____do
____do
.do__________________ _____
Maker___ ____________
___ do
____do________________ ____ _
____do..
____do___ __________ ____
____do...
____ do__________ _____
____do
____do
Varied_____________________
........ do_____________ _______ _____
Not reported__ ____________
Telephone operator 3._____ ____

Time at work

6 months_____

6 months; 4 months; 6 months

6 months_______ ____
3 years_______________________
5 + years.......... ...................

Exposure *
★
★
★
★
★
★

Blood picture

★
★
★
★
★
★

★--- Abnormal.2
★
Do.
★
Do.
★
Do.
Do.
Do.
Do.
Normal.
★ ★Abnormal.
Do.
★ ★ ....Normal.
★ ★
Do.
Abnormal.
Do.
★ ★---Do.
★ ★-- —
Do.
★----------Do.
★ ★------Do.
Slight
Do.4

1 Intensity of exposure is designated in the range from + to ★ ★ ★.
2 Died June 16, 1938.
3 Cleaned board daily with 50 percent benzol paint remover.
4 Died February 18, 1939.

In the periodic reports of the eight States tabulating disease cases
by sex, only four women were reported as having benzol poisoning.
In Wisconsin in 1938 a young woman employed as a dipper of radio
tubes suffered a permanent partial disability. Hers was the most
costly woman’s occupational-disease case in the State, receiving
$3,940 in compensation. In Massachusetts three benzol-poisoning
cases among women were investigated in 1938. Two of these women
were employed in plants manufacturing crepe soles. One case was
fatal.29
29 New York Industrial Bulletin, April 1938, pp. 166-168.

OCCUPATIONAL DISEASES, 193 5 TO 19 38

Among the remaining States benzol-poisoning cases of men were as
follows:
Total
number

State

Connecticut______
Illinois
__
Massachusetts____

7
1
12

New York 1_______ 109
.

Industry

Artificial-leather manufacturing
Not reported
Tannery_______
_ _ __________
Shoe manufacture_________
Cleaning machines with solvent__
Artificial leather and miscellaneous
Textiles and clothing____
Leather, rubber, and composition...
Chemical and allied products_____
Trade____________________________
Metal and metal products________
Hotels and restaurants___________
Other service_____________________
Other industries__________________

Number
reported
by
industry

1
12
8
27
18
3
3

1
1
1
1

1 New York Industrial Bulletin, July 1937, pp. 259-263.

In New York 3 of the 16 fatalities from all occupational diseases in
1937 were caused by benzol.30 Two fatal benzol-poisoning cases were
investigated in Massachusetts in 1938. In Illinois the one case of
benzol poisoning for which compensation was closed resulted in
permanent partial disability.
Other solvents are said to have caused the poisoning of workers in
several States. In Connecticut 15 men and 1 woman were reported
as suffering from such poisoning; the agency affecting the woman (a
cleaner in the manufacture of electrical apparatus) and 8 of the men
was carbon tetrachloride. In the 4-year period carbon tetrachloride
caused the poisoning of 3 women and 8 men in Ohio; 2 of these women
were employed at cleaning type in the manufacture of machinery,
and 1 was a maid in a hospital. Other solvents used in connection
with their occupations caused the poisoning of 10 men and 2 women
in Ohio. Among women in New York who received compensation in
1936 and 1937 for injury from the use of solvents were 2 cases caused
by wood alcohol, 2 by amido benzine, another by naphthalene, and
another by benzine and ether.
Other systemic poisoning.—Six cases of radium poisoning in 3 years
were reported in Connecticut; all these were women employed as dial
painters in clock and watch manufacture. Of the four reporting age,
none was more than 40 years old and two were under 30. The New
York Division of Industrial Hygiene, noting an increase in dial
painting plants in the State, issued a warning in 1937 as to the dangers
of work with radioactice material and standards for safe practice. The
conclusion is reached that, even with the greatest care in handling,
the effect of exposure to emanations of low power over long periods
is not known.31
One woman with radium poisoning was awarded compensation in
Illinois in 1938, and the company agreed to abide by the decision with
regard to other similarly disabled women. This woman and 13 others
who had been employed in the plant discovered the nature of their
disability early in 1934. The award was contested on the basis that
notice was not given the employer within 30 days of injury, though it
is known that radium poisoning may develop years after exposure to
Ibid.. February 1939, p. 68.
si Ibid., July 1937, pp. 291-292.

OCCURRENCE OF DISEASES AMONG WOMEN

the hazard has ceased. The Illinois commission agreed in this case
that the 30-day time limit began when the women first were informed
that they had the disease. The award made included $3,230 for medi
cal and hospital expenses, $11 a week for 315 weeks, followed by a
monthly pension of $23.13 for life, and a lump sum of $2,398 for com
pensation from April 25, 1934.32
Three women in New York State were compensated for chronic
poisoning caused by the use of hydrofluoric acid in their work as
solderers in electrical-apparatus manufacture.
Corn poisoning was reported as the cause of the death of a young
girl cannery worker in Minnesota, and of the disability of seven others
from 1935 to 1938. Dye poisoning was reported in 19 women’s cases
in Minnesota, most of them in garment manufacture, and 1 other
Minnesota woman suffered from eye infection caused by cement dust.
Gas-fume poisoning was reported as the disabling disease of women
in four cases each in Minnesota and Massachusetts. Poisoning from
fumigants in 1938 affected two Connecticut women employed in trade
occupations.
Chrome ulceration.—In the 4 years, work with chromic acid in the
plating, dipping, and scrubbing of metal stampings caused ulcerations
of the nasal septum of 33 women in Ohio. In 3 cases in 1936 the ulcer
had resulted in perforation of the septum. Most of the cases occurred
in 1936 and among the employees of one company. Twenty-three
cases of chrome ulceration or poisoning, one of them a woman, received
compensation in New York in 1936 and 1937.
Respiratory diseases.—Occasional cases are reported of respiratory
disease of women from work in dusty occupations. In Ohio silicosis
first became compensable in 1937, and in the year following 141 cases
were reported to the Department of Health, more than the total
reported in the 3 years 1935-37. Four of these 141 cases were
women, 2 of them in the manufacture of tile, 2 in pottery and stone
ware plants. All were seriously injured, 3 having tuberculosis as
well as silicosis, and the other being in the third stage of silicosis.
In the case of 1 of the women, employed 14 years in tile manu
facture, the industrial commission found that she had been working
in a room where 82 unhooded presses were used to press clay into
tile, her particular jobs being to dust the tile as it came off the press
and to place sand in the saggers of each layer of tile. Exposure to
silica dust was pronounced. She was totally disabled from July 22,
1938, and the commission awarded her compensation of $1,050, the
limit possible under the provisions of the silicosis act of 1937.33
A case of silicosis to a woman employee of a foundry and a case of
pneumoconiosis to a woman rubber worker were reported in Con
necticut. In Illinois in 1938 a woman was reported as having a
permanent partial injury from work exposing her to organic dusts,
and the case of another woman resulting from exposure to inorganic
dust was closed during the year. A case of pneumoconiosis in a
woman, and another of asbestosis, the latter causing death in 1936,
were investigated in Massachusetts. Compensation was awarded in
1937 to 2 women in New York because of their exposure to dust and
lint, and in 1936 to a woman machine operator in a bakery because
of inhalation of flour.
82 Chicago Federation of Labor, Federation News, July 1938.
33 Ohio Industrial Commission Monitor, February 1939, p. 26.

