months. He now suffers from indigestion, he can not eat his break-
fast, has a bad taste in his mouth in the morning, has lost weight
and strength, and has fits of trembling in his limbs so that he feels
** like he must nail himself together or he will fall apart." This
man has the lead line on his gums. His wife also works in the tile
factory ; she has to because his pay is so low.
Zanesville is used to illustrate conditions because there is more of
this work done there than in any other one town, but what has been
said of it applies to all other places studied except Trenton, where
conditions are markedly better. Two factories, one in Newport, Ky.,
and one in Chicago Heights, employ no women.
NUMBER OF CASES OF LEAD POISONING FOUND.
It has not been possible to separate the cases of lead poisoning
contracted in the tile works from those contracted in the art and
utility potteries. Zanesville, which is the center for the latter in-
dustry, has also three tile factories, and the physicians who see cases
of lead poisoning know that their patients are working in glaze
rooms, but often do not know what establishment they come from.
The following list of cases, therefore, includes those found in ithe 11
igitized by VjOOQIC
52
BULLETIN OP THE BUREAU OP LABOR.
tile factories studied and in the 7 art and utility ware potteries of
the Zanesville district.
In the 11 tile works 138 men and 204 women are employed; in the
7 potteries 16G men and 39 women, making 304 men and 243 women
in occupations exposing them to lead. The cases of lead poisoning
must be given without regard to occupation because it was usually
impossible to find out what particular work the individual was
engaged in.
NrjtfBER OF WORKPEOPLE AND OF LEAD POISONING CASES IN 11 TILE FAC-
TORIES AND 7 YELLOW WARE AND ART AND UTILITY WARE POTTERIKS.
ZANESVILLE DISTRICT, BY SEX.
Sex.
Number
employed.
Cases of lead
poisoning, 1910
and 1911.
Cas?s of lead
poisoning, 1911.
Males
304
243
63
35
4S
Females
28
Total
547
98
76
FREQLTINCY OF LEAD POISONING IN W^HITE-WARE POTTERIES AND IN ART
AND LTTLITY WARE POTTERIES AND TILE WORKS.
If the number of men poisoned in 1910-11 in these two classes of
potteries are compared with the number of men poisoned in the
white-ware potteries, the influence which the large percentage of
lead in the glaze and the poverty of the workmen have on the inci-
dence of industrial lead poisoning becomes apparent. The women are
omitted from the comparison because the white-ware women workers
are no better off than those employed in art and utility potteries and
tile works, with the exception of the difference in the glaze, but the
men in white ware are markedly better off than those in the art
potteries and tile works. Indeed, the women in white-ware potteries
are' all exposed to the dangers of dusty work, while many women tile
workers are engaged in simply placing the glazed tiles in saggers or
in tending different machines.
FREQUENCY OF LEAD POISONING CASES IN WHITE-WARE POTTERIES AND IN
YELLOW WARE AND ART AND UTILITY WARE POTTERIES .AND TILE WORKS.
Industry.
Men
employed.
Cases of lead
poisoning in 2
years.
Ratio of cases
of lead poison-
ing to number
of employees.
White ware
790
304
60
63
Ito 13
Yellow ware and art and utility ware and tile works
1 to 4 or 5
This table shows that the work in the last class of industries is
almost three times as dangerous as in the first. It must be remembered
that the discovery of cases of lead poisoning in these unorganized
Digitized by VjOOQIC
LEAD POISONING IN POTTERIES, TILE WORKS, ETC.
53
industries was much mere difficult than in the organized potteries
of Trenton and East Liverpool, but it must also be remembered that
the labor in the unorganized factories is more shifting and a larger
number of men were undoubtedly employed during those two years
than our figures indicate.
FREQUENCY OF LEAD POISONING IN BRITISH AND IN AMERICAN POTTERIES.
Even the white-ware potteries alone have an amount of lead
poisoning far in excess of that reported for all potteries in Great
Britain/ 0/Ccupations here are differently divided and between the
two countries workmen can not be compared class by class, but totals
may be compared as follows :
FREQUENCY OP LEAD-POISONING CASES IN EACH SEX IN ALL POTTERIES,
GREAT BRITAIN, 1910, AND IN WHITE-WARE POTTERIES, UNITED STATICS,
1911.
All potteries, Great Britain.
White-ware potteries. United
States, 1911.
Sex.
Number
Gases of
lead
poison-
ing, 1910.
Ratio of
cases of lead
poisDDinfT to
number of
employees.
Number
employed.
Cases of
lead
poison-
ing.
