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THE LIBRARY

OF

THE UNIVERSITY
OF CALIFORNIA

LOS ANGELES

GIFT OF

Perigord



'hi



THE NEW LIBRARY OF MEDICINE

EDITED BY C. W. SALEEBY, M.D., F.R.S.E.



DISEASES OF OCCUPATION



DISEASES
OF OCCUPATION

FROM THE LEGISLATIVE, SOCIAL, AND
MEDICAL POINTS OF VIEW



BY

SIR THOMAS OLIVER

M.A., M.D., LL.D., D.Sc., F.R.C.P.

CONSULTING PHYSICIAN, ROYAL VICTORIA INFIRMARY, NEWCASTLE-UPOK-TYNE ;

PROFESSOR OF THE PRINCIPLES AND PRACTICE OF MEDICINE,

DURHAM UNIVERSITY



WITH SIX ILLUSTRATIONS



THIRD EDITION, REVISED



METHUEN & CO. LTD.

36 ESSEX STREET W.C.

LONDON



Firtt Published tfarck

Second Edition September

Third Edition, Reviled . . Pfftrtmfor



rv




PREFACE TO THE FIRST EDITION

IN " Diseases of Occupation " I have endeavoured to place
before the general and professional reader important
facts dealing with the effects of industries upon health. The
subject is one which within the last few years has attracted,
and in the future is still likely to attract, considerable
attention. The health of the nation must be viewed from
all standpoints, and as the working-classes form the largest
proportion of the population the conditions under which they
labour call for thoughtful study. I am hopeful that this
book will prove useful to Members of Parliament, to all
persons interested in schemes for social betterment, to
medical officers of health, and to members of the medical
profession generally.

To the authorities at the Home Office and especially to
Dr. Whitelegge and Dr. T. M. Legge I take this opportunity
of acknowledging the great assistance I have received from
the Annual Reports of the Chief Inspector of Factories. My
thanks are due to M. Le Clerc de Pulligny, of the Ministere
du Travail, Paris, for his unvarying kindness and his genial
companionship in my visits to French factories ; also to Mr.
I. H. L. Van Deinse, of the Netherlands Factory Department,
and to Dr. G. Waller, of Amsterdam. To Professor Bedson
and Mr. Belger, of the Armstrong College, Newcastle-upon-
Tyne, and to Drs. R. A. Bolam and Alfred Parkin I am
indebted for help always cordially given.

THOMAS OLIVER

ELLISON PLACE

N EWCASTLE-UPON-TYNE



PREFACE TO THE THIRD EDITION

THE increasing interest taken in the subject of in-
dustrial diseases, the attention given to it by legislative
bodies of all countries, the introduction of new methods of
manufacture and development of new industries, also the
part which the war has played in dislocating occupations,
are a reasonable excuse for the publication of a new edition
of " Diseases of Occupation." The war has not only stimu-
lated the inventive faculty of man but has created fresh
social conditions, the effects of which may be far-reaching.
The prompt response of women to the call of our nation's
needs, and the manner in which they have undertaken all
kinds of work hitherto denied them (and for which they
were frequently thought to be unfitted), have wrung from
the opposite sex expressions of appreciation and an acknow-
ledgment of the value of the services rendered. What the
ultimate effect of the hard labour and long hours upon
young female munition and factory workers will be it is
impossible to say. To any one who regards home as the
true vocation of women the problem of the present-day
employment of female labour is a matter for careful con-
sideration. It will be a misfortune if, as a result of the long
shifts and the fatigue to which our young womanhood has
been exposed during these last two years, future generations
should suffer. It is just possible that our worst anticipations
in this respect may never be realized. There is little doubt,
when the war is over, that, as a consequence of the excite-
ment, the high wages received, and the freedom which has
been recently enjoyed, home life to many women will be
unattractive and domestic restraint extremely trying. There
is, however, an elasticity in the female character which must



PREFACE TO THE THIRD EDITION v

not be lost sight of. Just as women rose to a nation's
call of service, so may they again equally respond to the
domestic call of duty. At any rate, whatever may follow,
the claims of womanhood to higher recognition can no longer
be ignored. In the future a larger amount of female labour
will be employed, and opportunities given to women which
have hitherto been denied them.