OCCUPATIONAL DISEASES, 1935 TO 1938

Contagious diseases.—These diseases, not commonly considered
occupational, were compensated in a number of cases in New York
and in Wisconsin. There were 19 such cases of women compensated
in New York in 1936-37, 13 of them employed as nurses, 5 as attend
ants in hospitals, and 1 as a hotel housekeeper. Nine of the 15 cases
of women compensated for these diseases in Wisconsin in 1938 were
nurses; 1 had chickenpox, 2 measles, 3 scarlet fever, 1 trench mouth,
1 tuberculosis, and 1 sore throat. Three cases of mumps were
reported as occupational—a summer-resort waitress, a hospital at
tendant, and a city school teacher. The other cases included an
office worker with scarlet fever, a maid in domestic service with
measles, and a factory worker with an unclassified systemic infection.
The tuberculosis case resulted in serious loss of time from work—
301 days—and cost in compensation $983, with additional medical
expense of $437.
From the point of view of these diseases, nursing is, of course, a
most hazardous occupation. In Proctor v. Willard Parker Hospital
and Genesee Hospital, ex rel.—a case appealed from the New York
Industrial Board—the status of a nurse so injured was clarified. In
this case the student nurse was taking training at Genesee Hospital
in Rochester. Under a contract whereby the Willard Parker Hospital
of New York City furnished Genesee Hospital student nurses with a
3 months’ course in the nursing of communicable diseases, this nurse
was transferred to New York City, and while nursing there contracted
scarlet fever. The disease damaged her heart and contributed to her
death. The State industrial board found the disease occupational,
and made an award requiring compensation to be paid by both hos
pitals and their insurance carriers. Upon appeal the Genesee Hospi
tal contended that the medical testimony connecting the scarlet fever
with the death was conjectural, and that there was no employeremployee relationship between the nurse and this hospital during her
work at Willard Parker Hospital. The appellate division unani
mously affirmed the award on the finding that there was adequate
competent evidence of causal relation between the occupational dis
ease and the death of the decedent.34
Other occupational diseases oj women.—Among the diseases reported
that may not be classified in the foregoing groups was a case of undulant fever caused by food furnished to a nurse in a private Wisconsin
hospital. This was a costly compensation case, requiring $1,073 in
medical aid and $994 in compensation. The nurse lost 271 days of
working time.
In Wisconsin a case of neurasthenia affecting a stenographer was
compensated. In this connection may be mentioned a finding of the
Ohio Industrial Commission in the case of a young woman employed
as a piecer in a pants factory. The commission found that hysteria
brought on by a sudden strain on the nerves is not compensable,
and her claim for compensation due to such disability was disal
lowed.36 * 33
s4 New York Industrial Bulletin, March 1939, pp. 142,146.
33 Ohio Industrial Commission Monitor, November 1938, p. 151.

OCCURRENCE OF DISEASES AMONG WOMEN

Heat prostration was compensated as occupational disease in the
cases of 2 women in Wisconsin, 1 a mangle operator in a cleaning
and dyeing establishment, the other a waitress in a summer resort. S.
&
Two cases of paralysis, 1 a woman, resulting from temperature
abnormalities in stores, were reported as compensated in Connecticut
in 1935. In 1938, in another woman’s case in this State, arthritis
was compensated as an occupational disease resulting from tempera
ture extremes.
A case of hernia affecting an employed woman in Michigan was
reported as an occupational disease.
Noncoinpensable occupational diseases.
In the period of this study Ohio compensated workers according to
a limited schedule of diseases. In the 4 years the men and women
reported to the department of health as having diseases caused by
their occupations but not compensable numbered as follows:
Year

1935.
1936.
1937.
1938.

Men

Women

72
87

18
26

Included were cases of women with respiratory diseases, such as a
pneumoconiosis resulting from dust in the making of pasteboard
cartons, an inflamed respiratory tract caused by dust in the grinding
of hard rubber in rubber manufacture, a nasal ulcer resulting from
paper dust, rhinitis from the use of paint and lacquer. Also included
were a case of a woman with heat exhaustion who worked as a presser
in cleaning and dyeing and a case of typhoid acquired by a girl who
worked as a counselor in public service. Other cases reported in
cluded, among many: Infected flea bite affecting a clerk in a pet
shop; tularemia affecting a restaurant cook; tuberculosis in a 22-yearold girl who had been exposed to glass wool in her work in a glass
factory.
In some of these the results may have been slight and of brief
duration, in others they were of very serious nature. In either
case they were of occupational origin “and involved wage loss and
medical expense. The Ohio Legislature recognized this fact, and in
1939 passed an all-inclusive law for the coverage of occupational
diseases. The existence of such cases should point to the need for
revision of every act based on a limited list of diseases.
Illness among employed women.
A survey made by the National Institute of Health in the winter
of 1935-36 included a study of the occupational status, age, sex,
and disability of approximately 280,000 white persons in 8 cities.36
Included were 145,733 women, 34,085 of whom were workers 15
years old or over. For the women workers 15 to 64 years old the
rate of illness, based on those ill on the day of the canvass, was 27.7
per 1,000, in contrast to 22 for male workers. For both men and
S. National Institute of Health. Preliminary reports, National Health Survey, Sickness and Modical Care Senes, Bull.
Illness Among Employed and Unemployed Workers. 1938. pp. 3 and 12.

OCCUPATIONAL DISEASES, 193 5 TO 1938

women the rate increased directly with age. Women workers ex
perienced an illness rate higher than that for men workers in each
age group, and, as the following summary shows, the difference
increased with age:
Number of workers disabled

15
25
45
65

per 1,000
Female

Age group

Male

Total 15 to 64 years.

22. 0

27. 7

13. 9
2
30. 8
49. 6

20.
29.
40.
62.

to 24 years-------------------------------to 44 years 19.
to 64 years----------------------years and over________

2
1
0
1

An analysis by occupation of the male workers 15 to 64 years old
in these cities shows a direct relation between occupation "and dis
ability.37 The occupational class tends to be an index of economic
status comparable to family income, and the variations in illness
rates are similar for these two classifications. The summary following
shows a disability rate more than twice as high for unskilled workei?
as for professional persons or proprietors.
Number of male
workers disabled
per 1,000

All occupations
Professional persons
Dealers and other proprietors____
_____________
____
Clerks, salesmen, and kindred workers______________
___
Skilled workers and foremen ____________________________
Semiskilled workers'
_________________________
Unskilled workers
37 Ibid., table 4, p. 9.