Ratio of
cases of lead
poisoning to
numl)er of
employees.
Males
4,504
2,361
40
37
1 to 113
lto64
796
150
39
29
1 to 20 or 21
Females
I to6
Total
6,865 1 77
lto89
946
68
Ito 14
It is easy to see that the cases of lead poisoning among the men
and women in American white-ware potteries number about six times
as many as in all the British potteries and that the women here
suffer more than twelve times as much as do the English women
workers. Comparing individual classes of working people, as can be
done in a few instances, the following is found :
FREQUENCY OF LEAD-POISONING CASES IN SELECTED OCCUPATIONS, BY SEX,
ALL POTTERIES, GREAT BRITAIN, 1910, AND WHITE-WARE POTTERIES,
UNITED STATES, 1911.
Ail potteries. Great Britain,
White-ware potteries, United
States, 1911.
Occupation and sex.
Employees
Cases of
lead
poison-
ing, 1910.
Ratio of
cases of lead
poisoning to
number of
employees.
Employees.
Cases of
lead
poison-
ing.
Ratio of
cases of lead
poisoning to
number of
employees.
Dipper?, male
786
858
13
21
1 to eo or 61
Ito 41
132
135
18
26
lto7
Dippers* helpers and cleaners,
female
1 to5
* .\nnual Report of the Chief Indpector of Factories and Workshops for the year 1910,
p. 174.
Digitized by VjOOQIC
54
BULLETIN OF THE BUHEAU OF LABOB.
The contrast is even greater when all the American pottery workers
are included, as, indeed, must be done if a fair comparison is to bo
made, for the British report covers yellow ware, Rockingham,
majolica, tile works, etc.
FREQUENCY OP LEAD-POISONING CASES IN EACH SEX, IN ALL POTTERTES,
GREAT BRFfAIN, 1910, AND IN POTTERIES VISITED, UNITED STATES, 1911.
.
All potteries. Great Britain.
Potteries visited. United States, 1911.
Sex.
Employees
Cases of
lead
poison-
ing, 1910.
Ratio of
cases of lead
poisoning to
number of
employees.
Employees.
Cases of
lea4
poison-
ing.
Ratio of
cases of lead
poisoning to
number cf
employee?.
Males
4,504
2,361
40
37
1 to 113
lto64
1,100
393
87
57
1 to 12 cr 13
Females
1 to 7
Total
6,805
77
lto89
1,493
144
1 to 10 or 11
With less than one-quarter of the workpeople, American potteries
have almost twice as many cases of lead poisoning. This result was
entirely unexpected, for everywhere in the pottery districts in this
country one is told that lead poisoning is much less serious than it is
in Great Britain, and the reasons given are that living conditions are
better here and there is less alcoholism, but chiefly that there is more
lead in the British glaze. The people who give this information are
themselves Staffordshire men and have learned the trade over there.
They are describing a state of things that undoubtedly existed for-
merly in the Staffordshire potteries but which no longer exists. Of
late years, as the British reports show, there has been a great decline
in this form of industrial poisoning in Great Britain,* while in this
country, though there has been some improvement, especially in the
making of white ware, it has not been nearly so great.
If American wages are higher, living conditions better, and the
workmen more temperate, these advantages seem to be more than
offset by the lack of sanitary control over the potteries and the low
standard of sanitary conditions. The glaze used in the Staffordshire
potteries, in which the cases of lead poisoning reported for 1910
occurred, contained from 11.2 per cent to 33.1 per cent soluble lead.^
In American potteries the lead content ran from 5 per cent up to GO
per cent, but the lack of hygienic control in the United States is much
more important than the larger amount of lead in the glaze. There
is no freedom from lead poisoning even in those American potteries
which use the smallest proportion of lead. The enormous difference
1 Fee Bulletin of the United States Bureau of Labor, No. 95, p. 44.
2 Anniinl Koport of the Chief Inspector of Factories and Workshops for the year 11)10,
p. 43.
Digitized by VjOOQ IC
LEAD POISONING IN POTTERIES, TILE WOBKS, ETC.
S5
between the number of lead-poisoning cases here and in Great Britain
is due not so much to the control exercised over the amount of lead in
the glaze as to the strict regulations which there govern the hygiene
of the trade.
SEA-ERITY OF LEAD POISONING IN BRITISH AND IN AMERICAN POTTERIES.
Although the number of cases of lead poisoning is much greater in
this country, yet apparent^ the more serious forms of the di^^ease :^.re
not so frequent here as in England. Perhaj^s this is one reason for
the popular belief that lead poisoning is much greater in Staffordshire
than in Ohio and New Jersey.