As it is to be devoutly hoped that Great Britain will
never again allow herself to be so unprepared for war as
she was at the commencement of the present crisis, and as
military and naval requirements are bound to play a larger
part in our national life than hitherto, considerable space
has been allotted in the text to a consideration of some of
the occupational circumstances under which the needs of
these services may be met. To munition work, therefore, a
special chapter has been devoted.

It would have been a pleasure to me to have recast
several of the pages of the text, but this has been impossible
owing to pressure of work. My readers must therefore bear
with me in what may sometimes seem a faulty arrangement
and an uneven distribution of the material contained in the
book.

THOMAS OLIVER
NEWCASTLE-UPON-TYNE
September 1916



CONTENTS

CHAPTER PAGE

INTRODUCTORY . . . . . ix

I. FACTORS CONTRIBUTING TO INDUSTRIAL DISEASES

AND ACCIDENTS . . . i

II. DISEASES DUE TO GASES, VAPOURS, HIGH TEM-
PERATURES, ETC. . . . 54

III. DISEASES DUE TO WORKING IN CAISSONS AND

COMPRESSED AIR . . .88

IV. DISEASES DUE TO DIMINISHED ATMOSPHERIC PRES-

SURE ...... 115

V. CHEMICAL TRADES . . ' .120

VI. EXPLOSIVES AND THE EFFECTS UPON HEALTH BY

THE GASES EVOLVED . . . .130

VII. DISEASES DUE TO METALLIC POISONS, DUST,

FUMES, ETC. ..... 137

VIII. DISEASES DUE TO METALLIC POISONS, DUST,

FUMES, ETC. (Continued) . . .216

IX. DISEASES DUE TO ORGANIC AND INORGANIC DUST,

HEATED ATMOSPHERE, ETC. . . .242

X. MINING ...... 267

XI, DISEASES DUE TO PARASITES AND MICRO-ORGAN-
ISMS ...... 312

vii



viii DISEASES OF OCCUPATION

CHAPTER PAGE

XII. DANGERS ATTENDANT UPON THE GENERATION AND

USES OF ELECTRICITY AND ELECTRIC WELDING 347

XIII. DISEASES THE CONSEQUENCE OF FATIGUE; OCCU-

PATION NEUROSES .... 358

XIV. DISEASES IN MISCELLANEOUS TRADES AND OCCU-

PATIONS ...... 366

XV. SOLDIERS, SAILORS, FISHERMEN, AND MINOR OCCU-
PATIONS ...... 393

XVI. RESCUE WORK IN MINES .... 400

ADDENDA

NOTES ...... 413

MISCELLANEOUS CONDITIONS AFFECTING THE

LIFE AND HEALTH OF WORKERS . .429

MUNITIONS MAKING .... 444

TRICHLORETHYLENE .... 449

METALLIC POISONS .... 453

INDEX ....... 461



LIST OF ILLUSTRATIONS

PIG. FAGB

1. ANKYLOSTOMA DUODENALE (HUMAN, NATURAL SIZE) 322

2. (HUMAN, x 12 DIAMS.) . 322

3. (HUMAN, CONJUGATION,

x 7 DIAMS.) . 322

4. ANKYLOSTOMA CAN INUM (OVA OF, x 200 DIAMETERS). 322

5. (LARVA OF, x 300 DIAMS.) . 322
(Proc. Royal Society, Edin., Vol. xxv., Pt. ix. T. OLIVER)

6. DOUBLE ELECTRICAL BATH . . . -437



INTRODUCTORY



THE subject of Diseases of Occupation is so intimately
associated with the operation of the factory laws, that
in order to study the one we must know something of the
other. Factory legislation has been in the main devised to
protect the health of the workpeople and to safeguard their
interests.

It is a far cry from 1802, the date of the rise of factory
legislation in this country, to the passing of the Workmen's
Compensation Act in 1906. Within these years are included
all that is known of factory legislation and what it has accom-
plished. Before the dawn of the eighteenth century the
Industrial Revolution had already altered the conditions of
life and labour in Great Britain. The substitution of steam
for water power further changed those conditions, so that the
health of the workpeople necessarily became a matter of
State concern and State control. Labour flocked to where
machinery was most active. Since then may be dated the
rise of modern towns and the depletion of rural areas. It
was soon found that machinery could be worked by young
and, comparatively speaking, unskilled hands, hence came
the demand for women's and children's labour. Factory legis-
lation at its inception was in the main concerned with those
who could not take care of themselves. The exploitation of
child labour is a harrowing story, and one of the dark spots
on the page of the industrial history of our country. It is to
the credit of Great Britain that she was the first to move in