21. 9
1576
16. 3
18. 9
22. 8
24. 6
36. o

Part III.—EVALUATION OF THE EXPOSURE OF
WOMEN TO TOXIC SUBSTANCES AND CONDI
TIONS
STATE STUDIES

In about a third of the States the departments of health had pub
lished surveys of their industrial hygiene problems by the close of
1939. Most of these were completed during the years under discus
sion in this report. Made with the assistance, advisory and in some
cases financial, of the United States Public Health Service, the studies
cover a sample of the employments in mining, manufacturing and
mechanical industries, transportation and communication, trade, and
in dry-cleaning and laundry establishments. They include informa
tion as to the numbers of men and of women employed in these
industries, the numbers exposed to specified hazards, and the sanitary,
health, and medical facilities available to the workers.
Three of these States—Pennsylvania, second industrial State in the
country as measured by the number of wage earners in manufacturing
industries; Illinois, fourth in importance as a manufacturing State;
and Iowa, primarily an agricultural State—have made separate tabu
lations giving the exposure of women to specified hazards. In each
State figures show the possibilities of the problem and do not mean that
the exposures will result in health impairment. They do not measure
the degree nor magnitude of exposure. No physical examinations of
the workers were made. The results do show the toxic materials and
conditions to which men and women are being exposed, indicating the
importance of watchfulness even in States not highly industrialized.
Pennsylvania.1
It is startling to note in the following summary that there were, in
the 16,000 manufacturing establishments studied in Pennsylvania in
1934, over 4,500 women with potential exposures to lead and its com
pounds, and that 7,300 worked under conditions exposing them to
inorganic nonmetallic dusts and 228,000 to organic dusts. More than
19,000 worked under abnormal temperature or humidity conditions.
The total number of exposures found was 323,332—larger than the
number of women exposed because in many instances women were
subjected to more than one hazard.
In the prevention of industrial diseases, the importance of separate
lunchrooms, adequate wholesome drinking water, adequate washing
and toilet facilities, has been emphasized elsewhere and reflected in
State legislation and safety regulation in general. Nevertheless, the
survey of 16,000 manufacturing plants in Pennsylvania found over
nine-tenths of the establishments without a lunchroom and over half
without a cloakroom. A fourth of all the factories provided only
compion drinking cups and almost as many provided common towels.
There were 603 plants furnishing no drinking facilities whatsoever and
1 Pennsylvania Division of Industrial Hygiene. Control of Occupational Diseases in Pennsylvania,
November 22,1937.

OCCUPATIONAL DISEASES, 1935 TO 193 8

698 furnishing no toilet facilities. Unsatisfactory outdoor toilets
were provided in 1,946 other industrial plants.
Number of
:potentially
exposed women 1

Hazard

Organic dusts. 228, 106
Abnormalities of temperature
or humidity_____________
Repeated motion, pressure, and
shock--------------------------------Metals 11, 695
Miscellaneous 10, 800
Inorganic nonmetallic dusts__
Paints, pigments, inks, and
dyes---------------------------------Lead and its compounds_____
Organic chemical compounds,.
Inorganic
chemical
com
pounds_______
Petroleum and its products__
Solvents
2, 497
Infections. _ _______________

19, 120
13, 848
7, 322
6, 637
4, 554
3, 311
2, 711
2, 701
1,758

Number of
potentially
exposed women1

Hazard

Acids------------------- ----------------- l, 687
Rubber and rubber compounds.. 1, 376
Aluminum and its compounds... 1, 166
Calcium compounds __ 1,075
Mercury compounds______ ___ ’ 811
Rosins, resins, and synthetic
resins
585
Sodium compounds____________
534
Washing compounds___________
344
Chromium and its compounds . .
220
Arsenic and its compounds_____
185
Cyanides_______________________
91
Radiant energy________________
72
Asphalt and coal byproducts___
64
Ammonium compounds________
55
Disinfectants, insecticides, and
fungicides____________________
7

1 Some women were exposed to more than one

Illinois.
In round numbers, 50,000 women wore employed in the 2,846 plants
studied in Illinois in 1938. Women comprised more than a fifth of
all wage earners in these plants.2 The industries included and the
number of women surveyed are listed in table 6 following, with a
distribution of the number of exposures to harmful substances or
conditions.
Table 6.—Industrial distribution of 50,064 women surveyed in Illinois in 1938,
and number and percent of exposures to harmful conditions in industry1
Women employed

Women’s exposures
to harmful
substances

Industry

Total___________________________
Chemicals and allied industries_________
Cigars and tobacco____________________
Clay, glass, and stone__________________
Roofing, asbestos products, abrasives, etc.
Clothing______________________________
Food _______________________________
Iron, steel, machinery, vehicle__________
Other metal___________________________
Leather_______________________________
Lumber and furniture_________ ■______ _
Paper, printing, and allied industries___
Textile industries.______________ ______
Miscellaneous manufacturing industries..
Personal service 3_ ___________________
Commercial service 4 ________________

Number

Percent
of total
em
ployees 2

Total
number

50, 064

22.5

29, 741

59*

2, 637
181
750
243
5,919
7, 637
3, 660
4, 528
1,445
1.378
3, 704
3,087
11, 270
3,577
47

19.9
36.2
17.1
6.0
70.6
35.6
6.1
16.9
26.8
11. 1
26.0
56.2
32.0
62.4
8.3

2, 219
67
508
146
2,494
6, 400
3,102
2, 530
564
1.061
747
2, 022
7, 347
476
5S

84
37
68
60
42
84
85
56
39
77
20
65
65
13
123,

Number
per 100
women

1 Kronenberg, Milton H., MD., chief of Division of Industrial Hygiene, Illinois Department of Public
Health. v\ omen in Industry. In Industrial Medicine, September 1938.
2 Clerical employees not included.
3 Laundry, cleaning, and so forth.
4 Warehouse, jobbing, and so forth.
2 32 of the 2,846 plants employed no women.

EVALUATION OF EXPOSURE TO TOXICS

In proportion to the number employed, the personal-service in
dustries in Illinois exposed the fewest women to harmful substances,
13 of every 100 employed women. Of the large employers of women,
the food industry, iron, steel, machinery, and vehicle manufacturing,
and chemicals and allied products had the highest numbers of ex
posures in proportion to the women employed—84 or 85 per 100
women.
Analysis has been made of the harmful materials to which the
women employed in a selected list of miscellaneous industries were
exposed. The industries include electrical manufacturing, buttons,
brooms, brushes, rubber, artificial flowers, mattresses, signs, mirrors,
hair goods, lamp shades, scientific instruments, plastic molding, and
so forth. The greatest number of exposures, over one-fifth of the
7,347 exposures reported, were to lead; some 1,600 women had lead
exposures. Close to 1,000 women, 13.4 percent of the total exposures,
were exposed to organic dusts; there were 1,720 exposures to dusts of
various kinds. The third source of exposure in point of numbers
exposed were the alcohols, esters, and ethers, with 806 women, 11
percent of the total exposed. These three groups of harmful materials,
lead, dusts, and alcohols, esters, and ethers, account for 56 percent of
the exposures in miscellaneous manufacturing. Women were re
ported in 37 classified exposures, including 336 to petroleum products,
597 to lacquers, 138 to halogenated hydrocarbons, 130 to dermatitis
producers, and 51 to fluorine gas.
From data based on electrical-manufacturing plants, 95 percent of
all such plants in the State, the occupational exposures of women in
this industry have been determined. The factories studied employed
16,026 persons; women, totaling 4,798, were employed in 23 occupa
tions. Exposures of these women totaled 3,200, 49 percent of them
lead, 9 percent alcohols, esters, and ethers, 8 percent lacquer. No
occupation was entirely free from the possibility of harmful exposure
Ten occupations included lead among the harmful materials, five
included silica and silicate dusts.
Chart III following makes an analysis for electrical-products and
tinware manufacture in Illinois. In the tinware industry women are
employed in a variety of occupations and they constitute 28 percent
of total employment. Dusts, carbon monoxide, lead, solvents, and
miscellaneous metals and gases were the principal harmful substances
offering a potential hazard to the women employees.