The English expert. Dr. T. M. Legge, classifies* cases of industrial
lead poisoning under three heads —
Slight: (1) Colic short and uncomplicated ; (2) anemia in ado-
lescence, aggravated by employment.
Moderate: (1) A combination of colic and anemia; (2) profound
anemia, apparently without complications; (3) slight mus-
cular paresis, i. e., incipient paralysis.
Severe: (1) Encephalopathy; (2) marked paralysis.
He divides as follows 217 male cases and 280 female cases occurring
in Great Britain in the five years 1903 to 1907 :
NUMBER AND PER CENT IN EACH CLASSIFICATION OF LEAD POISONING CASES IN
BRITISH POTTERIES, 1903 TO 1907, BY SEX.
Males.
Females.
Classification.
Cases of
lead
poison-
ing.
Per cent.
Cases of
lead
poison-
ing.
Per cent.
Severe %
42
97
77
1
19.4
44.7
35.5
.5
35
97
144
4
12 5
Moderate
34.6
Slight
61 4
Not stated
1.4
Total
217
280
The death rate in 11 years, 1899-1909, averaged 1.11 for every
1,000 men employed, and 0.85 for every 1,000 women.^
Only a partial classification can be made of the cases among Ameri-
can workers under these heads for lack of accurate information con-
cerning most of them. Among the cases of lead poisoning that
occurred in 1911 in the potteries, historias were secured of 86 men
I ■•
* Report of the Departmental Committee Appointed to Inquire Into the Danpjprs Attend-
ant on the TJse of Lead In the Manufacture of Earthenware and China, Home Department.
1010, Vol. I, p. 11.
•Idem, Vol. II, p. 39.
Digitized by VjOOQ IC
66
BULLETIN OF THE BUBEAU OP LABOB.
and 51 women, which are full enough to pennit of dividing them
under these heads.
NUMBER AND PER CENT IN EACH CLASSIFICATIOIjJ OF 137 LEAD POISONING
CASES IN THE UNITED STATES, 1911, BY SEX.
Males.
Females.
Classification.
Cases of
lead
poison-
ing.
Percent.
Cases of
lead
poison-
ing.
Per cent.
Severe
7
39
40
8.1
45.3
46.5
6
14
31
11 8
Moderate
27 5
Slight
GO. 8
Total
86
51
The percentage of severe cases among the men in this table is not
nearly so high as in the British table. The cases among the women
are distributed more nearly as among the English women, but it is
very probable that many slight cases among women and girls were
j>ot reported.
The deaths for 2 years were 3, all men, among 1,500 employed, or
1.5 for each year, which is about the same as the English death rate.
There were no fatal cases found among women during these years.
RELATIVE FREQUENCY OF LEAD POISONING IN MEN AND IN WOMEN.
The British authorities insist that there is a true sex susceptibility
to lead poisoning, women being more prone to it than men.^ One
phj^sician stated that men are more liable to the chronic, and women
to the acute forms, such as colic and encephalopathy.* The cases of
encephalopathy found in this investigation among pottery workers
confirm this last statement, for 9 out of 14 cases of this severe form of
lead poisoning, and all of the three fatal cases, were women. (Some
of these 14 ca.ses occurred earlier than 1910.) At first sight it would
seem that the figures of this study bear out also the statement that
women are more susceptible to lead poisoning than men, for there are
57 cases among 400 women, or 1 to 7, and only 87 among 1,100 men, or
1 to 12 or 13, but a closer analysis shows that there are factors influ-
encing this difference other than the factor of sex.
In East Liverpool and Trenton the relative proportion of male and
female cases more than bears out the English theory. Seven hundred
and ninety-six men had 39 cases, or 1 to every 20 or 21, and 150
women had 29 cases, or 1 to every 5 or 6 employed (1911). But
* Report of the Departmental Committee Appointed to Inquire Into the Dangers Attend-
ant on the Use of Lead in the Manufacture of Earthenware and China, Home Department,
1910. Vol. I. p. 12.
«Idem, Vol, III, Q. 1254.
Digitized by VjOOQ IC
LEAD POISONING IN POTTEBIES, TILE WOBKS, ETC. 57
it has been seen that in those districts where white ware is made and
the National Brotherhood of Operative Potters holds sway the women
have many handicaps as compared with the men besides that of sex
idiosyncrasy. They are unorganized, underpaid, poorly housed, poorly
fed, subject to the worry and strain of supporting dependents on a
low wage, while the men are prosperous and independent. In the
unorganized pottery iSelds, however, in the tile works and art pot-
teries, men and women are in the same economic class, all making low
wages, with everything that that implies, and here no sufch dispropor-
tion is found between the two sexes in the matter of lead poisoning.
