In general, there would seem to be a decrease in fines for damaged goods, and also of deductions for materials. Miss Hastings (Leeds North) reports that the latter decrease in Leeds amounts to 50 per cent. In the East Lancashire Division the Shirt, Collar and Tie Manufacturers' Federation recently issued a circular list of piece-work rates of pay and certain trade regulations which added a stipulation that "no deduction was to be made from wages for cotton, needles, power or hot water." Mr. Barrett (Rochdale) reports that the system of fines and deductions has entirely disappeared in his district, where it is now the standard practice to punish bad work by suspension or dismissal. Mr. Jones (Halifax) states that the practice of fines in the clothing trade seems to be dying except in the larger works. There is general agreement among the Inspectors that the Trade Boards Acts, where they are in operation, have been instrumental in putting an end to unduly heavy fines and deductions for damaged work. CHAPTER II. REPORT OF SENIOR MEDICAL INSPECTOR, Inquiries of more than ordinary interest occurred for the Medical Inspectors, whose powers in overtaking them were heavily taxed during the year by the temporary reduction of their number to four owing to the loss of Dr. Eileen Hewitt who resigned in April, on the occasion of her marriage. These inquiries, among others, related to special incidence of lead poisoning in shipbreaking and in the manufacture of electric accumulators; visits to certain centres in Germany to see the effect on horsehair of low pressure current steam disinfection as a means of protection against anthrax; incidence of epitheliomatous ulceration among mule spinners from mineral oil (by Dr. Henry) and in the manufacture of arsenical compounds; the following up (by Dr. Bridge) of the first definitely recorded cases in this country of manganese poisoning. Reference is also made in some detail to fatal poisoning from arseniuretted hydrogen gas, from the deflagration of cadmium, and from benzol; and to effects on health from new developments in the use of organic chlorine solvents, such as trichlorethylene, in affixing crêpe soles in the boot trade. In their first report, the Workmen's Compensation (Silicosis) Committee acknowledge their indebtedness to Dr. Middleton in the conclusions they arrived at. A further account is given of determinations of dust by him, using for the purpose the Owen's dust counter, carried out at the request of the Research, Inventions, and Designs Committee of the National Council of the Pottery Industry, into the silica content of effluents from exhaust systems of ventilation. All the Inspectors have been much occupied with first aid and ambulance provision, and the suitability of the equipment of breathing and reviving apparatus in chemical works. În satisfying the requirements of the Chemical Regulations as to "approved" apparatus, we have been assisted by the Chemical Warfare Committee of the War Office who have tested for us the canisters and face pieces of the army box type of respirator, for use in factories. Below is a table of notifications under Section 73 of the Factory and Workshop Act, 1901, showing, as compared with 1922 and previous years, increase in the number of cases (though not in the deaths) from lead poisoning, a stationary condition as regards the total number of cases of anthrax, and a considerable increase in the number of reported cases of epitheliomatous ulceration. Table 1.-Notification of poisoning by Lead, Phosphorus, Arsenic and Mercury, Toxic Jaundice, Epitheliomatous and Chrome Ulceration and Anthrax (under Section 73, 1901). • The principal numbers relate to cases, the small figures to deaths. Fatal cases not reported in previous years are included as both cases and deaths. Lead. The excessive incidence in the manufacture of electric accumulators (confined to two works, in one of which 54 cases occurred and in the other 15) was due to a large impetus in the trade, owing to the advent of broadcasting and to extended. use of electric lighting on motor cars. Other contributory causes were high pressure of work, overtime, the engagement of many new unskilled workers, and the close proximity of persons, all of which tended to the creation of dangerous dust, much of it outside the scope of existing ventilation. There was also indifferent supervision in carrying out the spirit of the Regulations. The report by Dr. Bridge and Mr. Price, with recommendations for revision of the Code of Regulations-the first made under the 1901 Act-has been issued to the industry and steps are now being taken to give effect to their recommendations. Shipbreaking.