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The Performance o f Physically Impaired W orkers in Manufacturing Industries A Report prepared by the Bureau of Labor Statistics fo r the Veterans Administration Bulletin No. 923 UNITED STATES DEPARTMENT OF LABOR Bureau of Labor Statistics V eterans A dministration, Washington, D. C., November 28, 1947. 1. This study on the Performance of Physically Impaired Workers in Manu facturing Industries has been prepared by the United States Department of Labor at the request of, and with funds provided by, the Veterans Administration. 2. Authorization for making the study is contained in Public Law No. 16, 78th Congress, Section II, Part VII, Paragraph 9, which reads in part as follows: 9. T he Administrator shall have the power * * * to make, or, as b y agreement with other agency or institution, cause to be made studies, investigations, and reports inquiring into the rehabilitation of disabled persons and the relative abilities, aptitudes, and capacities of the several groups of the variously handicapped and as to how their potentialities can best be developed and their services best utilized in gainful and suitable em ploym ent * * *. Omar N . B radley, General, U. S. A r m y , Administrator of Veterans Affairs. UNITED STATES DEPARTMENT OF LABOR L. B. SchweUenbach, Secretary BUREAU OF LABOR STATISTICS Ewan Clague, Commissioner The Performance o f Physically Impaired W orkers in Manufacturing Industries A Report prepared by the Bureau o f Labor Statistics fo r the Veterans Administration Bulletin No. 923 UNITED STATES GOVERNMENT PRINTING OFFICE WASHINGTON : 1948 LETTER OF TRANSMITTAL U nited States D epartment of L abor, B ureau of L abor Statistics, Washington, D. C., November 28, 1947. T he Secretary of L abor : I have the honor to transmit a study on the performance of seriously physically impaired workers in manufacturing industries. The study was made possible through the financial assistance of the Veterans Administration. The report was prepared in the Industrial Hazards Division by Henry S. Hammond, assisted by Frances J. Montgomery and Norbert J. Prager. The work was under the direction of Max D. Kossoris, Chief of the Industrial Hazards Division. This is the first comprehensive, objective survey conducted in this field in the United States. E wan Clague, Commissioner. Hon. L . B . SCHWELLENBACH, Secretary of Labor. For sale by the Superintendent of Documents , U. S. Government Printing Office, Washington 25, D. C. Price 55 cents Foreword Since the original compilation of this report late in 1947 much work has been accomplished in liaison with the Veterans Administration in the final preparation of this document for public use. The January edition of the Monthly Labor Review published a digest of some of the more pertinent findings of the study, as part of our effort to provide facts for the private and governmental groups working for greater employment possi bilities for handicapped men and women. Since General Bradley has left the Veterans Administration, the same co operative liaison has been carried on under the administration of Carl Gray. This report is published for the information and education of the American people, employers, employees, and consumers, veterans and nonveterans, men and women, citizens all. June 30, 1948 David A. Morse, Acting Secretary of Labor CONTENTS Page Introduction_____________________________________________________________________________________ 1 The impaired worker in industry: A. Summary of statistical findings___________________________________________________________ 3 W ork performance_________________________________________________________________________ 4 M obility of working force____________________________________________________________ 4 Quality of work performance________________________________________________________ 4 Absenteeism------------------------------------------------------------------------------------------------------------------ 5 Nondisabling injury experience______________________________________________________ 6 Disabling injury experience---------------------------------------------------------------------------------------- 8 Output relative________________________________________________________________________ 10 Quit rate_______________________________________________________________________________ 11 Composition of the survey group_________________________________________________________ 12 Geographical coverage--------------------------------------------------------------------------------------------------------- 15 Industry coverage__________________________________________________________________________ 16 Occupations of impaired workers_________________________________________________________ 17 Placement practices------------------------------------------------------------------------------------------------------------- 19 The hernia cases: Summary of statistical findings___________________________________________________________ B. C. D. 22 Composition of the survey group_________________________________________________________ 22 Industry and occupational coverage______________________________________________________ 23 Placement p ractices_______________________________________________________________________ 28 W ork performance_________________________________________________________________________ 28 Absenteeism___________________________________________________________________________ 28 Nondisabling injury experience______________________________________________________ 29 Disabling injury experience---------------------------------------------------------------------------------------- 30 Output relative________________________________________________________________________ 31 Quit rate------------------------------------------------------------------------------------------------------------------------ 31 The cardiac cases: Summary of statistical findings______________________________________________ .____________ 33 Composition of the survey g r o u p ________________________________________________________ 34 Industry and occupational coverage--------------------------------------------------------------------------------- 34 Placement practices------------------------------------------------------------------------------------------------------------- 38 W ork performance_________________________________________________________________________ Absenteeism___________________________________________________________________________ Nondisabling injury experience---------------------------------------------------------------------------------- 39 39 40 Disabling injury experience__________________________________________________________ 41 Output relative________________________________________________________________________ 42 Quit rate------------------------------------------------------------------------------------------------------------------------ 42 T he vision cases: Summary of statistical findings___________________________________________________________ Composition of the survey group-------------------------------------------------------------------------------------- 43 43 Industry and occupational coverage______________________________________________________ Placement practices------------------------------------------------------------------------------------------------------------ 45 51 W ork performance_________________________________________________________________________ 52 Absenteeism___________________________________________________________________________ 52 Nondisabling injury experience---------------------------------------------------------------------------------- 53 Disabling injury experience---------------------------------------------------------------------------------------- 54 Output relative------------------------------------------------------------------------------------------------------------- 55 Quit rate----------------------------------------------------------------------------------------------------------------------- 56 The orthopedic cases: Summary of statistical findings----------------------------------------------------------------------------------------- 57 Composition of the survey group-------------------------------------------------------------------------------------- 57 Industry and occupational coverage--------------------------------------------------------------------------------- 59 Placement practices________________________________________________________________________ 69 v CONTENTS VI D. E. The orthopedic cases — Continued W ork performance___________________ 69 Absenteeism_____________________ 69 Nondisabling injury experience. 70 Disabling injury experience____ 71 Output relative__________________ 72 Quit rate_________________________ 73 The hearing cases: Summary of statistical findings_____ F. 74 Industry and occupational coverage. 75 Placement practices__________________ 79 W ork performance___________________ 80 Absenteeism_____________________ 80 Nondisabling injury experience. Disabling injury experience____ 81 82 Output relative__________________ 83 Quit rate_________________________ 83 The multiple impairment cases: Summary of statistical findings_____ G. 74 Composition of the survey group___ 84 Composition of the survey group___ 84 Industry and occupational coverage. 85 Placement practices__________________ 93 W ork performance___________________ 93 Absenteeism______________________ 93 Nondisabling injury experience. 94 Disabling injury experience____ 95 Output relative__________________ 95 Quit rate_________________________ 95 The ex-tuberculous cases: Summary of statistical findings_____ 97 Composition of the survey group___ 97 Industry and occupational coverage. 98 Placement practices__________________ 100 100 100 101 102 W ork performance___________________ Absenteeism_____________________ Nondisabling injury experience. Disabling injury experience____ Output relative__________________ Quit rate_________________________ 103 103 H . The peptic ulcer cases: Summary of statistical findings_____ 104 Composition of the survey group___ 104 Industry and occupational coverage. 105 Placement practices__________________ 106 W ork performance___________________ 107 Absenteeism_____________________ 107 Nondisabling injury experience. 107 Disabling injury experience____ 109 Output relative__________________ 109 Quit rate_________________________ 109 I. The diabetic cases: Composition of the survey group___ 110 110 Industry and occupational coverage 111 Placement practices__________________ 112 W ork performance___________________ 112 Absenteeism _____________________ 112 Summary of statistical findings_____ Nondisabling injury experience. 113 Disabling injury experience____ 114 Output relative__________________ 114 Quit rate_______ ______ ___________ 114 CONTENTS J. VII The epileptic cases: Summary of statistical findings___________________________________________________________ 115 Composition of the survey group_________________________________________________________ 115 Industry and occupational coverage--------------------------------------------------------------------------------- 115 Placement practices________________________________________________________________________ 116 W ork performance_________________________________________________________________________ 117 Absenteeism___________________________________________________________________________ 117 Non disabling injury experience______________________________________________________ 118 Disabling injury experience__________________________________________________________ 118 Output relative_______________________________________________________________________ 119 Quit rate______________________________________________________________________________ 119 Appendix: Scope and method of the s tu d y :_________________________________________________________ 120 Definition of impaired worker_______________________________________________________ 120 W ork performance factors studied__________________________________________________ 121 Selection of plants____________________________________________________________________ 122 Selection of survey group____________________________________________________________ 122 Collection of the d ata________________________________________________________________ 123 Processing of the d ata_______________________________________________________________ 123 W eighting_____________________________________________________________________________ 124 Presentation of the data_____________________________________________________________ 124 Forms used in the survey: Worksheet A — Employee record (Exhibit I ) _____________________________________ 125 Worksheet B — Absenteeism (Exhibit I I ) _________________________________________ 126 Worksheet C — Medical visits (Exhibit I I I ) ______________________________________ 127 Worksheet D — Disabling accident record (Exhibit I V ) _________________________ 128 Worksheet E — Occupational data (Exhibit V ) ___________________________________ 128 Worksheet F — General information (Exhibit V I ) ________________________________ 129 Worksheet G — Job separations (Exhibit V I I ) ____________________________________ 132 I. 133 B . M . tabulation schedule (Exhibit V I I I ) -------------------------------------------------------- The Performance o f Physically Impaired Workers in Manufacturing Industries Introduction Has industry a place for the person with a serious physical impairment? Is he a desirable employee? Can he hold his own in competition with unimpaired workers? The answers to these questions may well determine whether the man with a serious physical impairment shall take his place on the production line or in the bread line. No reliable estimates of the number of seriously physically impaired persons, either in the population or in the labor force, are available. On the basis of fragmentary data, the number of persons of employ able age who have disabilities serious enough to create difficulty in finding gainful employment is estimated at five or six millions. Each year additional thousands incur permanent disabilities as the result of illness or injury. In addition, approximately 2 million veterans who were disabled in the services are or will be a part of the labor force. Even in the absence of exact figures on the number of physically impaired persons in the population, it is clear that the total is appallingly large. The very size of the group creates an economic problem of serious proportions. As a practical matter, it is a question of whether these persons shall be productive members of their communities or whether they shall be public charges. The urgency of the problem is further emphasized by the fact that legislation was proposed in the seventy-ninth Congress to require that some propor tion of each employer’s pay roll be made up of im paired persons. This proposed legislation was similar to a British law which has been in effect for several years. Without attempting to evaluate the merits of the British practice, legal compulsion may not be a desirable solution in this country, because the impaired workers might, to cite only one reason, be stamped as an undesirable minority group in capable of satisfactory work performance. The purpose of the study upon which this report is based was to obtain factual answers to the follow ing basic questions: Will the impaired be able to keep up with production schedules? Will they tend toward excessive absenteeism? Will they display a proneness toward work injury and thereby increase workmen’s compensation insurance costs? Will they be stable on the job or will they be short-term employees? The most reliable answers to these questions, it was be lieved, could be found by examining the performance of impaired workers who had been employed in in dustry and basing the answers on the facts revealed by industry’s own records. The function performed by the Bureau of Labor Statistics was to assemble and organize into usable form the data obtained from many sources. This report of the findings is presented in 11 parts, of which the first gives a comparison of the work performance of the whole survey group of impaired and unimpaired workers. The 10 remaining parts are arranged in order of the size of the survey group; each of these contains the complete findings on the performance of one of the specific impairment types included in the study. Although this arrangement inevitably led to some repetition, it was believed that the material would be more useful in this form to those persons whose work or interest is with a specific kind of impairment. The methods used in this study are described in the appendix (p. 120). Acknowledgment is owed to the many persons and agencies whose published work in this field provided invaluable aid to the present study. The wholehearted interest and cooperation extended by the Veterans Administration, by the Veterans Em ployment Service, and by many other interested agencies — both private and governmental — played an important part in the successful completion of this work. The firms and the many plant officials who 1 2 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES contributed time and facilities in making the data available to the Bureau’s field representatives were extremely cooperative and provided many construc tive suggestions and criticisms. Special acknowledg ment is due an advisory committee composed of the following members: D r. Ira D . Scott Director, Advisement and Guidance Service Veterans Administration M r. Eugene Taylor Assistant Veterans’ Consultant New York Times D r. H . P. Dutton Chairman, Research Committee Society for the Advancement of M anagement D r. Dean A . Clark Medical Director Health Insurance Plan of Greater New York D r. R . B . Teachout Chairman, Rating Schedule Board D r. Rufus B . Crain Veterans Administration Assistant Medical Director Eastm an Kodak Co. Dr. H . Dwight Y ork Special Assistant for Planning, Registration and Research Service Veterans Administration D r. Thom as L . Shipman W orks Physician, River W orks General Electric Co. M r. T ed F . Silvey M a j. A . R . Cullimore Reconversion Officer President, Newark College of Engineering Congress of Industrial Organizations M r. M artin P. Durkin General President United Association of Journeymen Plumbers and Steamfitters The contributions made by this committee were invaluable, particularly in organizing and formulat ing the study. The Impaired Worker in Industry Summary of Statistical Findings The objective measures of work performance in this report reflect the experience of about 11,000 im paired and 18,000 matched unimpaired workers subject to the same job incentives and exposed to the same job hazards. These measures are based on data taken from industry’s own records. Analysis of the data shows conclusively that the physically impaired person was not necessarily a handicapped worker. When given reasonable job placement consideration — that is, the individual’s abilities balanced against the job requirements — the physically impaired workers as a group were fully able to compete suc cessfully with unimpaired workers similarly placed. An examination of the work-performance data in table 1 makes it apparent at once that the outstand ing features of the comparison are the similarities between the impaired and unimpaired workers. Differences in the measures of work performance between the two groups were fractional for the most part, with the balance slightly in favor of the im paired worker group: impaired workers produced at a slightly better rate and had relatively fewer dis abling work injuries than did unimpaired workers on identical jobs. The two groups had identical fre quency rates of nondisabling injuries, and average rates of absenteeism showed only nominal differences. Although the voluntary quit rate was higher for the impaired group, it is questionable whether the differ ence is large enough to be counted significant. It was equally true of the impaired and the un impaired workers that some made exceptionally good records and that a few made very poor records. It would be absurd to assume that the existence of a severe physical impairment automatically makes the T a b l e 1 . — W ork performance of workers with serious physical impairments, and of matched unimpaired workers Disabling injury Absenteeism frequency rate1 Group Nondisabling injury frequency rate2 Frequency rate3 Time-lost rate4 Average days of disability5 Output relative 6 Quit rate7 Average performance Total: Impaired..... ............................... .............................................. Unimpaired....................................... ......... ......... ................... 3.8 3.4 9.9 9.9 8.9 9.5 0.10 .11 14.5 14.9 101.0 100.0 3.6 2.6 Male: Impaired________ _______ _________ ____________________ Unimpaired------------------------- ---------- ---------------------------- 3.6 3.2 10.1 10.1 9.3 10.0 .11 .12 14.7 15.0 100.3 100.0 3.3 2.3 Female: Impaired---------------- ---------------- --------------------------- --------Unimpaired------------------------------------------- --------------------- 6.4 6.5 7.0 6.9 2.5 1.3 .01 .01 6.0 6.3 103.3 100.0 6.9 5.3 Number of workers Total: Impaired _ _ ______________________ Unimpaired__________________________________________ 11,028 18,258 10,858 18,001 10,973 18,202 10,973 18.202 895 1,404 5,217 8,783 Male: Impaired Unimpaired Female: Impaired Unimpaired _ _________________ ________________ 10,253 16,926 10,094 16,692 10,203 16,875 10,203 16,875 682 1,069 4,695 7,909 _ _ __________________ _ __ ___________ 775 1,332 764 1,309 770 1,327 770 1.327 213 335 522 874 1 Number of days lost per 100 scheduled workdays. 2 Number of injuries per 10,000 exposure-hours. 8 Number of injuries per 1,000,000 exposure-hours. 4 Number of days lost for disabling injury per 100 scheduled workdays. 6 Number of days of disability per disabling injury. 8 Percentage relationship of production efficiency of impaired to that of matched unimpaired. 7 Number of voluntary quits per 100 employees in the survey group. 3 4 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES individual a better worker. But the results of the study indicate that the assumption that a physical impairment makes a man a less efficient or a less de pendable worker is equally unsound. Many charac teristics of the individual (temperament, personality traits, etc.) influence the quality of the work per formance. These characteristics are possessed in the same infinite variety and degree by impaired and by unimpaired persons and undoubtedly influenced individual performance, but these obviously are out side the scope of this study. The factor under scrutiny here is the effect of the physical impairment. Based upon the record, it seems reasonable to con clude that physical impairment did not produce an adverse effect on either the quantity of work pro duced or the quality of the work performance. No matter how different these physically impaired persons may have been in other respects, on the job they were just another group of workers able to meet their unimpaired fellow workers on an equal competitive footing. Work Performance1 A proposal for the employment of impaired persons immediately raises questions as to how and to what extent employment of such persons may affect plant operating programs. There is uncertainty in many minds as to just what sort of work performance may reasonably be expected from these impaired persons. This doubt and uncertainty lead to the anomalous situation in which the impaired person may be re jected for employment because of what he cannot do rather than considered for employment on the basis of what he can do. Basically, only a relatively few points require de termination. These are summarized briefly in the following two paragraphs. Mobility of Working Force Impaired persons are somewhat more limited than unimpaired persons in their job assignments. This means that they cannot be transferred from job to 1 O ther studies w hich deal w ith on e phase o r an other o f jo b perform an ce are: P h ysical Im pairm ent and J o b P erform a n ce, b y V erne K . H a rv e y , M .D ., an d E . P arker L u on go, M .D ., U .S . C iv il Service C om m ission , in Journal o f the A m erican M e d ica l A ssociation , A p r. 7, 1945; T h e P h ysi cally H a n d ica p p ed W ork er in In du stry, b y G ilbert B righouse, B u lletin N o. 13, C aliforn ia In stitu te o f T e ch n o lo g y , Pasadena, 1946; A n E x perim ent w ith V oca tion a lly H a n d ica p p ed W orkers, b y J. W . D ie tz, in Personnel Journal, F ebru ary 1932. job quite as easily as the unimpaired. But this limita tion is one of degree and depends entirely upon the nature and extent of the impairment and the require ments of the jobs. In a given plant, there may be literally scores of jobs that a person with a specific impairment can perform, and he can be transferred among them as readily as any unimpaired worker. It was noted in many of the plants studied that at the time an impaired worker was assigned, alternative jobs were listed in the same and in other departments. The matter of mobility, then, is an operating prob lem peculiar to the individual plant. Quality of Work Performance What sort of work performance does the impaired worker bring to the job? What effect will employ ment of impaired persons have on production schedules, absenteeism, work-injury frequency, and labor turn-over? These are questions which lend themselves to specific and objective answers. Prob ably the most reliable evidence of what may be expected from impaired workers is the character of the performance of those who are employed. If the impaired worker, veteran or nonveteran, cannot hold his own on a job and cannot compete successfully with his unimpaired fellow worker, then his employ ment is questionable. If, however, he can compete successfully with unimpaired workers on the same jobs, his impairment ceases to be a valid basis for excluding him from employment. For the impaired and the unimpaired alike, the decision as to who gets the job then rests on skill, background, experience, education, and all the other elements of the job specification. In other words, the approach becomes a positive one based on what an applicant can do, and not a negative one based on what he cannot do. The present study was undertaken to evaluate on the basis of dependable, factual data the quality of the work performance of impaired workers in comparison with unimpaired workers on the same jobs. The remainder of this section and table 1 show how the impaired workers compared in their work performance with matched unimpaired workers on the same jobs.2 The measures are based entirely on objective, quantitative data taken directly from the records of cooperating firms. They contain no ele ments of subjective valuation or selection, or a desire to prove a preconceived thesis. 2 D escription of m atch in g process w ill be fo u n d in the discu ssion o f th e scop e an d m eth od o f the stu d y in the app endix (p. 120). 5 THE IMPAIRED WORKER IN INDUSTRY Absenteeism For the purposes of the study, an absence was defined as absence from the job for a full day or more when the employee was scheduled to work. Lay-offs, holidays, shut-downs, and regular vacations were not counted as days absent nor were they included as days scheduled to work. The absenteeism rate was computed as days lost per 100 scheduled workdays. The group of 11,028 impaired workers had an absenteeism rate of 3.8 as against 3.4 for the 18,258 unimpaired workers matched with them. The survey group was made up of 10,253 impaired males and 775 impaired females matched, respectively, with 16,926 unimpaired males and 1,332 unimpaired females. The female workers, both impaired and unimpaired, had a considerably higher absenteeism rate, but this did not affect the group averages materially. Table 2 and chart 1 show a frequency distribution of the absenteeism rates for the groups of impaired and unimpaired workers. There was a very heavy concentration in the low frequencies, with a scatter ing from both groups in the higher frequencies. No absences at all were reported for 22.6 percent of the impaired and 23.2 percent of the unimpaired during the periods in which they were studied. About 62 percent of the impaired and 65 percent of the unim paired had frequency rates of less than 3.0. T able 2.— Percentage distribution of impaired and matched unimpaired workers, by absenteeism frequency rate 1 and by sex Total Female Male Absenteeism frequency rate class Impaired 0________________________ 0.1 and under 1.0 _________ 1.0 and under 2.0______ __ 2.0 and under 3.0_________ 3.0 and under 5.0_________ 5.0 and under 10.0______ 10.0 and under 15.0_____ 15.0 and under 20.0_____ 20.0 and under 30.0______ 30.0 and over____________ Total__________ 22.6 15.1 13.7 10.4 13.3 13.8 5.9 2.7 1.9 .6 Unim paired 23.2 16.4 14.6 10.7 13.2 13.2 4.7 2.1 1.3 .6 Impaired 23.7 15.7 14.0 10.5 13.2 12.9 5.3 2.5 1.6 .6 Unim paired Impaired Unim paired 24.4 17.2 14.9 10.8 12.9 12.1 4.2 1.8 1.2 .5 10.5 8.6 9.0 9.3 14.8 24.6 11.9 5.5 4.8 1.0 10.1 6.2 10.0 10.1 15.8 27.9 10.1 5.0 2.6 2.2 _ 100.0 100.0 100.0 100.0 100.0 100.0 Number of workers_______ 11,028 18,258 10,253 16,926 775 1,332 1 Number of days lost per 100 scheduled workdays. Related to absenteeism as an element in work per formance is the question whether a physical impair ment predisposes a worker to greater absenteeism for certain specific reasons, such as illness, transportation 6 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES difficulties, etc. In an effort to see how significant the various reasons for absence were in actual prac tice, data on reason for absence were obtained wherever possible. Unfortunately, many of the plants studied did not keep such records. Hence, the reason for nearly half the absences had to be recorded as “ unknown.” However, table 3 indicates that for those cases in which reasons for absence could be ob tained, the rates were substantially the same in the two groups. There is some indication that a slightly greater incidence of absence because of illness may have been responsible for the fractionally higher rate recorded for the impaired group. However, only limited re liance can be placed on this inference. The sizable group of absences for which the reason was not avail able, if properly distributed, might have changed the pattern materially. On the information at hand, however, it seems reasonable to conclude that the physical impairment exercised at most only a very limited influence. T able 3.— Absenteeism frequency rates1 for impaired and matched unimpaired workers, by reason for absence and by sex * Nondisabling Injury Experience Reason for absence Impaired Unim paired Impaired Unim paired Impaired Unim paired Total____________________ 3.8 3.4 3.6 3.2 6.4 6.5 Illness_______ ______ _____ Personal business_________ Transportation difficulties. Unknown _______ __ — 1.5 .3 (2) 2.0 1.2 .3 (2) 1.9 1.3 .3 (2) 2.0 1.1 .3 (2) 1.8 2.4 .9 (2) 3.0 2.4 .9 (2) 3.1 Number of workers_______ 11,028 18,258 10,253 16,926 775 1,332 1 Number of days lost per 100 scheduled workdays. 2 Less than 0.05. Considering the group rates, 3.8 and 3.4, and the frequency distributions of the individual rates for the impaired and unimpaired workers, there is no significant difference between them with respect to regularity of work attendance. The statistics show a fractionally higher rate.for the impaired workers equivalent to about 1 day in each 250 scheduled workdays. In this connection there are three con siderations which are of primary significance. First, the level of the rates was very favorable for both impaired and unimpaired workers. Second, the similarity of the rates emphasizes the fact that while many forces influenced regularity of work attendance for better or worse, physical impairment did not seem to be one of them. In the third place, the frequency distributions show that there were cases of excessive Work Injury Experience. Two diametrically opposed opinions are commonly encountered in discussions of the employment of impaired persons with respect to injury frequency. One is that the impaired person is more likely to be injured because his actions, move ment, etc., are hampered by his impairment; the other, that the impaired person is believed to be less likely to be injured because he tends to be more safety conscious. The data obtained indicate that neither of these statements is completely accurate, although there is probably some truth in each. Possibly the force of the one tends to neutralize the effect of the other. In this study, work injuries were divided into nondisabling and disabling and are discussed sep arately. Female Male Total absenteeism among the unimpaired workers just as there were similar cases among the impaired workers. It is equally true for both groups, however, that these examples are the kind of individual cases of poor performance which one would expect to en counter in any large group of workers. A nondisabling injury was defined as an injury experienced in the course of the individual’s work which did not result in any permanent impairment or in any loss of time beyond the day or shift on which the injury occurred. The experience for each indi vidual was computed as a frequency rate on a base of 1,000 exposure-hours. The experience for the groups and subgroups of workers was computed on a base of 10,000 exposure-hours. Data were available for 10,858 impaired and 18,001 unimpaired workers. The group was composed of 10,094 impaired males matched with 16,692 un impaired males and 764 females matched with 1,309 unimpaired females. The difference between the number of workers constituting the survey groups for nondisabling injuries and absenteeism is ac counted for by the fact that in some few instances nondisabling injury records had not been kept, had been lost, or for other reasons were not available. Where this was true of either the impaired or the matched unimpaired worker it was necessary to drop that matched unit so far as nondisabling injury experience was concerned. To obtain a factual measure of the nondisabling THE IMPAIRED WORKER IN INDUSTRY 7 injury experience of the impaired workers compared further demonstrated by the frequency distributions shown in table 4 and chart 2. About half of each with that of unimpaired workers exposed to the same group had no injuries at all during the periods hazards, reliance was placed on the dispensary records of the cooperating firms. It does not seem & studied, about 70 percent had a rate of less than 1 per 1,000 hours, and 90 percent of each group had a that the level of the rates should be given much con rate of 2.9 or less per 1,000 hours. There was a sideration here because the level of the rate reflects not only the injury experience of the groups but also T able 4.— Percentage distribution of impaired and matched company policy in encouraging or requiring im unimpaired workers, by frequency rate 1 of nondisabling injury mediate treatment of minor injuries, employee and by sex cooperation on such a program, medical facilities maintained, etc. However, the conditions were the Male Female Total Frequency rate class same for both impaired and unimpaired workers Impaired Unim Impaired Unim Impaired Unim within each plant. Hence, while the level of the rate paired paired paired for the survey group as a whole is probably not 51.0 49.2 50.0 50.0 63.9 59.7 0________________________ very significant, the comparison between the rates 0.1 and under 1.0__ _ 19.1 19.4 19.7 13.4 19.9 16.3 14.2 1.0 and under 2.0___ 14.1 14.5 14.2 11.1 12.7 for the impaired and unimpaired workers is valid. 2.0 and under 3.0__ _ 6.5 6.7 6.5 6.8 5.3 6.0 3.0 and under 5.0 _. .. 4.9 5.1 5.3 5.5 2.9 4.1 The nondisabling injury frequency rates in the 3.2 3.2 5.0 and under 10.0 _ 3.3 3.4 2.2 1.7 10.0 and under 20.0_ ___ 1.0 .9 1.1 .9 .5 .2 two groups of workers were identical, 9.9 work .1 .1 20.0 and over............. ......... .1 .1 0 0 injuries per 10,000 exposure-hours. The female 100.0 Total_____________ 100.0 100.0 100.0 100.0 100.0 impaired workers had a fractionally higher rate than Number of w orkers.._ . . . 10,858 10,094 16,692 18,001 764 1,309 their matched unimpaired workers, 7.0 and 6.9, 1 Number of injuries per 1,000 exposure-hours. respectively. The male impaired and unimpaired had scattering of cases, about 5 percent, with a rate of identical rates, 10.1. The similarity of the nondisabling injury ex 5.0 or higher. The very marked similarity of the perience of the impaired and unimpaired workers is experience in the two groups is extremely significant. 8 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES Clearly, there was no special proneness on the part of the impaired toward minor work injuries. A further factor considered in connection with nondisabling injury experience was whether the presence of an impairment tended to increase the frequency of any particular kind of minor injury. Data were obtained on the nature of the injuries experienced by both impaired and unimpaired groups. The rates by type of injury are shown in table 5. Certain kinds of injuries, such as cuts and abrasions, are by their nature quite common in factory employ ment. The point of interest in this analysis, however, was that the kinds of injuries which had a high incidence in one group had an equally high incidence in the other. For example, cuts and abrasions had rates of 6.9 and 7.0 among the impaired and unim paired, respectively. The pattern of the rates by kind of injury is nearly identical in the two groups. When it is considered that these data reflect the experience of 10,858 impaired and 18,001 matched unimpaired workers, the data indicate clearly that the nondisabling injury experience was related to the hazards of the job and not to the impairments which characterized one of the groups. T able 5.— Nondisabling injury frequency rates1 for impaired and matched unimpaired workers, by nature of injury and by sex Total Female Male Nature of injury Impaired Unim paired Impaired Unim paired Impaired Unim paired Total................. ................... 9.9 9.9 10.1 10.1 7.0 6.9 Burns and scalds_________ Cuts and abrasions______ Eye injuries--------------------Strains and sprains. --------Fractures and dislocations. Dermatitis_______ _____ __ Other______________ _____ .6 6.9 1.5 .5 (2) .1 .3 .5 7.0 1.6 .4 .1 .1 .2 .6 7.1 1.6 .4 (2) .1 .3 .5 7.2 1.7 .4 .1 .1 .1 .6 4.6 .8 .6 (2) .1 .3 .5 4.5 .9 .5 (2) .2 .3 Number of workers. .......... 10,858 18,001 10,094 16,692 764 1,309 physician. These varying practices influenced the total number of redressings recorded in the study. In each plant, however, the practices affected im paired and unimpaired workers alike. To the extent that the average number of redress ings per injury reflects the severity of the injuries, there was no difference between the two groups. In both groups the average was 0.9 redressings per injury. It seems reasonable to conclude, therefore, that nondisabling injuries experienced by impaired workers did not tend to be any more or less severe than those experienced by unimpaired workers. A final point considered in connection with the medical record was nonindustrial use of medical facilities. This was defined as dispensary visits for treatment of illness or injury not related to the work er’s employment. Again, practices between plants varied widely. In some plants such visits were dis couraged; in others they were encouraged and even supplemented by home visits from the nurse or physician. The study showed that the average number of such nonindustrial visits to the dispensary was the same for both groups, 1.5 visits per person during the periods studied. Clearly, the existence of the impairments did not have a measurable effect on the demands made upon the medical facilities by impaired workers because of injury or illness not related to the job. In brief, nondisabling injuries of the same nature and severity were experienced with equal frequency by these groups of impaired and unimpaired workers matched on identical jobs and exposed to the same hazards. Also the existence of the impairment had no measurable effect on nonindustrial use of plant medical facilities. Disabling Injury Experience 1 Number of injuries per 10,000 exposure-hours. 2 Less than 0.05. An attempt was made to obtain a measure of the severity of the nondisabling injuries in terms of the number of redressings required per injury. A limita tion on these data is the fact that plant practices varied widely. In some cases redressings were given only if requested by the employee, in other cases employees were encouraged to have complete treat ment for the most minor scratches, and in still others the employee was required to report for redressings at intervals until given written clearance by the plant Probably one of the most difficult barriers for the impaired person to surmount in finding a place for himself in industry is the fear in the prospective employer’s mind that another injury, added to the existing impairment, may result in a permanent total disability, with a consequent skyrocketing of work men’s compensation insurance costs. Realizing that the employer might well be laying himself open to serious potential hazards, various agencies, govern mental and private, have advocated shifting that risk from the employer by establishment of secondinjury funds under the workmen’s compensation laws THE IMPAIRED WORKER IN INDUSTRY of the several States.3 Under this arrangement, the employer pays only for the specific injury. The fund pays the difference between the amount paid by the employer and the amount due the worker for the permanent total disability. As of August 1947, 36 States had second-injury funds or equivalent ar rangements. In a few other States, employees with certain physical impairments are permitted to sign waivers releasing the employer from second-injury liability under the workmen’s compensation law. Without going into the merits of the various secondinjury provisions, the significant fact is that in most of the highly industrialized States some provision is made to protect the employer against disastrous increase in insurance costs as a result of a “ second injury” to an impaired employee who becomes per manently and totally disabled through the combi nation of the work injury and the existing disability. Experience under various State second-injury funds indicates that the likelihood of injuries of this type in reality is small. A very modest number of claims have been made on these funds. The experi ence recorded in this study constitutes further evi dence that this type of injury is a comparatively rare occurrence. Of the 11,000 impaired workers compris ing the survey group, 172 experienced disabling in juries of one kind or another but not one of these resulted in additional permanent disability which would place the employee in the category of the permanently and totally disabled. However, there is a qualification which should be placed on these findings. It is possible that in some instances the permanent disability may have been increased even though not to the extent of permanent total dis ability. In such instances the provisions of the usual type of “ second injury ” fund would not be operative. The disabling injury record of the impaired workers of the survey group compared very favorably with that of the unimpaired workers matched with them and exposed to the same hazards. According to table 1 the injury frequency rate per million ex posure-hours was 8.9 for the impaired and 9.5 for the unimpaired group. According to the accident statis tics published by the Bureau of Labor Statistics, the rate for all manufacturing industry for the year 1946 was 19.9 per million exposure-hours. The experiences of the 11,000 impaired workers and their unimpaired 3 Second In ju ry F u nds as E m p lo y m e n t A ids t o the H an d icap p ed , U . S. D epartm en t of L a bor, D iv isio n of L a bor Standards, W ash in gton , 1947. 776106° — 4 8 — 2 9 co-workers, therefore, were considerably better than the experience in industry as a whole. There is, of course, the question as to the extent to which a worker is likely to experience a disabling injury as a result of his impairment. Inquiry made at the time the data were obtained from cooperating firms disclosed only one instance in which the injury was definitely caused by the impairment. In that instance the safety director of the plant informed the Bureau’s field representative that while the impair ment had caused the injury, the responsibility lay with a foreman who had placed the impaired worker on a job from which he was definitely restricted. As the result of an oversight, the foreman had assigned the man to one of the few jobs in the shop he was not supposed to perform. There were a few other instances in which it was possible that a causal relationship might have existed between impairment and injury, but the evidence was superficial and inconclusive. For ex ample, in one instance a worker blind in his right eye struck his right hand against a projection while walking down an aisle. It happened on the blind side. It is possible that the lack of vision con tributed to the accident. But this type of injury has been experienced by many people whose vision was in no way impaired. Similarly, in another plant, a worker with a crippled leg dropped a small casting on his foot. Possibly some lack of agility prevented him from jumping away from the falling piece and hence may have contributed to the injury. But in the same plant the same kind of injury was experi enced by an unimpaired worker of the survey group. There were several such instances in the various plants, but always parallel accident cases were encountered among the unimpaired workers studied. In the vast majority of the work injuries there was not even a remote indication of the existence of any causal relationship between the impairment and the injury. On this point, therefore, the findings of the study lead to the conclusion that there is little reason to believe that the existence of the impairment will be a factor in work injury if the impaired worker is properly placed on the job. Paralleling the belief that the impaired person may be a hazard to himself is the belief that he may con stitute a hazard to his fellow workers. It is certainly true that both beliefs may at times be realized. Im properly placed in a job in which the abilities do not correspond to the requirements of the job, any 10 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES worker — “ impaired” or “ unimpaired” — may well be a hazard to himself and to the people working in his vicinity. A man with even moderately defective depth perception operating an overhead crane may be a menace to himself and everyone working in the area. The same condition is true of any worker no matter how “ normal,” if he is placed in a job which he is not equipped to perform. The deficiency need not be physical — it may be mental or emotional. Among the disabling injuries recorded among the unimpaired workers of the survey group there was no evidence that any had been caused or contributed to by a fellow worker’s impairment. Information on this score was obtained from the accident records and accident-cause studies in the files of the various plants included in the survey. In order to get a broader coverage on this point, this question was raised at every plant studied, concerning impaired and unimpaired employees outside the survey group. While records were not examined in this connection, none of the plant officials questioned could recall any instances of the kind. The conclusion seems war ranted that the impaired worker was no more likely to be a cause of injury to either himself or others than was his fellow worker who had no such impairment. In summary, the impaired workers studied made a very favorable record in comparison with the un impaired workers exposed to identical hazards. A number of factors probably contributed to this result. It is likely that the impaired person received some what more careful placement. Moreover, having an impairment, he may be more safety conscious. In discussing this subject, a personnel director said: “ Take a walk through my plant. You won’t find the impaired fellows engaging in horseplay and chasing one another with air hoses. Of course they have a better accident record!” Time Lost. The time lost as the result of work in juries is another important consideration in this comparison. There is a fairly common belief that, because of the existing impairment, any additional injury may result in excessive loss of time; that the period of convalescence or recovery required for the impaired person may be much longer than for the person who is not burdened by an existing physical disability. What are the facts? Of the total survey group of 11,000 impaired workers, 172 experienced 174 disabling injuries dur ing the periods studied. The time lost as a result of these injuries amounted to 2,531 days, or a rate of 0.10 days per 100 scheduled workdays. In com parison, the 18,000 matched unimpaired workers experienced a disabling injury time-lost rate of 0.11 per 100 days scheduled to work. A further indicator of the severity of the injuries experienced in the two groups is the average time lost per injury. Among the impaired workers the time lost per injury was 14.5 days. For the unimpaired group, the time lost per injury was 14.9 days. For the entire group of impaired workers, then, the record clearly shows that excessive time lost as a result of disabling injuries was not a factor to cause concern. In assembling the data for each plant, it was noted too that there was a very marked similarity in the kinds of injuries experienced in the two groups. When burns or contusions were common among the impaired, they were also common among the matched unimpaired workers in the same plant. It was ap parent that the injuries experienced were related to the hazards of the particular job, not to a proneness on the part of the impaired person to experience certain kinds of injury. Because of its importance to the whole general subject of the impaired worker in industry, the disabling injury findings are summarized briefly here: If the impaired person is placed intelligently, then (1) The likelihood of an injury, which will result in permanent total disability when superimposed on an existing impairment, is very small. This is shown by this study and the experience of various State second-injury funds. (2) The impaired worker was no more likely — if anything, perhaps, a little less likely — to experience a disabling work injury than an unimpaired worker exposed to the identical hazards. (3) The impaired worker was not a source of danger to his fellow workers. (4) The average time lost as the result of disabling injuries was some what less among the impaired workers than among their unimpaired co-workers. Output Relative Data to provide a comparison of production efficiency were obtained in all instances where re corded measures of individual output were available. The number of cases for which such data were avail able is comparatively small, 895 impaired cases out of the total 11,028 studied. Subjective measures such THE IMPAIRED WORKER IN INDUSTRY as foreman’s evaluation, efficiency ratings, etc., were reviewed at the time the study was made but were not included or “ weighted” into the data recorded in table 1. The measure was computed as a relative of the production efficiency of the impaired to that of the matched unimpaired workers, the output of the unimpaired in each case equaling 100. - The output relative for this group of 895 impaired workers is 101.0 against 100.0 for the 1,404 unim paired workers with whom they were matched. Clearly, the impaired workers, as a group, were well able to hold their own with respect to volume of pro duction. Male and female impaired workers alike made a somewhat better production record than the un impaired workers with whom they were matched. Data were available, however, for only a relatively few female workers, 213 impaired who had an effi ciency relative of 103.3 against 100.0 for the 335 un impaired female workers matched with them. The difference was narrower among the male workers, where 682 impaired had a relative of 100.3 against 100.0 for 1,069 matched unimpaired workers. While the averages quoted are very favorable, they do not mean that every impaired worker produced at a better rate than did the unimpaired workers matched with him on the same job. Individual differ ences are as common among the impaired as among the unimpaired. As would be expected, some of the impaired showed a poor record. Many of them, on the other hand, had an excellent record. The follow ing tabulation shows the number of impaired workers in three broad performance groups: Output relative Number of impaired 11 work. A rather large number of such cases were found. On the assembly line operations the working speed was controlled by the speed of the line and those working on it had to keep up with it. Where group incentives are in use, one member of the group who cannot keep up his end will cut down the earn ings of all. No individual production records could be obtained for these people. But the fact of their employment demonstrates that they were able to match the speed of the unimpaired workers on the same assembly lines or groups. Quit Rate Various published works and magazine articles dealing with the subject of the impaired worker have advanced the opinion that these workers are more stable on the job and have a lower turn-over rate than unimpaired workers. In order to reduce this factor to a statistical determination, a follow-up was made in 68 of the plants included in the study to determine what the separation rates were for the survey group during a period of 6 months following the end of the survey period. Data obtained on 5,217 impaired and 8,783 unimpaired workers of the original survey group are shown in table 6 as quit, termination, and total separation rates per 100 em ployees in each of the two groups. T a b l e 6 . — Separation rates 1 for impaired workers and matched unimpaired workers, by reason for separation and by sex Total Male Female Reason for separation Impaired Unim paired Impaired Unim paired Impaired Unim paired Less than 9 5.0 _______________________ 245 95.0 and under 1 0 5 .0 _______________ 359 Voluntary quits__________ 3.6 2.6 3.3 2.3 6.9 5.3 105.0 and over_______________________291 Health reasons_______ Family reasons______ Moved from commu nity_______________ Transportation diffi culty_____ ________ Dissatisfied with job__ O t h e r . ___________ Unknown_______ ____ .6 .2 .3 .2 .4 .1 .2 (2) 1.8 1.1 .9 1.3 If it is assumed that an efficiency relative range of 95.0 to 105.0 represents about equal performance of the impaired and the matched unimpaired, 40.1 per cent of the impaired were as good as, 27.4 percent were poorer than, and 32.5 percent were better than the matched unimpaired workers. Thus, 650 or 72.6 percent of the group produced at a rate as good as, or better than, their unimpaired fellow workers on the same jobs. It is significant that the largest group of the impaired fell in the range 95.0 to 105.0. The figures quoted above do not take into con sideration the impaired workers who were employed on assembly lines or on jobs involving group piece .4 .2 .4 .2 1.0 J2 .1 .3 1.0 1.0 (2) .3 1.0 .6 (2) .3 1.1 1.0 (2) .2 1.1 .6 .4 .2 1.3 1.1 .1 .3 1.2 1.3 Terminations3....... ............. 5.2 3.1 5.2 3.1 4.4 2.9 Total separations. _. 8.8 5.7 8.5 5.4 11.3 8.2 Number of workers. ........... 5,217 8,783 4,695 7,909 522 874 1 Number of separations per 100 employees of the survey group. * Less than 0.05. > Separations initiated by the employer. As an indicator of relative stability on the job, the rate of voluntary quits provides a comparison be cause the responsibility for initiating the action rests 12 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES with the employee. This rate was 3.6 for the im paired workers and 2.6 for the unimpaired workers. It is questionable whether the difference is significant. Two reasons accounted for half the difference. More of the impaired quit because of health reasons and more moved from the community. It is interesting that the quit rate attributed to dissatisfaction with the job was identical in the two groups. The rate attributable to “ other” was made up of a variety of reasons. It was noticeable, however, that two rea sons were fairly common in this “ other” group — a sizable proportion of both impaired and unimpaired quit “ to take another position” or “ to set up own business.” Terminations 4 showed a rate of 5.2 for the im paired and 3.1 for the unimpaired workers. Termina tions because of reduction in force were primarily responsible for this difference. It is not surprising that the impaired workers had the higher termina tion rate. In large part, impaired workers were the last to be hired. Consequently, when cut-backs had to be made, those workers with the lower seniority were the first to be laid off. Composition of the Survey Group Estimates of the number of impaired persons in the labor force vary widely, as the number depends largely upon how the term “ impaired person” is defined. For the purpose of this study, the basic concept of impairment was a physical disability severe enough to constitute a serious problem for the individual in obtaining employment. With the assistance of an advisory committee, composed in part of industrial physicians, specific definitions were drawn in such a way as to exclude any doubtful, minor, or border-line cases.5 Nine impairment types selected and defined for the study were serious orthopedic, vision, hearing, hernia, cardiac, extuberculous, peptic ulcer, diabetic, and epileptic cases. A tenth group consisted of persons with a combination of two of these nine impairments, each in itself severe enough to fall within the adopted definitions. N o selection was exercised in including or ex cluding the various impairment types covered by the 10 categories selected for study. All of the impaired 4 Separations in itiated b y the em ployer; 5 T h e definitions o f im pairm ent as a p p ro v e d b y the a d visory co m m ittee are given in detail in the A p p en d ix (p. 120). workers within the definitions and with whom un impaired workers on the same jobs could be matched with respect to sex, age, experience, etc., were in cluded in the survey group at each plant studied. Consequently, the composition of the survey group may reflect fairly closely the composition of the impaired worker group in industrial plants in general. Table 7 shows the distribution of the impaired workers studied, by type of impairment. T able 7.