INDUSTRIAL HYGIENE PROBLEMS 
in 
BOLIVIA, PERU and CHILE 
Federal Security Agency 
PUBLIC HEALTH SERVICE INDUSTRIAL HYGIENE PROBLEMS 
in 
BOLIVIA, PERU and CHILE 
J. J. BLOOMFIELD 
SANITARY ENGINEER DIRECTOR 
Assistant Chief 
DIVISION OF INDUSTRIAL HYGIENE 
BUREAU OF STATES SERVICES 
PUBLIC HEALTH 
BULLETIN N0.301 
PREPARED BY DIRECTION OF THE SURGEON GENERAL 
Federal Security Agency • public health service 
PUBLIC HEALTH SERVICE UNITED STATES 
GOVERNMENT PRINTING OFFICE 
WASHINGTON : 1948 
For sale by the Superintendent of Documents, Washington, D. C. Price 40^ Contents 
Page 
Preface V 
Acknowledgments VI 
I. Introduction 1 
Activities of health and sanitation division, lIAA 1 
Content of reports 5 
11. Method of study . 6 
111. General information 8 
Economic resources 8 
Population 11 
Income 12 
Housing and living conditions 14 
Education 19 
Community health and sanitation 21 
Summary 24 
IV. Health in industry 25 
Gainfully employed 25 
Industries surveyed 27 
Occupational hazards 29 
Mines 29 
Manufacturing industries 39 
Occupational diseases 42 
Safety provisions 49 
Sanitation facilities 52 
Medical services 56 
Sickness benefits 61 
III V. Current activities concerned with industrial hygiene 66 
Official agencies 66 
Nonofficial agencies 
VI. Summary 
VII. Recommendations 78 
Bolivia 70 
Peru 80 
Chile - 82 
Appendix I B,°’ 
Appendix II 8^ 
Appendix 111 88 
IV Preface 
The United States for many years has been active in the conduct of 
industrial hygiene activities. Many visitors come from foreign shores 
every year to study American practices, both in industry and govern- 
ment. Our close working relationships with our South American 
neighbors have enabled us to render a further service to them in the 
detail of staff personnel, and the following report describes the studies 
of Sanitary Engineer Director J. J. Bloomfield, Assistant Chief of the 
Division of Industrial Hygiene, Public Health Service, in Bolivia, 
Peru, and Chile. The studies were undertaken, and the recommenda- 
tions made, at the request of the governments of these countries under 
the auspices of the Institute of Inter-American Affairs. 
This report does not purport to be a typical industrial hygiene study, 
establishing principles and recommendations that may be equally 
applicable elsewhere. It includes a wide sweep of considerations— 
such as various socioeconomic factors—which an industrial hygiene 
study per se normally would not encompass. It also ventures into fields 
outside of the province of the Public Health Service. The promulgation 
and enforcement of codes, such as that drawn up for Bolivia, for 
instance, is traditionally a function of departments of labor or indus- 
trial commissions in the United States. 
Faced with the task of developing effective industrial hygiene pro- 
grams in Bolivia, Pern, and Chile, our consultant considered all factors 
and measures which were required to formulate a meaningful whole. 
Because of the critical prevalence of disease in these countries, for 
example, any efforts directed at improving the working environment 
without looking at the community scene would have been doomed to 
sterility. It must therefore he borne in mind that this unusually 
comprehensive study does not set up a model program for general use 
but is rather intended to cover only the situations in Bolivia, Peru, 
and Chile. Based on a thorough investigation of all aspects of indus- 
trial life in those countries, it represents an effort to help them develop 
their rich natural resources by promoting and preserving a most vital 
asset, the health of their working people. 
J. G. Townsend, Medical Director, 
C7'ief. Division of Industrial Hygiene, Public Health Service 
V Acknowledgments 
Grateful acknowledgment is made to the Health and Sanitation 
Division of the Institute of Inter-American Affairs, under whose 
auspices these industrial hygiene studies originally were made possible. 
We are also indebted to government officials in Bolivia, Peru, and 
Chile for their cooperation in the conduct of the survey and to manage- 
ment officials for making their facilities available as study subjects. 
Invaluable assistance toward the completion of this work was con- 
tributed by Public Health Analyst Victoria Trasko, of the Division of 
Industrial Hygiene, Public Health Service, who made the statistical 
analyses of the survey data and prepared the tabulations, and by staff 
Information Specialists Prances Balgley and Tula Salpas, who aided 
in the editing, organizing, and presentation of the report. 
VI I. Introduction 
Unlike the feverish exploitation of the Klondike, the development 
of South America’s rich natural resources has been marked by a slow, 
steady tempo. Through centuries of effort, it has achieved distinction 
in certain fields, but some of its economic possibilities still lie dormant, 
while others are just now being aroused from their lethargy. 
This pace is mirrored in the debilitated activity of its workers, for 
the serious prevalence of disease saps them of vitality and productivity. 
Another factor to which this low-gear development schedule is in part 
attributable is the lack of a vigorous immigration program. Immigra- 
tion, which pumps fresh blood into a nation’s lifeline, consists of a 
mere trickle in Bolivia, Peru, and Chile. Both these factors militate 
against the full tapping of the vast store of natural resources in the 
three countries. The lack of an adequate public health program par- 
ticularly impedes progress. Only by a betterment of general living 
conditions will their productive capacity and purchasing power 
increase. 
Toward this end, studies of industrial hygiene problems and con- 
ditions were undertaken at the request of the governments of Bolivia, 
Peru, and Chile to recommend ways and means of ameliorating the 
health status of workers. Since these studies—and the resultant recom- 
mendations—were made possible under the auspices of the Division of 
Health and Sanitation of the Institute of Inter-American Affairs, a brief 
description of the origin and work of this division is indicated. 
ACTIVITIES OF THE DIVISION OF HEALTH 
AND SANITATION, lIAA 
The health and sanitation program of the Institute of Inter- 
American Affairs, a Federal agency of the United States, was born in 
Rio de Janeiro in January 1942, at the Third Meeting of the Ministers 
of Foreign Affairs for the American Republics. It sprang out of 
resolutions that health and sanitary measures were basic to mobiliza- 
tion activities. The program has transcended the war period, however, 
because its functions are equally vital in time of peace, and health 
1 and sanitation work is now being carried out in 14 Latin-American 
countries by the governments of those countries and of the United 
States. 
Under the aegis of this program, hospitals, health centers, water 
supply and sewerage systems, and other health and sanitary facilities 
have been constructed. Numerous projects have been undertaken in 
preventive medicine against major disease problems. 
In the industrial hygiene field, however, the only activity up to 
1947 was found in Bolivia. This program was precipitated by a series 
of studies undertaken by the United States at the request of the 
Bolivian Government. A discussion of the program will be found in 
the following section. 
Bolivia 
The deleterious effect of poor health on production in Bolivia was 
brought out forcefully during the early part of World War 11. As 
Bolivia was—and still is—the only source of tin available to the United 
States and the Allies, we were vitally concerned with her production 
schedules. It was soon realized that these schedules were seriously 
hampered by the poor health of Bolivian workers and the unsafe and 
insanitary conditions under which they worked and lived. 
The exigency of war, however, placed prime stress on financial and 
technical considerations in the production of strategic materials. 
Attention to the health factor was relegated to a later time, when the 
Bolivian Government requested the United States to undertake a series 
of studies with regard to health, sanitation, and other aspects of 
Bolivian mining. These studies resulted in the inauguration on October 
1, 1945, of a joint labor program, scheduled to operate for 2 years. 
The program was integrated into the regular public health program 
operated jointly by the Bolivian Government and the Division of 
Health and Sanitation of the Institute of Inter-American Affairs. This 
cooperative health service is known as the Servicio Cooperativo Inter- 
Americano de Salud Publica, or SCISP. The agreement with regard 
to the labor program had as its objectives (1) the development of 
industrial hygiene and safety in Bolivian industry; (2) the establish- 
ment of an employment service; (3) the establishment of a labor 
statistics system; (4) the development of a labor inspection service; 
and (5) the organization of an actuarial service. These were the same 
objectives as those defined by the joint Bolivian-United States Labor 
Commission (Magruder Commission), which had made the determining 
studies. The only recommendation omitted was that a study of living 
conditions in the mine regions be made. This responsibility was separ- 
ately assigned to a field party operating under flu* regular health and 
sanitation program. 
In accordance with the plans for carrying out this labor program, 
the Institute of Inter-American Affairs had employed several special- 
2 ists. 1 hese included a labor economist, an industrial hygiene engineer, 
a safety engineer, and a labor statistician. In the brief period of a 
year and a half, this small nucleus of specialists, with the help of 
Bolivian technicians whom they trained, has made an excellent start in 
the development of a program to improve the health and safety of 
Bolivian workers. 
Among some of the accomplishments of this small group, the follow- 
ing may be listed: (1) The recruitment and training of personnel. 
Several Bolivians were trained in the United States in industrial 
hygiene and safety and allied fields. These were a physician, an indus- 
tr al hygiene engineer, a safety engineer, a labor inspector, and a labor 
statistician. (2) \ arious mines and factories have been surveyed by 
the Institute of Inter-American Affairs’ field party. The total popula- 
tion in those industries which have been visited to date is slightly more 
than 30,000, As a result of some of these surveys, some recommenda- 
tions for the improvement of health and safety conditions have already 
been made. (3) An industrial hygiene dust laboratory has been estab- 
lished and personnel has been trained in the technique of sampling and 
determining dust. Some of these trainees have been employed by 
mining establishments. (4) Various factory inspection forms have 
been developed. (5) Manuals on industrial hygiene and safety have been 
developed, printed, and distributed widely. (6) Seminars have been 
held for physicians and engineers on health and safety problems. 
(7) Bolivia’s labor laws have been reviewed and abstracted for the 
use of labor inspectors. (8) An employment service manual has been 
prepared. (9) A dictionary of occupational titles for occupations 
common in Bolivia is in process of preparation. (10) A labor statistical 
service is being organized within the Ministry of Labor. 
As the labor program approached its final stages, those responsible 
for it deemed it advisable to have an outside person review its progress 
and accomplishments in the field of industrial hygiene and suggest 
steps which might be taken toward the organization of a permanent 
program to be carried on by the Bolivian Government itself at the 
close of the present cooperative program. At the request of the Insti- 
tute of Inter-American Affairs, the author of this report was assigned 
by the United States Public Health Service as an industrial hygiene 
consultant to the labor program. The Bolivian report is based on 
observations made by the author during the period of February 3 to 
April 16, 1947. 
Perti 
Abundant deposits of oil, coal, iron, and other metals insure broad 
economic horizons for Peru. A rapidly expanding manufacturing 
industry likewise augurs well for the country’s prosperity. The in- 
creasing emphasis on manufacture, however, has trained flu1 floodlight 
of inspection on the welfare of the country’s workers. In this changing 
3 economic order it has become more and more apparent that the full 
utilization of Peru’s capacities is impeded by the low standards of 
living of her people. 
Realizing her problem, Peru, during the last decade, enacted 
progressive social legislation to improve the lot of the worker. Un- 
fortunately, much of the legislation, though well conceived, has suffered 
from lack of adequate implementation. Compulsory sickness insurance, 
old age and death benefits, and workmen’s compensation for accidents 
and occupational diseases have been provided by law for some time, 
but Congress did not enact any legislation for the prevention of indus- 
trial disease until March 12, 1947. On that date, the Department of 
Industrial Hygiene was created by law in the Ministry of Public 
Health and Social Welfare. 
The enabling legislation authorized the Department to: (1) Carry 
on a medical and engineering control program in industry in order to 
minimize and eliminate occupational diseases; (2) conduct research; 
(3) carry on educational campaigns; and (4) promulgate rules and 
regulations for the control and prevention of industrial health hazards. 
(A copy of the law will be found in the appendix.) 
During the first 2 years of its operation, the work of the Department 
must be confined to six political departments: Lima, lea, Junin, Pasco, 
Huanuco, and Huancavelica. Later, if the need is indicated, the 
Department may extend its functions to the entire country. 
Financial support for the Department of Industrial Hygiene comes 
from a levy of 1.8 percent on pay rolls of companies employing more 
than 30 workers. For the present, contributions come from companies 
“which perform work or make use of mineral substances and soils, 
rocks, clays, sands, gravels, cements, as well as industrial processes 
related to the preparation and use of the above substances.” 
Soon after the law was enacted, the Minister of Health and Social 
Welfare invited the author to come to Pern to assist him in studying 
the industrial hygiene problems of the country and in organizing the 
new Department of Industrial Hygiene. On June 16, 1947, under the 
auspices of the Division of Health and Sanitation of the Institute of 
Inter-American Affairs, the author arrived in Lima where he worked 
jointly with the Ministry of Health and Social Welfare, and the 
Servicio Cooperative Inter-Americano de Salud Publica. The Peruvian 
report is based on observations made by the author during the period 
June 17 to August 29, 1947. 
Chile 
Chile enjoys world prominence in natural deposits of sodium nitrate 
and ranks second in copper production. The war, however, has caused 
Chile to look to new manufacturing vistas. This development of manu- 
facturing enterprises was necessitated both to satisfy home consump- 
tion needs and to take up the slack in the nitrate market which was 
4 caused by the production of synthetic nitrates. Chile has also launched 
steel production to help build a more widely industrialized economy, 
and at the same time she is directing parallel efforts at building up the 
health of her workers. 
An invitation was extended to the author early in September 1947 
by the Ministry of Health to study industrial hygiene problems in 
Chile and to devise methods of strengthening existing industrial 
hygiene services. The desired study was conducted under the auspices 
of the Division of Health and Sanitation of the Institute of Inter- 
American Affairs from September 22 to November 10, 1947. 
CONTENT OF REPORTS 
The reports of Bolivia, Peru, and Chile contain information on 
potential health hazards in industry and on methods currently em- 
ployed to deal with such hazards and set forth recommendations for 
the improvement of industrial hygiene practices. They discuss existing 
legislation bearing on industrial hygiene, the functions of agencies 
concerned with the practice of industrial hygiene, and recommenda- 
tions for the strengthening and coordination of such services. For the 
sake of brevity, other pertinent information essential to the adminis- 
tration of an industrial hygiene program is omitted from these reports. 
Such information has been presented separately to those responsible 
for industrial hygiene in the three countries under study. It includes 
rules and regulations for the control of occupational diseases; a manual 
of good practice, which in essence is an interpretation of the rules; a 
set of qualifications for industrial hygiene personnel; and, finally, a 
list of field and laboratory equipment necessary for the conduct of 
industrial hygiene. 
In short, an attempt lias been made to define the industrial hygiene 
problems in Bolivia, Pern, and Chile and to present a definite program 
for their solution. 
5 11. Method of Study 
Several methods may be employed in defining the industrial health 
problems of a locality. The nature and prevalence of industrial health 
hazards may be established either by detailed studies of workers’ 
health and job environments, or by an analysis of occupational mor- 
bidity and mortality statistics. In order to define fhe problem by the first 
method, it is necessary to make extensive studies of the health of the 
workers and the working environments in various industries. This is an 
undertaking of no small magnitude, requiring the services of a staff of 
specialists in the various phases of industrial hygiene. The second 
method is possible only if accurate statistics on occupational morbidity 
and mortality are available. Since conditions in Bolivia and Peru pre- 
cluded the use of either method and insufficient data were available 
in Chile, it was decided to determine fhe nature and extent of indus- 
trial hygiene problems by finding out the number and types of indus- 
tries in each country, the number of persons employed in them, and 
the health hazards to which these workers are exposed. 
Accordingly, a survey of a small number of representative mines 
and manufacturing establishments was conducted, during which special 
survey forms were used to record observations. In brief, the survey 
attempted to obtain information on operations and health hazards in 
the representative working establishments chosen and the control 
methods in use. Information was also obtained on other existing facili- 
ties for coping with these health hazards, such as medical services, 
safety and hygiene services, plant sanitation, and feeding facilities. 
Data were also obtained on labor turnover, housing conditions, schools, 
markets, recreation facilities, and community sanitation. Available 
records on occupational diseases were also obtained. (See appendix I 
for forms used.) 
In Peru it was apparent that those responsible for the enactment 
of the present industrial hygiene law had long been aware of the 
serious health hazards which exist in industry. However, there was no 
one source of information which presented a well-rounded picture of 
these hazards. Scattered information obtained from individual studies 
of silicosis, lead poisoning, industrial physiology at high altitudes, and 
other investigations indicated an extremely high incidence of oceupa- 
6 tional diseases among workers—especially among mine workers. There- 
fore, before the over-all problem could be defined and a solution 
devised, it was necessary to obtain first-hand information. 
In Chile there has been industrial hygiene activity for some 15 years. 
The Industrial Hygiene Division of the National Department of Health 
has made some surveys of potential health problems in a few of the 
nation’s industrial centers. These, of course, were available to the 
author. Finally, toward the close of the study, two conferences were 
held with key representatives of industry and government. The major 
findings of the survey were discussed and a specific program of indus- 
trial hygiene for Chile presented for consideration. These conferences 
were sponsored jointly by the Manufacturing Society of (’ldle and 
the School of Public Health. 
In Bolivia the regions where the study was made were the manu- 
facturing areas around La Paz and Cochabamba and the tin mines 
around Oruro and Potosi. 
In Peru the survey was made primarily in four regions of the 
country: the mining region of the central Andes; the mining region of 
southern Peru; the mining and petroleum area in the North; and the 
industrial area in Lima and its environs. 
In Chile the survey was conducted in three regions of the country: 
the industrial section around Santiago; the coal mining and manufac- 
turing region adjoining Concepcion; and the northern region around 
Antofagasta. Throughout the studies, the author received the whole- 
hearted cooperation of industry and government, both of which placed 
all of their facilities and records at his disposal. 
7 111. General Information 
Vicissitudes of living call for the dissociation of man into a number 
of functional units. For a certain number of hours a day, he is known 
as a worker. The rest of the time he is a citizen—taking an interest in 
his family and community affairs, seeking relaxation, undertaking 
other types of activity. In stepping from one role to another, however, 
man does not undergo a change, lie remains the same, subject to all 
the limitations and susceptibilities that are the lot of human beings. 
Clearly then, the health of workers cannot be considered in terms of 
the working environment alone. All factors that influence them as 
total personalities must be brought to bear in seeking to obtain a com- 
plete, meaningful picture. Full consideration must be given all these 
stimuli in the formulation of a sound, effective industrial hygiene pro- 
gram. For that reason, attention was also paid in this report to the 
economic resources of the countries studied, socioeconomic conditions, 
educational opportunities, and other related factors. An attempt was 
made to touch upon all the elements that enter into a complete evalua- 
tion of industrial hygiene problems. 
ECONOMIC RESOURCES 
Bolivia 
Although Bolivia has remarkable economic possibilities in agricul- 
ture, petroleum, and other raw materials, mining has been its principal 
industry for many centuries. The economy of the country is closely 
linked to mining, to tin mining in particular. Tin is Bolivia’s largest 
export and its most important source of revenue. 
Peru 
Peru’s natural resources are many and its opportunities for economic 
betterment are great. Although Peru is primarily an agricultural 
nation, its manufacturing industry is growing rapidly, and it is ex- 
tremely rich in mineral resources. Until recently, Peru’s topography 
has retarded the development of some of these resources. But in the 
8 past few years a number of good roads have been constructed which 
connect the three important sections of the country and make good 
transportation and communication services possible on a national scale. 
RESOURCES OF BOLIVIA 
PICTOGRAPH CORPORATION 
Aviation is also playing an increasingly large role in the communica- 
tion field. 
Peru has been a storehouse of minerals ever since colonial days and 
is still an important source of oil and metals. Its coal mines, which 
have recently been developed, will satisfy at least its domestic needs 
for a long time. Iron deposits which are now being opened will make 
it possible for Peru to have steel, especially when the hydro-electric 
projects are completed in the Chimbote area. 
Chile 
Chile’s mineral resources, especially its copper and nitrates, figure 
prominently in its international trade. Chile is the second copper 
producing nation in the world and is the only country which has 
9 sodium nitrate deposits of great commercial value. Prior to the war, 
minerals made up nearly 80 percent of 1 he total value of the country’s 
exports. However, the slump in the nitrate market caused by the pro- 
duction of synthetic nitrates and the war-induced need for producing 
manufactured goods for home consumption have forced Chile to de- 
velop manufacturing industries. 
RESOURCES 
OF PERU 
PICTOGRAPH CORPORATION ESOURCES OF CHILE 
DESERT 
AND 
MINING 
AGRICULTURE 
AND 
INDUSTRY 
FOREST 
AND 
PASTURE 
PICTOGRAPM CORPORATION 
With regard to natural resources, Chile may be roughly divided 
into three zones: the northern desert zone which contains important 
copper, nitrate, and iodine deposits, and other mineral mines; the 
central zone which includes the country’s largest cities and is an 
agricultural and industrial area; and the southern zone which is the 
forest and pasture land of the country. 
In the southern zone are also located coal mines, which are the 
largest in Latin America, and iron-ore deposits, which are being ex- 
ploited increasingly every year. These coal mines and iron-ore deposits 
make the area a natural center for the production of steel. At the 
present time a steel mill is under construction just outside of Con- 
cepcion. The production of steel should assist the country materially 
in developing manufacturing industries. 
POPULATION 
Bolivia, with an area approximately the size of the States of Texas 
and California, has an estimated population of 3,750,000. Of this 
number, about 500,000 are city dwellers and another 500,000 occupy 
11 the unexplored lowlands. The remainder of the population lives in 
rural areas of the altiplano and is predominantly Indian in race. 
According to the latest data on Bolivia, about 13 percent of the popu- 
lation is white and principally of Spanish descent, about 27 percent 
is of mixed Spanish and Indian blood, about 53 percent is Indian, and 
the remaining seven percent is unclassified and includes a small 
number of Negroes. 
Peru is the third largest country on the South America continent 
and is approximately the size of Texas, New Mexico, and Arizona 
combined. It has an estimated population of 7,853,953. Nearly three- 
fourths of this population lives in the Sierra region, which comprises 
about one-third of the total area of the country. The racial distribution 
of the population is about 57 percent, Indian; 25 percent, Mestizo; 
14 percent, white; two percent, Negro; and two percent, Asiatic, 
chiefly Japanese. When it comes to language spoken, however, the 
picture is somewhat different. Forty-seven percent speak Spanish only; 
35 per cent, one of the Indian tongues (Quechua or Aymara) ; and the 
rest speak a mixture of Spanish and other languages. 
Chile is slightly smaller than the West Coast States of California, 
Oregon, and Washington combined. In 3946, the estimated population 
of Chile was 5,702,000. More than half the population is concentrated 
in the central region, and about a fourth lives in the Santiago province. 
The people are distributed almost equally between urban and rural 
areas of the country. 
Chile is predominantly European in its racial make-up; its people 
trace their ancestry back to practically every country on the continent. 