iz



x DISEASES OF OCCUPATION

the matter, and thus became the pioneer of industrial legisla-
tion. Since then decade after decade has witnessed a succes-
sion of Factory Acts and Labour Laws based upon experience
and necessity. It might have been expected that at the end
of a century of experience and progress industrial evolution
would have reached such a degree of excellence and attained
to such a standard of hygienic perfection that little more
would require to be done. Not so, however, for the subject
is endless. Each succeeding decade brings its own problems
for solution, and each new invention imposes its own special
trials upon producers. Child labour was fostered by parental
greed and poverty, and was encouraged by employers.
Although Great Britain has, practically speaking, abolished
the iniquity, child labour still lingers in several of our home
industries, and is not unknown in other countries. It is only
within the last quarter of a century (1886), for example, that
the first Factory Act was passed in the State of New York.
There, as here, factory legislation began with child labour
and female labour questions, and the compelling agents were
the working men's trades unions and philanthropic societies.
The reproach is sometimes levelled at trades unions that
their interference with children's and women's labour has not
been altogether disinterested, since by raising the age for
commencing work they have diminished the numbers of
children employed, and by checking female labour they have
kept up the standard of wages and given more work to men.
In the United States there is a greater tendency to bring
labour questions within the range of politics than in Great
Britain. Organised labour and capital have more power
there than here. By the Factory Act of 1 886 no child was
allowed to work in New York State under thirteen years of
age ; since then the minimum age has been raised to four-
teen. The drawbacks to child labour are that children are
deprived of leisure and freedom in the open air, and are sub-
jected to a monotonous life when they ought to have variety.
The physical effects are those of degeneracy, as seen in
stunted growth and impaired nutrition, while of the moral
effects illiteracy and its consequences are the more imme-
diately apparent.



INTRODUCTORY xi

Factory legislation has been a gradual restriction of the
freedom of the individual and of his subjection to State
control. The events which stand out prominently in the
industrial legislation of last century are, in addition to the
curtailment of children's and women's labour, shortening of
the hours, improvement of the conditions under which labour
generally is carried on, hygiene of dangerous trades, restric-
tion of the power of employers, and the transference of this
power to organised labour. In factory work individualism is
subordinated to general requirements. Theoretically there
is nothing to prevent a man in his individual capacity work-
ing as long as he chooses, but there is no place for such
personal action in the corporate life of a factory. The con-
ditions do not admit of this. It is not maintained, for
example, that by working longer than eight hours a day a
man's health is injured, for experience proves the contrary,
but it is held that no employer has the right to utilise the
whole of the working part of a man's day, and thus deprive
him of the leisure to which he as a human being is entitled.
Since his whole nature has to be developed, it is claimed that
the intellectual, moral, and physical powers of man cannot be
developed if the hours of employment are too long, the work
too hard and of a grinding nature. Nor must the hours of
labour be the same for all trades. There are some, such as
the textile industries, work in shipbuilding yards and iron
works, coal mining, and several artisan trades, in regard to
which a common basis of agreement can be arrived at as to
whether the number of hours of work should be eight or nine.
In trades that are dangerous to health the hours should not
be long ; and in the textile industries as the speed of
machinery is quickened and the nervous tension upon the
worker becomes greater the hours of labour should be
proportionally reduced.

Shortening of the hours of work per day and the Saturday
afternoon holiday have given the working classes more
leisure, while improved conditions of labour in factories,
fencing of machinery and hoists, abolition of night work for
women and children, better provision of sanitary conveniences
for the workers, and better education generally have done



xii DISEASES OF OCCUPATION

much to raise the working classes to a higher platform of
comfort as well as to one of discontent. It was apparent
that the conditions of labour that prevailed before the
passing of the first Factory Act could not be allowed to
continue. There was a waste of human life which had to be
checked and a physical degeneracy and ignorance which had
to be stopped. No tongue can tell the saving of human life
that has been effected by the Factory Acts. At present each
fatal accident is carefully investigated, and the circumstances
attendant upon each death in a trade believed to be dangerous
to health are carefully sifted so that further fatalities may
be averted. These precautionary methods have only been
arrived at as a result of the death of many poor and
unknown men and women whose lives were sacrificed that
the life of others might be saved.