— Number of 'physically impaired workers of the survey group j by type of impairment Type of impairment Number of workers Total_________________________ 11,028 Orthopedic_________ __________ Amputees_______________ __ One hand_________________ Two hands_______________ One arm__________________ Two arms________________ One foot__________________ Two feet_________________ One leg__________ ________ Two legs_________________ Loss of use_________________ One hand________________ Two hands_______________ One arm__________________ Two arms__________ _____ _ One foot__________ _______ Two feet__________ _______ One leg___________________ Two legs_________________ Back deform ity____________ Multiple orthopedic_______ __ 1,522 484 183 5 72 2 38 1 176 7 761 114 8 174 9 51 19 335 51 214 63 Vision________________________ Totally blind_______________ Blind, one eye___________ Legally blind_______________ Partially blind______________ 1,721 34 941 25 721 Hearing______________________ Totally deaf________________ Hard of hearing_____________ Deaf m u t e _________________ 595 92 313 190 Hernia________ ________ ______ 3,543 Cardiac_______________________ 1,840 Ex-tuberculous________________ 513 Peptic ulcer___________________ 428 Type of impairment Number of workers Diabetic____________________ 144 Epileptic_________________ __ 134 Multiple____________________ Orthopedic-Vision_________ Orthopedic-Hearing_______ Orthopedic-Hernia Orthopedic-Cardi ac Orthopedic-Ex-tuberculous Orthopedic-Peptic ulcer___ Orthopedic-Diabetic Orthopedic-Epileptic_____ Vision-Hearing______ __ _ Vision-Hernia_____ __ Vision-Cardiac Vision-Ex-tuberoulmis Vision-Peptic ulcer Vision-Diabetic. Vision-Epileptic Hearing-Hernia Hearing-Cardiac Hearing-Ex-tuberculous___ Hearing-Peptic ulcer Hearing-Diabetic_________ Hearing-Epileptic Hernia-Cardiac Hernia-Ex-tuberculous____ Hernia-Peptic ulcer Hernia-Diabetic Hernia-Epileptic__________ Cardiac-Ex-tuberculous___ Cardiac-Peptic ulcer Cardiac-Diabetic___ Cardiac-Epileptic Ex-tuberculous-Peptic ulcer Ex-tubereulous-Diabetic. . . Ex-tuberculous-Epileptic. . . Peptic ulcer-Diabetic Peptic ulcer-Epileptic Diabetic-Epileptic 587 28 11 75 21 9 5 3 0 16 78 52 12 6 4 1 23 17 3 5 0 0 120 29 18 9 2 22 9 4 1 2 0 0 2 0 o The large number of hernia cases, 32.1 percent of the survey group, is probably the result of two factors: First, it is apparently relatively easy for the person with a hernia condition to get a job, as about the only restriction to which he is subject is that of excessive lifting; furthermore, the disability can be minimized by the use of a truss. Second, hernia is a common industrial injury and many of the workers studied probably remained with their employers after the impairment was acquired. Cardiac, vision, and orthopedic impairment cases were nearly equally common, 16.7, 15.6, and 13.8 percent, respectively. Epileptics constituted the smallest impairment THE IMPAIRED WORKER IN INDUSTRY group, 134 cases or 1.2 percent of the total impaired workers studied. An unexpectedly large number of multiple impairment cases were encountered, 587 or 5.3 percent of the group, making it sixth in the list of 10 impairments studied. A combination of im pairments naturally complicates the placement 13 problem, since additional qualifications and restric tions have to be considered in matching the man to the job. Nevertheless, a sizable number of these cases were encountered, although the number of cases in any given combination of impairments was small. Excluding the double orthopedics, 36 possible CHART 3 COMPOSITION OF SURVEY GROUP BY TYPE O F IMPAIRM ENT HERNIA CARDIAC VISION ORTHOPEDIC HEARING EX •TUBERCULOUS PEPTIC ULCER DIABETIC EPILEPTIC MULTIPLE U N ITED S T A T E S D EP A R TM E N T OF LABOR BUREAU OF LABOR S T A T IS T IC S combinations of the impairments were studied. The largest number recorded for any combination was 120 in the hernia-cardiac group. The distribution of the impaired workers by age group is shown in table 8 and in chart 4. Since im paired and unimpaired were matched with respect to age, no separate age tabulation was prepared for NOTE\ SUR V EY GROUP IN C LUD E D 11,028 P H Y SIC A LLY IMPAIRED WORKERS IN M ANUFACTURING. the unimpaired group. The impaired workers were concentrated in the middle age ranges with a slight tendency toward the higher ages. About 52 percent of all the impaired workers studied fell within the range between 25 and 50 years of age. Slightly less than 86 percent were under the age of 60. At the extremes of the age range were approximately 15 14 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES CHART 4 AGE DISTRIBUTION OF IMPAIRED WORKERS IN SURVEY GROUP PERCENT PERCENT 15 15 10 10 0 0 15 15 10 10 eo UNITED STATES DEPARTMENT OF LABOR BUREAU' OF LABOR S TA TIS TIC S YEARS OVER NOTE: SURVEY CROUP INCLUDED II,O SS PHYSICALLY IMPAIRED WORKERS IN MANUFACTURINS THE IMPAIRED WORKER IN INDUSTRY percent who were 60 years or over and about 5 per cent who were under 25. When calls for military service withdrew large numbers of younger workers from industrial employment, their places were fre quently taken by women or by older workers. To some extent this worked against inclusion of the younger impaired workers in the study because they frequently could not be matched with respect to age, sex, or experience with unimpaired workers on the same jobs. For the most part, the periods studied fell in 1945, a time during which this effect was especially pronounced. On the whole, however, the age distribution seems to show a reasonably balanced pattern. The age distribution for the male and female im paired workers differed widely. Whereas only 55 percent of the male workers were under the age of 50, 84 percent of the female workers fell in the same range. The difference was particularly marked in the upper and lower age brackets. Nearly 20 percent of the females, as against only 5 percent of the males, were under the age of 25 while 15 percent of the males and only 2 percent of the females were 60 years of age or over. T able 8 . — Number and 'percentage* distribution of impaired workers of the survey group, by age and by sex Percent Number of workers Age group Female Male Total Male ___ 11,028 10,253 775 100.0 100.0 100.0 Under 20 years___________ 20 and under 25 years____ 25 and under 30 years____ 30 and under 35 years____ 35 and under 40 years____ 40 and under 45 years____ 45 and under 50 years____ 50 and under 55 years____ 55 and under 60 years____ §0 and under 65 years____ 65 and under 70 years____ 70 and under 75 years____ 75 years and over________ 79 511 901 1,117 1,184 1,238 1,312 1,562 1,543 1,088 370 96 27 53 411 764 1,016 1,077 1,130 1,239 1,498 1,497 1,076 369 96 27 26 100 137 101 107 108 73 64 46 12 1 0 0 .7 4.6 8.2 10.1 10.7 11.2 11.9 14.2 14.0 9.9 3.4 .9 .2 .5 4.0 7.5 9.9 10.5 11.0 12.1 14.6 14.6 10.5 3.6 .9 .3 3.4 12.9 17.7 13.0 13.8 14.0 9.4 8.3 5.9 1.5 .1 0 0 Total....... ................. .. Total Female No attempt was made to regulate the proportion of male to female workers included in the survey group in any of the plants or in the study as a whole. As finally constituted, the survey group was made up of 10,253 impaired males matched with 16,926 unimpaired males, and 775 impaired females matched with 1,332 unimpaired females. This proportion of female workers is low: according to figures pubfished by the Employment and Occupational Outlook Branch of the Bureau of Labor Statistics, females constituted 26 percent of factory employees in man 15 ufacturing industries in December 1946. Nor can it be said that this proportion in the survey group reflects the composition of the employed impaired male and female workers in all manufacturing in dustries. A change in the number of plants studied in various industries could have changed the pro portion of male and female workers in the survey group. There were sizable differences in the performance rates for the two groups, and for this reason the separate tabulations by sex are shown. However, the effect of the female group on the over-all rates is nominal because of the relatively small number of cases involved. Geographical Coverage An effort was made to obtain some representation in the study from various sections of the country. As no information on the number of impaired persons employed or in the labor market in each area was available, no attempt was made to obtain a definite, proportionate share from each area. Furthermore, in order to obtain data on a group sufficiently large to yield statistically valid results within the limits of time and funds available for the study, it was neces sary to concentrate on the large industrial centers where information could be obtained on the largest number of impaired workers in the shortest possible time. (The distribution of the survey group by geographical area is shown in table 9.) No represen tation at all was obtained in the West South Central and Mountain States because industries in these areas generally tend toward small and scattered units. Petroleum refining, which would have been an exception, had already been covered in other areas. About three-quarters of the study was con centrated in the highly industrialized New England, Middle Atlantic, and East North Central areas. The rest of the establishments surveyed were in the West North Central, South Atlantic, and East South Central States and on the West Coast. On the whole, it is not likely that geographical location would exercise any pronounced effect on the factors under consideration in this study. It is true that various State workmen’s compensation laws, insurance regulations, second-injury funds, etc., have an effect on the industrial employment of im paired persons. But the effect of these factors is apparent in the number of such persons employed 16 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES rather than in a comparison of the work performance of impaired and matched unimpaired persons work ing on the same jobs. T able 9.— Distribution of impaired workers of the survey group, by geographical division Geographical division Number of plants Number of impaired Total______________________ _____________________ 109 11,028 New England__________________________ __ Middle Atlantic_________________________ __ __ __ East North Central________ ______ ________________ West North Central________________ ____________ South Atlantic________________ _____________ _ ___ East South Central_______________________________ West South Central____________________ __________ Mountain__ _____ ________________________________ Pacific___________________________________________ 28 30 33 7 3 2 0 0 6 1,748 2,737 5,359 399 105 111 0 0 569 Industry Coverage employment of impaired persons is proportionately greater in these industries. Large operating units were selected whenever possible in order to use the time of the field force most effectively in building up a large survey group in the shortest possible time. The number of impaired workers studied in any industry was further influenced by various con siderations, other than the number of such persons employed. For example, although the apparel in dustry employs impaired persons, records of pre- or post-employment physical examinations were rarely available in that industry. Without such records the study could not be made. The same difficulty was encountered in certain areas where, by custom or collective bargaining agreement, no medical exam inations were used in connection with employment. T able 10.— Number and percentage distribution of impaired workers of the survey group, by industry It was not intended that comparison of work per formance should be drawn between impaired workers in various industries. It was considered desirable, however, that a wide variety of industries should be represented in the impaired group studied. The Bureau of the Budget’s Standard Industrial Classi fication was used as the guide, and as the study progressed special efforts were made to obtain repre sentation in those major industries which were not turning up in the regular course of the field work. The number and percentage distribution of the im paired workers of the survey group, by industry classification of the plants in which they were em ployed, is shown in table 10. Some representation is present for each of the industry groups in the Standard Industrial Classi fication except lumber and timber basic products. Although it is known that impaired workers within the definitions used in this study are employed in logging, sawmill, and similar operations, the industry is characterized by small operations which frequently are not easily accessible. It was not considered feasible to spend the time required to locate plants in the industry sufficiently large, with records ade quate for survey purposes. Furthermore, this work would have been very costly. N o quota or representative sample could be set up by industrial groupings because the number of im paired workers employed in any given industry is not known. The concentration of coverage was heaviest in industries characterized by large operating units. It should not be inferred from this, however, that Standard Industrial Classifica tion Code 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 Industry group Number of workers Percent _ Food and kindred products_______________ Tobacco manufactures_________________________ Textile-mill products________ ______ ___________ Apparel and other finished products____________ Lumber and timber basic products_________ __ Furniture and finished lumber p ro d u cts______ Paper and allied products_______________ _______ Printing, publishing, and allied industries Chemicals and allied products__________________ Products of petroleum and coal____ _____________ Rubber products_______ ______ _________ _______ Leather and leather products___________________ Stone, clay, and glass products_________________ Iron and steel and their products_______________ Nonferrous metals and their products___________ Machinery except electrical_____________________ Electrical machinery____________ ________ _____ : Transportation equipment, except automobiles. __ Automobiles and automobile equipment_________ Miscellaneous manufacturing industries_________ 475 127 266 146 0) 91 134 32 213 652 136 143 472 1,753 663 1,314 974 1,608 1,656 173 4.3 1.2 2.4 1.3 P) .8 1.2 .3 1.9 5.9 1.2 1.3 4.3 16.0 6.0 11.9 8.8 14.6 15.0 1.6 Total_________ __________________ _______ 11,028 100.0 1 The lumber and timber basic products group was omitted from the survey because of the practical consideration of expense. The whole point of industry coverage so far as this study was concerned was that the performance data recorded should reflect a wide range of industrial activities. For this purpose the coverage and variety of manufacturing industry represented seems ade quate. It demonstrates that employment of the impaired person is not limited to a relatively few industries. Impaired workers were found in all kinds of industrial activity, from the lightest to the heav iest. This wide distribution indicates clearly that impaired workers were adaptable to a great variety of occupations and that reliance need not be placed upon some few carefully selected and defined in dustries to provide employment opportunities for 17 THE IMPAIRED WORKER IN INDUSTRY impaired persons generally, and for disabled veterans in particular. Occupations of Impaired Workers The findings of the present study indicate that practically any job in any plant is potentially a job for an impaired worker of one kind or another. The jobs held by the impaired workers are listed for each type of impairment. (See under Industry and Oc cupational Coverage, parts A to J.) But as far as a specific job is concerned, the use of an impaired worker is an individual problem. The employment manager, personnel director, shop foreman, or who ever is responsible for assigning a man to a job has to weigh the abilities of the individual applicant, his skills, experience, temperament, personality, etc., against the requirements of the particular job. This, however, is true of any scientific placement work, regardless of whether or not a worker is impaired. The impairment is an additional element for con sideration. As significant as the variety of jobs was the range of skills reflected by the jobs performed by impaired workers of the survey group. This range included everything from unskilled manual labor to the most highly skilled of the machinist classifications. The implications here are many and varied. Some of these workers had acquired their skills before suffering their impairments; in many cases the impairments did not affect the exercise of these skills. In other instances, either because the impairment occurred before skills were acquired or because the impair ment was such that it destroyed skills already ac quired, the impaired person had learned new jobs and had acquired new skills, some of them of a higher degree than those lost. In connection with the variety and range of skills reflected by the lists of jobs on which impaired workers were employed, one fact must be borne constantly in mind and cannot be overemphasized. These jobs are merely examples. Many of the im paired workers in each plant could not be included in the study because they could not be matched suit ably with unimpaired workers doing the same work. Hence, there were many jobs other than those listed which were being performed by impaired workers and which do not appear in these listings. Further, it is readily apparent that there are many jobs which differ in only minor respects from those listed and which would be equally suitable for impaired persons. These listings are not to be interpreted as a definitive list of occupations for impaired workers. In compiling the data for the study, the United States Employment Service publication Dictionary of Occupational Titles was used to assign a code number to the occupation of each of the impaired workers studied. In all, 971 different code numbers were used. But even this understates the case. The Dictionary of Occupational Titles frequently assigns the same code to a number of varied jobs. Actually, the 11,000 impaired workers of the survey group were employed in 1,488 separate occupations. To determine the general classes of operations in which the impaired workers were employed, their occupations were grouped according to the occupa tional patterns used for wage studies by the Wage Analysis Branch of the Bureau of Labor Statistics. T able 1 1 . — Percentage distribution of impaired workers, by occupational pattern Occupational pattern Maintenance___________ Working foremen___________ _____ _____ Processing______________ _______________ Inspection and testing__ ________ __ Recording and control__________ _____ _ Material movement____ _________________ Custodial__ __ _______________________ Total____________________________ Number of workers______________________ Total 15.2 .7 57.9 6.4 4.4 8.5 6.9 Male Female 16.3 .7 56.3 6.0 4.5 9.0 7.2 1.4 .8 80.7 11.1 2.2 1.2 2.6 100.0 100.0 100.0 11,028 10,253 775 The major proportion of the impaired workers were found in jobs in the processing or producing opera tions in the various plants studied. This kind of employment of impaired workers undoubtedly re ceived a sharp stimulus during the war years. It also reflects the efforts of public and private place ment agencies and personnel and medical depart ments of many industrial plants to assign the appli cant where he fits best by matching the require ments of the job with the abilities of the man. This practice, commonly referred to as selective place ment, has resulted in opening jobs throughout the plant to the impaired person. The very variety of skill requirements shown demonstrates conclusively that jobs such as watchman and janitor need no longer constitute the employment opportunities for those who have had even severe limitations placed on their physical equipment by the ravages of ac cident, illness, or the hazards of war. 18 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES CH AR T 5 OCCUPATIONAL DISTRIBUTIO N O F IM PAIRED W O RKERS IN SURVEY GROUP PERCENT 0 10 20 30 40 ___ 50 X, MAINTENANCE W o r k in g fo r em an INSPECTION & TESTING MATERIAL MOVEMENT UNITED STATES DEPARTMENT OF LABOR BUREAU OF LABOR STATISTICS NOTE- SURVEY GROUP INCLUDED It,0 2 8 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING. 60 ”1 THE IMPAIRED WORKER IN INDUSTRY Placement Practices6 A proper evaluation of the performance data of impaired and unimpaired workers requires that the analysis take into account the placement practices used in the plants studied. With adequate factual knowledge of the requirements of the particular jobs and of the environmental conditions under which the work is performed, and with an inventory of the physical abilities of the applicant (results of the physical examination), it is reasonable to believe that the placement officer will be able to place the appli cant intelligently. Under a hit-or-miss method, it is not unlikely that the person with a given impair ment will be placed on a job which requires powers or abilities he does not possess. Through no fault of his own the impaired person might be placed at such a disadvantage that he would be a failure in the job from the start. In the discussions preliminary to the study, the opinion was advanced that in the plants which prac tice selective placement the impaired automatically turn in a better record of work performance than the unimpaired workers matched with them. It was found however that, in practice, selective placement is not usually limited in its application to impaired persons. Consequently, the unimpaired benefit as well as the impaired. In the absence of intelligent placement practices, however, the impaired are likely to suffer disproportionately more. The basic fallacy underlying the opinion stated above is that the so-called “ unimpaired” person does not need selective placement. Whether the practice is dignified with the name of “ selective placement” or not, it has long been a basic tenet of sound personnel prac tice that an applicant, no matter how able-bodied, cannot be assigned to just any job. Every placement officer practices selective placement in some degree when he balances the qualities he wants in a certain job against the apparent abilities and capabilities of the applicant. To a degree, the data compiled in this report are 6 F or other detailed discussions o f various phases o f jo b p lacem ent see T h e P h ysically H a n d ica p p e d in Industrial E stablishm ents o f th e G overn m ent, b y V erne K . H a rve y, M .D ., an d E . Parker L u ongo, M .D ., U .S. C ivil Service C om m ission, in Journal o f the A m erican M e d ica l A ssociation , Jan. 9, 1943; J ob P lacem ent o f the P h ysically H an dicapped, b y C lark D . B ridges, N ew Y o r k , M c G r a w -H ill B o o k C o ., In c., 1946; O perations M anual fo r P lacem ent o f the P h ysically H an dicapped, U .S. C iv il Service C om m ission, W ash in gton , 1947; and M a tch in g the P h ysical Character istics o f W orkers and Jobs, b y B ert H anm an, in Industrial M ed icin e, M a y 1945. Selective P lacem en t fo r th e H an d icap p ed , R e v . F e b . 1945. U . S. E m p loy m en t Service. 19 biased in the direction of the plants with more ad vanced placement practices because of the necessity of selecting for study only plants whose medical records revealed physical impairments. This re quirement was necessary in order to select, first, the impaired workers within the definitions adopted for the study and, second, the unimpaired workers to be matched with them. The scope of the medical examinations varied widely among the 109 plants surveyed. In some instances the examinations were comprehensive and included blood and urine analysis, X-ray examina tion, etc., for every applicant. In other cases, such tests were made only when the applicant's history indicated their advisability or when the kind of employment being offered indicated their necessity. In most of the plants, the examination was made by a plant physician. In others, forms were supplied by the plant and the examination was made by the applicant's family physician or by a physician desig nated by the employer. A further factor which had tb be considered when setting up the survey groups was the recency of the physical examination. Some plants which otherwise might have been selected for study had to be ex cluded because the physical examination data for many of the employees were too old to be depend able. On the other hand, many of the plants studied provided annual physical examinations or examina tions following any illness or injury of the employee. In general, however, the absence of adequate data of this kind handicapped the study. Because no pre- or post-employment physical examinations were given, 62 plants had to be excluded from the survey. As already indicated, these plants were the larger firms in their various communities. There were various reasons why physical examinations were not used. In some cases it was a matter of tradition. In other cases it was because of objection on the part of the employees, who feared that the physical exami nations might be used to prevent the employment of workers objectionable to management for other reasons, or that workers would be laid off rather than placed in other suitable jobs. In many plants it has been a long-standing policy to exclude certain types of physical impairment. When in the course of the pre-employment physical examination the specific type of impairment is dis closed, the applicant is automatically rejected. The 20 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES type of exclusion referred to here is not selective in the sense that certain impairment types are rejected only for certain kinds of jobs. This exclusion is of a general nature and the person with the specified impairment will not be accepted for employment on any job in the plant. During the war most plants relaxed the physical standards to be met by new employees. Since the end of the war, however, many plants were found to have reinstituted exclusions in their hiring policies affecting certain types of impairments. A sizable number of the 109 plants included in the present study stated specific exclusions as a matter of com pany policy, as follows: Excluded impairments Number of plants Hernia_________________________ Epileptic______________________ 33 32 Cardiac------------------------------------ 27 Vision__________________________ Orthopedic____________________ 16 11 Diabetic_______________________ Ex-tuberculous_______________ 8 7 Peptic ulcer___________________ 4 Hearing________________________ 3 Six plants excluded all impaired applicants as a matter of policy, and 75 plants had no definite policy as to specific exclusions. On the other hand, only 25 of the surveyed plants had definite, stated policies of no exclusions because of any impairment. In these plants, if the abilities of the applicant met the requirements of the job vacancy, physical impair ment was not a cause for rejection. The question may well be asked: How were these plants included in the study in the face of these exclusion policies, particularly the six plants which professed to exclude all types of physical impair ment? The seeming contradiction is resolved by the fact that persons acquiring impairments subsequent to their employment were not discharged but were placed in jobs they were able to perform. There is a sort of unconscious distinction between the person who has acquired an impairment after entering the service of the company and the impaired applicant seeking employment. It is more than a sense of responsibility to the impaired employee, although that is a factor. The employee who has become im paired in the company’s service is a good man who, perhaps, has to be put on somewhat different work. The impaired applicant, on the other hand, is an untried person who presents an immediate problem of placement. Also, some of the impaired persons hired during the war were retained in their jobs. As a result, these firms had sizable numbers of impaired persons in their employment even though no addi tional persons with impairment were being hired. In a large number of plants, the exclusion of the impaired was more thorough: 76 of the large plants contacted had to be excluded from the study be cause not enough impaired workers were employed to justify the time and expense involved in searching the records and recording the performance data. The minimum had been set at 20 impaired workers. The employment methods used varied consider ably among the plants studied. The plants ranged from small to large operations, but in each of them a clearly defined personnel function had been (estab lished as the responsibility of some person or group. It seems reasonable to believe, therefore, that the placement practice which characterized these firms are representative of that segment in manufacturing industry in which the personnel problem had received careful consideration. The placement techniques used in the firms studied differed with the requirements of the various types of operations and the needs of the individual plants. In 55 plants, comprehensive job analyses were in use; 19 plants used job descriptions; and 7 plants utilized job analyses only for selected departments and occupations. In 28 plants no such data were used; but in 11 of them, job analysis studies were under way at the time the survey was made. Many of the plants also supplemented their own facilities with others obtained from the United States Em ployment Service and other sources. The actual placement of the impaired worker was also subject to a variety of methods. In many of the plants, the placement required the approval of the medical department, in some the approval of the safety department, and in a few the foreman made the assignment with the approval of the personnel or employment manager. Transfers from one job to another were handled in much the same way. In most of the plants studied, considerable importance was attached to the approval of transfers by either the medical, safety, or personnel departments, or some combination of the three. The reason, of course, was that if transfers were made by a foreman or other supervisor who was not acquainted with place ment techniques, and for that matter might not even have known which of his men had organic impair ments, serious difficulties might result. The impaired THE IMPAIRED WORKER IN INDUSTRY person might be put on a job he was not at all equipped to perform, one in which he might even endanger himself or others. A few such instances actually were encountered during the study. To insure against such mischance, most of the plants required approval by higher authority before trans fers and reassignments could be effected. In some places this applied to all employees, in others only to certain employees on “ limited” or “ restricted” lists. In practically all of the plants some form of follow up was maintained, but only in very few cases was it sustained over any considerable period of time. For the most part, a follow-up was made at the end of a probationary period. Beyond that point no further follow-up was made except in cases of complaint on the part of the supervisor or employee. It was prob ably because of this absence of systematic and periodic follow-up that some of the very high indi vidual rates of absence and injury on the part of both impaired and unimpaired workers were found in a number of plants. It is not the purpose of the present study to pass judgment on the placement practices as they affected impaired workers in the plants studied. Effective placement of the impaired worker is not a matter of interviews, formal job analyses, assignment con trols, etc. These are merely some of the tools which can be used. The care and understanding with which they are used is the final determinant. If the im paired worker is automatically excluded by the mere existence of the impairment, the tools at hand are meaningless for him. On the other hand, if he is considered in terms of what he can do as against what the given job requires he is on an equal com petitive footing with the unimpaired applicant. Obviously, the greater the extent to which place ment can be translated from a subjective to an ob jective plane by the use of such devices as job re quirements data, etc., the better. But the study indicates clearly that it is not essential that each company contemplating the employment of im paired persons must undertake elaborate and ex pensive research as a prerequisite. Assistance, if it is needed, is readily available from the United States Employment Service and other governmental and private agencies. For the most part, the techniques used for intelligent placement of so-called 11normal” workers are all that need be brought into play for effec tive placement of the impaired. The essential addition 21 is that the nature of the impairment and the require ments of the job be clearly understood by all concerned. One very significant fact brought out in the present study was the nearly complete absence of job re engineering for the impaired. One hundred and nine plants employing 11,000 impaired persons had not found extensive re-engineering necessary. In a few instances, slight modifications had been made in the machines or in the work place when impaired workers were placed on the job. However, in large part the same modifications had subsequently been adopted for the unimpaired workers as well. Thus, the study demonstrates clearly that extensive and expensive re-engineering of jobs was not necessary for the em ployment of sizable numbers of physically impaired persons. Selective placement as it applies to the impaired and to the unimpaired person differs only in degree. No matter how sympathetic the employer may be toward hiring impaired persons, the basic fact re mains that in one way or another the impaired person is limited as to job assignments. He cannot be put on just any job that happens to be available. In a large number of plants the management told Bureau field representatives that impaired persons would be hired regardless of impairment if they had special skills. In plain terms, the person with a severe physical impairment must have a skill to sell which will make it worth while for management to under take a solution to the problem of his placement. The industrial establishment with a competitive position to maintain can afford to hire the impaired person because of his skills, not because of his impairment. This, of course, throws the emphasis on rehabilita tion and retraining. Whether an impairment destroys an existing skill or an impairment exists before skills are acquired, it is of the utmost importance that the impaired person acquire specialized skills. The present study has indicated clearly that such skills can be exercised by impaired persons and that such persons can turn in a record of work performance comparable to that of unimpaired workers on the same jobs. The study also brought out the fact that the emphasis in placement is upon finding the job in which the impaired person can exercise his special abilities to the best advantage. If impaired persons are to be employed in greater numbers, it is highly desirable that they bring to the jobs for which they apply a specialized training and ability which will induce management to hire them. 22 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES A. The Hernia Cases Summary of Statistical Findings The record of work performance of 3,544 workers with hernias was nearly identical with that of 5,869 unimpaired workers matched with them on the same jobs. Differences between the two groups were fractional for most of the factors studied. With respect to frequency of absenteeism, nondisabling work injuries, and disabling work injuries the rates varied by tenths of a point. The time lost as a result of disabling injuries was higher for the hernia cases by only a fractional part of a day. The quit rate, too, was slightly but not materially higher for the hernia cases. However, as a group the hernia cases on in dividual incentive work recorded an output slightly over 1 percent higher than the unimpaired on the same jobs. In view of the marked similarity of the per formance records, it seems reasonable to conclude that the hernia cases were not handicapped by the impairment as far as job performance was concerned. T a b l e A - l .— Work performance of workers with hernias and of matched unimpaired workers Number of workers Average performance Factor Unimpaired Impaired Unimpaired 3,544 5,869 3.2 3.1 3,501 5,806 9.2 9.1 3,543 3,543 5,868 5,868 226 1,805 365 3,068 9.9 .12 14.8 101.5 2.9 9.9 .11 14.4 100.0 1.8 Impaired Absenteeism frequency rate1-----Nondisabling injury: Frequency rate2___________ Disabling injury: Frequency rate3___________ Time-lost rate4____________ Average days of disability 5 Output relative 6_ _ ______ ____ Quit rate7 __________ _________ 1 Number of days lost per 100 scheduled workdays. 2 Number of injuries per 10,000 exposure-hours. 2 Number of injuries per 1,000,000 exposure-hours. 4 Number of days lost for disabling injury per 100 scheduled workdays. 6 Number of days of disability per disabling injury. 8 Percentage relationship of production efficiency of impaired to that of unimpaired. 7 Number of voluntary quits per 100 employees in the survey group. Composition of the Survey Group The definitions adopted for the study required that in selecting impaired workers in each plant only cases of existing hernia were to be taken. All cases of incipient or potential hernia, relaxed rings, and cases in which the worker had undergone a successful herniotomy were excluded. Inguinal hernia was by far the most common type found, and accounted for 2,409 cases. Of those, 51 were direct, 145 were indirect, 565 were double, and 1,648 were listed merely as inguinal hernia without further designation; 220 cases were recorded as umbilical herinas. There was also a fairly large group, 915 cases, which the plant records described only as “ hernia” without any further information as to type. For the purposes of the present study, no comparative performance tabulations were prepared for each of the several types of hernias, and all data shown cover the entire group. Workers with hernias tended toward the higher age ranges. Only 6 percent of the hernia cases were under 30 years of age while 17 percent of the other impaired workers fell in this age group. On the other hand, while 38 percent of the other impaired workers were 50 years of age or over, fully 51 percent of the hernia cases fell in this group. Nearly 60 percent of the hernia cases fell in the 20-year range from 45 to 65 years, and 34 percent in the 10-year range from 50 to 60 years. This is probably owing to the fact that hernia is a fairly common work injury. Because of longer exposure to conditions that produce hernia, it is only natural for older workers to show a greater incidence of hernia than younger workers. It is possible, too, that there is less inclination on the part of the older worker to undergo a herniotomy except in emergency cases. In general, however, older men are not placed on jobs requiring heavy lifting or strenuous exertion. These conditions are also of major importance in placing workers with hernias, young or old. Hernia cases were encountered more frequently in the survey than any other type of physical impair ment. The 3,544 cases studied constituted nearly a third of all the impaired workers with whom unim- 23 A. THE HERNIA CASES T a b l e A -2 .— Comparison of number and percentage distribution of 8,544 hernia cases and 7,484 other impaired workers studied, by age group Percent Number of workers Age group Hernia cases Hernia cases Other impaired Other impaired ... 3,544 7,484 100.0 100.0 Under 20 years_________ _____ ______ 20 and under 25 years______________ 25 and under 30 years______________ 30 and under 35 years______________ 35 and under 40 years______________ 40 and under 45 years______________ 45 and under 50 years. ____________ 50 and under 55 years ------------- -------55 and under 60 years. ____________ 60 and under 65 years _ _____ . . . 65 years and over. ________________ 8 64 146 264 372 408 460 608 602 419 193 71 447 755 853 812 830 852 954 941 669 300 .2 1.8 4.1 7.4 10.5 11.5 13.0 17.3 17.0 11.8 5.4 .9 6.0 10.1 11.4 10.8 11.1 11.4 12.8 12.6 8.9 4.0 Total_________________________ paired workers could be matched in the 109 plants studied. This large group was overwhelmingly male. Only 35 of the group, or about 1 percent, were females. Because of the small number of observa tions for the female group, no performance data for these cases are shown. Their influence on the group averages was negligible. Industry and Occupational Coverage The hernia cases were very widely distributed throughout the 19 major industry groups surveyed. In fact, hernia cases were found in all of the 109 companies studied. This is particularly interesting in light of the fact that more companies had specific exclusion policies concerning hernia cases than for any other of the impairments included in the study. To some extent the large number of hernia cases encountered can be accounted for by the retention of employees who contracted hernias after entering the employment of a company. The jobs at which these impaired persons were employed were about as varied as the hernia cases were numerous. The following list of occupations in which these impaired persons were found employed indicates that most of them were in direct pro duction activities. The number on maintenance, inspection, and similar types of occupations was small. Only about 3 percent of the group were on custodial jobs, such as sweepers, janitors, etc. The range and variety of skills represented is very broad. This is not surprising because the nature of the her nia impairment does not tend to destroy skills al ready acquired unless heavy lifting is involved. Similarly, the impairment places few limitations upon the acquisition of new or additional skills. The evidence of the present study points clearly to the fact that employment opportunities for workers with hernias were present in a very wide variety of industries and occupations. The jobs listed are merely illustrative. Many other jobs on which work ers with hernias were employed do not appear in this list because the impaired worker could not be in cluded in the survey group. Jobs at which 8,544 Hernia Cases of the survey group were found employed [[Titles used are those app earing in the U n ite d States E m p lo y m e n t Service D ictio n a ry o f O ccu p ation a l T itles an d are grou p ed and n um bered a cco rd in g t o the classifications used b y the W age A nalysis B ran ch o f the B u reau of L abor Statistics. T h is is n ot to be interpreted as a com plete listing o f jo b s at w hich persons w ith hernia im pairm ent can be e m p lo y e d ] 1. Maintenance Electric-truck repairman Laborer (forging) Electrical-instrument repairman Laborer (foundry) Electrical repairman Laborer (glass manufacturing) Automobile mechanic Electrician, locomotive Electrician, powerhouse Laborer (iron and steel) Laborer (machine shop) Blacksmith II Fireman, stationary boiler Laborer (machinery manufacturing) Boiler operator II Flame-cutter operator Laborer (m alt liquors) Boilermaker H od carrier Bricklayer I I Instrument repairman Laborer (nonferrous metal alloys and products) Bricklayer, refractory brick Kitchen helper II Laborer (office machines) Carpenter Laborer (aircraft manufacturing) Laborer (paper and pulp) Carpenter, flask Laborer (ammunition) Laborer (petroleum refining) Cement finisher II Laborer (automobile manufacturing) Laborer (rayon and allied products) Chauffeur I I Laborer (boot and shoe) Laborer (wire) Coal pulverizer operator Laborer (building) Laborer, process (dental equipment) Concrete-chipper man Laborer (electrical equipment) Electric-truck operator Laborer (fabricated plastic products) Laborer, process (nonferrous metal and products) Airplane mechanic Asbestos worker, general 24 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES J o b s at w h ich 8 ,5 4 4 H e r n i a C a s e s o f the s u r v e y g r ou p w ere f o u n d e m p lo y e d 1. Maintenance — Continued — Continued Soda-room man Celluloid-roll man Stillman II Centering-machine operator Laborer, process (petroleum refining) Centerless-grinder operator L ay-ou t man I Charging-machine operator I Lead burner 3. Processing Machine apprentice Chassis assembler II Checker Machinist II Absorberman Chiller man Maintenance man, factory or mill Chipper, foundry Maintenance mechanic II Absorption-plant operator Acid maker I Millman Adjuster II Millwright Oiler II Ager Circular-sawing-machine operator Coil assembler II Aircraft carburetor subassembler Coil assembler IV Oiler, machinery Aircraft mechanic Coil winder I I Painter I Airplane woodworker Cold-saw operator Painter, sign Airplane woodworker II Annealer Color matcher IV Compounder helper Pipe fitter Pipe-fitter helper Annealer II Control man Annealing-bath operator Control man I I I Plumber Apprentice machinist Conveyor man Plumber apprentice Armature winder I Assembler IV Cooper I Powerhouse engineer Refrigerating engineer Assembler II Coremaker, machine I Refrigerator mechanic Assemblyman helper I I Coremaker, machine I II Rigger I I I Autoclave operator Core-oven tender Sheet-metal worker I I Stationary engineer Automobile mechanic, motor I Baker I Core paster Steam fitter Balancing-machine operator Crankshaft plugger Structural-steel worker Band-ripsaw operator Cupola tender Switchboard operator I I I Cutter, hand I V (boot and shoe) Tool-grinder operator Band-sawing-machine operator Barrel driller T ool maker Barrel filler II Cutter, machine V Truck mechanic Baster, hand Cutter-off II Tube cleaner Turbine operator W asher, machine II Batch-still operator II Batteryman II Cyanide furnace operator Cylinder-block repairman Cylinder-machine operator Cylindrical-grinder operator Welder, arc Batting-machine operator Bead flipper, hand Beater operator Welder, combination Bench assembler V Pipe bender, machine W ater filterer Wire-fence erector Bench grinder W elder helper, acetylene Bending roll operator Blacksmith II Yardm an I Blank horner Churn man II Coremaker I Correction man I II Cutter, machine I Defective-cigarette slitter Dehydrogenation operator Detail assembler I II Die-casting-machine operator II Die maker II Die-setter I Bottle-machine operator II D ie sizer operator Box maker, wood I II D ie weigher I I Absorption-plant operator Box tender I Digest operator I Brakeman, yard I Brakeman, automobile Dipper I I Chemical-laboratory chief Brake operator, machine I I Dissolver operator II Foreman (electrical equipment) Broaching-machine operator Dividing machine operator Foreman (paper and pulp) Bucket-conveyor operator Do-all-saw operator Foreman (petroleum refining) Buffer I Dockm an I I Foreman (nonferrous metal alloys and Buffer, machine Dough-mixer Burrer, hand Drawer builder Glass grinder Button-hole machine operator Drophammer operator II Glass polisher Calender operator I Dryer operator Grease maker, head Carton-forming-machine operator Drying-machine operator Hammersmith Casting finisher D yer V I I Laborer, process (glass manufacturing) Catalytic-convertor operator Dynam ic balancer Pumpman X I I Causticiser man 2. Working Foremen products) 25 A. THE HERNIA CASES J o b s at w h ich 8 ,5 4 4 H e r n i a C a s e s o f the s u r v e y g r ou p w ere f o u n d e m p lo y e d — Continued 3. Processing — Continued Ingredient scaler Instrument maker I Laborer, process (iron and steel) Laborer, process (leather manufacturing) Electric-arc furnace operator Instrument maker I I Laborer, process (machinery manufac Electric-motor assembler Instrument maker IV Electric-motor repairman Insulating-machine operator I Laborer, process (machine shop) Electrical assembler I I Internal-grinder-operator Laborer, Electrician, airplane I Jig-boring machine operator Engine-lathe operator Job setter II Laborer, process (m alt liquors) Experimental-body and minor assembler K ettle operator Laborer, process (nonferrous metal alloys turing) process (machine tools and accessories) Experimental mechanic Kettle operator, head External-grinder operator I Laborer (aircraft manufacturing) Extruder operator II Laborer (automobile manufacturing) Laborer, process (petroleum refining) Filler mixer I Laborer (automobile parts) Laborer, process (phonograph) and products) Laborer, process (paper and pulp) Film-drying-machine operator Laborer (bakery products) Laborer, process (plastic materials) Filter cleaner Laborer (boot and shoe) Laborer, process (plexiglas) Filter man V Laborer (cutlery tools) Laborer, process (plumbing supplies) Filter operator V Laborer (foundry) Laborer, process (radio manufacturing) Laborer, process (rayon and allied Filter-press operator I Laborer (furniture) Final assembler V II Laborer (glass manufacturing) Fireman, still Laborer (glass products) Laborer, process (rubber goods) Laborer, process (rubber tire and tube products) First helper II Laborer (iron and steel) Flaker operator I I Laborer (leather products) Floor assembler Laborer (machine tools and accessories) Foil-rolling-machine operator Laborer (m alt liquors) Ladle man I I Folder, hand I Lapping-machine operator Forging-press operator Laborer (nonferrous metal alloys and products) Lathe operator, automatic I Form builder I Laborer (paper and pulp) L ay-out man (foundry) Forming-press operator I Laborer (petroleum refining) Lay-out man (shop) Furnace-tender, heat treating Laborer (phonograph) Lead burner I I Furnace tender, oil-gas Gager man V II I Laborer (photographic apparatus) Laborer (plastic materials) Lehr man Gatherer I I Laborer (radio manufacturing) Leverman, shear table Gear-hobber operator Laborer (rubber tire and tube manu Lime slaker I I I Gear-milling machine operator manufacturing) Laborer, process (wire) Lead coater facturing) Lithographic-press man General assembler II Laborer (wire) Glass blower II Laborer, process Glass blower, laboratory apparatus Glass cutter Glass grinder ing) Laborer, Glass polisher Laborer, process (aluminum products) Laborer, process (ammunition) M achinist II Laborer, process (asbestos products) M ajor assembler I Laborer, process (automobile manufac M ajor-assem bly installer Marker Grainer, machine I I Grid-caster, automatic Grid-machine job setter Grid paster process Loader V II (aircraft manufactur (agricultural equip ment) turing) Machine adjuster I II Machine molder, jarring Machine molder, rollover Machine operator, separator department M achinist, bench Grinder Laborer, process (automobile parts) Grinder operator IV Laborer, process (bakery products) M c K a y stitcher Melter IV Hammersmith helper Laborer, process (chemicals) M etal finisher, hand filing Hardener II Laborer, process (coke production) Milling-machine operator I I H eat treater I I Laborer, process (cutlery tools) Milling-machine operator, automatic Heater I I I Laborer, process (electrical equipment) M illman Heater, forge Laborer, process (electroplating) M ixer II Heater tender Laborer, process (foundry) Mixing-machine operator I Honing machine operator Laborer, process (furniture) M ock-up assembler Hot-blaster man Laborer, process (glass manufacturing) M old closer Incinerator man II Laborer, process (glass products) Molder Induction-furnace operator Laborer, process (instrument and Molder, bench Induction-furnace operator helper 776106° — 48 — 3 appliances) Molder, squeeze 26 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES J o b s at w h ich 3 ,5 4 4 H e r n i a C a s e s o f the s u r v e y g rou p w ere f o u n d e m p lo y e d 3. Processing — Continued — Continued Reverberatory-furnace operator Surface-grinder operator Rheostat assembler Sweater man M olding-machine tender M old painter Ripening-room operator Swinging-cut-off-saw operator Switch adjuster M old setter I I I Riveter, pneumatic I II Switch room man M otor adjuster Roller operator V Table splicer I Multiple-spindle-drill-press operator Outsole molder Roller operator I X Tablem an I I I Rougher II Tacker V I I Oven fireman Router operator I II Tankroom man III Ovenman helper Rubber compounder Oven tender I Sandblaster, glass Tankroom man I V Teaser I I Oven tender V I Sand-cutter operator Temperer I I I Painter, aircraft Sand-slinger operator Template filer Riveter, aircraft Painter, brush II Saw filer, hand Tem plate maker IV Painter, sprayer I Saw filer, machine Thread-milling-machine operator Panel trimmer Saw setter II Thrower I I Paper cutter V Screw-machine operator, automatic Tin plater I I I Paste cooker Screw-machine operator, semiautomatic Tire bagger Patternmaker X I Seaming-machine operator IV Tire builder, drum Patternmaker, metal Second helper II Tire repairer Patternmaker, wood Setter, hand T ool designer Photostat operator Sewing-machine operator, shirts and re Pilot-control operator lated products Tool grinder operator T ool maker Pipe-threading-machine operator Shaper operator I Treater II Planer operator II Shaving machine operator Treater helper Platen-press feeder Sheet-metal-fabricating-machine Treer, hand Plater I operator Plexiglas former Sheet-metal worker II Trimmer, hand V I I I Trimming-press operator II Plunger Sheet-metal worker, aircraft Tube-bending-machine operator I Pointer operator Sheet-metal worker, aircraft II Tube cleaner Polisher Single-spindle-drill-press operator Tube drawer Pot fireman Slicking-lathe operator Tube-machine operator I I I Pot-heater tender Pourer, bull ladle Slitting machine V I Slitting machine operator Tumbler operator II Turret-lathe operator Pourer, crane ladle Power shear operator I Soda-room man Solderer I Twisting-machine I Up-fitter I I Press cutter Sorter Vertical-boring-mill operator Presser, hand I Speed-lathe operator Vertical-lathe operator Presser, machine I Spinner V I Spinning-bath patrolman Wafer-machine operator Pressman Pressman, paraffin plant Splicer II Watchcase-vulcanizer tender Profiling-machine operator Sprayer V I W elder, acetylene Profiling-machine operator I I Spreader I W elder, arc Pumpman I Spreader operator II Welder, butt Pumpman V II Sticker Welder, combination Pumpman X I I Stillman II W elder, flash Pumpman helper Stillman helper W elder, spot Punch-press operator I Still-operator helper W ire drawer I I I Punch-press operator II Straightener, hand Wire-tinning-maehine tender Pyrometer man I I Straightening-machine operator I I W ireman V I Quenching-car man Straightening-press operator W arm -in box Radial-drill-press operator Stranding-machine operator Radiator-core assembler Stretching-machine operator II Radiator-core dipper Strip-mill operator Airplane inspector Radio-chassis aliner Subassembler Airplane inspector I Reactor operator I Subassembler I I I Body-assembly inspector Repairman V Subassembly installer II Bottle inspector IV 4. Inspection and Testing 27 A. THE HERNIA CASES J o b s at w h ich 8 ,5 4 4 H e r n i a C a s e s o f the s u r v e y g r ou p w ere f o u n d e m p lo y e d — Continued 4. Inspection and Testing — Con tinued 5. Recording and Control Laborer (iron and steel) Laborer (leather products) Checker Laborer (machine tools and accessories) Casting inspector Clerk, general Laborer (machinery manufacturing) Checker Expediter I I Laborer (m alt liquors) Laborer (nonferrous metal alloys and Checker I M aterial clerk Chemist, assistant I I M aterial planner Chemist, organic M ill recorder Laborer (petroleum refining) Chemist, physical Parcel-post packer Laborer (photographic apparatus) Cloth examiner, hand II Production clerk II Laborer (plastic materials) Core checker Production planner Laborer (plumbing supplies) Deflector operator Receiving clerk I II Laborer (rayon and allied products) Electrical inspector I I Shipping checker Laborer (rubber tire and tube manufac Engineman II Shipping checker I I Experimental mechanic Shipping clerk I Shipping clerk II Final-assembly inspector Final-assembly inspector, fuselage Stock chaser I I products) turing) Laborer (surgical appliances) Laborer (wire) Laborer, process (automobile manufac turing) Final tester II Stock-control clerk Stock supervisor Gager I V Tallym an I I I Laborer, process (iron and steel) Gear roller Timekeeper Hardness inspector Tool clerk Laborer, process (nonferrous metal alloys and products) Hot-forging inspector Weigher I I Laborer, process (paper and pulp) 6. Material Movement Laborer, process (rayon and allied products) installation Inspector I Inspector I I Inspector, Chief I Laborer, process (bakery products) Laborer, process (rubber tire and tube) Inspector, Chief I II Brakeman, yard I Locomotive-crane operator Inspector, crude rubber Bucket-conveyor operator Locomotive engineer, gasoline Rigger X Inspector, hammers and presses Diesel-dinkey operator Inspector (machine shop) Dum p-truck driver Inspector, plate forming and drying Electric-bridge-crane operator Routeman I Shipping clerk I I Inspector, raw materials Inspector and tester Electric-monorail-crane operator Electric-truck operator Truck-crane operator Tractor operator Installation inspector Elevator operator, freight Truck driver, heavy Instrument maker I Floor boy II Truck driver, light Laborer (iron and steel) Follow-up man I II Laborer (machine shop) Laborer process (glass manufacturing) Gasoline-truck operator Hot-metal-crane operator 7. Custodial M eter tester Industrial-locomotive operator Laborer (aircraft manufacturing) Filter cleaner Planer operator I I Procurement inspector Laborer (aluminum products) Fire equipment man Fireman I I I Pump tester Laborer (automobile manufacturing) Gateman I V Radio repairmen I I I Laborer (automobile parts) Raw-material inspector II Laborer (bakery products) Grounds keeper I Janitor I Refrigerator inspector Laborer (chemical) Salvage inspector I I Laborer (cutting tools) Laborer (automobile manufacturing) Laborer (automobile parts) Sheet-metal inspector I Laborer (electrical equipment) Laborer (felt goods) Tester I Laborer (fabricated plastic products) Laborer (foundry) Tester, chemical process Laborer (firearms) Laborer (machinery manufacturing) Tire inspector II Laborer (foundry) Laborer (petroleum refining) Porter I Tool inspector Laborer (glass manufacturing) W elding inspector I Laborer (glass products) Porter I I X -r a y technician II Laborer (hardware) W atchm an I 28 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES Placement Practices N o special features of placement were encountered in the placement of hernia cases. For the most part, a knowledge of the existence of the condition and a knowledge of the simple physical requirements of the job were found to be sufficient for proper placement. The pre-employment physical examination is the only means by which the nature and extent of the impairment can be determined accurately. In the absence of the examination, the applicant may or may not admit the existence of a hernia. In the event he chooses to withhold the information, he may be placed on a job which will aggravate his condition. Such a result may have serious consequences for both the impaired person and the company employing him. The principal consideration involved when the existence of a hernia has been established is that the worker shall not be placed on a job requiring excessive lifting or other strenuous exertion which is likely to cause strain. In general, other factors such as the pres ence of moving equipment, high speed machinery, etc., are not particularly significant unless the applicant has other characteristics which influence the match ing of abilities to the requirements of the job. Place ment is thus comparatively simple, a fact which probably accounts in part for the large number of hernia cases encountered in the survey. Because restrictions were few, the hernia group was found to be more mobile than most of the other impairment groups. Given the requisite skills, a worker with a hernia can perfom many of the jobs in a given shop. Furthermore, clearance of transfers through the personnel and medical departments was also found to be comparatively simple. One of the most important aspects of the employ ment of a worker with a hernia is the possible ag gravation of the existing hernia, and the likely increase in workmen’s compensation costs. However, this factor can be controlled. In the entire survey group of more than 3,500 persons with existing hernias, only one instance of an abdominal strain was recorded as a disabling injury. The degree of control exercised in the various plants varied widely. In some plants an applicant with a hernia was re quired to have it repaired within some reasonable period after employment. In other plants, the em ployee had to agree to wear a truss. In some plants periodic checks were made to determine whether the employee complied with this requirement. Primarily, of course, the best control for existing cases is pro vided by careful placement and adequate provision for review of transfers by the personnel and medical departments. On jobs which do not involve factors that might aggravate the hernia condition, it probably is not important whether the worker has a hernia or not. Although it may be to the personal advantage of the individual to have his hernia re paired, if that can be done, the existence of the hernia did not have an adverse effect on work performance of the survey group. Work Performance As it was possible to obtain data on a large group of active hernia cases, findings were possible for all of the factors of work performance under considera tion in the study. Table A - l and the following paragraphs summarize the findings: Absenteeism All absences of 1 day or more on days on which an employee was scheduled to work were recorded for each member of the survey group. Absenteeism rates were computed for each individual as well as for the group as the number of days absent per 100 sched uled workdays. Lay-offs, regular vacations, etc., were not counted either as absences or as days scheduled for work. Data were available on absenteeism for all of the 3,544 hernia cases and the 5,869 unimpaired workers matched with them. The rates for the two groups were practically identical, 3.2 and 3.1, for the im paired and matched unimpaired workers, respec tively. The slight variation in the rates indicates that, as a group, the hernia cases had 1 day more of absence than the matched unimpaired in each 1,000 scheduled workdays — clearly not a significant difference. As a group then, it can be said that the hernia cases were as regular in their work attendance as the matched unimpaired workers on the same jobs. Comparison of the individual rates by means of a frequency distribution bears out the similarity of performance indicated by the group averages: 26 percent of the impaired and 25 percent of the unim paired had no absences at all during the period studied; 74 percent of the impaired and 75 percent of the unimpaired had rates of 3.9 days per hundred 29 A . THE HERNIA CASES or lower. A scattering of poor performance was found in both groups: 1.4 percent of the impaired and 1.5 percent of the unimpaired had excessively high individual rates of 20.0 or higher. Individual cases of this kind, however, may be expected in any sizable group of workers. T a b l e A - 3 .— Percentage distribution of 8,544 hernia cases and 5,869 unimpaired workers, by absenteeism frequency rate 1 Absenteeism frequency rate class Impaired Unimpaired 0....................................................................................... 0.1 and under 1.0........... ................................. .............. 1.0 and under 2.0_________________________________ 2.0 and under 3.0____________ ______ _____ _____ ___ 3.0 and under 4.0..... ............... ............. ........... ............ 4.0 and under 7.0............. ......................... - ............. ...... 7.0 and under 10.0............... ................... ....................... 10.0 and under 20.0_________________________ _____ 20.0 and over_____________ ___________ ______ _____ 25.7 17.5 14.2 9.5 7.4 12.1 5.4 6.8 1.4 24.7 17.9 15.5 9.8 7.0 12.9 4.8 5.9 1.5 Total.................. ........................... ....................... 100.0 100.0 1 Number of days lost per 100 scheduled workdays. An effort was made to determine the cause for each absence. The results were disappointing, how ever, as information on the reasons for absences were available for less than half the absences reported. To the extent to which such reasons were obtainable, however, the rates attributable to various causes for absence were nearly identical for both the im paired and the unimpaired workers (see table A -4). Within the limits of the data, it appears that the persons with a hernia condition did not lose any more time than the unimpaired workers because of actual or alleged illness. T able mately 2,000 hours of work per employee. Data were available for 3,501 of the impaired workers and for 5,806 of the unimpaired workers matched with them on the same jobs. For the re maining cases the records were not available. For the group as a whole, the rates were 9.2 and 9.1 nondisabling injuries per 10,000 exposure-hours among the impaired and unimpaired, respectively. The variation in the rates indicates that hernia cases as a group had about one more nondisabling injury than unimpaired workers for each 100,000 hours of exposure, clearly not a significant difference. It may be concluded safely that the nondisabling injury experience was the same in the two groups. The same similarity of the nondisabling injury experience was apparent on individual comparison. The individual rates computed on a 1,000-hour base are shown as a frequency distribution in table A -5. About 50 percent of the impaired and 49 percent of the unimpaired had no injuries at all during the pe riods studied; 85 percent of the impaired and 84 percent of the unimpaired had rates of less than 2 per 1,000 exposure-hours. As would be expected, some cases of very poor performance were found in both groups of workers: about 1 percent of the work ers in each group had rates of 10.0 or higher per 1,000 exposure-hours. T a b l e A - 5 .— Percentage distribution of 8,501 hernia cases and 5,806 unimpaired workers, by frequency rate 1 of nondisabling injuries A - 4 .— Absenteeism frequency rates 1 for 8,544 hernia Frequency rate class cases and 5,869 unimpaired workers, by reason for absence Reason for absence Impaired Unimpaired Total....................................... . . ......................... ............ 3.2 3.1 Illness____________________________________________ Personal business........................... —--------- -------------Unknown------------------------- -------------------------------- 1.1 .3 1.8 1.1 .3 1.7 1 Number of days lost per 100 scheduled workdays. Nondisabling Injury Experience A nondisabling injury was defined as one which did not result in any permanent impairment or in loss of time beyond the day or shift on which the in jury occurred. Frequency rates for the groups were computed on a base of 10,000 exposure-hours, and individual rates for frequency distributions on a base of 1,000 exposure-hours. The use of the smaller base was necessary for the individual cases because in most instances the periods studied covered approxi Impaired Unimpaired 0 ...................................................................................... .. 0.1 and under 1 . 0 _______ _____ ____ ______________ 1.0 and under 2.0___________ _____________ ______ 2.0 and under 5.0__________ ____________ ________ 5.0 and under 10.0______________ ________________ 10.0 and over __________________________________ 49.5 21.4 14.4 10.6 3.0 1.1 48.7 21.8 13.9 11.9 2.8 .9 Total. ................................................................... 100.0 100.0 1 Number of injuries per 1,000 exposure-hours. An effort was made to determine whether the hernia cases displayed a proneness toward any par ticular kind of injury. The rates attributable to the various kinds of injuries are practically identical in the two groups (see table A -6). Cuts and abrasions accounted for most of the injuries in both groups, and in about equal proportions. No more proneness on the part of the hernia cases toward any particular type of nondisabling injury could be determined than was apparent among unimpaired workers on the same jobs. 30 T able PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES A - 6 .