Fewer than one percent of the population are full-blooded Indians. 
INCOME 
Living standards are in direct ratio to the purchasing power of any 
locality. The meager purchasing power generated by low wage scales 
makes for low standards of living in Bolivia, Peru, and Chile. 
The average wages of a factory worker in Bolivia range from 14 
to 20 Bolivianos a day. A miner makes approximately 38 Bolivianos a 
day.1 
The wages of a mine worker in Peru range from a minimum of 4 to 
a maximum of 10 soles per day and average about 6.50 soles a day. In 
most factories wages are somewhat higher, starting with a minimum of 
2.50 soles for beginners and going as high as 14 soles a day in some 
of the large factories in Lima. Average pay is about 8 soles per day. 
In the Chilean factories visited during this study, average wages 
ranged from a minimum of 20 and 28 pesos a day for women and men, 
respectively, to a maximum of 95 pesos a day, the average being some- 
where around 75 pesos. However, the factories visited by the author 
1 Currency equivalents as of May 1948: $l, 42.0 Bolivanos; $l, 6.5 soles; $l, 31.1 pesos. 
12 were located in urban centers where wages are known to be higher 
than elsewhere in the country. According to statistics of the Workers’ 
Compulsory Insurance Fund, which has fairly accurate data on this 
subject, the average wage of a factory worker in Chile is 30 pesos a 
day. The wages of miners range from 50 to 90 pesos a day. 
On the whole, miners in the three countries are better off than fac- 
tory workers, in that they have employer-provided “benefits.” Free 
or low-cost housing, free medical care and hospitalization for mine 
workers and their families, and primary schools for their children are 
provided by the larger companies. Miners also have the opportunity to 
buy from company stores, or pulperias, which sell goods at cost or at a 
slight loss. 
In one large company store in Peru, for example, the prices of some 
eight essential food items were at least 20 percent lower than in other 
stores in the community. This practice creates a problem since em- 
ployees resell goods they buy to obtain extra funds. When company 
stores run out of goods, private stores raise prices for goods in short 
supply. Table 1 shows prices charged by private stores and a company 
store in one mining area in Peru. 
Table 1.—Comparison of prices between a company managed store and private stores in Peru 
Item 
Prices in soles 
Company managed 
Private 
Spaghetti per kilo.. . . - - 
1.00 
1,80 
Pork per kilo .. . - 
5.20 
8.00 
Shoes per pair . 
27.80 
39.00 
Sugar per kilo - 
0.32 
0.40 
Cloth materials per metre . 
1.60 
3.50 
Meat per kilo _ . - - 
1.00 
2.20 
Oats per kilo . . __ _ 
1.60 
2.20 
Bread: 
0.05 
0.05 
Most companies claim that they lose a day’s pay on every worker in 
the pulperia. On the other hand, rather than raise wages so that the 
miner may purchase his goods wherever he wishes, the mining com- 
panies prefer the pulperia system for many reasons, even though the 
pulperia has been outlawed in some countries. Perhaps one of the 
most important reasons for not abandoning the pulperia lies in the 
fact that workmen’s compensation and other social security benefits 
are based on the miner’s actual wages, and do not take into considera- 
tion wages in kind, such as accrue to the worker from the cheap pul- 
peria and other employer-provided “benefits.” 
Despite the cheap food, housing facilities, free primary schools, and 
13 recreational facilities furnished by the larger companies, the prevail- 
ing low wages in Bolivia, Peru, and Chile do not provide sufficient 
funds for a decent standard of living. 
The rampant inflation which these countries have experienced has 
made the lot of the wage earner even more difficult. Many of the bare 
necessities of life, such as clothing, are so expensive that they con- 
stitute a luxury to the average mine and factory worker. The same is 
true of many basic food supplies. 
The food problem is further complicated in Bolivia because that 
country is largely dependent on foreign, and sometimes distant, pro- 
duction. There have been shortages recently of sugar, wheat, meat, 
rice, flour, and other staples, especially in the mining centers and in 
some of the large cities of the altiplano. Frequently, crop failure in 
other countries and breakdowns in Bolivia’s poor transportation system 
halt the steady flow of food into the country. 
Chilean studies, too, bear out the disproportionately high cost of 
food. It is estimated that the amount of income spent for this neces- 
sity ranges anywhere from 33 to 75 percent. As a result of the high 
cost of foodstuffs, 50 percent of the workers and their families suffer 
from malnutrition. In fact, recent investigations in the coal mining 
areas of Chile indicate that coal miners have a daily diet deficiency of 
1,600 calories. This lack must certainly play an important role in the 
high incidence of many communicable diseases among this group of 
workers. 
HOUSING AND LIVING CONDITIONS 
Housing in Bolivia, Peru, and Chile is in acutely short supply. Even 
in Chile, where management-furnished housing is an improvement over 
that of some of the other South American countries, most dwellings, 
especially in the mining communities, are drab, overcrowded, and in- 
sanitary. They frequently lack even the most elementary sanitary 
facilities. Such conditions are also true of some of the large cities in 
these countries. Information obtained from a survey of establishments 
in Peru typifies the prevailing situation in all three countries under 
study. Detailed data on community facilities available to these workers 
are presented in table 2. 
Many of the miners’ homes are of the adobe type or built out of 
cinder blocks. Usually, houses are constructed in a series of 20 or 
more to a unit or block. The houses vary from one room to as many 
as three and sometimes four rooms. The latter, however, are usually 
reserved for white collar workers, or empleados, and a nominal charge 
is made for them. At one large establishment in Peru two-room houses 
rented for 3.75 soles a month; three-room houses, for 7.50; and the 
four-room variety, for 12.50. 
14  
Housing conditions 
Community stores 
Plant 
Type of industry 
Number 
of 
workers 
Sanitary facilities 
Garb- 
age 
col- 
lection 
Schools 
Remarks 
No. 
General 
Water 
Sewage 
Toilets 
Com- 
munal1 
facili- 
ties 
Oper- 
ated by 
Type 
1 
Metal mine 
250 
Very poor; adobe 
huts; crowded 
Spigots outside 
Latrine 
yes 
Company, 2 grades 
Company 
Mercantile; 
meat; 
2 
Metal mine and mill— 
3,000 
Poor; crowded. 
do 
Private system 
Open ditch 
Privy 
yes 
yes 
yes 
yes 
Company, 3 grades, 
2 rooms 
Company, 5 grades 
Company, 4 grades 
(clean) 
Company built; 
government 
operated 
Company, 4 grades 
Company, 6 grades 
Company, 4 grades, 
2 rooms 
Company, 6 grades, 
(fair) 
Company, grade 
Company, 5 grades 
Company, 3 grades 
vegetables 
General 
Mercantile 
New houses being built. 
3 
Copper mine and mill 
650 
Crowded 
do.. 
Daily 
4 
Metal mine and mill.... 
707 
Fair. 
do 
None 
Privy over 
river 
Latrine 
5 
do.. 
626 
Open ditch 
Mercantile; 
meat 
6 
do 
1,487 
yes 
yes 
yes 
General, 
meat, 
vegetables 
Mercantile 
GeneraL 
Mercantile 
Mercantile, 
meat, 
vegetables 
Mercantile 
7 
do_ 
500 
8 
Vanadium mill 
750 
Privy — 
All facilities inadequate. Iso- 
lated camp. New houses 
and school being built. 
Bad and insanitary camp. 
Malaria sources. 
9 
Goldmine and mill 
450 
10 
Metal smelter 
3,150 
1,900 
yes 
yes3 
yes 
yes 
yes 
Company 
11 
Coal mine.. 
New homes and recreation 
facilities being built. 
Dusty and insanitary camp. 
Inhabitants’ faces black. 
12 
Coal mine and washer. 
500 
Poor; crowded; filthy . 
do. 
13 
Coal washer. 
150 
Poor; adobe; crowded 
do.. 
Company 
Company 
and 
private 
Company 
14 
Oil and gasoline pro- 
5,000 
Poor; crowded; tilthy 
Private system 
yes 
Company, 6 grades 
(good) 
Company, 5 grades 
All types ... 
Building new town. Old site 
insanitary and poorly 
maintained. 
duction 
15 
Dam and tunnel con- 
1,060 
Privy 
yes 
yes 
General 
16 
struction 
R.R. and power plant 
350 
17 
construction 
Woo! cloth mill 
984 
Town, Company 
pays tuition 
Company, grade 
Company 
Mercantile 
General 
18 
Cement nroduction 
809 
Spigots outside 
Septic tank 
yes 
Will provide better housing. 
Plant has auditorium, li- 
brary, classes in hygiene. 
19 
Asbestos building ma- 
180 
20 
terial 
Refractory bricks, 
262 
21 
chinaware 
Glass Pottles 
170 
1 
Table 2.—Community facilities available to workers in establishments surveyed in Peru 
1 Refers to common areas for baths, toilets, and laundry facilities. 
■ Company controls prices. 
3 Clean. 
15 Nearly three out of four houses in many of the camps are of the 
one-room variety. As a consequence, crowding is a critical problem. 
It is not uncommon to find four to eight persons living in one room, 
which also serves as a kitchen, dining room, and bedroom. For example, 
in one community where 2,600 workers are employed, there are 1,650 
houses. In another large mining camp employing nearly 3,000 only 
450 houses are available. 
Similar conditions were observed in Chile. Houses around the 
sulfate mines in the northern desert and the coal mines around Con- 
cepcion were too few in number and lacking in sanitation besides. 
Dwellings around the larger copper mines were fair on the whole, 
although there were not enough of them. Homes at a sugar refinery 
and in the nitrate fields in the north were perhaps the best found in 
this survey. The photographs which follow clearly show the difference 
between the houses provided. 
In the coal mining area of Chile some 4,000 houses were surveyed. 
Nearly 1,500 were insanitary and 1,600 uninhabitable. Single persons, 
as a rule, shared one-room houses, which were occupied by as many as 
four adults.l In one large copper mining concern there were approxi- 
mately 1,700 houses for 8,000 persons. The average number of persons 
per room was 3.7, and the average number of persons per bedroom, 5.1. 
The average number of persons per bed was 2.2. Housing conditions 
in these mines were by no means the worst in Chile; dwellings provided 
for workers in the fishing industry were not even as good. 
A worker's dwelling and his family at a coal mining camp 
16 Worker's model house at a sugar refinery 
As a rule, water is obtained from spigots at each end of a block of 
houses. Toilets, as well as laundry and shower facilities, are usually 
of the communal type. Waste water runs into uncovered troughs in 
outside ditches which are also used for garbage and sewage. As far 
as can be determined, none of the water supplies is approved. 
With the exception of two or three large mining concerns in Chile, 
human waste was permitted to flow untreated into nearby streams or 
into the open desert. In only a few instances are facilities available 
for garbage removal. Carrion and fly-infested garbage litter the backs 
of houses and the streets. 
There is no denying that, by comparison with some of the privately 
owned huts of some of the workers, most company houses are a great 
improvement. In many, but not all, of the larger mining communities, 
animals are not allowed around the houses in the camps. In all the 
privately owned homes, domestic animals have free access to the 
workers’ homes. At present, few miners own their own homes. It is 
understood that most of them would like to own their own homes, so 
that they can have gardens, keep their animals, and gain a sense of 
stability, which they do not have now. 
The problem of labor turnover is influenced to some extent by this 
lack of stability. It is felt that industrial establishments should en- 
courage workers to have their own homes and assist as much as possible 
toward the achievement of this objective. The excuse which many 
17 firms now give for failing to encourage home ownership is that the 
workers would abuse it. This is not a valid excuse, since a company’s 
responsibility, as well as that of the Government itself, should not end 
with the provision of the means and the opportunity for owning a 
home. It should go beyond that and include an educational program 
to teach the workers how to live in a sanitary and healthful fashion. 
Most of the larger concerns are fully aware of the housing problem 
and are attempting to build additional housing. Unfortunately, with 
the single exception of one large petroleum company in Peru which 
has an ambitious modern housing program, the companies are making 
the same mistakes in their new housing projects that they did in their 
old ones. Many of the townsites are selected with no regard for health 
and sanitation requirements, and the houses still lack elementary sani- 
tary facilities. The workers’ houses being built by the petroleum com- 
pany are an exception to the rule. They are models in construction and 
sanitation and should be conducive to good health and well-being. 
In 1936, Chile established the Popular Housing Fund for the con- 
struction of low-cost houses. The Fund has improved the situation 
somewhat, but its program has been inadequate for the needs of the 
country. It is estimated that about 300,000 homes are needed to 
alleviate the present congestion. At the current rate of construction, 
10 years will elapse before that many houses can be built. 
In summary, therefore, it may be said that housing and living con- 
ditions in industrial communities in these three countries, especially 
Workers' houses at a smeller 
18 in the mining areas, are inadequate in quality and insufficient in quan- 
tity. A vigorous housing program on the part of the Government and 
the industries concerned is needed. Concurrently with such a program, 
workers and their families should get the benefit of a vigorous educa- 
tional program on healthful living. With perhaps one or two excep- 
tions, neither the Government nor industry has conducted such cam- 
paigns. Living conditions as they exist now are potential sources of 
ill health and no doubt are factors contributing to the social unrest 
and labor strife prevalent in Bolivia, Peru, and Chile. 
EDUCATION 
Closely related to poor health, poor housing, and low wages, are 
such social problems as illiteracy. It has been estimated that in Bolivia 
80 percent of the population is illiterate and that not over one-sixth 
of the school age children are enrolled in schools. 
Many children under 14 years of age are employed in mines and 
factories Child labor not only deprives these youngsters of the educa- 
tional opportunities they should have, but definitely imperils their 
health and future productiveness. 
Perhaps the greatest educational problem in Peru is the incorpora- 
tion of the Indian into the nation’s life and society. Native Indian 
languages are spoken by a great majority of the people. Indian cul- 
ture and tradition affect every aspect of Peruvian life, including 
industry. 
According to the 1940 census, only 42 percent of the population was 
literate. The rate of literacy varied from approximately 93 percent 
in Callao to only 12.6 percent in Apurimac. In the Sierra, where most 
of the mining communities are located, the percentage of literacy was 
lowest, because of the large Indian population there and the lack of 
adequate educational facilities. According to law, mining companies 
in whose communities more than 30 children live are required to main- 
tain schools. The company is required to build and maintain the school 
building and pay the salaries of the teachers who are appointed by the 
Government. The equivalent of at least the first four grades must be 
taught in these schools. Special literacy schools are also supposed to 
be provided for adults whenever 20 persons make known their wish 
to study. 
Most of the schools visited in both Bolivia and Peru were over- 
crowded and lacked the most elementary materials and equipment. A 
few of these schools did not go beyond the second grade of instruction. 
Various studies reveal that primary education, such as it is, is avail- 
able to only a small fraction of the population. As already mentioned, 
many schools lack rudimentary facilities such as chairs, desks, books, 
blackboards, and chalk. Many of those visited lack proper sanitary 
19 facilities and, with but one or two exceptions, fresh air is shunned in 
most of the schools—the windows are hermetically sealed. Obviously, 
the lack of ventilation and the unhygienic state of the pupils are not 
conducive to either good health or comfort. Furthermore, the ex- 
tremely low salaries paid to teachers do not attract qualified persons 
to the profession. 
Hygiene is generally unknown to the Indians, so that health educa- 
tion is a major and urgent necessity. In Bolivia no effort was made to 
teach it in the schools before the initiation of the cooperative programs 
of the Inter-American Educational Foundation and the Institute of 
Inter-American Affairs. However, it is impossible to bring such educa- 
tion to large groups of people who cannot read and who do not even 
speak the same language as the teachers. 
In comparison with other South American nations, Chile is making 
great progress in the field of public education. More than 70 percent 
of its people are literate and the number of persons receiving higher 
education is steadily increasing. Table 8 shows the extent of school 
attendance in Chile as revealed by the 1940 census. It may be seen 
from this table that nearly 60 percent of the population 7 years of 
age or older receive primary instruction. This is all the education that 
the vast majority of the population receives, for only about ten percent 
Table 3.—Educational status of persons 7 years old and over, 
in Chile 
Number 
Percent 
Degree of instruction 
Total 
Male 
Female 
Total 
Male 
Female 
Primary -- 
2,376,065 
1,190,160 
1,185,905 
58.8 
59.7 
58.0 
Secondary 
390,884 
191,788 
199,096 
9.7 
9.6 
9.7 
University 
50,087 
35,042 
15,045 
1.2 
1.8 
0.7 
Technical - 
44,223 
25,604 
18,619 
1.1 
1.3 
0.9 
Cannot read 
1,177,699 
549,652 
628,047 
29.2 
27.6 
30.7 
Total-- 
4,038,958 
1,992,246 
2,046,712 
100.0 
100.0 
100.0 
113,231 
56,384 
56,847 
go on to high school. About one percent receives university training; 
and another one percent, training of a technical character. Many other 
countries in South America send students to universities in Chile. 
Most of the Chilean schools visited during the survey were fairly 
adequate and were maintained in a sanitary condition. 
In general, the lack of adequate school facilities and instruction all 
operate against building a strong and healthy race. Education plays 
an important role in determining the health and productivity of the 
working population. 
20 COMMUNITY HEALTH AND SANITATION 
Bolivia 
According to studies made by personnel of the Institute of Inter- 
American Affairs and studies of medical and sanitary conditions made 
by the United States Army, general health conditions in Bolivia are 
very unsatisfactory. 
Malaria, tuberculosis, venereal diseases, leprosy, epidemic typhus, 
intestinal parasites, smallpox, typhoid fever, yellow fever, and bubonic 
plague are common throughout Bolivia. Malaria is prevalent in over 
80 percent of the country. Epidemic louse-borne typhus is common 
throughout the highlands. Official reports state that 98 to 100 percent 
of the population has helminthiasis. Infant mortality is known to be 
much higher than the reported 110 per 1,000 live births. Disease con- 
trol is made especially difficult by the diversity of races,. the hetero- 
geneity of customs, lack of transportation and means of communica- 
tion, and low standards of living. 
The development of Bolivia’s rich natural resources is largely in- 
hibited by disease, control of which is in turn limited by lack of funds 
and trained personnel. In 1944, Bolivia appropriated about $1,041,742 
(U.S.) for public health, less than 30 cents per capita for the estimated 
population of about 3,750,000. By comparison, the United States 
budgets more than $2 per capita for State health work. 
In 1945, there were 72 hospitals in Bolivia, with a total of 4,229 
beds, the ratio of beds per 1.000 inhabitants ranging from 0.6 in the 
Department of Santa Cruz to 2.7 in the Department of Beni. In 1946, 
there were 569 physicians in the entire country (one for every 6,000 
persons), nearly half of whom were concentrated in La Paz. Well- 
trained nurses and technicians are also scarce, so that thousands of 
Bolivians are not able to secure even the simplest medical attention. 
According to a survey made by the United States Army Medical Corps 
it was found that over 60 percent of the people in Bolivia do not have 
medical attention during their final illness. 
There is not a single safe water system under proper control in the 
entire country and there are, as a result, recurrent outbreaks of 
typhoid fever all over the country. Several of the larger towns have 
sewers, but there are no sewage treatment facilities. 
Pern 
As in Bolivia, lack of funds and trained personnel militates against 
the control of disease in Peru. The rural areas especially suffer from 
the scarcity of doctors, nurses and hospitals. Most of the trained pro- 
fessional workers and facilities are located in Lima. In 1947, Peru 
appropriated approximately $4,800,000 (U. 5.,) for public health, or 
about 60 cents per capita. 
21 There are only about two safe water systems in the entire country, 
find it is only within the last year that the Ministry of Public Health 
and Social Welfare has been given responsibility for the administration 
of water supply. This function will be carried out by the Department 
of Sanitary Engineering, which, at the moment, has only seven trained 
sanitary engineers. 
Sewage treatment is practically unheard of in Peru. Several of the 
large cities have sewers, but no treatment facilities. Incidence of 
tuberculosis is known to be high in Peru and is one of the major com- 
municable disease problems of the country. Although rates are not 
available for most of the communicable diseases, some idea of the 
health problems of the country may be gleaned from the experience of 
1946. In that year, 123,490 cases of infectious diseases were reported 
to the Ministry of Health. Of these, 57,883 were malaria; 18,671, 
tuberculosis; 12,295, whooping cough; and 6,931, dysentery. Mortality 
from tuberculosis averages about ten times as high as in the United 
States. It is well known that the reporting of communicable diseases in 
Peru is inadequate, and undoubtedly these data are an underestimate. 
Proportional mortality is available for 1945. These data show that 
of all deaths reported, tuberculosis accounted for 6.2 percent; pneu- 
monia, 1.4 percent; grippe, 8.1 percent; and other respiratory diseases, 
12.9 percent. In other words, respiratory diseases accounted for 28.6 
percent of all deaths in Peru during 1945. 
The administration of public health in Peru is largely a centralized 
function of the Ministry of Health and Social Welfare. With the ex- 
ception of the work going on in cooperation with the Institute of Inter- 
American Affairs in a few restricted areas, departmental, provincial, or 
local public health work is an unheard of phenomenon in Peru. Al- 
though mining companies are obliged by law to provide camps, schools, 
and sanitation services, such as water and sewage disposal, there has not 
been adequate governmental supervision and administration of com- 
munity sanitation. Leadership has been lacking, too, in assisting indus- 
try to improve public health conditions in industrial areas. 
Chile 
Many agencies concern themselves with health and welfare in Chile. 
The majority of these, however, are interested in curative medicine. 
Preventive medical care is left largely in the hands of the Department 
of Health. 
The administration of pnhlic health in Chile, as in most Latin Ameri- 
can countries, is centralized under the Director General of Health 
whose headquarters are in Santiago. Branch offices are located in the 
various provinces, which for administrative purposes are grouped to- 
gether into zones. With the exception of one or two provinces, public 
health work is in the hands of part-time professional personnel, most 
of whom have not had formal public health training. This deficiency 
22 is slowly being overcome through training programs for public health 
workers given by the recently organized School of Public Health. Chile 
is slowly building up a nucleus of trained public health workers, but 
many years will elapse before a sufficient number are trained. 
Another drawback to the expansion of public health programs has 
been lack of funds. At the present time, the budget for public health 
in Chile is approximately 25 pesos, or roughly, 75 cents (U.S.) per 
capita per year at the official rate of exchange. 
It is well known that there is a scarcity of physicians, nurses, and 
hospitals in Chile. There are approximately 2,000 physicians, or rough- 
ly one for every 2,500 persons. This distribution is better than in some 
South American countries, but it is not good. The shortage of pro- 
fessional health personnel is more acute in rural areas since physicians 
and nurses tend to congregate in the larger urban centers where re- 
muneration is greater. 