Chart

III.—Harmful substances to which employed women are exposed in the electrical-products and tinware industries in Illinois, by
occupation

Dusts

Occupation

★

★
★

★

OCCUPATIONAL DISEASES, 1 9 3 5 TO 1938

ELECTRICAL-PRODUCTS MANUFACTURING

★

★
★

★

★
★

★
★
★

★

★
★
★

★

................

★
★

★
★
-—
★

—

★
★

★
— —

—
............. -

★
★
★

★
★

★
—

EVALUATION OF EXPOSURE TO TOXICS

TINWARE MANUFACTURING
★

OCCUPATIONAL DISEASES, 1935 TO 1938

Iowa.
The potential exposure of women to toxic materials and hazardous
conditions was the subject of special consideration in Iowa in 1938.
The survey covered 28,170 workers in the extraction of minerals,
manufacturing, and the two service industries, laundries and dry
cleaning and pressing. It excluded office workers unless definite
exposure to some harmful substance was found. The facts presented
are proof of the need even in relatively nonindustrial States for con
stant watchfulness to prevent disease resulting from conditions in
industry.
The Iowa Division of Public Health Engineering and Industrial
Hygiene included in its study 4,388 women, 15.6 percent of all employ
ees. Well over half of these women, 2,496, were exposed to some
harmful material or condition. Table 7 following shows how these
women were distributed by industry and the number of their harmful
exposures. The greatest number of women in manufacturing indus
tries, a fourth of all women studied, were working in food and allied
industries. Nearly half of these (490) had some harmful exposure,
principally from the presence of organic dusts and from the handling
of oils, fats, and other materials.
Table 7.—Industrial distribution of 4,388 women surveyed in Iowa in 1988,
number exposed to harmful conditions, and number of such hazards per woman1
Women wage earners
Industry
Number2

Total

_____ ...

______ ____ ____

Number Number of
Percent of exposed to hazards per
all workers harmful
exposed
conditions
woman

4,388

15.6

2,496

1.4

Chemical and allied_____

253
53

30.0
31.2

143

1.1

Clothing_______

649
256

84.8
78.8

560

1.0

1,088
133
95
589

18.4
63.6
65.1
18.4

490

1.1

Food and allied-------------- ----------------------------- -------Canning and preserving....... .................... ............. .......

134

1. 2

Leather.______ ___________________

______

306
175

50.2
52.6

144

1.1

Paper, printing, and allied____ _________ .

_____

101

14.5

1.5

451
258

56.2
55.5

184
155

79.3
46.8

36
69

1.0
2.1

Miscellaneous:

Service:
Laundries_________ _______ ___________ _______
Dry cleaning.. __________ _____________________

1 Iowa. Department of Health. Unpublished data.
2 Totals exceed details. Only important woman-employing industries are shown separately.

Second in number of employed women but first in number with
harmful exposures were the clothing industries. Over 85 percent of
all women engaged in such work were exposed to organic dusts.
A relatively small proportion of women in the survey worked in the
iron and steel machinery, and vehicle group of industries, but a large

EVALUATION OF EXPOSURE TO TOXICS

proportion of the women there employed worked with materials or
under conditions potentially hazardous. The exposed women in this
industry group averaged almost four exposures—more than in any
other. Exposures included silicate and asbestos dusts, extremes of
temperature, petroleum products, carbon monoxide and other gases,
metallic substances, various oils, waxes, and dermatitis producers.
In the laundry industry women especially need protection from the
high humidity, from the extreme temperatures, and to some extent
from organic dusts. Harmful materials are more diverse in dry
cleaning; in addition to exposure of 58 women to extreme temperature,
35 women were exposed to organic dusts, 12 to acids, 8 to organic
solvents, and smaller numbers to alkalies, organic chemicals, alcohols,
halogenated hydrocarbons, oils, and silicate dusts.
Of the types of harmful material, organic dusts were the principal
potential hazard to women workers. Women were exposed to these
dusts in every industry studied except the clay, glass, and stone
group, and in the following numbers:
Total--------------------------------------------------------

Women
exposed to
organic dusts

Clothing--------------------------------------------------Food and allied
218
Leather
110
Iron, steel, and other metals______________________
Laundries and dry cleaning_______________________
Lumber and furniture__
Paper, printing, and allied
37
Textile---------------------------------------------------------------Chemical and allied
21
Miscellaneous manufacturing
393

1, 491

560
41
40
39
32

One hundred seven women were exposed to the more hazardous
dusts containing silica or asbestos, 52 of these in metals (including
iron and steel).
Extremes of temperature may give rise to many varieties of illness.
Exposure to high temperatures may result in heat exhaustion or heat
stroke, and low temperatures may be a factor in the incidence of
neuralgia and respiratory diseases. Of the 135 women working under
conditions of excessive temperature or moisture, almost two-thirds
(89) were in laundries or dry-cleaning establishments, and another
large group (38) were in metal manufacture. Materials known to
produce dermatitis existed in the principal industries and were poten
tial hazards to 174 women, about half of them being in food and allied
groups. Paper, printing, and allied, and metal industries (including
iron and steel) each had a considerable group.
Ninety women were exposed to alkaline compounds in their work,
chiefly in chemical and allied and food and allied industries.
The dangers of inhalation of even small amounts of carbon monoxide
are well known, and chronic as well as acute cases are not uncommon
in industry. In addition to the processes where high concentrations of
the gas may be a hazard, as in automobile repairing, other processes
where flames come in contact with cold surfaces may give rise to
carbon-monoxide poisoning. Workers may be exposed to the gas
because of leaky gas fixtures or pipes. Common appliances, such as
ironing machines and hand irons, soldering stoves, and gas ovens and
furnaces, may afford an exposure. The metal-manufacturing industry
employed 37 of the 54 women exposed to carbon-monoxide gas.

OCCUPATIONAL DISEASES, 1935 TO 1938

Fifty women were in occupations exposing them to hazards that
may accompany the use of dyes, 29 of them being in the lumber and
furniture industry and 7 each in iron and steel and leather manu
facturing.
Exposure to lead and its compounds was a potential hazard to 11
of the women in the Iowa survey, 7 of whom worked in paper, printing,
or allied industries, 4 in the chemical and allied group.
Table 8 indicates the extent to which the women surveyed were
protected by specified health services. Accident records are kept for
3,875 of all women surveyed, sickness records for 1,478. Least served
by accident records were women in the paper, printing, and allied
industries and in clothing manufacture. Sickness records were not
kept for any women in laundries and dry-cleaning plants, nor in lumber
and furniture factories, nor in paper, printing, and allied industries.
Insurance provision was made for all but 29 of the women, 17 of them
in laundries and dry-cleaning establishments. For a very considerable
number (4,235), represented in every industry but lumber and furni
ture, a part-time physician was available in the plant. The advantage
of a safety director was recognized by employers of 2,825 women; in
most cases only the part-time services of such an official were provided.