— Frequency rates 1 of nondisabling injuries for 8j501 hernia cases and 5,806 unimpaired workers, by nature of injury Nature of injury Unimpaired .......... 9.2 9.1 Burns and scalds____________________________ ____ Cuts and abrasions__________ _____ ________ _____ Eye injuries______________________ ____ _________ .5 6.5 1.4 .5 .3 .5 6.4 1.5 .4 .3 Total . Impaired Strains and sprains Othnr . _ ..... . . . aged 1.3 visits per person while the 5,806 unimpaired workers matched with them averaged 1.4 visits per person. The difference between these two groups of workers with respect to demands upon plant medical facilities for nonindustrial purposes clearly is not significant, and whatever difference there may be appears to be in favor of the hernia cases. Disabling Injury Experience l Number of injuries per 10,000 exposure-hours. As a possible measure of the severity of these minor injuries, the number of redressings required per in jury was computed for each group. Although policies on first-aid services varied widely between companies, this comparison is valid because the conditions in each plant were the same for the impaired and the unimpaired workers. Among the hernia cases and the unimpaired workers matched with them practi cally no difference was found in this measure. The hernia cases had an average of 0.9 redressings per injury against an average of 1.0 for the unimpaired. Measured in this way, there was no tendency indi cated on the part of the hernia cases to experience nondisabling injuries of greater severity than was the case among the unimpaired workers. So far then as the nondisabling injury experience is concerned, frequency, severity, and nature of injury were practically identical in the two groups. From these facts it seems reasonable to infer that the nondisabling injuries were related to the hazards of the jobs and were not influenced by the existence of the hernias. The medical records also disclosed pertinent facts on the prevalence of nonindustrial illness and injury in the two groups. “ Nonindustrial visits” were de fined as dispensary visits occasioned by causes not related to the worker’s employment. For this factor, too, policies varied widely as to the use of medical facilities. However, the policies did not vary for im paired and unimpaired workers in the same plant. The purpose of these data was to determine how the two groups of workers compared with respect to demands made upon the medical facilities of the plant. Most plants were liberal in their policies and it is conceivable that impaired persons might make demands on such facilities for treatment or medi cation related to the impairment. For the hernia cases this was definitely not true. The 3,501 workers with hernias for whom data were available aver Frequency. A disabling injury was defined as a workconnected injury which resulted in a permanent im pairment or in a time loss of 1 day or more beyond the day or shift on which the injury occurred. The frequency rate was computed as the number of in juries per million exposure hours. Data on disabling injuries were available for 3,543 of the hernia cases matched with 5,868 unimpaired workers on the same jobs. The rates were identical, 9.9 for the impaired and the unimpaired groups. The workers with hernias and the unimpaired workers exposed to the same hazards had the same disabling injury experience. The similarity of this injury experience extended also to the kinds of injuries sustained. Contusions of the hands, arms, legs, and feet accounted for a sizable proportion of the injuries in both groups. Fractures of the extremities were also fairly common. Several lost-time cases resulted from infected cuts. Sprains and strains, particularly of the back and legs, were also fairly numerous in both groups. But no case of aggravation of an existing hernia was found among the impaired workers. On the other hand, four of the unimpaired workers incurred hernias during the pe riods surveyed. One reason for this difference may have been that the workers with hernias exercised somewhat greater caution when handling materials. Time Lost. Not only were the injury frequency rates nearly identical, but the average time loss per injury was nearly the same in both groups. The time-lost factor was computed in two ways: As a rate per 100 days of scheduled work for the im paired and unimpaired groups, and as the number of days lost per injury in each group. In either way, the differences between the two groups are not signif icant. The time-lost rate was 0.12 days per 100 scheduled workdays for the hernia cases and 0.11 days for the unimpaired group. On the time-lostper-injury basis, the hernia cases averaged 14.8 days 31 A. THE HERNIA CASES per injury, and the unimpaired workers 14.4 days. In each group most of the injury disabilities were of short duration, with the heaviest concentrations at 10 days and under. Plant accident reports were examined to deter mine whether injuries among the impaired workers were caused by or related to the worker’s impair ment. In none of the injuries was this found to have been the case. Similarly, no instance was found in which the hernia of an impaired worker was a causal factor in an injury to an unimpaired worker. These findings were confirmed by interview with the plant safety directors or other responsible officials. In summary, it was found that (1) the hernia cases had the same disabling injury frequency as the unim paired workers exposed to the same hazards; (2) the injuries were of about the same severity, as meas ured by the amount of time lost per injury; (3) no causal relationship between impairment and injury could be established. According to the survey find ings as well as in the opinions of responsible plant officials, the existence of a hernia condition was not a causal factor in the injury experience of either the impaired workers or their unimpaired fellow workers. Output Relative This measure was computed as a relative of the production efficiency of the impaired to that of the matched unimpaired workers, the output of the un impaired in each case equaling 100. The output rel ative could be computed only for those cases for which data on individual production were available. For all practical purposes, this meant that data for this factor could be recorded only where the impaired worker and the unimpaired workers matched with him on the same job were paid on an individual piecework or similar incentive system. In order to maintain an objective comparison, no subjective measures such as foreman’s evaluation or efficiency ratings were used. Of the present survey group, individual produc tion records were available for 226 of the hernia cases matched with 365 unimpaired workers on the same jobs. As a group, workers with hernias were 1.5 percent more efficient, and averaged that much more output per hour worked than their unimpaired co workers. This does not mean, of course, that every worker with a hernia was a superior worker. Cases of very good and very poor performance were found among both the impaired and the unimpaired workers. In general, however, the individual comparisons support the group averages. About 49 percent of the workers with hernias were as efficient as workers without hernias. For these impaired workers relative effi ciency ranged from 95 percent to 105 percent of the average performance of unimpaired workers. About 29 percent exceeded the performance of the un impaired workers with whom they were matched, by 5 percent or more; and in 22 percent of the cases the performance was poorer by 5 percent or more. Fully 78 percent of the hernia cases, then, had individual production records as good as or better than the unimpaired workers with whom they were matched on the same jobs. The percentage of im paired workers with poor performances was more than offset by the percentage of workers with su perior performances: Output relative Number o f impaired workers Under 9 5 .0 _____________________ 95.0 and under 1 0 5 .0 _________________ 105.0 and over___________________________ 50 110 66 These findings deal only with those hernia cases for whom output records were available. But there were many others who were on production work for which the basis of payment was group production. Others worked on assembly lines where the pro duction was paced by the speed of the entire line. In these instances, the impaired worker must have been able to hold his own in order to hold his job. Quit Rate Voluntary quits were made up of all the instances in which the employee severed his connection with the employer on his own volition. The quit rates are shown as the number of such cases per 100 em ployees in each group, i. e., the impaired and the un impaired. It was possible to obtain these data for 1,805 of the hernia cases and 3,068 unimpaired workers matched with them. The data were ob tained by means of follow-up and show the quits which occurred in a period of 6 months after the end of the survey period. At the same time, data on terminations were obtained to provide a total sepa ration rate, but it is with voluntary quits that the study is primarily concerned. The quit rate was slightly higher for the hernia 32 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES cases than for the unimpaired group, 2.9 and 1.8, respectively. Actually there were 53 quits among the impaired and 55 among the unimpaired. Six persons in each group quit for health reasons and one impaired worker quit for family reasons. A variety of reasons were lumped together under “ other ” and it is in this category that most of the difference between the groups is found; 26 impaired and 19 unimpaired fell into this classification. Most common reasons in this group were “ to accept other employment” and “ to establish own business. ” These reasons were equally common among the impaired and unimpaired workers. It is probable that these impaired workers had acquired industrial skills and experience which enabled them to find jobs a little more readily than they could before. The rates may be influenced too by the fact that conditions were rather unstable dur ing the period covered by the data. Reconversion from wartime to peacetime production was under way in many plants, and there was considerable moving around among the working population in general. 33 B. THE CAKDIAC CASES B. The Cardiac Cases Summary of Statistical Findings The record of work performance of about 1,800 workers with cardiac impairments was very similar to that of the 3,000 unimpaired workers matched with them on the same jobs. Differences in the measures of performance were, for the most part, fractional. The cardiac cases had slightly higher rates of absenteeism and disabling work injuries and a slightly lower rate of nondisabling work injuries. The voluntary quit rate also was higher but hardly sufficiently so to be counted sig nificant. The greatest difference occurred in the case of work output, where the cardiac cases as a group produced at a rate a little more than 2 percent higher than the unimpaired workers on the same jobs. The impaired male and female cases compared in much the same way with the unimpaired workers with whom they were matched. Although the level of the rates for the male and female groups was sub stantially different, the latter group was not large enough (except for the output relative) to exercise a very marked effect on the rates for this survey group as a whole. Based on the record it seems reasonable to con clude that the workers with cardiac impairments, properly placed, were not handicapped workers. As a group they displayed about the same work char acteristics as the unimpaired workers subject to the same incentives and exposed to the same hazards and were able to compete successfully with them. T a b l e B - l .— W ork performance of cardiac cases and of matched unimpaired workers Disabling injury Absenteeism frequency rate1 Group Nondisabling injury frequency rate2 Frequency rate3 Average days of disability5 Time-lost rate4 Quit rate7 Output relative6 Average performance Total: Impaired________________________ _ __ Unimpaired_________________________ ___ 4.7 3.8 10.0 10.7 10.2 9.3 0.11 .09 14.0 12.9 102.4 100.0 4.4 2.7 Male: Im paired______________________________ Unimpaired____________________________ 4.2 3.4 10.5 11.2 11.3 10.5 .13 .11 14.2 13.1 101.9 100.0 3.4 2.1 Female: Impaired_______________________________ Unimpaired____________________________ 7.6 6.7 6.5 6.7 2.4 1.2 .01 (8) 7.0 102.8 100.0 7.6 5.2 1.0 Number of workers Total: Impaired______________________ ___ Unim paired___ ________ __ _ _ _ _ Male: Impaired Unimpaired Female: Impaired U nim paired_________ 1 Number 2 Number 3 Number 4 Number 5 Number _ _ _ _ _ 1,840 3,055 1,820 3,025 1,840 3,055 1.840 3,055 236 329 836 1,376 1,557 2,613 1,541 2,590 1,557 2,613 1,557 2,613 114 169 638 1,085 283 442 279 435 283 442 283 442 122 160 198 291 of days lost per 100 scheduled workdays. of injuries per 10,000 exposure-hours. of injuries per 1,000,000 exposure-hours. of days lost for disabling injury per 100 scheduled workdays. of days of disability per disabling injury. 6 Percentage relationship o f production efficiency of impaired to that of matched unimpaired. 7 Number of voluntary quits per 100 employees in the survey group. 8 Less than 0.01. 34 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES Composition of the Survey Group All workers recorded as organic cardiac cases in the medical files of the plants surveyed were included in the study. Hypertensive heart disease cases were included, but hypertension and potential heart dis ease cases were excluded. An attempt was made to classify the cases in accordance with the classifica tions of organic heart disease devised by the Amer ican Heart Association, but in only a few plants were these classifications readily available from the med ical records. In a few instances cases were recorded as rheumatic heart disease, hypertensive heart dis ease, etc., but they were scattered and too few in number to permit conclusions as to their relative significance in the group. As a consequence, all data are shown for the entire group of cardiac impairments without any more detailed break-down by type of disease. Authorities state that the rheumatic type constitute most of the employable cardiac cases, and presumably the present survey group is made up largely of such cases.7 It would have been desirable also to obtain data on the duration of the impairment. Provision was made for obtaining these data, but in the overwhelm ing proportion of the cases the information was not given in the plant records. The further investigation which would have been required to develop the data was not deemed practicable in the present study. The cardiac impairment is one which the layman generally associates with advanced age. But in the present study over half the impaired workers in this group were under the age of 45. This finding raises an interesting question but one which the survey cannot answer: Whether the nature of the impair ment generally causes earlier withdrawal from the labor market for reasons of health than is true of workers generally or whether this kind of impair ment — coupled with advancing age — raises a sub stantial barrier to employment. A rather high percentage of workers with cardiac impairments were found in the lower age ranges in comparison with the rest of the impaired workers studied: 21 percent of the cardiac cases as against only 12 percent in the remainder of the survey group were under the age of 30; further, 52 percent of the cardiac cases against 44 percent of the rest of the survey group were under the age of 45. This tend 7 Selective P lacem ent o f the H a n d ica p p ed , W ar M a n p ow er C om m ission, W ash in gton , revised 1945. ency toward concentration in the lower age ranges was noted in both the male and female groups. T a b l e B - 2 .— Comparison of number and percentage distribution of 1,840 cardiac cases and 9,188 other impaired workers studied, by age group and by sex Number of workers Percent Age group and sex Cardiac cases Other impaired Cardiac cases Other impaired Total______________________________ Under 20 years___ _______ __ _ 20 and under 25 years__________ 25 and under 30 years_______ __ 30 and under 35 years__________ 35 and under 40 years__________ 40 and under 45 years__________ 45 and under 50 years__________ 50 and under 55 years__________ 55 and under 60 years__________ 60 and under 65 years__________ 65 years and over______________ 1,840 33 134 210 211 164 200 186 203 236 173 90 9,188 46 377 691 906 1,020 1,038 1,126 1,359 1,307 915 403 100.0 1.8 7.3 11.4 11.5 8.9 10.9 10.0 11.1 12.8 9.4 4.9 100.0 .5 4.1 7.5 9.9 11.1 11.3 12.3 14.8 14.2 9.9 4.4 M a le s ________ ______________ Under 20 y e a r s _______________ 20 and under 25 years__________ 25 and under 30 years____ _____ 30 and under 35 years__________ 35 and under 40 years__________ 40 and under 45 years __ ______ 45 and under 50 years______ __ 50 and under 55 years, _ 55 and under 60 years_____ __ 60 and under 65 years___ ____ 65 years and over______________ 1,557 20 100 152 177 125 150 168 189 217 170 89 8,696 33 311 612 839 952 980 1,071 1,309 1,280 906 403 100.0 1.3 6.4 9.8 11.4 8.0 9.6 10.8 12.1 14.0 10.9 5.7 100.0 .4 3.6 7.0 9.6 11.0 11.3 12.3 15.1 14.7 10.4 4.6 Females, _____ _____ ________________ Under 20 years_____________ 20 and under 25 years __ ______ 25 and under 30 years _ _ _ 30 and under 35 years. _ 35 and under 40 years___ _ _ 40 and under 45 years____ ___ 45 and under 50 years. _________ 50 and under 55 years_________ 55 and under 60 years. _________ 60 and under 65 years__________ 65 years and over______________ 283 13 34 58 34 39 50 18 14 19 3 1 492 13 66 79 67 68 58 55 50 27 9 0 100.0 4.6 12.0 20.4 12.0 13.8 17.7 6.4 4.9 6.7 1.1 .4 100.0 2.6 13.4 16.1 13.6 13.8 11.8 11.2 10.2 5.5 1.8 0 The survey group consisted of 1,840 workers with cardiac conditions matched with 3,055 unimpaired workers on the same jobs — the second largest of the 10 impairment groups studied. 1,557 males were matched with 2,613 unimpaired males, and 283 im paired females were matched with 442 unimpaired females. This was the largest female group included in any of the impairment types surveyed. As both groups were large enough to provide reasonably de pendable results, separate performance figures have been shown for the male and female cases. Industry and Occupational Coverage Workers with cardiac impairments are included in the survey group from each of the 19 major in dustry groups and from 104 of the 109 plants covered by the study. Cardiac cases were found in 3 of the 5 plants not represented but could not be included be cause unimpaired workers could not be matched with 35 B. THE CARDIAC CASES them on the same jobs. The plant and industry coverage obtained in this group indicates that cardiac cases are adaptable to an extremely wide variety of job requirements and that the job opportunities for such workers are potentially very broad. In addition, the work record is more impressive as it reflects per formance under a variety of conditions in light and heavy industries. The jobs at which the cardiac cases studied were employed are shown in the listing below. As was true of the other impairment groups, most of the cardiac cases were on processing or production jobs. However, the proportion found in maintenance and in inspection and testing work was perhaps a little higher than was the case in the other impairment groups. The most significant feature of this listing of jobs is the very broad range and variety of skills repre sented. Only a small proportion— 5 percent of the group — were found in unskilled custodial work, such as gateman, porter, and similar occupations; this probably was to be expected. Practically any skill which does not involve excessive exertion or expo sure to extreme dust and temperature conditions is within the physical capacities of a person with the most common — the rheumatic — type of cardiac impairment, and the findings in this case lend fac tual substance to what otherwise might be no more than a reasonable inference. It should be noted here, too, that the jobs listed are only illustrative. Many cardiac cases could not be matched with unimpaired workers; hence, many other jobs on which these impaired persons were em ployed could not be included in the study. Jobs at which 1,840 Cardiac Cases of the survey group were found employed [T itles used are those appearing in the U n ited States E m p lo y m e n t Service D ictio n a ry o f O ccu p ation a l T itles and are grou ped a n d n um bered a ccord in g t o the classifications used b y the W a g e A n alysis B ran ch of the B ureau o f L a bor Statistics. T h is is n ot to b e in terp reted as a com plete listing o f jo b s at w hich persons w ith cardiac im pairm ent can be e m p lo y e d ] M ALE1 Laborer (printing and publishing) 2. Working Foremen Laborer (railroad) 1. Maintenance Laborer (rayon and allied products) Absorption-plant operator Laborer (wire) Chemist assistant II Air-compressor operator Laborer, process (boilermaking) Darkroom man Airplane mechanic Automobile-mechanic helper Laborer, process (forging) Foreman (electrical equipment) Laborer, process (machine shop) Boiler operator I I Laborer, process (petroleum refining) Foreman (petroleum refining) Glass polisher Bricklayer I I Lead-burner helper Hammersmith Bucker-up I I Machinist I I Inspector, machine shop Cable splicer I Machinist apprentice Installation inspector Carpenter, maintenance Chauffeur II Maintenance man, building Laborer (railroad) Pumpman X I I Stillman I I Electrician apprentice Maintenance man, factory or mill Maintenance mechanic II M illman Electrician, powerhouse Oiler I 3. Processing Engine-lathe operator Oiler II Fireman, low pressure Fireman, stationary boiler Flame-cutter operator Painter I Electrical repairman Instrument repairman Laborer (aircraft manufacturing) Painter, sign Pipe fitter Pipe-fitter helper Polymerization helper Aircraft carburetor subassembler Airplane woodworker Airplane woodworker I I Annealer Annealer I I I Laborer (ammunition) Power house engineer Anodic operator Laborer (automobile manufacturing) Refrigerator mechanic Apprentice machinist Laborer (boot and shoe) Rigger I I I Armament mechanic Laborer (chemicals) Salvage man I I Assembler I Laborer (electrical equipment) Steam fitter Automobile mechanic, motor I Laborer (forging) Structural-steel worker Baker I Laborer (iron and steel) Tool-grinder operator Ball-mill man Laborer (machine shop) T ool maker Banbury mixer Laborer (machinery manufacturing) Turbine operator Band builder Laborer (nonferrous metal alloys and W ater filterer Band-saw-straightener operator Welder, acetylene Barrel filler II Welder, arc Batch-still operator II products) Laborer (petroleum refining) 36 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES J o b s at w h ich 1 ,8 4 0 C a rd ia c C a s e s o f the s u r v e y g r ou p w ere f o u n d e m p lo y e d 3. Processing — Continued Forging-press operator Forging-press operator I Beater operator — Continued Laborer, process (machinery manufac turing) Form builder I Laborer, process (m alt liquors) Laborer, process (nonferrous metal alloys Bed-las ter Forming-press operator I B elt sander Friction-sawing machine operator Bench assembler V Furnace operator II Laborer, process (paper and pulp) Bench grinder Furnace tender, heat treating Laborer, process (phonograph) Bending roll operator Gager man V I I I Laborer, process (plastic materials) Blacksmith I I Gear-generator operator Laborer, process (rayon and allied Blank horner General assembler II Box maker, wood I I I Glass cutter and products) products) Laborer, process (rubber goods) Brake operator, machine I I Glass grinder Laborer, process (wire) Buffer I Glass polisher Lapping-machine operator Buffer, machine Grinder Burnisher II H eat treater Lay-out man (shop) Lens molder II Burrer, hand Heater I I I Lim e slaker I I I Celluloid-roll man Heater, forge Line walker Centerless-grinder operator Heel-seat laster, machine M achine molder, jarring Chassis assembler II Honing machine operator Machine molder, rollover Chipper, foundry Incinerator man II M achinist I I Churn man II Induction-furnace operator Machinist, bench Cigarette-making-machine operator Induction-furnace operator helper M ajor assembler I Circular-sawing-machine operator Jig-boring machine operator Coding machine operator V Job setter II M ajor-assem bly installer Marker Coil assembler I V K ettle operator M c K a y stitcher Compounder helper Laborer (aircraft manufacturing) M etal finisher, hand filing Control man Laborer (ammunition) Milling-machine operator I I Coremaker I Laborer (automobile manufacturing) Coremaker, machine I Core paster Laborer (bindery) Milling-machine operator, automatic M illm an Laborer (foundry) M old closer Cupola tender helper Laborer (furniture) M old painter Cutter, machine I Laborer (glass manufacturing) Molder Cutter, machine V Cutter-off II Cylindrical-grinder operator D etail assembler II Laborer Laborer Laborer Laborer Molder, squeeze M ultiple-spin dle-drill-press operator Developer I Laborer (paper and pulp) Die-casting-machine operator I I D ie maker I I Laborer (petroleum refining) Nigger-hand-machine operator Ovenman helper Packer Laborer (radio manufacturing) Painter, aircraft Die-setter I Laborer (rubber goods) Painter, spray I Dipper I I Laborer, process (aircraft manufacturing) Do-all-saw operator Dockman I I Laborer, process (aluminum products) Painter, spray II Patternmaker X I Laborer, process (ammunition) Patternmaker apprentice, metal Double-seamer, hand Laborer, process (asbestos products) Patternmaker, metal Drophammer operator I I Laborer, process (automobile manufac Patternmaker, wood Electric-motor assembler (hardware) (iron and steel) (machinery manufacturing) (m alt liquors) turing) Nailing-machine operator I Pipe straightener Electrician, airplane I Laborer, process (automobile parts) Planer operator II Engine-lathe operator Laborer, process (bakery products) Platen-press man Etcher, hand II Laborer, process (chemicals) Plater I Experimental-body and minor assembler Laborer, process (confectionery) Pointer operator Experimental mechanic Laborer, process (cutlery tools) Polisher Facing mixer Laborer, process (electrical equipment) Pourer, crane ladle Fancy stitcher Laborer, process (foundry) Power-shear operator I Film spooler Laborer, process (glass manufacturing) Precipitator operator I I Final assembler V II Laborer, process (iron and steel) Pressman Fireman, still Laborer, process (machine shop) Pressman, paraffin plant Floor assembler Laborer, process (machine tools and Process helper accessories) Puller-over, hand 37 B. THE CARDIAC CASES J o b s at w h ich 1 ,8 4 0 C a rd ia c C a s e s o f the s u r v e y g rou p w ere f o u n d e m p lo y e d — Continued 3* Processing — Continued Tool maker Tester I Tool inspector Puller-over-machine operator Tool-maker apprentice Treater I I 5. Recording and Control Pumpman I Treer, hand Pumpman V II Trimmer, hand Punch-press operator I Tube-bending-machine operator I Checker Punch-press operator I I Tube drawer Expediter I I Pusher man I Turret-lathe operator Production clerk II Radial-drill-press operator Valve grinder II Receiving clerk I I I Radiator-core dipper Valve repairman Shipping clerk I Radio-chassis aliner Vamper I I Stock chaser I I Rewinder operator Vertical-boring-mill operator Stock supervisor Riveter, aircraft Vertical-turret-lathe operator Timekeeper Riveter, pneumatic I I I Weigher-up T ool clerk Roller, bar mill Welder, acetylene Roller operator V W elder, arc Roller operator I X Rolling-mill operator Welder, combination Welder, spot Brakeman, yard I Rubber compounder W ire drawer I I I Bucket-conveyor operator Sandblaster I W ood turner Electric-bridge-crane operator Sand mixer, hand Saw filer, hand 6. Material Movement Electric-truck operator 4. Inspection and Testing Elevator operator, freight Screw-machine operator, automatic Balancing-machine operator Laborer (aircraft manufacturing) Screw-machine operator, semiautomatic Body-assembly inspector Laborer (automobile manufacturing) Seaming-machine operator IV Casting inspector Laborer (bakery products) Shaper operator I Checker I Laborer (chemical) Sheet catcher Chemist, physical Laborer (cutlery tools) Sheet-metal worker I I Cigarette-package examiner Laborer (electrical equipment) Sheet-metal worker, aircraft Core checker Laborer (firearms) Sheet-metal worker, aircraft II Shredder operator II Dynamometer tester, motor Laborer (foundry) Electrical inspector Laborer (glass manufacturing) Single-spindle-drill-press operator Engine tester Laborer (hardware) Slitting machine operator II Experimental mechanic Laborer (iron and steel) Solderer I Final-assembly inspector Laborer (machine tool and accessories) Sole assembler Final-assembly inspector — fuselage Saw filer, machine Speed-lathe operator Spinner V I Follow-up man I I I installation Laborer (machinery manufacturing) Laborer (m alt liquors) Spinning-bath patrolman Final tester I I Gager IV Laborer (nonferrous metal alloys and products) Straightener and parts fitter Hot-forging inspector Laborer (petroleum refining) Stillman I I Stillman helper Inspector Inspector I Laborer (rayon and allied products) Laborer (wire) Still-operator helper Inspector, chief III Straightening-machine operator II Straightening-press operator Inspector, crude rubber Laborer, process (automobile manufac turing) Inspector, hammers and presses Laborer, process (iron and steel) Stranding-machme operator Inspector (machine shop) Subassembler Inspector, raw materials Laborer, process (nonferrous metal alloys and products) Subassembler II Inspector and tester Locomotive-crane operator Subassembler I I I Installation inspector Truck driver, heavy Surface-grinder operator Instrument maker I Sweater man Laborer (fabricated plastic products) Machinist 7. Custodial Tacker V I I Tailor I I Paint-spray inspector Fireman I I I Tapper I II Procurement inspector Gateman I V Tenter-frame operator Pulp tester Grounds keeper I Tool dresser I Radio repairman I Janitor I Tool grinder I Salvage inspector I I Laborer (automobile manufacturing) Tool grinder operator Tester Laborer (automobile parts) 38 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES J o b s at w h ich 1 ,8 4 0 C a rd ia c C a s e s o f the s u r v e y g r ou p w ere f o u n d e m p lo y e d 7. Custodial — Continued Labeler, machine I I — Continued Laborer (aircraft manufacturing) Single-spindle-drill-press operator Skiver, machine Laborer (machinery manufacturing) Laborer (bakery products) Still-operator helper Porter I Laborer (boot and shoe) Porter I I Laborer (glass products) Stitcher, machine II (boot and shoe) Stripper, machine W atchm an I FEMALE 1. Maintenance Counterman, cafeteria Laborer (printing and publishing) Subassembler I I Laborer (surgical appliances) Thread grinder Laborer, process (aircraft manufactur Tool grinder operator ing) Laborer, process (ammunition) T op stitcher I Laborer, process (bakery products) Vamper I I Laborer, process (boot and shoe) Y arn winder Turret-lathe operator Laborer, process (confectionery) 2. Working Foremen Laborer, process (dental equipment) Foreman (bakery products) Laborer, process (garment manufactur- Airplane inspector I Casting inspector 3. Processing ing) Laborer, process (instruments and ap 4. Inspection and Testing Laborer, process (electrical equipment) pliances) Airplane woodworker I I Assembler I I I Laborer, process (machinery manufac Assembler IV Laborer, process (nonferrous metal alloys Assemblyman helper II Checker II Engine tester turing) Film inspector II Gager I and products) Inspector (boot and shoe) Inspector (hat and cap) Bander and eellophaner, machine Laborer, process (photographic appara Inspector (machine shop) Baster, hand Laborer (printing) Blank horner tus) Laborer, process (radio manufacturing) Burrer, hand Laborer, process (rayon and allied Button-hole machine operator Laborer, process (automobile manufac turing) products) Laborer, process (glass manufacturing) Button-sewing machine operator Laborer, process (rubber goods) Cementer, hand I I (boot and shoe) Laborer, process (surgical appliances) Magnaflux inspector Cigar packer Laborer, process (tobacco) Salvage inspector II Cloth winder M ajor assembler I Coil assembler I M ajor-assembly installer Coil taper, machine Coil winder I I Milling-machine operator I I M ounter V II I Pipe-threading-machine operator Laborer, process (radio manufacturing) 5. Recording and Control Cutter, machine V Presser, machine I Parcel-post packer Shipping checker Shipping clerk I Cylindrical-grinder operator Profiling-machine operator II Stock clerk I I Detail electrical assembler Riveting machine operator IV T ool clerk Dipper II Rubber-press man Do-all-saw operator Double-seamer, hand Sewing-machine Electrician, airplane I Sewing-machine operator (m en’s tailored Cut-out stitcher Engine-lathe operator Exhaust operator operator (fabricated 6. Material Movement products, n. e. c.) Laborer (rayon and allied products) garments) Sewing-machine operator, shirts and 7. Custodial related products Fancy stitcher Floor assembler I I Sewing-machine operator (textile) Porter I Gear-shaper operator Sheet-metal worker, aircraft Porter II Hem-stitching machine operator Shoe cleaner I (boot and shoe) Rest-room attendant Instrument maker I Placement Practices As with organic impairments generally, the preempioyment physical examination is extremely im portant to both the impaired person and the em ployer. Full knowledge of the nature and extent of this impairment are important to the placement offi cer so that he may avoid work assignments which would tend to aggravate the condition. Depending upon the nature of the impairment, various factors such as exertion, dust, temperature, working position, etc., have to be taken into consideration in making 39 B. THE CARDIAC CASES the placement. If reliance is placed only upon the statements of the applicant, some important infor mation may not be disclosed — either intentionally or because the applicant does not have accurate knowledge of the details of his case. Medical examinations in the plants studied, wheth er given by the plant physician or by an outside physician, were quite comprehensive for the cardiac cases. In many plants cardiograms were taken. In some plants, too, periodic examinations were re quired more frequently for the cardiac cases than for other workers. Exclusion policies prohibiting employment of car diac cases were found in 27 of the plants studied. Only in the case of the epileptic and hernia groups were exclusion policies more common. However, car diac cases were found employed in all but 2 of the 27 plants which had these exclusion policies. In large part, of course, this is accounted for by the fact that persons who develop a cardiac condition after em ployment are usually retained. In a few plants there was a prohibition against employment of cardiac cases in certain departments, but these policies were directed at preventing employment of these persons under harmful conditions, not at general exclusion. the unimpaired workers. For the group as a whole, the rates were 4.7 and 3.8 for the impaired and unim paired, respectively. The impaired males had a rate of 4.2 as against 3.4 for the unimpaired males. The female cases ran a substantially higher rate, 7.6 and 6.7 for the impaired and unimpaired females, respectively. These rates indicate that the cardiac cases tended to have nearly 1 day more of absence than the unimpaired workers in each 100 scheduled workdays, or about 2l/2 days more per year. Individually, the experience in the two groups was fairly similar, as is indicated by the frequency dis tribution of the individual rates shown in table B-3. No absences at all were reported for 19 percent of the impaired and 21 percent of the unimpaired during the periods studied. Well over half in both groups, 62 percent of the impaired and 69 percent of the un impaired, had individual rates of 3.9 or less. As was to be expected, some individuals in both groups had very high absence rates: 3.8 percent of the impaired and 2.1 of the unimpaired had rates of 20.0 or higher. The female cases, both impaired and unimpaired, tended toward a heavier concentration in the higher frequencies. This coincides with findings in other studies of absenteeism. T able B - 3 .— Percentage distribution of cardiac cases and matched unimpaired workers, by absenteeism frequency rate1 Work Performance Data were available on groups of cardiac cases and matched unimpaired workers large enough to permit showing measures for each of the five factors of work performance covered by the study. The findings are summarized in table B - l and in the fol lowing paragraphs. Absenteeism The absenteeism rate was computed for the indi viduals and for the groups as the number of days absent for personal reasons per 100 scheduled work days. Lay-offs, shut-downs, vacations, etc., were not counted either as days absent or as days scheduled for work. Data on absenteeism were available for 1,840 car diac cases matched with 3,055 unimpaired workers on the same jobs. This group was composed of 1,557 impaired males matched with 2,613 unimpaired males, and 283 impaired females matched with 442 unimpaired females. The absenteeism rates for both sexes were somewhat higher for the impaired than for and by sex Male Total Absenteeism frequency rate class Impaired Unim paired Impaired Female Unim paired Impaired Unim paired 22.3 15.7 14.7 12.2 20.6 6.2 6.6 1.7 8.8 6.4 5.3 11.0 26.1 12.7 21.9 7.8 10.9 5.0 7.7 11.1 28.8 14.7 17.1 4.7 100.0 100.0 100.0 100.0 1,557 2,613 283 442 0 ............................................ 0.1 and under 1.0_________ 1.0 and under 2.0________ 2.0 and under 3.0_________ 3.0 and under 7 . 0 _______ 7.0 and under 10.0-----------10.0 and under 20.0______ 20.0 and over____________ 18.9 12.3 13.3 9.8 22.2 8.6 11.1 3.8 20.7 14.1 13.7 12.0 21.9 7.4 8.1 2.1 20.9 13.4 14.7 9.6 21.6 7.8 9.0 3.0 Total______________ 100.0 100.0 Number of workers_______ 1,840 3,055 1 Number of days lost per 100 scheduled workdays. Wherever possible, the reason was recorded for each absence. Unfortunately, the reasons could be obtained only for less than half the absences, the rest being recorded merely as “ unknown.” Within the limits of the available data shown in table B-4, it appears that a somewhat greater incidence of absence because of illness probably accounts for the slightly higher group rate for the impaired workers. The differences in the group rates, the frequency distributions of the individual rates, and the reasons 40 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES T a b l e B - 4 .— Absenteeism frequency rates 1for cardiac cases and matched unimpaired workerst by reason for absence and by sex Total Male Female Reason for absence Impaired Unim paired Impaired Unim paired Impaired Unim paired Total. .............................. .. 4.7 3.8 4.2 3.4 7.6 6.7 Illness____ ______ ________ Personal business________ Unknown________________ 1.8 .4 2.5 1.3 .4 2.1 1.6 .3 2.3 1.1 .3 2.0 3.1 3.5 2.6 .9 3.2 Number of workers_______ 1,840 3,055 1,557 2,613 283 442 1.0 1 Number of days lost per 100 scheduled workdays. for absence are not large enough to be labeled as serious or significant. Nevertheless, the data show clearly that workers with cardiac impairments tend to be absent somewhat more frequently than unim paired workers on the same jobs and that a sub stantial part of the difference is probably accounted for by illness. The duration of the impairment may be a factor which influenced the absences because of illness. The early stages of the cardiac impairment may be char acterized by considerable, perhaps protracted, ab sence because of illness. An effort was made to exclude cases in which the worker had acquired the impairment within 6 months of the beginning of the survey period. It was felt that to include cases which were in the very early stages and in which compen sation had not yet taken place would bias the results in the direction of excessive illness absenteeism. Undoubtedly, some cases of this kind were included because duration generally was not on record. How ever, the differences in the two groups is so small that if a few such cases were included they apparently did not influence the results materially. Nondisabling Injury Experience impaired males, and 279 impaired females were matched with 435 unimpaired females. Analysis of the data revealed no substantial dif ferences in the nondisabling injury experience of the two groups. The cardiac cases experienced a rate of 10.0 against 10.7 for the matched unimpaired work ers. As would be expected, there was a considerable difference between the male and female groups. The impaired males had a rate of 10.5 against 11.2 for the unimpaired males, while the females had rates of 6.5 and 6.7 for the impaired and unimpaired, respec tively. The group averages indicate clearly that the cardiac cases displayed no greater proneness toward nondisabling injuries than the unimpaired workers exposed to the same hazards. In fact, their experience was slightly better. The frequency distribution of the individual rates (table B-5) shows the same similarity of performance as is indicated by the group averages. More than half, 53 percent of the impaired and 51 percent of the unimpaired, had no injuries at all during the periods studied. Fully 91 percent of the impaired and 89 percent of the unimpaired had fewer than 3 such in juries per 1,000 exposure-hours. As would be expected, instances of very unfavor able injury experience were found in both groups: 0.9 percent of the impaired workers and 1.2 percent of the unimpaired workers had excessively high fre quency rates of 10.0 or higher per 1,000 exposurehours. It is clear, however, that these were the usual individual instances of poor performance and were uncommon in both groups. T able B - 5 .— Percentage distribution of cardiac cases and matched unimpaired workers, by frequency rate 1 of nondisabling injury and by sex Total Impaired A nondisabling work injury was defined as a workconnected injury which did not result in a permanent impairment or in any loss of time beyond the day or shift on which the injury occurred. The experience of each group is expressed as a rate reflecting the number of injuries per 10,000 exposure-hours. In dividual rates were also computed in order to obtain a frequency distribution; but for these rates the base used was 1,000 exposure-hours. Data on nondisabling injuries were available for nearly all of the survey group — 1,820 of the cardiac cases and 3,025 of the matched unimpaired workers. 1,541 impaired males were matched with 2,590 un Male Female Frequency rate class 0________________________ 0.1 and under 1.0_________ 1.0 and under 2 . 0 . ______ 2.0 and under 3 . 0 _____ 3.0 and under 5.0 5.0 and under 10.0_______ 10.0 and over____________ Total_____________ Number of w orkers........... 53.1 17.3 13.9 6.6 5.4 2.8 .9 Unim paired Impaired 50.7 18.2 14.3 6.0 5.9 3.7 1.2 50.1 18.6 14.7 6.9 5.9 2.9 .9 100.0 100.0 1,820 3,025 Unim paired Impaired Unim paired 48.4 19.1 14.6 6.3 6.2 4.0 1.4 70.9 10.0 9.3 4.7 2.5 1.8 .8 64.2 12.9 12.6 4.8 4.1 1.2 .2 100.0 100.0 100.0 100.0 1,541 2,590 279 435 1 Number of injuries per 1,000 exposure-hours. The nature of the injury was readily available from company records, and the rates attributable to the various kinds of injury are shown in table B-6. These rates were computed on the 10,000-hour base. B. THE CARDIAC CASES The pattern of the rates is very similar in the two groups of workers. There is no evidence that the cardiac cases had any proneness toward any partic ular kind of minor injury. It seems reasonable to conclude therefore that the injuries experienced were related to the hazards of the job and not to the im pairment which characterized one of the groups. T able B - 6 .— Frequency rates1 of nondisabling injury for 41 and unimpaired workers exposed to the same hazards. The nondisabling injury experience was about the same with respect to frequency and nature of injury and, as indicated by redressings required, was of about the same severity. Demands upon the plant’s medical facilities for treatment of nonindustrial ill ness or injury were about equal in the two groups. Disabling Injury Experience cardiac cases and matched unimpaired workers, by nature o f injury and by sex Total Male Female Nature of injury Impaired Unim paired Impaired Unim paired Impaired Unim paired Total. ............................... 10.0 10.7 10.5 11.2 6.5 6.7 Burns and scalds_________ Cuts and abrasions. .......... Eye injuries______________ Strains and sprains_______ Other.__________________ .7 6.8 1.8 .4 .3 .5 7.7 1.7 .5 .3 .7 7.1 2.0 .4 .3 .5 8.1 1.8 .5 .3 .4 4.5 .8 .5 .3 .4 4.1 1.1 .6 .5 Number of workers----------- 1,820 3,025 1,541 2,590 279 435 1 Number of injuries per 10,000 exposure-hours. In an effort to derive some measure of the severity of these nondisabling injuries in the two groups, the number of redressings required in each case was re corded. Although company policies with respect to requiring redressings for minor injuries varied widely among plants, they were the same for impaired and unimpaired workers in the same plant. The average number of redressings per injury was 1.0 for the im paired workers and 0.9 for the unimpaired. Measured in this way there was no significant difference in the severity of the injuries experienced in the two groups. A final factor considered in connection with the nondisabling injury and medical record was the de mand made by impaired and unimpaired workers on medical facilities for illness or injury not related to the worker’s employment. Most of the plants studied had liberal policies with regard to such use of medical facilities by their employees. In some instances this service included home visits by the plant nurse or physician. Not all of the plants, however, had such elaborate facilities. Some were equipped only to handle work injuries. Records of nonindustrial visits to the dispensary again emphasized the similarity rather than any dif ference between the two groups: the cardiac cases averaged 1.5 and the matched unimpaired 1.6 such visits per person. In brief, the medical records showed no significant differences between persons with cardiac conditions 776106° — 48 — 4 Frequency. A disabling injury was defined as a work injury which resulted in a permanent impairment or in disability of one full day or more beyond the day or shift on which the injury occurred. The frequency rates for the groups were computed on the conven tional base of one million exposure-hours. The group for which disabling injury data were available was the same as for absenteeism: 1,840 cardiac cases were matched with 3,055 unimpaired workers. The impaired group was composed of 1,557 males and 283 females. As was true of nondisabling injuries, no significant difference was found in the performances of the two groups with respect to disabling injuries. The im paired workers had a rate of 10.2 against a rate of 9.3 for the matched unimpaired workers exposed to the same hazards. The variation in the rates reflects a difference of something less than 1 injury per million exposure-hours, or 1 injury per 500 workers per year. The female workers of the group had very much lower rates as they tended to be concentrated in lighter and less hazardous activities. Plant accident records were examined but in no case did they indicate that the accident was caused or contributed to by the worker’s impairment. Nor were any cases encountered in which the impairment was found responsible for an injury to a fellow worker. The point was confirmed by discussion with man agement officials. Time Lost. Regardless of the similarity or the dis abling injury frequency rate, there was the question as to whether the impairment impeded recovery and resulted in a materially greater time loss than was the case for injured unimpaired workers. The average period of disability for an injured worker with a cardiac impairment was 14.0 days. In comparison, the matched unimpaired workers aver aged 12.9 days per injury. On the average, then, the injured cardiac worker lost 1 more day than his in jured unimpaired co-worker. 42 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES The disabling injury experience of cardiac workers was not as good as that of the unimpaired workers matched with them in this survey. They were in jured more frequently, and their disabilities lasted longer. The differences, however, are not marked and it is questionable whether they are significant. Output Relative Wherever the impaired worker was on a job for which individual production data were available, a comparison was made between the production of the impaired worker and that of his matched unimpaired co-workers on the same job. The comparison was made by means of a relative of the production effi ciency of the impaired to that of the matched unim paired workers, the output of the unimpaired in each case equaling 100. Data of this kind were available for 236 cardiac cases matched with 329 unimpaired workers. More that half of this group were female workers: 114 impaired male workers were matched with 169 unimpaired male workers, and 122 impaired female workers were matched with 160 unimpaired female workers. The impaired group as a whole produced 2.4 per cent more than the unimpaired group. The male workers averaged 1.9 percent better, and the female workers 2.8 percent better. Not all of the impaired persons, of course, were superior workers. As was true of the unimpaired, some produced well, others produced poorly, as the following tabulation shows: Number of impaired Output relative Total Male Female Under 9 5 .0 -___________ 68 39 95.0 and under 105.0__ 75 93 29 42 43 50 105.0 and over____ _ 33 32 percent were as good, and 39 percent were defi nitely superior to their co-workers. Thus, about 71 percent of the workers with cardiac impairments pro duced as well as or better than the unimpaired work ers on the same jobs. Only 29 percent were inferior. The evidence of these cases shows conclusively that the cardiac workers competed successfully with their unimpaired fellow workers. With respect to output on the job, they not only held their own but maintained a slight advantage as well. Quit Rate Data for this factor were obtained by follow-up for 836 cardiac cases and 1,376 matched unimpaired workers. The group was made up of 638 impaired males matched with 1,085 unimpaired males and 198 impaired females matched with 291 unimpaired fe males. The rates reflect the number of voluntary quits per 100 employees in each group during the 6 months following the end of the survey period. Those plants which were scheduled late in the study of course could not be included. For the group as a whole the cardiac cases had a quit rate of 4.4 as against 2.7 for their matched un impaired workers. The group rates were influenced substantially by the rates for the female workers. The impaired females had a rate of 7.6 compared with a rate of 5.2 for the matched unimpaired female workers. The male workers, on the other hand, had much lower rates, with 3.4 for the impaired and 2.1 for the unimpaired. The 1.7 difference in the quit rates is accounted for, in large part, by differences in the number of quits for which the reason was not obtainable; 11 of the im paired and 10 of the unimpaired quit for unknown reasons, yielding rates of 1.4 and 0.7, respectively. Another sizable difference occurs in the case of quits because of dissatisfaction with the job — 4 of the im paired and 2 of the unimpaired quit for this reason. These rates, 0.5 and 0.1, respectively, account for an additional 0.4 of the difference in the group rates. Quits because of health reasons accounted for 7 quits among the impaired workers and 8 among the un impaired workers. Terminations were much higher for the impaired than for the unimpaired workers, 6.5 and 3.6, re spectively. Terminations were primarily for reduc tion in force and the impaired, being in general the last to be hired, consequently were among the first to be laid off because of their lower seniority. That the impaired workers were not as stable on the job as the unimpaired workers matched with them was indicated by the quit rate, although the difference, particularly for the male workers, was not extreme. It is possible that some of these workers took industrial employment during the war emer gency and when the emergency had passed withdrew from the labor force. It was noted that the reasons for about one-fifth of the quits in both groups were “ to take other employment” and “ to start own busi ness. ” The period represented by the data was one of considerable instability. Conversion from wartime to peacetime production was under way in many places and there was considerable moving about among the working population in general. 43 C. THE VISION CASES C. The Vision Cases Summary of Statistical Findings As a group, the persons with impaired vision made a somewhat better production record, were equally as regular in their work attendance, and had a some what better work injury experience than the unim paired workers matched with them on the same jobs. Although the impaired workers had a slightly higher quit rate, it is questionable whether the difference is large enough to be considered significant. The male and female impaired workers both com pared favorably with the unimpaired workers with whom they were matched. The level of the rates of absenteeism and voluntary quits for the female groups, impaired and unimpaired alike, were higher, while the injury rates were lower than for the male groups. On the whole, however, the female workers did not exercise any excessive influence on the rates for the vision cases as a group. Performance figures by sex have been shown as a matter of interest rather than because separate analysis of the groups is re quired. In light of the favorable record of work perform ance made by the persons with seriously impaired vision, it seems reasonable to conclude that they were able to compete successfully with unimpaired workers on the same jobs. These impaired persons, properly placed on the job, were not handicapped in their work performance. Composition of the Survey Group Four classifications of visual impairment were in cluded in the survey. “ Blindness” was defined as complete loss of light perception, and this concept was applied to both the totally blind and the blind T a b l e C - l .— Work performance of workers with seriously impaired vision, and of matched unimpaired workers Disabling injury Group Absenteeism frequency rate1 Nondisabling injury frequency rate2 Time-lost rate4 Frequency rate3 Average days of disability5 Output relative8 Quit rate6 7 Average performance Total: Im paired... Unimpaired. 3.6 3.7 9.6 8.8 8.8 10.6 0.10 .14 14.1 17.6 101.9 100.0 4.4 3.3 Male: Impaired. Unimpaired. 3.3 3.3 10.0 9.0 9.8 11.8 .11 .16 14.1 17.4 (8) (8) 3.2 2.8 Female: Impaired. Unimpaired. 5.7 6.4 6.1 7.8 0 1.0 0 (8) (8) 9.3 5.5 0 (9) 6.0 Number of workers Total: Im paired... Unimpaired. 1,721 2,847 1,696 2,809 1,699 2,825 1,699 2,825 108 198 862 1,444 Male: Impaired. _. Unimpaired. 1,513 2,472 1,490 2,439 1,495 2,454 1,495 2,454 (8) (8) 690 1,135 Female: Impaired. _. Unimpaired. 208 375 206 370 204 371 204 371 (8) (8) 172 309 1 Number of days lost per 100 scheduled workdays. 2 Number of injuries per 10,000 exposure-hours. 3 Number of injuries per 1,000,000 exposure-hours. 4 Number of days lost for disabling injury per 100 scheduled workdays. 5 Number of days of disability per disabling injury. 6 Percentage relationship of production efficiency of impaired to that of matched unimpaired. 7 Number of voluntary quits per 100 employees in the survey group. 8 Data available for too few cases to justify showing performance figures. 9 Less than^O.Ol. 44 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES in one eye. For“ legal blindness” the Social Security Board’s definition of 20/200 Snellen or less corrected in the better eye was used. “ Partial blindness” was defined as less than 20/50 but better than 20/200 Snellen corrected in the better eye. The composition of the survey group by specific type of visual impairment is shown in table C-2. Only a comparatively few cases of total blindness were found, 34 in all; also, a very small group was the 25 cases of legal blindness encountered. The pos sibility that some of the legally blind might have been classified as blind in one eye was carefully examined. For the most part, however, Snellen readings were shown in the medical records and the chance that any cases were misclassified was small. It was not ex pected that large numbers of totally and legally blind would be encountered, but it was expected that there would be many more than these 59 cases. No expla nation of this small number is available from the ma terial at hand, beyond the obvious one that the difficulty of placement for the blind or nearly blind is so great that their employment opportunities are very limited. It is probably true, also, that the inci dence of these two types of visual impairment is substantially less than that of the other types studied. corded the visual field, the second of these reasons may be the explanation for the rare incidence of this impairment in the survey. The vision cases provided the third largest cat egory in the survey group — 1,721 cases. Of this number, 208 cases were females — the second largest group of impaired female workers included in the study. The 1,513 male vision cases were matched with 2,472 unimpaired males, and the 208 female vision cases were matched with 375 unimpaired fe males. The age characteristics of the vision cases were very similar to those of the rest of the impaired worker group: 34.6 percent of the vision cases and 34.4 percent of the rest of the impaired workers were under the age of 40. Similarly, at the upper age range 5.1 percent of the vision cases and 4.4 percent of the other impaired workers were 65 years of age or older. The largest single age group of vision cases, consisting of 255 persons, was the group in the age range from 55 to 60. For the other impaired workers, however, the largest number in any single age group was slightly lower and fell into the 50- to 55-year span. T able C -3. — Comparison of number and percentage distribu tion of 1,721 visually impaired and 9,307 other impaired work T able C-2.— Distribution of 1,721 vision cases, by type of ers, by age group and by sex impairment and by sex Number of workers Number of cases Impairment group Total Male Vision cases Female T o t a l,..................... ........... .................. ....... 1,721 1,513 208 Totally blind_________ _____ ____________ Blind, one eye__________________ _ ______ Legally b lin d ________ __________________ Partially blind__________________________ 34 941 25 721 28 876 22 587 6 65 3 134 Shortly after the survey got under way, a fifth category of vision impairment was added: 50 per cent or greater restriction of the visual field. Al though this classification was retained throughout the study, it was not possible to include any cases in the survey group. Only an extremely small number of such cases were found on the plant records, and in the few instances where they were found it was not possible to match them with unimpaired workers on the same jobs. It is not certain whether this partic ular type of impairment constitutes so severe a placement problem that workers having it are rarely hired, or whether there is no real placement problem unless the field of vision is so restricted as to amount to “ rifle barrel” vision. As medical files rarely re Percent Age group Other impaired Vision cases Other impaired Total _________________ ________ _ Under 20 years_____________ __ 20 and under 25 years______ ___ 25 and under 30 years__________ 30 and under 35 years__________ 35 and under 40 years__________ 40 and under 45 years. ________ 45 and under 50 years____ _____ 50 and under 55 years__________ 55 and under 60 years__________ 60 and under 65 years__________ 65 years and over_____ ________ 1,721 18 100 155 154 168 157 195 246 255 185 88 9,307 61 411 746 963 1,016 1,081 1,117 1,316 1,288 903 405 100.0 1.0 5.9 9.0 8.9 9.8 9.1 11.3 14.3 14.8 10.8 5.1 100.0 0.7 4.4 8.0 10.4 10.9 11.0 12.0 14.1 13.8 9.7 4.4 Males_____________________________ Under 20 years________________ 20 and under 25 years__________ 25 and under 30 years__________ 30 and under 35 years__________ 35 and under 40 years__________ 40 and under 45 years__________ 45 and under 50 years__________ 50 and under 55 years__________ 55 and under 60 years__________ 60 and under 65 years__________ 65 years and over______________ 1,513 11 70 117 131 143 138 173 222 241 179 88 8,740 42 341 647 885 934 992 1,066 1,276 1,256 897 404 100.0 0.7 4.6 7.7 8.7 9.5 9.1 11.4 14.7 16.0 11.8 5.8 100.0 0.5 3.9 7.4 10.1 10.7 11.3 12.2 14.6 14.4 10.3 4.6 Females. ................................................ Under 20 y e a r s _______________ 20 and under 25 years__________ 25 and under 30 years__________ 30 and under 35 years__________ 35 and under 40 years __ __ _ 40 and under 45 years__________ 45 and under 50 years__________ 50 and under 55 years__________ 55 and under 60 years__________ 60 and under 65 years__________ 65 years and over______________ 208 7 30 38 23 25 19 22 24 14 6 0 567 19 70 99 78 82 89 51 40 32 6 1 100.0 3.4 14.4 18.3 11.1 12.0 9.1 10.6 11.5 6.7 2.9 0 100.0 3.4 12.3 17.5 13.7 14.5 15.7 9.0 7.1 5.6 1.0 .2 C. THE VISION CASES The age patterns for the male and female vision eases varied considerably. Among the males only 31.2 percent were under the age of 40, while 59.1 per cent of the females fell into this age group. At the upper extreme, while nearly 6 percent of the male group were 65 years or over, none of the females were over 65 and less than 10 percent were over the age of 55. The largest number of male vision cases fell in the age group 55 to 60. The largest female group fell within the range from 25 to 30 years. On the whole, and particularly for men, it appears that age did not affect materially the chances for a person with a visual impairment to obtain employ ment. Serious impairment of vision is sometimes pro gressive and the individual has a period of years dur ing which to adjust to it. In such cases he may acquire new skills in anticipation of increasing im pairment or may so adjust that he can continue to perform the kinds of work to which he is accustomed eyen after very severe impairment of vision has set in. Industry and Occupational Coverage Persons with visual impairments were encountered in each of the 19 major industry groups covered in the study. There was, however, no marked concen tration of these workers in any particular industry. The variety of industries represented in the study indicates that, for the most part, persons with visual impairments could be employed in a large variety of industrial activities and that it was not necessary for them to rely on any special types of enterprise to provide employment opportunities. The listing on pages 46-50 shows the jobs at which 45 the impaired persons of this survey group were em ployed during the period studied. It is immediately apparent from an examination of this list that the variety of jobs for which these people were equipped was extremely broad. A second point emphasized by this tabulation is the tremendous range and variety of skills represented. It seems evident that, with proper rehabilitation and training, a person who acquired or was born with a visual impairment could acquire complex mechanical skills and with them make him self a useful and self-supporting member of the com munity. The jobs performed by the various members of the survey group were further classified under the occu pational patterns used by the Wage Analysis Divi sion of the Bureau of Labor Statistics in making its industry wage studies. The significant feature re vealed in this job listing is the heavy concentration in the production or processing occupations. Few of the impaired employees studied were found in cus todial'jobs, such as janitor, watchman, etc. For the most part, the impaired workers were in direct com petition with the unimpaired workers matched with them. It is extremely important in this connection to note that the jobs listed for the members of the survey group are only illustrations of the kinds of jobs the visually impaired can do. In each plant some of the impaired had to be excluded because no unimpaired workers could be matched with them on the same jobs. Many other jobs in which such impaired per sons were employed in manufacturing industries are not listed in the present study. Although the list is impressive as it stands, it understates the case sub stantially, and is far from exhaustive. 