The general mortality rate in Chile is roughly double that of the 
United States. Although infant mortality is decreasing, it is still high, 
the average rate registered for the period 1941-45 being 170. The con- 
trol of communicable diseases, especially tuberculosis, is still a major 
and serious problem. Typhoid is quite prevalent. Hookworm is epidemic 
in some areas, notably in the coal mining section of the country. In 
some of the coal mines studied recently about 65 percent of the workers 
were found to be infested with the hookworm parasite. 
Tuberculosis merits special discussion since it is probably Chile’s 
outstanding health problem. Although the death rate from this disease 
recorded for 1946 is approximately 208 per hundred thousand, in many 
sections of the country the rate is much higher. In the city of Concep- 
cion, the death rate in 1945 was slightly more than twice that registered 
for the country as a whole. 
The tuberculosis problem is aggravated by the scarcity of hospital 
beds and by overcrowded housing, which make it impossible to isolate 
patients in their homes. 
General community sanitation in Chile also leaves much to be desired. 
Only 25 percent of the people in all of Chile are served by water supply 
systems and an equal number are provided with sewerage facilities. 
With the exception of Santiago, only 85 percent of the urban popula- 
tion have approved drinking water while 65 percent have public sewer- 
age facilities. There are 64 cities of more than 1,000 and less than 5,000 
inhabitants which have no drinking water facilities and 155 cities which 
have no public sewerage. At present, through a cooperative program 
conducted by the Institute of Inter-American Affairs and the Ministry 
of Health, quite a lot is being done to improve the sanitary environ- 
ment. This cooperative program is also improving the general health 
picture by constructing health centers in some districts. The work car- 
ried on in this joint program will be touched on later in this report. 
23 This brief summary of public health problems in Chile indicates that 
progress is being made toward their solution. The problems are so 
large, however, that it will take many years of vigorous, sustained effort 
on the part of the Government, the people, industry, and labor itself, 
to raise the health level of the labor force. Unless this is done, however, 
Chile’s plan to develop its resources and to raise its living standards 
will be seriously frustrated. 
SUMMARY 
The brief foregoing sketch of the background of the industrial popu- 
lations of Bolivia, Peru, and Chile points up that niggardly wage 
scales, congested and unhygienic living conditions, and primitive sani- 
tation predispose these countries to disease. Sickness rates—both gen- 
eral and occupational—are high. The pall of illiteracy in Bolivia and 
Peru further fosters these conditions and makes remedial education 
difficult. A comprehensive educational program in hygienic living 
should l)e attempted, however, despite these limitations. To improve 
facilities without accompanying sanitary instruction is to build on 
quicksand. Even the finest structure will soon crumble without proper 
maintenance. Against these socioeconomic needs, the added health 
problems which have their origin in the working environment must be 
studied and solved. 
24 IV. Health in Industry 
Since a worker’s health is determined to a large degree by the re- 
sponse to both nonoccupational and occupational stimuli, a considera- 
tion of both sets of factors is necessary for a complete study. The socio- 
economic conditions highlighted in the foregoing section reflect non- 
occupational influences. Attention is now concentrated on the health 
problems that are directly related to the working environment. 
In the course of these studies, health and safety problems inherent in 
industrial working environments were assessed in several ways. Al- 
though it was impossible to make detailed studies of the health of the 
workers or of working conditions, sufficient information was obtained 
about working environments and industrial health services provided in 
plants to get a good idea of occupational hazards and measures taken 
to correct them. 
The present studies, although limited to a visual survey of the work- 
ing environments in representative industries and a study of statistics 
available in the various government agencies concerned with industrial 
hygiene, do present a fairly comprehensive review of occupational 
hazards and the measures now in force to correct them. 
GAINFULLY EMPLOYED 
Bolivia 
Although no accurate data are available on the size of the labor force 
in Bolivia, it is estimated from data furnished by the Caja de Seguro 
and the Chamber of Commerce that there are approximately 100,000 
persons employed in the country’s mines, factories, and service indus- 
tries. Of this number, approximately 40,000 are employed in the mines. 
Not even an estimate of the number of workers engaged in agricul- 
tural pursuits is available. It is known, however, that large numbers 
of agricultural workers, employed by owners of rubber and coffee 
plantations, live and work in isolated communities in the tropics. 
Peru 
The latest information on the size of the labor force in Peru is that 
based on the rather extensive 1940 census. At that time the number of 
25 gainfully employed persons totaled 2,475,339, of which nearly 1,600,000 
were males. It may be seen from table 4 that about 50 percent of the 
gainfully employed were found in agriculture. Manufacturing account- 
ed for 380,000 persons and mining for nearly 45,000. 
Due to the fact that most manufacturing industries produce light 
consumer goods for domestic use, a larger proportion of female workers 
is found in these establishments. Of the 380,000 persons in manufac- 
turing, approximately 215,000 or 56 percent are women. The most 
important manufacturing industry in Peru is the textile industry. The 
manufacture of clothing and its accessories is second. 
Table 4.—Labor force by major industry group in Bolivia, Peru, and Chile 
Industry group 
Number of persons 
Total 
Male 
Female 
BOLIVIA (data not available) 
(?) 
(?) 
(?) 
40.000 
60.000 
(?) 
(?) 
(?) 
(?) 
PERU (1940 census) 
2,47.5,339 
1,598,321 
877,018 
1,293,214 
252,975 
44,694 
380,281 
45,659 
51,079 
112,126 
89,021 
165,099 
41,191 
931,468 
129,008 
43,463 
165,516 
44,782 
48,656 
76,025 
72,514 
53,879 
33,010 
361,746 
123,967 
1,231 
214,765 
877 
2,423 
36,101 
16,507 
111,220 
8,181 
CHILE (1940 census) 
1,621,300 
1,325,939 
295,361 
620,489 
91,220 
64,559 
286,730 
200,636 
89,707 
14,628 
3,279 
115,453 
133,591 
1,008 
580,723 
89,479 
63,640 
193,463 
132,414 
84,468 
12,487 
2,844 
93,656 
72,196 
569 
39,766 
1,741 
919 
93,267 
68,222 
5,239 
2,141 
435 
21,797 
61,395 
439 
Unemployed 
Of the nearly 45,000 persons employed in mines, the largest number, 
7,000 are in the oil fields, with gold and copper mines coming next. 
It may be seen from these data that more than a third of the popu- 
lation of Peru is gainfully employed. Of those employed, slightly more 
than a half million are engaged in industries, such as mining, milling, 
and manufacturing, with which major health hazards are usually 
associated. 
Chile 
Although no current estimate of the number of gainfully employed 
persons in Chile is available, 1940 census data are still accurate enough 
26 to give an approximation of the total labor force. In 1940, out of a 
total population of approximately 5,000,000, nearly one-third were 
gainfully occupied. As may be semi from table 4, slightly more than 
600,000, or 38 percent of the 1,700,000 gainfully employed persons, 
were engaged in agriculture. Al. A'acturing ranked second with ap- 
proximately 290,000 workers; and mining accounted for slightly more 
than 90,000 persons. Only 300,000 women were in the labor force. 
Industrial workers in Chile constitute as large a group of employed 
persons as those engaged in agricultural pursuits, the two groups ac- 
counting for approximately 75 percent of the labor force. The balance 
of the working population includes professional and white-collar workers 
and a small number of people engaged in domestic service. 
To summarize, one-third of the nation’s population is employed, and 
of this number approximately 1,000,000 work in occupations with 
which health hazards are associated. From the standpoint of numbers 
alone, therefore, it is obvious that serious consideration should be di- 
rected to the health and safety problems of this group which makes up 
some 20 percent of the nation’s human resources. 
INDUSTRIES SURVEYED 
A representative group of mining and manufacturing establishments 
in each of the three countries was surveyed to obtain first-hand informa- 
tion on health hazards and facilities for coping with them. The specific 
types of industries surveyed, together with number of establishments 
and workers included, are shown in table 5. In Bolivia, dust determina- 
tions made previously by the personnel of the labor section indicated 
silica dust exposures in the various establishments. Statistics on occu- 
pational diseases and some figures on accidents were obtained from in- 
dividual concerns or government agencies. These helped to define the 
problem on a quantitative basis. 
In general, the information gathered pertains to hazards in the work- 
ing environment and their control; compensation and sickness benefits; 
medical services, including dentistry and nursing; safety precautions; 
disability records; feeding facilities; and general sanitation, such as 
water supply, sewage disposal, toilet facilities, and locker rooms. 
Even though the number of workers and plants included in the sur- 
vey appears to be small in relation to the total number of workers and 
establishments in eacli of the three countries, the plants selected were 
sufficiently representative of industry to allow the drawing of valid 
conclusions. 
Bolivia 
In Bolivia, 23 establishments were surveyed, employing a total of 
26,488 workers, or approximately 25 percent of the estimated popula- 
27 tion in manufacturing and mining industries. Fifteen of these were 
mines and mills, and eight were manufacturing or service industries. 
Thirteen of the mines produced tin, three of them producing some 
tungsten ore as well. AH but 3 of the 13 tin mines also operated mills 
for concentrating ore. Of the two remaining mines, one produced 
antimony and the other copper. The latter also had a mill as part of its 
operations. 
Table 5.—Type of industries surveyed in Bolivia, Peru, and Chile 
Bolivia 
Peru 
Chile 
Industry group 
Estab- 
lishments 
Workers 
Estab- 
lishments 
Workers 
Estab- 
lishments 
Workers 
All establishments surveyed - - - - 
23 
26,488 
21 
22,935 
21 
46,089 
15 
23,774 
16 
20,530 
8 
34,552 
Mining, milling and/or smelting of: 
1 
28 
3 
2,550 
650 
1 
9,200 
1 
786 
1 
3 
12,856 
Gold . . _ 
1 
450 
7 
9,720 
2 
10,250 
746 
1 
Tin . . 
13 
22,960 
1 
750 
1 
5,000 
Hydroelectric construction; tunnel 
2 
1,410 
1 
1,500 
Manufacturing industries 
8 
2,714 
5 
2,405 
13 
11,537 
1 
900 
1 
606 
Cotton, woolen textile mill products- 
1 
3 
1,000 
315 
1 
984 
2 
2,815 
Glass products; china ware; ceramics 
Cement; asbestos building material- 
1 
1 
750 
200 
2 
2 
432 
989 
4 
3,201 
1 
840 
1 
145 
2 
1,750 
140 
1 
1 
1,285 
1 
304 
The 15 mining establishments employed a total of 23,774 workers, 
thereby accounting for the bulk of the persons included in this survey. 
This is not disproportionate, since mining and milling of ore is Bolivia’s 
major industry and the most important one from the standpoint of 
economics and health hazards. Nine of the 15 mines and mills em- 
ployed more than 500 workers, while the remainder employed fewer, 
two employing under 100 workers each. 
The eight manufacturing and service estaolishments surveyed em- 
ployed 2,714 workers. They included two shoe factories, a tannery, a 
large cotton textile plant, a glass bottle works, a cement mill (the only 
one in Bolivia), a foundry and machine shop, and an airplane repair 
shop. 
Peru 
The 21 mines and factories visited in Peru employed 22,935 workers. 
Of these 21 plants, five were manufacturing (a glass bottle works, a 
28 cement mill, a refractory brick and chinaware plant, an asbestos and 
cement building material plant, and a woolen mill) ; 13 were mines, 
including a tunneling job for tin* hydroelectric project, a petroleum 
operation, a hydroelectric construction project, a smelter, and a coal 
washer. All the mines which produced metallic ores had concentrators. 
Of the 11 mines actually producing ore and concentrate, one was a 
gold mine; two produced coal; one, vanadium ore; and the balance, a 
mixture of copper, lead, zinc, and silver. Only 2,405 of the 22.935 
employees surveyed were employed in the manufacturing establish- 
ments. 
Chile 
A total of 21 establishments which employ 40,089 workers were cov- 
ered in the Chile survey. Eight of these were mining establishments 
typical of mining operations in Chile. Included were one coal mine, two 
nitrate mines, one sodium sulfate mine, and two copper mines and 
smelters. The eight mining establishments employed 34,552 workers, or 
75 percent of all the workers covered by the survey. 
The 13 manufacturing plants surveyed employed 11,537 workers of 
whom about 20 percent were women. Included in the variety of indus- 
tries represented were: a fish cannery, a sugar refinery which also 
made industrial alcohol, two textile plants, one lithography and print- 
ing shop, two glassware plants, one ceramics plant, one plant making 
steel rods, another plant producing copper wire, and another producing 
stoves and other metal products. 
OCCUPATIONAL HAZARDS 
Health and safety consciousness was at a low level among manage- 
ment and workers in most of the mines, mills, and the manufacturing 
and service industries covered by the surveys. Working conditions 
described in this and following sections reflect this apathy. 
In Chile, the author was impressed with the fact that the managers 
of the manufacturing establishments at least were not deliberately ex- 
posing their employees to health and safety hazards but were usually 
doing so unwittingly because of ignorance. A few industrialists felt 
that they made a sufficient contribution to social welfare by paying 
taxes and that anything else necessary should be done by the Govern- 
ment. It would be helpful if the Government itself would take the 
initiative in providing industrial hygiene and safety services. The fault 
has not been a lack of willingness on the part of the governmental 
agencies charged with this responsibility, but mainly a lack of suf- 
ficient funds and trained personnel. 
MINES 
Occupational health hazards in the mines in the three countries under 
observation were similar in many respects. The chief health hazards 
29 were exposure to silica dust released during drilling, loading, and 
transportation operations; carbon monoxide in some mine galleries; 
sulfur dioxide in a few mines where ores were sulfide in character, as 
in Peru; fumes from blasting powder; and high humidity, particularly 
in the lower levels of the mines, and other temperature extremes. 
The most serious of these health hazards was the exposure to silica 
dust which confirmed the high rate of silicosis among Bolivian, Peruvi- 
an, and Chilean miners. 
Bolivia 
The ore obtained from Bolivian mines surveyed contained free silica 
varying from 35 to 90 percent. The. silica was present as amorphous 
quartz mineral and also as crystalline quartz. Most of the dust was 
produced during drilling, blasting, and waste removal operations. 
Drilling was the mining operation which produced the greatest 
amount of dust. It was usually done with compressed air drills. 
Although drilling was supposed to be done wet to cut down on dust 
hazards, dry methods were frequently used. Even though some miners 
employed wet methods, a single mine crew using dry methods in a sec- 
tion could heavily contaminate the air in the entire section. One or two 
of the mines had installed air washers in the main air courses, but these 
only partially reduced the dust contamination. 
Air samples taken by members of the staff of the labor section during 
drilling operations indicated dust exposures varying from approximate- 
ly 30 million particles (wet drilling) to 600 million particles per cubic 
foot (dry drilling). 
Blasting operations were carried on during all development and 
stoping activities using 40 to 60 percent gelatin dynamite. During 
stoping operations, blasting was used not only to break the ore from 
the solid body, but also to break up large aggregates of mineral. Blast- 
ing produced much dust and, as a rule, took place at the beginning of 
the lunch hour or at the end of a shift. Lunch hour blasting, however, 
did not provide sufficient time for smoke and dust to clear. 
In the mines surveyed, the ore was usually conveyed to the surface 
and to the mill for dressing. Waste materials were used to till slopes. 
In these mines, the waste from crosscuts, drifts, and similar places was 
transported to the slopes and to other localities where it was needed. 
Generally, transportation was effected by vertical or horizontal means, 
and often by both methods. For vertical transfer downward gravity 
was usually employed either by raises made especially for the purpose, 
which connected levels with levels, or by stopes, which had shafts or 
ore chutes, similar to raises but connecting to the main level. Trans- 
portation methods were of mechanical and manual types. In the large 
mines, locomotives and haulage equipment were commonly used for 
horizontal transportation and skips for vertical transportation. The 
small mines used hand trams. 
30 Dust was released in all parts of the mines during rock removal and 
during transfer, but by far the largest amount of dust was produced 
during mucking or loading operations. A great deal of dust was also 
produced when ore was transferred from raises and ore chutes to cars. 
When mechanical methods were used in mucking dry ore, the dust was 
very excessive. For example, some of the dust counts made in typical 
mines showed concentrations of about 50 million particles per cubic 
foot during slope filling, 90 million particles during mechanical muck- 
ing, and 271 million particles when ore was transferred from loading 
chutes to cars. Concentrations of 50 million particles were found dur- 
ing mucking operations. On the other hand, some concentrations of 
only 5 million particles per cubic foot were obtained during loading 
operations when the ore had been thoroughly wetted down. 
Illumination in the mine workings came mostly from electric or car- 
bide lamps worn by the miners. Miners had to depend on natural 
ventilation through various shafts in the workings. In some of the 
lower levels the ventilation was very bad. Unguarded machinery in all 
of the mines and mills caused many serious accidents. Floors in the 
mills were all in bad condition, and generally wet. Most stairways and 
platforms were unguarded, and those that did have railings were in 
need of repair. 
In a good many of the mines transportation was by trolley. Low 
trolley wires were unguarded, and many switches were hazards. 
Peru 
At present, no data are available as to the amount of free silica in 
the various ores nor have any dust studies ever been made in Peruvian 
mines. However, some information is available to indicate that free 
silica is present in the ores and, in some instances, in high concentra- 
tions. In many of the mines, it was not necessary to make dust de- 
terminations to know that miners were breathing high concentrations 
of dust, since the amount of dust created in some of the mines was great 
enough to be visible to the naked eye. 
Drilling was one of the mining operations which produced great 
amounts of dust. Most of the drilling was accomplished with com- 
pressed air and although drilling was supposed to be done wet, dry 
methods were frequently encountered. Invariably the collaring of holes 
was done dry. In most instances where wet methods were employed, it 
was apparent that an insufficient amount of water was fed to the hol- 
low drill. The one gold mine visited, which was said to he typical of 
mines in the Southern area, was particularly dusty, since sufficient 
water was usually unavailable. In fact, the water used underground 
was brought to the mine in tins attached to ore buckets hauled over an 
8 kilometer aerial cable. 
Dust was released in many of the mines during rock removal and 
during transfer, but by far the largest amount of dust was produced 
31 during mucking or loading operations. A great deal of dust was also 
produced when ore was transferred from raises and ore chutes to cars. 
When mechanical methods were used in mucking dry ore, such as in 
scraping operations, the dust was excessive. 
With but one or two exceptions, mechanical ventilation was not em- 
ployed in Peruvian mines. When mechanical ventilation was provided, 
it was obviously insufficient in quantity, and in one case it was com- 
pletely ineffective because the system was not operating at the time of 
the visit. Natural ventilation was the rule and this was insufficient. 
Even when wet methods were employed, workers were still exposed to 
clouds of dust. Automatic air and water throttles were nonexistent, so 
that it was practically impossible to prevent dry collaring. Mine oper- 
ators did not know how much water was fed to the drills, although 
scientific studies have indicated the exact amount of water needed for 
various types of drills and drill speeds. Blasting, which produced tre- 
mendous quantities of dust, took place during the lunch hour in all 
mines. There was not enough time between the noon-hour blasting and 
the miners’ return to work for all the dust to settle. All of these factors 
were conducive to the inhalation of excessive amounts of silica dust, 
and the resultant rapid development of silicosis. 
It may be of interest to note in passing that in the fall of 1945 the 
Sociedad Nacional de Mineria of Pern invited an eminent ventilation 
Dry drilling in a coal mine 
32 Lead furnace in insoluble anode plant of copper smelter 
engineer of the Ontario Mining Association of Canada to study repre- 
sentative mines and mills in Peru and to make recommendations for the 
prevention of silicosis. The author of this report surveyed 10 of the 
mines and mills that had been \dsited by the Canadian engineer. In 
spite of excellent recommendations made by the Canadian concerning 
the prevention of silicosis, the author found that conditions in these 10 
mines were about the same as they had been Avhen he visited them 
nearly 2 years earlier. 
Most of the mills where ore was concentrated were in as poor condi- 
tion as the mines underground. Dumping and crushing of ore was done 
with few enclosures and no exhaust ventilation. On the whole, manage- 
ment in Peruvian mines has paid little attention to the control of dust 
at its sources, whether it be above or below ground. Although hundreds 
of thousands of dollars are now being paid out in compensation for 
silicosis, no company has tried to find out the composition or concen- 
tration of its dust exposures; to insist on wet drilling at all times; to 
provide mechanical ventilation where required; to use Avet methods in 
other dust producing operations such as loading and dumping; or to 
make anyone responsible for the maintenance of control methods. Res- 
pirators used in some of the mines and mills were of the unapproved 
type and no maintenance services Avere offered Avhen respirators were 
employed. Everything for compensation but nothing for prevention 
seemed to be the rule. Other pertinent obserArations on working condi- 
tions in the mines will be discussed later in this report, Avhen the sub- 
ject of occupational diseases is treated. 
33 At this point, it may be well to discuss working conditions in the 
large and only smelter in Peru in somewhat greater detail. This smelter 
employed approximately 3,000 persons and produced some 12 different 
products, including lead, copper, and silver. In addition to the smelter 
itself, there were many maintenance shops essential to such operations. 
The foundry which employed about 80 men on one shift was a com- 
bination brass, steel, and iron foundry. Housekeeping in this shop was 
bad. On dusty operations, the men wore cloth bag respirators. Sand 
blasting was done outside the building but with no control. There was 
a definite potential silicosis hazard in this shop. 
The machine shop, although offering no occupational disease hazards, 
contained many safety hazards from moving machinery, unguarded 
belts and gears. 
The steel fabricating shop contained welding, forging and rolling 
operations. It was observed that many workers who were welding did 
not wear goggles and that many of the welding operations were un- 
shielded, thus exposing nonwelders to welding hazards. 
The carpenter shop contained many accident hazards from unguard- 
ed moving machinery. 
The ore crushing and grinding department handled about 2,000 tons 
of ore a day. Some of these ores contained as much as 75 percent total 
silica. There was absolutely no attempt made to control dust on such 
operations as dumping, crushing, grinding, and mechanical conveying, 
so that clouds of dust given off polluted the entire plant. Although most 
Filling a mold with lead in a copper smelter 
34 Lead cathode starter machine 
workers were supplied with respirators and wore them, not a single 
respirator was of an approved type. 
The copper roaster, nearby, gave off tremendous quantities of sulfur 
dioxide gas. Nearly 1,200 tons of this gas were discharged through the 
furnace stack every day and polluted the atmosphere. 
About 12 people worked in the arsenic department. Although derma- 
titis cases occurred in this plant, it was claimed that no eases of poison- 
ing occurred. Personal hygiene in this department was rather good on 
the whole. The men were furnished clean overalls, bathing facilities, 
and a separate lunchroom. However, case histories on some of these 
men showed symptoms suggestive of arsenic poisoning. 
The copper furnace room also contained two lead blast furnaces. The 
operations in and about the lead furnaces were mostly unenclosed, so 
that Ihere was ample opportunity for exposure to high concentrations 
of lead dust and fumes. This was especially true at the two lead sinter- 
ing machines, which were observed to give off heavy clouds of lead 
oxide fumes. Other toxic lead locations weie found around the lead 
furnaces, in the production of lead cathode starters, and in the lead 
rolling mill. 