Safety provisions:
Safety director 3_------ --------Insurance- Medical provisions:

52
45
134

647

820
853
1,087

284

249

306

118

253
205
253

176
433
176
643
176

863
419
767
1,085
860
676

58
90
106
108
14
72

306
306
__

120
2
41

101
3
94

451
84
451

258
258
258
258
258
258

337
120
312

209
239

176
407

676
1,058

75
134

16
284

105

53
451

258
258

277

253

2, 825
1,177
4, 359

1,828
First-aid kit__ ____
_____ 3, 426
Trained first-aid worker------ 2, 239
Physician (part time) - - ___ 4,235
1, 308
1,052
Statistical information:
1,478
Accident record _ _ ------------- 3, 875

cleaning

171

4,388

m achinery

120

Number of women surveyed____________

L a u n d r ie s
and d ry

E le c tr ic a l

306

B uttons

Lum ber

134

steel

Leather

1,088

ucts

649

Clothing

Iro n and

in g , a n d

allied prod
ucts

Paper, print

allied prod

Food and

C h e m ic a l

tries 2

Health service

and allied
products

of women to whom health services specified were available in
industries surveyed in Iowa, 1938 1

A ll in d u s

Table 8.—Numbers

451

258

339

392

101

45l

258
258
258

322

101

162

1 Iowa. State Department of Health. Unpublished data.
2 Totals exceed details. Only important woman-employing industries are shown separately.
3 All but the 71 in clothing were on part time.

INDUSTRY STUDIES

Of the many industries that have been the subject of investigation
from the point of view of industrial-disease prevention, the following
are summarized here because of their particular interest to employed
women:
Manufacturing:
Pottery—West Virginia.
Shoes—Massachusetts.
Wood heels—Massachusetts.
Asbestos textiles—Pennsylvania and North Carolina.
Service industries, Dry cleaning—Michigan.
Professional occupations, Nursing—Various.

EVALUATION OF EXPOSURE TO TOXICS

Reports on these industries are of great importance to employed
women, in some cases because of the large numbers of women em
ployed, as in shoe manufacture, in others because of the peculiar
susceptibility of women to the hazards presented.
Pottery manufacturing.3
Between September 1936 and July 1937 the United States Public
Health Service, in collaboration with the West Virginia Bureau of
Industrial Hygiene, completed physical examinations, with X-ray of
the chest, of 2,516 men and women engaged in the manufacture of
pottery products in West Virginia. Intensive surveys were made in
10 plants, selected on the basis of a preliminary engineering survey
of the 17 plants operating in the State at this time, to evaluate the
working conditions and investigate methods in use to control health
hazards. Medical examinations were conducted in 9 plants.
More than a third of all workers in the 17 plants in the State were
women, employed in various departments and occupations as follows:
Number
of women

Clay shop------------------ ----------------- -------------------------------------------------------------- 332
Finishers (table ware) 172, finishers and drillers (insulator and porcelainspecialty) 122, trimmers and fettlers 34.
Bisque kiln placers, drawers, and so forth___________ 4g
Bisque warehouse, 339
Brushers, tumblers, sandblasters 308, tile sorters and mounters 25.
Underglaze decorating 134
Printers 39, decorators, decal, foremen 93.
Glaze department 170
Dippers, helpers, spray-machine operators, hand sprayers, foremen, and
miscellaneous 141.
Glost kiln drawers, sagger emptiers 32
Glost warehouse 388
Selectors 49, dressers and chippers, grinders, cleaners, and polishers 140,
warehouse workers 167, foremen and miscellaneous 32.
Overglaze decorating 874
Decal cutters and appliers 479, dusters 145, gilders and liners 107,
patchers and burnishers 26, stampers 51, washer operators 43.
Office, laboratory and miscellaneous 121

Data show that both women and men are likely to work for a longer
time in this industry than in others studied by the Public Health
Service. In 9 of the plants surveyed in 1936-37, 60 women, about 7
percent of the 889 studied, had been employed in the industry from 20
to over 45 years. As many as 249, 28 percent of the total studied,
had worked at pottery manufacture 10 and under 20 years.
In making this study of the lead hazards involved in pottery fac
tories, all the 92 men and 45 women making glaze, dipping ware in
glaze, or handling glaze-coated articles were examined. One man,
a dipper, was suffering from lead poisoning, and 6 other persons, 1 a
woman employed as a dipper’s helper, showed signs of lead absorption.
The results of the medical study for lead poisoning indicate a very
considerable reduction in incidence of lead poisoning since the pottery
study of 1919.4 The reduction is attributed to the substitution of
fritted glazes for glazes containing more readily soluble lead com
pounds, and to the mechanical methods of applying glaze in use in
3U. S. Public Health Service. National Institute of Health. Division of Industrial Hygiene. Public
Health Bull. No. 244. Silicosis and Lead Poisoning Among Pottery Workers. February 1939. Figures
1, 2, and 3, reproduced from figures 10, 19, and 65 on pp. 18, 38, and 121, respectively, are gratefully
acknowledged.
4 U. S. Public Health Service. Public Health Bull. No. 116. Lead Poisoning in the Pottery Trades.
1921.

OCCUPATIONAL DISEASES, 1935 TO 1938

many factories. The warning is made that where soluble lead com
pounds arc added to the glaze before use and hand dipping is the method
used or the spray machines are inadequately ventilated, the danger of
poisoning is as great as ever.
The progress has by no means been so good in lessening the hazards
from silicosis. Authors of the report conclude from engineering study
of the industry that the gravity of the dust problem in the clay shops
has not been adequately appreciated. In the clay shop a great vari
ety of operations for forming ware are in use. The formed ware is
placed on ware boards and air-dried to remove most of the remaining
moisture. When sufficiently dry it is finished or fettled. Fettling
and finishing are principally done by women who may be exposed to
dangerous concentrations of dust. A single dust count made at the
breathing level of a fettler working over a down-draft ventilator such
as is pictured in figure 1 gave a valve of 2 million particles per cubic
foot, while fottlers in other plants wore exposed to an average of 19
million particles per cubic foot.
A large number of women are in occupations that may have a dust
hazard in the bisque warehouse. Much of the work of women is in
sandblasting, and much of the ware, particularly flatware, is now
cleaned in sandblast machines, such as that shown in figure 2. These
machines are provided with exhaust ventilation, requiring careful
periodic inspection. Even partial failure of the ventilating system
could result in the release of large quantities of dust.
In the careful medical examination of nine potteries 22 women were
found to have silicosis, 5 of them second-stage cases complicated by
infection. Seventeen were in the first stage, 10 without complications,
2 with tuberculosis, and 5 with infection of a nonspecific nature. Of
these women with silicosis, 12 were 25 to 34 years of age, 1 was
younger, 2 were 45 or older.
Eight of the 14 women who had worked at finishing and fettling for
more than 20 years were found to have silicosis. One of the women
silicosis victims who had been working as a fettler of tile in a press
room for 14 years was exposed to an estimated dust of 153 million
particles per cubic foot—an unusually high dust concentration for
this type of fettling. Tableware finishing and fettling are carried on
by women who are exposed to an average dust concentration of 12
million particles per cubic foot, of which about 33 percent is quartz.
As the chart, figure 3, shows, silicosis was found in 11 percent of the
finishers and fettlers employed in these operations from 10 to 19 years,
in 37 percent of those employed from 20 to 29 years, and in 83 percent
of the group employed for more than 30 years.
A similar rise in the incidence of silicosis with length of employment
is observable if all clay-shop workers are grouped together. Two
women working as decorators were found to have silicosis contracted
in the course of earlier employment in the clay shop.
Bisque- and glost-kiln workers have similar dust exposures, about 6
million particles per cubic foot. Because of relatively high wages they
tend to remain for long periods in the industry. Silicosis was found
in 6 percent of those employed from 10 to 19 years, 21 percent of
those employed 20 to 29 years, and in 52 percent of those employed
over 30 years.