46 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES Jobs at which 1}721 Vision Cases of the survey group were found employed [T itles used are those appearing in the U n ited States E m p lo ym e n t Service D ictio n a ry of O ccup ational T itles an d are grou ped and num bered a cco rd in g t o th e classifications used b y the W a g e A n alysis B ran ch o f the B u reau o f L a b o r Statistics. T h is is n o t t o b e interp reted as a co m p le te listing o f jo b s a t w hich persons w ith vision im pairm ent can b e e m p lo y e d ] M ALE Totally Blind 3. Processing Laborer (paper and pulp) Coremaker, machine I Laborer (paper products) Coremaker, machine I I I Laborer (petroleum refining) Core-oven tender Laborer (railroad) Cupola charger I I Laborer (rayon and allied products) Cupola-tender helper Lead burner Cutter, hand I I I Assembler Locomotive repairman, Diesel Commutator assembler Machinist II Cutter, machine V Cutter-off II Final assembler V I I Insulating-machine operator I Machinist apprentice Dental ceramist Mechanic II Die maker II Laborer, process (automobile manufac Millwright Dipper II Painter I Drawer builder turing) Machinist, bench Screw-machine operator, semiautomatic Painter, spray I Drier operator Patternmaker, wood Electric-motor assembler Single-spindle-drill-press operator Pipe fitter Electrician, airplane I Subassembler I Pipe-fitter helper Engine-lathe operator Power-house engineer Extruder operator II Sheet-metal worker I I Fabric flap builder Sheet-metal worker helper Felting-machine operator I Steam fitter Filter cleaner Inspector I Structural-steel worker Final assembler V II Tool inspector Tool maker Floor assembler Tube cleaner Form builder I Welder, combination Forming-press operator I (automobile manufac turing) 4. Inspection and Testing 6* Material Movement Furnace operator Laborer (aircraft) Laborer (automobile manufacturing) 2. Working Foremen Laborer (iron and steel) Fireman (electrical equipment) 7. Custodial Stillman II Turret-lathe operator Porter I II Furnace tender, heat treating Furnace tender, oil and gas Gatherer II Gear-hobber operator General assembler II Glass blower, laboratory apparatus Glass cutter 3. Processing Glass grinder Hardener I I Airbag recoverer Heater, forge Assembler H otbed man Assembler I Induction furnace operator Automobile mechanic Assembler I I I Ingredient sealer Blacksmith II Instrument maker I Boilermaker Assembler IV Bag-making-machine operator Bricklayer I I Baker I Blind in One E y e 1. Maintenance Internal-grinder-operator Jet man Bricklayer, refractory brick Band-saw-straightener operator Job setter II Carpenter Band-top maker. Kettle operator, head Carpenter, flask Barrel filler II Laborer (aircraft manufacturing) Concrete-chipper man Bench grinder Laborer (automobile manufacturing) Cooper I Electrical-instrument repairman Bending roll operator Laborer (electrical equipment) Boring-machine operator, automobile Laborer (foundry) Electrical repairman Box maker, wood I I I Laborer (furniture) Electric-truck repairman Broaching-machine operator Laborer (iron and steel) Fireman, stationary boiler Buffer I Laborer (leather products) Laborer (aircraft manufacturing) Burrer, hand Laborer (automobile manufacturing) Cabinetmaker I Laborer (nonferrous metal alloys and products) Laborer (iron and steel) Charging-machine operator I Laborer (paper and pulp) Laborer (machinery manufacturing) Chipper, foundry Laborer (petroleum refining) Laborer (nonferrous metal alloys and Conveyor man II Laborer (photographic apparatus) products) Coremaker I 47 C. THE VISION CASES J o b s at w h ich 1 ,7 2 1 V i s i o n C a s e s o f the su r v e y g r ou p w ere f o u n d e m p lo y e d M A L E — Continued Paper slitter Vertical-boring-mill operator Patternmaker, metal Vertical-turret-lathe operator Watchcase-vulcanizer tender Welder, spot Planer operator II Blind in One Eye — Continued Platen-press feeder 3. Processing — Continued Laborer (radio manufacturing) Laborer, process (agricultural equip Plater I Wire drawer I I I Plexiglas foreman W ireman V I Power-shear operator I Woodhandler, inside Pulpit man I I Pumpman V I I ment) — Continued 4. Inspection and Testing Laborer, process (aircraft manufactur- Punch-press operator I ing) Laborer, process (aluminum products) Punch-press operator II Balancer I Radial-drill-press operator Balancing-machine operator Laborer, process (ammunition) Rebeamer I Body-assembly inspector Laborer, process (asbestos products) Recovery operator Casting inspector Laborer, process (automobile manufac Riveter, pneumatic I I I Chemist assistant II Rotary-furnace tender Final assembly inspector Hardness inspector Laborer, process (boot and shoe) Rubber compounder Sam m y man Laborer, process (cutlery tools) Sandblaster I Inspector turing) Laborer, process (automobile parts) H o t forging inspector Laborer, process (electrical equipment) Sand mixer, hand Inspector I Laborer, process (foundry) Sand-slinger operator Inspector and tester Laborer, process (glass manufacturing) Screw-machine operator, automatic Laborer, process (iron and steel) Screw-machine process (machine tools semiauto matic Laborer, process (machine shop) Laborer, operator, and accessories) Laborer, process (machinery manufac turing) Laborer, process (malt liquors) Laborer, process (nonferrous metal alloys and products) Inspector (machine shop) Inspector, raw materials Laborer, process (cutlery tools) Shaper operator I Laborer, process (fabricated plastic Sheet-metal lay-out man products) Sheet-metal worker, aircraft Laborer, process (glass manufacturing) Single-spindle-drill-press operator Skein washer T ool inspector Solderer I 3. Recording and Control Spinner V I Laborer, process (paper and pulp) Sticker Laborer, process (petroleum refining) Stillman I I Follow-up man I I I Laborer, process (phonograph) Stopper maker I I Laborer, process (radio manufacturing) Clerk general Straightener and parts fitter Laborer (machine tools and accessories) M aterial clerk Laborer, process (surgical appliances) Straightening-press operator Production clerk Laborer, process (wire) Stranding-machine operator Ladle finer Lapping-machine operator Subassembler I turing) Lathe operator, automatic I Subassembler I I I Lay-out man (shop) Lithographic-press man Surface-grinder operator Tack puller, machine Machine molder, jarring Teaser II T ool clerk Machine molder, rollover Template maker IV Weigher I I Machinist II Machinist apprentice Thread grinder Thrower II 6. Material Movement Machinist, bench Tire bagger M ajor assembler I Tire builder, drum Dispatcher, locomotive M c K a y stitcher Tire repairer Electric-bridge-crane operator Mechanical engineer I I Tool and diemaker operator Electric-truck operator M old closer Tool grinder operator Elevator operator, freight Molder, bench Tool maker Laborer (aircraft manufacturing) Molder, floor Tread-milling-machine operator Laborer (ammunition) M old painter Trim steamer Laborer (automobile manufacturing) Multiple-spindle-drill-press operator Trimming-press operator I I Laborer (bakery products) Nailing-machine operator I Tube drawer Laborer (button manufacturing) Laborer (cutlery tools) (automobile Receiving clerk I I manufac Receiving clerk I I I Shipping clerk I Stock chaser I I Stock supervisor Timekeeper Painter, aircraft Tumbler operator II Painter, spray I Turret-lathe operator Laborer (firearms) Painter, spray I I Vamper I I Laborer (foundry) 48 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES J o b s at w h ich 1 ,7 2 1 V i s i o n C a s es o f the s u r v e y g rou p w ere f o u n d e m p lo y e d M A L E — Continued Laborer, process (automobile manufac turing) Laborer, process (machinery manufac turing) 6. M aterial M ovem en t — C on tin u ed Laborer, process (nonferrous metal alloys Laborer (glass products) Laborer (heating apparatus) Laborer (iron and steel) Laborer (machine tools and accessories) Oiler I I Painter I Blind in One E ye — Continued Laborer (glass manufacturing) — Continued and products) Painter, sign Pipe fitter Pipe-fitter helper Riveter, hydraulic Molder, bench Sheet-metal worker I I Polisher T ool maker Reverberatory-furnace operator Welder, combination Solderer I Subassembler 2. W ork in g F orem en Laborer (machinery manufacturing) Laborer (m alt liquors) 4. In sp ection an d T estin g Laborer (mattresses and bedsprings) Laborer (nonferrous metal alloys and Chemist assistant I I products) Laborer (paper and pulp) 6. M aterial M ovem en t Laborer (rayon and allied products) Laborer (rubber tire and tube manufac turing) Laborer (wire) Laborer, process (ammunition) Laborer, process (automobile manufac turing) Laborer, process (foundry) Laborer, process (nonferrous metal alloys Bucket-conveyor operator Glass polisher Laborer, process (glass manufacturing) Stillman I I 3. P rocessin g Elevator operator, freight Laborer (m alt liquors) Assemblyman helper Automobile mechanic, motor I 7. C u stodial Baker I Band-ripsaw operator Porter I Bench grinder Porter I I Broaching-machine operator Buffer I and products) Partially Blind Laborer, process (rayon and allied products) Foreman (glass manufacturing) Burrer, hand Card tender 1. M ain ten an ce Casting-machine operator II Chipper, foundry Asbestos worker, general Churnman II Boilermaker Coremaker I Boilermaker helper I I Bricklayer II Bricklayer, refractory brick Core paster Cripple cutter (boot and shoe manufac turing) Carpenter, maintenance Cupola tender Drophammer operator I I Cupola tender helper Gateman IV Electrical repairman Cylindrical-grinder operator Machine cleaner Electrician Porter I Electrician apprentice Porter I I Rest room attendant Engine-lathe operator Die cutter Die maker II Dockm an II Fireman, stationary boiler Dough mixer W atchm an I Instrument repairman Electrical assembler I I W indow cleaner I Laborer (aircraft manufacturing) Electrician, airplane I Laborer, process (rubber tire and tube) Spreader I Truck driver helper Truck driver, light Yardm an I 7. C u stodial Legally Blind Laborer (bakery products) Electric-motor assembler Laborer (chemical) Emulsion operator Laborer (glass manufacturing) Engine-lathe operator Laborer (iron and steel) Filer, machine Laborer (machinery manufacturing) Filterman I V Laborer (electrical equipment) Laborer (petroleum refining) Final assembler V II Machinist II Laborer (rayon and allied products) Fireman, still Laborer, process (petroleum refining) Floor assembler Machinist II Form builder I Machinist apprentice Forming press operator I Bench grinder Maintenance man, factory or mill Furnace tender, heat treating Engine-lathe operator Maintenance mechanic II Gager V I I I Laborer (automobile manufacturing) Millwright Gear-shaper operator Laborer (m alt liquors) Oiler I Glass polisher 1. 3. M ain ten an ce P rocessin g 49 C. THE VISION CASES J o b s at w h ich 1 ,7 2 1 V i s i o n C a s e s o f the s u r v e y g rou p w ere f o u n d e m p lo y e d M A L E — Continued Partially Blind — Continued 3. Processing — C on tin u ed — Continued Milling-machine operator, automatic M old holder Casting inspector Deflector operator M older, floor Fluoroscope operator Multiple-spindle-drill-press operator Inspector, chief I Oven fireman Inspector (machine shop) Ovenman helper Tool inspector Painter, brush I I H eat treater II Painter, spray I H eat treater I I I Plater I Ingredient scaler Pointer operator Job setter II Power-shear operator I K ettle operator Pressman Labeler, machine II Pressman, paraffin plant Pumpman I Laborer (alloys and products) Laborer (automobile manufacturing) Pumpman V II Laborer (automobile parts) Pumpman helper Laborer (boot and shoe) Punch-press operator I Laborer (furniture) Radial-drill-press operator Laborer (glass manufacturing) Riveter, pneumatic I I I Laborer (glass products) Riveting-machine operator I I I 5. R ecord in g an d C on trol Expediter II Follow-up man III Laborer (machine tools and accessories) Receiving checker II Shipping clerk I Stock clerk I I Timekeeper 6. M aterial M ovem en t Laborer (iron and steel) Screw-machine-operator, automatic Electric-bridge-crane operator Laborer (machinery manufacturing) Seaming-machine operator I V Elecfcric-hoist man I I Laborer (m alt liquors) Shaper operator I Electric-truck operator Laborer (nonferrous metal) Sheet-metal-lay-out man Elevator operator, freight Laborer (petroleum refining) Sheet-metal worker II Laborer (aircraft manufacturing) Laborer (phonograph) Sheet-metal worker, aircraft Laborer (automobile manufacturing) Laborer (plastic materials) Shredder operator I Laborer (automobile parts) Laborer (radio manufacturing) Single-spindle-drill-press operator Laborer (bakery products) Laborer (woodworking) Slitting-machine operator II Laborer (electrical equipment) Laborer, process (aircraft manufactur Soda-room man Laborer (firearms) Speed-lathe operator Spinner V I Laborer (foundry) Stillman I I Laborer (glass products) Laborer, process (automobile parts) Stillman, beer Laborer (heating apparatus) Laborer, process (baking products) Stretcher-leveler operator Laborer (iron and steel) Laborer, process (electrical equipment) Subassembler Laborer (machine tools and accessories) Laborer, process (foundry) Subassembler I I Laborer (m alt liquors) Laborer, process (furniture) Laborer, process (glass manufacturing) Subassembler I I I Sweater man Laborer (mattresses and bedsprings) Laborer (nonferrous metal alloys, and Laborer, process (machine shop) Tankman ing) Laborer, process (automobile manufac turing) Laborer, process (machine tools and Laborer (glass manufacturing) products) Tapper I I Laborer (photographic apparatus) accessories) Laborer, process (machinery manufac Thrower I I Laborer (rayon and allied products) Tool designer turing) Laborer, process (m alt liquors) Tool grinder operator Tool maker Laborer (wire) Loader V I I Laborer, process (mattresses and bed- Tube cleaner Tractor operator Tube drawer Truck driver, heavy springs) Laborer, process (nonferrous metal alloys and products) Tumbler operator I I Turret-lathe operator Laborer, process (petroleum refining) Vertical-boring-mill operator Laborer, process (tinware) Welder, combination Lathe operator, automatic I W ire drawer I I I Machine molder, rollover Y arn winder 7. C u stodial Gateman IV Janitor I Laborer (automobile parts) Machine molder, squeeze Laborer (malt liquors) Machinist II Machinist apprentice Routeman I 4. In sp ection an d T estin g Locker-room attendant Porter I Machinist, bench M etal finisher, hand filing Balancing-machine operator Porter II Milling-machine operator I I Body-assembly inspector W atchman I 50 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES J o b s at w h ich 1 ,7 2 1 V i s i o n C a s e s o f the s u r v e y g rou p w ere f o u n d e m p lo y e d FEM ALE Sewing-machine operator, men’s tailored garments Totally Blind — Continued Foreman (bakery products) Laborer, process (glass manufacturing) Sewing-machine operator, shirts and related products 3. P rocessin g 2. W orkin g F orem en Single-spindle-drill-press operator Splicer I I Assembler Foreman (automobile parts) Straightener and parts fitter Assembler I I I Stripper, machine Assemblyman helper I I Subassembler II Coil winder II 3. Processin g Final assembler V II Floor assembler Subassembler I I I Commutator assembler Thrower II Cutter, machine Tongue and quarter stitcher Field coil winder Laborer, process (electrical equipment) Blind in One E ye 2. W ork in g F orem en Foreman (bakery products) 3. P rocessin g Final assembler 4. In sp ection an d T estin g Casting inspector Folder, machine I Checker II Folding-machine operator I I I Core checker Friction-sewing machine operator Inspector (machine shop) Glazing-machine operator Laborer, process (glass manufacturing) Job setter I I Laborer, process (phonograph) Labeler Laborer (electrical equipment) Assembler Bander and cellophaner, machine 5. R ecord in g a n d C on trol Blank horner Book finisher Burrer, hand I Chassis assembler I I Cigar packer Coating-machine operator I I I Stock clerk II Laborer (machinery manufacturing) Laborer, process (automobile manufac turing) Sorter II Laborer, process (bakery products) Laborer, process (confectionery) 7. C u stodia l Porter I Laborer, process (instruments and appliances) Laborer, process (paper products) Legally Blind Floor assembler 3. Processing Instrument maker I Laborer (boot and shoe manufacturing) Laborer (bakery products) Laborer (electrical equipment) Laborer (surgical appliances) Laborer (glass products) Laborer, process (bakery products) Laborer (phonograph) Laborer, process (bakery products) Laborer, process (plexiglas) Laborer, process (plumbing supplies) Laborer, process (surgical appliances) 4. In sp e ctio n an d T estin g Checker I I Chemist (biologicals) Partially Blind Laborer, process (confectionery) Laborer, process (cutlery tools) Laborer, process (electrical equipment) Laborer, process (furniture) Charwoman Die maker I I Folder, machine I Laborer (hardware) 6. M aterial M ovem en t Coil assembler IV Electrician, airplane I Electric-motor assembler Laborer (furniture) Laborer (glass products) Baster, hand Bead flipper, hand Floor assembler Folder I I I Inspector (machine shop) Laborer, process (automobile parts) 1. M ain ten an ce Laborer, process (glass manufacturing) Laborer, process (electrical equipment) Counter man, cafeteria Laborer, process (garment manufactur- Kitchen helper II 7. C u stodia l ing) Laborer, process (glass manufacturing) Laborer, process (laundry) Charwoman Sewing-machine operator (laundry) Locker room attendant II Laborer, process (dental equipment) Laborer, process (nonferrous metal alloys and products) Porter II 2. W orkin g F orem en Laborer, process (rubber tire and tube manufacturing) Foreman (automobile parts) C. THE VISION CASES Placement Practices In general, no special provisions were found in the plants surveyed for the placement of the visually impaired persons beyond the customary physical ex amination and job analysis. A few plants, however, had counselors and placement officers who had re ceived some specialized training in job placement for the visually impaired. When such specialized tech niques were used they seemed to yield excellent results. The need for such services, however, seemed to depend largely upon conditions peculiar to individ ual plants. It was equally true that where placement of the visually impaired was handled through less specialized channels, as was the case in most of the plants surveyed, the impaired persons performed well on their jobs. The pre-employment physical examination, or at least that part of it which dealt with vision testing, was of the utmost importance in these cases. Where defective vision is present, it is essential that the medical and placement officers know the extent of the defect as well as the nature of it. It is also im portant to know the cause of the impairment — whether it is progressive or arrested — in order to know whether the kind of assignment contemplated for the applicant might aggravate the impairment. Careful placement has particular significance for the visually impaired. Improperly placed, the impaired person may cause injury to himself or to others, or an aggravation of his impairment may result. As a glaring example, the person with defective vision as signed to operate an overhead crane would be a con stant source of danger to himself and to others. It was the general opinion of officials in most of the plants studied that job evaluation was a very im portant factor in proper placement of the person with a visual impairment. Depending upon the nature of the visual impairment, it may be necessary to guard against such seemingly unrelated factors as nervous tension as well as elements of physical exertion or movement. Formulated policies excluding visually impaired persons were not common. Of the 109 firms studied, only 16 had definite policies concerning vision cases; but even in these plants the exclusions were not rig idly enforced. A few firms felt that hiring of the totally blind called for specialized kinds of work and specialized facilities which they could not provide. The rarity with which totally blind persons were 51 encountered in the survey, however, indicates clearly that it is extremely difficult for the totally blind in dividual to find a place in manufacturing industries. Of the total survey group of 1,721 visually impaired persons, there were only 34 who were totally blind and only 25 who fell in the “ legally blind ” category. Follow-up practices as well as original placement as a rule were carried on in the same way for the vis ually impaired as for persons with other types of physical impairments. In general, and except for special cases, no systematic follow-up was used be yond the probationary period. It was expected that job re-engineering would be found most frequently in connection with the em ployment of the visually impaired. This expectation was not supported by actual findings. Job re-engi neering was rare and was no more common for this group than for other impairment types. Had job re-engineering on an extensive scale been encoun tered, it would have handicapped the study seriously as it probably would have removed the complete comparability between impaired and unimpaired workers. In a few instances modifications so changed the jobs that no unimpaired workers could be matched with the impaired working on them. But such cases were rare. For the most part, when changes had been made at all, they were either of such minor character that they did not change the essentials of the job or the changes had been found so desirable that they had been adopted for the un impaired workers as well. The findings suggest the conclusion that while some kinds of jobs might re quire extensive modifications or re-engineering, there are many other jobs which the visually impaired per son can perform without the imposition of special conditions. There are, however, special problems in the em ployment of visually impaired workers. Admittedly, the more serious the impairment of vision, the more necessary it is to consider the accessibility of the work place. For the person who is totally blind there is the problem of getting to and from the plant as well as that of getting around in the plant. In several plants totally blind workers used their Seeing Eye dogs to guide them. In other cases, blind workers were able to get about with no more than a little assistance from the people working near them. It probably is not advisable to require such workers to pass through a crowded shop or among moving equipment. Workers with partial blindness or otherwise im 52 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES paired vision appeared to offer no special problems in this connection. Work Performance The visually impaired persons, placed on jobs for which they were equipped with the requisite skills and physical abilities, produced as well, were as reg ular in their work attendance, and made a somewhat better safety record than the unimpaired workers subject to the same incentives and exposed to the same hazards. The following paragraphs and table C -l provide a summary of the performance records of the visually impaired persons and the unimpaired workers matched with them on identical jobs: Absenteeism An absence was defined as absence of 1 full day or more on days on which the employee was scheduled to work. Holidays, lay-offs, shut-downs, and regular vacations were not counted as either scheduled days or as absences. The rate of absenteeism was com puted as days lost from work for every 100 scheduled workdays. Data were available for 1,721 visually impaired persons matched with 2,847 unimpaired workers. Of this group, 1,513 were impaired males and 208 were impaired females. For the group as a whole the rates were 3.6 and 3.7 days per 100 scheduled workdays for the impaired and unimpaired workers, respectively. The record of the female workers tended to raise the group rates slightly. The male impaired and unimpaired had an identical rate of 3.3, while the impaired females had a rate of 5.7 against 6.4 for the unimpaired females. Although these group averages show the visually impaired worker in a favorable light, a clearer pic ture emerges from an analysis of individual perform ances. The frequency distribution of individual absenteeism rates shown in table C -4 reveals that about 24 percent of the visually impaired and 23 percent of the matched unimpaired had no absences at all during the periods studied; 70 percent of the impaired and 71 percent of the unimpaired had ab senteeism rates of 3.9 or less. Both groups contained scattered cases with very high rates; 1.9 percent of the impaired workers and 2.6 percent of the unim paired workers had individual rates of 20.0 or higher. The similarities between the two groups are striking. A heavy concentration of cases at the lower end of the range is evident in both groups. At the other end of the distribution there was a scattering of very high rates. Clearly, these extremely high rates were cases of poor individual performance, and were not char acteristic of either group. T a b l e C - 4 .— Percentage distribution of visually impaired and matched unimpaired workers, by absenteeism frequency rate 1 and by sex Total Female Male Frequency rate class Impaired Unim paired Impaired 23.4 16.2 13.9 10.2 7.7 5.3 13.9 6.8 2.5 .1 25.4 15.3 13.2 11.4 7.3 5.8 12.0 8.2 1.4 0 100.0 100.0 1,721 2,847 0______________ _______ 0.1 and under 1.0_________ 1.0 and under 2.0_________ 2.0 and under 3.0_________ 3.0 and under 4.0_________ 4.0 and under 5.0_________ 5.0 and under 10.0_______ 10.0 and under 20.0____ __ 20.0 and under 50.0______ 50.0 and over__................... 23.7 14.7 13.2 11.3 7.4 6.1 12.8 8.9 1.9 0 Total..... ......... .......... Number of workers.__ . . . Unim paired Impaired Unim paired 25.1 17.5 13.9 10.6 7.5 5.3 12.0 6.0 2.1 0 11.1 10.1 12.9 10.1 8.6 8.6 18.3 14.0 6.3 0 11.2 7.2 14.1 8.0 9.0 5.3 26.6 12.0 6.1 .5 100.0 100.0 100.0 100.0 1,513 2,472 208 375 1 Number of days lost per 100 scheduled workdays. An important aspect of absenteeism analysis is the reasons for which workers absent themselves. For instance, do various specific reasons for absence, such as illness, transportation difficulties, etc., hold any special significance for the visually impaired person? An effort was made to determine reasons for absence in each case. Unfortunately, for more than half the cases reasons for absences were not recorded and in such cases had to be listed as unknown. For those cases in which a reason was obtainable, however, the pattern of the rates attributable to specific reasons is markedly similar in the two groups. The impaired were absent about as often and for about the same reasons as the unimpaired. However, it is possible that this similarity might have disappeared if the cases grouped in the “ unknown” category could have been included in the analysis. T able C - 5 .— Absenteeism frequency rates 1 for visually im paired and matched unimpaired workers, by reason for absence and by sex Total Male Female Reason for absence Impaired Unim paired Impaired Unim paired Impaired Unim paired Total____________________ 3.6 3.7 3.3 3.3 5.7 6.4 Illness. _________________ Personal business_________ Unknown________________ 1.1 .3 2.2 1.4 .3 2.0 1.1 .3 1.9 1.2 .3 1.8 1.8 .7 3.2 2.4 .8 3.2 Number of w ork ers______ 1,721 2,847 1,513 2,472 208 375 1 Number of days lost per 100 scheduled workdays. 53 C. THE VISION CASES Considered as a group, then, there was no sig nificant difference between the visually impaired and the matched unimpaired workers so far as regularity of work attendance was concerned. T a b l e C - 6 .— Percentage distribution of visually impaired and matched unimpaired workers, by frequency rate 1 of nondis abling injury and by sex Female Male Total Frequency rate class Nondisabling Injury Experience Data on nondisabling injuries, i. e., work injuries which did not result in any permanent impairment or loss of time beyond the day or shift on which the injury occurred, were available for 1,696 visually im paired persons matched with 2,809 unimpaired work ers on the same jobs. This group was composed of 1,490 visually impaired males matched with 2,439 unimpaired males and 206 impaired females matched with 370 unimpaired females. The frequency rate of nondisabling injuries was computed for the groups on a base of 10,000 exposurehours. The rate was fractionally higher for the im paired than for the unimpaired workers, 9.6 against 8.8, respectively. There was a rather sizable differ ence in the frequency rates between the male and female groups, the females having the lower rate. For the male cases the rates were 10.0 and 9.0 for the im paired and unimpaired workers, and for the female cases, 6.1 and 7.8 for the impaired and unimpaired. The lower injury experience among the female cases, however, did not affect the group rates materially. For the group as a whole, the variation in the rates indicates that the visually impaired workers expe rienced about 1 more nondisabling injury in each 12.000 hours of work (or 1 more injury for each 6 workers per year) than unimpaired workers on the same jobs. Considering the kinds of injuries involved here — minor cuts, abrasions, bumps, scratches, etc. — the difference does not seem to be significant. The frequency distributions of the individual rates for the two groups computed on a 1,000-hour base further emphasize the similarity of the injury expe riences. About 53 percent of the visually impaired and 51 percent of the unimpaired had no minor in juries at all during the periods studied; 70 percent of the workers in each group experienced less than 1 such injury per 1,000 hours; and about 90 percent of the impaired and unimpaired had less than 3 per 1.000 exposure-hours. However, there was a scat tering of cases (1.1 percent of the impaired and 1.0 percent of the unimpaired) with excessively high rates of 10 or more per 1,000 hours. While these excessive rates were present in both groups, they were infre quent and clearly were not group characteristics. Impaired 0____________________ 0.1 and under 1.0________ 1.0 and under 3.0________ 3.0 and under 5 . 0 _______ 5.0 and under 10.0_______ 10.0 and over___________ _ Total_____________ Number of workers_______ Unim paired Impaired Unim paired Impaired Unim paired 50.5 18.8 21.7 4.9 3.0 1.1 60.1 18.0 17.9 2.0 1.5 .5 56.5 20.0 15.9 5.4 1.9 .3 100.0 100.0 100.0 100.0 1,490 2,439 206 370 52.8 17.5 20.3 5.0 3.3 1.1 51.4 18.9 20.9 5.0 2.8 1.0 51.6 17.4 20.6 5.5 3.7 1.2 100.0 100.0 1,696 2,809 1 Number of injuries per 1,000 exposure-hours. It was realized that while over-all rates of injury might be similar, there nevertheless might be a proneness on the part of visually impaired persons toward certain specific kinds of injury. If such were the case, it would be an important consideration in the placement of these workers. At each plant studied, information on nature of injury was recorded. The rates attributable to these various kinds of injury were computed on the 10,000 exposure-hour base and the differences between the impaired and unimpaired workers were found to be only fractional in all cases. This, of course, reflects group experience and not in dividual experience. It was equally true of both the impaired and unimpaired workers that there were certain individuals who experienced a very high in cidence of certain kinds of injury. It is possible that a greater emphasis on periodic follow-up than was found in a majority of the plants included in the study would have reduced these extreme cases, with a consequent improvement in the over-all rates for the impaired and unimpaired workers alike. As al ready indicated, however, the differences between impaired and unimpaired were only slight. Cuts and abrasions accounted for fully two-thirds of all the injuries in each group. Eye injuries were next most common, and about equally so, among both impaired and unimpaired workers. The pattern is strikingly similar throughout. The evidence in dicates clearly that the injuries experienced were related to the hazards of the job and not to the im pairments which characterized one of the groups. (See table C-7.) First-aid records also indicated the number of re dressings required per injury. As practice varied widely between plants with respect to giving or re- 54 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES T able C - 7 .— Frequency rates1 of nondisabling injury for visually impaired and matched unimpaired workers, by nature of injury and by sex Female Male Total Nature of injury Impaired Unim paired Impaired Unim paired Impaired Unim paired Total__________ _________ 9.6 8.8 10.0 9.0 6.1 7.8 Burns and scalds_________ Cuts and abrasions_______ Eye injuries......................... Strains and sprains_______ Other____________ _______ .5 6.6 1.4 .5 .6 .4 6.0 1.6 .5 .3 .5 6.9 1.5 .5 .6 .4 6.3 1.6 .4 .3 .6 3.5 .8 .4 .8 .7 5.0 Number of workers_______ 1,696 2,809 1,490 2,439 206 370 1.0 .6 .5 1 Number of injuries per 10,000 exposure-hours. quiring redressings, the averages for the two groups are valid only for comparison purposes. It cannot be said that they represent the actual severity of the nondisabling injuries in each group. However, the visually impaired group and the unimpaired group each averaged 0.9 redressings per injury. There can be little question, on this basis of measurement, that there was no significant difference in the severity of the injuries in the two groups. The opinion has sometimes been advanced that physically impaired persons have a tendency toward excessive illness, or that such persons tend a little toward hypochondria. The absenteeism record made by the visually impaired of the survey group refutes that idea: sickness absenteeism was no more pro nounced among them than among the unimpaired workers matched with them. Data were obtained on the number of visits to the dispensary because of nonindustrial illness or injury, i. e., dispensary visits for causes not related to the worker’s employment. Company policies again varied widely in the extent to which such use of medical facilities was encouraged. However, while these policies varied widely among plants, they were the same for impaired and unim paired workers within the same plant. During the periods studied, the visually impaired workers aver aged 1.2 such visits per person while the matched un impaired had an average of 1.3. The visually impaired workers clearly made no greater demands on a plant’s medical facilities than did unimpaired workers. In brief, the visually impaired workers as a group were no different from unimpaired workers of the same age, experience, etc., working on identical jobs. Nondisabling injuries were experienced in about the same frequency in the two groups and were of about the same severity. Even the kinds of injuries were the same and occurred in about the same proportion. Finally, the demands of the visually impaired per sons because of nonindustrial injury or illness were no greater than the same demands made by unim paired workers. Disabling Injury Experience Frequency. For the purpose of this study a disabling injury was defined as one which resulted in permanent impairment or in the loss of time of at least one full day beyond the day or shift on which the injury oc curred. Frequency rates were computed on the standard base of a million exposure-hours. The survey group for which data were available consisted of 1,699 visually impaired persons and 2,825 unimpaired workers. 1,495 impaired males were matched with 2,454 unimpaired males, and 204 impaired females were matched with 371 unimpaired females. The impaired as a group had a somewhat better disabling injury experience than the unimpaired, with a frequency rate of 8.8 against 10.6. The impaired females experienced no disabling injuries at all dur ing the periods studied. The unimpaired females matched with them did not have the same perfect record but their rate, 1.0, was very low. How sig nificant the difference is between the groups of im paired and unimpaired workers is difficult to say. A difference of about two injuries per million exposurehours is not great although it is conceivable that two injuries of sufficient severity could make a sizable difference in compensation costs. In any case, how ever, the impaired workers had the better safety record. Probably as important as the frequency rate in the case of these impaired workers is the fact that none of the injuries resulted in additional permanent impairment to bring about permanent total dis ability. It was also confirmed in each plant that there had been no such injury among visually impaired workers outside the survey group. The experience of this fairly large group indicates that there is no foundation in fact for the frequently held belief that the visually impaired person is an accident hazard to himself or to his fellow workers. However, there is no question that proper placement is an extremely important factor. Only one of the visually impaired workers experienced a disabling injury which was directly traceable to the impair- 55 C. THE VISION CASES ment; and then only because he had been put on a job from which he was restricted. The foreman, ap parently through an oversight, assigned the man to a job he was not supposed to perform. Other in stances were found in which a causal relationship might have existed, but the evidence was very super ficial. For example, a visually impaired [worker mounted a low scaffold which broke down. Possibly the defect in the scaffold might have been apparent to one with good sight. On the other hand, an iden tical injury was experienced by an unimpaired worker in the same plant. Inquiry was also made to determine whether any injuries among the unimpaired workers, either within or outside the survey group, were attributable to the lack of vision of an impaired fellow worker. Not a single instance of this kind was found. The nature of the injuries experienced in the two groups was also fairly similar. Eight of the impaired and 14 of the unimpaired had suffered contusions of the upper or lower extremities, accounting for about 30 percent of all injuries in each group. Fractures of legs and hands were more common among the im paired; about 15 percent as against 10 percent for the unimpaired. Strains and sprains showed the re verse situation in which such injuries accounted for about 10 percent among the impaired and 15 percent among the unimpaired. The remaining injuries con sisted of a variety of burns, cuts, infections, etc. The number of injuries in the two groups combined is hardly large enough to support conclusions. On the whole, however, there seems to be sufficient similarity in the injuries to indicate that their nature was re lated to the job hazards and not to the visual impair ments which characterized one of the groups, Time Lost. It is conceivable that the time lost as a result of disabling injuries by visually impaired workers might have been very much greater even though the frequency rate was lower. Although the visually impaired might be more cautious, their inju ries nevertheless could be more severe. As measures of injury severity the average days lost were com puted as a group rate per 100 scheduled workdays as well as in terms of the average number of days lost per injury. The time-lost rate for the impaired group was somewhat lower than for the matched unimpaired group, 0.10 and 0.14 days per 100 scheduled work days, respectively. For the impaired workers the average period of disability per injury was 14.1 days, as against 17.3 days for the unimpaired group. Not only did the visually impaired tend to experience somewhat fewer injuries than unimpaired workers on the same jobs, but their injuries tended to be some what less severe. As injury severity is largely a matter of chance, the important fact which emerges out of these com parisons is that, given proper placement, visually impaired workers as a group certainly were no worse than their unimpaired co-workers as far as injury ex perience was concerned. Output Relative Individual production data were available for only 108 visually impaired persons. These were matched with 198 unimpaired workers on the same jobs. Of this group, 73 impaired males were matched with 129 unimpaired males, and 35 impaired females were matched with 69 unimpaired females. The number of cases is small for the group as a whole and too small to warrant showing performance figures by sex. As a group, the visually impaired persons turned in a very creditable performance. Their average out put was 1.9 percent better than that of the group of matched unimpaired workers. Although there were substantial variations in the individual l*ates, the visually impaired also fared well in this respect as is shown by the following comparison, in which the average performance of the entire unimpaired group is used as a base of 100. Number of Out-put relative impaired workers Under 9 5 .0 ______________________________________ 95.0 and under 105.0____ _____________________ 28 49 105.0 and over___ _____________________________ 31 25.9 percent of these workers had an efficiency rela tive of 95.0 or less, 45.4 percent had a relative between 95.0 and 105.0, and 28.7 percent had a relative of 105.0 or higher. If it is assumed that an efficiency relative between 95.0 and 105.0 represents about equal performance, 74.1 percent of the visually im paired produced as well as or better than the unim paired workers with whom they were matched. Nearly 29 percent were substantially superior. In evaluating this performance it must be borne in mind that it represents only those cases for which quantitative measures of individual production were available. Although this group is small the compar ison is entirely objective, and there is no reason to 56 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES believe that it is not true for the group as a whole. Subjective evaluations — such as foreman’s opinions, efficiency ratings, etc. — are not weighted into the findings. It was somewhat disappointing that data were not available for a larger group, as a fairly sizable num ber of these workers were on production work on as sembly lines or on group piecework. While measured production for individuals was not obtainable in these cases, the facts of their employment strengthen the findings shown above. On assembly line and group incentive work each individual must keep up with the speed of the line or the group. Therefore, the fact that a considerable number of the visually im paired were found to be so employed indicates that they were able to keep pace with their unimpaired co-workers. Quit Rate Data for the computation of quit rates were ob tainable for 872 of the visually impaired group and for 1,444 unimpaired workers matched with them. This group was composed of 690 visually impaired males matched with 1,135 unimpaired males, and 172 impaired females matched with 309 unimpaired fe males. The rates are based on the number of persons per 100 in each group who had voluntarily left the employ of the company 6 months after the end of the survey period. Among the female workers the voluntary quits were very high, particularly among the impaired, where the rate was 9.3 against 5.5 for the unimpaired. The quit rates for the impaired and unimpaired male workers were very similar, 3.2 and 2.8, respectively. The effect of the high quit rates for the female work ers on the group rates was pronounced. About twice as many impaired workers as unimpaired workers quit for health reasons, and more than twice as many quit because they moved out of the community. These two reasons accounted for most of the dif ference in the rates for the two groups. The reasons listed as “ other” were varied, the most common one being “ to take other position.” This was equally true of the impaired and unimpaired workers. The higher rate for the impaired workers is prob ably accounted for in part by the fact that some of these people had taken jobs during the war and had withdrawn from the labor market after the war was over. This may be especially true of the female work ers. Also, as is indicated by the number who took other positions, many of these impaired workers ac quired industrial skills and experience which in creased the range of their employment opportunities. A third factor, which affected both groups, was the fact that the data covered a period shortly after the end of the war when there was considerable moving around among the working population in general. Terminations showed a substantially higher rate for the impaired workers, 4.3 against 2.8 for the un impaired. These terminations were mostly for re duction in force. The impaired, generally the last to be hired, were the first to be affected by reductions in force. In general, however, while the impaired female workers had a very high quit rate, that for the male workers was not substantially higher than for the unimpaired workers matched with them. D. THE OHTHOPEDIC CASES 57 D. The Orthopedic Cases Summary of Statistical Findings The orthopedically impaired persons made a favor able record of work performance in comparison with the unimpaired workers matched with them on iden tical jobs. As a group the impaired workers produced at a slightly higher rate, as indicated by the higher output relative. The work injury experience also was a little better among the impaired workers as is shown by the slightly lower frequency rates of nondisabling and disabling work injuries. The impaired workers had a fractionally but not significantly higher absence rate. It was only with respect to the quit rate that the im paired workers failed to match the performance of their unimpaired fellow workers. Unfortunately, the reasons for the quits could not be obtained in a suf ficiently large number of these cases to provide a sat isfactory analysis. T able D - l .— W ork p erfo rm a n ce o f w o rk ers w ith serio u s or th op ed ic i m p a ir m e n ts a n d o f m atched u n im p a ir e d w ork ers Number of workers Average performance Factor Unimpaired Impaired 1,522 2 463 3.8 3.4 1,482 2,402 9.4 10.0 1,499 1,499 0 121 632 2,439 2,439 0 193 1,019 5.9 .07 15.8 101.3 5.7 8.9 .10 13.9 100.0 2.9 Impaired Absenteeism frequency rate1-----Nondisabling injury: Frequency rate2 ________ Disabling injury: Frequency rate3___________ Time-lost rate 4____________ Average days of disability 5_ _ Output relative6_______________ Quit rate7___________ — -------- Unimpaired 1 Number of days lost per 100 scheduled workdays. 2 Number of injuries per 10,000 exposure-hours. 3 Number of injuries per 1,000,000 exposure-hours. 4 Number of days lost for disabling injury per 100 scheduled workdays. 6 Number of days of disability per disabling injury « Percentage relationship of production efficiency of impaired to that of matched unimpaired workers. 7 Number of voluntary quits per 100 employees in the survey group. The most significant feature of these comparisons is the marked similarity of the performance of the two groups of workers. Subject to the same incen tives and exposed to the same hazards, their records 776106° — 4 8 — 5 of work performance revealed only fractional dif ferences. On the basis of this record, it seems reason able to conclude that the orthopedically impaired persons constituted a group of competent workers who, properly placed, were fully capable of holding their own in competition with unimpaired workers on the same jobs. Composition of the Survey Group The types of orthopedic impairment included in the definitions adopted for the study fell within three major classifications: First, cases in which some member or major portion of a member of the body was lost through amputation; second, cases in which there was severe loss of use of a member even though the member itself was retained; and third, cases of back deformity which severely restricted the use of the back in such movements as walking, stooping, crouching, bending, etc. An additional classification, multiple orthopedics, included cases in which a per son had two of the major orthopedic impairments mentioned above, each in itself severe enough to fall within the adopted definitions. Amputation cases were easily defined, and infor mation was readily obtainable from company medi cal records. Where an arm, leg, hand, or foot had been amputated, there was no question as to dis ability. In the case of loss of use, however, the im pairment was one of degree. In such cases the deter mination to include the worker in the study was based upon whether the loss of use of an important body member amounted to 50 percent or more. For the most part, if not indicated on the medical record, the plant physician was able to specify the extent of the impairment. In doubtful cases, the employee was not included in the survey group. The same pro cedure was followed for back deformity, with its attendant limitations on the use of the back. In this way, it was possible to restrict the impaired group to 58 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES cases which constituted serious impairment and posed real problems of job placement. Although the layman tends to think of impaired workers primarily as persons with orthopedic im pairments, the survey indicates that this concept probably is in error. The 1,522 orthopedic cases con stituted only about 13.8 percent of the survey group. Three other types of impairments — hernia, cardiac, and vision — were encountered more frequently. Furthermore, only one third of the orthopedic cases were amputees. With only 80 exceptions, the orthopedic workers studied were male. The instances of female ortho pedic employment were so few, in fact, that no sepa rate data are shown for them. Indicating perhaps a greater difficulty of older workers with orthopedic impairments to find em ployment, the age distribution of this group tended to be somewhat lower than that for the impaired group as a whole. About 70 percent of the orthopedic group were below 50 years of age, as against 56 per cent of the rest of the impaired workers. When arranged by 5-year intervals, the age group containing the largest number of orthopedic impair ment cases was the one from 30 to 35 years. By contrast, the 5-year class containing the heaviest proportion of the other impaired workers in the en tire survey was from 55 to 60 years. Interestingly, however, the oldest impaired worker included in the entire survey was a man who had lost the use of one arm many years ago but who neverthe less was actively employed at the age of 87. T able amputations accounted for only one third of the total, with 484 cases. Hand amputations were the most common and were found in 183 cases. Amputations of one leg were nearly as frequent, with 176 cases. In 7 cases both legs had been amputated and in 2 both arms had been lost. The loss of use of one or more members of the body accounted for 761 cases, exactly 50 percent of all the orthopedic cases studied. Back deformities and multiple impairment cases accounted for the rest. Inasmuch as the various types of orthopedic im pairments present different placement problems, it would have been desirable to present performance data for each specific type. An examination of the following table, however, will make it apparent that while there are significant numbers of cases compris ing some of the subgroups, there are many instances in which the available number of observations is too small to support conclusions. T a b l e D ~ 3 .— Distribution of orthopedically impaired workers, by type of impairment Number of workers Type of impairment Type of impairment Number of workers 1,522 Total................ ....................... .. Amputation cases____________ One hand________________ Two hands______________ One arm________________ Two arms_______________ One foot_ ______________ Two feet _ _ .._ . _ One leg. _ Two legs . .. 484 183 5 72 2 38 1 176 7 Loss of use cases____________ One hand_______________ Two hands____________ One arm______ ____ ____ Two arms____ One foot______ ______ Two feet_____ ____ __ One leg___________ Two legs. Baek deformity eases 214 Multiple eases . 761 114 8 174 9 51 19 335 51 63 D - 2 .— Comparison of number and percentage distri bution of 1,522 orthopedic cases and 9,506 other impaired workers studied, by age group Number of workers Percent Age group Orthopedic cases Other impaired Orthopedic cases Other impaired Total....................... .............. ........ 1,522 9,506 100.0 100.0 Under 20 years............................... 20 and under 25 years__________ 25 and under 30 years__________ 30 and under 35 years__________ 35 and under 40 years__________ 40 and under 45 years__________ 45 and under 50 years__________ 50 and under 55 years__________ 55 and under 60 years______ __ 60 and under 65 years______ __ 65 years and over______________ 10 106 166 226 211 164 178 189 139 94 39 69 405 735 891 973 1,074 1,134 1,373 1,404 994 454 .7 6.9 10.9 14.9 13.8 10.8 11.7 12.4 9.2 6.1 2.6 .7 4.3 7.7 9.4 10.2 11.3 11.9 14.4 14.8 10.5 4.8 The detailed break-down of the orthopedic cases shown in table D -3 indicates the wide variety of spe cific impairments in this group. As already indicated, In the individual case the cause of the impairment, the length of time the individual has had to adjust to it, and the prosthetic aid he uses may exercise a con siderable influence on the quality of his work per formance. An attempt was made to obtain data on cause, duration of impairment, and prosthetic aid used in each case. Unfortunately, information on these points was not available in a great many cases. Information on cause of the impairment was obtained for 743 workers, on duration of impairment for 439, and on prosthetic aid for 125. While in some instances information on all 3 points was available for the same case, in others only cause and aid were given, and in some the only available reference indicated the pros thetic aid used. Among the 743 cases for which cause was given, 119 impairments had resulted from work injuries. D. THE ORTHOPEDIC CASES On other causes, however, the records were vague or incomplete. As the records of the cooperating firms as a rule did not provide this information, the only other alternative was to interview the persons who constituted the survey group. This, however, was not considered feasible on this study. In 33 cases, the cause given was arthritis, and in 104 the cause was stated to be polio. The impairment cause in an ad ditional 69 cases was given merely as “ illness. ” Duration of the impairment was recorded in only 654 cases; 439 workers were listed as having acquired the impairment in adulthood, 175 in childhood, and in 40 cases the impairment had been present since birth. In only 125 cases was it reported that a prosthetic aid, such as artificial limb or brace, was being used by the worker. Unfortunately, the data available with respect to the whole general subject of cause and duration of the impairment and the prosthetic aid used, if any, are too fragmentary to be of much assistance in the anal ysis of the work performance of these workers. Industry and Occupational Coverage The orthopedic cases were not concentrated in any particular industry. A fairly sizable number were en countered in every one of the 19 major industry groups represented in the survey. The occupations in which persons with orthopedic impairments were found employed are shown in the listing on pp. 6(M38. The two facts which stand out immediately are the great variety of jobs and the concentration of these jobs in the processing or pro duction operations. Perhaps the most significant fact brought out by an examination of various jobs in which these workers 59 were employed is the great range and variety of skill requirements represented. There is strong evidence here that the person with an orthopedic impairment was fully capable either of exercising skills he had acquired before the impairment, or of learning new ones in keeping with the physical abilities he had re tained. Further evidence of this is the fact that so few of the orthopedic cases studied were found in the unskilled custodial group. It seems almost trite to point out that the skill a worker has acquired with his hands is not affected by loss of a leg, yet where arbitrary exclusion policies are in force, it may well be that a worker is prevented from using the skill h e1 has in his hands for the reason that he has lost a leg. It is obvious too from the occupations listed that industry had not found it necessary to set up any particular set of conditions or to handpick cer tain obvious jobs for the orthopedically impaired person. The data suggest that, except for extreme cases, an orthopedic impairment left more abilities than it took away. A man who has lost an arm was not necessarily incapable of performing jobs that required the use of two hands. Nor, for that matter, did the survey indicate that the worker who had lost a leg necessarily had to be confined to sed entary occupations. Many cases were encountered in which the individual who had lost a member, or the use of a member, was able to neutralize, or at least minimize, the disability by use of a prosthetic aid. Men who had lost a hand were found engaged in machine operations or in handling materials; and workers who had lost a leg were engaged in work re quiring considerable walking and moving about. It must be borne in mind that the jobs listed are merely illustrative. Many impaired workers em ployed on other jobs could not be included in the study and consequently those jobs do not appear in the listing. 