No cases of zinc oxide chills had been reported from the zinc roaster 
department, but the exposure should be studied. 
There were potential hazards from hydrofluoric acid in the hydro- 
fluosilicic acid plant. There was also a silicosis hazard in this plant, 
since the raw materials employed were free silica, fluorspar, and sul- 
furic acid. 
35 There was also a potential silicosis hazard in the brick manufacturing 
plant. 
This smelter contained many hazards to safety and health. The only 
exhaust ventilation installations observed were those in connection with 
coal pulverizing where it was necessary to protect the plant from dust 
explosions. 
Handkerchief used as a protection against 
acid mist in a copper smelter 
The antimony plant was also well controlled, but primarily in order 
to recover antimony. Housekeeping throughout the entire plant was 
very bad. One could not escape the conclusion that all this was but a 
reflection of the attitude of top management toward health and safety. 
A company as large as this one, employing nearly 12,000 workers in 
all of its operations, would find it profitable, in the long run, to pay 
some attention to the control of occupational diseases. In fact, it would 
be of distinct monetary benefit to the company and a forward step in 
labor relations if management established a full-time industrial hygiene 
department, with responsibility to study and control occupational dis- 
eases. Such a department should be responsible only to top manage- 
ment, so that its recommendations would be put into effect expeditious- 
ly. As a start, it would be imperative for this company to employ im- 
mediately a trained industrial hygiene engineer who could begin to 
control the many toxic exposures now present in the smelter. 
36 Chile 
One of the two large copper mines visited in Chile had installed an 
excellent industrial hygiene and safety program within the 2 preceding 
years. In that mine, working conditions underground were excellent. 
Some 215,000 cubic feet of air per minute (approximately 270 c. f. m. 
per man) were moved. In addition to ventilation, many other dust con- 
trol procedures were employed. The crusher plant associated with this 
mine was also well controlled from the standpoint of dust exposure. 
Four large fans, each with a capacity of 35,000 cubic feet per minute, 
were in operation. The dust exhausted from crushing operations was 
trapped in four air washers of the water spray type. 
The other large copper mine made only a slight effort to control the 
silica dust exposure. The greatest source of dust was the gyratory 
crusher building which handled approximately 140 tons of ore per 
minute in its two 60-inch gyratory crushers. The ore was dumped out 
of two gondolas at a time, each holding 70 tons. The mechanism by 
which this ore was dumped into the crusher is shown in one of the 
accompanying photographs. Also shown is the tremendous cloud of 
dust created during this operation which was carried on, as a rule, from 
3 o’clock in the afternoon until 7 in the morning. Considerable ex- 
posure to dust was also present in the open pit of the mine, where some 
2,700 men were employed; at the various secondary crushers; and all 
the way through the plant up to the leaching vats. The dust at this 
mine contained approximately 50 to 60 percent silica in the form of 
quartz. 
View of 2-car ore dumper 
37 Cloud of dust created at 2 gyratory ore crushers (same mill) 
One of the two nitrate mines covered in this survey maintained ex- 
cellent conditions in its various crushing, grinding, and bagging opera- 
tions. The other had no dust control program. It is true that the 
amount of quartz in nitrate ore is comparatively low; however, the 
dense clouds of dust liberated in the various crushing and pulverizing 
operations in the second nitrate mine should have been controlled if 
only to prevent accidents and damage to machinery. 
Working conditions in the sulfate mine and mill were probably the 
worst encountered in the entire survey. Much dust was in evidence and 
the only controls employed were respirators of an unapproved type. 
Serious hazards were found in the mills and smelters maintained by 
the copper mines including those associated with the copper mine which 
had instituted an industrial hygiene program. One smelter, which 
maintained a brick plant, had a serious silica dust exposure for which 
no control measures were in evidence. In addition, the smelters had ex- 
posures to sulfur dioxide, metallic fumes, and excessive heat from the 
furnaces. The various repair and maintenance shops, which were oper- 
ated in connection with the mining establishments, were poorly equipped 
to handle both safety and health hazards. 
On the whole, the survey revealed that some attempts to control occu- 
pational diseases and accidents had been made by two of the mining 
establishments and that the other establishments had a long way to go 
to achieve even fair working conditions. Perhaps this lack of health 
and safety consciousness on the part of the large concerns at least is 
due to the fact that until now the cost' for indemnifying workers for 
38 accidents or occupational diseases lias not been prohibitive. However, 
in recent years silicosis rates (and apparently silicosis is about the 
only occupational disease recognized and compensated in Chile), and 
rates for total disability have increased. Production costs have risen 
sufficiently to make management give serious consideration to the im- 
provement of working conditions. 
MANUFACTURING INDUSTRIES 
In general, it may be said that with the exception of a few of the 
manufacturing establishments surveyed, all of the industries in Bolivia, 
Peru, and Chile are about as backward in industrial hygiene and safety 
practices as were working establishments in the United States at the 
beginning of the present century. This is not hearsay evidence alto- 
gether, since the author of this report first began observing industrial 
hygiene practices in the United States some 28 years ago. 
For example, in the manufacturing and service industries surveyed 
in Bolivia only three of the plants—the textile plant, the cement plant, 
and the airplane repair shop—could be considered modern. Some at- 
tempt was made to guard machinery and control hazardous operations, 
and fair sanitary facilities were provided. 
Conditions in the remaining five Bolivian and in all Peruvian plants 
were not conducive to good health or safety. Illumination and general 
ventilation were inadequate. Machinery was completely unguarded. 
Electric wires were bare, and almost all hazardous operations were in- 
effectively controlled, or not controlled at all. Much of the machinery 
Cleaning table in a small fish cannery 
39 Flint grinding mill in a ceramic plant 
was old and badly maintained and most of the power machinery was 
belt driven and unguarded. Grinding wheels were unguarded and un- 
exhausted, nor were goggles worn by any of the men using these wheels. 
Housekeeping was, in all cases, poor. Floors were wet and in need 
of repair. In several plants stairs were dark, steep, and unguarded. 
Some of the plants which had mezzanine work rooms had no guard rails 
on these mezzanine floors. Sanitation was grossly inadequate and badly 
maintained. 
Bolivia 
Specific exposures to toxic substances and materials were found to be 
typical of such manufacturing establishments. For instance, in the 
three Bolivian plants manufacturing shoes or processing hides, ex- 
posures were found to various dyes, solvents, oils, acids, and other 
chemicals used in hide treating and tanning operations. Some exposure 
was found to gasoline which was kept in open containers. In the textile 
plant, exposures to cotton dust and dyes were common. Humidity was 
high in the spinning, carding, and weaving rooms, and noise was exces- 
sive in the weaving room. 
One of the worst plants visited in Bolivia was the glassware plant 
where observations were made during the night shift. Conditions in 
this plant are described here in detail, not because they were excep- 
tional, but because they were typical of present-day manufacturing 
establishments in Bolivia. 
The glassware plant contained about all the known health and safety 
hazards one can imagine. It was a typical sweat shop. Crowding was 
40 especially hazardous in the manual blowing rooms. Little boys sidled 
and jostled each other carrying glass-blowing rods, the ends of which 
were molten glass, and constantly exposed themselves to burns. In the 
same room, though unshielded open furnaces and the glaring molten 
glass presented serious eye and heat hazards, workers had neither pro- 
tective goggles nor clothing. Adequate air douches to combat the heat 
hazard were also lacking. In other parts of the plant, unguarded ma- 
chinery and bare electric wires were all in need of corrective attention. 
Dust of a toxic nature was present in several of the other workrooms. 
The respirators furnished the workers in the batch mixing rooms were 
ineffective and badly maintained. In fact, it was just as well that the 
men did not wear them, since they would only have instilled a false 
sense of security. Needless to say, sanitary facilities were almost nil. 
Peru 
Of the four manufacturing plants which handled toxic dusts, such as 
silica and asbestos, only one made any effort to install dust control 
equipment. The remaining three had heavy exposures to dust. The 
cement plant could be spotted some distance away from its location, 
merely by the dust cloud which appeared on the horizon, even during a 
typical Lima winter overcast. In these plants, too, whenever respira- 
tors were worn, they were of the cheap, unapproved and ineffective 
variety. The textile mill which produced woolen cloth was very archaic. 
All machinery was unguarded, floors were wet and slippery and the 
few sanitary facilities available were at some distance outside the plant. 
Most of the women workers, of whom there were 350, were Indians and 
wore long braids and many layers of exposed clothing. Both are con- 
ducive to accidents from unguarded machinery. 
Chile 
Most of the products manufactured in Chile are light consumer 
goods for domestic consumption. The principal goods made are food 
products; textiles such as cotton, wool, rayon; chemical products; 
leather and leather products; and light machinery. World War II gave 
impetus to the production of manufactured products for home con- 
sumption; the assistance industry is obtaining from the Chilean De- 
velopment Corporation is another factor in the recent growth of 
industrialization. 
With the exception of a few enterprises, most Chilean industries are 
small and employ few workers. Heavy industry is a recent develop- 
ment. For this reason, the country suffers from a shortage of skilled 
labor and technicians. 
It is apparent that Chile must conserve its manpower if it wants to 
compete with other countries which are rapidly developing industrially. 
To date, however, little has been done to conserve the health of workers 
41 in manufacturing plants. With but one or two exceptions, conditions 
in manufacturing plants in Chile are as backward in health and safety 
practices as those observed in Bolivia and Peru. 
OCCUPATIONAL DISEASES 
Occupational disease legislation has been enacted in all three coun- 
tries, but the emphasis is on compensation rather than on prevention. 
The compensation system in all three countries is characterized by 
certain weaknesses, both in the wording of the laws and in their ad- 
ministration. At the time of the studies, no reliable statistics on the 
incidence of occupational diseases in each of the countries were avail- 
able, but sufficient evidence was found to indicate that such diseases 
occur frequently. 
A characteristic of the compensation laws common to each of the 
countries under study is provision for payments for partial disability 
from silicosis. This is also one of the factors influencing high com- 
pensation expenditures for silicosis. This practice overlooks the fact 
that the medical profession does not have the exact scientific tools for 
evaluating partial disability from silicosis. The X-ray is a great aid in 
the diagnosis of chest conditions, but most authorities agree that in the 
field of silicosis it is an inadequate instrument for assessing disability 
from silicosis except in a gross manner. Neither is it possible to assess 
partial disability by daily work capacity, since that criterion varies 
with personal incentive, natural physical and mental endowments, and 
the nature of the job. Clinical criteria are also quite inadequate. A 
thorough study of all the factors involved is needed to arrive at a 
diagnosis of total disability. The problems involved in an attempt to 
assess partial disability are even greater. 
In Peru there seems to be no consistency with regard to the handling 
of partial disability cases. For example, some concerns employ men 
underground with first and second stage silicosis while others pay total 
disability for silicosis in its early stages. In Chile, many concerns 
prefer to pay a worker for partial disability from silicosis rather than 
to keep him on the job and later be faced with a claim for total disability. 
A far better approach to the silicosis problem would be to control the 
dust exposure to a safe limit and keep the man on the job. So long as 
he does not inhale more dust, his disease in the early stages should not 
progress. Only if infection sets in should he be indemnified for total 
disability and taken off the job. Experience in the United States has 
shown that, barring infection, a man with early silicosis is capable of 
doing a fair day’s work, provided he is protected from exposure, to 
dust. Indemnifying a worker for partial disability from silicosis does 
him harm rather than a favor, since he finds it difficult to procure 
employment elsewhere. 
42 liolicia 
'fhe only reliable statistics regarding occupational accidents ami 
diseases in Bolivia are those of the Caja de Seguro y. Ahorro Obrero, 
the governmental agency responsible for the national workmen’s com- 
pensation fund. This fund is maintained by collections from indus- 
trialists in the form of a payroll tax. Compensation is paid to work- 
men insured with the Caja for certain classifiable occupational diseases 
and accidents according to a schedule set up by law. 
The present occupational disease law provides for compensation for 
the pneumoconioses—silicosis, anthracosis, chalicosis, byssinosis, ta- 
bacosis, etc.; metallic poisonings; ophthalmic diseases; dermatoses; 
pulmonary sclerosis; nephritis; tuberculosis; and chronic bronchitis. 
During 1946, the Caja insured 35,000 workers, anti indemnified 
11,603 of them for occupational accidents and diseases. Of this number, 
231 workers received compensation for total disability from accidents, 
and 10,203 received compensation for partial or temporary disability, 
being paid anywhere from 50 to 100 percent of their wages for such 
injuries. In addition to these accidents, many more occurred which 
were not compensable by law, since they could not be classified as 
permanent or total, or temporary partial. In such instances, the worker 
received medical and hospital attention only. 
The 10,434 compensable accidents cost 8/ million Bolivianos in 
actual cash. This sum represented only the actual compensation paid 
workers for accidents and did not include medical and hospital bills 
and intangibles, such as spoiled work, breakage of machinery, and other 
factors which have been estimated to cost four times as much as the 
actual compensation cost. In other words, work accidents alone really 
cost nearly 50 million Bolivianos in 1946. 
The occupational disease picture was even more striking and tragic. 
In the same year, the Caja de Seguro indemnified 1,169 workers for 
occupational or professional diseases at a cost of 36 million Bolivianos 
in cash benefits. Thus, occupational diseases accounted for about 80 
percent of the total payments made to workers. This percentage was in 
direct contrast with compensation figures in the United States, where 
benefits paid for occupational diseases account for only about 5 percent 
of all the money spent on compensation for all types of disability. 
, If all costs are considered, cash benefits as well as production losses, 
Bolivian industry has been spending somewhere in the neighborhood 
of 200 million Bolivianos a year for accidents and occupational diseases. 
Disability in Bolivian industry is a costly affair not only in terms of 
human life and health, but also from the standpoint of economics. As 
a matter of fact, unless something drastic is done to curb these high 
accident and disease rates, manpower will soon be in short supply. 
About one-third of all,the workers insured with the Caja were indemni- 
fied for some form of disability in 1946. Obviously, the total disability cases were unemployable, since they presented insurance risks too great 
for an employer to take. Unemployable, also, were those who contracted 
silicosis, since totally disabling silicosis, that is, silicosis in the second 
and third stage, renders the worker uninsurable. Those workers who 
received partial disability compensation were also unable to work since 
preemployment physical examinations required by law weeded them 
out of the labor supply. 
A few pertinent observations must be made in connection with these 
high disease and accident rates, not for the sake of exposing unholy 
practices, but in the hope that something constructive can be done to 
eliminate them. 
Because of the low order of education among Bolivian workers, many 
of them deliberately exposed themselves to hazards. For example, many 
of them, in an attempt to contract first-stage silicosis (a compensable 
disease) refused to use the wet drilling methods required by law and 
internal regulations, even though water was right at their elbows. 
Management could have fined a disobedient worker 20 percent of his 
wages for a maximum of 15 days for violating internal regulations. 
(The money received from these fines went to the Minister of Labor 
for the purchase of school books.) A miner, however, was not greatly 
disturbed by such fines, since he still had pulperia privileges. Manage- 
ment could also have imposed more serious penalties by laying off the 
worker for 3 or 4 days, during which he lost not only his pay, but also 
his pulperia privileges. Management, however, hesitated to penalize 
the men drastically because of the labor unrest which existed in the 
mines. The miners had issued a manifesto advocating workers’ seizure 
of the mines. Mine labor was in a militant mood and not to be trifled 
with. 
Peru 
Although Peru has had an occupational disease compensation law 
since January 12, 1935, it is practically impossible to obtain nation- 
wide statistics on the incidence of occupational diseases. The reason 
for this paucity of data is to be found in the manner in which com- 
pensation for occupational diseases is administered. For example, if a 
worker believes that he is suffering from an occupational disease, he goes 
before the company physician who examines him. If he finds the 
worker’s claim valid, the doctor certifies him to the company for pay- 
ment. If the legal department of the company refuses to pay the claim, 
the worker has recourse to the local judge of the Ministry of Justice and 
Labor. If the claim fails to be adjudicated in the regional office of the 
Ministry of Justice and Labor, the worker’s last recourse is the court 
in Lima. It is apparent, therefore, that whatever data are available are 
scattered and no attempt has been made, so far, to centralize the in- 
formation. However, some idea of the incidence of occupational diseases 
44 in Peru was obtained during this survey from the records of a few 
companies which collected such information. 
The present occupational disease law provides disability payments 
for the pneumoconioses, and for poisoning incurred from exposure to 
mercury, arsenic, lead, bismuth, carbon monoxide, quartzite, calcite, 
cement, pitch, and hydrocarbons. Payment of indemnities for these 
causes, as well as for X-ray burns, is made on the same basis as for 
industrial accidents. In addition, acute or chronic pathological dis- 
orders, which may be brought on by the inhalation of noxious fumes or 
poisonous substances, are also considered on the same basis as indus- 
trial accidents. Two stages of disability are recognized for the pneu- 
moconioses, namely, total and permanent disability and partial and 
permanent incapacity. 
One firm which employs nearly 12,000 workers reported that 271 
cases of silicosis were certified by its medical department for payment 
in 1946. This same firm also reported 16 cases of lead poisoning which 
occurred in its smelter that year. Two years previously the same firm 
had reported 25 cases of lead poisoning at its smelter. Forty-two cases 
of dermatitis occurred in this plant in 1946 and 17 during the first 6 
months of 1947. 
A total disability case in Peru costs 2,400 soles. A worker who re- 
ceives total compensation is released. He is also entitled, by law, to 
service time payment amounting to 2 weeks’ salary for each year 
worked. It is obvious that compensation payments were an expensive 
item in this particular company’s budget. In fact, some half million 
soles ($BO,OOO at the official rate of exchange) were paid by this com- 
pany for occupational disease compensation in 1946. In addition, this 
firm paid $60,000 a year in bonuses to workers exposed to lead hazards. 
This same firm also spent approximately $lBO,OOO to operate its 135-bed 
hospital. No data were available on the amount of money this firm paid 
its workers because of general illnesses. Although not required by law, 
this company paid its workers half salary for the duration of any ill- 
ness. Because of this extra expenditure, it was not possible to figure 
out the total amount of money spent by this firm for disability cases, 
but it certainly must have been close to a half million dollars a year. It 
was quite obvious that this company was wasting not only its own 
capital, but also that of its workers through loss in wages, ill health, 
and inefficiency. A modern preventive health program run by the com- 
pany, under the leadership of the Government, is the only answer. 
Other examples of occupational diseases in Peruvian industry are at 
hand. In one mine, which employed nearly 1,500 workers at its various 
installations, some 1,900 applicants for work were examined in 1946. 
Three percent of these were rejected because of silicosis, apparently 
acquired elsewhere. Another mine employing some 500 men examined 
890 applicants for work during the first 6 months of 1947. Nine per- 
45 cent of these men were rejected because of silicosis and 14 percent be- 
cause of tuberculosis. Still another mine, employing about 450 men, 
reported that 8 percent of its workers had silicosis and tuberculosis. 
Another mine, employing 500 workers, reported 26.1 percent illness 
among its workers. The causes were pneumonia, grippe, bronchial pneu- 
monia and silicosis. There were 84 cases of silicosis at this establish- 
ment. At this same mine 19 percent of 815 persons examined for em- 
ployment in 1946 were rejected because of silicosis and tuberculosis. Of 
the 156 men rejected for these two causes, 128 had silicosis. And finally, 
the experience of still another mine was available for the period 1935 
through 1942. During those 8 years, out of some 6,499 men examined, 
14.3 percent were found to have silicosis. During the same period, only 
1.9 percent of those examined were found to have tuberculosis. 
It is obvious from the above data, even though they are from scat- 
tered sources, that high rates of silicosis and tuberculosis exist through- 
out Peruvian mines and mills. Unquestionably these rates are an under- 
estimate, since it is known that a high labor turnover tends to mask 
true conditions. Labor turnover in the factories is slight, with the ex- 
ception of one factory where it was reported to be 50 percent annually. 
But in most of the mines it is extremely high, running from 35 and 50 
percent yearly to more than 100 percent, especially for unskilled labor. 
It should be pointed out that there are many factors influencing the 
high labor turnover, among them being the fact that many of the un- 
skilled workers like to return to their farms for several months of the 
year during planting and harvesting time. On the other hand, one 
cannot escape the fact that high turnover is due largely to bad working 
conditions, low pay, and extremely bad living conditions. Much has 
already been made of the fact that the men live in company camps 
where restrictions are placed on their freedom. Workers feel that no 
matter how bad living conditions are on their farms, at least they are 
in their own homes and enjoy a certain sense of stability and freedom. 
■At the present time, Peruvian mines are in dire need of labor and 
production is at a low ebb. This survey revealed that anywhere from 
two to three hundred men were needed at each mine and mill without 
exception. A simple computation reveals the fact that the mines in 
Peru could use thousands of men to produce minerals and other re- 
sources which are at hand and which would go a long way toward 
raising the standard of living and the prosperity of the nation. The 
present practice of running mines with silicosis hazards, paying off 
men with partial or total disability, and doing nothing to clean up 
hazardous conditions, only serves to deplete the nation’s labor force. 
Apparently, something drastic must be done to eliminate the various 
evils discussed in this report, if production and purchasing power are 
to be raised. Before leaving this section, it is only fair to point out that manage- 
ment has difficulties in obtaining full-hearted cooperation from the 
workers in its few attempts to control accidents and occupational 
diseases. Because of the low order of education of Peruvian labor, it is 
difficult to get many workers to use preventive measures, such as wet 
drilling. Labor is quite militant in Peru and is difficult to handle, even 
though the labor laws provide for disciplinary action when health and 
safety rules are broken by workers. Experience has shown that educa- 
tion is a far stronger weapon than discipline and it would pay manage- 
ment to inaugurate an educational program among its workers in the 
field of health and safety. Such a program has been found to be sound 
business practice in other countries. 
Chile 
Chile has had a law providing for compensation of occupational 
or professional diseases since 1927. This law is an extension of the law 
passed in 1925 for the compensation of accidental injuries, and pro- 
vides that diseases developed in the course of employment be given the 
same interpretation as accidents. All wage earners, including agri- 
cultural and domestic workers, are covered by the law under a volun- 
tary insurance system. A State Insurance Fund competes with private 
insurance carriers and employers who have the right of self-insurance. 
The law grants total or partial disability compensation for profes- 
sional diseases and accidents in accordance with the injury sustained. 
Compensation payments are provided for these illnesses: lead poison- 
ing, mercurial poisoning, and intoxication produced by copper, anti- 
mony, zinc, chrome, barium, manganese, brass, gold, silver, tin, hydro- 
carbons, and sulfocarbons; diseases caused by infectious and parasitic 
agents, such as anthrax, carbuncles, glanders, actinomycosis, tetanus, 
and hookworm; diseases caused by the inhalation of dust, gases, and 
vapors; diseases induced by compressed air; diseases produced by toxic 
vapors of resins, tar, and its compounds; silicosis and other forms of 
pneumoconioses; cellulitis; synovitis; inflammation of the tendons : 
cataracts among glass workers; telegraph operators’ cramps, nystag- 
mus; diseases of the joints, muscles, and tendons; mental conditions; 
skin diseases; and diseases caused by exposure to alcohol and tobacco 
in industries which handle these two substances. 