ills?
W 25®*:;

■RBPPM" ■

Figure I.—Greenware Fettling Under Controlled Conditions Over Down
Draft Ventilation.

:)W^SW-

Hwlp&ftii

Figure 2.—Sandblasting Tableware.

EVALUATION OP EXPOSURE TO TOXICS

Operations offering no exposure to the silicosis hazard include
decorating, selecting ware, and work in the mold shop and officework usually carried on in buildings or parts of buildings remote from
dust-producing operations.

Years in industry
Number exposed__

10-19
37

20-29

Over 30

Figure 3.—Percentage Of Finishers And Fettlers Who Were Found To
Have Silicosis.

Two fatal cases of silicosis occurring in the plants studied are
reported. One of these was a 26-year-old white woman who had
worked for 5 years as a “finisher or remover” in the press room of a
tile plant with an estimated dust exposure of more than 200 million
dust particles per cubic foot. Symptoms of the disease were first
noticed 2 years before her death. Radiograms taken during the 15
months’ hospitalization preceding death, the post mortem radiogram
and the autopsy following gave a picture of advanced silicosis.
Asbestos textiles.
Asbestos textiles employed approximately 8,000 wage earners in
the United States in 1929, 1,100 of them women. Asbestosis was
recognized clinically in 1900, but it was not until 1930 that a study
was made evaluating the degree of exposure in the industry.5 Nearly
a fourth of the plants and about two-fifths of the wage earners were in
two States, New Jersey and Pennsylvania.
Pennsylvania, second in production of asbestos products, was the
scene of an exposure study in the industry, findings of which were
ardjC' ?V' P™*- Report OP Effects of Asbestos Dust on the Lungs and Dust
Suppression in the Asbestos Industry. Home Office. H. M. Stationery Office, London, 1930.

OCCUPATIONAL DISEASES, 1935 TO 1938

published in 1934 and 1935.6 This study covered four plants and in
cluded not only data on the nature and amount of dust encountered
but a report on the effects on the health of a group of workers of
exposure to dust. While the various occupations differed considerably
in dust concentration, occupation is not always important, since all
the operations may take place in the same room.
Complete physical examinations were made of 64 persons, 48 men
and 16 women. Seven of the men were without previous exposure
and were used as controls. The workers chosen for study were all
employed in textile manufacture and a large proportion were those
longest employed in the industry. The disease was found in 2 of the
women and 12 of the men, or 25 percent of the exposed group. Three
other persons were diagnosed as doubtful, the remaining 40 negative.
A study of the asbestos-textile industry of North Carolina found
substantially the same proportion of workers (27.5 percent) having
asbestosis.7 Of the 481 employees in 4 plants studied, 90 were women,
employed in the following occupations:
Dust exposure in
occupations employing
Number of
women (Million
women
particles per cubic foot)
Minimum Maximum

Total 90
Spoolers 22
Winders 28
Creelers and cop winders (cloth weaving) 11
Tape weavers and calenderers 7
Cord, rope, and braid workers 12
Twisters--- ------------Treaters 2
Office and shipping clerks-------------------------------------------

1
7

___

____

3.
1.
3.
2.
1.
3.
1.

13.
8.
9.
5.
10.
13.
3.

2
2
6
4
2
2
7

1
0
8
1
2
2
6

. 12

Concentration of dust has a direct correlation with incidence of
asbestosis. None of the employees exposed to dust concentrations
below 2.5 million particles per cubic foot had a case of asbestosis, and
three doubtful cases fell in the range 2.5 to 4.9 million particles.
Clean-cut cases of asbestosis were found only in dust concentrations
exceeding 5 million particles. Engineering study demonstrated that
it is possible to reduce the dust exposure of a majority of asbestostextile workers to less than 5 million particles per cubic foot.
Shoe industry.8
The Massachusetts Division of Occupational Hygiene included in its
industrial chemical survey of 1936, 49 establishments making shoes.
Employed were 7,970 women, 44 percent of all workers. Thirty-one
of the establishments used materials containing benzol. The chief
use of benzol in the shoe industry is in rubber cements, but it is found
also in stains and cleaners. In quantity of benzol, rubber-heel
cements and breasting cements are most important. Benzol was
used more commonly in the Massachusetts factories making highgrade shoes, in about 9 in 10 of these compared with only 1 in 7 of
those making the cheap types of shoe.
6 Pennsylvania. Department of Labor and Industry. Special Bull. No. 37. Asbestosis. Oct. 1, 1934.
Special Bull. No. 42. Asbestosis. Sept. 20, 1935.
7 U. S. Public Health Service. Public Health Bull. No. 241. A Study of Asbestosis in the Asbestos
Textile Industry. August 1938. p. 16 ff.
8 Massachusetts. Division of Occupational Hygiene. Report for year ending November 30,1936. pp. 13
to 17.

EVALUATION OF EXPOSURE TO TOXICS

Tests made of the 6 processes involving the use of benzol cements
and not equipped with blower systems showed, in every case but 2,
amounts of benzol vapor greater than 100 parts per million, the greatest
concentration considered safe for all-day exposure. Local exhaust
systems in several of the same operations resulted in exposure of less
than 50 parts per million.
Tests of exposure in various individual operations using benzol
showed women employed in breasting and using a breasting cement
analyzing 50 percent benzol to be exposed to an average of 355 parts
per million under natural ventilation. Women cementing rubber
heels under local-exhaust ventilation had some exposure, but much less
than the maximum safe concentration.
Air analyses for other solvents showed workers exposed to acetone
in bleaching soles, to acetone and ethyl acetate in pasting underlays,
and to ethyl acetate in cementing lasting allowance. Found in small
quantities were carbon tetrachloride, methanol, and carbon bisulphide.
Wood-heel covering.9
An important source of employment for women in Massachusetts,
the wood-heel-covering industry, employed in 1934 a total of 1,249
persons in 41 establishments. Practically all employees were women.
In the 1936 industrial chemical survey, 13 plants, employing 508
persons, were studied. Women working in the covering rooms are
exposed to methanol vapors. Methanol when breathed as vapors,
though rarely fatal, may have serious effects on nervous tissue, partic
ularly the optic nerve. Exposure may result in temporary or
permanent blindness.
Air analyses in eight plants showed average concentrations of the
vapor varying from 160 parts to 780 parts per million in the covering
rooms surveyed. Average exposure exceeded the accepted safe maxi
mum of 200 parts per million in five of the eight plants. While
general ventilation was entirely inadequate in large rooms, it was
found possible to install at small expense equipment with local exhaust
ventilation bringing the exposure well below the maximum limit.10
Dry cleaning.11 *
In a survey of the health hazards of 2,141 inside employees in 97
dry-cleaning establishments in Detroit and the surrounding area, 1,147
women were studied. The principal occupations women operatives
were engaged in may be listed as follows:
Pressers—fancy
Pressers—steam 179
Tailors and seamstresses 159
Shippers and receivers 154
Spotters—fancy 43