60 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES Jobs at which 1,522 Orthopedic Cases of the survey group were found employed {[Titles used are those appearing in the U n ited States E m p lo y m e n t Service D ictio n a ry o f O ccu p ation a l T itles and are grou p ed and n u m bered a cco rd in g t o the classifications used b y the W age A nalysis B ran ch o f the B u reau o f L a bor Statistics. T h is is not to be interpreted as a co m p lete listing of jo b s a t w h ich persons w ith this im pairm ent can b e e m p lo y e d ] M ALE Amputee — One Hand Laborer (iron and steel) Tallym an I I I Laborer, process (electrical equipment) Tool clerk Laborer, process (foundry) Laborer, process (glass manufacturing) 1 . M a in te n a n c e 6 . M a te r ia l M o v e m e n t Laborer, process (paper and pulp) Machinist II Brakeman, yard I Automobile mechanic Machinist, bench Electric-bridge-crane operator Bricklayer II M ash-tub man Electric-truck operator Carpenter Milhng-machine operator II Elevator operator, freight Electrical-instrument repairman Molding-machine tender Hot-metal-crane operator Electrical repairman Multiple-spindle-drill-press operator Laborer (automobile manufacturing) Fireman, stationary boiler Offset-press man Laborer (automobile parts) Laborer (pulp and paper) Painter, spray I I Laborer (cutlery tools) Machinist I I Panel trimmer Laborer (electrical equipment) Maintenance mechanic I I Patternmaker X I Millwright Patternmaker, metal Laborer (firearms) Laborer (foundry) Oiler I Polisher Laborer (m alt liquors) Pipe-fitter helper Power-shear operator I Laborer (nonferrous metal alloys and R oll polisher Punch-press operator I Tube cleaner Radial-drill-press operator Welder, combination Radiator-core assembler Roller operator I X 2 . W o r k in g F o r e m e n products) Laborer (surgical appliances) 7 . C u sto d ia l Rubber compounder Sandblaster-shotblast tumbler operator Gateman I V Foreman (asbestos products) Sand mixer, hand Laborer (automobile manufacturing) Foreman (nonferrous metal alloys and Sheet-metal worker, aircraft Laborer (automobile parts) Still-operator helper Laborer (felt goods) Straightening-press operator Laborer (machine parts) Stranding-machine operator Porter I Subassembler Porter I I Subassembler I I I W atchman I products) Turret-lathe operator 3 . P ro cessin g Automobile mechanic, motor I Surface grinder Beater operator Tankroom man I V Tire bagger Bench grinder Box maker Buffer I I I Tool designer Compound mixer I I Control man Turret-lathe operator Vertical-boring-mill operator Cutter, machine V Vertical-turret-lathe operator Cylindrical-grinder operator Wire drawer I I I 3 . P ro cessin g Cylinder-machine operator Form builder I 5. R e c o r d in g a n d C o n tr o l Shipping clerk I 4 . In s p e c tio n a n d T e s tin g Die setter I Drophammer operator II Inspector, crude rubber Engine-lathe operator Inspector (machine shop) External-grinder operator I Torsion tester 7 . C u sto d ia l Porter I I Final assembler V II Floor assembler Two Hands — Tube drawer Desk assembler Die maker I I Amputee Amputee — One A rm 5 . R e co rd in g a n d C o n tro l Forming-press operator I I. M a in te n a n c e Hardener II Follow-up man I I I H eat treater I I Laborer (aircraft manufacturing) Machinist I I Induction-furnace operator helper Laborer, process (iron and steel) Maintenance mechanic I I Insulating-machine operator I Production clerk I I Oiler I Job setter I I Production planner Sheet-metal worker II Laborer (automobile parts) Receiving checker I I Tool-grinder operator Laborer (foundry) Stock clerk I I Welder, combination 61 D. THE ORTHOPEDIC CASES J o b s at w h ich 1 , 5 2 2 O rth o p ed ic C a s e s o f the s u r v e y g rou p w ere f o u n d e m p lo y e d M A L E — Continued Amputee — One Arm — Continued 3. Processing Amputee — — Continued One Foot Amputee — One Leg 1. Maintenance 1. Maintenance Carpenter Carpenter Electrical repairman Brake operator, machine I I Machinist II Dipper I I Heater, forge Maintenance mechanic I I Pipe fitter Laborer^ foundry) Tool-grinder operator Laborer (iron and steel) Laborer (rayon and allied products) Maintenance mechanic II Oiler I Laborer, process (automobile manufac turing) Laborer, process (leather manufacturing) Laborer, process (rubber goods) Machinist, bench Painter I 3. Processing Tool-grinder operator Assembler 3. Processing Burrer, hand Offset-press man Final assembler Riveter, pneumatic I I I Shaper operator I Assembler Floor assembler Jigger-brim-pouncing-machine operator Subassembler Job setter I I Switchroom man Laborer, process (leather manufacturing) Milling-machine operator II 4. Inspection and Testing Single-spindle-drill-press operator Casting inspector Subassembler I I I Final-assembly inspector Inspector I Circular-sawing-machine operator Core paster Tool maker Cutter-off II Inspector (fabric plastic products) Cylindrical-grinder operator Inspector (machine shop) 5. Recording and Control M aterial clerk Production clerk I I Burrer, hand Churn man II Tool-grinder operator Wireman I I I Installation inspector Broaching-machine operator Buffer I Centerless-grinder operator Chipper, foundry Subassembler Electrical inspector I I Battery assembler Bench assembler V 4. Inspection and Testing D ie maker I I Casting inspector Die-m aker apprentice Electrician Inspector (machine shop) Electric-motor repairman Radio repairman I Engine-lathe operator Raw-material inspector II Final assembler Forming-press operator I Receiving checker I I Stock-control clerk 5. Recording and Control Tool clerk 6. Material Movement Production clerk II Gear-hobber operator General assembler I I Germination worker Glass polisher Stock clerk I I Hat-brim-curler, hand Follow-up man I I I Laborer (aircraft manufacturing) 6. Material Movement Laborer, m ent) Laborer (automobile manufacturing) Dispatcher, locomotive Laborer, process (automobile manufac turing) Laborer (glass manufacturing) Electric-bridge-crane operator Laborer, process (chemicals) Laborer (machine tools and accessories) Fireman, industrial locomotive Laborer, process (cutlery tools) Elevator operator, freight Laborer (iron and steel) process (agricultural equip Laborer, process (foundry) Laborer, process (iron and steel) 7. Custodial Laborer, process (m alt liquors) 7. Custodial Janitor I Porter I Laborer, process (nonferrous metal al loys and products) W atchm an I Porter I I Laborer, process (rubber goods) Laborer, process (rubber tire and tube Amputee — Amputee Two Arm s — Two Feet manufacturing) Lapping-machine operator 4. Inspection and testing 6. Material Movement Inspector, hammers and presses Laborer (foundry) Machinist, bench Milling-machine operator I I Milling-machine operator, automatic 62 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES J o b s at w h ich 1 ,5 2 2 O rth op ed ic C a s e s o f the s u r v e y g r o u p w ere f o u n d e m p lo y e d M A L E — Continued Amputee — One Leg — Continued 3. Processing — Continued Molding-machine tender Multiple-spindle-drill-press operator Painter, spray I Paper slitter Pull-over-machine operator Punch-press operator I Punch-press operator, automatic Radial-drill-press operator Repairman V Screw-machine operator, automatic Screw-machine operator, semiautomatic Sheet-metal worker, aircraft Shredder operator I I Single-spindle-drill-press operator 6. Material Movement 3. Processing Bucket-conveyor operator Annealer Diesel-dinkey operator Bag-making-machine operator Electric-bridge-crane operator Bench grinder Elevator operator, freight Boring-machine operator, vertical Laborer (automobile manufacturing) Chipper, foundry Laborer (fabric plastic products) Churn man II Laborer (paper and pulp) Circular-sawing-machine operator Core paster Laborer, process (automobile manufac turing) Cylindrical-grinder operator Laborer, process (rayon and allied prod ucts) Glass grinder Insulation-machine operator I Gateman IV Laborer (foundry) Jig-boring-machine operator Janitor I Laborer (m alt liquors) W atchm an I Laborer, process (automobile manufac turing) Amputee — Two Legs 3. Processing Laborer, process (tire and tube manufac turing) Burrer, hand Lehr man Subassembler I I I Tool maker Tumbler operator I I Turret-lathe operator Vertical-boring-mill operator Weigher-up Welder, acetylene Welder, combination Laborer, process (automobile parts) Laborer, process (malt liquors) Straightening-press operator Tool-grinder operator Forging-press operator 7. Custodial Straightener, hand Switch adjuster Electrician apprentice Engine-lathe operator Truck driver, heavy Straightener and parts-fitter Subassembler — Continued Engine-lathe operator Machine-molder, squeeze Laborer (automobile manufacturing) Machinist II Punch-press operator I Machinist, bench Tool-grinder operator M ake-up man V Milling-machine operator I I 4. Inspection and Testing Molder Pointer operator Inspector (machine shop) W ood handler, inside Loss of Use of One Hand Planter I Plunger Punch-press operator I Saw filer, machine 4. Inspection and Testing Balancer I Gager I Hardness inspector Inspector, chief I Inspector, hammers and presses Inspector (machine shop) Inspector, material test Laborer, process (fabric plastic products) Salvage inspector Tool inspector 1. Maintenance Screw-machine operator, semiautomatic Shaper operator I “Blacksmith II Carpenter Stillman Subassembler Electrical repairman Tool-grinder operator Instrument repairman T ool maker Laborer (aircraft manufacturing) Turret-lathe operator Laborer (machinery manufacturing) Welder, combination Laborer (petroleum refining) Laborer, process (nonferrous metal alloys and products) Machinist I I Maintenance mechanic I I Millwright 5. Recording and Control Painter I Pipe fitter Chemist assistant I I Tool-grinder operator Production clerk I I Welder, combination 4. Inspection and Testing Casting inspector II Checker Inspector I Inspector (machine shop) Laborer, process (glass manufacturing) Salvage inspector II Production planner Shipping clerk I 2. Working Foremen 5. Recording and Control Absorption-plant foreman Checker Stock clerk I I Tool clerk 63 D. THE ORTHOPEDIC CASES J o b s at w h ich 1 > 5 2 2 O rth o p ed ic C a s e s o f the s u r v e y g r ou p w ere f o u n d e m p l o y e d M A L E — Continued Loss of Use of One Hand — Continued 5. Recording and Control — Con tinued Production clerk II Timekeeper T ool clerk Milling-machine operator, automatic Laborer (tobacco) Laborer, process (machine shop) Machinist I I Mixing-machine operator I Molder, bench Maintenance mechanic I I Pumpman V I I Milling-machine operator I I Punch-press operator I Pipe-fitter helper Punch-press operator I I Power-house engineer Rubber pressman Sheet-metal worker I I Saw-filer, hand Tool-grinder operator Saw-filer, machine Welder, combination Screw-machine operator, automatic Weigher-up Shaper operator I 6. Material Movement 2. Working Foremen Crane operator, portable Foreman (cutlery tools) Electric-bridge-crane operator Forming-press operator I I Elevator operator, freight Tin plater I I I Sheet-metal worker, aircraft Single-spindle-drill-press operator Slitting-machine operator Slitting-machine operator II Straightening-machine operator I I Stranding-maehine operator Laborer (automobile manufacturing) Laborer (iron and steel) Laborer (machinery manufacturing) — Continued Subassembler I (aircraft manufacturing) Subassembler I I 3. Processing Swinging-cut-off-saw operator Laborer (malt liquors) Buffer I Tankroom man IV Laborer (nonferrous metal alloys and Chipper, foundry Tool-grinder operator products) Loader operator I I I 7. Custodial Coil-machine operator Tool maker Compositor I Tube drawer Core-oven tender Cutter-off I Turret-lathe operator Vertical-boring-mill operator Cylindrical-grinder operator Vertical-turret-lathe operator Gateman IV Developer I Welder, arc Porter II Die maker I I Welder, combination Die-maker apprentice I W ireman V I W atchm an I Evaporator operator I. Loss of Use of Two Hands Experimental mechanic 4. Inspection and Testing Floor assembler 1. Maintenance Forming-press operator I Checker Furnace tender, heat treating Core checker Inspector (machine shop) Locomotive repairman, Diesel Gager V I I I 3. Processing Laborer (automobile manufacturing) Laborer (foundry) Job setter I I Circular-sawing-machine operator Laborer (m alt liquors) Film spooler Laborer, ment) Laborer (m alt liquors) Subassembler II Upholsterer I I Loss of Use of One Arm process (agricultural equip Laborer, process (automobile manufac turing) Laborer, process (bakery products) Laborer, process (nonferrous metal al loys and products) 1. Maintenance Laborer, process (photographic appara Bricklayer, refractory brick tus) Laborer, process (radio manufacturing) Pyrometer man II Radio repairman I 5. Recording and Control Checker Expediter I I Production clerk I I Shipping clerk I Stock clerk I I Tool clerk 6. Material Movement Electrical repairman Laborer, process (rubber tire and tube manufacturing) Brakeman, yard I Fireman, stationary boiler Laborer, process (wire) Electric-bridge-crane operator Floor assembler Ladle man I I Lapping-machine operator Laborer (automobile manufacturing) Laborer (foundry) Carpenter Laborer (aircraft manufacturing) Laborer (building) Machinist I I Laborer (glass manufacturing) Laborer (electrical equipment) Laborer (iron and steel) Machinist, bench M ajor assembler I Laborer (iron and steel) Laborer (leather products) Laborer (petroleum refining) Milling-machine operator II Laborer (m alt liquors) 64 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES J o b s at w h ich 1 , 5 2 2 O rth op ed ic C a s e s o f the s u r v e y g rou p w ere f o u n d e m p lo y e d M A L E — Continued Loss of Use of One Arm — Continued — Continued General assembler I I Punch-press operator I Glass cutter Sheet-metal worker, aircraft Hardener I I Single-spindle-drill-press operator Job setter I I Tool maker 6. Material Movement — Continued Laborer (automobile manufacturing) Treater helper Laborer (paper and pulp) Laborer, process (foundry) Laborer (wire) Laborer, process (m alt liquors) Trailer-truck driver Machinist I I Hardness inspector Truck-crane operator Machinist, bench Tester helper Laborer (iron and steel) 4. Inspection and Testing Milling-machine operator, automatic 7. Custodial Painter, aircraft Painter, spray I I Gateman IV Punch-press operator I Laborer (machinery manufacturing) Shaper operator I Porter I Stillman helper Porter I I Tool-grinder operator Tool maker Loss of Use of Two Arm s 6. Material Movement Electric-bridge-crane operator Laborer (glass manufacturing) 7. Custodial Porter I Turret-lathe operator Wire drawer I I I Loss of Use of One Leg 1. Maintenance 4. Inspection and Testing Laborer (machine shop) 1. Maintenance Machinist I I Casting inspector Boilermaker Boiler-operator helper 2. Working Foremen Inspector, machine shop Laborer, process (glass manufacturing) Tool inspector Structural steel worker 5. Recording and Control Final assembler V I I Laborer, process (machine shop) Laborer, process (nonferrous metal 6. Material Movement Single-spindle-drill-press operator Subassembler I Electric-bridge-crane operator Turret-lathe operator Laborer (automobile manufacturing) Loss of Use of One Foot Fireman, stationary boiler Laborer (tobacco) Stock clerk II Laborer, process (machine shop) Carpenter, flask Electrical repairman 3. Processing Job setter II Carpenter Elevator operator, freight alloys and products) Machinist II Maintenance man Maintenance mechanic Millwright Laborer (bakery products) Oiler I Laborer (foundry) Painter I Laborer (wire) Painter, spray I 1. Maintenance Pipe fitter 7. Custodial Plumber Laborer (electrical equipment) Porter I Laborer (iron and steel) Laborer (petroleum refining) Sheet-metal worker Porter II Structural-steel worker Electrical repairman Power-house engineer II Saw filer, machine II W elder, combination Loss of Use of Two Feet Welder helper, acetylene Sheet-metal worker helper 1. Maintenance 2. Working Foremen Electrical repairman Developer I 3. Processing Bench grinder Box maker, wood I I I 3. Processing Inspector (machine shop) Cigarette-packing-machine operator Cylindrical-grinder operator Coil assembler IV 3. Processing Die maker II Electrician, airplane I Electric-motor assembler Furnace operator I I Glass polisher Die maker II Laborer, process (nonferrous metal alloys and products) Machinist II Aircraft-carburetor subassembler Arbor-press operator Assembler IV 65 D. THE ORTHOPEDIC CASES J o b s at w h ich 1 , 5 2 2 O rth o p ed ic C a s e s o f the s u r v e y g rou p w ere f o u n d e m p lo y e d M A L E — Continued Loss of Use of One Leg — Continued — Continued Laborer, process (wire) W elder, butt Lapping-machine operator Lay-out man (machine shop) Welder, combination W ire drawer I I I Lehr man 3. Machinist I I Processing — Continued Machinist apprentice 4. Inspection and Testing Assembler, office machines Machinist bench Automobile machanic, motor I Babbiter I I M etal finisher, hand fifing Body-assembly inspector Milling-machine operator I I Casting inspector Balancer I Milling-machine operator, automatic Chemist, organic Body maker I I I Molder Deflector operator Box maker, wood I I I M older apprentice Dynamometer tester, motor Brazer Molder, floor Experimental mechanic Broaehing-maehine operator M otorm an I Final-assembly inspector Buffer I Burrer, hand Multiple-spindle-drill-press operator Painter, spray I I Inspector and tester Churn man II Planer operator I I Inspector (machine shop) Cigarette-packing-machine operator Plexiglas former Inspector (rubber goods) Circular-sawing-machine operator Plunger Installation inspector Coil winder I Pointer operator Instrument maker I Core maker I Polisher Laborer, process (glass manufacturing) Core paster Power-shear operator I Tester I T ool inspector Inspector I Cutter, machine I Pressman Cylindrical-grinder operator Punch-press operator I Die-casting-machine operator I I Punch-press operator I I Die-maker apprentice I Drawer builder Radial-drill-press operator Reaming-machine operator I Engine-lathe operator Recovery operator Experimental mechanic Rewinder operator Final assembler V II Rubber pressman Floor assembler Sandblaster I Furnace tender, heat treating Scrap-drop craneman Glass cutter Screw-machine operator, automatic Glass grinder Screw-machine operator, semiautomatic Glass polisher Sheet-metal worker, aircraft Heat treater I I I Single-spindle-drill-press operator Electric-bridge-crane operator Internal-grinder operator Slitting-machine operator V I Electric-monorail-crane operator Instrument maker I Job setter I I Sorter Spinner V I Electric-truck operator Elevator operator, freight Laborer (foundry) Laborer (glass products) Sticker Laborer (aircraft manufacturing) Laborer (automobile manufacturing) 5. Recording and Control Follow-up man I I I Receiving checker I I Stock clerk I I Timekeeper T ool clerk 6. Material Movement Laborer (machine tools and accessories) Still-operator helper Straightener, hand Laborer (nonferrous metal alloys and Stuffer, machine Laborer (foundry) Laborer (glass manufacturing) Subassembler I Laborer (malt liquors) Subassembler I I Subassembler I I I Laborer (mattress and bedspring manu facturing) Switch adjuster Laborer (paper and pulp) Template maker IV Laborer (plastic materials) Laborer, process (automobile parts) Tool-grinder operator Laborer (wire) Laborer, process (chemicals) Tool hardener Trailer-truck driver Laborer, process (firearms) Tool maker Truck-driver, light Laborer, process (foundry) Tool-maker apprentice products) Laborer, process (agricultural equip ment) Laborer, process (automobile manufac turing) Laborer, process (furniture) Tube drawer Laborer, process (glass manufacturing) Turret-lathe operator Laborer, process (m alt liquors) Vertical-turret-lathe operator Laborer, process (paper and pulp) Washer Gateman IV Laborer, process (radio manufacturing) Watchcase-vulcanizer tender Porter I I Laborer, process (rayon and allied prod Welder, arc W atchm an I ucts) 7. Custodial 66 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES J o b s at w h ich 1 ,5 2 2 O rth op ed ic C a s e s o f the s u r v e y g r ou p w ere f o u n d e m p lo y e d M A L E — Continued 7. Custodial — Continued Gear-hobber operator General assembler I I Porter II Glass cutter Loss of Use of Two Legs Glass grinder Back Deformity 1. Maintenance Carpenter Electrician helper 1. Maintenance Glass polisher Induction-furnace operator Insulating-machine operator I Job setter I I Fireman, stationary boiler Laborer (furniture) Instrument repairman Laborer (glass manufacturing) Laborer (aircraft manufacturing) Laborer (iron and steel) Laborer (automobile manufacturing) Laborer, process (automobile parts) Assembler (office machines) Laborer (iron and steel) Laborer, process (electrical equipment) Bench assembler V Laborer (petroleum refining) Laborer, process (foundry) Burrer, hand Machinist I I Laborer, process (glass manufacturing) 3. Processing Chipper, foundry Maintenance man, factory or mill Laborer, process (m alt liquors) Coil-machine operator Maintenance mechanic II Laborer, process (nonferrous metal al Electrical adjuster Millwright File cutter Fireman, still Sheet-metal worker I I Ladle man I I W ater tender I I I Lehr man Jigger-brim-pouncing-machine operator Welder, combination turing) Machinist I I Machinist, bench Job setter I I Laborer, process (automobile manufac loys and products) Milling-machine operator II 2. Working Foremen Multiple-spindle-drill-press operator Painter, spray II Laborer, process (rubber goods) Glass grinder Laborer, process (tobacco products) Teaser II Pumpman V I I Tinplater I I I Presser, machine I Pressman 3. Processing Radial-drill-press operator Punch-press operator I Repairman V Saw filer, machine Shaper operator I Single-spindle-drill-press operator Straightener I I I Subassembler I Subassembler I I Tool-grinder operator Tool maker Welder, spot 4. Inspection and Testing Patternmaker-apprentice, metal Punch-press operator 1 Recovery operator Aircraft mechanic Riveter, pneumatic I I I Automobile mechanic, motor I Sandblaster I Bench assembler V Box maker, wood III Scorer I Broaching-machine operator Screw-machine operator, semiautomatic Sheet-metal worker, aircraft Side-laster machine Buffer I Burrer, hand Single-spindle-drill-press operator Spreader I Centerless-grinder operator Straightener, hand Brakeman, automobile Charging-machine operator I Subassembler I Cigarette-making-machine operator Subassembler I I I Body-assembly inspector Cigarette-packing-machine operator Deflector operator Switchroom man Circular-sawing-machine operator Hardness inspector Tapping-machine operator I Coremaker, machine I Inspector I Tool-grinder operator Cylinder-block repairman Inspector (machine shop) Tool maker Cylindrical-grinder operator Tool inspector Trimmer, hand V I I I Dental ceramist Turret-lathe operator Desk assembler W arm -in boy Die-casting machine operator W elder, combination Die maker II Welder, spot Production clerk I I Electrician apprentice Wire drawer I I I Shipping checker I I Electric-motor assembler Tool clerk Engine-lathe operator 5. Recording and Control Experimental-body-and-minor assembler 6. Material Movement 4. Inspection and Testing Filling-machine operator I Final assembler V I I Casting inspector Diesel-dinkey operator Floor assembler Core checker Laborer (cutlery tools) Forming-press operator I Deflector operator 67 D. THE ORTHOPEDIC CASES J o b s at w h ich 1 ,5 2 2 O rth op ed ic C a s e s o f the s u r v e y g r o u p w ere f o u n d e m p lo y e d M A L E — Continued Back Deformity— Continued 4. Inspection and Testing — Con tinued 3. Processing 7. — Continued Custodial Chipper, foundry Gateman IV Cutter-off I I Porter I I Desk assembler Electric-motor assembler FEM ALE Filter cleaner Gear matcher Inspector (machine shop) Installation inspector Laborer (electrical equipment) Laborer, process (fabricated plastic products) 5. Recording and Control Glass grinder Amputee — Two Hands Glass polisher Laborer (foundry) Laborer, process (automobile manufac turing) Laborer, process (automobile parts) 5. Recording and Control Stock clerk I I Laborer, process (electrical equipment) Laborer, process (m alt liquors) Amputee — One Arm Expediter II Lathe operator, automatic I Laborer (machine tools and accessories) Machinist apprentice 5. Recording and Control Laborer (petroleum refining) Production clerk I I Milling-machine operator V I Paper slitter Stock clerk II Shipping clerk I Pulpit man II Stock clerk I I Shaper operator I 6. Material Movement Tool clerk Sheet-metal-fabricating-machine operator Laborer, process (glass manufacturing) 6. Material Movement Sheet-metal worker, aircraft I I Single-spindle-drill-press operator Brakeman, yard I Still-operator helper Electric-bridge-crane operator Tool designer Elevator operator, freight Tool-grinder operator Industrial locomotive operator Welder, combination 7. Custodial Rest-room attendant Amputee — One Leg Laborer (automobile manufacturing) Laborer (bakery products) Laborer (glass manufacturing) Laborer (machine tools and accessories) Laborer (machinery manufacturing) Laborer (m alt liquors) Laborer (rayon and allied products) Laborer (wire) 4. Inspection and Testing 3. Processing Airplane inspector I Profiling-machine operator I I Body-assembly inspector Casting inspector Inspector (machine shop) Tool inspector 4. Inspection and Testing Laborer, process (cutlery tools) Laborer, process (automobile manufac turing) Loss of Use of One Hand 5. Recording and Control 7. Custodial Porter I I Clerk, general Production clerk I I Rest-room attendant W atchman I Shipping checker Multiple Orthopedic 1. Maintenance Laborer, process (aircraft manufacturing) 6. Material Movement 4. Inspection and Testing Electric-truck operator Laborer, process (automobile parts) Fireman, portable boiler W eaver IV Floor assembler Laborer (automobile manufacturing) Maintenance mechanic II Laborer (iron and steel) Millwright Laborer (rayon and allied products) Painter I Laborer (wire) 3. Processing 5. Recording and Control Stock clerk I I PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES 68 J o b s at w h ich 1 ,5 2 2 O rth op ed ic C a s es o f the s u r v e y g rou p w ere f o u n d e m p lo y e d FEMALE — Continued Loss of Use of Two Hands 4. Inspection and Testing Inspector (machine shops) — Continued Sewing-machine operator products, n. e. c.) (fabricated Sewing-machine operator (m en’s tailored garments) 3. Loss of Use of One Leg Processing W elder, filament Laborer, process (aircraft manufactur- 3. Processing 7. Custodial tag) Laborer, process (garment manufactur- Bench grinder Charwoman Bench hand X I mg) Cake wrapper Back Deformity Cementer, hand II Coil assembler I V Loss of Use of One Arm Coil taper, machine Final assembler V II 1. Maintenance Laborer (machinery manufacturing) 3. Processing Instrument maker I Laborer, process (electrical equipment) Sewer, hand I II Sewing-machine operator (shirts and re Instrument maker II 3. Processing Bander and cellophaner, machine Baser II Laborer, process (automobile parts) Floor assembler Laborer, process (confectionery) Laborer (bindery) Laborer, process (electrical equipment) Sewer, hand I II Laborer, process (confectionery) M ajor assembler I Sewing-machine operator (shirts and re Rotor-core assembler lated products) Solderer I Sewing-machine operator (m en’s tailored garments) Stripper, machine 4. Inspection and Testing Subassembler I I I Subassembler I I I Complete-and-final-assembly inspector Yarn winder Final assembly inspector, fusilage instal 4. Inspection and Testing 4. Inspection and Testing Inspector (machine shop) lated products) lation Inspector (machine shop) Laborer, process (automobile parts) Laborer, process (glass manufacturing) Tester I Tire inspector II 5. Recording and Control Stock clerk I I 6. Material Movement X -r a y inspector Laborer (rayon and allied products) 6. Material Movement Multiple Orthopedic Laborer (rayon and allied products) Sorter II 3. Processing 7. Custodial Raster, hand Loss of Use of One Foot 3. Processing Armature winder I Laborer, process (dental equipment) Charwoman Porter II Loss of Use of Two Legs Loss of Use of Two Feet 3. Processing Baser I I 3. Processing Laborer, process (confectionery) 4. Inspection and Testing Inspector (machine shop) 5. Recording and Control Stock-control clerk D. THE ORTHOPEDIC CASES Placement Practices In general, the pre-employment physical exami nation was found to be relatively unimportant in the case of the person with an orthopedic impairment because the impairment usually was visible and could be evaluated readily. A placement officer is not likely to put such an applicant on a job which he obviously is incapable of performing. However, the physical examination may make a considerable con tribution to proper placement by revealing the cause of the impairment, such as arthritis, varicosity, etc., which results in a limitation of the use of a body member. This information may prevent placing the applicant in working conditions which might ag gravate the impairment. In 10 of the 109 plants surveyed, it was a matter of company policy to prohibit the hiring of orthopedic cases coming within the definitions used in this study. Yet, orthopedically impaired workers were found em ployed in each of these 10 plants. Apparently, these were persons who had acquired the impairment after being employed by the company and either had con tinued on in their jobs or had moved to other jobs which their residual abilities permitted them to per form. In several other plants the policy was to exclude persons with orthopedic impairments unless they pos sessed some particular skill which was urgently needed at the moment. In all cases, however, the exclusion rules were relaxed to permit the hiring of disabled veterans. The placement of a person with an orthopedic impairment tends to be simple in its essential prin ciples. The application of these principles, however, may be quite complex. The impairment or limitation is usually visible and the matching of the abilities of the individual to the requirements of the job is not difficult. Flexibility in applying the rules, however, is the most necessary requirement. To say that an applicant who has lost a leg cannot do a job that re quires standing or walking, may or may not be true. An instance encountered during the survey will il lustrate the point. A man who had lost a leg in a plant accident asked to be trained for a certain job. It was believed that the man could acquire the skill but the job required constant standing and moving. However, as the employee had asked for it, the man agement decided to let him try. He was taught the job and had been performing it successfully for sev eral years at the time of the survey. In another case 69 a man who had lost a hand was found handling steel drums. He used a hook in place of the hand and had no trouble at all in keeping up with his fellow workers. These instances are cited not to prove that a man with one leg should be put on jobs requiring standing and moving or that a man with one hand should be assigned to jobs handling heavy materials, but to emphasize the fact that placement of the orthopedi cally impaired person was found to be an individual matter. It is necessary to consider the job in terms of all the abilities and attributes of the individual applying for it and not exclusively in terms of the physical impairment. The use of prosthetic aids was found to open many jobs to the man with an orthopedic impairment. For example, the worker who had lost an arm was not necessarily excluded from a job requiring the use of two arms. An artificial limb enabled many such workers to do the same work they had always done, or to learn new jobs even though these required the use of two arms or two hands. Because of the many and complicated ways in which persons with ortho pedic impairments were found to adjust to different requirements, job analysis and evaluation of job re quirements are extremely important placement tools in these cases. Work Performance The group of persons with serious orthopedic im pairments compared favorably with their matched unimpaired workers on the same jobs. Table D - l and the following paragraphs summarize the find ings of the study of this group with respect to the five major factors of work performance for which data were obtained. Absenteeism An absence was defined as absence from the job on days on which the employee was scheduled to work. Lay-offs, vacations, etc., were not counted either as days absent or as days scheduled to work. The average rate of absenteeism, computed as days lost per 100 scheduled workdays, was 3.8 for the 1,522 orthopedic cases against 3.4 for the 2,463 un impaired workers matched with them. These rates are the same as those for the survey group as a whole. The slight difference in the rates indicates that, 70 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES as a group, the orthopedically impaired worker might be expected to have about 1 day more of absence than the unimpaired in each 250 scheduled workdays. If two applicants presented themselves at the em ployment office and it was known that one of them would be absent 1 more day than the other in each 250 days of scheduled work, it is doubtful whether this fact in itself would determine which applicant got the job. While the level of the rates as such is not a consideration in this study, the fact is that the fa vorable level of the rates also tends to minimize the difference between the two groups. * The frequency distribution of the individual rates for the impaired and unimpaired workers (table D -4) provides further evidence of the similarity of the per formance of the two groups. There is a very high concentration in the lower range with a scattering among the very high frequencies. Nearly one quarter of each group had no absences at all during the period studied, and about 70 percent of the impaired and 73 percent of the unimpaired had absenteeism rates of 3.9 or less. Isolated instances of very poor perform ance occurred in both groups. Two of the ortho pedic cases and four of the unimpaired workers had extremely poor rates of 50.0 or higher. Such in stances, however, can be expected in any large group of workers. T able D - 4 .— Percentage distribution of 1,522 orthopedically impaired workers and 2,463 unimpaired workers, by absenteeism frequency rate 1 Absenteeism frequency rate class _______ _____ ______________________________ 0 0.1 and under 1.0----------------------------------------------1.0 and under 2.0___________ ______ — ---------------2.0 and under 3.0--------------------------------------------------3.0 and under 4.0------ ---------------------------------- --------4.0 and under 5.0_________________________________ 5.0 and under 10.0------------------------ -----------------------10.0 and under 20.0_______________________________ 20.0 and under 50.0_______________________________ 50.0 and over_____________________________________ Total..... .................................... - ..................... - Impaired Unimpaired 22.2 15.0 12.6 11.4 8.0 5.4 14.9 8.0 2.4 .1 23.7 16.7 12.6 11.6 6.9 6.6 13.0 7.1 1.6 .2 100.0 100.0 1 Number of days lost per 100 scheduled workdays. Unfortunately, no reason was obtainable for well over half the total number of absences recorded. To the extent to which such reasons were obtainable, however, the rates attributable to various causes for absence as shown in table D -5 were very similar for the impaired and unimpaired workers. Personal busi ness accounted for a rate of 0.3 in each group; and illness, the most frequent cause of absence, yielded a rate of 1.2 for the impaired against 1.0 for the unim paired. It is, of course, impossible to say how the comparisons would have been affected had it been possible to obtain the reasons for absences in the large groups recorded as unknown. However, within the limits of the known facts, there does not seem to be any material difference between the orthopedically impaired and the unimpaired workers matched with them as to the reasons why they absented themselves on scheduled workdays. T able D - 5 .— Absenteeism frequency rates 1 for 1,522 ortho pedically impaired workers and 2,463 unimpaired workers, by reason for absence Reason for absence Impaired Unimpaired Total____________________________________________ 3.8 3.4 Illness_______ __ __________________________ ______ Personal business_________________________________ Unknown__________________________ _______ ___ 1.2 .3 2.3 1.0 .3 2.1 1 Number of days lost per 100 scheduled workdays. Nondisabling Injury Experience A nondisabling injury was defined as one which did not result in a permanent impairment or in loss of time beyond the day or shift on which the injury occurred. The group injury experience was expressed as a rate reflecting the number of injuries per 10,000 exposure-hours. The individual rates were computed on a 1,000-hour base. Data for this factor in work performance were available for 1,482 orthopedic cases matched with 2,402 unimpaired workers. The difference between the two groups was frac tional, with a small advantage on the side of the im paired workers. The rates of minor work injuries were 9.4 and 10.0 per 10,000 exposure-hours for the impaired and unimpaired, respectively. The differ ence indicates that the impaired, as a group, might be expected to experience about 1 less nondisabling injury than the unimpaired in each 15,000 hours of work. Considering that this represents typically the single treatment antiseptic-and-adhesive-tape type of injury with no lost time, the difference does not seem to be significant. Because group averages might not be truly repre sentative of the group experience, frequency distri butions were developed. The patterns of the two frequency distributions shown in table D -6 are nearly identical in the two groups. 55 percent of the im paired and 53 percent of the unimpaired had no inju ries at all during the periods studied. 95 percent in each group had a rate of 4.9 or less. Exactly 0.2 per cent in each group were in the extremely high bracket, D. THE ORTHOPEDIC CASES with a rate of 20.0 or more. It seems reasonable to conclude on this evidence that the nondisabling in jury experience was the same for the orthopedically impaired workers and for the unimpaired workers exposed to the same hazards. There was no evidence of accident proneness on the part of the worker with an orthopedic impairment. T able D - 6 .— Percentage distribution of 1,482 orthopedically impaired workers and 2,402 unimpaired workers, by frequency rate 1 of nondisabling injury Frequency rate class Impaired Unimpaired ____________ _____________________ 0 _ _ ___ 0.1 and under 1.0_________________________________ 1.0 and under 2.0________ _____ _____ _____ ______ 2.0 and under 3.0__________________________ ______ 3.0 and under 5.0-------------------------------------------------5.0 and under 1 0 .0 ----------------- --------------------------10.0 and under 20.0---------------- --------- --------------------20.0 and over________________ _____ _______________ 54.9 15.3 13.8 6.7 4.4 3.7 .2 52.5 16.0 14.3 6.7 5.4 4.3 .6 .2 Total_____________________ _______ ________ 100.0 100.0 1.0 1 Number of injuries per 1,000 exposure-hours. Nor did the orthopedically impaired differ from the unimpaired as to the nature of injuries. The rates attributable to various kinds of injury, shown in table D -7, have very similar patterns for the two groups of workers. Considering the fact that the fig ures shown here reflect the experience of a sizable number of cases, it seems clear that the injuries ex perienced were related to the hazards of the jobs. There appears to have been no tendency on the part of the person with an orthopedic impairment toward some particular kind of injury. T able D - 7 .— Nondisabling injury frequency rates1for 1,482 orthopedically impaired workers and 2,402 unimpaired workers, by nature of injury Nature of injury Impaired Unimpaired 10.0 Total_____________ 9.4 Burns and scalds __ Cuts and abrasions. Eye injuries_______ Strains and sprains. Other_____________ .6 .6 6.4 1.4 .5 .5 6.8 1.7 .4 .5 71 obtained largely at the discretion of the employee. However, while the practices varied among plants, they were the same for the impaired and unimpaired in each plant. Thus, while the redressings per injury are some measure of the severity, they are so only on a comparative basis between the two groups. The impaired and unimpaired groups alike aver aged 0.8 redressings per injury, indicating that injuries of orthopedically impaired workers were no more severe than those of the unimpaired workers matched with them. In brief, the nondisabling injury experience in the two matched groups of workers was practically iden tical with respect to frequency, severity, and nature of injury. In the light of this record, it seems reason able to conclude that the injury experience was related to the hazards of the jobs and not to the orthopedic impairments which characterized one of the groups. The dispensary records yielded an additional fact of considerable interest — visits for reasons other than work injuries. These were visits to the dispen sary occasioned by causes not related to the workers employment, such as illness, home accidents, etc. Again, plant practices varied widely with respect to treatment of such non-work-connected injury or ill ness. Some plants encouraged, others discouraged, such use of plant medical facilities. However, the significant consideration here is not the actual de mands made on such facilities but the comparison of the demands made by the impaired and unimpaired workers under the same conditions. In this respect again there was no difference between the two groups. The orthopedically impaired group and the matched unimpaired group each averaged 1.3 such visits per person. The opinion sometimes encountered that the orthopedically impaired worker tends to make ex cessive demands upon the medical facilities of the plant, clearly is not supported by the recorded ex perience of 1,482 such workers compared with 2,402 unimpaired co-workers. 1 Number of injuries per 10,000 exposure-hours. Disabling Injury Experience The number of redressings required per injury pro vides some indication of the severity of first-aid in juries. In the present study it was found that practices concerning redressings varied widely among plants. In some instances intensive follow-up was made to be sure that the employee reported for re dressings on each injury until released by the com pany physician. In other plants redressings were Frequency. This kind of injury was defined as one which resulted in a permanent impairment or in time loss of at least one full day beyond the day or shift on which the injury occurred. Data on disabling work injuries were obtained for 1,499 orthopedically impaired persons matched with 2,439 unimpaired workers. The orthopedic cases had 72 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES a substantially better disabling injury record than the unimpaired workers matched with them and exposed to the same hazards. Computed on the standard base of a million exposure-hours, the rates for the impaired and unimpaired groups were 5.9 and 8.9, respectively. As was true of nondisabling work injuries, the sim ilarity in the nature of the disabling injuries was very pronounced. Contusions of the lower extremities were the most common and accounted for about onethird of all the injuries in both groups. Two of the impaired cases suffered fractures, as did three of the unimpaired. All five cases involved fractures of the toes. The only amputations, however, were recorded among the unimpaired workers; there were five of these, all amputations of fingers. With this exception the pattern of injuries in the two groups was prac tically identical. Again, the conclusion seems war ranted that the injuries were attributable to the job hazards and not to any accident proneness of the im paired workers. The significance of these figures lies in the fact that the workers of the two groups were working on the same jobs and consequently were ex posed to identical hazards. Time Lost The time lost by each group as a result of disabling injuries was computed as a rate per 100 scheduled workdays. The rates for the two groups were small, 0.07 and 0.10 days per 100 scheduled days for the impaired and unimpaired groups, respectively. On this basis of comparison, the severity of disabling injuries was about the same for impaired and unim paired workers. A slightly different approach to the time-lost factor is the average time lost per injury. Again, the dif ference between the two groups was small, 15.8 and 13.9 days per injury for the impaired and unimpaired groups, respectively. Orthopedically impaired work ers experienced a total of 15 disabling injuries with a total time loss of 237 days. Included in this group was one case — a contusion of the foot — which re sulted in a time loss of 96 days. This single case raised the average from 10 days to nearly 16 days. Among the unimpaired there were 36 disabling injuries, among which was also one very high case — a foot frac ture with a time loss of 87 days. If, for the sake of a better comparison the extreme case is removed from each group, the averages become 10 days per injury for the impaired and 13 days per injury for the unimpaired workers. Either way, the difference does not seem to be large enough to indicate any signif icant difference in the severity of the injuries in the two groups. A careful examination of accident records, supple mented by discussion with the safety director or other responsible plant official, showed that in no case was the injury of an orthopedically impaired person at tributed to his impairment. None of the injuries experienced by the orthopedically impaired workers resulted in any additional permanent disability severe enough to result in total permanent disability. Nor were any of the injuries among the unimpaired re corded as caused or contributed to by a fellow work er’s impairment. Furthermore, no instance of this type was discovered for any impaired workers not included in the group. In brief, the person with an orthopedic impairment, if reasonably placed, was found to be neither a hazard to himself nor to others. On the contrary, he expe rienced a somewhat better accident record than did unimpaired workers exposed to the same hazards. Output Relative Of the 1,522 orthopedically impaired workers who comprised the survey group, individual production data were available for only 121. Matched with these impaired workers were 193 unimpaired workers on the same jobs and subject to the same incentives. As a group, the orthopedic cases were about 1 percent more efficient, with an output relative of 101.3 as against 100.0 for the unimpaired workers with whom they were matched. Although the group of 121 ortho pedic cases was not as large as was desirable, it will be noted that the output relative is nearly identical with that for the 895 cases of the total survey group for whom production data were available. Not all of the orthopedic workers studied produced at a better rate than did the unimpaired workers matched with them. It would not be reasonable to expect that they should. However, even on an indi vidual comparison basis, the impaired workers made a favorable record, as the following tabulation indi cates: Output relative Number of impaired workers Under 9 5 .0 ___________________________________ 31 95.0 and under 105 .0 _________________________ 49 105.0 and over________________________________ 41 If an output relative between 95.0 and 105.0 can be taken to represent satisfactory performance, 74 D. THE ORTHOPEDIC CASES percent of the impaired workers produced at a rate equal to or better than the unimpaired workers with whom they were matched on the same jobs. Only 26 percent were less efficient than the unimpaired workers with whom they were compared, while, on the other hand, 34 percent were substantially better. Incentive work was not restricted to any one or a few types of orthopedic impairment. Among the 121 cases for whom data were available, 14 of the 18 spe cific kinds of orthopedic impairments were repre sented. The evidence here indicates that the existence of orthopedic impairments did not prevent workers from keeping up an adequate production pace, provided they were reasonably placed. For the firms repre sented in this study, the employment of the orthopedically impaired on incentive work did not result in any lag in production schedules. On the contrary, the records indicate that the effect was slightly in the other direction. In evaluating the ability of these orthopedically impaired workers to keep up with production sched ules, there are two additional factors which must be taken into consideration. First, the small number of cases for which data were available does not indicate that orthopedic cases were not widely used on pro duction work. Many cases had to be excluded be cause they could not be matched with the unimpaired workers on the same jobs. Second, only those who were on individual incentive work could be used. Orthopedic cases working on group incentive systems and on assembly lines could not be included. How ever, on group incentive work the impaired worker had to keep up with the group in order to hold the job, and on assembly line operations the work was paced by the speed of the line. Hence, the fact of their employment on these jobs is evidence that the orthopedically impaired workers so employed were able to meet the production pace of the unimpaired workers on the same jobs. Quit Rate Data on job separations were obtainable for 632 orthopedically impaired workers matched with 1,019 unimpaired workers. Data for the computation of the separation rates were obtained by means of follow-up and consisted of the number of persons of the survey group, im776106° — 48 — 6 73 paired and unimpaired, who were no longer in the employ of the company 6 months after the end of the period used for the study. Thus, if the survey period covered the period January 1 through December 31, 1945, the data on separations covered the 6-month period January 1 through June 30, 1946. The rates were computed as the number of workers no longer employed per 100 workers in the survey group. The total separation rate is made up of two factors, the terminations (lay-offs, discharges, etc.), over which an employee has no control, and the voluntary quits, where the action is initiated by the em ployee. For the purpose of comparing the stability on the job of these groups of impaired and unimpaired work ers, it is the quit rate which is of principal interest. In the present survey group the orthopedically im paired workers had a substantially higher quit rate, 5.7 as against 2.9 for the unimpaired workers. The difference in the quit rates amounts to 2.8 and is accounted for in part by the fact that the number of quits was higher for the impaired for health reasons and because a somewhat larger number of these em ployees moved out of the community. These two reasons accounted for 1.2 of the 2.8 difference. The other sizable difference occurred in the cases where the reason for quits was unknown. Unfortunately, this category accounts for more than half the dif ference between the two groups. It is possible that part of this group may have taken jobs during the war and then, when the emergency had passed, may have withdrawn from the labor force. Profiting from the opportunities offered by wartime employment many impaired persons acquired industrial skills and experience for which there was a ready market, and many undoubtedly quit to take other or better jobs. These factors probably influenced the rates for the impaired persons, especially during 1945 and 1946 when there was considerable shifting around among the working population in general. Miscellaneous reasons for quits classified as “ other” made up a large category for both the impaired and the unim paired, the principal reason listed for both groups being “ to start own business. ” Terminations primarily as a result of reduction in force ran 6.3 per hundred for the orthopedically im paired as against 4.3 for the matched unimpaired workers. This is not surprising since in general the impaired were the last to be hired and, as a result of lower seniority rating, were among the first to be laid off when reductions in force became necessary. 74 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES E. The Hearing Cases Summary of Statistical Findings In most respects the performance of the workers with impaired hearing compared favorably with that of the unimpaired workers with whom they were matched. The two groups were about equally regular in their work attendance and had about the same nondisabling work injury experience. Contrary to the findings for most of the other impairment groups, the frequency of disabling injury was higher for the workers with impaired hearing than for the unim paired workers on the same jobs. The severity of the injuries as measured by the resultant time loss, however, was substantially less. The rate of voluntary quits was also substantially lower for the hearing cases. Observations on measured individual pro duction were not available on a group sufficiently large to permit showing comparative performance data. Nearly 20 percent of the hearing cases were fe males, and the performance of this group exerted a fairly marked influence on the performance of the survey group as a whole. The female cases had a somewhat higher incidence of both disabling and nondisabling injuries than was characteristic of the female cases in other impairment groups, but the absenteeism rate was about the same. On the whole, the workers with impaired hearing acquitted themselves creditably. Properly placed, the impairment did not seem to constitute a handicap and their work performance, except for the incidence of disabling work injuries, was about the same as that of the unimpaired workers matched with them on the same jobs. Composition of the Survey Group The hearing group included three specific impair ments : (1) the totally deaf, defined as an 0/20 classi fication or 50 decibel loss; (2) the hard of hearing, T a b l e E - l .— W ork performance of workers with hearing impairments, and of matched unimpaired workers Croup Absenteeism frequency rate1 Nondisabling injury frequency rate2 Disabling injury Frequency rate3 Time-lost rate 4 Average days of disability 5 Output relative6 Quit rate 7 Average performance Total: Impaired____________________ __ ________ ___________ Unimpaired_________ _____ _______ _____ _ _____ ______ Male: Impaired_______ ___ _________ __________ Unimpaired_________________ _____ — -- -- --Female: Impaired_____________________ ____________ _____ Unimpaired-------------------- ------------------------ --------------- 3.4 3.9 11.4 11.0 8.1 4.6 3.0 3.4 n T 11.4 5.1 0.08 .06 —- — ----------.09 .07 5.4 6.6 11.5 9.3 6.1 2.1 .04 (9) sJ ■■ ■■ -■ 13.4 17.0 ------ 2.8 4.7 (8) (8) — ■ 12.3 17.8 (8) (8) (8) (8) 9.0 1.0 (8) (8) (8) (8) (8) f8) 272 430 Number of workers Total: Impaired______ . . . ________________________ __ Unimpaired_______ _______ - ____________ _ _ ___ _____ _______ Male: Impaired___________________________ _____________________ U nim paired ___ _____ ____________________________ __ _______ _______ Female: Impaired_____________________________________________ ________ ________ Unim paired ______________ ____________________ __ _________ __ 1 Number 2 Number 3 Number 4 Number 6 Number of of of of of days lost per 100 scheduled workdays. injuries per 10,000 exposure-hours. injuries per 1,000,000 exposure-hours. days lost for disabling injury per 100 scheduled workdays. days of disability per disabling injury. 595 937 568 892 588 930 588 930 -T " r-.-, 494 753 470 716 487 746 487 746 (8) (8) (8) (8) 101 184 98 176 101 184 101 184 (8) (8) (8) (8) 6 Percentage relationship of production efficiency of impaired to that of matched unimpaired. 7 Number of voluntary quits per 100 employees in the survey group. 8 Data available for too few cases to justify showing performance figures. 9 Less than 0.01. E. THE HEARING CASES defined as 10/20 classification or a loss of 30 decibels but less than 50 decibels in the better ear; and (3) the deaf-mute. The readings used were those taken without use of hearing aid because it was found early in the study that employees usually were classified in that way on plant medical records. This impair ment group yielded a total of 595 cases, making it fifth in size among the 10 impairment groups studied. T able E - 2 .— Distribution of 595 hearing cases, by type of impairment and by sex Male Total Impairment group Female Total________ _______ ______ ____________ 595 494 101 Totally deaf __________________________ Hard of hearing___________ __ _________ Deaf-mute_______________ __ __________ 92 313 190 61 275 158 31 38 32 The hard of hearing were encountered most fre quently and accounted for 313 cases in this survey group. The deaf mutes provided 190 cases. Only a comparatively few totally deaf workers were found, T a b l e E - 3 .— Comparison of number and percentage distribution of 595 hearing cases and 10,433 other impaired workers, by age group and by sex Number of workers Percent Age group Hearing cases Other impaired Hearing cases _ Other impaired Total______________________________ Under 20 years________________ 20 and under 25 years__________ 25 and under 30 years____ _____ 30 and under 35 years___ _ __ 35 and under 40 years 40 and under 45 years_________ 45 and under 50 years_ _ _ _ 50 and under 55 years _ _ _ _ 55 and under 60 years ____ __ 60 and under 65 years__________ 65 years and over______________ 595 5 50 82 80 63 79 67 55 51 38 25 10,433 74 461 819 1,037 1,121 1,159 1,245 1,507 1,492 1,050 468 100.0 .8 8.4 13.8 13.4 10.6 13.3 11.3 9.2 8.6 6.4 4.2 100.0 .7 4.4 7.9 9.9 10.8 11.1 11.9 14.4 14.3 10.1 4.5 Males__________ __________________ Under 20 years___ ______ 20 and under 25 years__________ 25 and under 30 years_____ ____ 30 and under 35 years_____ i_ _ 35 and under 40 years__________ 40 and under 45 years__________ 45 and under 50 years__________ 50 and under 55 years__________ 55 and under 60 years__________ 60 and under 65 y e a r s _________ 65 years and over______________ 494 3 32 65 67 52 61 54 48 50 37 25 9,759 50 379 699 949 1,025 1,069 1,185 1,450 1,447 1,039 467 100.0 .6 6.5 13.2 13.6 10.5 12.3 10.9 9.7 10.1 7.5 5.1 100.0 .5 3.9 7.2 9.7 10.5 11.0 12.1 14.9 14.8 10.6 4.8 Females___________________________ Under 20 years________________ 20 and under 25 years__________ 25 and under 30 y e a r s . _______ 30 and under 35 years_________ 35 and under 40 years_________ 40 and under 45 years_________ 45 and under 50 years_________ 50 and under 55 years_________ 55 and under 60 years_______ __ 60 and under 65 years_________ 65 years and over_____________ 101 2 18 17 13 11 18 13 7 1 674 24 82 120 88 96 90 60 57 45 11 100.0 2.0 17.8 16.8 12.9 10.9 17.8 12.9 6.9 100.0 3.6 12.2 17.8 13.1 14.2 13.4 8.9 8.5 6.7 1.6 (0 i Less than 0.05. 1 0 1 1.0 1.0 0 75 92 in all. Because of the comparatively small total number of cases in the group, performance data are not shown separately by specific type of impairment. With respect to age characteristics, the group showed a fairly heavy concentration in the lower age ranges: 47 percent, or nearly one-half, were under the age of 40. Among the remainder of the impaired workers only 34 percent, or about one-third, were in this age range. 