There are several deficiencies in the occupational disease compensa- 
tion law as it is written and administered. It is obvious that little study 
of Chile’s occupational disease problem preceded the formulation of 
the list of diseases to be compensated. The list reads as though it were 
copied from laws passed in other countries. Some of the diseases listed 
may never occur in Chile. A few are not occupational in origin; others, 
perhaps, should be added. Insofar as the practical application of the 
law is concerned, silicosis is about the only disease which is recognized 
47 by physicians and compensation authorities and for which compensa- 
tion is granted. 
Because of the statistical system employed in the Labor Department 
and the State Insurance Fund which deals with accidents (Bureau of 
Labor Accidents) and because of incomplete reporting, it is difficult to 
determine the incidence of occupational diseases. For statistical pur- 
poses, little distinction is made between occupational diseases and in- 
dustrial accidents. In 1946 the Bureau of Labor Accidents paid com- 
pensation for only 81 occupational diseases among its more than 300,000 
insured workers. Other factors which preclude accurate statistics are 
high labor turnover, failure of physicians to recognize occupational 
diseases, and ignorance on the part of the workers. 
It is well known that many workers with silicosis are still employed 
in industrial establishments, in which silica in the form of quartz is 
handled. For example, 15 percent of 1,000 copper miners examined in 
1946 were found to have silicosis with varying degrees of disability. 
The company indemnified 62 cases that year. In the same mine, nearly 
500 silicosis cases had been settled during the preceding 12-year period. 
Although dust hazards are now being controlled in this establishment, 
there are still approximately 150 men employed by the company who 
will eventually be compensation cases because of previous dust ex- 
posure. 
In Chile, as was mentioned previously, the compensation law pro- 
vides for payments for partial disability from silicosis. 
Among other weaknesses of the present workers’ compensation system 
are the low benefits paid to disabled workers, with the exception of 
those paid to workers with total disability from silicosis. 
As has already been noted, little attention is paid to occupational 
diseases other than silicosis. Neither are there any special medical 
boards to decide on controversial claims for occupational diseases. 
No credit is given to industry for improvements made in working 
conditions; management is thereby robbed of an incentive for main- 
taining a preventive program. There is no second injury fund in Chile 
to remove the burden created by the aggravation of a previous injury 
from industrial management. This is a serious deterrent to the employ- 
ment of workers who have been injured, since employers are loathe to 
hire such poor insurance risks unless they are protected by a second 
injury fund. There is but a token amount of work being done to re- 
habilitate injured workers. The country is thus robbed of potentially 
productive workers and burdened needlessly from the point of view of 
welfare costs. 
Perhaps the most serious flaw in the entire administration of the 
compensation law is the lack of an adequate program for the preven- 
tion of disability among workers. This will be treated further in the 
48 discussion of governmental agencies which operate in the field of indus- 
trial hygiene. 
SAFETY PROVISIONS 
Although the elimination of safety hazards is not considered to be 
an integral part of an industrial hygiene program in most countries of 
the western hemisphere, the subject was considered during the present 
survey. In the few plants which had personnel responsible for safety 
practices, many obvious safety hazards were found to exist. Even in 
fairly new manufacturing plants, machinery was unguarded and poorly 
maintained. The extent to which safety provisions were made available 
to the workers in the establishments surveyed in the three countries is 
shown in table 6. 
Table 6.—Availability of safely provisions in all plants surveyed in Bolivia, Peru, and Chile 
Bolivia 
Peru 
Chile 
Provision or service 
All es- 
tablish- 
ments 
Mining 
Manu- 
factur- 
ing 
All es- 
tablish- 
ments 
Mining 
Manu- 
factur- 
ing 
All es- 
tablish- 
ments 
Mining 
Manu- 
factur- 
ing 
Establishments surveyed. 
23 
26,488 
15 
23,774 
8 
2,714 
21 
22,935 
16 
20,530 
5 
2,405 
21 
46,089 
8 
34,552 
13 
11,537 
Percent of workers to whom service is available 
Safety director: 
Full-time . 
19 
21 
60 
7 
53 
68 
8 
36 
35 
44 
15 
17 
(*) 
31 
(») 
35 
(*) 
31 
42 
Health and safety com- 
mittee 
33 
42 
6 
Number of plants providing service2 
Safety director: 
Full-time 
1 
1 
8 
7 
1 
6 
5 
1 
3 
1 
2 
4 
4 
4 
4 
Health and safety com- 
1 
1 
5 
4 
1 
1 Organizing. 
J Percent not computed because of small numbers. 
Bolivia 
In Bolivia, only one mine employed a full-time safety director. This 
person, however, did not spend his entire time on safety problems since 
he frequently served as a section boss in the mine. Three other estab- 
lishments had part-time safety directors. Shop safety committees in 
these plants were nonexistent, although one tin mine and mill indicated 
that such a committee was being organized. In one mine, a health and 
safety committee functioned. Such committees have been found ex- 
tremely useful in the control of health and safety hazards in some of 
the more highly industrialized nations of the world. 
49 Peru 
Eight establishments surveyed had full-time safety directors, and 
four plants employed them on a part-time basis. In none of the Peruvi- 
an industries surveyed were there such instrumentalities for the im- 
provement of health and safety as shop committees or joint labor- 
management health and safety committees. 
This lack of attention to safety was reflected in the accident experi- 
ence of many concerns. One large establishment with a population of 
nearly 12,000 workers experienced 14 deaths and 1,006 lost-time acci- 
dents in 1946. This experience yields a frequency rate of 39.87 per 
million man-hours of exposure. One mine which employed 1,500 persons, 
and which had obvious safety hazards both above and below ground, 
experienced 1,410 minor accidents, 31 serious and 10 fatal accidents 
in 1946. 
No current national statistics were available for accidents in mines, 
but data were at hand for 1944. In that year there was a total of 2,854 
accidents in the mines and mills. For manufacturing plants, the latest 
data available were for 1945, when a total of 18,310 accidents was 
reported. 
Chile 
Although Table 6 indicates that five of the mining establishments and 
one manufacturing plant had full-time safety directors, only three 
companies employed men in this capacity. One of these companies 
operated a coal mine and a ceramic plant; another operated a copper 
mine, smelter, and repair shop; and the third, a copper mine and 
smelter. The first company held safety classes for workers; the other 
two had shop safety committees. 
The one coal mine visited during the survey was reputed to be the 
best mine of that type in operation. However, safety hazards were 
found both underground and on the surface. 
Health and safety committees functioned in one glass plant, in a 
copper mine and smelter, and in establishments of another copper 
company. 
The lack of attention paid to the safety of Chilean workers is 
dramatically reflected in accident statistics for the year 1946. Accord- 
ing to information obtained from the Labor Department, some 90.000 
accidents occurred in Chilean industry that year. Manufacturing con- 
tributed nearly 30,000 accidents to the total; agriculture, approxi- 
mately 16,000; and mining, 14,000. In other words, these three indus- 
tries accounted for two-thirds of all accidents which occurred. In 
passing, it should he noted that agricultural workers sustained a rela- 
tively high number of accidents. Although accidents and occupational 
diseases are rarely associated with agricultural pursuits, problems of 
this character have been on the increase in these occupations largely 
50 as a result of advances in farm mechanization and the increasing use 
of toxic insecticides. Experience all over the world indicates that just 
as much attention should be paid to industrial hygiene and accident 
control work for those engaged in agriculture as for those engaged in 
manufacturing and mining. 
Chile’s accident statistics in 1946 show that accidents and costs are 
on the increase. (Although occupational disease statistics are included 
with those for accidents in Chile’s records, the former make up a very 
small part of the total.) In 1946, accidents increased 45 percent over 
1945, and 37 percent over 1944. It is of interest to estimate the mone- 
tary cost of industrial accidents. 
According to Labor Department statistics, approximately 90 million 
pesos were paid out in compensation alone. It is now well established 
through careful studies that the hidden costs of accidents, such as those 
involved in breakage of machinery, time lost by other workers when a 
fellow worker is injured, and other similar losses, average four times 
the compensation costs. In other words, the sum lost because of acci- 
dental injuries in Chile in 1946 was approximately 360 million pesos. 
To that sum must be added the cost borne by the nation because of loss 
of production. Some estimate of this sum can be obtained by an 
analysis of statistics furnished by the Bureau of Labor Accidents. 
In 1946, this organization kept accurate data on 60 industries which 
employed 17,764 workers. In these 60 industries, accidents accounted 
for the loss of 68,699 work days. On the average, each worker in the 
60 plants lost about 4 days a year because of accidents. If we apply 
this figure to the whole of Chile’s labor force, we arrive at a loss of 
about 7 million work days a year. Taking an average wage of 30 pesos 
a day per worker and estimating that a Chilean worker produces goods 
valued at 170 percent of his wages, each worker may be said to produce 
50 pesos of goods a day. Fifty pesos lost for 7 million days a year 
produces a loss of 350 million pesos of production value for the nation. 
Adding this figure to the 360 million pesos paid for compensation, it 
is evident that industrial accidents cost Chile some 700 million pesos 
annually. 
At this point it may be of interest to make a comparison between 
accident experience in Chile and in the United States, where there has 
been an active preventive program for a good many years. In the 
United States accidents in industrial pursuits account for only 0.7 
of a day of lost time per person per year. Even if we take into con- 
sideration the fact that occupational diseases are included along with 
accidents in Chilean statistics, we are still confronted with the in- 
escapable fact that nearly six times as much time is lost from work 
because of accidents in Chile as in the United States. These figures 
are significant, since work accidents can practically always be pre- 
vented. 
51 SANITATION FACILITIES 
Sanitation facilities in Bolivian and Peruvian mines and mills, and 
in manufacturing establishments as well, are wholly inadequate and 
in a terrible state of maintenance. In some mining communities, 
workers have no facilities for the disposal of human excreta and use the 
neighboring hills for this purpose. Such practice helps to spread com- 
municable disease, which is already prevalent throughout these coun- 
tries. Water supplies, washing facilities, personal clothing lockers, and 
other sanitary facilities are completely lacking in many establishments 
and are entirely inadequate in others. 
Chilean workers fare a little better in that sanitation facilities, 
though sometimes inadequate, are available to most of them. Toilet 
facilities, however, are generally insanitary; washing facilities are 
sometimes lacking; and clothing locker facilities are not always pro- 
vided. A summary of the availability of sanitation and certain welfare 
facilities in all plants surveyed in each of the three countries is pre- 
sented in table 7. 
Bolivia 
Sanitation facilities in the 23 plants surveyed were grossly inade- 
quate. Three plants had no water supply at all. Public or private 
water supplies were available in 20 of the plants in which 97 percent 
of the workers were employed. In most instances, the water came from 
wells which were not of approved types. 
Drinking facilities were available in 14 plants which employed 85 
percent of the workers. Only two of these plants had drinking foun- 
tains. In the remaining plants, workers drew water from spigots and 
shared common drinking utensils. 
Washing facilities were lacking in 10 mines and one factory. Nine 
plants, employing 55 percent of the workers, provided wash basins 
or sinks. Eight plants, employing 63 percent of the workers, supplied 
a few showers, but only one or two of these had hot water. Six plants, 
employing 13 percent of the workers, had running cold water, while 
six other plants, employing 53 percent of the workers, provided both 
cold and hot running water. In most instances, the plants provided 
neither towels nor soap. 
Toilet facilities were available in seven manufacturing plants and in 
six mining and milling establishments. In the mines they were chiefly 
of the pit privy type. In general, these facilities were inadequate 
as to number and type, were located in foul, dank, and dark enclosures, 
and were revoltingly insanitary. 
Sewage disposal facilities were provided in 12 of the 23 plants sur- 
veyed. Six plants had public disposal systems and six used private 
disposal methods. 
Little attention was paid to other personal comfort facilities. Very 
52 few plants provided workers with individual lockers. A few such 
lockers were found in four plants, which employed 8 percent of the 
workers. Two small plants had separate locker rooms. Only two 
mining establishments had lunchroom facilities for their workers. 
Peru 
Sanitation facilities in the 21 establishments surveyed in Peru were 
likewise grossly inadequate. Public water supply systems were avail- 
able to four plants. The remaining 17 establishments, wrhich employed 
the majority of the workers in the survey, were furnished water from 
private systems. In only one plant was the water filtered. In most 
instances the water came from unapproved sources, and in some of the 
mining camps the water supply was scarce. 
No drinking facilities were available in seven establishments, em- 
ploying 15 percent of the workers. Eight establishments, with 44 per- 
cent of the workers, had drinking fountains. In five establishments 
workers drew water from spigots, and in three others open buckets 
and carboys were used. 
No washing facilities were available in 13 establishments, employing 
almost one-half, or 41 percent, of the workers surveyed. One of these 
establishments was a manufacturing plant, and the rest were mining 
enterprises. Seven plants, employing 43 percent of the workers, pro- 
vided wash basins or had spigots available for washing purposes. 
Seven plants, employing 56 percent of the workers, provided some 
showers. Only two establishments, a mine and a smelter, provided both 
hot and cold running water, and two of the manufacturing establish- 
ments provided individual towels and soap. As a rule, towels and soap, 
when used, were provided by the workers themselves. 
Toilet facilities in the plants and mines were even worse than those 
provided the men in their homes. Flush toilets were available in only 
two of the mining enterprises and in four of the manufacturing group 
of establishments surveyed. In the remaining 15 establishments cover- 
ing 64 percent of the workers, facilities consisted of latrines, ditches or 
troughs, and cans underground. One large mine provided no under- 
ground facilities whatsoever. In general, these facilities were inade- 
quate and grossly insanitary. 
Only 3 percent of the establishments, employing 4 percent of the 
workers, had public sewage disposal systems, while six used private 
methods of sewage disposal. In the remaining 12 establishments (all 
in the mining group) which employed 48 percent of the workers, either 
no sewage disposal facilities were provided or open ditches were used 
for this purpose. 
Lockers for street clothing were the exception rather than the rule. 
They were provided by three plants, employing 6 percent of the 
workers. Two of these plants were in the manufacturing group of 
53 industries. One other plant was building locker rooms at the time of 
the survey. 
Lunchrooms or space for eating at the work place were provided by 
four establishments and in four of the mines underground. These 
covered a little over one-third of the surveyed population. Seven 
establishments provided no space, although most of the workers ate 
their lunch at the work place. In six of the mining enterprises the 
workers went home for lunch, as did the mill workers in seven of the 
mining and milling establishments. One camp provided a dining room 
for single men where they could get three meals for one sole per day. 
One of the plants not only provided lunchrooms for its workers, but 
also served coffee at 4 o’clock in the afternoon. These were the only 
instances encountered in which management undertook supplementary 
feeding. 
Chile 
Sanitation facilities were provided in most of the 21 establishments 
surveyed in Chile. 
Sewage disposal systems were available in all establishments studied. 
In one nitrate plant and at one copper mine and smelter the sewage 
was treated fairly thoroughly. 
Public or private water supplies were likewise available in all the 
plants surveyed. In 10 establishments, employing 28 percent of the 
workers, drinking fountains were furnished. In 10 other establish- 
ments, employing a similar number of workers, the only drinking 
water available had to he taken from spigots, while in 4 mining estab- 
lishments the workers carried their own water in canteens. Three 
establishments provided both fountains and spigots. Drinking utensils 
were usually of the common type. 
Washing facilities were lacking in two raining and in three manu- 
facturing establishments, which employed 26 percent of the population 
surveyed. Sixteen establishments, employing 74 percent of the workers, 
provided wash basins or sinks. Six mining establishments, employing 
71 percent of the workers, provided showers with both hot and cold 
water. Two manufacturing plants provided cold showers. 
Toilet facilities were provided in all establishments except one mine. 
These were of the flush type in 19 establishments, pit privy type in 1 
mine, and chemical toilets in another mine. In general, these facilities 
were inadequate and insanitary. 
Lockers were available in six mining and in nine manufacturing 
establishments which employed 72 percent of the workers. In one 
factory clothes hung on wall nails. 
Feeding facilities at workplaces were provided in three mining and 
in one manufacturing establishment. No facilities were provided in 
10 establishments; and in 7 others, the workers lived close to their 
homes and went home for lunch. 
54 Table 7.—Availability of sanitation and welfare provis:ons in all plants surveyed in 
Bo'ivia, Peru, and Chile 
Bolivia 
Peru 
Chile 
Provision 
All es- 
tablish- 
ments 
Mining 
Manu- 
factur- 
ing 
All es- 
tablish- 
ments 
Mining 
Manu- 
factur- 
ing 
All es- 
tablish- 
ments 
Mining 
Manu- 
factur- 
ing 
Establishments surveyed- 
Workers included 
23 
26,488 
15 
23,774 
8 
2,714 
21 
22,935 
16 
20,530 
5 
2,405 
21 
46,089 
8 
34,552 
13 
11,537 
Percent of 
workers to whom service is available 
Water supply: 
32 
25 
93 
9 
4 
48 
26 
1 5 
57 
65 
71 
7 
91 
96 
52 
74 
85 
43 
Sewage disposal: 
12 
4 
SO 
4 
2 
18 
26 
15 
57 
56 
60 
19 
48 
44 
82 
74 
85 
43 
Open ditch or none 
Drinking facilities; 
32 
36 
1 
48 
54 
5 
44 
47 
15 
28 
23 
41 
80 
83 
52 
18 
11 
75 
28 
17 
59 
23 
2i 
11 
45 
60 
15 
17 
16 
Washing facilities: 
50 
99 
43 
42 
74 
71 
81 
63 
62 
76 
56 
57 
71 
13 
13 
9 
44 
37 
34 
66 
17 
66 
Hot and cold water 
53 
34 
53 
38 
55 
1 
22 
41 
25 
42 
34 
57 
26 
71 
29 
15 
19 
Toilet facilties; 
50 
99 
30 
26 
59 
73 
64 
100 
Privy, latrine, ditch 
31 
35 
64 
67 
41 
22 
29 
14 
15 
1 
6 
7 
5 
7 
8 
81 
6 
15 
72 
71 
73 
Feeding facilities at work- 
place: 
33 
35 
36 
39 
15 
42 
54 
6 
Space not provided 
Workers eat at home 
67 
0) 
65 
(*) 
100 
(l) 
32 
32 
30 
31 
44 
41 
46 
12 
44 
2 
52 
42 
Number of establishments providing service2 
Water supply; 
9 
2 
7 
4 
2 
2 
10 
1 
9 
11 
10 
1 
1 
17 
14 
1 
3 
11 
7 
4 
Sewage disposal: 
6 
3 
2 
10 
1 
9 
6 
4 
2 
6 
3 
3 
11 
7 
4 
Open ditch or none 
Drinking facilities: 
11 
2 
10 
1 
12 
12 
2 
8 
6 
2 
10 
5 
5 
12 
6 
6 
5 
3 
2 
10 
2 
8 
3 
2 
1 
4 
4 
9 
9 
(s)7 
7 
(s)7 
4 
Washing facilities: 
9 
2 
7 
3 
16 
6 
10 
8 
3 
7 
4 
3 
8 
6 
2 
6 
2 
4 
8 
4 
4 
8 
8 
6 
3 
3 
2 
2 
8 
6 
2 
11 
10 
1 
(s) 13 
(3) 12 
1 
5 
2 
3 
Toilet facilities: 
9 
2 
7 
6 
2 
4 
19 
6 
13 
Privy, latrine, ditch 
4 
4 
14 
1 
2 
2 
10 
9 
1 
1 
1 
1 
(4)1 
4 
4 
3 
1 
2 
15 
6 
9 
Feeding facilities at work- 
place: 
2 
2 
8 
6 
2 
4 
3 
1 
Space not provided 
Workers eat at home 
21 
(l) 
13 
(') 
8 
(') 
7 
13 
(*)12 
2 
1 
10 
7 
4 
1 
6 
6 
1 Not determined. 
2 Percent not computed because of small numbers. 
3 Includes mining establishments where provisions differ for underground and mill workers. 
* Mine. The availability of medical services in the establishments surveyed 
in each of the three countries is presented in table 8, which gives the 
proportion of workers provided with services and the number of 
establishments providing the service or facility. On the whole, the 
figures indicate a high percentage of facilities in groups of establish- 
ments under study, but the figures are for most part misleading when 
one takes into consideration the type of facilities provided. This is 
especially true in Bolivia and Peru, where medical services are grossly 
inadequate from the standpoint of quality and quantity. Workers in 
Chile fare considerably better as will be explained in the following 
discussions. 
MEDICAL SERVICES 
Bolivia 
Some form of medical service was offered in all but three of the 
establishments surveyed and was available to 97 percent of the workers 
involved. Plant physicians, on a full-time, part-time or on-call basis, 
were retained by all but three of the plants. Ten mining and milling 
plants, employing 86 percent of all workers surveyed, had full-time 
physicians. No full-time physicians were found in any of the manu- 
facturing or service industries. Two mines and mills and four manufac- 
turing plants employed part-time physicians. Four other manufacturing 
plants had physicians on call. Sixteen percent of all the workers sur- 
veyed were covered by these part-time services. 
Preplaceraent examinations were given in all but two establishments. 
Periodic examinations, however, were given in only three of the plants, 
and, in those, only upon a worker’s request. 
These plants employed 66 percent of all the workers .surveyed. Part- 
time nursing services were never used. 
First-aid facilities were available to a large proportion of the 
workers surveyed. Seventeen plants, employing 82 percent of the 
workers, had first-aid rooms; 15 plants, employing 89 percent of the 
workers, had first-aid kits; and eight plants, employing 62 percent 
of the workers, employed trained first-aid workers. These facilities 
were fairly well distributed among the mining and manufacturing 
groups. 
Evidence of hospital facilities made available to workers by their 
employers was also found. Two types of hospital facilities were 
observed, company-owned hospitals and contract hospitals. Seven of 
the mines, employing 87 percent of the workers in this group of indus- 
tries, operated their own hospitals. Another mine, employing 3 per- 
cent of the workers, had a contract with a private hospital for the 
hospitalization of its workers. Four manufacturing plants, employing 
78 percent of the workers, had similar arrangements. In other words, 
hospital facilities were available to 89 percent of the workers included 
in this survey. 
56 Dental services were available to 86 percent of the workers. Five 
mining establishments employed full-time dentists, -while three others 
retained part-time dentists, as did three of the manufacturing estab- 
lishments. 
Nursing services, on the other hand, were less common. Nine mines 
and mills and two manufacturing plants had nurses on full-time duty. 