392

In point of numbers the principal exposures were of a physical
nature. Constant lifting and pressure on the irons necessary in hand
pressing exposes these workers to tenovitis, an inflammation of the
cords in the backs of the hands. Steam-press operators and to a less
extent hand pressers using electric irons are subject to excessive heat.
9 Ibid., pp. 17-20.
10 Ibid. Year ending November 30, 1937. pp. 139-40.
11 Cary, W. H., Jr., and Hepler, John M. Health Hazards in the Dry-Cleaning Industry. Industrial
Hygiene Section, American Public Health Association. New Orleans. 1936. Mimeographed.

OCCUPATIONAL DISEASES, 1935 TO 193 8

Steam-press operators are subject also to hazards of posture, since in
operating the presses they are required to use both feet as well as their
hands. Other exposures grow out of the use of spotting fluids (52
compounds listed), in addition to the naphtha solvents and chlorinated
hydrocarbons used in general cleaning. The numbers of women
exposed to these conditions and materials follow:
Total973
Tenovitis 377
Heat_____________________________________________
Posture 191
Spotting fluids 52
Chlorinated solvents..

326
27

The study found many agents in use that have never been ade
quately investigated in connection with possible toxic properties under
commercial use. Other findings include these facts: (1) In every in
stance of the use of chlorinated solvents a definite exposure was found
to exist; (2) in most cases where very volatile petroleum products such
as cleaners’ naphtha and gasoline were used, unsafe concentrations of
vapors were found; (3) dermatitis occurs on the hands and arms of
practically all workers using solvents; (4) fancy spotters are exposed
to a wide variety of solvent vanors. In specific instances spotters
were found exposed to chlorinated-solvent vapors as much as cleaners
working with the solvents.
In plants using synthetic solvents the cleaning operation generally
is conducted in the same building and often in the same workroom as
finishing and other operations, so neighboring workers in many cases
are exposed to the toxic vapors produced by the solvents used by the
cleaners, spotters, and soap makers.
The difficulty of carrying out an adequate program of prevention is
increased by the seasonal character of the industry and by the small
units commonly in operation. Of the 97 plants inspected, 66 had 25
or fewer employees, 44 of these having not more than 10. Only 4 had
over' 100 employees. Peak employment occurs in the spring.
The nursing profession.
The relation between tuberculosis and occupation is not easy to
establish, but it is generally recognized that exposure to the tubercle
bacilli through contact with cases of tuberculosis is an occupational
hazard for nurses. A number of investigations of the extent of the
problem as it relates to nurses have been made in recent years.
In a study of 12,000 university students overwhelming preponder
ance of lesions in students of the schools of nursing and medicine was
noted, as compared to other departments. Of the three nursing
schools included in a study 12 continuing since 1929, one had a 30-bed
tuberculosis service and each student was required to spend 3 months
on this service before graduation. Of all the students who entered
this school from the fall of 1929 until 1937, 22.8 reacted positively to
the tuberculin test on admission and 94.3 percent on graduation.
The other hospitals had no regular tuberculosis service, but they
accepted occasional patients for diagnosis and treatment and one of
them had 1-year affiliation with a tuberculosis sanatorium. The18
18 Myers, J. Arthur. Tuberculosis Among Nurses. In Public Health Nursing, February 1939.

EVALUATION OF EXPOSURE TO TOXICS

percentages of students graduating from these schools with a positive
tuberculin test were respectively 43.6 and 35.3.
The high incidence of infection in students of nursing makes a
sharp contrast with the marked decline in incidence of positive reaction
among young adults in the general public. Of students attending the
school of education of the University of Minnesota in about the same
age groups as the student nurses, approximately one in a hundred in
each of the 4 school years became infected. Other studies show that
the infection attack rate in the community is about this figure.
That the hazard can be eliminated if it is recognized is evidenced by
a study of Bellevue Hospital nurses published in 1936. In a 5-year
period “tuberculosis * * * has been controlled so that its serious
ness as a disabling and fatal disease does not appear to exceed that
expected among young women in other occupations in New York
City.”18
Nurses have been awarded compensation for tuberculosis as an
occupational disease by the industrial commissions of Massachusetts,
New York, North Dakota, and Wisconsin.
>3 Amberson, J. Burns, Jr., and H. McLeod Riggins. Tuberculosis Among Student Nurses: A Five-Year
Study at Bellevue Hospital. Annals of Internal Medicine, vol. 10, August 1936.

Part IV.—PROGRESS IN PREVENTION, 1935 TO 1939 1
Enactment of occupational-disease compensation laws.2
The years 1935 to 1939 have seen greatly increased interest in
problems connected with the diseases of industry, an interest resulting
in legislation in a number of States. At the close of 1934 only 12
States, 3 Territories, the District of Columbia, and the Federal
Government compensated for occupational diseases. By the close of
the legislative sessions of 1939 the number of States had doubled.3
Quite as important were the amendments enacted in New York in
1935, in Illinois in 1936, and in Ohio in 1939, which added to the
schedule of diseases to be compensated in the State “any and all other
occupational diseases.” In Minnesota the schedule was enlarged to
include certain diseases due to the hazards of fire fighting, and to
make compulsory the reporting of all occupational diseases by phy
sicians. In Washington the occupational-disease law of 1937 was
amended to delete the provision that cost coverage should be borne
equally by employer and employee.
On the other side of the ledger must be placed the 1939 amendment
to the Pennsylvania occupational-disease law of 1937. While this
amendment provided the same coverage as before, it greatly reduced
the benefits injured workers will receive.
Of the 30 occupational-disease laws now on the statute books, 15
are laws in which the compensable diseases are listed.4 There is
considerable variation in the number of diseases included in these
statutes, and even the longest lists fall short of the ideal situation—■
that industry bear the costs of all injuries resulting from its productive
processes.
The remaining 10 States, the District of Columbia, two Territories,
and the two Federal laws compensate for these diseases by general
coverage, either a blanket inclusion under the law of all diseases
peculiar to the occupation or a use of the word “injury” to cover both
accidents and diseases.
That there is a trend away from the schedule plan of compensation
is evidenced by the change from a schedule to a blanket law in New
York, Illinois, and Ohio. From the resolutions and recommendations
made by the International Association of Industrial Accident Boards
and Commissions and by the Conferences on Labor Legislation held
by the Secretary of Labor, it is apparent that administrators of work
l Though the preceding pages of this report deal with the occurrence and prevention of occupational dis
eases as reported for 1935-38, legislation relating to this subject includes 1939.
___
! F0r detail of laws see U S Bureau of Labor Statistics Bull. No. 652, Occupational-Disease Legislation
in the United States, 1936, with appendix for 1937, and Monthly Labor Review, July 1939, pp. 136-139.
3 Arkansas (suspended pending referendum vote), California, Connecticut, Delaware, Idaho, Illinois,
Indiana, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New Jersey,
New York, North Carolina, North Dakota, Ohio, Pennsylvania, Rhode Island, West Virginia, Washington,
and Wisconsin.
,, , „
4 Arkansas (38 diseases), Delaware (12 diseases), Idaho (15 or more diseases), Kentucky (diseases due to
inhalation of gases or silica dust), Maryland (34 diseases), Michigan (31 diseases), Minnesota (23 diseases),
Nebraska (diseases of three industries), New Jersey (10 diseases), North Carolina (25 diseases), Pennsylvania
(12 diseases), Rhode Island (31 diseases), Washington (21 diseases), West Virginia (silicosisonly), and Puerto
Rico (15 diseases),