28 percent of the hearing cases and 43 percent of the rest of the impaired workers were 50 years of age or older. The largest single group, 82 cases, fell within the age range from 25 to 30 years. The concentration of the female workers in the lower age ranges was even more pronounced. Slightly over 91 percent of the females, as against 68 percent of the males, were under the age of 50. It is not apparent from the material at hand why the hearing cases should have displayed this deviation from the gen eral pattern. Industry and Occupational Coverage Workers with impaired hearing were found in each of the major industry groups covered by the study. The cases on which performance data were obtained are not concentrated in any one or a few of the indus tries, and small numbers of these cases were encoun tered in almost every plant. This broad plant and industry coverage indicates that the person with im paired hearing can be employed in a great variety of industrial activities. Also, the performance figures shown in the report reflect the performance of these workers under a wide variety of employment condi tions. It is generally known that certain industries employ relatively large numbers of persons with im paired hearing in certain operations where noise is very objectionable to persons with good hearing. Unfortunately, however, it was impossible to obtain the performance records for these cases. The specific jobs at which the impaired workers of this group were employed during the periods studied are shown in the listing on pp. 76-79. For the most part, the impaired persons were utilized in processing or producing operations. Maintenance work, mate rial movement, and inspection and testing accounted for only a relatively small proportion of the group. Not only were these workers concentrated in the processing operations, but the range and variety of skills represented in those operations were very wide. 76 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES In general, the tendency seemed to be toward the higher skilled jobs. This is not surprising, as the im paired person frequently must be able to exercise some special skill in order to gain employment. How ever, the low skilled jobs — the process laborers, maintenance laborers, etc. — were also represented. But very few, less than 5 percent of the group studied, were found in custodial occupations, such as janitor and porter. The tabulation indicates clearly the wide variety of industrial occupations which the person with seri ously impaired hearing is capable of performing. While it is illustrative of the point, it is by no means to be interpreted as a complete list of suitable occu pations. Many jobs on which impaired persons were found to be employed were not recorded because, for one reason or another, the qualifications of the survey could not be met. A complete list of all jobs filled by workers with impaired hearing and encountered in the survey would have resulted in a much larger tab ulation but still would not have been exhaustive or complete. Jobs at which 595 Hearing Cases of the survey group were found employed [T itles used are those appearing in the U n ite d States E m p lo y m e n t Service D ictio n a ry of O ccup ational T itles an d are g rou p ed and n um bered a cco rd in g to the classifications used b y the W a g e A n alysis B ran ch o f the B u reau o f L a b or Statistics. T h is is not to b e interp reted as a com plete listing o f jo b s a t w hich persons w ith hearing im pairm ents can b e e m p lo y e d ] M ALE Straightener, hand Pipe fitter Subassembler I I I Plumber Switch adjuster Plumber apprentice Template maker IV Power-shear operator I 1. Maintenance Tinner, automatic Tool-grinder I Pumpman I Electrical repairman Tool-grinder operator Stationary engineer Machinist II Welder, combination Switchboard operator I I I Totally Deaf Maintenance mechanic II Sheet-metal worker II Welder, combination Oiler I 5. Recording and Control 3. Processing Production clerk II 2. Working Foremen Stock clerk II Airplane woodworker II Band-sawing-machine operator 6. Material Movement Inspector (machine shop) Stillman II Coil winder II Detail assembler II Die maker I I Drop-hammer operator I I Laborer (automobile manufacturing) Laborer (bakery products) 3. Processing Laborer (leather products) Engine-lathe operator Tractor operator Airplane woodworker II Assembler Electrician, airplane I 7. Custodial Automobile mechanic, motor I Battery-charger placer File cutter Final assembler V II Porter II Boring-machine operator, automatic Box maker, wood I I I Electrical assembler II Box tender I Form builder I Laborer (iron and steel) Hard of Hearing Laborer (nonferrous metal alloys Laborer, process Buffer, machine and products) 1. Maintenance (agricultural Brake operator, machine II Burrer, hand Calender operator I equip Boilermaker Centerless-grinder operator Laborer, process (cutlery tools) Carpenter Chassis assembler II Laborer, process (rayon and allied prod- Electrical repairman Instrument man IV Circular-sawing-machine operator Coil winder II Lurer Laborer (ammunition) Cylindrical-grinder operator Machinist, bench Laborer (boot and shoe) Dental ceramist M ajor assembler I Laborer (malt liquors) Detail assembler II M ajor-assem bly installer Laborer (petroleum refining) Milling-machine operator Machinist II Die-casting-machine operator I I Die maker II Repairman V Maintenance mechanic II Dipper II Riveter, aircraft Millwright Electric-motor assembler Single-spindle-drill-press operator Oiler I Engine-lathe operator Slieking-lathe operator Painter I Final assembler V II ment) ducts) 77 E. THE HEARING CASES J o b s at w h ich 5 9 5 H e a r in g C a s e s o f the s u r v e y g rou p w ere f o u n d e m p lo y e d M A L E — Continued Hard of Hearing — Continued 3. Processing — Continued Punch-press operator I 7. — Continued Custodial Radial-drill-press operator Reactor operator I Gateman IV Rotor assembler Janitor I Saw setter I I Laborer (machinery manufacturing) Sheet-metal-fabric-machine operator Porter I Sheet-metal worker I I Porter II Sheet-metal worker, aircraft W atchm an I Floor assembler Sheet-metal worker, aircraft II Form builder I Forming-press operator Single-spindle-drill-press operator Sorter Friction-sawing-machine operator Spinner V I Furnace operator I I Sprayer V I Furnace tender, heat treating Spreader I Deaf-M ute 1, Maintenance Gear-hobber operator Stillman, beer Carpenter Heater III Stock maker Maintenance mechanic I I Heater, forge Subassembler Instrument maker I Subassembler I I Insulating-machine operator I Subassembler I I I Job setter II Tool-grinder operator Laborer (automobile manufacturing) Tool maker Laborer (automobile parts) Topm an V M illm an Painter I Pipe fitter 3. Processing Laborer (m alt liquors) Topping-off operator Assembler Laborer, process (aircraft manufactur- Turret-lathe operator ing) Laborer, process (automobile manufac Upholsterer I I Boring-machine operator, automatic Box tender Washer Brake operator, machine II 4. Inspection and Testing Centerless-grinder operator Chipper, foundry Air-box tester Cigarette-packing-machine operator Commutator assembler turing) Laborer, process (foundry) Laborer, process (garment manufacturing) Laborer, process (glass manufacturing) Laborer, process (iron and steel) Laborer, process (machine shop) Laborer, process (machine tools and ac Burrer, hand Final-assembly inspector Final tester II Inspector (machine shop) cessories) Laborer, process (malt liquors) Coremaker, machine I Cylindrical-grinder operator Dental ceramist Die cutter I 5. Recording and Control Laborer, process (nonferrous metal al Die maker I I Die-maker apprentice loys and products) Laborer, process (plastic materials) Shipping checker Stock chaser II Laborer, process (rayon and allied prod ucts) Tool clerk Engine-lathe operator File cutter 6. Material Movement Final assembler V II M ajor assembly installer Distributor I Folding-machine operator V I Forming-press operator I Milling-machine operator II Electric-truck operator Furnace tender, heat treating Milling-machine operator, automatic Laborer (aircraft manufacturing) Gear-hobber operator Molder Laborer (automobile manufacturing) Gear-tooth rounder Multiple-spindle-drill-press operator Laborer (bakery products) General assembler II Stock clerk I I Final assembler Laborer, process (wire) Machine adjuster I I I Die setter I Embosser V Machinist II Painter, spray I Laborer (button manufacturing) Hardener II Paper slitter Laborer (electrical equipment) Instrument maker I Plater I Laborer (iron and steel) Jet man Pointer operator Laborer (malt liquors) Job setter II Polisher Laborer (petroleum refining) Laborer (bindery) Press cutter Laborer (plastic materials) Laborer (photographic apparatus) Pressman Laborer (rayon and allied products) Pressman, paraffin plant Laborer (wire) Laborer, process (automobile manufac turing) Pumpman V II Teamster Laborer, process (bakery products) Pumpman helper Truck-crane operator Laborer, process (electrical equipment) 78 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES J o b s at w h ich 5 9 5 H e a r in g C a s e s o f the s u r v e y g r ou p w ere f o u n d e m p lo y e d M A L E — Continued 6. Material Movement — Continued Cementer, hand II Coil assembler IV Deaf M ute — Continued Laborer (automobile manufacturing) Final assembler V I I Laborer (electrical equipment) Floor assembler Laborer (foundry) Grid operator 3. Processing — Continued Laborer (iron and steel) Laborer (rubber goods) Laborer (plumbing supplies) Laborer, process (bakery products) Laborer, process (foundry) Laborer (rayon and allied products) Laborer, process (iron and steel) Laborer, process (machine shop) Laborer, process (nonferrous metal al 7. Custodial loys and products) Lapping-machine operator Machine adjuster I I I Laborer (photographic apparatus) Porter II ing) Laborer, process (tobacco products) M ounter V I I I Painter, spray I I Sewer, hand III M ake-up man V Milling-machine operator I I FEMALE Molder, floor Sewing-machine operator (shirts and re lated products) Slitting-machine operator Molding-machine tender Totally Deaf M otor stamper Offset-press man Laborer, process (electrical equipment) Laborer, process (garment manufactur Subassembler Thrower II I. Maintenance Yarn winder Glass worker 4. Inspection and Testing 3. Processing Body-assembly inspector Casting inspector Painter, aircraft Painter, spray I Paper slitter Plater I Plunger Powderer Punch-press operator I I Assembler II Radial-drill-press operator Bander-and-cellophaner, machine Saw setter II Battery assembler Sheet-metal worker II Blank horner Sheet-metal worker, aircraft Burrer, hand Inspector I Inspector (printing) 5. Recording and Control Single-spindle-drill-press operator Final assembler V II Stock clerk I I Slicking-lathe operator Sole-leather-cutting-machine operator Straightener, hand Floor assembler Tool clerk Laborer, process (baking products) Laborer, process (confectionery) 6. Material Movement Straightening-press operator Laborer, process (electrical equipment) Stranding-machine operator Laborer, process (garment manufactur ing) Subassembler Subassembler I I I Surface grinder Switch adjuster Distributor I Laborer (rayon and allied products) Laborer, process (radio manufacturing) Riveter, aircraft Deaf-M ute Riveting-machine operator IV Tool-maker apprentice Single-spindle-drill-press operator Turret-lathe operator Solderer I Vertical-turret-lathe operator Stripper, machine Welder, spot Subassembler 1. Maintenance Glassblower, laboratory apparatus Switch adjuster 3. Processing 4. Inspection and Testing 4. Inspection and Testing Balancer I Inspection (machine shop) Baser II Inspector (machine shop) Tester I Burrer, hand Assembler I I I Final assembler V II Tester I Hard of Hearing 5. Recording and Control Laborer (pulp and paper) Laborer, process (automobile manufac turing) 3. Processing Laborer, process (bakery products) Laborer, process (confectionery) Expediter I I Production clerk II Battery assembler Laborer, process (dental equipment) Shipping checker Burrer, hand Laborer, process (electrical equipment) 79 E. THE HEARING CASES J o b s at w h ich 5 9 5 H e a r in g C a s e s o f the s u r v e y g rou p w ere f o u n d e m p lo y e d F E M A L E — Continued Deaf-Mute — Continued 3. Processing — Continued Major-assembly installer Subassembler M ounter V I I I Subassembler I I I Multiple-spindle-drill-press operator Punch-press operator I Thrower I I Riveter, aircraft Sewing-machine operator (shirts and re Laborer, process (garment manufactur- Placement Practices In locating a job for the person with impaired hear ing, the conditions under which the work is to be performed frequently are as important as the require ments of the job itself. In the case of the totally deaf, the problem sometimes is simplified. Obviously if the person cannot hear, he cannot be placed where sound signals are used or where his own safety or the safety of others may depend upon warning signals. On the other hand, depending upon the nature of the hearing impairment, the noisiest kind of surroundings may not affect him. In fact, the loss of hearing may be an advantage. This is equally true for the deafmute. A serious problem, of course, is that of com munication between the person who is totally deaf or the deaf-mute and his fellow workers or super visors. This is a problem of rehabilitation. Lip read ing, sign language, written communication, etc., pro vide means to clear this obstacle. Placement of the hard of hearing may frequently be a more complex problem. In the case of the totally deaf, the place ment officer is dealing with a definite and clearly defined condition. In the case of the hard of hearing, the loss of hearing acuity is a matter of degree. The use of a hearing aid may minimize the condition. In many cases, too, it may be difficult to determine how important hearing is in the requirements of a job. Just how much loss of hearing acuity may the indi vidual have before he is hampered in performing the duties of a particular job? To interpret the require ment too strictly may result in depriving an other wise qualified person of the chance at the job; to interpret it too freely may result in placing the indi vidual in a spot where he is almost sure to be a failure. For the person with impaired hearing the portion of the pre-employment physical examination which tests his hearing acuity is of course the essential con sideration. The remainder is in a sense negative in 4. Inspection and Testing lated products) Solderer I mg) — Continued Inspector (printing) that it merely establishes the presence or absence of other physical impairments of sufficient significance to require consideration in the job placement. Either the examination or the case history will indi cate whether the impairment of the hearing arises from causes which may be aggravated by certain conditions, such as a damp environment for a ca tarrhal type. It must be borne in mind that the physical examination contemplated here is directed toward the objective of job placement and differs from that directed toward rehabilitation, which the impaired person may already have undergone. In most of the plants studied the hearing tests were the conventional ones, conducted by speaking to the patient in a whisper from certain distances or by de termining at what distance the patient could no longer hear the ticking of a watch. In only a very few cases was the audiometer used and the loss of hearing acu ity expressed in terms of decibels. In general, the hearing cases were not seriously affected by exclusion policies. Only 3 of the plants studied had a definite policy refusing employment to applicants who had defective hearing. Under these conditions it would have been reasonable to expect that the hearing cases would constitute a large seg ment of the survey group. On the contrary, however, it was fifth in size among the 10 impairment groups included in the study, There are a number of possible explanations for this seeming contradiction. It may be more difficult for the person with impaired hearing to obtain employment than is indicated by the mere absence of exclusion policies. Furthermore, work in juries resulting in the loss of hearing are not common; and one would not expect to find many persons who had acquired the impairment as a result of work in jury and were therefore kept on in the employ of the company. No special techniques in the placement of persons with impaired hearing were encountered. The same 80 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES techniques were used with respect to these persons as were used with other impaired workers. In none of the plants studied was any job re engineering encountered for the workers with hearing defects. Although minor job modifications were made in some instances, it apparently had not been necessary to engage in any extensive job changes in order to utilize such workers. Work Performance Data were obtained on work performance of 595 persons with impaired hearing matched with 937 un impaired workers on the same jobs. The two groups were compared with respect to absenteeism, work injuries, output, and voluntary separations, i. e., quits. The findings are detailed in the following paragraphs and in table E - l. The paucity of individual produc tion data for this impairment group precludes any discussion of that phase of the comparison. Absenteeism Attendance records were available for all members of the survey group. For the purpose of the study an absence was defined as lasting at least one full day when the employee was scheduled to work. Lay-offs, shut-downs, regular vacations, etc., were not counted either as absences or as days scheduled to work. The rate of absenteeism for individuals and for the several groups was computed as the number of days absent per 100 scheduled workdays. Considered as a group, the persons with hearing impairments were slightly more regular in their work attendance than were the unimpaired workers matched with them. The impaired and matched un impaired workers, lost 3.4 and 3.9 days, respectively, per 100 scheduled workdays. There was a substantial difference between the rates of male and female groups, among both the im paired and the unimpaired. The 101 impaired females had an absence rate of 5.4 as against a rate of 6.6 for the unimpaired females matched with them. On the other hand, the 494 impaired males had a rate of 3.0 as against 3.4 for the matched unimpaired males. The number of females involved and the higher level of their rates were sufficient to exercise measurable effects on the group rates. According to these rates, the impaired lost about 1 day less than the unimpaired in each 200 scheduled workdays. Although this is not a significant differ ence, it does indicate that the persons with hearing impairments were at least as regular in their work attendance as the unimpaired workers. While these group averages are informative, it is of some interest to consider comparisons of individual performances. A frequency distribution of the indi vidual rates is shown in table E-4. About 22 percent of the impaired and 21 percent of the matched unim paired had no absences at all during the survey period; 69 percent of the impaired and 66 percent of the un impaired had individual rates of 3.9 or less. As was to be expected, individuals in both groups had un favorable attendance records: 1.7 percent of the impaired and 2.2 percent of the unimpaired had rates of 20.0 or higher. These were scattered cases, how ever, and not characteristic of either group. While the distributions for the male and female workers differed considerably, the patterns for the impaired and unimpaired males and for the im paired and unimpaired females were similar. For ex ample, about 24 percent of the males, impaired and unimpaired, had no absences. Among the females, a very much smaller group, 14 percent of the impaired and 7 percent of the unimpaired, had a like experi ence. The higher absenteeism rates of the female workers in both groups correspond with results ob tained in other absenteeism surveys. T a b l e E -4 . — Percentage distribution of hearing cases and matched unimpaired workers, by absenteeism frequency rate 1 and by sex Total Male Female Absenteeism frequency rate class Impaired Unim paired Impaired Unim paired Impaired Unim paired 0________________________ 0.1 and under 1 . 0 _ ______ 1.0 and under 2.0________ 2.0 and under 3.0_________ 3.0 and under 4.0________ 4.0 and under 7.0________ 7.0 and under 10.0 10.0 and under 20.0______ 20.0 and over____________ 21.9 13.3 15.5 10.4 8.2 14.5 8.5 6.0 1.7 20.8 11.7 14.6 10.6 8.4 15.6 7.7 8.4 2.2 23.8 14.8 16.9 10.5 8.9 12.3 6.8 4.4 1.6 24.1 13.3 16.2 11.0 8.2 13.0 5.4 6.7 2.1 13.9 5.9 8.9 9.9 5.0 24.7 15.8 13.9 2.0 7.1 5.4 8.2 8.7 9.2 26.1 17.4 15.2 2.7 Total. ...................... 100.0 100.0 100.0 100.0 100.0 100.0 Number of workers_______ 595 937 494 753 101 184 1 Number of days lost per 100 scheduled workdays. Where the necessary information was available, the cause or reason for each absence was recorded. It was hoped to determine by this means whether any specific reason or reasons for absence had par ticular significance for workers with impaired hearing. 81 E. THE HEARING CASES Unfortunately, the reason could be obtained for only about 40 percent of the absences recorded. However, the rates attributable to the various reasons were nearly identical in the two groups, as shown in table E-5. Although these rates are based on compara tively small groups, it seems reasonable to infer that whatever factors may have caused absences, the pres ence of a hearing impairment did not tend to empha size any one or any combination of them. T able E - 5 .— Absenteeism frequency rates 1 for hearing cases and matched unimpaired workers, by reason for absence and by sex Male Total Female Reason for absence Impaired Unim paired Impaired Unim paired Impaired Unim paired Total........... ......................... 3.4 3.9 3.0 3.4 5.4 6.6 Illness............. ................. .. Personal business_________ Unknown________________ .9 .4 2.1 1.0 .5 2.4 .8 .3 1.9 .9 .4 2.1 1.5 .9 3.0 1.4 1.3 3.9 Number of workers_______ 595 937 494 753 101 184 1 Number of days lost per 100 scheduled workdays. So far as absenteeism is concerned, then, it may be said that the workers with impaired hearing com pared favorably with the unimpaired workers under the same conditions of employment. In fact, as a group, they were slightly more regular in their w'ork attendance. Although there were individual cases of poor performance, the proportion of such cases was small and about the same in both groups. The differences in the rates for the various com ponents of the survey group were fractional. The impaired had a rate of 11.4 as against 11.0 for the un impaired. For the males alone the rates were iden tical, 11.4 for both groups of workers. The small group of female workers with impaired hearing, however, had a rate of 11.5 as against the substantially lower rate of 9.3 for the unimpaired females. The reason for this difference was not apparent. For the group as a whole, however, there appears to be no material difference in the nondisabling injury experience be tween the persons with impaired hearing and the un impaired workers on the same jobs. The similarity of the pattern of the frequency dis tribution of the individual rates shown in table E -6 supports the inference from the group rates that the nondisabling injury experience was about the same for workers with hearing defects and the unimpaired workers exposed to identical hazards. No injuries at all were reported for 45 percent of the impaired group and 46 percent of the unimpaired during the periods studied. About 80 percent of the impaired and 81 percent of the unimpaired had less than 2 minor in juries per 1,000 exposure-hours. It was inevitable, of course, that a small number of the workers in each group should have had very unfavorable experiences: 0.2 percent of the workers in both the impaired and unimpaired groups experienced excessively high rates of 20.0 or more. However, these were isolated cases of poor individual performance, not group character istics. Nondisabling Injury Experience T able A nondisabling injury was defined as a work injury which did not result in any permanent impairment or in the loss of at least one full day beyond the day or shift on which the injury occurred. In computing the frequency rates two different bases were used. For the groups and subgroups the rates were computed on a base of 10,000 exposure-hours. The individual rates used for the frequency distribution were computed on a base of 1,000 exposure-hours. Data on nondisabling injuries were obtained for 568 persons with impaired hearing and for the 892 unimpaired workers matched with them. This num ber differs from the number studied on absenteeism because in some instances injury records were not available. In the group analyzed were 470 impaired males matched with 716 unimpaired males, and 98 impaired females matched with 176 unimpaired fe males. E - 6 .— Percentage distribution of hearing cases and matched unimpaired workers, by frequency rate 1 of nondis abling injury and by sex Total Male Female Frequency rate class Impaired 0 _ _ _ _ .................... ............................. 0.1 and under 1.0_________ 1.0 and under 2.0_________ 2.0 and under 5.0_________ 5.0 and under 10.0________ 10.0 and under 20.0 _ .. 20.0 and ov e r...................... Total....... ............. .. Number of workers,........... Unim paired Impaired Unim paired Impaired Unim paired 45.1 18.7 16.0 15.0 3.9 1.1 .2 46.4 19.4 15.4 14.6 3.6 .4 .2 43.8 19.4 16.8 15.4 3.3 1.1 .2 44.0 20.1 15.4 15.8 4.0 .4 .3 52.1 15.3 12.2 13.3 6.1 1.0 0 55.7 16.5 15.3 9.6 2.3 .6 0 100.0 100.0 100.0 100.0 100.0 100.0 568 892 470 716 98 176 1 Number of injuries per 1,000 exposure-hours. In an attempt to determine whether the person with impaired hearing wTas prone to incur any kind of nondisabling injury which might be attributed spe cifically to the impairment, data on the kind of in 82 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES juries experienced in the two groups were examined. It was found that the patterns for impaired and un impaired were nearly identical, and that no partic ular kind of injury could be attributed to the hearing defects. As shown in table E-7, minor cuts and abra sions predominated and held about the same relative importance in both groups. The similarity is the same for the other kinds of injuries. The data seem to justify the conclusion that the injuries were re lated to the hazards of the job and not to the impair ments which characterized one of the groups. T able E - 7 .— Frequency rates 1 of nondisabling injuries for hearing cases and matched unimpaired workers, by nature of injury and by sex Male Total Female Nature of injury Impaired Unim paired Impaired Unim paired Impaired Unim paired Total..... ............... ............... 11.4 11.0 11.4 11.4 11.5 9.3 Burns and scalds________ Cuts and abrasions_______ Eye injuries______________ Strains and sprains_______ Dermatitis________ ______ Other ............................ .4 8.3 1.5 .5 .1 .6 .4 7.9 1.8 .5 .1 .3 .3 8.3 1.7 .4 .1 .6 .3 8.2 1.9 .5 .1 .4 .8 8.4 .8 1.2 .2 .1 .5 6.8 1.2 .5 .1 .2 Number of w orkers--------- 568 892~ 470 716 98 176 1 Number of injuries per 10,000 exposure-hours. In order to determine whether there was any ma terial difference in the severity of the nondisabling injuries in the two groups, data on the number of re dressings required were obtained. Although policies with regard to requiring redressings varied among companies, the policies were the same for impaired and unimpaired workers in the same plant. The number of redressings for nondisabling injuries aver aged 0.8 per injury for the hearing cases and 0.9 for the unimpaired workers. Measured in this way there clearly was no difference in the severity of the non disabling injuries in the two groups. An effort was also made to determine the compar ative demand of impaired and unimpaired workers on medical facilities for illness or injury not connected with employment. Again, company policies differed with regard to the use of such facilities for disabilities not related to the work. However, a comparison is valid because the policy in any given plant was the same for both impaired and unimpaired workers. Based upon dispensary records, the hearing cases averaged 1.6 nonindustrial visits per person as against 1.5 such visits for the unimpaired workers during the periods studied. It is obvious that the employment of persons with hearing impairments did not increase demands upon existing medical facilities because of nonindustrial illness or injury. Disabling Injury Experience Frequency. A disabling injury was defined as a workconnected injury which resulted in permanent im pairment or in the loss of at least one full day beyond the day or shift on which the injury occurred. The frequency rate is expressed as the number of such injuries per million exposure-hours. Data on disabling injuries were available for 588 hearing cases matched with 930 unimpaired workers. The group was composed of 487 impaired males matched with 746 unimpaired males, and 101 im paired females matched with 184 unimpaired females. Although workers with impaired hearing had as good a record of nondisabling injuries as the unim paired workers matched with them, they had a less favorable disabling injury experience. The frequency rates were 8.1 and 4.6, respectively, for the impaired and unimpaired groups. The male and female im paired groups each had a substantially higher rate than the unimpaired workers matched with them. The total number of injuries on which these rates were based, however, was small for each group — 8 for the impaired and 9 for the unimpaired. A very important consideration is whether the in juries experienced by the impaired workers were in any way caused or contributed to by the impairment. Accident reports were examined in each case. In no instance was the impairment recorded by the plant as the cause of the injury to an impaired worker. Furthermore, none of the injuries among the unim paired workers in the survey were attributed to a fellow worker’s impairment. At each plant discus sions with responsible company officials substantiated the findings made from the records. Finally, while records were not examined for workers outside the survey group, plant management was questioned as to whether there had been any instances during the survey period in which a disabling injury was attrib utable to a hearing impairment. No such cases were found. Time Lost. An indicator of the severity of disabling injuries is the time lost as the result of such injuries. This time loss was measured in two ways: (1) As the number of days lost per 100 scheduled workdays for the group and (2) as the average time lost per injury in each group. E. THE HEARING CASES The impaired workers had a rate of 0.08 day lost per 100 scheduled workdays as against 0.06 day for the unimpaired group. However, the impaired work ers averaged only 13.4 days of lost time per injury against 17.0 days for the unimpaired. The rates and the averages were influenced by one extreme case in each group. One hearing case had an injury resulting in a time loss of 46 days while all others ranged from 1 day to 27 days. One injury among the unimpaired resulted in a time loss of 69 days, whereas the remain ing injuries ranged from 1 day to 33 days. In summary, the disabling work injuries were more frequent among the hearing cases than among the unimpaired workers matched with them; their in juries, however, tended to be less severe. Most im portant, company records did not indicate that any of the injuries were caused or contributed to by the hearing impairment. Output Relative Measured individual production data were avail able for only 67 of the persons with impaired hearing matched with 102 unimpaired workers on the same jobs. Of this group, 51 of the impaired were male and 16 were female. A group of this size does not provide enough observations to yield dependable results. While these observations are included in the over-all total for the impaired survey group, no comparative figures are shown for the hearing cases alone. Quit Rate Data on job separations were obtainable for 272 83 of the hearing cases and 430 matched unimpaired workers. The data were obtained by means of follow-up contacts and consisted of the number of persons in the survey group who were no longer in the employ of the company 6 months after the end of the period used for the study. Rates are computed as the num ber of workers no longer employed per 100 workers included in the survey group. The separation rate is made up of two factors — terminations (lay-offs, discharges, etc.) over which the employee has no control, and voluntary quits where the action is initiated by the employee. As an indication of stability on the job, it is the quit rate which is of principal interest. The hearing cases had a somewhat lower quit rate than the unimpaired workers matched with them, 2.8 and 4.7, respectively. Male and female impaired workers both had lower quit rates than their matched unimpaired workers. For the male workers alone the rates were 2.7 and 5.7 for the impaired and unim paired groups, respectively. Termination rates were higher for the impaired than for the unimpaired workers. For the group as a whole the rates were 3.4 and 1.8, respectively. Ter minations were principally for purposes of reduction in force, and the impaired, being in general the last to be hired, were among the first to be laid off. The rates are probably influenced by the fact that the period was one during which there was consider able moving around among the working population in general. Although the group for which data were available is small, there is some indication that the workers with impaired hearing tended to be a little more stable on the job. 84 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES F. The Multiple Impairment Cases Summary of Statistical Findings The record of work performance of 587 workers with multiple impairments compared very favorably with that of 919 unimpaired workers matched with them on the same jobs. Differences were small but for the most part were in favor of the impaired work ers. The impaired group had a somewhat better injury experience than did the unimpaired workers, as indi cated by the lower frequency rates of disabling and nondisabling injuries. The time lost as the result of disabling injuries, however, was about the same when measured as a rate based on scheduled workdays in the respective groups but was a little higher in terms of the number of days lost per injury. The impaired workers tended to be a little more stable on the job, as shown by the lower rate of voluntary quits, but were not quite as regular in their work attendance, as shown by the higher rate of absenteeism. Measured individual production was not available for a group sufficiently large to permit showing comparative out put on the job for this survey group. T able F -l . — W ork performance of workers with multiple impairments and of matched unimpaired workers Number of workers Average performance were not handicapped workers. Unquestionably* proper job placement made a major contribution to this result; but the record indicates clearly that when properly placed the workers with multiple impair ments were able to compete successfully with unim paired workers on the same jobs. Composition of the Survey Group This group was composed of those persons who had two or more physical impairments, each in itself se vere enough to fall within the definitions adopted for the study and with whom unimpaired workers could be matched, on the same jobs. The double orthopedic cases were not classified with this group but were in cluded with the orthopedic group. As shown in table F -2 this multiple impairment group is made up of a small number of cases in each of a large number of impairment combinations. Some cases were found in 29 different impairment combinations. The largest single group was 120 persons who had both a hernia and a cardiac condition. The number of cases was too small to permit showing performance figures sepaately for the various impairment combinations. The number of cases in the group as a whole, however, was unexpectedly large. With 587 cases, it is the sixth Factor Impaired Unimpaired Impaired Unimpaired 919 4.3 3.3 T able F-2. — Number of impaired workers, by type of multiple impairment Absenteeism frequency rate1-----Nondisabling injury: Frequency rate2___________ Disabling injury: Frequency rate8___________ Time-lost rate4______ _____ Average days of disability 5_ Output relative 6_______________ Quit rate 8_____________________ 587 583 915 10.0 11.4 586 586 918 918 (7) 320 (7) 531 7.3 .14 24.8 (7) 1.5 9.4 .15 20.2 (7) 2.8 1 Number of days lost per 100 scheduled workdays. 2 Number of injuries per 10,000 exposure-hours. 3 Number of injuries per 1,000,000 exposure-hours. 4 Number of days lost for disabling injury per 100 scheduled workdays. 6 Number of days of disability per disabling injury. 6 Percentage relationship of production efficiency of impaired to that of matched unimpaired. 2 Data available for too few cases to permit showing performance data. 8 Number of voluntary quits per 100 employees in the survey group. In the light of the performance records, it seems reasonable to conclude that the impaired persons Type of impairment Total_______________ _____ _ Orthopedic-Vision_____________ Orthopedic-Hearing___________ Orthopedic-Hernia____________ Orthopedic-Cardiac____________ Orthopedic-Ex-tuberculous_____ Orthopedic-Peptic ulcer________ Orthopedic-Diabetic__________ Vision-Hearing________________ Vision-Hernia________________ Vision-Cardiac________________ Vision-Ex-tuberculous_____ __ _ Vision-Peptic ulcer____________ Vision-Diabetic. ______ ________ Vision-Epileptic_______________ Number of workers Type of impairment Number of workers 587 28 11 75 21 9 5 3 16 78 52 12 6 4 1 Hearing-Hernia Hearing-Cardiac _ Hearing-Ex-tubercul ous Hearing-Peptic ulcer Hernia-Cardiac Hernia-Ex-tuberculous Hernia-Peptic ulcer Hernia-Diabetic_______ __ . Hernia-Epileptic Cardiac-Ex-tuberculous Cardiac-Peptic ulcer____ Cardiac-Diabetic Cardiac-Epileptic_____ _____ Ex-tuberculous-Peptic ulcer___ Peptic ulcer-Diabetic 27 13 3 5 120 29 18 9 2 22 9 4 1 2 2 85 F. THE MULTIPLE IMPAIRMENT CASES largest among the 10 impairment groups studied. Only 12 of the multiple impairment cases were female, and consequently no break-down of the performance figures by sex has been prepared. The multiple impairment cases tended somewhat toward the higher age brackets in comparison with the rest of the impaired workers studied. Only about 7 percent of the multiple cases as against 14 percent of the other impaired workers were under 30 years of age. In addition, nearly 45 percent of the multiple cases but only 27 percent of the other impaired were 55 years or older. This tendency toward the higher age levels perhaps is natural, as the fact of the exist ence of a second impairment would tend to bias the group in this direction. T a b l e F -3 .— Comparison of number and percentage distribution of 587 multiple impairment cases and 10,441 other impaired workers studied, by age group Percent Number of workers Age group Multiple cases Other impaired Multiple cases T o t a l _____________________ _______ 587 10,441 100.0 100.0 Under 20 y e a r s _______________ 20 and under 25 years______________ 25 and under 30 years______________ 30 and under 35 years---------------------35 and under 40 years---------------------40 and under 45 years-------------------45 and under 50 years---------------------50 and under 55 years---------------------55 and under 60 y e a r s -------------------60 and under 65 years--------------------65 years and over_____________ _____ 1 10 33 42 46 45 61 88 121 99 41 78 501 868 1,075 1,138 1,193 1,251 1,474 1,422 989 452 .2 1.7 5.6 7.2 7.8 7.7 10.3 15.0 20.6 16.9 7.0 .8 4.8 8.3 10.3 10.9 11.4 12.0 14.1 13.6 9.5 4.3 Other impaired Industry and Occupational Coverage Multiple impairment cases were found in each of the 19 industry groups and in 92 of the 109 plants covered by the study. In most of the 17 plants not represented in the survey group, multiple impair ment cases were encountered; but they could not be matched with unimpaired workers on the same jobs and consequently had to be excluded. The signifi cance of this wide plant and industry distribution is that employment opportunities are potentially broad. These workers were not found exclusively in plants which had specialized programs for their employ ment. The jobs at which the multiple impairment cases were employed are shown in the following listing. The occupational pattern is substantially the same as that found in the other impairment groups, w7ith perhaps a little less concentration in the processing and producing operations and a slightly higher per centage in the custodial and unskilled jobs. On the whole, however, the range and variety of skill re quirements represented by these jobs is very wide. These workers were found in jobs ranging from man ual labor to the highly skilled machinist classifications. In analyzing this list of occupations, it must be borne in mind that many other jobs on which workers with multiple impairments were employed are not shown because the impaired worker could not be included in the study. Jobs at which 587 Multiple Impairment Cases of the survey group were found employed [T itle s used are those appearing in the U n ite d States E m p lo y m e n t Service D ictio n a ry o f O ccu p ation a l T itles and are grouped an d n u m bered acco rd in g to the classifications used b y the W age A n alysis B ran ch o f the B ureau o f L a bor Statistics. T h is is n o t to b e interp reted as a com plete listing o f jo b s a t w hich persons w ith m ultiple im pairm ents can b e e m p lo y e d ] Loss of One Hand and Hernia M ALE Loss of One Hand and Cardiac 1. Maintenance 3. Processing 5. Recording and Control Riveter, hydraulic Power-shear operator I T ool clerk 3. Processing Loss of One Hand and Blind in One E y e Loss of One Hand and Partially Blind 5. Recording and Control Milling-machine operator I I Checker 3. Processing Laborer (petroleum refining) 6. Material Movement Electric-bridge-crane operator Loss of One Arm and Blind in One E ye 6. Material Movement 7. C u s to d ia l 1. Maintenance Laborer (rubber tire and tube manufac turing) Laborer (machine shop) Electrical repairman 86 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES J o b s at w h ich 5 8 7 M u l t i p l e I m p a i r m e n t C a s e s o f the s u r v e y g rou p w ere f o u n d e m p lo y e d M A L E — Continued Loss of One Leg and Partially Blind — Continued Loss of Use of One Leg and Diabetic 1, Maintenance 4. 3. Processing Pipe-fitter helper Deflector operator Laborer, process (wire) 5. Recording and Control Loss of One Hand and Blind in One E ye Checker 3. Processing Loss of One Arm and Partially Blind Inspection and Testing Loss of One A rm and Hard of Hearing Cylindrical-grinder operator 1. Maintenance Steam-fitter-apprentice Loss of One Leg and Hard of Hearing 7. Custodial 3. Processing Porter II 7. Custodial Buffer Loss of Use of One Hand and Partially Porter LI 7. Custodial Porter I Blind 3. Processing Loss of One A rm and Hernia Barrel filler II 5. Recording and Control Timekeeper 6. Material Movement Loss of One Leg and Hernia 1. Maintenance Machinist II Tool-grinder operator Loss of Use of One Hand and Hernia 1. Maintenance Laborer (boot and shoe manufacturing) Laborer, foundry 3. Processing 7. Custodial Single-spindle-drill-press operator Airplane woodworker II Gateman IV Gear-shaper operator Porter I I Laborer, process (electrical equipment) M ajor assembler I Pipe fitter Loss of Use of One Hand and Cardiac 3. Processing Box maker, wood I I I Loss of One Foot and Hernia 1. Maintenance 4. Inspection and Testing Body-assembly inspector Loss o f Use of One Hand and Ex-Tuberculous Inspector and tester Laborer (rayon and allied products) Single-spindle-drill-press operator 3. Processing 5. Recording and Control Centerless-grinder operator Stock chaser II Machinist, bench Stock-control clerk 5. Recording and Control 6. Material Movement 3. Processing Stock clerk I I Electric-bridge-crane operator Laborer, process (glass manufacturing) 7. Custodial 6. Porter I I Laborer (machine shop) Loss of One Leg and Blind in One E ye 3. Processing Lapping-machine operator Loss of Use of Two Hands and Hernia Material Movement 4. Inspection and Testing Loss of Use of Two Hands and Casting inspector Loss of One Leg and Ex-Tuberculous Peptic Ulcer 6. Material Movement 3. Processing 3. Processing Elevator operator, freight Single-spindle-drill press operator Subassembler I I 87 F. THE MULTIPLE IMPAIRMENT CASES J o b s at w h ich 5 8 7 M u l t i p l e I m p a i r m e n t C a s e s o f the s u r v e y g r ou p w ere f o u n d e m p lo y e d M A L E — Continued Loss of Use of One Arm and Blind in Loss of Use of One A rm and Cardiac — Continued 5. Recording and Control 1. Maintenance Laborer, process (aluminum products) Boilermaker 6. Material Movement 3. Processing Laborer (glass manufacturing) Laborer, process (glass manufacturing) 7• Custodial 4: Inspection and Testing Laborer (machinery manufacturing) One Eye 3. Processing Subassembler I I I 5. Recording and Control Receiving clerk III Inspector, chief I II Loss of Use of One Leg and Partially Blind Tool clerk Loss of Use of One Arm and Loss of Use of One A rm and Partially Blind 7. Custodial Ex-Tuberculous Porter I I. Maintenance 3. Processing Pipe fitter Rubber pressman 6. Material Movement Porter I I Loss of Use of One Leg and Totally Deaf 3. Processing Electric-bridge-crane operator Multiple-spindle-drill-press operator Loss o f Use of One A rm and Deaf-M ute Loss of Use of One Arm and Peptic Ulcer 4. Inspection and Testing Loss of Use of One Leg and Hard of 3. Processing Hearing H o t forging inspector Loss of Use of One Arm and Hernia 1. Maintenance Electrical repairman Sheet-metal worker I I (aircraft) 1. Maintenance 7. Custodial Pumpman I Porter II Loss of Use of One Leg and Hernia Loss of Use of One A rm and Diabetic Oiler I 1. Maintenance I. Maintenance Electrical repairman Fireman, stationary boiler 2. Working Foremen 3. Processing Do-all-saw operator Glass polisher Laborer, process (nonferrous metal al loys and products) Stranding-machine operator Foreman (electrical equipment) Loss of Use of Two Arm s and Hernia 3. Processing 3. Processing Centerless-grinder operator Laborer (glass manufacturing) 4. Inspection and Testing 7. Custodial Inspector (machine shop) Magnetic inspector 5. Recording and Control Laborer (malt liquors) 7. Custodial Porter I Loss of Use of One Foot and Hernia Final assembler V I I Floor assembler Laborer (radio manufacturing) Multiple-spindle-drill-press operator Template maker IV 4. Inspection and Testing 3. Processing Inspector (machine shop) Planer operator II 5. Recording and Control Punch-press operator I Porter I I Shaper operator I Tool clerk PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES 88 J o b s at w hich 5 8 7 M u l t i p l e I m p a i r m e n t C a s e s o f the s u r v e y g r ou p w ere f o u n d e m p lo y e d M A L E — Continued Loss of Use of One Leg and Hernia — 7. Custodial Porter I I — Continued 6. Material Movement Laborer (glass manufacturing) Continued Back Deformity and Ex-Tuberculous 7. Custodial Back Deformity and Hard of Hearing 3. Processing Elevator operator, passenger 1, Maintenance Porter I I Subassembler I I I M achinist II 6. Material Movement Loss of Use of One Leg and Cardiac 4. Inspection and Testing 1. Maintenance Tractor operator Laborer, process (m alt liquors) Back Deformity and Peptic Ulcer Machinist II 5. Recording and Control 3. Processing 3. Processing Receiving clerk I I Floor assembler Gager V I I I Multiple-spindle-drill-press operator Turret-lathe operator Back Deformity and Hernia Blind in One E ye and Totally Deaf Universal-grinder operator 1. Maintenance 5. Recording and Control Electrical repairman Shipping clerk I Loss of Use of One Leg and Machinist II 3. Processing 3. Processing Machinist, bench 5. Recording and Control Receiving checker Ex-Tuberculous Dryer operator 3. Processing Glass cutter Blind in One E y e and Hard of Hearing Jobsetter I I Subassembler I I I Loss of Use of One Leg and Diabetic 6. Material Movement Laborer, process (glass manufacturing) 1. Maintenance 4. Inspection and Testing Mechanic I I Final-assembly inspector 5. Recording and Control Laborer, process (glass manufacturing) Elevator operator, freight 5. Recording and Control Loss of Use of Two Legs and Hernia Shipping checker 1. Maintenance Production clerk II Stock clerk Blind in One E ye and Hernia 1. Maintenance Back Deformity and Cardiac Oiler I Laborer (nonferrous metal alloys 1. Maintenance Back Deformity and Blind in One E y e products) Mechanic I I Machinist I I Millwright 3. Processing Millman Painter I Cabinet maker I 3. Processing W ater tender I I I Tufting-machine operator 3. Processing Do-all-saw operator Back Deformity and Partially Blind Laborer (glass manufacturing) Burrer, hand Punch-press operator I Centerless-grinder operator Chipper foundry 1. Maintenance 5. Recording and Control Laborer (automobile manufacturing) Die maker II Engine-lathe operator Carpenter Store clerk I I Final assembler V I I and 89 F. THE MULTIPLE IMPAIRMENT CASES J o b s at w h ich 5 8 7 M u l t i p l e I m p a i r m e n t C a s e s o f the s u rv ey g r ou p w ere f o u n d e m p lo y e d M A L E — Continued Sheet-metal worker II 6. — Continued Material Movement Tool maker Blind in One E ye and Hernia — Tube drawer Laborer (m alt liquors) 5. Recording and Control 7. Custodial Shipping checker Porter I Continued 3. Processing — Continued Floor assembler 7. Glass grinder Custodial Heater I I I Partially Blind and Hernia Laborer (automobile manufacturing) Porter I I 1. Maintenance Laborer (malt liquors) Laborer (petroleum refining) Blind in One E ye and Peptic Ulcer Carpenter Laborer, process (automobile manufac 3. Processing turing) Laborer (petroleum refining) Mechanic I I Laborer, process (phonograph) Punch-press operator I Laborer, process (radio manufacturing) Millwright Subassembler I Turret-lathe operator Painter I (automobile manufac Pipe-fitter helper turing) Turret-lathe operator 4. Inspection and Testing 4. Inspection and Testing Inspector I 2. Working Foremen Foreman (chemical) Inspector I Blind in One E ye and Epileptic Laborer, process (glass manufacturing) 3. Processing 6. Material Movement 6. Material Movement Barrel filler I I Laborer (pulp and paper) Elevator operator, freight Laborer (automobile manufacturing) Legally Blind and Hernia Laborer (electrical equipment) Laborer (machinery manufacturing) 1. Maintenance Box maker, wood I I I Fireman, still Floor assembler Form builder I Heater I I I Laborer (malt liquors) 7. Custodial Fireman, stationary boiler Laborer, process (aircraft manufactur W atchm an I Legally Blind and Peptic Ulcer Blind in One E y e and Cardiac Laborer, process (petroleum refining) Machinist II Boilermaker Milling-machine operator I I Molder, floor Paper cutter I Legally Blind and Hard of Hearing Millwright 2. Working Foremen Foreman (electrical equipment) ing) Laborer, process (malt liquor) 1. Maintenance 1. Maintenance Friction-sawing-machine operator Machinist I I Laborer (petroleum refining) Patternmaker, metal Pressman, paraffin plant 1, Maintenance Pumpman helper Boilermaker 4. Inspection and Testing Mechanic II Pipe fitter Magnaflux inspector 3. Processing 5. Recording and Control Engine-lathe operator Blast furnace blower Tool clerk Floor assembler Laborer, process (iron and steel) Labeler, machine I I Stillman helper Laborer, process (automobile manufac Subassembler I I I 3. Processing Balancer I Laborer (bakery products) turing) Laborer, process (iron and steel) 5. Recording and Control 776106° — 48 — 7 Laborer (chemicals) Laborer (m alt liquors) Laborer, process (nonferrous metal al loys and products) 6. Material Movement Stock clerk I I Laborer (rayon and allied products) 90 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES J o b s at w h ich 5 8 7 M u l t i p l e I m p a i r m e n t C a s e s o f the s u r v e y g rou p w ere f o u n d e m p lo y e d M A L E — Continued Pipe fitter — Continued 3. Processing Sheet-metal worker II Bolt-threading-machine operator Partially Blind and Hernia — Continued 6. Material Movement 7. Porter I H ot-m etal crane operator Job setter I I Laborer (iron and steel) Laborer, process (glass manufacturing) Porter II W atchman I Burrer, hand Final assembler V I I Custodial Punch-press operator I Partially Blind and Peptic Ulcer Riveter, aircraft Single-spindle-drill-press operator Partially Blind and Cardiac 1. Maintenance Subassembler I (automobile manufac turing) 1, Maintenance Pipe-fitter helper Electrical repairman 3. Processing 4. Inspection and Testing Electrical inspector II Fireman, stationary Laborer (iron and steel) Cylindrical-grinder operator Installation inspector Laborer (petroleum refining) Partially Blind and Diabetic Machinist II Mechanic II Oiler I Pipe-fitter helper Sheet-metal worker I I 3. Processing Chipper, foundry Fireman, still Glass polisher Laborer, process (glass manufacturing) Laborer, process (petroleum refining) 1. Maintenance Laborer (automobile manufacturing) Oiler I 7. Custodial Riveter, hydraulic Porter I I 3. Processing Machinist I I Pressman, paraffin plant Rubber compounder Hard of Hearing and Ex-Tuberculous 5. Recording and Control 3. Processing Stock clerk II Engine-lathe operator Molder, bench Painter, spray I 6. Material Movement Milling-machine operator II Totally Deaf and Hernia 3. Processing Hard of Hearing and Peptic Ulcer Subassembler I II Universal-grinder operator Engine-lathe operator 1. Maintenance Punch-press operator I 5. Recording and Control Machinist I I 7. Custodial Tool clerk Painter I Welder, combination W atchman I 6. Material Movement 5. Recording and Control Totally Deaf and Cardiac Laborer (iron and steel) Laborer (machine shop) Tool clerk 1. Maintenance Laborer (m alt liquors) Machinist II Deaf-Mute and Hernia 7. Custodial Totally Deaf and Ex-Tuberculous 3. Processing Gateman IV Porter I 4. Inspection and Testing W atchm an I Broaching-machine operator Laborer, process (nonferrous metal al Porter I I Inspector (machine shop) loys and products) Multiple-spindle-drill-press operator Partially Blind and Ex-Tuberculous Hard of Hearing and Hernia Radial-drill-press operator 1. Maintenance 1. Maintenance 4. Inspection and Testing Laborer (iron and steel) Boilermaker Hardness inspector 91 F. THE MULTIPLE IMPAIRMENT CASES J o b s at w h ich 5 8 7 M u l t i p l e I m p a i r m e n t C a s es o f the s u r v e y g rou p w ere f o u n d e m p lo y e d Laborer, process (nonferrous metal al M A L E — Continued 7. Boilermaker helper I I Electrical repairman loys and products) Deaf-M ute and Hernia — Continued — Continued Loader V II I Millwright M ajor assembler I Oiler I Milling-machine operator I I Custodial Milling machine operator, automatic 3. Processing Power-shear operator I Laborer (foundry) Hernia and Cardiac 1. Maintenance Punch-press operator I Engine-lathe operator Radial-drill-press operator Floor assembler Sheet-metal worker, aircraft Gear-hobber operator Single-spindle-drill press operator Sorter Instrument maker I Still-operator helper Jobsetter I I Laborer, process (foundry) Stopper maker I I Blacksmith II Carpenter Subassembler I turing) Internal-grinder operator (automobile manufac Laborer, process (glass manufacturing) Laborer, process (petroleum refining) Carpenter helper Subassembler I I Fireman, stationary boiler Surface-grinder operator Milling-machine operator I I Plunger Laborer (forging) Tool-grinder operator Screw-machine operator, semiautomatic Laborer (railroad transportation) Tool maker Tool-grinder operator Machinist II Turret-lathe operator Welder, spot Mechanic I I Millwright 4. Inspection and Testing Pipe fitter Sheet-metal worker I I Inspector (machine shop) Steam fitter Sheet-metal inspector I Tank tester I 5. Recording and Control Laborer, process (iron and steel) T ool clerk 6. Material Movement 2. Working Foremen 5. Recording and Control Foreman, turret-lathe operator Checker Stock clerk I I Brakeman, yard I Industrial-locomotive operator Laborer (machinery manufacturing) 3. Processing Tool clerk 7. Custodial Airplane woodworker I I 6. Material Movement Gateman IV Assembler I II W atchm an, crossing Baker I Brakeman, yard I Brush hand Buffer I Electric-bridge-crane operator Laborer (bakery products) Burrer, hand Chemical operator I I I Laborer (iron and steel) Laborer (machinery manufacturing) Cylindrical-grinder operator Laborer (machine tools and accessories) Dividing-machine operator Laborer (nonferrous metal alloys and Electrician, airplane I products) Hernia and Peptic Ulcer !• Maintenance Instrument repairman Engine-lathe operator Laborer (petroleum refining) Machinist II M illman Filter operator V Laborer (rayon and allied products) Pipe-fitter helper Final assembler V I I Welder, combination Floor assembler 7. Custodial Foil-rolling-machine operator Glassblower, laboratory apparatus Internal-grinder operator Porter I Laborer (foundry) Porter I I Laborer, process (foundry) Hernia and Ex-Tuberculous Laborer, process (glass products) Laborer, process (iron and steel) accessories) (machine Die-casting-machine operator I I Laborer, process (automobile parts) Laborer, process (glass manufacturing) process Cylindrical-grinder operator Floor assembler Laborer (iron and steel) Laborer, 3. Processing Elevator operator, passenger tools Laborer, process (leather manufacturing) M ajor assembler I 1. Maintenance Milling-machine operator I I Planer operator I I Boilermaker Plater I and 92 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES J o b s at w h ich 5 S 7 M u l t i p l e I m p a i r m e n t C a s e s o f the s u r v e y g r ou p w ere f o u n d e m p lo y e d M A L E — Continued Glass grinder — Continued Ex-Tuberculous and Peptic Ulcer Job setter I I Hernia and Peptic Ulcer — Continued Milhng-machine operator II 3. Processing Radial-drill-press operator 3. Processing — Continued Sandblaster I Vertical-boring-mill operator Tool grinder I Presser, machine I Tool maker 6. Material Movement 4. Inspection and Testing Treater I I Electric-bridge-crane operator Inspector I 4. Inspection and Testing Inspector (machine shop) Body-assembly inspector 7. Custodial 5. Recording and Control Gateman IV Diabetic and Epileptic 6. Material Movement Laborer (petroleum refining) Porter I Stock clerk II Porter II 7. Custodial 7. Custodial Police officer Cardiac and Peptic Ulcer Gateman IV Porter II FEM ALE 1. Maintenance Hernia and Diabetic Instrument repairman Machinist II 1. Maintenance Mechanic I I Welder, combination Lead burner Machinist II Loss of Use of One Leg and Cardiac 4. Inspection and Testing Inspector (optical goods) 3. Processing M illm an (woodworking) Loss of Use of One Hand and Partially Gear-shaper operator 3. Processing Treater II Engine-lathe operator 5. Recording and Control Blind 3. Processing Laborer, process (malt liquors) Laborer, process (electrical equipment) T ool clerk 5. Recording and Control 7. Custodial Loss of Use of One Arm and Blind T ool clerk in One Eye Porter I 6. Material Movement W atchm an I Laborer (automobile manufacturing) 3. Processing Sewing-machine operator (shirts and re Cardiac and Diabetic lated products) 7. Custodial 1. Maintenance Loss of Use of One Leg and Hard Porter I I of Hearing Carpenter Cardiac and Ex-Tuberculous 3. Processing 3. Processing Die maker I I Laborer, process (boot and shoe) 1. Maintenance Machinist I I Induction-furnace operator Machinist apprentice Straightener, hand Loss of Use of One Leg and Pipe fitter Ex-Tuberculous 3. Processing Cardiac and Epileptic 3. Processing Brake operator, machine I I 6. Material Movement Assembler Film spooler Floor assembler Laborer (paper and pulp) Floor assembler 93 F. THE MULTIPLE IMPAIRMENT CASES J o b s at w h ich 5 8 7 M u l t i p l e Im p a ir m e n t C a s es o f the s u r v e y g rou p w ere f o u n d e m p lo y e d Blind in One E ye and Cardiac M A L E — Continued Loss of Use of Two Legs and Cardiac 4. Inspection and Testing — Continued Totally Deaf and Cardiac 3. Processing 3. Processing Cigar packer Floor assembler Inspector (machine shop) Partially Blind in One E ye and Totally Deaf and Cardiac Cardiac and Ex-Tuberculous 3. Processing 3. Processing 3. Processing Laborer, process (electrical equipment) Laborer, process (glass manufacturing) Stripper, machine Placement Practices The medical examination was found to be very im portant for cases of multiple impairment. For ex ample, in the combination of orthopedic and hernia the first impairment might be visible but the second would not. The existence of the second might not be disclosed in the absence of physical examination, with the resultant danger of work assignment which would aggravate the condition. Placement of cases of multiple impairment nat urally is complicated by the requirements of two im pairments. The job which is suitable for a man with only one arm might be entirely out of the question if he happens also to have a diabetic or cardiac con dition. None of the plants studied, however, seemed to have any special arrangements for placement of multiple impairment cases. The regular techniques were used , and it seem ed to be merely a matter of considering a few more factors. Work Performance Absenteeism is expressed as a rate reflecting the num ber of days absent per 100 scheduled workdays. Data for this factor of work performance were available for 587 multiple impairment cases and for 919 matched unimpaired workers. As a group the impaired workers were a little less regular in their work attendance, with an average rate of absenteeism of 4.3 as against 3.3 for the unimpaired group. The individual rates of absenteeism are shown as a frequency distribution in table F-4. About the same proportion, 24 percent, of the workers in each group had no absences during the periods studied. Among the impaired workers, however, there was a slightly higher percentage of cases in the higher fre quencies. For example, 3.8 percent of the impaired group as against only 2.1 percent of the unimpaired had excessively high rates of 20.0 or higher. It seems that while in general the two groups showed no sub stantial difference in regularity of attendance, the individuals with very poor records are slightly more numerous in the impaired group. T able F -4 .— Percentage distribution of 587 multiple impair ment cases and 919 unimpaired workers, by absenteeism fre The comparison of the work performance of the workers with multiple impairments and the unim paired workers with whom they were matched is summarized in table F - l and the following para graphs. Absenteeism An absence was defined as a full* day or more away from the job on days on which the employee was scheduled to work. Lay-offs, vacations, etc., were not counted as either absences or as scheduled days. quency rate 1 Absenteeism frequency rate class Impaired Unimpaired 0_______________ ___________ ________ _ _ . _ 0.1 and under 1.0_________ _______________________ 1.0 and under 2.0--------------------------- ----------- ----------2.0 and under 3.0_________________________________ 3.0 and under 5.0-------------------------------------------------5.0 and under 10.0_________________ _____________ 10.0 and under 20.0----------------------- ------------ --------20.0 and over_____________________________________ 24.2 12.6 14.7 9.2 13.0 12.2 10.3 3.8 24.6 17.1 15.0 9.2 13.3 12.2 6.5 2.1 Total............................................ ......................... 100.0 100.0 1 Number of days lost per 100 scheduled workdays. Wherever possible, the reason for the absence was recorded. Unfortunately, company records provided 94 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES this information for only about half the absences, and the rest bad to be recorded as “ unknown. ” The rates attributable to various reasons for absence are shown in table F -5, and it is apparent that absence because of illness accounted for most of the difference between the two groups of workers. Although the data were fragmentary, there was some indication that a greater incidence of illness absenteeism among the diabetic and the peptic ulcer cases accounted for much of the higher absenteeism rate among the multiple impair ment cases. T able F - 5 .— Absenteeism frequency rates1 for 5 87 multiple impairment cases and 919 unimpaired workers, by reason for absence Reason for absence Impaired Unimpaired Total____________________________________________ 4.3 3.3 Illness___________________ _________ _______ _____ Personal business_____ __ ____________ _____ __ _ Unknown__________ _______ _____ _________________ 2.1 .4 1.8 1.3 .3 1.7 A frequency distribution of the individual rates shows that 51 percent of the impaired and 48 percent of the unimpaired experienced no nondisabling in juries during the periods studied. In the higher fre quencies there were scattered cases of poor perform ance in both groups; 1.5 percent of the impaired and 1.1 percent of the unimpaired had excessively high rates of 10.0 or higher. Information as to the nature of the injuries was obtained in order to determine whether the impaired workers displayed any proneness to some particular kind of injury. The group rates based on 10,000 ex posure-hours and attributable to various types of in jury are shown in table F-7. The similarity of the pattern of the rates in the two groups is very marked. It seems reasonable to infer from this similarity of pattern that the injuries were attributable to the job hazards, not to the impairments which characterized one of the groups. T a b l e F - 7 .— Frequency rates1 o f nondisabling injury for 5 8 8 1 Number of days lost per 100 scheduled workdays. multiple impairment cases and 9 15 unimpaired workers, by nature of injury Nondisabling Injury Experience Nature of injury A nondisabling injury was defined as a work-con nected injury which did not result in a permanent impairment or in any loss of time beyond the day or shift on which the injury occurred. The frequency of such injuries is expressed as a rate based on 10,000 exposure-hours for the group and on 1,000 exposurehours for each individual. Data were available for 583 of the multiple impair ment cases and the 915 unimpaired workers matched with them. As a group the impaired workers had the lower frequency rate, 10.0 as against 11.4 for the un impaired workers. The variation here can hardly be considered a significant difference, but it does show that the impaired workers were no more prone to this type of injury than unimpaired workers exposed to the same hazards. T able F - 6 .— Percentage distribution o f 5 88 multiple impair ment cases and 915 unimpaired workers, by frequency rate1 of nondisabling injury Frequency rate class Impaired Unimpaired 0_____ ________ ______ ____________________________ 0.1 and under 1.0________________________ ________ 1.0 and under 2.0_________ ___________________ __ 2.0 and under 3.0____________________ _______ _____ 3.0 and under 5.0___________ __ _ ___ ________ 5.0 and under 10.0__________ __ ___ __ _________ 10.0 and over________________________ _____________ 51.0 19.4 13.6 6.3 5.5 27 1.5 47.8 21.8 13.6 6.9 5.7 3.1 1.1 Total.................... ............. .................................... 100.0 100.0 1 Number of injuries per 1,000 exposure-hours. Total__________ _____ Burns and scalds____________________ _____________ Cuts and abrasions_____________________________ _ Eye injuries___________________________ _______ _ Strains and sprains__________________ _____________ Other__________________ ________ ___________ _____ Impaired Unimpaired 10.0 11.4 .5 7.6 1.4 .3 .2 .6 8.6 1.5 .4 .3 1 Number of injuries per 10,000 exposure-hours. In an effort to obtain some measure of the relative severity of these nondisabling injuries in the two groups, data on redressings wore also recorded. Prac tices varied between plants with respect to encourag ing or requiring redressings, but the conditions were the same for both the impaired and the unimpaired in any given plant. There was no material difference in the average number of redressings required in the two groups. The impaired averaged 1.0 and the un impaired 0.9 redressings per injury. It would seem reasonable to conclude, therefore, that there was no material difference in the severity of these injuries in the two groups. In brief, the nondisabling injury experience was nearly identical among the impaired persons of this survey group and the unimpaired workers matched with them. There was clearly no proneness on the part of the impaired worker toward either greater frequency or greater severity of nondisabling injury. A final consideration in connection with the med ical record was nonindustrial use of medical facilities. F. THE MULTIPLE IMPAIRMENT CASES Such use was defined as a dispensary visit for illness or injury not connected with the worker’s employ ment. Again, policies varied widely between com panies but were the same for the impaired and unimpaired workers in the same company. The fre quency of nonindustrial visits was nearly identical in the two groups. The impaired averaged 1.9 and the unimpaired 1.7 such visits per person during the pe riods studied. Disabling Injury Experience Frequency. A disabling injury was defined as one which resulted in a permanent impairment or in a time loss of at least one full day beyond the day or shift on which the injury occurred. The frequency of injury was expressed as a rate reflecting the number of such injuries per million hours worked. The impaired workers had a somewhat better rec ord in this respect than did the unimpaired workers exposed to the same hazards. For the impaired, the rate was 7.3 and for the unimpaired 9.4. This might or might not represent a considerable difference, de pending upon the severity of the injuries and the re sultant compensation claims. Various materials such as accident reports, cause analysis studies, etc., available in the files of cooper ating firms were examined in connection with the disabling injuries recorded. None of the injuries among the impaired workers of this survey group were indicated as having been caused or contributed to by the worker’s impairment. Similarly, none of the in juries experienced by unimpaired workers of the sur vey group were related in any way to a fellow work er’s impairment. This subject of causal relationship between impairment and injury was discussed with responsible officials at each plant studied. In each case the opinions of these officials and the findings of the study were in accord. These impaired persons, properly placed on the job, w'ere not a hazard either to themselves or to their fellow workers. The record demonstrated in fact that, in general, the impaired workers as a group experienced a slightly lower in cidence of disabling injury than did the unimpaired workers exposed to the same hazards. Time Lost. An important consideration with respect to disabling injury experience is the severity of the injuries. In this survey group the severity of the in juries is indicated in two ways: as a group rate (days 95 lost per 100 scheduled workdays) and as the number of days lost per injury. In both the impaired and the unimpaired groups, the time lost per injury was rather high. For the im paired the average was 24.8 days and for the unim paired 20.2 days per injury. This average, of course, is based on only a small number of observations. There were only 8 disabling injuries in the impaired group and 16 in the unimpaired group. In each group there was an extreme case which influenced the aver age sharply. Among the impaired, 1 injury resulted in 53 days of lost time, and in the unimpaired group 1 case resulted in a time loss of 91 days. If the aver ages were computed eliminating these two cases, they would be nearly identical, 20 days and 19 days per injury for the impaired and unimpaired, respectively. Output Relative Measured individual production data were obtain able for only 43 of the impaired workers and 64 unim paired workers matched with them. These data have been included in computing the output relative for the total survey group, but the number of observa tions was considered too small to permit showing an output relative for the multiple impairment cases separately. Although comparatively few of these workers were on individual incentive jobs, it was noted that others wTere working on group incentive or on assembly lines. On group incentive, the impaired worker would have to be able to contribute his share of the work or the earnings of the group would suffer accordingly. Sim ilarly, on assembly line work the speed of work was generally paced by the line. Under both sets of con ditions, the fact of their employment indicated that the multiple impairment cases were able to hold up their end of the job. Quit Rate The quit rate reflects the number of voluntary quits per 100 employees during the 6 months following the end of the survey period. Data were obtained by means of follow-up on 320 of the multiple impairment group and 531 unimpaired workers matched with them. These impaired workers were somewhat more stable on the job, with a quit rate of 1.5 as against 2.8 for the unimpaired. Two impaired and two unimpaired workers quit for reasons of health. None of the im 96 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES paired as against two of the unimpaired quit because of dissatisfaction with the job. One of the impaired and eight of the unimpaired quit for reasons listed as “ other, ” principal of which were “ to take other job ” and “ to start own business.” Terminations were very much higher for the im paired workers, with a rate of 7.2 as against 3.4 for the unimpaired. In these separations, however, the initiative did not lie with the employee. Reduction in force was the principal cause for terminations. It was to be expected that the impaired would have the higher rate because, being in general the last to be hired, their lesser seniority would place them among the first to be laid off. 97 G. THE EX-TUBERCULOUS CASES G. The Ex-Tuberculous Cases Summary of Statistical Findings The work performance record of about 500 extuberculous cases compared favorably with that of about 900 unimpaired workers matched with them on the same jobs. That the impaired and unimpaired workers were about equally regular in their work attendance and had about the same nondisabling injury experience is indicated by the similar group rates for these two factors. In the case of disabling work injury, however, the ex-tuberculous cases made a substantially better record than did the unimpaired workers exposed to the same hazards. In addition, the ex-tuberculous cases were somewhat more stable on the job, as in dicated by the lower voluntary quit rate. Data with which to measure relative output was not available for a sufficiently large number of cases to permit showing performance figures. T able G - l .