Table 8.—Availability of medical provisions and services in all plants surveyed in Bolivia 
Peru, and Chile 
Provision or service 
Bolivia 
Peru 
Chile 
All es- 
tablish- 
ments 
Alining 
Manu- 
factur- 
ing 
All es- 
tablish- 
ments 
Mining 
Manu- 
factur- 
ing 
All es- 
tablish- 
ments 
Mining 
Manu- 
factur- 
ing 
Establishments surveyed- 
23 
15 
8 
21 
16 
5 
21 
8 
13 
Workers included- 
26,488 
23,774 
2,714 
22,935 
20,530 
2,405 
46,089 
34,552 
11,537 
Percent of 
workers to whom service is available 
Hospital: 
78 
87 
87 
98 
77 
98 
13 
11 
3 
78 
6 
2 
First-aid room 
82 
82 
86 
98 
98 
100 
98 
100 
91 
First-aid kit-, _ 
89 
89 
92 
100 
100 
100 
100 
100 
100 
Trained first-aid worker.. 
62 
60 
84 
96 
96 
93 
98 
100 
91 
Physician: 
80 
96 
87 
98 
77 
98 
13 
11 
61 
10 
93 
37 
29 
62 
47 
3 
2 
7 
6 
25 
Nurse: 
Full-time 
66 
68 
48 
92 
98 
41 
93 
100 
72 
Dentist: 
55 
62 
62 
56 
13 
31 
28 
56 
9 
10 
41 
42 
39 
8 
7 
18 
3 
11 
Physical examinations: 
Preplacement - - - 
99 
99 
100 
97 
98 
93 
95 
98 
86 
Periodic - - 
8 
4 
42 
39 
41 
18 
67 
71 
55 
(') 
(l) 
(1) 
24 
27 
77 
98 
15 
Medical care provided 
87 
97 
62 
69 
78 
98 
28 
Environmental hygiene 
program. 
55 
56 
44 
2 
18 
15 
17 
6 
Number of plants providing service2 
Hospital; 
7 
7 
14 
14 
9 
7 
2 
1 
4 
3 
1 
2 
First-aid room. .. 
17 
12 
5 
20 
15 
5 
19 
8 
11 
First-aid kit - 
15 
9 
6 
21 
16 
5 
21 
8 
13 
Trained first-aid worker.. 
8 
3 
5 
18 
14 
4 
19 
8 
11 
Physician: 
10 
10 
14 
14 
9 
7 
2 
6 
2 
4 
4 
4 
8 
2 
6 
4 
4 
3 
2 
1 
5 
5 
Nurse: 
Full-time 
n 
9 
2 
16 
15 
1 
16 
8 
8 
Dentist: 
5 
5 
4 
4 
5 
3 
2 
6 
3 
3 
4 
4 
8 
4 
4 
4 
2 
2 
2 
2 
Physical examinations: 
Preplacement. ....... 
21 
13 
8 
19 
15 
4 
17 
7 
10 
Periodic 
3 
1 
2 
5 
3 
2 
13 
6 
7 
C1) 
(') 
(') 
2 
2 
10 
7 
3 
Medical care provided 
11 
11 
6 
6 
11 
7 
4 
Environmental hygiene 
program 
4 
2 
2 
2 
2 
4 
3 
1 
1 Not determined. 
2 Percent not computed because of small numbers. 
57 With the exception of one or two hospitals which were well staffed 
and equipped, most of the facilities available to the mine and mill 
workers in Bolivia were completely inadequate by ordinary standards. 
One mine, which claimed it had a hospital, made no provisions for 
separate rooms for men and women, and had no instruments or medical 
equipment. 
Peru 
According to Peruvian law, all mines and mills which have a staff 
of 50 or more and are situated more than 30 hours from a resident 
certified physician, must have a staff physician residing permanently 
on the site. Those establishments with 100 or more persons must pro- 
vide dental consultation at least weekly, and if the personnel is 1,500 
or more a permanent dental service must be provided. Establishments 
employing more than 2,000 persons in a locality where no hospital is 
available within 50 kilometers must provide a hospital. Those mines 
with less than 50 persons must provide at least a medicine chest and 
a male nurse trained in first-aid. 
Medical services on full-time or limited basis were offered in all but 
one of the establishments surveyed. In the factories, however, the 
medical services were of a part-time character. 
Hospitals were owned and operated by 14 establishments in the 
mining group of industries, covering 87 percent of the workers. One 
construction project had hospital arrangements with the Servicio Co- 
operative Inter-Americano de Salud Publica, and two of the manu- 
facturing plants had arrangements with the National Social Insurance 
Fund for hospitalization of their employees. 
A total of 35 full-time physicians were employed in the mining in- 
dustries surveyed. These were chiefly employed in connection with 
hospitals operated by these companies. However, two mining camps 
employed physicians on an “on call” basis. No full-time physicians 
were retained by any of the five manufacturing plants. Four of these 
retained physicians on a part-time basis and one on an “on call” 
basis. 
Full-time nurses were employed by 15 establishments in the mining 
group and by one plant in the manufacturing group. Very few trained 
nurses were observed with the exception of those employed in the largo 
hospitals maintained by two large mining concerns. Most of the 
medical assistants were practical nurses, or practicantes, as they are 
called. Most of the smaller mines, that is those employing less than 
£OO persons, had hospitals with anywhere from 6 to 10 beds, but these 
could only be classed as first-aid stations. As a rule, these hospitals 
were poorly equipped and the one doctor in attendance not only had 
to take care of all the workers, but their families, too. For example, 
cne mine, employing nearly 1,500 persons, of whom 800 worked under- 
ground, had only one physician in attendance who looked after all the 
58 workers and their families. This meant that one physician had to look 
after six or seven thousand people with only three practicantes to 
assist him. The hospital was extremely inadequate and insanitary. It 
contained just 10 beds, which had no springs or mattresses, but merely 
planks. Sick people had to bring their own bedding. 
There were few exceptions to this state of affairs. On the whole the 
medical and hospital facilities provided most of the workers in the 
mines visited were grossly inadequate. Furthermore, the physicians in 
these localities were so overworked that about all they had time to do 
was to render first-aid and emergency medical care. In only one plant, 
one belonging to the Government, was there a physician who also had 
responsibility to do something about the prevention of occupational 
diseases and illnesses. 
First-aid facilities were provided in practically all establishments 
surveyed. The construction project did not have a first-aid room nor 
a trained first-aid worker, but it did have a first-aid kit. One coal 
mine and a glass manufacturing plant had no trained first-aid workers, 
but the former employed several practical nurses and maintained a 
hospital. Some of the mines had underground first-aid stations. 
Although physical examinations before employment are required by 
law, two establishments did not comply with this provision. Periodic 
examinations were only conducted in two factories and in three mining 
establishments. In spite of the fact that silicosis is a major health 
hazard in the mines of Peru and the X-ray a valuable tool in the 
diagnosis and medical control of this disease, only two mines utilized 
the X-ray during preemployment examinations. Another was plan- 
ning to do so. As a result, most of these establishments were hiring 
some men who unquestionably were already silicotic. One would expect 
that some of these plants would at least install an X-ray machine for 
their own protection so as to weed out silicotics who might put in a 
claim later. 
Few establishments gave dental services as required by law. Eight 
establishments in the mining group, employing 64 percent of the 
workers, maintained full-time or part-time dentists. Two other estab- 
lishments in this group and two in the manufacturing group had 
dentists on call, but in most instances these services were not in 
existence. 
Chile 
Chile has had medical care, social security, public health, and social 
welfare programs since the passage of its famous Law 4054 on Septem- 
ber 8, 1924. This law covers practically the entire working population. 
No attempt will be made in this report to discuss the ramifications 
of Chile’s social security system, since this has been done adequately 
by many students of the problem. An attempt will be made to indicate how the social security benefits provided impinge on the health and 
welfare of industrial workers. 
Medical services and plant dispensaries required by Law 4054 were 
available in all but two of the establishments surveyed—the cannery 
and the printing shop. In these two plants a physician was available 
on an “on-call” basis, but no other medical facilities were provided. 
Full-time plant physicians were retained by seven mining and two 
manufacturing establishments covering 77 percent of the surveyed 
population. These establishments owned and operated their own 
hospitals. 
Part-time physicians were employed by two mining and six manu- 
facturing establishments, and in the remaining five manufacturing 
plants the physicians were on an ‘ ‘ on-call ’ ’ basis. These physicians were 
usually supplied by the Workers’ Compulsory Insurance Fund. 
Nurses were employed by all eight mining and by eight of the 13 
manufacturing establishments for hospital work and for plant dis- 
pensaries, These services were available to 93 percent of the workers 
surveyed. A few of the large companies employed other medical person- 
nel, such as technicians and pharmacists. The hospitals operated by 
some of the large mining concerns were well equipped, staffed and 
maintained. 
Full-time dentists were employed by three mining and two manu- 
facturing establishments. Part-time services were provided in eight 
establishments, while in two others dentists were “on-call.” 
First-aid facilities, including a first-aid room and trained first-aid 
workers, were available in all but two of the plants surveyed. First- 
aid kits were available in all the establishments. 
Chile’s Preventive Medicine Law, which was enacted early in 1938, 
provides for free periodic compulsory medical examinations for 
workers. The law is administered by the Workers’ Compulsory Insur- 
ance Fund. 
Preplacement physical examinations were given in all but four of 
the establishments surveyed and reached 95 percent of the workers. 
Periodic examinations were given for employees in 13 establishments, 
employing 67 percent of the workers. Chest X-rays were included in 
the physical examinations given in 10 establishments, employing 77 
percent of the workers. One mine took X-rays of all workers who had 
worked in other mines and made stool examinations on miners coming 
from mines where hookworm was known to be prevalent. 
The practice with regard to periodic examinations differed from 
plant to plant. Usually they were given annually. In two establish- 
ments such examinations were voluntary. One company reexamined its 
old workers two or three times a year, while a glassware plant with 
a definite silicosis hazard examined its men twice a year. 
In eleven of the plants surveyed medical services were also provided 
for workers’ families. 
60 It is pertinent to the present discussion to note that the Preventive 
Medicine Law is in principle perhaps the finest social law which the 
country has passed. From the standpoint of industrial hygiene, how- 
ever, there is a weakness in its application. The law does not utilize 
the physical examination as an aid toward the proper placement of the 
worker. In reality, an examination made under the provision of the 
law is a periodic examination and not a preemployment or preplace- 
ment examination. Most often, except in large concerns which employ 
physicians on a full-time basis, preemployment physical examinations 
are given by physicians employed by the Workers’ Compulsory Insur- 
ance Fund. These physicians are unacquainted with the specific re- 
quirements of jobs in industrial plants. In fact, it is doubtful if many 
of them have ever stepped inside such a plant. As a result, they are 
not able to utilize the physical examination as a means of placing the 
worker in the right job. In the United States anti in Great Britain 
this technique has been developed into a useful tool and is a new 
approach, particularly in regard to the employment of persons who 
are physically handicapped. In the past a person’s handicaps were 
listed by the physician and sent to the employment department. Today 
the practice is to list a person’s abilities and to match them with the 
physical and mental requirements of a job. In this manner, every 
prospective worker has an opportunity for useful employment. Such 
an approach is especially to be commended to a nation like Chile which 
needs every trained person it can muster. 
Another aspect of Chile’s medical care program deserves mention. 
Although close relationships are maintained between the various social 
insurance funds and the Ministry of Health, Social Insurance and 
Social Assistance, these relationships apply only to the administration 
of the funds and not to the substantive aspects of a public health pro- 
gram. The agencies concerned with social insurance and assistance 
maintain their own medical and professional staffs, and make little 
use of the technical staffs of the public health agencies. Much work 
of mutual benefit can be done cooperatively by the Public Health De- 
partment and the social insurance funds, especially in epidemiology, 
health education, and specific preventive health services. A cooperative 
program has been attempted in the field of venereal disease control 
but has not been carried over into other public health activities. 
SICKNESS BENEFITS 
A summary of the availability of sickness benefits and disability 
records in the establishments surveyed in each of the three countries 
is shown in table 9. Some form of sickness benefits is compulsory in 
each of the three countries. As the situations differ, each country will 
be discussed separately. 
61 '('able 9.—Availability of sickness benefits and records in all plants surveyed in Bolivia, 
Peru and Chile 
Bolivia 
Peru 
Chile 
Service 
All es- 
tablish- 
ments 
Mining 
Manu- 
factur- 
ing 
.A 11 es- 
tablish- 
ments 
Mining 
Manu- 
factur- 
ing 
All es- 
tablish- 
ments 
Mining 
Manu- 
factur- 
ing 
Establishments surveyed 
23 
26,488 
15 
23,774 
8 
2,714 
21 
22,935 
16 
20,530 
5 
2,405 
21 
46,089 
8 
34,552 
13 
11,537 
Percent of workers to whom service 
is available 
Sickness benefits; 
Supplemented by: 
91 
96 
66 
11 
45 
Management and 
4 
34 
1 
5 
40 
54 
95 
95 
100 
Disability records kept on: 
(>) 
85 
8 
(*) 
84 
7 
(‘) 
100 
19 
76 
82 
25 
88 
100 
54 
Occupational illness 
Nonoccupational illness 
76 
79 
82 
82 
25 
59 
87 
33 
98 
32 
54 
36 
Number of plants providing service2 
Sickness benefits: 
Supplemented by: 
19 
15 
4 
5 
Management and 
1 
1 
1 
1 
3 
3 
19 
11 
8 
Disability records kept on: 
(') 
14 
3 
(l) 
6 
1 
(') 
8 
2 
17 
14 
3 
16 
8 
8 
Occupational illness 
Nonoccupational illness 
17 
18 
14 
14 
3 
4 
15 
9 
7 
4 
8 
5 
1 Not determined. 
2 Percent not computed because of small numbers. 
Bolivia 
According to Bolivian law, owners of mines and industries who 
employ more than a specified number of workers must pay sickness 
benefits to their employees for nonoccupational illnesses. A worker who 
has been employed from 3 to 6 months is entitled to one-fourth of his 
pay up to a maximum of 15 days. If he has been employed from 6 
months to a year, he is entitled to half his pay for 15 days. Day 
workers employed more than a year are entitled to 1 month’s pay 
during nonoccupational disability. Salaried employees may obtain 
sickness benefits up to a maximum of 3 months’ pay, if they have been 
employed more than 1 year. Nineteen of the establishments surveyed, 
in which 95 percent of the workers were employed, offered these sick- 
ness benefits and hospitalization covering nonoccupational illness and 
accidents. 
Although 19 plants paid nonoccupational sickness benefits, only 
three plants kept records of these illnesses. There were, therefore, no 
accurate data available as to the extent or cost of nonoccupational 
illness. 
62 Peru 
The compulsory social insurance scheme providing benefits for sick- 
ness, maternity, invalidism, old age, and death, established by lawr in 
Peru in 1936, is now regulated by a decree promulgated in 1941. Com- 
pulsory insurance applies to all persons from 14 to 60 years of age who 
habitually work for an employer and wrhose annual wage does not 
exceed 3,000 gold soles. Certain classes of workers, such as Govern- 
ment employees, are excluded from the lawr. The funds are made up of 
contributions from the workers (1.5 percent), employers (3.5 percent) 
and the State (1 percent). 
In order to receive sick benefits under compulsory insurance, the 
beneficiary must have paid four weekly contributions in the four 
months preceding sickness. Benefits which start from the third day 
of illness may continue for 26 weeks, and in protracted illness up to 
52 weeks. Medical, hospital, and limited dental services are furnished 
free. In addition, 50 percent of the average daily wage is paid as cash 
benefits during the first 4 weeks of illness and 40 percent thereafter. 
The fund also provides maternity benefits and invalidism benefits wdien 
the earning capacity of the worker has been reduced by two-thirds. 
Old age and death benefits are also provided. 
The program is administered by the National Social Insurance Fund 
and managed by an advisory board. Workers’ hospitals where treat- 
ment under this law may be obtained were in operation. The finest of 
these w-as the one in Lima which opened in 1940. This was 1 of a net- 
work of 12 hospitals which the social insurance fund wras constructing. 
Unfortunately, several of the hospitals constructed by the Fund have 
not been fully completed inside and lack essential equipment. As a 
result, many workers in Peru had to put up with the inadequate serv- 
ices provided by some of the industrial establishments. 
All workers in the plants surveyed received sickness benefits as re- 
quired by law' covering hospitalization, occupational and nonoccupa- 
tional illnesses, and accidents. In 15 of the mining establishments the 
workers received additional cash payments from management to sup- 
plement the amounts provided by the National Social Insurance Fund. 
In four manufacturing establishments supplementary sickness bene- 
fits were furnished by management and in one manufacturing plant 
by management and the union. 
Disability records on accidents and occupational illness were kept 
by 17 establishments, employing 76 percent of the workers. Records 
on nonoccupational illness were maintained by 18 establishments, em- 
ploying 79 percent of the workers. As a rule, these records were in- 
adequate and did not furnish reliable data on the extent of illness 
among the workers and their families. 
Nearly all employed persons in Peru come under the National Social 
Insurance Fund, Disability records, therefore, were maintained for 
63 all of them. However, it was just as difficult to obtain nation-wide 
statistics on sickness as it was on accidents and professional diseases. 
Sufficient scattered data were obtained to indicate that sickness among 
employed persons in Peru was a real problem and one which resulted 
in large monetary losses due to absenteeism. 
One large mining concern, employing 5,000 persons, experienced 689 
cases of illness during 1946 with a total loss of time from work of 
6,875 days. Another large establishment, employing approximately 
2,400 persons, stated that its sickness absenteeism amounted to 2 per- 
cent. Perhaps the best information covering the fairly large group of 
employed persons was that obtained from the Obrero Hospital in Lima, 
which is maintained by the Caja Nacional de Seguro Social. The 
records of this Hospital showed that in 1946 it had 106,318 workers 
on its beneficiary rolls. The lost time among this group for that year 
totaled 998,960 days. This yields an average of approximately 9.4 
days per person per year, a rate considerably higher than that expe- 
rienced in the United States, where the average days lost from just 
sickness is about seven per person per year. 
It would be helpful if the National Social Insurance Fund could 
maintain more adequate and complete records, so that it could analyze 
its experience and, on the basis of its findings, launch a preventive 
program. Or at least it might provide leadership to help the public 
health authorities and the industries of the nation conduct such a 
program. 
Chile 
Nearly all workers in Chile are entitled to sickness insurance under 
the Compulsory Insurance Law. It was found, however, that sickness 
benefits required by law, which entitle a worker to medical, surgical, 
pharmaceutical and dental care and hospitalization beginning with the 
first day of illness and lasting 26 weeks, do not entitle him to full 
weekly salary payments, except for the first week of illness. In five 
of the manufacturing plants, employing 11 percent of the workers, 
cash benefits were supplemented by management; unions supplemented 
payments in three mining establishments, employing 40 percent of the 
workers; and management and the union jointly supplemented pay- 
ments in another manufacturing plant. The amount of supplementa- 
tion varied—one plant added ten pesos daily to the fund, while an- 
other added 15 pesos daily. In one textile plant, management stated 
that it paid out 50.000 pesos annually for this purpose, while in a 
glassware plant, management made up the difference between what the 
workers received and his full salary. 
Five manufacturing establishments kept no disability records. The 
other 16 establishments maintained records on accidents; 15 had 
records on occupational diseases; and 9 on nonoccupational illnesses. 
Records of nonoccupational illness were very meager, but they did in- 
64 dicate a high tuberculosis rate. In general, disability records were 
neither extensive, uniform, nor adequate. 
Fairly reliable statistics on sickness among workers can be obtained 
from the records of the Workers’ Compulsory Insurance Fund. Un- 
questionably, workers’ illnesses are the most important cause of lost 
time and production. 
Data are available on 836,505 physical examinations made from 1938 
to 1945, inclusive. During these 8 years, 50,824 persons (5.9 percent) 
were found to have tuberculosis; 55,437 (6.4 percent) had venereal 
disease; and 37,513 (4.3 percent) were suffering from cardiovascular 
diseases. In other words, about 16 percent of those examined were 
suffering from these three serious conditions alone. Emphasis is placed 
on these three diseases because the law provides total or partial pre- 
ventive rest with full wages for a period of time determined by the 
possibilities of reemployment for persons found to have them. Special 
medical boards determine a worker’s rights to a rest cure. 
In 1946, 1,200,000 persons were insured with this agency. Payments 
were made for 4,500,000 days of time lost because of illness, including 
chronic illnesses which required rest cures. 
If one makes a correction for the fact that the Fund' requires a 4- 
day waiting period, it is found that the average worker in Chile loses 
about 7 days a year because of sickness. Applying this figure to the 
total labor force in Chile, we arrive at a yearly production loss from 
illness of 12,250,000 man-days. Using the figure of 50 pesos a day which 
was employed in the discussion of accidents, we find that 612,500,000 
pesos are lost yearly to the national income because of illness. Add 
to this the cost of operating the Fund itself, and we arrive at a 
total annual monetary loss because of illness of 1,250,000,000 pesos. 
This figure is actually an underestimate, since some half million persons 
are not insured with the Fund. If we add the monetary loss caused by 
illness to the loss previously cited for accidents and professional 
diseases, we are confronted with the fact that some 2 billion pesos are 
lost in Chile every year because of disability experienced by its labor 
force. This sum represents ten percent of the present national income 
of Chile and constitutes one-third the national budget. 
It is obvious from the foregoing that time lost on the job because 
of illness and accidents in Chile is a serious problem from several 
points of view. The task of improving the health status of Chilean 
workers must be attacked from two sides at once—through the work- 
place and the community. 
65 V. Current Activities 
Concerned with 
Industrial Hygiene 
In the three countries under study it was found that several official 
and nonofficial agencies have a legal responsibility or an interest in the 
field of industrial hygiene. Since any permanent industrial hygiene 
and safety program that may be established should take advantage of 
every available resource in existence, the survey included a study of 
all agencies which might have some bearing on the problem. 
OFFICIAL AGENCIES 
Bolivia 
Although on May 8, 1946, the Villarroel Government promulgated 
a decree establishing an industrial hygiene inspection service, the 
decree was never implemented. As a matter of fact, the Government 
in power in March 1947, was the third Government which failed to 
implement it. As a result, no official industrial hygiene and safety 
division existed in Bolivia at the time of the survey here reported. 
It was found, however, that several official agencies were engaged in 
activities which were directly or indirectly related to industrial hygiene 
and safety. 
The activities of the following official agencies were studied during 
the survey: Direccion General de Sanidad (Department of Health), 
Inspeccion General de Trabajo (Department of Labor), and Caja de 
Seguro y Ahorro Obrero (Workmen’s Compensation) all agencies 
within the Ministerio del Trabajo, Salubridad y Prevision Social 
(Ministry of Labor, Health and Social Welfare, later replaced by two 
separate ministries) ; Direccion General de Minas y Petroleos (Depart- 
ment of Mines) ; and the. Servicio Cooperative Inter-Americano de 
Salnd Publica (SCISP) (Inter-American Cooperative Public Health 
Service). Of the agencies located within the Ministerio del Tabajo, Salubridad y Prevision Social, and the Caja de Seguro y Ahorro Obrero 
enjoyed the greatest autonomy. 