PROGRESS IN PREVENTION, 193 5 TO 193 9

men’s compensation laws agree in favor of complete coverage of all
diseases of industry. The Committee on Workmen’s Compensation
of the Conference on Labor Legislation recommended in 1934 and at
each succeeding annual meeting that a blanket coverage of occupa
tional diseases be adopted in preference to the schedule coverage.5
In line with the recent development of legislation in the field of
compensation for occupational disease, a number of States authorized
commissions to study the legislative problems involved and submit
reports to the legislatures. During 1939 such commissions were
appointed in New Hampshire, Oregon, Tennessee, Texas, and Utah.8
Industrial hygiene activity in the United States.
In 1935 it became possible for the Federal Government to use
Social Security funds in cooperation with State authorities in the
development of State industrial-hygiene projects. As a result divi
sions of industrial hygiene have been established in the public-health
departments of a number of States. In addition to the two divisions
previously established in State labor departments 67 and the two in
State health departments,8 there has been set up in the health depart
ments of 25 States special personnel for investigation of the industrialhygiene problems of the State. The importance of such research and
regulatory bodies has been discussed elsewhere,9 and something of the
work already accomplished by the new divisions has been summarized
in part III of the present study.
Development of independent agencies for the prevention of occupa
tional diseases.10
•
Agencies not governmental in character have played an important
part in industrial-health work in recent years. Certain private
foundations and agencies have been active in this field for many
years, for example, the American Association of Industrial Physicians
and Surgeons organized in D etroit in 1916. For a quarter of a century
the American Public Health Association has engaged through its
Industrial Hygiene Section in a study of industrial-health problems.
Illustrative of the work of groups of employers in safeguarding the
health of workmen is the Air Hygiene Foundation of America, Inc.,
a nonprofit organization supported by 250 affiliated corporations with
approximately a million members. In addition to research in indus
trial health, the foundation makes plant surveys and special investi
gations for member companies, and serves as a central agent for the
collection and distribution of data on occupational-health topics.11
Among notable efforts of labor organizations in the field of industrial
health is the Union Health Center, since 1934 an integral part of the
International Ladies’ Garment Workers’ Union. Supported almost
entirely by fees from its members, it has developed a health program
largely responsible for the fine health showing among New York
garment workers. Recent evidence of the value of its work lies in
6 Monthly Labor Review, April 1934, p. 781, November 1935, p. 1261, December 1936, p 1440- and U S
Department of Labor, Division of Labor Standards, Proceedings of the National Conference on Labor
Legislation. 1937 and 1938. Bulls. No. 18 and 25.
6 National Safety News, January 1940, p. 58.
7 Massachusetts and New York.
8 Connecticut and Ohio.
9 U. S. Women’s Burean Bull. No. 114, State Reporting of Occupational Diseases. 1934. pp. 29-32.
American Medical Association, Proceedings of First Annual Congress on Industrial Health, January
1939, pp. 17 19.
'
11 National Industrial Conference Board, Inc., Management Record, January 1940, pp. 9-10,

OCCUPATIONAL DISEASES, 1935 TO 1938

the report of New York City’s Tuberculosis Bureau, in which it was
found that the tuberculosis rate among garment workers in the city,
which is 1 in every 150 persons among members of the International
Ladies’ Garment Workers’ Union, is only about half the general rate
for the city’s population.12
Labor organizations must be given credit, too, for pressure on the
employers and State authorities for control of chemical hazards in the
rayon industry of Pennsylvania,13 in the fur-felt-hat industry of Con
necticut, in the manufacture of insulated electrical wires, and in other
highly organized industries. An indication that organized labor
realizes its stake in the movement for healthful working conditions is
found in the increased mention of the subj ect in labor contracts. An
analysis of 7,000 labor contracts revealed that 2,500 carried some
provision relating to safety and health.14
Among other organizations whose work should be consulted in a
study of preventive programs are the following: American Medical
Association (Section on Preventive and Industrial Medicine and
Public Health), American Public Health Association (Industrial Hy
giene Section), American Standards Association, National Safety
Council, National Tuberculosis Association, Industrial Health Con
servancy Laboratories. The insurance agencies are another group of
independent associations actively interested in the promotion of indus
trial health work. A number of compensation carriers maintain in
dustrial hygiene laboratories for the purpose of assisting plants they
insure.
A recent study made by the National Industrial Conference Board,
covering 301 establishments, shows the extent to which individual
firms investigate cases of occupational disease.16 Slightly over fourfifths of all the establishments investigated occupational diseases oc
curring, and the proportion rose to 96 percent for establishments with
as many as 5,000 employees. The need for investigation of diseases
of industry is not so well recognized as the need for investigation of
industrial accidents. Over nine-tenths of all establishments investi
gated accidents and without exception all the largest firms made such
investigations. It is interesting to note that nearly 70 percent of the
154,265 women covered by the study were found in the 22 companies
having 5,000 or more workers. As would be expected because of the
cost of such supervision, it is the large companies that are most likely
to supervise the health of employees, to provide for physical examina
tions, and to furnish adequate medical and health programs.
Among the programs of individual employers whose health programs
have been outstanding may be mentioned the medical work of a large
communications organization, one feature of which is a health and
nutrition course for its women employees. Others include a large
chemical plant, whose laboratory of industrial toxicology determines
the toxicity of the chemical products manufactured by the founding
firm and recommends safe methods for their use.* il
12 New York Times, February 6, 1940, p. 20.
il Perkins,Frances. The Worker’s Stake in Industry. U. S. Government Printing Office, 1940.
National Industrial Conference Board, Inc. Studies in Personnel Policy, No. 17, Medical and Health
Programs in Industry. 1939.

Full text of The Occurrence and Prevention of Occupational Diseases Among Women, 1935 to 1938 : Women's Bureau Bulletin, No. 184

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