Industrial problems in their medical aspect not only con-
cern society, in many instances they control the future of
the race, as witness the employment of women during preg-
nancy and after confinement, also the baneful effects of lead
upon motherhood. All work should ennoble, and yet there
are certain trades that tend more to degrade man than raise
him, as witness the work of the iron puddler. The cheerless
days, too, spent in a textile factory amid the din of
machinery, and the monotonous character of the work, are
not such as of themselves to quicken the intellect and pro-
mote the higher interests of life. Is it not rather that they
tend, through the strain they cause, to encourage a craving
for that form of recreation which seeks an outlet in excite-
ment and pleasure, and, on the other hand, to dishearten
men and women who, as factory operatives, feel that they
cannot rise to a higher occupation than that of minding
machinery? The despotism of some branches of modern
labour is overpowering. Factory legislation has done some-
thing to minimise this. The present age is marked by social,
benevolent, and parliamentary schemes which are meant to
dispense industrial justice and to provide greater personal
opportunities. To be of helpful service factory legislation
must be progressive and keep pace with the industrial
problems special to each succeeding age.



INTRODUCTORY xiii

The Rise and Progress of the Factory System

The Peel Act of 1802 was passed to preserve the health
and morals of apprentices and others employed in " cotton
and other mills and factories " ; the rooms of the factories
were to be washed with quicklime and water twice a year,
night work was prohibited, the hours of work were to be
twelve per day, the apprentices were to be instructed in
reading, writing, and arithmetic every working day for the
first four years, and in the principles of the Christian religion
on Sunday. The factories and mills were to be visited by a
justice of the peace and by a clergyman. Although not a
Factory Act in the usual acceptation of the term, but simply
an extension of the Elizabethan Poor Law relating to parish
apprentices, and therefore likely to fall short of the actual
requirements of the time, it was something to have succeeded
in getting a few of the principles of factory legislation recog-
nised, such as the limitation of the hours of work. The Bill
passed without serious opposition from the manufacturers.
It was otherwise when, later on, fresh factory legislation was
attempted. In 1816, on Sir Robert Peel's proposition, Par-
liament caused an inquiry to be made into the condition of
the factory population, and three years afterwards powers
were conceded to the Government to limit the age at which
children should be admitted into factories. When in 1833
Lord Ashley inaugurated the industrial and social reforms
with which his name is associated, and by which it was
sought to limit the working hours of children under thirteen
to eight hours a day^ 1 and girls under eighteen to twelve
hours a day, employers and several members of the House of
Commons urged that Parliament was exceeding its duty in
attempting to restrict the hours of labour. At this period
the infant death-rate was high. One half of the children
born in Manchester died under three years of age, and in
factory towns the youthful population was physically worn
out before manhood. Four inspectors had been appointed to
see that the factory laws were obeyed throughout the country.
Power was given to these Government officials to enter fac-
tories at any hour and to examine the workers. The employ-



xiv DISEASES OF OCCUPATION

ment of children under eight years of age was prohibited, and
women's labour restricted by the 1844 Act. The following
year witnessed the passing of Lord Ashley's Print Works Act.
A demand for shorter hours of labour was also raised. In
1847 the Ten Hours' Bill was passed, and by it the working
time for women and children was restricted to ten hours a
day ; it was also arranged that the working day was to be
the period between 5.30 a.m. and 8 p.m. In 1854 the fencing
of all shafts was made a requirement, but not without con-
siderable opposition from a section of employers. The Act
of 1853 limited the working time for children to the period
between 6 a.m. and 6 p.m. In 1864 certain trades were
scheduled as unhealthy, and regulations were issued bearing
upon ventilation. Under the 1864 Act were included
earthenware and other manufactures. Removal of dust by
fans was required by the Act of 1867 both in factories and
workshops. Three years later bleaching and dye works were
brought within factory law. The Act of 1878 forbade chil-
dren to work in certain processes of white lead manufacture.
This was the first Consolidating Act. It was passed after an
exhaustive inquiry by a Royal Commission, and was followed
by a series of Amending Acts : that of 1883, in which were
embodied Special Rules for white lead factories and bake-
houses ; of 1891, in which were included Special Rules for
dangerous trades, notification of accidents, and the abolition
of the employment of children under eleven years of age ; of
1895, whereby laundries were brought within the sphere of
factory inspection, and rules were made applicable to docks ;
while the Act of 1897 dealt mainly with cotton, cloth, and
other factories.