— W ork performance of ex-tuberculous cases and of matched unimpaired workers Number of workers Average performance Factor Impaired Absenteeism frequency rate1____ Nondisabling injury: Frequency rate 2___________ Disabling injury: Frequency rate 3___________ Time-lost rate 4____________ Average days of disability 6_ Output6_______________________ Quit rate 8_____________________ Unimpaired Impaired Unimpaired 513 910 3.7 3.5 507 902 15.2 14.2 512 512 909 909 (7) 200 (7) 383 5.9 .05 11.7 (7) .5 10.3 .09 11.4 (7) 2.6 1 Number of days lost per 100 scheduled workdays. 2 Number of injuries per 10,000 exposure-houw. 3 Number of injuries per 1,000,000 exposure-hours. 4 Number of days lost for disabling injury per 100 scheduled workdays. 6 Number of days of disability per disabling injury. 6 Percentage relationship of production efficiency of impaired to that of matched unimpaired. 7 Data available for too few cases to permit showing performance figures. 8 Number of voluntary quits per 100 employees m the survey group. On the whole, the outstanding feature of the find ings was the similarity between the two groups of impaired and unimpaired workers. Differences were present but they were minor except with respect to disabling work injuries, where the ex-tuberculous cases made a substantially better record. In light of the comparative records of the two groups, it seems reasonable to conclude that the ex-tuberculous cases were normal workers who, properly placed, were able to compete successfully with unimpaired workers on the same jobs. Composition of the Survey Group All workers who were specifically designated in the medical records as arrested pulmonary tuberculous cases and with whom unimpaired workers could be matched on the same jobs were included in the study. An effort was made to classify each case as minimal, moderate, or far advanced, but information on this point was available from company records in only a very few instances. It was necessary, therefore, to dispense with classification and to show performance figures for the arrested tuberculosis cases as a single group. The 513 arrested tuberculosis cases showed a heav ier concentration in the middle age brackets, in com parison with the 10,515 impaired workers comprising the rest of the survey group. About 11 percent of the ex-tuberculous cases as against 14 percent of the other impaired workers were under the age of 30, T able G-2.— Comparison of number and percentage distribu tion of 513 ex-tuberculous cases and 10,515 other impaired workers studied, by age group Number of workers Percent Age group Ex-tuber culous Other impaired Ex-tuber culous Total__________ __________ ________ 513 10,515 100.0 100.0 Under 20 years...................................... 20 and under 25 years______________ 25 and under 30 years______________ 30 and under 35 years---------------------45 and under 40 years______________ 30 and under 45 years---------------------45 and under 50 years______________ 50 and under 55 years---------------------55 and under 60 years---------------------60 and under 65 years---------------------65 years and over_______________ 2 14 40 65 65 98 72 76 52 24 5 77 497 861 1,052 1,119 1,140 1,240 1,486 1,491 1,064 488 .4 2.7 7.8 12.7 12.7 19.1 14.0 14.8 10.1 4.7 1.0 .7 4.7 8.2 10.0 10.7 10.8 11.8 14.1 14.2 10.1 4.7 Other impaired 98 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES while only 16 percent of the ex-tuberculous as against nearly 30 percent of the rest of the impaired workers were 55 years of age or older. It may be that the rather long period of time usually required to arrest tuberculosis may result in raising slightly the age at wdiich these impaired persons enter upon active em ployment when the illness is contracted in early years. The group is too small to support definite conclu sions, but it is possible too that the person with ar rested tuberculosis may tend to withdraw from the labor market at a slightly earlier age than is charac teristic of other types of physical impairment. The number of cases of arrested tuberculosis en countered in the study was smaller than had been expected. In the 109 plants there were 513 such cases with whom unimpaired workers could be matched on the same jobs making this impairment group seventh in point of size among the 10 impairments studied. The survey group was composed of 483 im paired males matched with 858 unimpaired males and 30 impaired females matched with 52 unimpaired females. The female cases constituted too small a group to permit showing performance figures sepa rately for them. Their presence did not affect mate rially the performance figures for the group as a whole. Industry and Occupational Coverage The ex-tuberculous cases were widely distributed among the various industry classifications. The sur vey group contains some representation from 17 of the 19 major industry groups and from 82 of the 109 plants covered by the study. The fact that a large number of plants and indus tries are represented in the survey group is an impor tant consideration in evaluating the findings. The performance figures do not show results attained under some special or ideal set of conditions but are a composite of performance records under widely dif fering conditions of employment. The jobs at which the impaired persons of this sur vey group were employed are shown in the following listing. Work in the processing or production op erations accounted for a majority of the workers studied, with a lesser representation in jobs in main tenance and material movement. The range of skills represented by these jobs is very broad, extending from common labor to highly skilled machinist work. The jobs involving some skill and training were the most common, and it is signif icant that only about 5 percent of the cases studied were employed on the unskilled custodial jobs, such as janitor, porter, etc. This tendency toward the more-skilled jobs may have been the result of two forces: First, the person with arrested tuberculosis either was able to continue to exercise skills he had acquired before the impairment or was able to acquire new ones readily; and, second, job opportunities were probably greater for those who had a skill to sell than for those who did not. It must be borne in mind, however, that this listing of jobs is merely a token list. Because of the requirement of matching with unim paired workers on the same jobs, many ex-tuber culous cases could not be included in the study and consequently their occupations are not recorded. Jobs at which 518 Ex-Tuberculous Cases of the survey group were found employed [T itle s used are those app earin g in the U n ite d States E m p lo ym e n t Service D ictio n a ry o f O ccu p ation a l T itles a n d are grou p ed an d num bered a c co rd in g t o th e classifications used b y the W a ge A nalysis B ran ch of the B u rea u o f L a b o r Statistics. T h is is n o t to be in terp reted as a com plete listing o f jo b s at w hich persons w ith this im p airm ent can b e e m p lo y e d ] M ALE 1. Maintenance Laborer (petroleum refining) Steam-fitter apprentice Laborer (railroad transportation) Truck mechanic Laborer, process (machine shop) W ater tender III Boilermaker Lead burner Welder, acetylene Bricklayer, refractory brick Machinist I I Carpenter Machinist apprentice Electrical repairman Maintenance mechanic I I Fireman, stationary boiler Millwright Foreman (nonferrous metal alloys and products) Inspector (machine shop) 2. Working Foremen Floor assembler I Oiler I Hostler, inside Painter I Laborer (aircraft manufacturing) Pipe fitter Laborer (automobile manufacturing) Pipe-fitter helper Aircraft mechanic Laborer (building) Rigger I I I Sheet-metal worker I I Airplane woodworker I I Laborer (iron and steel) 3. Processing Bending-roll operator 99 G. THE EX-TUBERCULOUS CASES Jobs at which 513 Ex-Tuberculous Cases of the survey group were found employed — Continued M A L E — Continued 3. Processing — Continued Laborer, process (machinery manufac turing) Final assembly inspector, fuselage Ladle liner Gater I V installation Lathe operator, automatic I Inspector I Lehr man Inspector, chief I I I Leverman, table Inspector (machine) Machine molder, jarring Inspector and tester Boring-machine operator Machine molder, squeeze Machinist I I Boxmaker, wood I II Machinist I I Radio repairman I Buffer I Machinist, bench Tester I Bulldozer operator M ajor-assem bly installer T ool inspector Burrer, hand Marker Charging-machine operator I Milling-machine operator II Chassis assembler I I Molder 5. Recording and Control Laborer, process (iron and steel) Chipper, foundry Molding machine tender Cigarette-making-machine operator Multiple-spindle-drill-press operator M aterial clerk Circular-sawing-machine operator Ovenman helper Production clerk I I Circle-shear operator I Painter, spray I Receiving clerk I I I Coremaker I Patternmaker X I Shipping checker Crankshaft plugger Patternmaker, wood Shipping clerk I Crusher man IV Planer operator I I Cupola tender Plunger Stock clerk I I T ool clerk Cut-off-saw operator Power-shear operator I Cyanide-furnace operator Presser, machine I Cylindrical-grinder operator Detailer II Punch-press operator I Die maker I I Dockman II Radiator-core assembler Rewinder operator Dough mixer Riveter, aircraft Electrical adjuster Riveter, pneumatic I I I Electrician, airplane I Roller operator V Engine-lathe operator Sandblaster Radial-drill-press operator Experimental mechanic Screw-machine operator, automatic Facing mixer Second helper I I Final assembler V I I Sheet-metal worker, aircraft Flame-cutter operator Shredder operator I I Floor assembler I I Forging-press operator Forming-press operator I Single-spindle-drill-press operator Soaker-cleaner operator Still-operator helper Gatherer Subassembler Gear-generator operator Gear-hobber operator Subassembler II H eat treater II Subassembler I I I Surface-grinder operator Heater, forge Horizontal-boring-and-milling machine Template maker IV Tool-grinder operator 6. Material Movement Brakeman, yard I Electric-bridge-crane operator Electric truck operator Fireman, industrial locomotive Fireman, portable boiler Follow-up man I I I Laborer (aircraft manufacturing) Laborer (automobile manufacturing) Laborer (bakery products) Laborer (foundry) Laborer (iron and steel) Laborer (machinery manufacturing) Laborer (m alt liquors) Locomotive-crane operator Truck-crane operator 7. Custodial Gateman Laborer (automobile parts) T ool maker Laborer, process (automobile manufac turing) Internal-grinder operator Tool-maker apprentice Police officer Job setter II Trimming-press operator I I Porter I Laborer (foundry) Turret-lathe operator Porter II Laborer (iron and steel) Vertical-boring-mill operator W atchm an I Laborer, process (automobile manufac Vertical-turret-lathe operator operator turing) Welder, acetylene Laborer, process (automobile parts) Wireman V I Laborer, process (cutlery tools) Yarn winder Laborer, process (foundry) 4. Inspection and Testing FEM ALE 3. Processing Laborer, process (iron and steel) Assorter V I Airplane woodworker Assembler I II Laborer, process (machine tools and ac Balancer I Box maker I Checker Burrer, hand Laborer, process (hardware) cessories) 100 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES Jobs at which 518 Ex-Tuberculous Cases of the survey group were found employed — Continued F E M A L E — Continued 30, Processing — Continued Cigar packer Laborer (surgical appliances) 4. Inspection and Testing Laborer, process (foundry) Laborer, Coil winder I I Stripper, machine Laborer, process (electrical equipment) process (tobacco products Cigarette-package examiner manufacturing) Inspector (machine shop) Cutter, machine I Painter, aircraft Detail assembler I I Sewing-machine operator (textile) Final assembler V II Sewing-machine operator (men’s tailored Instrument maker I Laborer (radio manufacturing) Stitcher, machine (boot and shoe) Placement Practices For the person with arrested tuberculosis the pre employment physical examination is extremely im portant. So too are the periodic physical check-ups which are provided in many plants or are available to the employee from outside sources. From the standpoint of proper placement, the degree of the ar rested case and the general appraisal of physical abil ities are essential. Proper placement of the person with arrested tu berculosis requires the exercise of careful analysis and good judgment on the part of the placement officer. Certain types of dust conditions, humidity, and tem perature extremes are generally avoided in placing these cases. In general, too, jobs which may produce excessive general fatigue or great mental strain are also avoided. The placement officer, however, has to consider the environmental and physical requirement factors against a variety of others, such as the skills the applicant possesses, how long the case has been arrested, and the general physical capacities of the individual. The problems posed for the placement officer by the extreme variety of environmental and job requirement conditions to which the individual case may be adaptable are further indicated by the preceding job listing. Only 7 of the 109 plants studied had exclusion pol icies affecting ex-tuberculous cases. In some plants persons with arrested tuberculosis were excluded from certain departments because of environmental conditions not suitable for their employment. These policies, however, were directed at protecting the im paired person against employment under conditions which might aggravate the impairment, not at ex cluding him from employment in the plant. Apparently no need for job re-engineering to pro vide for employment of these cases had been encoun 6. Material Movement garments) Distributor I tered in the plants studied. For this impairment changes might have been directed toward either the environmental conditions or the work methods, but no such instances were encountered in the study. Work Performance The ex-tuberculous cases, as a group, turned in a record of performance which compared favorably with that of the unimpaired workers matched with them on the same jobs. Data were available for a sufficiently large group to permit showing performance for four of the five factors under consideration in the study. The num ber of cases for which production data were obtain able were too few to permit showing an output relative. Table G -l and the following paragraphs summarize the findings. Absenteeism For the purpose of this study, an absence was de fined as absence of one full day or more on days on which the employee was scheduled to work. Vaca tions, lay-offs, shut-downs, etc., were not counted as either days absent or as scheduled workdays. Ab senteeism was computed as a rate reflecting the num ber of such absences per 100 scheduled workdays. The 513 impaired workers of the survey group had a fractionally higher rate than the 910 unimpaired workers with whom they were matched, 3.7 and 3.5, respectively. The variation in these rates indicates that the impaired workers as a group might be ex pected to be absent from their work about one more day than unimpaired workers in each 500 scheduled workdays. This does not seem to constitute a signifi cant difference, and it probably should be said that as a group the impaired and unimpaired workers were about equally regular in their work attendance. 101 G. THE EX-TUBERCULOUS CASES The individual rates for workers in the two groups are compared by means of a frequency distribution in table G-3. This comparison bears out the simi larity of performance indicated by the group averages. About 20 percent in both groups had no absences at all during the periods studied. There were 63 percent of the impaired and 67 percent of the unimpaired who had rates of less than 3 days per 100 scheduled days. In both groups there were individual instances of very poor work attendance: 1.2 percent of the im paired and 0.8 percent of the unimpaired had exces sive rates of 30.0 or higher. While these were scat tered individual cases, not group characteristics, their presence accounts for the slightly higher rate among the impaired workers. Both the group averages and the comparison of individual rates point toward the similarity of the performance of the two groups of workers. Clearly, there was no greater tendency toward excessive ab senteeism on the part of the arrested tuberculosis cases than was apparent among the unimpaired work ers matched with them. T able G—3.— Percentage distribution of 513 ex-tuberculous cases and 901 unimpaired workers, by absenteeism frequency rate 1 Absenteeism frequency rate class Impaired Unimpaired 0_______________ ___________ ____________ ________ 0.1 and under 1.0____ ________ ____________________ 1.0 and under 2.0....... ................... ................... ......... . 2.0 and under 3.0------------------- ----------- ------------------3.0 and under 5.0_________________________________ 5.0 and under 10.0............. ..................... ....... ........... . 10.0 and under 20.0_______________________________ 20.0 and under 30.0..................... ......... ......................... 30.0 and over______ ______________________________ 19.7 16.6 15.4 11.3 12.5 12.9 8.6 1.8 1.2 20.5 16.6 18.2 11.4 11.5 12.9 7.2 .9 .8 Total................ ......................................... ........... 100.0 100.0 1 Number of days lost per 100 scheduled workdays. An effort was made to determine the reason for each absence. Unfortunately, in many cases com pany records did not provide this information and the reason for more than half the absences had to be recorded as unknown. However, for the cases in which reason for absence was given, the similarity between the two groups is marked. Table G -4 shows that the rates attributable to illness were identical and those attributable to personal business were very nearly the same in the two groups. While the number of absences for which the reason was unknown is too large to permit conclusions, there is some indication that the impaired and unimpaired not only had about the same rates of absenteeism but were absent for about the same reasons. T able G-4. — Absenteeism frequency rates1 for 513 ex-tuber culous cases and 910 unimpaired workers, by reason for absence Reason for absence Impaired Unimpaired __________________________________________ 3.7 3.5 ________________________ _____ Til t>Piss Personal business_________________________________ Unknown------------ ----------------------- - - - - - - --------- 1.1 .3 2.3 1.1 .4 2.0 Total 1 Number of days lost per 100 scheduled workdays. Nondisabling Injury Experience A nondisabling injury was defined as a work-con nected injury which did not result in a permanent impairment or in any lost time beyond the day or shift on which the injury occurred. The group injury experience is expressed as a rate reflecting the num ber of injuries per 10,000 exposure-hours. The indi vidual rates were computed on a 1,000-hour base. Data for this factor were available for 507 of the ar rested tuberculosis cases matched with 902 unim paired workers on the same jobs. Among the impaired workers the rate was 15.2 and among the unimpaired workers 14.2 injuries per 10.000 exposure-hours. This variation in the rates indicates that the impaired workers experienced one more nondisabling injury than the matched unim paired workers in each 10,000 hours of work. Con sidering that these are typically the iodine-andadhesive-tape type of injury, this difference does not seem significant. While the averages indicate a very similar group experience, they may or may not be an accurate re flection of the individual experience. In order to com pare this individual experience, the injury frequency rate for each individual was computed on a base of 1.000 exposure-hours and the rates are shown as a frequency distribution in table G-5. The nearly iden tical pattern of the rates in the two groups is further evidence of the similarity of the experience. Nearly half the workers in each group had no nondisabling injuries during the periods studied. The concentra tion was heavy in the lower frequencies, with 82 percent of the impaired and 81 percent of the unim paired having a frequency of 1.9 or less per 1,000 exposure-hours. The experience, however, was not uniformly good. In each group there were scattered examples of poor performance. About 3 percent of the impaired and 2 percent of the unimpaired had very high rates of 10.0 or higher. PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES 102 ‘T able G -5. — Percentage distribution of 507 ex-tuberculous <cases and 902 unimpaired workers, by frequency rate 1 of non disabling injury Frequency rate class Impaired Unimpaired ft 0.1 and under 1.0_________________________________ 1.0 and under 2.0_________________________________ 2.0 and under 3.0_________________________________ 3.0 and under 5.0______ ______ ____________________ 5.0 and under 10.0_____________________ ______ __ _ 10.0 and over------------- ------------------ ----------------------- 48.1 20.5 13.4 3.9 5.3 5.8 3.0 48.6 21.6 10.8 6.1 6.2 4.8 1.9 Total...................................................................... 100.0 100.0 1 Number of injuries per 1,000 exposure-hours. An effort was made to determine whether there was any difference in the nature of the injuries expe rienced by the two groups of workers. Very satisfac tory data of this kind were obtainable, as the nature of the injury was a matter of record in nearly all cases. The frequency rates for the two groups, by nature of injury, are shown in table G-6, and the similarity of these rates is marked. It was the slightly higher in cidence of minor cuts and abrasions which account for the slightly higher group frequency rate for the impaired workers. However, no noticeable proneness on the part of the ex-tuberculous cases toward injury of any particular nature is indicated. The similarity of the rates seems to justify a conclusion that the in juries experienced were related to the hazards of the jobs and not to the impairment which characterized one of the groups. T able G-6. — Frequency rates 1 of nondisabling injury for 507 ex-tuberculous cases and 902 unimpaired workers, by nature of injury Unimpaired Impaired Nature of injury Total................ ................................... ............... ......... .. 15.2 14.2 Burns and scalds .6 11.9 2.1 .3 10.3 2.4 .4 . .. .. Cuts and abrasions_______________________________ Eye injuries _______________________________ Strains and sprains_____ __________________________ Other____________________________________________ .3 .7 .4 1 Number of injuries per 10,000 exposure-hours. A rough indication of the severity of the nondis abling injuries is provided by the number of redress ings required per injury. Policies varied widely among companies. In some plants employees were required to report for redressings, in others redressings were obtained at the option of the employee. However, in each plant the policies were the same for both the impaired and the unimpaired workers. The ex-tuber culous cases averaged 1.0 and the unimpaired workers 0.9 redressings per injury. Measured in this way there was clearly no difference in the severity of the nondisabling injuries in the two groups. A final consideration in connection with the med ical record was a comparison of the demands made on plant medical facilities by impaired and unim paired workers for nonindustrial purposes. Nonin dustrial visits were defined as visits to the dispensary for illness or injury not related to the workers’ em ployment. Again policies varied among plants in the extent to which such use of medical facilities was encouraged or discouraged. But in any given plant the policy was the same for both impaired and unim paired workers. The ex-tuberculous cases made some what fewer nonindustrial visits than did the unim paired workers matched with them. The impaired averaged 1.7 and the unimpaired 2.3 such visits per person. In summary, the medical record showed that the ex-tuberculous cases and the unimpaired workers matched with them on the same jobs had very similar nondisabling injury experience both as to frequency and nature of injury. There was no difference in the severity of such injuries as measured by the redress ings required; and dispensary visits of a nonindus trial nature were somewhat less common among the impaired workers. Disabling Injury Experience Frequency. A disabling injury was defined as one which resulted in a permanent impairment or in a loss of one full day or more beyond the day or shift on which the injury occurred. The frequency rate was computed on the conventional base of one million exposure-hours. Data on this factor were available for 512 of the impaired and 909 of the unimpaired workers of the survey group. The experience of the workers with arrested tuberculosis was substantially better than that of the unimpaired workers matched with them on the same jobs. The rate for the impaired group was 5.9 and for the matched unimpaired 10.3 injuries per million exposure-hours. This difference of about four injuries per million exposure-hours seems sig nificant when considered in terms of the effect four disabling injuries might have on compensation and insurance costs. For the entire survey group there were only 6 dis abling injuries among the impaired workers and 22 among the unimpaired workers. So far as the limited number of cases will permit comparison, the injuries G. THE EX-TUBERCULOUS CASES were about the same. Contusions of the upper and lower extremities were fairly common, and in each group there was 1 case of amputation of a part of a hand. There were no fractures among the impaired although this type of injury accounted for 5 cases among the unimpaired. Among the unimpaired, too, there was 1 case of strain resulting in a hernia. In each case of disabling injury, accident reports and cause studies in the company’s files were con sulted and the cases were discussed with responsible company officials. The purpose of this was to deter mine whether the impairment might have in any way caused or contributed to an injury experienced by an impaired worker. In no instance was such a causal relationship indicated in this impaired group. Sim ilarly, none of the injuries among the unimpaired was attributed to a fellow worker’s impairment. The experience of this group indicates that these impaired workers, properly placed on the job, worked safely and did not constitute a hazard either to them selves or to their fellow workers. There is no readily apparent reason why the injury experience of the extuberculous cases should have been so much better than that of the unimpaired workers exposed to the same hazards. Careful placement certainly played a major part in the fact that there were no instances of aggravation of the impairment in the survey group. Because the group is of only moderate size, there is probably some room for coincidence but it is hardly likely that coincidence could account for all of the difference. Time Lost. The frequency of disabling injury is one important consideration; the time lost as the result of such injury is a second. In terms of a rate based on 100 scheduled days the impaired workers tended to lose slightly less time because of disabling injuries than the unimpaired workers matched with them. The rates were 0.05 and 0.09 day per hundred sched uled days for the impaired and unimpaired, respec tively. Another measure, time lost per injury, is also available; among the impaired the injuries experi enced resulted in an average time loss of 11.7 days and among the unimpaired a loss of 11.4 days, a difference of 0.3 day per injury. In brief, the arrested tuberculosis cases had a very favorable disabling injury experience in every respect. The frequency rate was substantially lower than for the unimpaired exposed to the same hazards, and the time lost as the result of such injuries was about the same in both groups. 103 Output Relative Measured individual production data were avail able for only 52 of the ex-tuberculous cases and 81 matched unimpaired workers on the same jobs. This group was not large enough to permit showing per formance data. The data collected, however, has been included in computing the output relative for the total survey group. It should be noted in this connection that there were a fairly large number of ex-tuberculous cases employed on assembly line operations and on group piecework. Although individual performance data could not be obtained for these cases, the fact of their employment is significant. On the assembly line op erations the speed of the work was controlled by the speed of the line and each worker had to keep up with the line. Similarly, on group incentive each member of the group or team has to produce his share or por tion of the job or the earnings of the group will suffer. Apparently these impaired workers were able to meet the production requirements in those cases or they could not have held their jobs. Quit Rate Data on voluntary quits among the employees of the survey group were obtained by means of follow up, and the rates reflect the number of quits per 100 employees in the 6 months following the end of the survey period. These data were obtainable for 200 of the ex-tuberculous cases and 383 unimpaired work ers matched with them. The voluntary quit rate was very substantially lower for these impaired workers, 0.5 per hundred as against 2.6 per hundred for the unimpaired. All of the quits among the impaired were due to dissatis faction with the job. Among the unimpaired most of the quits were classified as “ other” and included a variety of reasons such as “ to take other job, ” “ start ing own business,” etc. Actually, the quantity of data and the number of cases are too small to sup port generalizations, but the 200 ex-tuberculous cases for whom data could be studied were evidently very stable on the job. Terminations in this group were much higher for the impaired than for the unimpaired workers, 2.5 and 1.5, respectively. These terminations were for the most part the result of reductions in force and it is probable that the impaired being, in general, the last to be hired had the least seniority and consequently were among the first to be laid off. 104 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES II. The Peptic Ulcer Cases Summary of Statistical Findings The peptic ulcer cases did not, in general, perform quite as well as the unimpaired workers with whom they were matched on the same jobs. The nondis abling injury experience was about the same in the two groups, but disabling injuries were somewhat more common among these impaired workers than among the unimpaired workers exposed to the same hazards. The peptic ulcer cases were considerably less regular in their work attendance than the matched unimpaired workers. The difference in the absentee ism rates was due largely to a higher incidence of absence because of illness among the peptic ulcer cases. The voluntary quit rate was also much higher for the impaired workers of the group. Measured in dividual production data for computation of an out put relative were not available for a group large enough to permit showing performance figures. diagnosis had been confirmed by X-ray or other ap proved laboratory test. Persons listed as peptic ulcer cases but without confirmation by test could not be included in the survey group either as impaired or as unimpaired workers. This impairment is one of the three which were added on recommendation of the advisory committee about 3 months after the study was begun. In spite of the fact that the impairment was not included at the beginning of the study, a fairly siz able number of cases were recorded. As finally con stituted, this survey group consisted of 428 peptic ulcer cases matched with 806 unimpaired workers, making it eighth in point of size among the 10 impair ments studied. Only 14 of the peptic ulcer cases were female and consequently no break-down was made of performance figures by sex. T a b l e H - 2 .— Comparison of number and percentage distribu tion of 1+28 peptic ulcer cases and 10,600 other impaired workers T able H - l .— W ork performance of peptic ulcer cases and of matched unimpaired workers studied, by age groups Number of workers Number of workers Average performance Peptic ulcer cases Factor Impaired Absenteeism frequency rate1___ Nondisabling injury: Frequency rate 2___________ Disabling injury: Frequency rate3___________ Time-lost rate4____________ Average days of disability 5_ Output relative5______ __ ___ Quit rate8....... ............... . ....... Unimpaired Impaired Unimpaired 428 806 5.4 2.9 424 799 11.0 11.1 428 428 806 806 (7) 195 (7) 357 10.7 .10 11.6 (7) 4.6 8.7 .12 18.0 (7) 2.0 1 Number of days lost per 100 scheduled workdays. 2 Number of injuries per 10,000 exposure-hours. 3 Number of injuries per 1,000,000 exposure-hours. 4 Number of days lost for disabling injury per 100 scheduled workdays. 5 Number of days of disability per disabling injury. 6 Percentage relationship of production efficiency of impaired to that of matched unimpaired. 7 Data available for too few cases to permit showing performance figures. s Number of voluntary quits per 100 employees in the survey group. Composition of the Survey Group Persons shown on the medical records of the com pany as peptic ulcer cases were eligible for inclusion in the survey group as impaired workers only if the Percent Age group Other impaired Peptic ulcer cases Other impaired Total__________________ ______ _ 428 10,600 100.0 100.0 Under 20 years________________ 20 and under 25 years_________ 25 and under 30 years _ _______ 30 and under 35 years_____ ____ 35 and under 40 years____ 40 and under 45 years____ ___ 45 and under 50 years______ _ 50 and under 55 years_____ __ 55 and under 60 years __________ 60 and under 65 years______ __ 65 years and over_____________ 0 21 55 54 68 57 54 59 34 23 3 79 490 846 1,063 1,116 1,181 1,258 1,503 1,509 1,065 490 0 4.9 12.9 12.6 15.9 13.3 12.6 13.8 7.9 5.4 .7 .7 4.6 8.0 10.0 10.5 11.1 11.9 14.2 14.3 10.1 4.0 The peptic ulcer cases showed a very marked con centration in the lower and middle age ranges in com parison with the rest of the impaired workers. About 60 percent of the peptic ulcer cases were under the age of 45 years as compared with 45 percent of the remainder of the impaired group. Further, 55 per cent of these cases as against only 40 percent of the rest of the impaired workers fell within the 20- 105 H. THE PEPTIC ULCER CASES year age range from 25 to 45 years. In the upper age ranges the number of peptic ulcer cases decreased rapidly. Only 6 percent of these cases as against 15 percent of the other impaired workers were 60 years of age or older. The present study cannot explain these age groupings. It may be that the incidence of the impairment is less in the higher age ranges; also, the person with this impairment may tend to withdraw from the labor market at an earlier age. Industry and Occupational Coverage Peptic ulcer cases were encountered in compar atively small numbers in individual plants but were widely distributed; 18 of the 19 industry groups and 70 plants are represented in the survey group. In about half of the plants not represented some peptic ulcer cases were employed but could not be matched with unimpaired workers for inclusion in the study. The wide distribution of these impaired workers is significant for two reasons. In the first place, it indi cates that employment opportunities are potentially fairly broad for persons with this impairment; and secondly, the record reflects performance under a variety of conditions and not in some one or a few plants with specialized programs for employment of peptic ulcer cases. The following listing shows the jobs at which the impaired workers of the survey group were em ployed. The occupational pattern is much the same as that found in the other impairment groups — a concentration in the processing or producing oper ations, a secondary concentration in maintenance work, and a scattering of custodial jobs. The variety of skill requirements represented by these jobs is very broad, ranging from unskilled labor to the highly skilled machinist classifications. It should be noted in this connection that this listing of occupations is merely illustrative of some of the jobs which can be performed by peptic ulcer cases. Many impaired workers could not be included in the study, conse quently their jobs are not recorded. Jobs at which 4 28 Peptic Ulcer Cases of the survey group were found employed [T itles used are those appearing in th e U nited States E m p lo y m e n t Service D ictio n a ry o f O ccup ational T itles and are grou ped and num bered a ccord in g t o the classifications used b y the W age A nalysis B ran ch o f the B u reau of L a b o r Statistics. T h is is not to be interpreted as a co m p lete listing of job s at w hich persons w ith p e p tic ulcer im pairm ent can be e m p lo y e d ] 1. Maintenance Asbestos worker, general Painter I Charging-machine operator I Pipe fitter Cigarette-making-machine operator Pipe-fitter helper Cigarette-packing-machine operator Boilermaker Plumber Circular-sawing-machine operator Boilermaker helper II Riveter, hydraulic Boiler operator Rodman II Cloth-shrinking-machine operator Control man Bucker-up II Carpenter, maintenance Welder, combination Control man I I I Cook Y 2. Working Foremen Coremaker I Cutter, hand I X Batch-still operator II Cylindrical-grinder operator Dockman I I Compounder II Floor assembler Electrical assembler I I Electrician, airplane I Electrical repairman Engine-lathe operator Extruder operator I I Fireman, stationary boiler Electric-motor assembler Flame-cutter operator H od carrier 3. Processing Engine-lathe operator Extruder operator II Instrument man IV Instrument repairman Acid-retort operator Final assembler V II Laborer (aircraft manufacturing) Air-compressor operator Floor assembler Laborer (automobile manufacturing) Annealer Form builder Laborer (nonferrous metal alloys and Annealer I I I Forming-press operator Assembler I I I Forming-press operator I Laborer (paper and pulp) Banbury mixer Friction-sawing-machine operator Laborer (petroleum refining) Bookbinder Gager V II I Laborer (rayon and allied products) Boring-machine operator, automatic Gear-hobber operator Laborer, process (petroleum refining) Brush hand Glass grinder Machinist II Buffer I Hardener II Horizontal-boring-and-milling- products) Machinist apprentice Burrer, hand Maintenance mechanic I I Buttonhole-machine operator Millwright Centerless-grinder operator 776106°—48—8 machine operator Induction-furnace operator 106 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES Jobs at which J+28 Peptic Ulcer Cases of the survey group were found employed — Continued 3. Processing — Continued Induction-furnace operator helper Instrument maker II Internal-grinder operator Job setter I I Labeler, machine I I Laborer (nonferrous metal alloys and products) Laborer, process (ammunition) Laborer, process (asbestos products) Laborer, process (automobile manufac turing) Laborer, process (automobile parts) Laborer, process (cutlery tools) Laborer, process (dairy products) Laborer, process (electrical equipment) Laborer, process (glass manufacturing) Laborer, process (malt liquors) Laborer, process (nonferrous metal al loys and products) Laborer, process (phonograph manufac turing) Laborer, process (rayon and allied prod ucts) Laborer, process (tobacco) Laborer, process (wire manufacturing) Lehr man Profiling-machine operator I I Engine tester Pumpman V II Experimental mechanic Pumpman helper Inspector (machine shop) Radial-drill-press operator Machinist I I Saw filer, hand Test driver I I Screw-machine operator, semiautomatic Tester I Seaming-machine operator IV Sewing-machine operator (m en’s tailored Sheeter operator Laborer (electrical equipment) Single-spindle-drill-press operator Shipping checker Spinner V I " Stock clerk II Spreader I Tool clerk Sticker 6. Material Movement Stillman I I Stillman helper Electric-bridge-crane operator Still-operator helper Electric-truck operator Straightener, hand Laborer (bakery products) Subassembler I Laborer (chemicals) Subassembler I I I Surface-grinder operator Machine adjuster I I I Machine molder, jarring Machinist, bench Marker Milling-machine operator II Molder, finish Molder, floor Multiple-spindle-drill-press operator Ovenman helper Planer operator I I Plater I Thread-mill-machine operator products) Tire builder, drum Laborer (petroleum refining) Tool dresser I Laborer (plastic materials) Tool grinder I Laborer (plumbing supplies) Tool-grinder operator Laborer (tobacco) Laborer (wire) Treater helper Laborer, process (ammunition) Tube cleaner Laborer, process (tobacco) Tube drawer Tractor operator Tumbler operator I I Turret-lathe operator Turret-lathe operator, automatic Waterproofing-machine operator Welder, arc Wire drawer I I I W ireman V I Truck driver Yardm an I 7. Custodial Fire marshal Gateman IV 4. Inspection and Testing Janitor I Body-assembly inspector Laborer (aircraft manufacturing) Porter II Cloth examiner, hand II W atchm an I Placement Practices As in the other organic impairment cases, the phys ical examination is very important in cases of peptic ulcer. If reliance is placed upon the statements of the applicant, there is the chance that he may not have accurate knowledge of his condition or may tend to understate the case. Improper placement may result in poor performance and possible aggravation of the impairment. Comparatively few of the plants studied had ex Laborer (m alt liquors) Laborer (nonferrous metal alloys and Thrower II Pointer operator Polisher Presser, machine I Laborer (glass manufacturing) Laborer (machine tools and accessories) Sweater man Tool maker Loader V I I 5. Recording and Control garments) clusion policies prohibiting the employment of peptic ulcer cases, yet this group is eighth in point of size among the 10 impairment groups studied. It may be that the incidence of this impairment among the working population is comparatively low. It may also be that employment opportunities are not as great for persons with this impairment, as indicated by the absence of specific exclusion policies. No specialized methods or techniques for placement of peptic ulcer cases were encountered in the plants studied. In most instances special consideration was 107 H. THE PEPTIC ULCER CASES given to environmental conditions when placing these workers. In general, the environmental conditions were considered as important in these cases as the physical requirements of the job. Among the factors considered in making the placement were working speed, odors which might cause gastric upset, eating facilities, etc., depending upon severity of the case and the general physical equipment of the applicant. It was noted that no special follow-up practices were in effect for these peptic ulcer cases, nor were there any instances in which job re-engineering had been necessary for them. Work Performance Data were obtainable for a fairly large group of peptic ulcer cases although not as large as would be desirable to support definite conclusions. The find ings of the study of this group are summarized in table H - l and in the following paragraphs: Absenteeism This measure is based on the number of days ab sent for personal reasons on days on which the em ployee was scheduled to work. Vacations, lay-offs, etc., were not counted either as days absent or as days scheduled to work. The rate represents the number of days absent per 100 scheduled workdays. The 428 peptic ulcer cases were not as regular in their work attendance as the 806 unimpaired workers with whom they were matched. The average rates of absenteeism for the two groups were 5.4 and 2.9 for the impaired and unimpaired, respectively. In some operations this difference in performance might well be significant. The absenteeism rate was also computed for each individual of the survey group, and these individual rates are shown in a frequency distribution in table H-3. The comparison of the individual rates sup ports the comparison drawn from the group averages. Only 17 percent of the impaired as against 27 percent of the matched unimpaired had no absences at all during the periods studied. Only about 60 percent of the impaired had rates of 3.9 or less, while 78 percent of the unimpaired were in this group. It should be noted here that coincidence may be playing a part in this case. While the peptic ulcer cases had the poor est attendance record of the several impaired groups, the unimpaired workers matched with them had the best record of any of the several unimpaired groups. This tends to accentuate but does not account for the difference. There were also more instances among the peptic ulcer cases of very high absenteeism: 3.7 per cent of these impaired workers as against 1.4 percent of their matched unimpaired workers had rates of 20.0 or higher. T a b l e H - 3 .— Percentage distribution of 428 'peptic ulcer cases and 806 unimpaired workers, by absenteeism frequency rate 1 Absenteeism frequency rate class Impaired 0________________________________________________ 0.1 and under 1.0_________________ ___ __________ 1.0 and under 2.0_____ _________________ _ ___ _ 2.0 and under 3.0_____ _______ ___ __ _ _ _____ __ 3.0 and under 4.0__ _ _______ __ _________ 4.0 and under 5.0_____ __ _______ ________ ________ 5.0 and under 7.0___________ ________ _____________ 7.0 and under 10.0________________________________ 10.0 and under 20.0------------------------------------ ------20.0 and over_____________________________________ Total______________________________________ Unimpaired 16.5 14.7 8.4 12.1 8.2 8.0 6.5 9.1 12.8 3.7 27.3 16.7 15.8 11.8 6.3 6.1 6.1 3.8 4.7 1.4 100.0 100.0 1 Number of days lost per 100 scheduled workdays. Information on reason for absence was obtained wherever possible. In this particular survey group fairly good coverage was obtained, a reason for ab sence was available for well over half of all the ab sences recorded. The rates attributable to various reasons for absence are shown in table H -4. It is at once apparent that absence because of illness is the factor which accounts for the higher absenteeism rate among the peptic ulcer cases. T a b l e H - 4 .— Absenteeism frequency rates 1 for 428 peptic ulcer cases and 806 unimpaired workers, by reason for absence Reason for absence Impaired Unimpaired Total________________ ________ ___________________ 5.4 Illness___________________________________________________ __ 3.1 Personal business____________________ ______ __ __ Unknown_______________________ ____ _____________ .4 .9 .3 1.9 1.7 2.9 1 Number of days lost per 100 scheduled workdays. In brief, the peptic ulcer cases tended toward a higher rate of absenteeism than unimpaired workers matched with them on the same jobs, and the dif ference is accounted for by a higher incidence of ab sence because of illness. It was not possible to deter mine how much of this illness absenteeism among the peptic ulcer cases was attributable to the impairment, but it seems reasonable to believe that a substantial part of it was. Nondisabling Injury Experience A nondisabling injury was defined as one which did not result in a permanent impairment or in any loss of time beyond the day or shift on which it occurred. 108 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES The experience of the group shown in table H -l is expressed as a rate based on 10,000 exposure-hours. Individual rates used to establish the frequency dis tribution in table H -5 are based on 1,000 exposurehours. Data on this factor were available for 424 of the peptic ulcer cases and their 799 matched unim paired workers. As a group the impaired workers had about the same nondisabling injury experience as did the un impaired workers exposed to the same hazards. The group rates were 11.0 and 11.1 per 10,000 exposurehours for the impaired and unimpaired groups, re spectively. The difference in injury experience rep resented by these rates is not significant. Comparison of the individual rates by means of a frequency distribution further emphasizes the sim ilarity of the injury experience. 39 percent of the impaired workers and 44 percent of the unimpaired had no injuries at all during the periods studied. The overwhelming majority in both groups had a moder ate injury experience, with 82 percent of the workers in each group showing a frequency rate of less than 2 per 1,000 exposure-hours. As would be expected there were some instances of poor performance in both groups: about 1 percent of the impaired and 2 percent of the unimpaired had excessively high rates of 10.0 or higher. T a b l e H - 5 .— Percentage distribution of 4®4 peptic ulcer cases and 799 unimpaired workers, by frequency rate 1 of nondis abling injury Frequency rate class Impaired Unimpaired _________ _______ ____________________________ 0 0.1 and under 1.0_________ _______________________ 1.0 and under 2.0__________________________ ______ 2.0 and under 5.0___________________________ . . . 5.0 and under 10.0______________________________ 10.0 and over_____________________________________ 39.2 25.0 17.9 13.9 3.1 .9 44.2 21.2 16.6 12.7 3.5 1.8 Total______________________________________ 100.0 100.0 1 Number of injuries per 1,000 exposure-hours. For each of the nondisabling injuries the nature of the injury was also recorded. The rate attributable to the various kinds of injury show a practically identical pattern in the two groups. The peptic ulcer cases did not show any proneness toward injury of some particular nature. In light of the similarity of the experience it seems reasonable to conclude that the injuries were attributable to the hazards of the jobs, not to the impairments which characterized one of the groups. T a b l e H - 6 .— Frequency rates 1 of nondisabling injury for 4%4 'peptic ulcer cases and 799 unimpaired workers, by nature o f injury Nature of injury Impaired Unimpaired Total__________________ _________________________ 11.0 11.1 Burns and scalds____________ _____________________ Cuts and abrasions____________ ___ ____________ Eye injuries._______ _____ _________ . . . _____. . . Strains and sprains_______________________________ Other____ __ ______________________ ___________ .7 7.4 2.1 .6 .2 .6 7.4 2.1 .5 .5 1 Number of injuries per 10,000 exposure-hours. An effort was made to determine whether there was any difference in the severity of the nondis abling injuries in the two groups. While not entirely satisfactory, a rough indication can be found in the number of redressings required for such injuries. Practices in requiring or encouraging redressings varied widely among companies but impaired and unimpaired were affected alike in each company. The difference again is negligible and the similarity pronounced. Among the impaired group the average was 0.8 redressings per nondisabling injury and among the matched unimpaired, 1.1 redressings per injury. So far as this type of injury is concerned, the pep tic ulcer cases and the matched unimpaired workers had a practically identical experience. Injuries of the same nature were experienced with the same frequency and were of about equal severity in the two groups. A final consideration in connection with the medi cal record was use of medical facilities for nonindus trial purposes, i.e., visits to the dispensary occa sioned by causes not related to the workers’ employ ment. Again, company policies varied with regard to such use of medical facilities as well as to the extent of the medical facilities maintained. How ever, in each plant the conditions as they affected the impaired and unimpaired were the same. The peptic ulcer cases made somewhat greater use of plant medical facilities than did their matched unim paired workers. During the periods studied the impaired workers of this survey group averaged 3.7 nonindustrial visits per person while the matched unimpaired averaged 2.9 such visits per person. This seems to be of a pattern with the higher inci dence of illness absenteeism among the peptic ulcer cases. 3. THE PEPTIC ULCER CASES Disabling Injury Experience Frequency. A disabling injury was defined as one which resulted in a permanent impairment or in a time loss of one full day or more beyond the day or .shift on which the injury occurred, and the frequency rate was computed on the conventional base of one million exposure-hours. Data were available for 428 peptic ulcer cases and 806 unimpaired workers matched with them. The frequency rate was higher for the impaired group than for the matched unimpaired workers, 10.7 and 8.7, respectively. In this instance the few female impaired workers exercised a marked influ ence on the group rate. For the 414 impaired males and their 778 matched unimpaired workers, the fre quency rates were 9.7 and 9.0. For the larger group of male workers, then, the difference in the dis abling injury rate was hardly significant. The number of injuries experienced were too few to establish any sort of a pattern in either group. Among the peptic ulcer cases the nature of the in juries varied widely and there was no proneness indicated toward any particular kind of injury. Materials available in company files, such as acci dent reports, accident cause analyses, etc., were examined for each of the injuries recorded for the survey group to determine whether the accident was caused or contributed to by the existence of the im pairment. This aspect of the study was also dis cussed with the safety director or other responsible company officials. In none of the injuries recorded for this survey group was there a causal relationship indicated between the injury and the worker’s im pairment or the impairment of a fellow worker. So far as this survey group is concerned, the existence of the impairment was not considered an accident factor, and the peptic ulcer cases were not a hazard either to themselves or to their fellow workers. Time Lost. Given the fairly close similarity in the Injury frequency rates, it was possible that the* time lost as a result of such injury might have been dis proportionately higher among the impaired workers because of either slower recovery or greater severity. Expressed as a rate, the time lost amounted to 0.10 and 0.12 days per 100 scheduled days for the im paired and unimpaired, respectively. On a per in jury basis the difference was even more pronounced. 109 Among the peptic ulcer cases the time lost averaged 11.6 days per injury, while among the matched un impaired the time lost averaged 18.0 days per injury. This might be a substantial difference when con sidered in terms of compensation and insurance costs. Output Relative In the present survey group such data were avail able for only 33 of the peptic ulcer cases and their 58 matched unimpaired workers. While these data were included in computing the output relative for the entire survey group, the number of peptic ulcer cases was considered too small to warrant showing sepa rate performance figures. Quit Rate An attempt was made to measure the relative sta bility on the job of impaired and matched unim paired workers by determining the number of voluntary quits in each group during the 6 months following the end of the survey period. These data were obtained by means of follow-up but unfortu nately cover only a comparatively small group — 195 of the peptic ulcer cases and 357 matched unimpaired workers. The rate reflects the number of quits per 100 employees. The quit rate was substantially higher for the peptic ulcer cases, 4.6 as against 2.0 for the matched unimpaired workers. Two of the impaired workers constituted the only quits because of health reasons. For two of the impaired and one of the unimpaired no reason was obtainable. The largest number, 3 of the impaired and 5 of the unimpaired, quit to accept other jobs or to start business of their own. Alto gether there were 9 quits among the peptic ulcer cases and 7 among the matched unimpaired workers. In addition to the fact that the group covered is small, the time period which had to be used was an unsettled one. Postwar readjustments were under way in many places with resultant reductions in force and changes in personnel requirements. Some of the workers too had taken wartime employment and after the emergency had passed either withdrew from the labor force or returned to former occupa tions. Even considering these factors, however, the peptic ulcer cases were indicated as being somewhat less stable on the job. 110 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES I. The Diabetic Cases Summary of Statistical Findings The diabetic cases as a group did not make quite as good a record of work performance as did the un impaired workers with whom they were matched. Specifically, they were a little less regular in their work attendance and experienced a somewhat higher incidence of work injuries than the unimpaired work ers on the same jobs. Data on individual production and voluntary quits were available for too few cases to permit showing separate performance figures for this group. The findings are subject to qualification because of the small number of observations on which they are based and are presented primarily as a matter of interest. the same jobs. Workers listed as diabetic cases on the medical record but not confirmed by test could not be included in the study either as impaired or as unimpaired workers. There was a marked concentration of the diabetic cases in the older age groups. Only 8 percent of the diabetic cases as against 14 percent of the other im paired workers were under the age of 30. More than 50 percent of the diabetic cases fell within the 15year range from 45 to 60 years. Also, about 37 per cent of the diabetic cases but only 28 percent of the other impaired workers were 55 years of age or older. T a b l e 1 -2 . — Comparison of number and percentage distribution of 144 diabetic cases and 10,884 Number of workers T a b l e 1 -1 .— Work performance of diabetic cases and of matched unimpaired workers Number of workers Age group Absenteeism frequency rate1___ Nondisabling injury: Frequency rate2___________ Disabling injury: Frequency rate3___________ Time-lost rate4 ________ __ Average days of disability5 Output relative5_______________ Quit rate 3_____________________ Unimpaired Impaired Unimpaired 144 244 4.4 3.1 143 243 7.8 7.4 144 144 244 244 (7) (7) (7) (7) 15.6 .11 9.3 (7) (7) 12.9 .07 7.2 (7) (7) 1 Number of days lost per 100 scheduled workdays. 2 Number of injuries per 10,000 exposure-hours. 3 Number of injuries per 1,000,000 exposure-hours. 4 Number of days lost for disabling injury per 100 scheduled workdays. 5 Number of days of disability per disabling injury. 6 Percentage relationship of production efficiency of impaired to that of matched unimpaired. 7 Data available for too few cases to permit showing performance figures. 8 Number of voluntary quits per 100 employees in the survey group. Composition of the Survey Group Eligible for inclusion in the survey group were all workers carried on the medical records of the com pany as diabetic cases and for whom the diagnosis had been confirmed by glucose tolerance test. The survey group is made up of all such impaired workers with whom unimpaired workers could be matched on Diabetic cases Other impaired Percent Diabetic cases Other impaired Average performance Factor Impaired other impaired workers studied, by age group Total__________________________ 144 10,884 100.0 100.0 Under 20 years________________ 20 and under 25 years__________ 25 and under 30 years__________ 30 and under 35 years _________ 35 and under 40 years__________ 40 and under 45 years__________ 45 and under 50 years__________ 50 and under 55 years'__________ 55 and under 60 years__________ 60 and under 65 years__________ 65 years and over______________ 1 3 7 12 11 12 25 20 30 18 5 78 508 894 1,105 1,173 1,226 1,287 1,542 1,513 1,070 488 .7 2.1 4.9 8.3 7.6 8.3 17.4 13.9 20.8 12.5 3.5 .7 4.7 8.2 10.1 10.8* 11.3 11.8 14.2: 13.9 9.8 4.5 A total of 144 diabetic cases were encountered which could be matched with unimpaired workers, making this group ninth in size among the 10 im pairments studied. Only 8 of the diabetic cases were females, consequently no performance figures by sex are shown. This impairment was one of the three added on recommendation of the advisory committee after the study was already under way. Consequently, if any of these cases were present in the first 10 plants studied they were not picked up. However, this fact alone would not account for the very small number of cases encountered. 