-Thirty-eight cases were reported, as compared with 17 in 1922, in this developing industry, which, in some cases, does not come under the Factory Acts. It dates practically from within the last three years. The work consists in applying the oxy-acetylene flame by means of a special holder, carrying the burner along the special line of the armour plating to be cut, and poisoning can only result where the surfaces have been previously painted with lead paint, or when the flame, on cutting through, comes in contact with the red lead caulking (sometimes inch thick). The flame volatilises the lead so that it is inhaled by the workers. I would recall* that experiments under the direction of the Principal Chemist of the Government Laboratory showed that 49 milligrammes of lead per 10 cubic metres of air were given off during the experiment, that is 25 times as great as the daily dose (2 milligrammes), which I regard as the minimum which may cause chronic plumbism if inhaled daily. Not only is there the risk from lead, but also the unpleasant symptoms of "brass founders' ague," which ensue in cutting plates which have been galvanised. The usual procedure is to chip or scrape away the paint (with evolution of dust), before applying the flame, but unless the flame is carefully applied along the line previously chipped, it spreads outside the clean area. In the six years, 1918-1923, there have been 69 cases; of these, 25 had been employed for less than one year, and of these again 12 under three months. As is to be expected in a new employment, before the constitution has become undermined, 40 of the cases are described as slight, and 59 as being the first attack. The industry is carried on in some 60 yards, not a few of them temporary in character. Nearly all of these have been visited during the last two years by the Medical Inspectors, who have examined 329 men, of whom 119 (36 per cent.) showed blue line, 16 (5 per cent.) partial wrist drop, or weakness of the wrist, 45 (14 per cent.) anaemia, and 56 (17 per cent.) gave a history of colic. Trials of various types of respirators have been made, but none have proved satisfactory. Indeed, the report of the Principal Chemist stated that the fume was only retained by a layer of six inches of cotton wool. Inhalation is entirely responsible for the poisoning, and yet one has had to ask for the withdrawal of printed working instructions issued by a firm to their workmen, * Annual Report for 1921, pages 69-70. saying that "illness is not caused by inhaling the fumes, but by particles of material being carried to the mouth." Periodic medical examination is the most important single means of minimising the risk, but naturally this is only effective if followed by transference to other work of those workers who show signs of absorption. This other work would generally be rather less well paid, and so long as such an examination is voluntary and not statutory there will be inclination on the part of the burners to avoid the examination. The Medical Inspectors have secured, in nearly every yard, some form of voluntary medical examination, without, however, having ensured in all cases the important requisite of regularity in the examination. Comparatively recently mechanical cutters which carry the flame holder have been introduced. In some of these the holder is moved along the surface of the plate by mechanical means, not only horizontally but also vertically, and in others by the operator turning a small wheel. By the first named method, there is no necessity for the person in charge of the machine to be in close proximity to it, for, once started, all that is required is to see that the flame keeps alight. Where the flame is moved otherwise than by mechanical means, there is little advantage from the point of view of inhalation over hand cutting, except that with the mechanical cutter the flame travels accurately along the chipped line. The use of such appliances has undoubtedly proved of immense service where they have been seriously pushed, but their action is limited (at present) to flat surfaces. They cannot travel round the curved surface of the hull. Arsenic.-Absorption of arsenic is recognised as associated occasionally with slowly developing epitheliomatous ulceration. In 1922, Dr. A. Leitch described the first instance of its production experimentally in mice.* Among 30 cases cited by the late Dr. Pye-Smith,† one was of a worker in a sheep dip factory. In the Annual Report for 1902, I described my examination of 18 workers in a sheep dip factory, and showed how employment in the manufacture of this substance (arsenite of soda), which forms a dust which "flies" readily, very irritating to the upper air passages, brought about the characteristic pigmentation of the skin, and keratosis indicative of arsenic absorption. Dr. Bridge and I visited the same factory last year, and examined eight men, some of whom I had examined at my previous visit over 20 years before. This fact in itself tends to show that however irritating the dust may be, its action in inducing cancer is very slow indeed. Among the men examined, an epitheliomatous condition was noted in three. As knowledge of such cases adds * “ Experimental Production of Cancer by Arsenic," by Dr. A. Leitch and Dr. E. L. Kennaway, British Medical Journal, 9th December, 1922. "Arsenic Cancer," by R. J. Pye-Smith, Lancet, 26th July, 1913 and 2nd August, 1913. |