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Medical Supervision of the Coal Tar Industries. By Dr. F. G. Mohlau, Buffalo, N. Y.

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Conserving Nervous Energy. By Edwin F. Bowers, M. D., New York City..
Iron Carbonate Mineral Waters Without Excess of Carbonic Acid.
Felix von Oefele, New York City...

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BUFFALO MEDICAL JOURNAL

Yearly Volume 74

OCTOBER, 1918

Number 3

ORIGINAL ARTICLES

The right is reserved to decline papers not dealing with practical medical and surgical subjects, and such as might offend or fail to interest readers. Contributors are solely responsible for opinions, methods of expression and revision of proof.

Medical Supervision of the Coal Tar Industries.

By DR. F. G. MÖHLAU, Buffalo, N. Y.

Protection of health of the working men engaged in the manufacture of Coal Tar Products is the most important problem facing the management of the Chemical Industries. The health of the worker naturally is a great asset to the successful maintenance of equilibrium.

It must be remembered that the Coal Tar industry is, comparatively speaking, a new one in this country, and the welfare of the worker must be scrupulously guarded along the most approved lines compatible with factory administration. The greatest care must be taken in introducing reforms and changes to obtain maximum results and reduce expense.

Health is the primary factor for the efficient performance of the working man's duties. Sickness decreases the worker's efficiency and production, and increases the risk of accidents in the various departments. An epidemic can disorganize a department, even the whole force of the factory. We have to consider outside influences, (environment, fatigue, accident), and inside influences (disease and defects).

Surroundings in factory work, such as light, ventilation and dust, influence the efficiency of the workers to a great extent, and to this may be added humidity and heat, also cold and drought.

In all human, or, broadly speaking, muscular activity, carbon dioxid is produced. With hard work, double the amount is produced and thrown off with the expired air. Toxic proteins are also thrown off of the working body. These toxic products are the odors we sense in an illventilated (close) room. The headache, tired feelings, lassitude and malaise experienced in close surroundings, we must

attribute to heat and humidity rather than to the inspiring of waste products. The effect of heat and moisture on the skin we must consider as the determining cause of discomfort. From these facts we gather that the working quarters must have a free circulation of fresh air, also that the humidity of the air surrounding the worker must be within certain limits in working quarters. It should have not more than six per 10,000 parts of CO2, the temperature should not rise. above 68° F, and the humidity should not be higher than 72 wet bulb.

Good light is not only a prima facie factor in the health of the workman, but also in the efficiency of his work. General semi-direct illumination supplemented where necessary by individual shaded lights probably gives best results. Each worker, or group of workers, can thus regulate the light supply. The light should fall on the work and not on the workers' eyes. Thus, three dangers would and should be avoided: (1) over-illumination, which is liable to cause irritation of the retina or contracted iris, (2) under-illumination, causing eye strain, (3) reflected light on bright surface or colors tends to confuse and produce effects of over-illumination. Poor illumination, besides injuring the worker, reduces output and increases the number of accidents.

Fatigue should be carefully guarded against as it decreases capacity for work, and follows excess of work or lack of rest. No subject that has to do with industrial health has received more thought and attention than industrial fatigue. Especially since the beginning of the war the question of fatigue has found serious consideration by the ministers of war munitions all over Europe. From a physiological standpoint, we have for instance the poisons produced by the contraction of the muscular fibres, especially the voluntary muscles, the changes of glycogen in the muscles, and the consumption of the stored-up glycogen in the muscles and liver. Even physiologically these substances are of an acid reaction due to carbon dioxid and sarcolactic acid. These are the factors producing fatigue, not only causing a tired feeling in the muscle, but also in the nerves and nerve centers. These waste products are eliminated slowly or gradually during the period of rest which, naturally, is necessary for the repair of body waste, and for this reason it must be understood that rest during the working days is necessary. If sufficient rest is not allowed a deficit is the result and we must consider this an injury to the working power of the following days. The strain of the work done after such symptoms are manifest, not only requires more effort, but also results in defective production. The effort increases, but still you must acknowledge that during such conditions the working man

accomplishes less. Over-work must be guarded against. Yo must also consider that over-work, where fatigue is manifest, increases the danger of accident, and is the starting point of impairment of health.

As the type of work varies in different departments, the physical condition of each man is varying, and so will the efforts put forth vary and increase or diminish the working power.

Considering accidents, we always claim that they are largely due to carelessness on the part of the working man. But, while a great percentage of accidents are caused by carelessness, we must admit that in coal tar industry they are due to the complexity of the work rather as compared with the worker's ability and knowledge. The continuation of the work of any man we must consider as defective until he has completely recovered of such an accident. The proportion of accidents due to sickness or physical defects is generally considered rather low as records here will show. All accidents, no matter how minute, should therefore be treated by able assistance; injuries in any way serious should be attended by a trained surgeon. By prompt and efficient treatment is meant that the workman should be taken care of within at least thirty minutes of such injury.

Physical defects are an aggravating factor against health and a cause of accidents if the worker is not properly placed. A defective worker is not by any means an inefficient worker, and inefficiency only occurs when the physical defect interfers with the power of producing a normal output, especially by fatigue and discomfort. Defective workers are very often the best workers in certain departments, but they will not remain so unless properly supervised.

Sickness is prevalent among a large percentage of workers, is most marked during changeable weather or high temperature, and is an important factor in the loss of time. We can safely state that 2% of all working men at one time or another are absent on account of sickness. These conditions should most seriously be guarded against and all efforts should be made for the protection of the health of the working man. Absentees from work naturally decrease the output.

Considering the foregoing factors which control the health of the worker, it is evident that the responsibility for the workers' health falls on four men: the engineer of the plant, the safety engineer, the manager of the works, and the factory surgeon.

1. The engineer of the plant controls the external factors of environment.

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