Until 1891 workshops had not been included under all
the provisions of the Factory Acts ; the difference between
the two places lay in the use of motive power in factories.
The Factory Act of 1891 repealed the special exemption
enjoyed by women's workshops and extended sanitary
regulations to workshops in which only adult men are
employed. The main "design and object" of this Bill
"was to bring all workshops and factories up to the same
sanitary level." To local sanitary authorities was entrusted



INTRODUCTORY xv

the supervision of the sanitary condition of the workshops,
and although to give this effect special inspectors of work-
shops for certain large towns were appointed it cannot be
said that the dual control was an unqualified success, owing
to the fact that local authorities too frequently shirked
their responsibilities. By the Act of 1901 increased powers
were given to local authorities, and medical officers of health
were called upon to keep registers of the workshops in their
districts and to report upon them annually.

It is required by the factory laws that all dangerous
machinery shall be fenced, safety valves and steam gauges
be provided on steam boilers, that boilers be examined by
an expert and reported upon once in every fourteen months,
and that no machinery in a factory shall be cleaned by a
child when the machinery is in motion, nor shall a young
person clean any dangerous part of mill gearing. Women
are also forbidden to clean mill gearing while the machinery
is in motion. Fire escapes must be provided. At present
no child under twelve can be employed in a factory or
workshop. The Act of 1878 allowed children to be employed
at the age of ten ; the Act of 1891 raised the age to eleven;
and now no child can be employed under twelve. To the
Home Secretary has' been given greater power for the
regulation of dangerous trades. In Great Britain Sunday
employment is forbidden.

The last decade of the nineteenth century and the com-
mencement of the present have been marked by the appoint-
ment of several Departmental Committees of the Home
Office. As I had the honour and the privilege of sitting as
a member on a few of the Committees appointed to inquire
into the effect of certain industries upon the health of the
workpeople, to that circumstance and to the experience
gained as a hospital physician must be attributed the raison
d'etre of this contribution to the subject of factory legisla-
tion and occupation diseases.

The work of the Factory Department of the Home Office
has enormously increased within the last few years, and
recent legislation tends still further to increase it. Beginning
with four factory inspectors in 1833 there are now upwards



xvi DISEASES OF OCCUPATION

of 170 all told in the department. The appointment of
special inspectors has been most useful. It is only within
recent years that female inspectors have been employed, but
the excellent work done by the Principal Lady Inspector of
Factories and her staff of ladies has more than justified the
creation of this particular section of the department.

Into the details of the Workmen's Compensation Act of
1906, which is an extension of the Act of 1897, I do not
propose to enter. In this country industrial legislation is
based upon experience and expediency, so that no sooner is an
Act in operation than its weak points become apparent and
a fresh Act is required to remedy defects and remove flaws,
but it too generally ends in introducing controversial matter
and in providing employment to lawyers and doctors. The
Workmen's Compensation Act of 1906 repeals the Acts of
1897 and 1900, and it extends the principle of compensation
to all classes of persons engaged under contracts of service,
including domestic servants and sailors. In addition, by
including certain defined trades, it makes employers liable to
pay compensation for diseases arising out of and in the
course of employment By a " workman " is meant " any
person who has entered into a works under a contract of
service or apprenticeship with an employer, whether by way
of manual labour, clerical work, or otherwise, and whether
the contract is expressed or implied, is oral or in writing."
Certain persons are outside the Act, e.g. t policemen, persons
in the naval and military services, profit-sharing fishermen,
non-manual workers whose remuneration exceeds 250 a
year, and others. The Act is comprehensive and includes
most trades and lowly-paid members of professions, among
which are mentioned house-surgeons and hospital nurses.
It also includes certain industrial diseases, the consequences
of which may be immediate or remote and which are often
more severe than accidents. A workman is entitled to com-
pensation if he is incapacitated by a disease contracted in his
trade and due to his employment exactly in the same way as
if he had been thrown hors de combat by an accident. The
following have been scheduled : Poisoning by nitro- and
amido-derivatives of benzene or its sequelae, carbon bisulphide



INTRODUCTORY xvii

or its sequelae, nitrous fumes or sequelae, nickel carbonyl
or sequelae, arsenic poisoning or sequelae, lead poisoning,
African boxwood or sequelae, chrome ulceration or sequelae,
ulcerations produced by dust or caustic or corrosive liquids,



Online LibraryThomas OliverDiseases of occupation from the legislative, social, and medical points of view → online text (page 1 of 45)