In the establishments that were studied there were in 1911 304 men
employed and 48 cases of lead poisoning, or 1 for every 6 to 7 men ;
243 women were employed, and there were 28 cases found, or 1 for
every 8 or 9. The ratio of cases is actually greater among the men.
Of course, these figures are offered very tentatively, realizing that
they can in no way be compared with the British, which are based
on a medical examination of all men and women employed and on
accurate records as to the nimiber of employees during the year. The
results obtained in this investigation can only be suggestive; they are
given simply because the contrast between the number of male cases
in East Liverpool and Trenton and those in unorganized branches of
the trade is too great to be accidental and does seem to point to the
influence of poverty as a predisposing factor in lead poisoning even
greater than sex.
In discussing the relative frequency of lead poisoning among men
and women, several physicians in the unorganized pottery towns
said that they saw more m^ile cases than female, and one of them
explained this fact by the universal habit of tobacco chewing among
the men. Most of the men, he said, use scrap tobacco, carrying it
in the pocket of their working clothes and handling it with fingers
covered with glaze. A great many of them believe that chewing
tobacco helps to keep them from getting poisoned. Two other
doctors said that while they saw more men with the typical gastric
form of lead poisoning, they saw large numbers of women and
young girls with less pronounced and characteristic symptoms which
ihey, however, attributed to the lead, such as profound anemia with
constipation and sometimes amenorrhea. Now, it is more than
probable that many of these cases were not revealed in the course
of this study, for the majority of physicians hesitate to speak of
lead poisoning if there is no colic. The British statistics, however,
include just this class of cases: "Anemia of adolescence aggravated
by employment." Certainly it is probable that this is one reason
for the discrepancy between the results obtained here as regards
female cases and the results obtained there.
Digitized by VjOOQ IC
68 BULLETIN OF THE BUEEAU OF LABOB.
No evidence was secured as to the influence of lead on women as
an abortifacient. Miscarriages are very common among these
women pottery workers, but physicians and the women themselves say
that so many are mechanically self-induced that it would be impossible
to discover the part played by the lead. The women feel obliged
to work after marriage, and they consider it economically impos-
sible to have more than one or two children at the most. They do
not, for the most part, know that lead glaze has an abortifacient
action.
LEAD POISONING IN THE MAKING OF PORCELAIN ENAMELED
IRON SANITARY WARE.
More difficulty was found in tracing cases of lead poisoning in
this industry than in the pottery industry proper, because so many
of the workmen are non-English-speaking Slavs. A very large num-
ber of cases were reported, but when corroborative evidence was
sought it was often found that the man had gone back to Austria,
or had moved on to one of the other centers of the trade, or that he
was timid and suspicious, refusing to answer any questions. Chicago
and Pittsburgh offered the greatest difficulty, because all the fon?e
employed there is of this character, and the men are scattered all
over the foreign colonies. To give an instance of the trouble ex-
perienced, there were 96 cases reported in 1 city as having occurred
in the last 2 years. Thirty-seven of these could be traced to the
physicians neiar the plant, 11 were on hospital records, 2 were per-
sonally examined, but 46 were unverified cases, depending only on
the statement of men who had departed or who refused to let them-
selves be examined.
It has seemed best, therefore, to give a statement as to the source
of these cases side by side with the list of cases.
In all of these towns, except one large town with a small factory
employing only Slavs, the fact that sanitary-ware enamelers suffer
from lead poisoning is notorious, and physicians in the neighborhood
of the plant are able to tell of cases of severe colic, of palsy, and
even of encephalopathy, for the form of lead poisoning seen among
these men is often severe. The statement was repeatedly made by
physicians that " one man in every three," " at least one-half of all
the men," " all of them who stay a;ny length of time," suffer from
lead poisoning.
The following table gives the number of men employed in the
glaze departments of the 10 plants which are included in this study,
the number of cases occurring in the 2 years covered by the inquiry,
1910 and 1911, the number in a single year, 1911, the proportion of
people then working who had recently suffered from lead poisoning,
and the sources from which the cases were obtained :
Digitized by VjOOQ IC
LEAD POISONING IN POTTEKIES, TILE WOBK6, ETC. 59
NUMBER OF EMPLOYEES AND OP LEAD-POISONINCx CASES, AND RATIO OF
CASES TO NUMBER EMPLOYED, IN GI^IZE DEPARTMENTS OP 10 PORCELAIN
ENAMELED IRON SANITARY- WARE PLANTS.