111 I. THE DIABETIC CASES Industry and Occupational Coverage Although the cases were few in total, they repre sent 15 of the 19 major industry groups and 45 of the 99 plants studied subsequent to the addition of this impairment group. In some of the plants not repre sented, diabetic cases were employed but could not be included in the study because they could not be matched with unimpaired workers. The jobs at which these impaired workers were employed are listed below. As was true of the other impairment groups studied, the concentration was heaviest in the processing or producing opera tions. Also, the range and variety of skill require ments represented by these jobs is very broad. It was to be expected that the more-skilled jobs would be fairly common because this group tended toward the higher age brackets. It is possible, too, that the impairment developed toward middle life after skills had been acquired, although information on duration of impairment was not obtainable from company records in any significant number of cases. Jobs at which 144 Diabetic Cases of the survey group were found employed [T itles used are those appearing in the U n ited States E m p lo y m e n t Service D ictio n a ry o f O ccu p ation a l T itles and are grou ped and n u m bered a cco rd in g to the classifications used b y the W a g e A nalysis B ran ch of the B ureau of L a bor Statistics. T h is is n o t t o be interp reted as a com p lete listing o f jo b s at w hich persons w ith diabetic im pairm ent can be e m p lo y e d ] 1. Maintenance 4. Inspection and Testing General assembler I I Job setter I I Bricklayer II Carpenter Compositor I Electrical repairman Electrician, powerhouse Flame-cutter operator Glass blower, laboratory apparatus Laborer (automobile manufacturing) Laborer (rayon and allied products) Machinist II Maintenance mechanic I I Oiler I Pipe-fitter helper Sheet-metal worker II T ool maker W ater filterer Laborer (furniture) Checker I Laborer (m alt liquors) Experimental mechanic Gager I Laborer (nonferrous metal alloys and •products) Inspector (machine shop) Laborer, process (aluminum products) Inspector and tester Laborer, process (automobile manufac Laborer, process (fabricated plastic prod ucts) turing) Laborer, process (bakery products) Laborer, process (electrical equipment) Laborer, process (glass manufacturing) 5. Recording and Control Laborer, process (plastic material) Checker Laborer, process (plumbing supplies) Laborer (machine tools and accessories) Laborer, process (wire) Line walker Machinist apprentice 6. Material Movement Milling-machine operator, automatic 3. Processing Power-shear operator I Pumpman V I I Anodic operator Automobile mechanic, motor I Pumpman helper Punch-press operator I Bench grinder Saw filer, machine Box maker, wood I I I Screw-machine operator, semiautomatic Brakeman, automobile Sewing-machine operator (shirts and re Burrer, hand Cigarette-packing-machine operator Stillman I I Cylinder-press man Still-operator helper Desk assembler Straightener, hand Die-casting-machine operator II Subassembler Die maker II Surface-grinder operator Drier operator Template maker IV Engine-lathe operator Tool-grinder operator lated products) Distributor I Electric-bridge-crane operator Laborer (ammunition) Laborer (automobile manufacturing) Laborer (glass manufacturing) Laborer (machinery manufacturing) Laborer (machine tools and accessories) Laborer (m alt liquors) Laborer (nonferrous metal alloys and products) Laborer (wire) Truck driver, heavy 7. Custodial Fireman, still Tool maker Gateman IV Final assembler V I I Treater I I Laborer (aircraft manufacturing) Floor assembler Vertical-boring-mill operator Porter I Forming-press operator I Welder, spot Porter I I Furnace tender, heat treating Wire drawer I I I W atchman I 112 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES Placement Practices The physical examination generally was con sidered important in these cases in order to deter mine whether there was any involvement of such a nature as to require reduced activity. Particularly where the case had a history of visual, cardiac, or other impairment, it was necessary for the placement officer to have an inventory of the applicant's physi cal abilities in order to make proper work assignment. Special provisions for employment of diabetic cases were not encountered in the present study. Assign ments were made by the same placement officers who handled other impaired workers, and the same clear ance of transfers, etc., was required. The diabetic cases were not the subject of exclusion policies in many plants. In only eight of the plants studied was there an exclusion policy prohibiting em ployment of diabetic cases; but, nevertheless, very few of these cases were encountered. There are a number of reasons which may serve to account for this seeming contradiction: (1) The incidence of this impairment may be relatively low in comparison with the others studied; (2) because of the nature of the treatment these cases may not ordinarily seek factory employment; or (3) they may not be as read ily accepted for employment as the absence of formal exclusion policies would seem to indicate. Work Performance The findings relating to the comparative work per formance of the diabetic cases and the unimpaired workers matched with them on the same jobs are summarized in table 1-1 and the following para graphs. It must be borne in mind that these results are based on a comparatively small number of obser vations and consequently are influenced by extreme cases. For that reason, only limited reliance should be placed on findings for this impairment group. Absenteeism An absence was defined as absence of a full day or more on days on which the employee was scheduled to work. Regular vacations, lay-offs, shut-downs, etc., were not counted either as days absent or as days scheduled to work. The absenteeism rate reflects the number of days of such absence per 100 scheduled workdays. Data were available for 144 diabetic cases and for 244 unimpaired workers matched with them. As a group the impaired workers were not as regular in their work attendance as the unimpaired workers. Respectively, the rates were 4.4 and 3.1 per 100 scheduled workdays. This difference, while not ex treme, does mark a tendency toward greater absen teeism on the part of the diabetic cases as a group. The individual rates of absenteeism, computed in the same way as the group rates, are compared by means of a frequency distribution in table 1-3. About 24 percent of the diabetic cases and 26 percent of the unimpaired workers had no absences at all during the period studied; 55 percent of the impaired and 57 percent of the unimpaired had rates of 1.9 or less. Thus, slightly more than half of each group fell within the low frequency classes. It is in the extremely high rates that the difference in the performance of the two groups is apparent: 15 percent of the impaired as against only 8 percent of the unimpaired had ex cessively high frequency rates of 10.0 or more. While the major portion of the workers in each group were about equally regular in their work attendance, ex treme cases were more common among the impaired workers and raised the group rate of the impaired over that of the unimpaired. T a b l e 1 -3 .— Percentage distribution of 144 diabetic cases and 244 unimpaired workers, by absenteeism frequency rate 1 Absenteeism frequency rate class 0________________________________________________ 0.1 and under 1.0__________________________ ______ 1.0 and under 2.0_______ ________ __ _____________ 2.0 and under 4.0_____________________ _________ __ ___ ___ 4.0 and under 7 . 0 ___________________ 7.0 and under 10.0 __ ________________________ _ 10.0 and under 20.0____________________ _______ 20.0 and over_____________________________ _____ Total__________________ _______ ___________ Impaired Unimpaired 23.5 16.6 14.6 12.5 11.2 6.3 11.1 4.2 26.3 16.5 14.0 18.0 9.3 7.8 6.1 2.0 100.0 100.0 1 Number of days lost per 100 scheduled workdays. Wherever the data were available, the reason was recorded for each absence. Unfortunately, reason for absence was available from the records for only a little more than half the absences reported. However, where the reason was known, the diabetic cases showed an absence rate because of illness twice as high as that of the unimpaired workers. On the other hand, absences because of personal business were much less frequent among the impaired workers. It seems reasonable to conclude that illness of the em ployee accounted for the higher group absenteeism rate among the impaired workers and probably for a substantial number of the extremely high individual 113 I. THE DIABETIC CASES rates. It could not be determined from the material at hand how much of the illness absenteeism among the impaired workers was related to the impairment, although opinion expressed by several plant physi cians indicated that much of it was. T a b l e 1 -4 .— Absenteeism frequency rates 1for 144 diabetic cases and 244 unimpaired workers, by reason for absence Reason for absence Impaired Unimpaired Total______________ ______ _______________________ 4.4 3.1 Illness___________________________________________ Personal business_________________________________ Unknown_______________________ _______ _____ ____ 2.6 .1 1.7 1.3 .4 1.4 The nature of the injury was recorded in each case and the rates attributable to the various kinds of in jury in each group are shown in table 1-6. In general, the pattern of the rates in the two groups is fairly similar. Cuts and abrasions, experienced most fre quently in both groups, had a somewhat higher rate among the impaired workers. There is a possibility that, because of the ever-present and serious danger of infection which accompanies diabetes, workers with this impairment would be more conscientious in reporting even the most minor injuries for immediate treatment. This factor might bear an influence on these rates. 1 Number of days lost per 100 scheduled workdays. T able 1 -6 .— Nondisabling injury frequency rates 1 for 143 diabetic cases and 243 unimpaired workers, by nature of injury Nondisabling Injury Experience Nature of injury A nondisabling injury was defined as one which did not result in a permanent impairment or in any loss of time beyond the day or shift on which the injury occurred. The frequency rate was computed for the group as the number of injuries per 10,000 exposurehours and for each individual as the number of in juries per 1,000 exposure-hours. The nondisabling injury experience was about the same in the two groups. The impaired had a rate of 7.8 as against 7.4 for the unimpaired. Considering that these were minor injuries without any resultant loss of time, the difference was not considered sig nificant. Comparison of the individual rates supports the similarity of experience indicated by the group rates: 51 percent of the impaired and 56 percent of the un impaired experienced no injuries at all during the period studied; 86 percent of the impaired and 87 percent of the unimpaired had rates of 1.9 or lower per 1,000 exposure-hours. Extreme cases were very few in both groups. Ouly 2.8 percent of the impaired and 1.6 percent of the unimpaired had rates of 5.0 or higher. T a b l e 1 -5 .— Percentage distribution of 143 diabetic cases and 243 unimpaired workers, by frequency rate 1 of nondisabling injury Frequency rate class 0_____ ___________________________________________ 0.1 and under 1.0-------- ------- ----------------- ------------1.0 and under 2.0__________ _____ _____ ___________ 2.0 and under 5.0_______________________________ _ 5.0 and under 10.0 _ - __________________ ______ 10.0 and over_____________________________________ Total_____________ _________ ________ ______ 1 Number of injuries per 1,000 exposure-hours. Impaired Unimpaired 51.0 22.4 12.6 11.2 2.8 0 56.5 19.3 11.5 11.1 .8 .8 100.0 100.0 Total_______________________ __ Burns and scalds_______________________ _____ _____ Cuts and abrasions_______________________ ________ Eye injuries____________ __________ __ ___________ Strains and sprains________________ ___ ___ __ Other____________________________ _______ ________ Impaired Unimpaired 7.8 7.4 .4 5.7 1.2 .4 .1 .2 5.0 1.6 .4 .2 1 Number of injuries per 10,000 exposure-hours. As a measure of the severity of the nondisabling injuries, data on the number of redressings were taken in each case where available. Policies of course varied widely between plants with respect to encouraging or requiring redressings but were the same for impaired and unimpaired workers in any given plant. As in dicated by this measure, the severity was slightly greater among the diabetic cases, where the redress ings averaged 1.3 per injury as against 0.8 per injury among the unimpaired. This finding, too, may be conditioned by the nature of the impairment and the realization on the part of the impaired worker of the necessity for complete care of even the most minor injury. A final consideration in connection with the med ical record was nonindustrial use of plant medical facilities. A nonindustrial visit was defined as a dis pensary visit for illness or injury not related to the worker’s employment. Such visits were more fre quent among the impaired workers, with an average of 1.7 as against an average of 0.8 per person among the unimpaired. Again, it seems reasonable to believe that some substantial part of these visits were at tributable to the existence of the impairment. In brief, the medical and nondisabling injury rec ords for the two groups of workers were fairly similar. Nondisabling injuries had about the same frequency 114 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES and were similar in nature. The injuries among the impaired either tended to be a little more severe or, perhaps because of the impairment, required a little longer period of attention. The record indicated that the diabetic cases tended to make a somewhat greater but not excessive number of nonindustrial visits to the dispensary. by the amount of time lost was slightly greater for the diabetic cases. As a rate, the impaired lost 0.11 and the unimpaired 0.07 days per 100 scheduled workdays. On a per injury basis, the impaired aver aged 9.3 and the unimpaired 7.2 days of time loss per injury. Again, however, since the data reflect only 4 injuries in each group the findings are hardly reliable. Disabling Injury Experience Output Relative Frequency. A disabling work injury was defined as one which resulted in a permanent impairment or in a time loss of at least one full day beyond the day or shift on which the injury occurred. The rate is com puted on the conventional base to reflect the number of injuries per million exposure-hours. With the present small group, the million-hour base may tend to inflate the rate somewhat, as the impaired workers had a total of less than half a million exposure-hours and the unimpaired just over a million. As a group the impaired workers had a substan tially higher rate than the unimpaired, 15.6 and 12.9, respectively. Actually, there were four disabling in juries among the impaired and four among the un impaired workers. This number is obviously too small to provide basis for analysis. It should be noted, however, that none of the injuries among the im paired involved infection, a serious possibility in dia betic cases. Time Lost The severity of the injuries as measured Measured individual output data were available for only five of the diabetic cases matched with seven unimpaired workers on the same jobs. While these data have been included in computing the output rel ative for the total survey group, no separate perform ance figures are shown for the diabetic cases. It should be noted that some of the diabetic cases were employed on group piecework. Although no in dividual production data could be obtained for these workers, they must have been able to keep up with the pace of the group in order to hold their jobs. Quit Rate Data with which to compute a rate of voluntary quits were not obtainable for a sufficiently large num ber of the diabetic cases to permit showing separate performance figures for this group. The data, how ever, have been included in computing the quit rate for the total survey group. 115 J. THE EPILEPTIC CASES J. The Epileptic Cases Summary of Statistical Findings The epileptic cases did not make quite as good a record of work performance as the unimpaired work ers matched with them. Specifically, regularity of work attendance, as measured by the absenteeism frequency rate, was about the same; and the inci dence of nondisabling and disabling work injuries was slightly higher among the impaired workers. How ever, the differences in the various performance rates are, for the most part, too small to be considered sig nificant. Data on measured individual production and voluntary quits were not available for a suffi ciently large number of the epileptic cases to permit showing performance figures. The findings for this group are of only limited re liability because of the small number of observations available, and performance data are shown primarily as a matter of interest. workers could be matched on the same jobs were in cluded in the survey group. Wherever possible, the cases were classified as petit mal or grand mal, but this information was available from the records in very few instances. The age pattern of the epileptic cases was very similar to that of the remainder of the impaired worker group. The epileptic cases tended slightly to ward the higher age groups, but the tendency was not pronounced. Only 4 of the 134 epileptic cases studied were fe males, and consequently no break-down of the per formance figures by sex is shown. T able J-2.— Comparison of number and percentage distribution of 134 epileptic cases and 10,894 other impaired workers studied, by age group Number of workers Percent Age group Epileptic cases Other impaired Epileptic cases Other impaired T able J -l. — W ork 'performance of epileptic cases and of matched unimpaired workers Number of workers Total_____________ _____ _______ Average performance Factor Unimpaired Impaired Unimpaired 134 208 3.7 3.6 134 208 5.5 4.0 134 134 208 208 (7) (7) (7) (7) 8.3 .02 3.0 (7) (7) 7.6 .13 22.8 (7) (7) Impaired Absenteeism frequency rate1___ Nondisabling injury: Frequency rate2___________ Disabling injury: Frequency rate3___________ Time-lost rate4____________ Average days of disability 5_ Output relative6_______________ ♦Quit rate8_____________________ 1 Number of days lost per 100 scheduled workdays. 2 Number of injuries per 10,000 exposure-hours. 3 Number of injuries per 1,000,000 exposure-hours. 4 Number of days lost for disabling injury per 100 scheduled workdays. 5 Number of days of disability per disabling injury. 6 Percentage relationship of production efficiency of impaired to that of matched ^unimpaired. 7 Data available for too few cases to permit showing performance figures. 3 Number of voluntary quits per 100 employees in the survey group. Composition of the Survey Group All persons who were listed in the company medical records as epileptic cases and with whom unimpaired Under 20 years. .......... ..... ........... 20 and under 25 years__________ 25 and under 30 years_____ __ _ 30 and under 35 years____________ 35 and under 40 y e a r s ________ 40 and under 45 years__________ 45 and under 50 years__________ 50 and under 55 years__________ 55 and under 60 y e a r s ___________ 60 and under 65 years__________ 65 years and over______________ 134 10,894 100.0 100.0 1 9 7 9 16 18 14 18 23 15 4 78 502 894 1,108 1,168 1,220 1,298 1,544 1,520 1,073 489 .8 6.7 5.2 6.7 11.9 13.4 10.5 13.4 17.2 11.2 3.0 .7 4.6 8.2 10.2 10.7 11.2 11.9 14.2 14.0 9.8 4.5 Industry and Occupational Coverage The epileptic cases were less widely dispersed on an industry basis than any of the other impairment groups studied. Only 12 of the 19 major industry groups covered by the study are represented in the epileptic group. This is one of the 3 impairment groups added on recommendation of the advisory committee after the study had begun. Consequently, any epileptic cases in the first 10 plants studied would not have been 116 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES picked up. However, only 29 of the 99 plants studied after inclusion of this impairment are represented in the survey group. In a few of the plants not repre sented, epileptics were employed but could not be matched with unimpaired workers. The number of such instances was not very great, however, and comparatively few epileptic cases were encountered throughout the study. The jobs at which the epileptic cases were em ployed are listed below. The concentration in the processing or producing operations was fairly heavy, with a secondary concentration in main tenance work. The variety of skill requirements among the jobs listed was broad, ranging from un skilled labor to the highly skilled machinist classi fications. Jobs at which 184 Epileptic Cases of the survey group were found employed [T itle s used are those appearing in the U n ited States E m p lo ym e n t Service D ictio n a ry o f O ccu p ation a l T itles a n d are grou p ed an d n u m bered a ccord in g t o the classifications used b y the W a g e A n alysis B ran ch of the B u reau o f L a b or Statistics. T h is is n o t t o be interpreted as a com p le te listing o f jo b s atw hich persons w ith epilep tic im pairm ent can be e m p lo y e d ] 1. Maintenance 4. Inspection and Testing Heater, forge Honing-machine operator, semiauto matic Laborer (petroleum refining) Balancer I Checker Electrician, powerhouse Laborer, process (automobile manufac turing) Core checker Laborer (building) Laborer, process (chemical) Inspector I Laborer (electrical equipment) Laborer, process (electrical equipment) Inspector, chief I Laborer (foundry) Laborer, process (machinery parts) Inspector, machine shop Laborer (petroleum refining) Laborer, process (nonferrous metal al Inspector, raw materials Carpenter Electrical repairman Electrical instrument repairman Machinist I I Laborer, process (fabricated plastic loys and products) products) Oiler I Ladleman I I Pipe-fitter helper L ay-out man, machine shop Plumber Loader Y I I Machinist II Tool maker Machinist, bench Welder, combination Mechanical engineer II Molder, bench Automobile mechanic, motor I Buffer I Tester I 5. Recording and Control Plumber apprentice 3. Processing Casting inspector Chemist assistant II M otor adjuster Multiple-spindle-drill-press operator Pourer, crane ladle Shipping checker Stock clerk I I Tool clerk 6. Material Movement Chipper, foundry Power-press operator I Punch-press operator I Coremaker, machine I Sand^linger operator Core-oven tender Screw-machine operator, automatic Laborer (glass manufacturing) Core paster Cylindrical grinder operator Single-spindle-drill-press operator Laborer (machine tools and accessories) Laborer (wire) Centerless grinder operator Die maker II Swinging-cut-off-saw operator Tool maker Engine lathe operator Topping-off operator Feller, hand Turret lathe operator Floor assembler Welder, arc Laborer (automobile manufacturing) Laborer (foundry) Laborer, process (foundry) 7. Custodial Furnace tender, heat treating W ireman V II Fireman I I I Glass polisher Yarn winder Porter II Placement Practices In the plants in which epileptic cases were em ployed, the placement practices were the same for these cases as for other impaired workers. With the inventory of physical abilities supplied by the pre employment physical examination, the history of the case, and the job requirements the placement officer made the assignments; and the customary review of transfers, follow-up, etc., were practiced. With re spect to the epileptic cases, the environmental con ditions were given considerable emphasis. Place ments had to be made with consideration for the possibility of seizure during working hours. In the 117 J. THE EPILEPTIC CASES event of such seizure, certain types of machine opera tions, the presence of moving equipment, or work above ground level might prove to be extremely hazardous for these cases. It is probable that the epileptic case might have the physical capacity to perform any job for which he had the requisite skill. The determination of place ment in these cases revolves primarily around a contingency. What will be the results if the worker has a seizure on the job? This factor complicates the placement problem for these cases. The nature of the seizures and the time of their occurrence are also matters to be considered in these cases. During the study a number of plant physi cians expressed the opinion that recent developments and discoveries in methods of treatment and medica tion may make significant strides in controlling the seizures and consequently increase the employability of persons with this impairment. Admittedly, the problem of safe placement for these cases presents serious difficulties at present. An additional obstacle to employment of epileptic cases is the reaction on the part of other employees when the impaired person has a seizure during work ing hours. Instances were encountered in the study in which plants had attempted to use epileptic cases but had discontinued the practice because of unfav orable reaction on the part of the other workers. Definite exclusion policies prohibiting the employ ment of epileptic cases were encountered in 32 plants. Exclusion policies were encountered more frequently for only one impairment, hernia, excluded in 33 plants. However, in number of actually employed cases, hernia was highest and epilepsy lowest among the 10 impairments studied. Work Performance The elements of work performance for the epileptic cases and the unimpaired workers matched with them are summarized in table J - l and the following paragraphs. Absenteeism An absence was defined as absence of a full day or more on days on which the employee was sched uled to work. Lay-offs, shut-downs, and regular vacations were not included as either days absent or days scheduled to work. The rates reflect the num ber of days absent per 100 scheduled workdays. As a group the epileptic cases and the unimpaired workers matched with them were about equally regular in their work attendance. Rates for the two groups were 3.7 and 3.6 for the impaired and unim paired, respectively. Comparison of the individual rates by means of the frequency distribution in table J-3 bears out the similarity of performance indicated by the group rates. Seventeen percent of the epileptic cases and 18 percent of the unimpaired had no absences during the periods studied. More than half of each group, 55 percent of the impaired and 52 percent of the un impaired, had nominal absence rates of 1.9 or lower. A number of the workers in each group, 3 percent of the epileptic cases and 2 percent of the unimpaired, had excessively high rates of 20.0 or higher. These isolated instances of poor performance would be expected in any sizable group of workers and dupli cate the experience in the other impairment groups studied. T able J-3.— Percentage distribution of 184 epileptic cases and 208 unimpaired workers, by absenteeism frequency rate 1 Absenteeism frequency rate class Impaired Unimpaired 0__________________________ 0.1 and under 1.0_ _______________________________ 1.0 and under 2,0_________ _______________________ 2.0 and under 3.0_________________________________ 3.0 and under 5.0_________________________________ 5.0 and under 7.0____________ _______ _______ _____ 7.0 and under 10.0_______________________________ 10.0 and under 20.0__________________________ ___ 20.0 and over______________ ______________________ 17.2 17.2 21.0 16.4 4.4 9.0 2.9 8.9 3.0 18 3 21.6 12.0 16.3 12.5 6.3 5.7 5.3 2.0 Total_____________ _____ ___________________ 100.0 100.0 i Number of days lost per 100 scheduled workdays. An effort was made to determine whether epileptic cases tended toward higher rates of absenteeism for specific reasons. Unfortunately, adequate informa tion on this point was not available from company records. No reason for absence was given for more than half the total absences recorded. In the portion for which the reason was given, however, there seems to be no material difference between the impaired and unimpaired groups. T able J-4.— Absenteeism frequency rates 1 for 184 epileptic cases and 208 unimpaired workers, by reason for absence Reason for absence Impaired Unimpaired Total____ ________________ _________ 3.7 3.6 Illness__________________________ Personal business. _________ _____ ______ _ Unknown_____ ____________________ __ __ _ 1.4 .2 2.1 1.3 ll 2.2 1 Number of days lost per 100 scheduled workdays. 118 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES Nondisabling Injury Experience T able J - 6 .— Nondisabling injury frequency rates1 for 134 epileptic cases and 208 unimpaired workers, by nature of injury A nondisabling injury was defined as a work-con nected injury which did not result in any loss of time beyond the day or shift on which the injury oc curred. The rates for the groups reflect the number of such injuries per 10,000 exposure-hours. The rate for each individual was computed for purposes of the frequency distribution on a base of 1,000 exposurehours. As a group the epileptic cases experienced a slightly higher incidence of nondisabling injuries than the matched unimpaired workers. The rates for the two groups were 5.5 and 4.0, respectively. The difference is small and considering the type of injury involved is probably not significant. Compared on an individual basis, the similarity of the experience in the two groups was even more marked: 63 percent of the impaired and 71 percent of the unimpaired had no injuries during the period studied; 92 percent of the epileptic cases and 93 percent of the unimpaired workers had very favor able rates of 1.9 or lower. It was the slightly larger number of epileptic cases with rates of 5.0 or higher— 2.2 percent as against 0.5 percent of the unimpaired— which influenced the group averages. T able J - 5 .— Percentage distribution of 134 epileptic cases and 208 unimpaired workers, by frequency rate 1 of nondisabling injury Frequency rate class Impaired Unimpaired 0____ ________________ ____________________________ 0.1 and under 1.0___________ _____________________ 1.0 and under 2.0_____ __________ _______________ 2.0 and under 5.0___________________ ________ _____ 5.0 and under 10.0____________ ___________________ 10.0 and over_____________________________ ______ _ 62.7 15.7 13.4 6.0 1.5 .7 70.6 11.5 11.1 6.3 .5 0 Total...................................................................... 1CO.O 100.0 i Number of injuries per 1,000 exposure-hours. Data were obtained on nature of injury, and the rates attributable to the various kinds of injuries in the two groups are shown in table J-6. The pattern of the rates in the two groups is very similar, and the epileptic cases did not show any marked proneness toward injury of any particular nature. It seems rea sonable to infer from this that the injuries exper ienced were attributable to the hazards of the jobs rather than to the impairment which characterized one of the groups. Nature of injury Total _ _ _ ... Burns and scalds_________________________________ Cuts and abrasions_______________________________ Eye injuries---------------------------------------------------------Strains and sprains___________________________ ____ Other_____________________________ _______ _______ Impaired Unimpaired 5.5 4.0 .2 3.2 1.4 .3 .4 .4 2.3 .9 .1 .3 1 Number of injuries per 10,000 exposure-hours. An attempt was made to measure the severity of the injuries in terms of the number of redressings re quired. Policies with respect to encouraging or re quiring redressings varied among companies but were the same for impaired and unimpaired workers in any given company. Measured in this way, the in juries were, if anything, a little less severe among the epileptic cases. In this group the nondisabling in juries averaged 1.6 redressings as against 1.9 per injury for the matched unimpaired workers. A final consideration with respect to the medical record was the use made of plant medical facilities for nonindustrial illness or injury. This use was defined as dispensary visits for treatment of illness or injury not related to the worker’s employment. Again, pol icies on this point varied among plants but were the same for impaired and unimpaired workers in the same plant. The epileptic cases made somewhat the greater use of plant medical facilities. Visits per per son during the periods studied averaged 1.1 for the epileptic cases as against 0.7 for the matched unim paired. Disabling Injury Experience Frequency. A disabling injury was defined as a workconnected injury which resulted in a permanent im pairment or in a time loss of at least one full day beyond the day or shift on which the injury occurred. The frequency rate reflects the number of injuries per million exposure-hours. Use of this base may tend to inflate the rate because exposure-hours for the 134 epileptic cases totaled only about a quarter of a million. The frequency rate was slightly higher for the ep ileptic cases, 8.3 as against 7.6 for the unimpaired group. This difference of less than one injury per million exposure-hours does not appear significant. J. THE EPILEPTIC CASES The number of injuries was not sufficient to provide a comparison between the two groups with respect to the nature of the injuries experienced. The impaired group experienced two injuries and the unimpaired group three, during the periods studied. In connection with each disabling injury the ac cident reports and cause studies in the company files were examined in an effort to determine whether the injury was in any way caused or contributed to by the existing impairment. This subject was also dis cussed with the safety man and other responsible company officials. Neither of the injuries experienced by the epileptic cases were in any way attributable to the impairment. Similarly, none of the injuries experienced by the unimpaired workers were caused or contributed to by a fellow worker’s impairment. Time Lost. As a measure of the severity of the dis abling injuries, the time lost has been computed as a rate showing the days lost per 100 scheduled work days and also as the number of days lost per injury. The time-lost rate was 0.02 days and 0.13 days per hundred scheduled workdays for the impaired and unimpaired groups, respectively. On a per injury 119 basis, the epileptic cases averaged a time loss of 3.0 days per injury and the unimpaired 22.8 days per injury. The number of injuries in both groups, how ever, is too small to support definite conclusions. Output Relative Measured individual production data were ob tainable for only four of the epileptic cases and seven unimpaired workers matched with them. These data are included in the computation of the output rela tive for the total impaired and unimpaired groups, but no performance figures are shown separately for the epileptic cases. Quit Rate The quit rate was intended to show the number of voluntary quits per hundred employees of the survey group during the 6 months following the end of the survey period. These data were obtainable for only 23 of the epileptic cases, too few to permit showing separate performance figures for this group. 120 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES Appendix Scope and Method of the Study r The study posed a considerable number of problems because of the complexity of the data and the num ber of factors which had to be measured. It was found possible, however, to provide reliable measures by means of standard statistical techniques. As will be apparent from the following description of the method used, the solutions to these problems hinged essentially upon the adaptation of these methods to the practical considerations of the nature of the in formation readily available in the records of cooper ating plants. Basically, the objective of the study was to compare, over the same period of time, the work performance of impaired workers with that of unimpaired workers on the same jobs. The two groups were matched with respect to such elements as age, experience, and working conditions, so as to rule out as many extraneous factors as possible, and to reduce the difference between the two groups to only one important factor: The existence of a serious physical impairment. The comparisons could be expressed best in terms of averages, frequency dis tributions, and similar common measures of five factors in work performance: Absenteeism, minor work injuries, disabling injuries, production effi ciency, and separations. Definition o f Impaired Worker Fundamental to the undertaking of this study of the performance of impaired workers was a definition of exactly what types and degrees of disabilities should constitute the impairments to be studied. At the outset it was decided by agreement between the Bureau of Labor Statistics and the Veterans Administration that the study should be limited to physical impairments. It was not considered feasible to include mental disabilities. The first requisite was that the concept of the “ impaired worker” should be sufficiently restrictive to exclude any minor disabilities. If the study was to provide the much needed objective findings on the performance of impaired workers, it was essential that definitions be so strict as to eliminate all im pairments that did not require special job placement considerations. A second requirement was that the impairments studied must be those recognized by industry. The definitions would have to fit the usages and terminology common to the medical de partments of industrial plants. Tentative definitions of a group of impairments were drawn, and were tested for data collection in several plants. With this experience as a back ground, an advisory committee, composed in part of practicing industrial physicians recommended by the American Medical Association, was consulted. With the assistance of this committee the scope and method of the study were reviewed carefully and in great detail. The definitions of impairment were revised. Because of their fundamental importance, these definitions are given here in detail: Orthopedic: (а) Loss of a member or members of the body (arm, hand, leg, or foot). (б) Loss of a part of a hand (a thumb and one finger, or two phalanges of each of three fingers) or loss of part of a foot (all toes or any part of the front portion of the foot). (c) Loss of use or severely restricted use of — (1) An arm or leg comparable to (a) above, or (2) A hand or foot comparable to (b) above. (d) Deformities or abnormalities of the spine which severely restrict movement and use of the back in bending, stooping, lifting, crouching, etc. Vision: (а) Totally blind, meaning loss of both eyes or complete loss of light perception in both eyes. (б) Blind, one eye, meaning loss of one eye or APPENDIX complete loss of light perception in one eye. (c) “ Legally” blind. Legal blindness for this purpose was based on the Social Security Board's definition as 20/200 Snellen or less corrected in the better eye. (d) “ Partially” blind. This classification in cluded persons whose vision was more than 20/200 but less than 20/50 corrected in the better eye. (e) Restricted field. For the purpose of this study, the restriction of the visual field had to amount to 50 percent or more. Hearing: (а) Deaf. Complete loss of hearing in both ears without use of hearing aid. A loss of 50 decibels or 0/20 classification placed the person in this category. (б) Hard of Hearing. Persons who had not more than 50 percent of hearing in the better ear without use of hearing aid. Fifty percent loss of hearing was defined as 10/20 hearing when 20/20 was con sidered normal hearing. If the medical records expressed the loss of hearing acuity in terms of decibels, a hearing loss of 30 decibels or more (but less than 50) placed the person within the definition. (c) Deaf-Mutes. Hernia: Those who had an existing hernia condition such as umbilical, inguinal, post-operative, etc. The definition excluded — (a) Employees who had had a successful herniotomy; (5) Employees who had only an incipient, potential, or incomplete hernia; and, (c) Those who had only enlarged or relaxed rings. Cardiac: Those persons who were recorded by the company doctor as definite organic cardiac cases, including cases of hypertensive heart disease. How ever, hypertension cases where there was no de terioration or enlargement of the heart and cases of potential heart disease were excluded. Ex-Tuberculous: All persons recorded by the com pany doctors as having arrested pulmonary tuberculosis. Peptic Ulcer: These cases were included if the record 776106°— 48 — 9 121 showed that the diagnosis was confirmed by X-ray or other approved laboratory methods. Diabetic: Cases recorded in this category were taken if the diagnosis had been confirmed by a glucose tolerance test. Epileptic: Both grand mal and petit mal were in cluded. Multiple Impairment: All cases in which the indi vidual had two or more impairments each severe enough in itself to come within the adopted definitions. In order to yield statistically valid findings in each of the impairment groups, the total number of im paired workers to be studied was set at 10,000. Upon completion of the survey, however, it was found that even this figure did not yield adequate data for some of the impairment types. Work Performance Factors Studied The primary purpose of the study was to establish on a factual and objective basis a comparison of the work performance of impaired workers with matched unimpaired workers on the same jobs. But, “ work performance” has many phases and many aspects. It was necessary at the outset to select certain factors in work performance which would lend themselves to objective quantitative measurement, for which data could reasonably be expected to be available in com pany records, and which would have practical sig nificance in the placement of impaired persons in useful jobs. Because of the likelihood that such data could be found more frequently in manufacturing plants, the survey was limited to manufacturing in dustries. Interviews with plant and personnel managers, Federal, State, and local rehabilitation and placement agencies, trade associations, unions, and various asso ciations of the impaired resulted in the selection of five major factors to be studied. These factors were discussed with the advisory committee and it was agreed that the work performance of the impaired worker should be compared with that of the matched unimpaired workers with respect to — (a) Production efficiency, based entirely on quantitative measurements of individual output. All subjective measures such as foreman's evalua tion, efficiency ratings, etc., were to be excluded. (b) Absenteeism, defined as scheduled workdays 122 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES lost for personal reasons. Because of the limita tions of industrial records, absences of less than a full day were to be disregarded. (c) Nondisabling injuries, defined as work in juries which did not result in a permanent im pairment or any loss of time beyond the day or shift on which the injury occurred; in other words, first-aid cases. (d) Disabling injuries, defined as work injuries which resulted in loss of time of one full day or more beyond the day or shift on which the accident occurred, or which resulted in permanent impair ment even if no time was lost. (e) Job separations, meaning the voluntary and involuntary terminations in the two groups within a fixed period of time. These data were to be ob tained on return visits to plants which had been surveyed earlier with respect to the other four performance factors. Supplementary information such as reasons for absence, number of redressings for nondisabling in juries, nonindustrial medical visits, medical facilities, job placement practices, job re-engineering, etc., was also provided for. Selection of Plants There is no central source which provides informa tion as to which plants employ seriously impaired workers. It was necessary to resort to a number of methods to find such plants. Early in 1944 a mail questionnaire survey on the subject of impaired workers had been made and about 450 usable returns from that many plants were tab ulated.1 This source provided some leads as to plants employing sizable numbers of impaired workers. Some assistance in this connection also was obtained from various trade associations, rehabilitation serv ices, the United States Employment Service, and the Veterans Employment Service in the various large industrial centers. Field representatives of the Bureau of Labor Statistics were sent to various cities in all parts of the country, and the selection of plants was made after utilizing all available sources of in formation in the community. For the most part, the question as to whether or not a given plant could be included in the study could be determined only after interviews with the company officials. 1 T h e results o f this opin io n su rve y w ere published in the M o n th ly L a b or R ev iew for O ctob e r 1944. Given willingness on the part of plant management to cooperate, the inclusion of a plant in the study de pended upon three considerations: 1. Employment of a number of physically im paired workers sufficiently large to justify the expenditure of time necessary to search records and record the data for the study. The minimum limit was set at 20 such workers. 2. The existence of pre- or post-employment physical examination records adequate for a selec tion of impaired persons within the definitions of impairment, and for the selection of unimpaired workers to constitute the control group. 3. The existence of records of absences, injuries, and production in such form that the time required for the assembling of the data would not be pro hibitive. It was necessary that all of these requirements be fulfilled in each plant included in the study. The first and third were necessary as a practical matter of cost and the limited time available for the data collection. The second was necessary if positive accuracy in the selection of impaired and unimpaired workers was to be maintained. In order to use the limited field staff most effectively, effort was concentrated for the most part in the large industrial centers. As far as pos sible, however, coverage was sought in every large center throughout the country. As a result the sur vey was conducted in 16 States, from Massachusetts to California, and as far south as Georgia. A conscientious effort was made to select plants in all fields of manufacturing industry so as to obtain a fair indication of the actual employment of impaired workers and the variety of occupations at which they worked. As a result, the industries surveyed include 19 of the 20 major industry groups recognized by the Standard Industrial Classification. The lumber and timber basic products group had to be omitted be cause of the practical consideration of expense. Selection of the Survey Group Through discussion with company officials, a period of relatively stable operation was selected for study in each plant. This period ranged from 6 to 18 months, depending on the particular circum stances. Data were collected for each employee of the survey group for a period of at least 6 months and wherever possible, for a full year. APPENDIX By reference to medical records or other sources available at the plant, a record was made of each impaired worker who had been employed for 6 months or more during the selected period. Identify ing information such as name, clock number, sex, age, shift, impairment, cause and duration of the impair ment, etc., were entered on prepared work sheets for each impaired worker. The impaired workers in clerical, administrative, and supervisory jobs were eliminated at the outset. As many as possible of the remaining impaired workers were then matched with from one to three unimpaired workers to make up the survey group. It will be observed that these records gave no clues as to the performance of the workers in either group, so that it was not possible to exert any bias. The matching operation set up a control group of unimpaired workers subject to the same incentives and exposed to the same hazards as the impaired workers with whom they were matched. Ideally, the comparison of work performance should be made be tween workers identical in every respect except for the existence of the impairment. In practice, how ever, this ideal comparison is impossible. However, as many variables as could be controlled were elimi nated by matching the impaired worker with one or more unimpaired workers of the same sex, on the same shift, of closely similar age, with about the same length of experience, and working on the same job in the same department of the same plant. Thus, at least the physical facts and conditions of employ ment were the same in both groups. Where possible, three unimpaired workers were matched in this way with each impaired worker. Where three comparable unimpaired workers could not be obtained, two or one were used. Thus, the survey group consisted of a number of cells, each of which was composed of one impaired worker and from one to three unimpaired workers. Collection o f the Data The data from which the measures or rates for the several performance factors were computed were taken in their entirety from original sources — the records of cooperating firms. The study was made during 1946 and 1947 and the periods studied ranged from 1945 through early 1947. The data were tran scribed from company records — such as pay roll, attendance,, medical visits, personnel, etc. — to pre 123 pared work sheets by trained field personnel of the Bureau. (Samples of the work sheets are attached as exhibits I through VI at the end of this section.) Supplemental information relating to placement and safety practices, job re-engineering, job requirements, etc., were obtained by interviews with company officials and first-hand observation in the plant. The work sheets for each impaired worker and his matched unimpaired workers were assembled into cells by the field representatives and sent to the Bureau’s Washington office for editing, coding, and tabulation. Data for job separation rates (Exhibit VII) were obtained by follow-up contact with the company about 6 months after the end of the survey period. This method, however, made it impossible to obtain such data from plants studied within the last 4 or 5 months of the survey. Office Processing of the Data The data received from the field agents were first edited and reviewed to be sure that (1) impairments listed were clearly within the adopted definitions and (2) the impaired and unimpaired were properly matched as to sex, age, job, and the other prescribed limitations. Plant schedules were given a code designation for industry from the Standard Industrial Classifica tion. Each impaired worker’s job was coded accord ing to the U. S. Employment Service Dictionary of Occupational Titles and the jobs were classified ac cording to the patterns used by the Wage Analysis Division of the Bureau of Labor Statistics. Thus, each schedule was related to three standard classi fications in common use in the Bureau: the industry, to the Standard Industrial Classification; and the impaired worker’s occupation to the Dictionary of Occupational Titles and to the Bureau of Labor Statistics wage analysis pattern. As the matched impaired and unimpaired workers had to be on the same jobs, the same job code applied for each of the impaired and unimpaired workers comprising a single cell. The number of days scheduled to work was com puted for each impaired and unimpaired worker from the operating schedule of the plant during the survey period. Deductions were made for observed holidays, shut-downs, and lay-offs so that scheduled days rep resented the number of days the employee was ex 124 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES pected to be at his place of work. The scheduled days of work provided the base on which absence rates were computed. The scheduled days less absences, multiplied by the hours worked each day, provided the exposure-hours for the computation of nondisabling and disabling injury frequency rates. The absences for each individual were accumulated to a total for the survey period and, where available, with subtotals for the number of absences attrib utable to the various reasons for absence. Similarly, the data for nondisabling injuries by nature of injury, number of redressings, number of nonindustrial med ical visits, and number of disabling injuries were summarized for each individual of the survey group. All of these data were transcribed to a specially designed code sheet from which I. B. M. cards could be punched for machine tabulation. At this point a weighting factor was applied to the data for the un impaired workers to equalize the 1 to 1, 1 to 2, and 1 to 3 matchings. A sample of this form is attached to this section as Exhibit VIII. After the data for any one plant had been tabulated and analyzed, a confidential report of the findings was prepared and submitted to the plant management. The objective was to make the data available to the management of cooperating plants for their imme diate information and administrative use. Judging from the replies, this somewhat unusual procedure was well received by management. Weighting As already explained, each impaired worker was matched with from 1 to 3 unimpaired workers, de pending upon the number of comparable unimpaired workers available. This matching process resulted in uneven cells, some of which consisted of 1 impaired worker matched with 1 unimpaired worker, some of 1 impaired matched with 2 unimpaired, and some of 1 impaired matched with 3 unimpaired. In combining the data of these cells for group aver ages and rates, it was obvious that the results for the unimpaired workers would be influenced by the per formance in those cells in which the matching was on a 1 to 2 or 1 to 3 basis. It was necessary, therefore, to apply a weighting factor to the data for the unim paired workers which would neutralize any excessive influence on the part of these units. Since the survey group was composed of cells in which the unimpaired were variously 1,2, or 3 persons, the least common multiple was 6. The numerical data for the unimpaired workers was therefore multiplied by 6 in the cells of 1 impaired and 1 un impaired, by 3 in the cells of 1 impaired and 2 unim paired, and by 2 in cells of 1 impaired and 3 unim paired. Thus, while the rates for individuals and unit would not be affected, the data when combined would be relieved of any excessive influence from the units in which the number of unimpaired workers exceeded 1. Although tests made with weighted and unweighted data in the early stages of the study did not show appreciable differences, it was believed best to take the probability into account at the outset. The data as prepared for machine tabulation were weighted. Thus, it was possible to prepare final tab ulations from the punch cards and eliminate the ne cessity for testing and weighting the data in the final stages of analysis. Presentation of the Data The form and organization of the final report were aimed at simplicity and greatest utility. While the broad concept of impaired and unimpaired workers is of wide interest, the practical day-to-day problems of rehabilitation and placement require findings in terms of specific impairments. Consequently, tables were prepared not only for the group as a whole, but for each of the types of impairment covered by the definitions. It was frequently found, however, that some of the detailed data represented too few cases to be valid statistically. As various organizations concerned with the wel fare of persons with specified impairments would undoubtedly wish to utilize the section of the report dealing with their individual specialties, the data for each impairment type was presented as a complete unit capable of standing by itself. This determination was further influenced by the consideration that placement officials — whether governmental or pri vate — would want ready recourse to data organized along impairment lines in their dealing with individ ual impaired workers. Considerations of industry and occupation were believed to be of minor impor tance. As pointed out throughout the report, the problem of utilizing a seriously impaired worker is one of matching his abilities to the requirements of a job, regardless of what that job may be called or in what industry it is found. 125 APPENDIX EMPLO Y E E RECORD (Worksheet A) 1. Name________ ______________________________________________________ 2. Clock No.________________ 3. Dept._____________________4. Shift 5. Occupation_______________________________________________________ 6. Age_____________________7. Sex______________________8. Cell No. 9. Impairment:_____________________________________________________ 10. Cause of Impairment: (a) Congenital________ (b) Illness______________(c) Work Injury. (d) Other Injury_________ (e) Other Cause_________ (f) Unknown_____ 11. Duration of Impairment: (a) From Birth__________________ (b) Acqui r e d in Childhood________ (c) Acquired in Adulthood____________________ 12. Rehabilitation:______________________________________ ______________________ 13. 15. 16. 17. Date placed on present job:_____________ .14. Date entered plant:. Rate of pay on present job:_____________ Yes ___________ No Is employee a veteran of World W a r II? What special aids, job revision, etc., are required?_ Exhibit I to os ABSENTEEISM (Worksheet B) 3. 1. Cell N um b e r ______ ___________ R e c o r d of A b sence 2. Period: From______________ Thru Jan. Feb. Mar. Apr. May June 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 July Aug. Sept. Oct. Nov. Dec. 4. Code for Cause of 1. 2. 3. 5. Comments: Absence: Own Illness Fam i l y Illness Personal Business 4. Trans. 5. 6. Diff i c u l t i e s 7. 8. 9. U n k n o w n Exhibit II 30 31 M E D I C A L VISI T S (Worksheet C) 1. Cell Number_______ _______ 2. Period: F r o m . ___________ Thru 3. R e c o r d of Medical Visits Jan. Feb. Mar. Apr. May June 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 a. b. c. d. Burns and Scalds Cuts and Abrasions Eye Injuries Strains and Sprains 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 July Aug. Sept. Oct. Nov. Dec. 4. Type of Visit: 1. Welfare 2. R e d r e s s i n g for Nondisabling Injury 3. N o n d i s a b l i n g Injury 4. D i s a b l i n g Injury 5. Comments: e. f. g. h. D i s l o cations a n d Fractures Ampu t a t i o n s D ermatitis Infections hExhibit III m 128 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES D I SABLIN G ACCID E N T R E C O R D (Worksheet D) 1. Cell No._________________ 2. Dept._____________________3. Date. 4. Occupation_______________________________________________________ 5. Nature of Injury and B ody Part Affected 6. Resultant Type of Disability. 7. Cause of Accident 8. (a) Days Lost______________________ ____________________________________________ _ (b) Date of 1st Full D ay Absent____ Date of Last Full D a y of Disability. 9. Was Accident Attributable to Worker's Impairment?__________________________ Exhibit IV OCCUPATIONAL DATA (Worksheet E) 1. J ob Title_____________________________________ 2. Dept. 3. Description of Duties________________________________ 4. 5. 6. 7. Machines Used _____________________________________________________________ Han d Tools Used________________________________ , _________________________________ Skill Demands: over 2 yr.__________ 6 mo. to 2 yr.__________ u n d e r 6 mo.____ Physical Requirements: (a) standing____ (b) sitting_____(c) stooping___ _ ( d ) m o ving____ (e) lifting. 8. Working Conditions: (a) Condition of Floors: Wet_______Dry_____ Greasy______ Rough_______Housekeeping: Good _____ Bad__ (b) Atmosphere: Dusty___________ Humid___________ Dry _________ Fumes___________ Clean (c) Moving Equipment: Overhead_______ ._____________ Floor Level_________ ._______ None_______ . ______ (d) Illumination: Dim___________________ Good_______________________ G l a r e ----------------9. Cell Number Applicable__________________________________________________________ 10. Comments___________________________________________ ,__________________________ _ Exhibit V 129 APPENDIX U. S. BUREA U OF L A B O R S TATISTICS Impaired Worker Study (Worksheet F) 1 . Name of Company_____________ .________________________ 2 . Business Affiliation________________________________ 3. Authorizing Official (full name, title, address) 4. Scheduled Plant (name and address)_________________________ 5. Furnishing Officials (full names, titles, and addresses) 6. Products of S c heduled Plant 7. Employment: Ave. monthly for per. sched. - Total________ Unimpaired_ Male 8. Impaired, F e male Orthopedic Vision Hearing H e rnia Cardiac Diabetic Epileptic Gastric U lcer Other Placement: (a) Labor Recruitment, (b) Pre-Employment Physical Examination: (1) Scope_____________________________ (2) Exclusions, (3) Comments, Exhibit VI 130 PHYSICALLY IMPAIRED WORKERS IN MANUFACTURING INDUSTRIES (Worksheet F— Continued) (C) Indue t i on________ (1) Interviews (2) Tests. (3) Training Programs (d) Job Analysis (e) Placement and Transfer (f) Job Follow-up. (g) J ob Reengineering for Impaired (h) Plans for Veterans. 9. Work Schedule (schedule period b y dept, or occupational group) (a) Days/wk. (b) H r s . / d a y (c) H o l i d a y s Observed 10. Company Policies (a) Saf e t y Programs. (b) Safe t y Department Organization. APPENDIX (c) (d) (Worksheet F— Continued) First Aid Program____________________________ Location__________________________________ Doctor on duty___________________________ R e gistered nurses________________________ Technician________________________________ Other attendants Physical equipment Workmen's Compensation (1) Company attitude. (2) Insurance coverage. (3) Waivers. 11. General (a) Records used. (b) Selection of sample. (c) Special features to be covered in plant report. (d) Plant report to be addressed to. (e ) Comments. 131 Job Separations Poor atten. Other Unsuited for work Red. in force j Work conn, disab. Nonwork conn, disab. Other Unknown Trans. (9) Remarks: Break rules (8) Deceased (7) Moved Family rea sons Health (6) Military service (5) Unknown (4) Unimpaired Impaired End of survey period (3) Terminations Other (2) Voluntary quits Dissatisfied (1) Line No. Page No. Survey list Date checKeu: (10) (ID (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) (22) (23) (24) Disc, for cause — Exhibit VII ☆ U.S GOVERNMENT PRINTING OFFICE: 1 9 4 8 - 776106 PHYSICALLY IMPAIKED WORKERS IN MANUFACTURING INDUSTRIES (Form G) Company:____________________________________________________________________________________ R 'PlA'ffT- £ ~py>js*c*.L ~T?*$ 0 e t « y > ‘i //• v r h i R 0 7> U. C JT »A TiyTF (3 * O -'aJ /« (src) 'l n // it u< M t* IS *4 $ £E /ftf*r*o J/ 1J>-l7J ■*=•/*-r j a#' J r j *. *7 - ■~ ... - I ... .... - - \ C 0^ £ f f l C l E N C y A jvJ) A V s e ifr T tis n Stlf*/*\«d. Hit. ft* /c. */■ X>*y i ~ffe tm h -ttie « ■ M *2- ** ** k " -- -7 Jcr/ilC. y TostJ^j___ Hi*,-**- 1/erifitKluat^ —i c A K 2> i -y>Mjrr~ / .*■ -yfL > j yt l»* .c £ 7 0 / IT 2- ... .1*■ 31 7¥».*"7*7? ULJJL r> r :i ... ... .... - ... ... - ... ... - _ - — A/ON D I S A B L I N G INJURIES £Ay*s*r*'fte- (p.oy A R -P hi r xs A 7 JL - - - 2> AS /■* rt - ~ ... ... .. . 7/ 7,7 /# - -- - - - “ ... 1^ I ... JCNJ - .... 3> I S A ' B L l J f G - l£ S A^flarl Tt.mri - » . 1 -■ /* */ S3. ~ .. . / % titi* ... - ■■ / »■ jL 0 - - y ? u » -t ~ -7^ H - 2> - J . 1 VafM*■ - ” C -rzr.l *•a ^•r>« N1 S3keJLmU4L jU y j •/ > JT > r j 77/*/ A*st~ •/ zrv - r j G A R I? jzzt ~ ... - -p / a .* .* - - *■ h\ jF 6 7 *a IT /j ■O' SSI s i *7 4/ i* 4f 4/ 7/ 7/ 7 J 74 S7 ^7 7 7 # » ... - ... ■- - ... ... ... ... ... - 3.HA). Sche.tLu.fe. — ~tr* EXHIBIT (Face p. 132.)