Department of Health (Direccion General de Sanidad).—Bolivia is 
politically divided into nine departments, which are subdivided into 
provinces, which, in turn, are further broken down into cantones. The 
Department of Health, however, administered its services through 12 
sanitary districts, headquarters of which were most often located in 
department capitals. Those in charge of sanitary districts directed 
public health programs through the capitals of the provinces under 
their jurisdiction. Those in charge of health programs in the provinces 
had jurisdiction, in turn, over health establishments in the cantones. 
During 1946, the Department of Health and its related services, 
including hospitals, employed approximately 2,000 persons on a full- 
or part-time basis. This figure did not include the personnel of the 
various health missions sent into the country by the United States, 
the Rockefeller Foundation, and religious groups. 
The Department of Health encompassed several Divisions—Vital 
Statistics, Records, Technical Services, Nursing Services, Biologic 
Products, Ophthalmology, Maternal Hygiene, Sanitary Engineering, 
and Research. At the time of this survey, however, the greatest proof 
of these Divisions’ existence was an organization chart. 
The Director General of Public Health was deeply interested in 
industrial hygiene, but the limited funds and organization at his dis- 
posal are not conducive to the furthering of an industrial hygiene and 
safety program. 
Department of Labor (Inspeccion General de Trabajo).—The De- 
partment of Labor included Divisions of Labor Conciliation and 
Factory Inspection. The latter function was administered through 
four geographic zones. The number of factory inspectors employed, 
however, was far too small even to begin to cope with factory problems. 
It is doubtful whether the staff could visit the mines and factories for 
which they were responsible once a year. The Division of Factory 
Inspection, like the Department of Health, has left the field of indus- 
trial health completely untouched, although it has concerned itself 
somewhat with the prevention of accidents. 
Workmen’s Compensation (Caja de Seguro y Ahorro Ohrero).—The 
government agency which has done most in the field of industrial 
hygiene and safety, with the exception of the SCISP (a temporary 
agency), is Workmen’s Compensation. This agency handles the na- 
tional workmen’s compensation fund and workers’ savings. The agency 
lias a director, a general manager, and Divisions of Safety, Adminis- 
tration, Engineering, and Economic Studies. 
In an effort to protect its funds, the Agency has attempted to in- 
augurate industrial hygiene and safety practices in those industries 
with which it dealt. Under the jurisdiction of the Medical Division. 
67 a small group of workers concerned itself with a program for the pre- 
vention and control of occupational accidents and diseases. This sec- 
tion was staffed by a safety engineer on loan from the International 
Labour Office and a physician who had been sent to the United States 
to study industrial medicine. This small staff had instituted a pro- 
gram of preplacement examinations for workers, including chest X-rays 
to determine their fitness for employment in the dusty trades. The 
clinical examinations given were quite sketchy, however, and it was 
questionable whether they would yield the results desired. 
Department of Mines (Direccion General de Minas y Petroleos).— 
The Department of Mines took no active part in insuring mine safety 
and hygiene. It concerned itself primarily with economic studies of 
mine resources in Bolivia. 
Inter-American Cooperative Public Health Service (Servicio Co- 
operative Inter-Americano de Salud Puhlica) (SCISP).—The only 
industrial hygiene and safety work of any note was that conducted 
by the Labor Section of the SCISP. Some of SCISP’s activities have 
been mentioned in an .earlier section of this report. In addition, SCISP 
was attempting to strengthen the Division of Factory Inspection within 
the Department of Labor. 
Although SCISP was set up as a temporary organization, its activi- 
ties provide an excellent foundation for a long-range permanent indus- 
trial hygiene and safety program. 
This study of official agencies which might have been concerned with 
industrial hygiene revealed quite clearly that little was being done 
which might serve as a nucleus for an industrial hygiene program. 
Nevertheless, if a permanent program is to be established, there will be 
a need to coordinate all the scattered activities which are in existence, 
so that all resources may be used to advantage. 
Peru 
Although only the Ministry of Health and Social Welfare is author- 
ized to conduct industrial hygiene activities, other official and non- 
official agencies in Peru have a stake in the problem. The official 
agencies covered in the present inquiry were the Department of Labor 
in the Ministry of Justice and Labor, the Bureau of Mines and Petrol- 
eum in the Ministry of Development and Public Works, the Depart- 
ment of Health in the Ministry of Public Health and Social Welfare 
and the Inter-American Cooperative Health Service. 
Bureau of Mines and Petroleum.—The Bureau of Mines and Petrol- 
eum is charged with the prevention of accidents in mining establish- 
ments. Although the law under which the Bureau functions states that 
mining establishments must hire security inspectors and regional tech- 
nical delegates to make inspections and recommendations, the Bureau 
has one chief mine inspector and three assistants to administer the 
68 program in the entire country. Obviously, this is an inadequate staff. 
Its impotence is reflected in the fact that many safety hazards were 
observed during this survey. 
Department of Labor.—This Department maintains a division of 
factory inspection which concerns itself primarily with safety hazards, 
employment of women and minors, and workhours and wages. The 
factory inspection division maintains 21 regional offices. The Depart- 
ment of Labor also handles compensation claims for occupational 
diseases and accidents. Neither this Department nor the Bureau of 
Mines concerns itself with industrial hygiene. 
Department of Health.—The Department of Health in the Ministry 
of Health and Social Welfare is a centrally organized activity. The 
author observed the work of its various divisions, particularly the work 
of such divisions as sanitary engineering, venereal disease control, 
malaria control, vital statistics, tuberculosis control, nutrition, and the 
National Institute of Hygiene, Avhich operates the laboratories of the 
Health Department. All of these divisions were operating with limited 
funds and personnel, but evidenced a deep interest in the possible in- 
tegration of industrial hygiene with their work. As pointed out in the 
earlier sections of this report, general public health problems in the 
industries of Peru are so great that it will be essential to integrate 
industrial hygiene work with the other public health activities if a 
total health program is to reach all workers. This phase of the program 
will be discussed in the recommendations which will follow. 
Inter-American Cooperative Public Health Service.—Under the 
terms of the contract between the Institute of Inter-American Affairs 
and the Ministry of Health and Social Welfare setting up the Servicio 
Cooperative Inter-Americano de Salud Publica, the work of the 
Servicio is limited to certain areas of the nation. The mining sections 
in the Central Andes and in the northern and southern sections of the 
country have not yet been touched by this cooperative program. The 
Servicio is badly needed in these areas in which the largest part of 
the nation’s population lives and works. It is hoped that the coopera- 
tive service will play an important role in the establishment and de- 
velopment of an industrial hygiene program in Peru. 
Chile 
The official agencies covered in the study were the Ministry of 
Health, Social Insurance and Social Assistance, including the Depart- 
ment of Health, the Workers’ Compulsory Insurance Fund, the School 
of Public Health, and the Inter-American Cooperative Public Health 
Works; the Industrial Hygiene Section of the Department of Inspec- 
tion in the General Labor Office of the Ministry of Labor; the Bureau 
of Labor Accidents; the Department of Mines and Petroleum in the 
Ministry of Economics and Commerce; and the Development Corpora- 
tion, 
69 Department of Health.—The Department of Health in the Ministry 
of Health, Social Insurance and Social Assistance functions as a cen- 
trally organized activity. The divisions in this Department have been 
created and developed in a haphazard fashion, which has often led to 
overlapping services. The author reviewed the work of these Divisions, 
paying particular attention to those which might be involved in a 
complete health program for industrial workers. Among these Divi- 
sions were Industrial Hygiene, Sanitary Engineering, Tuberculosis 
Control, Venereal Disease Control, Health Education and Vital Statis- 
tics. For the purpose of the present discussion, only the work of the 
Division of Industrial Hygiene will be considered in detail. It is suf- 
ficient to report that the heads of other Divisions were deeply interested 
in coordinating their work with any industrial hygiene program which 
might be developed. The importance for such a coordinated approach 
in a country such as Chile, where so much public health work needs to 
be done, has already been discussed and will be treated again in the 
recommendations which follow. 
The Division of Industrial Hygiene in the Department of Health 
was organized in 1932, but until a few years ago, it was staffed by un- 
trained people. During the early period, the Division devoted itself 
to inspection work in Santiago and placed its main emphasis on general 
sanitation. A physician, an engineer, and chemist were trained in the 
United States during 1944-45, but since 1946 only the physician has 
been engaged in industrial hygiene work. At the present time, the 
Division consists of one physician, one engineer, one secretary, and 
one stenographer. The physician and engineer have responsibilities 
other than their industrial hygiene activities in the Department of 
Health; their salaries are derived from several sources. In addition to 
his duties in the Division, the physician works in a hospital, is re- 
sponsible for the industrial hygiene course at the School of Public 
Health, and has been used by the Labor Department as an impartial 
arbiter in medico-legal problems in connection with compensation 
claims; the engineer is employed in one of Sanitago’s sanitary districts. 
The present budget for the Industrial Hygiene Division is pitifully 
small; it provides the part-time salaries of the personnel listed, and a 
pittance for travel. No funds are allowed for equipment or supplies. 
With the aid of funds acquired from the Institute of Inter-American 
Affairs, the Industrial Hygiene Division has begun to establish a 
laboratory at the School of Public Health and is also acquiring chem- 
ical reagents needed for its work. Some equipment needed for field 
studies has also been obtained. The Division’s library is not very ex- 
tensive. It contains little besides books and reprints which are the 
personal property of the physician. At the Department of Health, 
the Division has two offices and no laboratory. Better facilities for the 
Division are located in the School of Public Health where there is au 
office for the physician and engineer, and two laboratoi’ies. 
70 After unsuccessful attempts to organize a minimum staff for the 
Industrial Hygiene Division, the physician has confined his activities 
to the conduct of preliminary surveys in Chile’s important industries. 
These have been done with the assistance of other divisions in the 
Health Department, the Department of Mines and Petroleum, the In- 
dustrial Hygiene Section in the Labor Department, and other agencies. 
A report of these surveys has been presented to the Department of 
Health. Other activities of the Division have been of an epidemiological 
nature, such as a study of anthrax, an investigation of hazards in the 
hemp industry, and animal studies on carbon monoxide poisoning. 
More recently, the Industrial Hygiene Division surveyed some 400 in- 
dustries in Sanitary District 1 of Santiago. This survey was pre- 
liminary in character and served only to define the industrial hygiene 
problem. In order to assist these industries with the solution of their 
problems, it will he necessary to make detailed studies of the health 
of the workers and their working environments. This can only be 
done through the activities of a complete industrial hygiene program. 
The Industrial Hygiene Division of the Department of Health is 
responsible for supervising all matters relating to industrial welfare, 
investigating occupational diseases, and developing methods for their 
control. Because of a lack of funds and limited personnel, these re- 
sponsibilities have not been fulfilled. The Division’s outstanding ac- 
complishment has been the definition of the industrial hygiene problem 
in Chile’s industries through the conduct of preliminary surveys of 
health hazards. Since this is the first step which must be taken when 
a complete industrial hygiene program is established, the work which 
has been done so far is a step in the right direction. 
Workers’ Compulsory Insurance Fund.—No attempt will be made 
to discuss the work of the Workers’ Compulsory Insurance Fund in 
this report since .a comprehensive article on the subject, entitled 
“Social Security in Chile,” by Wilbur J. Cohen was published in the 
May 1947 issue of the Social Security Bulletin. The author wishes to 
point out that this agency has some responsibility for industrial 
hygiene through the work of its Institute of Labor Medicine and its 
activities under the Preventive Medicine Law. 
Unquestionably, the social security laws of Chile, taken as a unit, 
constitute one of the most important pieces of social legislation enacted 
anywhere in the world. Chilean workers who are suffering from some 
form of disability are assured of adequate medical and hospital care 
and relief from some of their financial burdens. In this respect, 
workers in Chile are far better off than workers almost anywhere else 
in the world. 
Chilean industries place great emphasis on a worker’s welfare. Some 
of the larger plants offer facilities for recreation and education, and 
provide nurseries and counseling on personal problems through social 
service divisions. 
71 It is unfortunate that Chile’s attitude toward compensating a 
worker for disability is not matched by a similar attitude toward the 
prevention of disability. With but one or two outstanding exceptions, 
this study shows that industry pays no attention to the prevention 
and control of accidents, occupational diseases, and illnesses. Ap- 
parently, management believes that it has done its duty when it has 
paid taxes for social security and welfare benefits. There is apparently 
little realization on the part of management that it is far cheaper in 
the long run to prevent a disability than to pay for it; workers do not 
seem to recognize that no amount of money will give them back their 
health or lost limbs. An effective and vigorously prosecuted industrial 
hygiene program is needed to prove to industry and labor that preven- 
tion is cheaper than compensation in the long run. 
School of Public Health.—The School of Public Health, created in 
1943, is supported by the Department of Health, the University of 
Chile, and the Rockefeller Poundation. Its erection was a project of 
the Inter-American Cooperative Public Health Works. Since its estab- 
lishment, the School has presented a course in industrial hygiene and 
built up its facilities in this field. Through its many contacts the 
School has gained the confidence and respect of industry which looks 
to it for guidance and leadership on industrial hygiene matters. 
The School of Public Hcaltii is the only agency in Chile wiiich has 
the trained personnel, equipment and laboratory facilities for the con- 
duct of an effective industrial hygiene program. While enjoying close 
working relationships with the National Department of Health and 
other governmental agencies which administer social welfare laws, the 
School is able to carry on its work untrammelled by political considera- 
tions. Dor these reasons, the School is in an excellent position to render 
impartial fact-finding services in industrial hygiene to botli industry 
and government. 
Inter-American Cooperative Public Health Works.—Since early 
1943, the Ministry of Health, ISociai insurance and iSocial Assistance 
and the Institute of inter-American Affairs have been operating a co- 
operative public health program. The agreement between these two 
agencies is similar to agreements which the Institute of Inter-American 
Affairs has made with health ministries in other Latin American 
countries. No attempt will be made to discuss the excellent work which 
this program is accomplishing in the field of public health. The sani- 
tation projects, health centers, and hospitals built by the Inter-Amer- 
ican Cooperative Public Health Works should be mentioned, however. 
The author desires to point out that the Inter-American Cooperative 
Public Health Works is in an excellent position to assume an active 
role in any industrial hygiene work which may develop in Chile. 
Labor Department.—The Department of Labor has responsibility in 
the field of industrial hygiene, and in the administration of the work- 
72 men’s compensation laws. The Industrial Hygiene Section in the De- 
partment of Inspection is composed of three physicians and three 
engineers. The latter operate on a regional basis—one out of Santiago, 
one out of Antofagasta, and the third out of Concepcion. This staff, 
however, is not specifically trained in industrial hygiene and has 
neither equipment nor laboratory facilities for evaluating health haz- 
ards and devising methods of control. The services of the industrial 
hygiene physician in the Department of Health have been used to 
diagnose questionable occupational disease claims. 
Bureau of Labor Accidents.—The Bureau of Labor Accidents is a 
government-controlled insurance fund which insures workers against 
accidents and occupational diseases in Chile. The Bureau has a staff 
of eight inspectors whose duty it is to study and eliminate hazards. 
None of these inspectors has been trained. The Bureau maintains a 
Traumatological Institute, which treats injured workers and provides 
them with some vocational training after their treatment is completed. 
An educational program, designed to prevent accidents in industry, is 
also conducted by the Bureau. 
Department of Mines and Petroleum.—The Department of Clines 
and Petroleum functions primarily as a technical and scientific agency 
and deals with matters related to mining and allied industries. This 
Department is responsible for administering the mining code and other 
legislation which regulates working conditions in mines. The few mine 
inspectors employed by the agency do not have the technical knowledge, 
the equipment, or the facilities for conducting an effective health pro- 
gram in-the mining industry. 
Development Corporation.—The Development Corporation of Chile 
is a government-financed organization established in 1939 to spur 
Chile’s industrial and economic development. The Corporation func- 
tions by means of loans, capital investments, and direct operations. As 
a result of the activities of the Corporation, many new manufacturing 
industries have been developed and others have received financial sup- 
port for expansion and modernization. The Corporation is particularly 
interested in developing heavy industry in Chile and has recently as- 
sisted with the development of power resources and the construction 
of a steel mill. 
The Development Corporation has an unusual opportunity to estab- 
lish progressive and modern industrial hygiene programs in those 
industries which it operates itself and to foster such programs in those 
industries which it is assisting financially. 
Overlapping of Functions.—Cohen, in his recent article on social 
security in Chile, points out that some 40 separate agencies administer 
social insurance laws. Although the majority of the country’s insured 
wage earners are beneficiaries of only five of these agencies, there is 
bound to be some duplication of effort even among these five. This 
73 duplication of effort stems largely from the fact that there is an over 
lapping of authority in the basic laws under which the agencies func- 
tion. 'ibis is especially true with regard to industrial hygiene activi- 
ties. For example, the Ministry of Labor has the right to maintain an 
Industrial Hygiene Section within its Department of Labor while the 
Ministry of Health has authorization for a Department of Industrial 
Hygiene in the National Department of Health. The Bureau of Labor 
Accidents is empowered to carry on an advisory industrial hygiene and 
safety program among its insured. The Workers’ Compulsory Insur- 
ance Fund, through its Institute of Labor Medicine, also functions in 
this field. The Department of Mines and Petroleum has responsibility 
for the health and safety of workers in mining and allied industries. 
And, finally, even the municipalities have broad authority in many 
phases of industrial hygiene. In order to avoid some of the duplica- 
tion of effort present in the limited programs now in existence in these 
agencies in Chile, there is obvious need for leadership to effect coordina- 
tion. One of the recommendations will discuss how this may be ac- 
complished. 
NON OFFICIAL AGENCIES 
Important resources in the development of public health programs 
are the nonofficial voluntary agencies. Industrial hygiene authorities 
have stated that the major needs fulfilled by an industrial health and 
safety program are the prevention of disability in industry through 
proper control of the working environment, medical and surgical care 
to effect prompt restoration of health and earning capacity following 
disability, and promotion of good general health among workers. It is 
obvious that voluntary organizations can help immeasurably with the 
fulfillment of these needs. 
For example, in the United States, the Council on Industrial Health 
of the American Medical Association lias suggested activities and stand- 
ards for physicians who work in industry, as well as for private prac- 
titioners. Although it is true that the official industrial hygiene agenej' 
can serve as a spearhead for bringing health services to workers, it is 
also true that most workers turn to their own physicians when they 
are in need of medical attention. For this reason, the work done by the 
Council on Industrial Health has been of great value. Similarly, in- 
dustrial hygiene in the United States has drawn heavily upon the 
assistance and support of agencies sponsored by management groups, 
local medical societies, universities, and, in recent years, progressive 
labor unions. 
Bolivia 
In Bolivia, no activities of the type described above were in progress. 
There are almost 600 physicians in Bolivia, nearty half of them in 
74 La Paz. Some of these physicians are employed full time by industrial 
concerns, but few of them have a working knowledge of the occupa- 
tional diseases or of the preventive aspects of medical practice. During 
this survey, the medical society was in process of reorganization, and 
it was urged that a committee on industrial health and safety be 
established. 
Management organizations, such as the National Chamber of Com- 
merce and local chambers of commerce, were also inactive in the field 
of industrial hygiene and safety. The same was true of labor unions 
which were intensively preoccupied with bargaining for higher wages 
and shorter hours. Internal regulations, in -effect in most industries, 
were not used to improve health and working conditions to any extent. 
Medical, mining, and engineering schools took no active part in 
training students for work in industrial hygiene and safety. 
I*eru 
As in Bolivia, the picture of nonofficial industrial hygiene activity in 
Peru is an impoverished one. Like their Bolivian colleagues, few of 
the 1,500 physicians in Peru are familiar with occupational and pre- 
ventive medicine. 
In Peru there is a national Chamber of Commerce and also a 
National Manufacturing Association. Neither of these two management 
groups has been active in the field of industrial hygiene. Peru also has 
a national mining association but until now, by way of an industrial 
hygiene program, the organization has sponsored a survey by a Cana- 
dian mining engineer and has vigorously fought the recently enacted 
industrial hygiene law. 
Labor, too, has not shown any active interest in the field of indus- 
trial hygiene, except in isolated instances when labor unions demanded 
investigations of adverse working conditions. 
Medical and engineering schools have taken no active part in train- 
ing students for work in industrial hygiene. 
Potentialities are great for a coordinated official-nonofficial attack 
on the various industrial hygiene problems of Peru, and much good 
would redound from such a concerted effort. 
Chile 
In Chile, too, there is a dearth of activity on the part of nonofficial 
agencies which should take an interest in industrial hygiene. Typical 
of the existing apathy, the medical profession is poorly informed on 
occupational diseases. Industrial health problems are slighted by 
manufacturers’ associations and organized labor alike. The National 
Manufacturing Society of Chile and the National Mining Society, 
however, are definitely interested in industrial hygiene but have not 
yet found a way to turn their interest into action. 
A National Safety Council, which is primarily interested in acci- dent prevention both on and off the job, has been organized in Chile. 
The Society issues a magazine, which has published on occasion in- 
formation relating to industrial hygiene and safety, but the organ- 
ization has done little more in the realm of health and safety education. 
Organized labor has not shown any particular interest in industrial 
hygiene, probably because it has been too busy fighting for concessions, 
such as higher wages and seniority rights. In isolated instances, labor 
unions have demanded investigations of adverse working conditions, 
but because they lack an understanding of industrial hygiene and its 
implications, they have accepted slightly increased wages for those 
working in hazardous occupations as a satisfactory solution. No de- 
mands have been made by labor unions for improvement of working- 
conditions and elimination of unhealthful situations. 
The University of Chile, through its recently established School of 
Public Health, is doing an excellent job of training physicians and 
other public health workers in industrial hygiene practice. The en- 
gineering school has taken no active part in training engineering stu- 
dents for this important activity. 
Obviously, Chile has the resources, among its official and nonofficial 
agencies, for a coordinated attack on its many and urgent industrial 
hygiene problems. What is required is the active leadership of a well 
staffed and supported industrial hygiene division which can coordinate 
all the'e potential resources into an integrated program. VI. Summary 
The industrial hygiene scene in Bolivia, Peru, and Chile is funda- 
mentally characterized by duplication of effort and inadequate pro- 
gramming in official quarters and apathy in nonofficial groups. There 
are a few overtones here and there of a real interest in industrial 
hygiene work, but lack of funds, personnel, and knowledge of the 
modus operand! hinders development of this interest beyond an em- 
bryonic stage. 