EMPLOTEES.
In mills
Enazxifiters
Total
LEAD-POISONINO CASES.
In 1910 atnd 1911
In 1911:
Reported by doctors
Reported by hosDitals
Found by examination
Reportedi by men ,
Total
Cases among fbrce still at work in 1911
Number.
RaUo of
lead-poison-
ing CilSCS
to number
of em-
ployees.
112
900
1.012
303
1 to 3.3
106
15
66
30
217
199
1 to 4.7
1 to 5.1
The same warning must be given here as in the chapter on lead
poisoning in the potteries, namely, that the number of men employed
in this work in the course of a year is undoubtedly greater than
1,012 because helpers drop out frequently and ennmelers leave work
when they are incapacitated or frightened by illness; and, also, that
the number of men poisoned is probably larger than 309, for even
with the best of efforts discovery of all the cases can not be expected.
This is shown in the fact that the number for two years, 1910 and 1911,
is not nearly double the number for the single year 1911 ; yet lead
poisoning is probably not on the increase. The large number of cases
in 1911 simply means that these were still in the memory of physi-
cians or still at work in the plant, while some of those who had been
ill in 1910 had gone away and been forgotten. It is probable that a
number double that for 1911, or 434, would be nearer the truth for the
two years than 309. The difficulty in tracing these older cases was
especially great in Chicago and Pittsburgh, with their large pro-
portion of shifting foreign workpeople with unfamiliar names. In
smaller towns, with American workmen, the names of workpeople
are fairly well remembered.
INTENSIVE STUDY OF 148 MEN.
If the most rigid standard be applied to the table given above, and
only those cases accepted which were obtained from the records of
physicians and hospitals, we should still have 121 in a force of 1,012,
or one man for every eight or nine emploj^ed. It seems impossible,
however, that the number should be as low as that, for it has been
made evident that all the cases occurring in a given year could not
Digitized by VjOOQ IC
60 BULLETIN OF THE BUREAU OP LABOR.
be brought to light by the methods outlined above. That the num-
ber is below the truth, that those physicians come nearer to it who
assert that one man in every three is poisoned by the lead, would ap-
pear from the results of a physical examination and an examination
of the histories of 148 men who at the time this investigation was
made happened to be out on strike. These men were not acutely
sick and they had all been at work up to a few days before the ex-
amination. They were Slavs, many of them powerfully built peas-
ants, and they were employed in two factories, one of which was un-
usually dusty while the other was said to be fairly clean.
In making the diagnosis of chronic lead poisoning no one symptom
can be taken as positively characteristic. The diagnosis must depend
upon a combination of symptoms and physical signs, together with
the fact that the man's occupation has exposed him to lead. The
detection of granular changes in the red blood cells is looked on as a
great help in diagnosis by most German authorities, but Oliver, the
English authority, does not find this test of value, and Biondi, an
Italian authority on blood, says that it helps in the diagnosis when it
is present, but that its absence can not be taken as a proof against
lead poisoning. Oliver and certain German writers advise the search |
for lead in the urine ; other Germans say that its presence is not con- \
stant enough to make this a trustworthy test.
As for the symptoms which constitute a picture of chronic lead
poisoning, the following are given by the principal modern authori-
ties: R. V. Jacksch says: "In typical cases, in spite of the variety
of the symptoms, diagnosis is always easy. The presence of the lead
line in a man working in lead and a history of colic makes it cer-
tain."^ As symptoms he gives various disturbances of digestion,
sense of oppression in the stomach, vomiting, loss of appetite, metallic
taste in the mouth, anemia.
Oliver describes the symptoms as pallor and sallowness, with me-
tallic taste, especially in the morning, and says : " If the distaste for
food is increasing, the individual should retire or be suspended from
work, for it is one of the earliest indications of the resistance to lead
having become diminished. There may also be complaint of a feel-
ing of sickness and a tendency to vomit. Obstinate constipation and
a sense of tiredness out of proportion to the amount of energy ex-
pended are also complained of." *
Laureck* says that if a lead worker whose digestion has been good
begins to suffer from chronic loss of appetite, more or less coated
tongue, disagreeable sweet taste, foul breath, eructation of gas, and
general lassitude, one would seldom go wrong in making the diag-
iNothnagel's Spezlelle Pathologic und Theraple, Vol. I. 1010. p. 194.
sRuIlotin of the United States Bureau of Labor, No. 95, p. 9S.