Although the coordination of industrial hygiene activities with 
general health programs is axiomatic anywhere, it is particularly 
urgent in these South American countries because of the serious 
prevalence of disease. Passive agencies must be awakened to the im- 
port of the problem while aware groups are galvanized into effective 
action. There is need to evoke the maximum potential that each agency 
can contribute and to arrange these activities in an orderly pattern 
which avoids overlapping of function and enables the highest degree 
of efficacy. 
Based upon pertinent observations in each country, the following 
recommendations were made to assist Bolivia, Pern, and Chile in the 
development of sound, effective industrial hygiene programs. Such a 
sturdy foundation of industrial health is mandatory if these nations 
are to realize their full industrial potentialities. 
77 VII. Recommendations 
These recommendations were offered in an attempt to help those 
officials who are interested in industrial hygiene plan and establish 
comprehensive and progressive programs in Bolivia, Peru, and Chile. 
Although the suggested organizational structure varied in the three 
countries, the recommendation common to all was that a division of 
industrial hygiene be established, or implemented as in the case of 
Chile. This unit would then act as the keystone in the development 
of industrial hygiene programs. Based on the premise that corrective 
measures for the protection of the health of industrial workers are put 
into effect by private effort and by use of private funds, the unit’s 
most important task would be to show industry how to solve its own 
problems. 
The types of service which the unit would render to industry to 
fulfill its broad responsibilities are: (1) Evaluating industrial work- 
ing environments and recommending steps to be taken to correct con- 
ditions found to be detrimental to health; (2) Advising management 
and medical supervisors concerning the relative toxicity of materials 
or processes, giving special attention to new materials prior to their 
introduction into industry; (3) Offering consultant services to medical 
supervisors and private physicians regarding illnesses affecting 
workers; (4) Providing necessary clinical and physical laboratory 
services; (5) Assisting management to develop, maintain, and analyze 
absenteeism records and health education programs; and (6) Offering 
technical guidance and advice on adult health and health education 
programs for workers. 
The unit would also be responsible for formulating standards for 
safe practices and reasonable rules and regulations for the prevention 
and control of occupational diseases. These standards and regulations 
would be used in making recommendations to industry regarding the 
correction of conditions inimical to health. Legal regulations, of course, 
should be resorted to only when friendly persuasive measures have 
failed, since the latter is often more successful. 
Close liaison would be maintained with other agencies to avoid dupli- 
cation of effort and to encourage correlated, supplemental activities. 
78 The unit would likewise stimulate and coordinate the work of related 
voluntary agencies. 
Responsibility for collecting and analyzing occupational disease re- 
ports would also rest with this unit. To ensure completeness of reports, 
the unit would have to educate physicians and industrial management 
to the importance of occupational disease reporting and to maintain 
close contact with them by investigating all cases reported promptly. 
Whenever called upon, the unit would render impartial advice to the 
Workmen’s Compensation Agency in the settling of claims. 
Another important function of the unit would be to assume the 
leadership in encouraging large industries to sponsor complete indus- 
trial hygiene programs of their own. These programs should include 
general health activities and draw upon all the health resources avail- 
able in the community. This expansion of industrial health programs 
into the broader field of adult health has been encouraged in the 
United States by both Federal and State industrial hygiene agencies. 
Progressive industrial management has been quick to realize that a 
worker’s productivity is directly influenced by his general health. 
Some of the illiteracy and negligence obstacles may be surmounted 
by the formation of labor-management committees to educate and train 
the workers. This device gives the workers a sense of participation and 
was used with great success in both the United States and Great 
Britain during the war. 
One of the first educational jobs that would confront the unit, how- 
ever, is the development of courses of instruction for physicians, engi- 
neers, and nurses who wish to work in the field of industrial health. 
This project should be undertaken with the cooperation of universities 
and professional societies. 
Sufficient funds should be granted the unit to purchase the special- 
ized equipment needed for field and laboratory work and to set up and 
stock a library. To ensure the employment of properly qualified indi- 
viduals, a description of the positions entailed in the conduct of an 
industrial hygiene program and of the requisite qualifications was pre- 
pared for submission to the appropriate agencies. 
Manned by a qualified staff and equipped with adequate facilities, 
the unit would be in a position to chart an ambitious course, utilizing 
all existing knowledge and techniques in the promotion and preserva- 
tion of industrial health. 
The following individual recommendations are peculiar to the respec- 
tive situations in Bolivia, Peru, and Chile and are based upon the 
special needs, administrative channels, and operating facilities observed 
in those countries. 
Bolivia 
It is recommended that the unit of industrial hygiene, propounded 
in the preceding section, be established as a Division of Industrial 
79 Health and Safety within the new Ministry of Labor and Social Wel- 
fare. The Division should have complete autonomy, reporting directly 
to the Minister or a subminister. It is further recommended that the 
basic industrial health and safety law, drafted to meet Bolivia’s 
particular needs, be adopted by the Bolivian Congress as speedily as 
possible. 
In addition to miners and industrial workers, the Division’s activi- 
ties should embrace the uncounted thousands engaged in agricultural 
pursuits. 
The Division’s staff should include at least one physician, industrial 
hygiene engineer, safety engineer, and clerk, all members functioning 
as a, team. The duties and functions of the Division have been dis- 
cussed in the foregoing description of the industrial hygiene unit’s 
responsibilities. 
It is also recommended that the Minister of Labor and Social Wel- 
fare appoint an Advisory Committee to the Division of Industrial 
Health and Safety. The Committee should be made up of representa- 
tives of the Ministry of Hygiene and Health, the Workmen’s Com- 
pensation Agency, the Bolivian Medical Society, industrial manage- 
ment and organized labor. The function of the Committee would be 
to advise the Division on matters of policy and operation. 
It is recommended, too, that the occupational disease compensation 
law now in effect in Bolivia be revised. Diseases which are not occu- 
pational in origin, such as tuberculosis and nephritis, should not be 
compensable. Provision for compensation for partial disability from 
silicosis should be eliminated. Compensation funds saved by these 
changes should be used to support a vigorous program of prevention 
and health education for industrial workers. 
Legislation to prohibit child labor should he adopted by the Bolivian 
Congress as speedily as possible. At the same time, educational facili- 
ties should be improved so that the growing generation will be able to 
take advantage of a health education program. 
To furnish experienced leadership to the proposed Division of Indus- 
trial Health and Safety in the launching of its program, it is recom- 
mended that a consultant in industrial hygiene and safety be attached 
to the SCISP for several years after the scheduled termination of the 
labor program. 
Peru 
On March 12, 1947, a law was enacted creating a Department of In- 
dustrial Hygiene in the Ministry of Public Health and Social Welfare, 
whose function is tin' prevention of professional diseases-—-the pneumo- 
conioses, in particular. It is recommended that the activities of this 
Department be administered under the direction of the (SCISP), 
Servicio Cooperative Inter-Americano de Salud Publica. Directed by 
trained and well-qualified personnel, the Servicio has demonstrated its ability and usefulness in administering a public health program in Peru. 
The services of a physician and a chemist from the United States 
should be added to this program as soon as possible to supplement the 
work of the engineer already assigned by the Institute of Inter- 
American Affairs. Necessary field and laboratory equipment should be 
obtained immediately to permit prompt operation. 
The industrial hygiene program should start as soon as is practicable 
in the region of Cerro de Pasco, with headquarters in the town of Cerro 
de Pasco, the center of the most important mining area in the Central 
Andes. This field office should be equipped for the conduct of physical 
examinations, as required by the new law, and for the activities of an 
engineer. 
Field centers should later be established in La Oroya, Moroeoeha, 
and Lima. Each field office should be staffed with a physician trained 
in silicosis techniques, an X-ray technician, an engineer, and a clerk. 
The necessary apparatus for conducting physical examinations, in- 
cluding X-rays of the chest, and field and laboratory apparatus for the 
engineer, will also be needed. The Lima office should have portable 
X-ray and other equipment for conducting physical examinations in 
the Southern mining area. 
The Department’s chemical laboratory should be located in Lima. 
Personnel, both medical and engineering, should be selected as speedi- 
ly as possible and sent to the United States for training. The physician 
now studying at Harvard should spend at least 8 months studying 
silicosis at the Saranac Laboratory for the Study of Tuberculosis 
before he returns to Peru. In order to initiate the program of physical 
examinations at once, a physician should be employed immediately. (It 
is understood that a Peruvian physician will be immediately assigned 
to this program from the Servicio Cooperative Inter-Americano de 
Salud Publica and will receive his training in Peru. A Peruvian 
chemical engineer has already been selected and engaged to work under 
the engineer now assigned to the program by the Institute of Inter- 
American Affairs.) 
It is also recommended that the President of the Republic of Peru 
appoint an advisory committee to the Department of Industrial 
Hygiene. The committee should be made up of representatives of the 
Ministry of Justice and Labor, the Ministry of Development and Public 
Works, the Ministry of Public Health and Social Welfare, the Peruvian 
medical society, industrial management, and organized labor. The com- 
mittee should advise the Department on matters of policy and operation. 
As provided by law, the scope of the Department’s activities should 
be extended at the end of 2 years of operation to include all the indus- 
tries of Peru. Services should also be available to the more than 
1,000,000 agricultural workers. 
lii order to assure the new Department of Industrial Hygiene com- 
81 petent guidance during the period immediately following its organiza- 
tion, the program should be administered by the Servicio Cooperative 
Inter-Americano de Salud Publica for at least the next 2 years. Steps 
should be taken to include an industrial hygiene program among the 
cooperative activities carried on by the Institute of Inter-American 
Affairs and the Ministry of Public Health and Social Welfare of Peru. 
Chile 
Since the School of Public Health possesses superior operating fa- 
cilities and enjoys political freedom and public confidence, it is recom- 
mended that an Institute of Industrial Hygiene be created within this 
State institution. 
Approximately 1,250,000 pesos a year will be needed to carry on a 
minimum program in industrial hygiene. This sum might well be 
obtained from those sources which would benefit most from such a pro- 
gram, namely, labor, industry, and government. 
As a minimal staff, the Institute should have a physician director, 
an engineer, a chemist, a clerk and a laboratory assistant. For the first 
several years, the program should be based in Santiago. It is recom- 
mended, however, that at a later date branch offices be established in 
Antofagasta and Concepcion to serve the northern and southern zones. 
There is now in Chile a nucleus of personnel trained for the conduct 
of industrial hygiene activities. In order to interest these people in 
joining the Institute of Industrial Hygiene, it is essential that positions 
in the Institute be set up as full-time, permanent, well-paying posts. 
As in the case of Bolivia and Peru, it is recommended that the Presi- 
dent of Chile appoint an advisory committee to the Institute of Indus- 
trial Hygiene, composed of representative members. 
Consideration should be given to strengthening the Preventive Medi- 
cine Law of Chile so that annual physical examinations may be better 
employed in the interest of improving workers’ health. This law should 
also be revised so that the preemployment examinations now given can 
be more fully utilized as placement guides. 
Because of weaknesses in the workmen’s compensation legislation, 
it is recommended that a Presidential committee be appointed to study 
the law and suggest corrective changes in its content and administration. 
Finally, in order to coordinate the activities of all the participants 
in the proposed program, it is recommended that an experienced tech- 
nician from the United States be employed for a period of 1 to 2 years. Date.. - - 
Name of establishment 
Departmsnt .. 
Official interviewed ------ 
Owner 
- - Province 
Title - 
Male 
- . Female - 
. Total 
Number of employees 
Medical provisions 
Benefits and records 
Safety provisions 
Hospital:, Company - 
Contract 
None - _ _ 
Phvsician: Fulltime — ■_ 
Part time 
Sickness benefits: 
Management 
Safety director: Full time 
Part time - 
None-. 
Shop committee: Yes 
No 
Nurse: Fulltime — 
Part time 
Insur. Co - - 
Insurance company service: Yes 
No 
First-aid kit: Yes 
No __ _ 
Trained first- Yes-- - 
Extent of benefits: 
Sickness - . — 
Accident- -- - 
Hospital- - 
Disability records: 
Occupational 
Nonoccup.. - 
Accident — 
Sanitation 
Dentist; Fulltime. _. - 
Part time . _ 
On call — 
None _. . - 
Water supply: 
Sewage disposal: 
aid worker: No 
Approved - - - 
Drinking facilities: 
Washing facilities: 
Preplacement examination: Yes_- 
Periodic examination; Yes _ 
No 
No 
Feeding facilities: 
At workplace - _ — - 
Health and safety committee: Yes 
No_ .. 
Lockers: 
Toilet facilities: 
Industrial hygiene responsibility: - 
Community: 
Other 
Type of stores 
Average wages: 
Housing conditions 
Labor turnover: 
\ 
How operated: 
Number rooms.. - - — - 
_ .. Water 
Number shifts worked: - — 
Number occupants . — 
Sewage. 
Sanitary facilities . . 
Toilets 
Garbage 
APPENDIX I INDUSTRIAL HYGIENE SURVEY GENERAL DATA 
83 INDUSTRIAL HYGIENE SURVEY—EXPOSURE DATA 
Date . 
Name of establishment: 
Raw materials: 
Products: 
Processes: 
Exposures: Estimate number exposed 
Dusts: 
Type: 
Control measures: 
Fumes and gases: 
Type: 
Control measures: 
Special poisons: 
Type: . 
Control measures: 
Temperature extremes: 
Control measures: 
Ventilation : 
Type: 
Adequacy; 
Other notes: 
84 Appendix II 
ORGANIZATION OF THE DEPARTMENT OF 
INDUSTRIAL HYGIENE IN THE MINISTRY 
OF PUBLIC HEALTH 
Law No. 10833 
The President of the Republic: 
Whereas; 
Congress has enacted the following Law: 
Congress of the Peruvian Republic : 
Has enacted the following Law : 
Article I.—The Department of Industrial Hygiene in the Ministry of 
Public Health and Social Welfare shall begin work regarding preven- 
tion and attendance of professional diseases, especially the pneumo- 
conioses. 
Article 2.—Work stated in Article 1 shall include, besides work 
specified by the Executive Power in later dispositions and regulations, 
the following: 
(a) Clinical and radiographic examination of candidates for mining 
work and the same examination, periodically done, on workmen per- 
forming such work; 
(&) Medical examinations, requested by the Pneumoconiosis Expert 
Board; 
(c) Medical control of individuals suffering from pneumoconiosis or 
other professional diseases, who continue working; 
(d) Periodic inspection of mines and plants of the industry itself 
for dust control. This work shall include the sampling and analysis of 
dusts in suspension, smoke, gases, acids and other noxious substances; 
(e) Planning and application of ventilating systems and methods 
for the mines and working places; 
(/) Investigations regarding suitability of installation of apparatus 
and dust removal equipment and use of given types of protective masks; 
(y) Investigations regarding suitability of establishing plants for 
administration of aluminum powder with preventive and welfare pur- 
85 poses; and medical control of healthy or ailing individuals, subjected to 
this process in plants to be established as a result of such investigations 
or by private initiative of companies; 
(h) Educational work among the administrative and labor staff of 
raining companies with purpose of demonstrating usefulness of pre- 
ventive measures and insuring cooperation to be given for fulfillment 
thereof; and, 
(i) Incorporation of all measures connected with this problem in 
future. 
Article 3.—The Department of Industrial Hygiene shall gradually 
extend its action to all mining centers of the country, but shall begin 
operations in the region including the Departments of Lima, lea, 
Junin, Pasco, Huanuco, and Huancaveliea. 
To duly fulfill its mission and after the necessary studies, it shall 
establish a Central Office and Departmental Offices in principal mining 
regions, said offices to include administrative sections and medical and 
engineering laboratories, as well as portable equipment, which may be 
necessary. 
Article 4.—The operation of the Department of Industrial Hygiene, 
in connection with the mining industry and allied industries, shall be 
maintained by those companies occupying over 30 laborers, by a con- 
tribution of 1.8 percent on the total amount of payrolls. 
The designation “mining company” is understood to include indi- 
vidual or collective persons performing work for making use of any 
mineral substance and soils, rocks, clays, sands, gravels, and cements, 
as well as all industrial processes related to the preparation and use of 
such substances. 
There are included in the computation of the tax salaries of all 
employed in those industries, under the direct dependency of said indi- 
vidual or collective persons or of contractors and middlemen, without 
any exception whatsoever. 
Article s.—The contribution established in Article 4 shall begin to 
govern within 30 days of the promulgation of the present law, in the 
Departments of Lima, lea, Junin, Pasco, Huanuco, and Huancaveliea. 
The same contribution shall be applied, successively and with approval 
of the Executive Power, to other districts, when the organization of the 
Department of Industrial Hygiene extends thereto. 
Article 6.—Companies may not deduct, directly or indirectly, the 
amount of the contribution created by this law, from the salaries or 
other remunerations paid to their employees. 
Article 7.—A Board of Vigilance and Economic Control, formed by 
representatives of the Executive Power and of the industries contrib- 
uting to the support thereof, the number whereof shall be determined 
by the Government, shall control the economic progress of the Depart- 
ment of Industrial Hygiene and the investment of its income for the 
purposes specified in the present law. Article 8.-—After a period of two years, to be counted from the date 
on which the Department of Industrial Hygiene begins its duties, the 
Government shall make up another taxation plan, based on the degree 
of danger of the work in each mining enterprise and the number and 
source of the cases of professional disease. 
The National Bureau of Social Insurance shall proceed to effect the 
necessary mathematical calculations and within the maximum period 
of two years, from date of promulgation of the present law, shall estab- 
lish an insurance for professional diseases, to include the granting of 
an income to ailing individuals, with partial or total disability, tem- 
porary or permanent, which may have been established by the Pneumo- 
coniosis Board of Experts. Said insurance shall include nursing bene- 
fits available in hospitals and other dependencies of the National Bureau 
of Social Insurance. 
In the making up of the new taxation plan and establishment of the 
insurance, referred to in this Article, the information resulting from 
the studies performed by the Department of Industrial Hygiene shall 
be used. 
Article 9.—The Minister of Public Health and Social Welfare shall 
make up, within a maximum period of 60 days from the date of promul- 
gation of this law, the necessary drafts for the organization and regu- 
lation of the services created thereby, the technical training of its per- 
sonnel, and those necessary for the coordination of the work effected by 
other Government Departments. 
Article 10.—Laws and dispositions insofar as opposed to the present 
law are hereby repealed. 
Let this be transmitted to the Executive Power for promulgation. 
Congress House, in Lima at ten days of the month of March, nineteen 
forty-seven. 
(Sgd.) 
Jose Galvez, President of the Chamber of Senators. 
Pedro E. Muniz, President of the Chamber of Deputies. 
L. F. Ganoza, Senator Secretary. 
A. llaya de la Torre, Deputy Secretary. 
Therefore: I order this to be published and complied with. 
Given in Government House in Lima, at twelve days of the month of 
March, nineteen forty-seven. 
(Sgd.) 
J. L. Bustamante. 
Alberto Hortado. 
87 Appendix 111 
SUGGESTED RULES AND REGULATIONS FOR THE 
PREVENTION AND CONTROL OF OCCUPATIONAL DISEASES AND 
A DISCUSSION OF CURRENT PRACTICES FOR COMPLIANCE 
WITH SUCH RULES AND REGULATIONS 
J. J. Bloomfield, Sanitary Engineer Director, Assistant Chief, 
Division of Industrial Hygiene, Public Health Service 
and 
Bernard D. Tebbens, Industrial Hygiene and 
Safety Engineer, Institute of 
I liter-American Affairs 
JUNE 1947 
88 F or e word 
One of the major causes of lost time in industry is workers’ ill health, 
some of it caused by physical conditions in the job environment. 
Although industrial hygienists now have the techniques to prevent 
almost any kind of occupational disease, unfortunately the application 
of this knowledge has not progressed as rapidly as it has been acquired. 
The problem, then, is the promotion of industrial hygiene techniques so 
that they reach every industry. 
One effective means of disseminating and applying information on 
good industrial hygiene practice has been through the promulgation 
and administration of reasonable rules and regulations designed to set 
forth systematically the principles involved in such practices. Such 
rules and regulations, or codes, as they are sometimes called, can be of 
significant aid to industry in achieving safe and healthful working con- 
ditions, if they are based on scientific fact, are practical and adequate. 
In our opinion, the main purpose of a code is to provide information 
which would enable industry to maintain the health of its workers at a 
high level. If a code is to accomplish this purpose, it must also be 
reconciled with the chief aim of industry, which is to turn out goods 
and services in the most efficient way possible so as to achieve maximum 
production at minimum cost. To accomplish all this, a code should con- 
tain not only rules and regulations for the prevention and control of 
occupational diseases, but also an informative discussion of the best 
practices in industrial hygiene, which would indicate to management 
and labor just how compliance with the rules may be achieved. Only 
the rules and regulations of such a code should be mandatory. 
At the present time, there is a great deal of activity in the United 
States and in other countries in the development of rules and regula- 
tions, or codes, for the prevention and control of occupational diseases. 
For the most part, this activity has been stimulated by legislation which 
places certain responsibilities on industrial hygiene divisions for the 
promulgation and enforcement of rules and regulations. In the United 
States, where each State is more or less autonomous, one finds a diversity 
of laws and codes, not only as to content, but also as to administration. 
Such a state of affairs makes it extremely difficult for large industrial 
concerns, which operate in several States, to set a definite policy for the 
89 maintenance of healthful conditions in their industries. For this rea- 
son, several national agencies have been attempting to develop codes of 
a general basic character which could be adopted by all the States in 
the interest of uniformity of content and administration. 
The Institute of Inter-American Affairs has had a cooperative pro- 
gram with the government of Bolivia on health and sanitation problems. 
Part of this program has been concerned with working conditions among 
Bolivian industrial workers, and particularly the workers in the mines 
of that country. It is not the purpose of the present discussion to go 
into detail regarding the joint labor program in Bolivia with which 
both authors have been identified, except to indicate that one of the 
objectives of this labor program was the development of a practical 
code designed to prevent and control occupational diseases. 
The rules and regulations which follow, as well as the current prac- 
tices for compliance with these rules and regulations, are based, for the 
most part, on the material prepared for the use of the Bolivian 
government. 
These rules and regulations have certain unique features which will 
become obvious to the reader, and which we feel merit serious con- 
sideration not only by management and labor, but also by governmental 
administrative agencies which have the responsibility for industrial 
hygiene work. As a matter of fact, the section dealing with current 
practices for compliance with the suggested rules and regulations is in 
itself a novel feature in codes of this type. Although the current prac- 
tices discussed herein for the attainment of healthful working condi- 
tions could be presented in greater detail, we do feel that in its present 
brief form it contains sufficient information to be of aid to industry in 
attempting to comply with the rules and regulations. 
It is our desire to emphasize the need for a realistic approach to this 
whole subject. We feel that there is a definite responsibility upon gov- 
ernmental agencies administering industrial hygiene to implement 
rules and regulations for the prevention and control of occupational 
diseases in a practical and impartial manner. It seems to us that before 
an industry is told that it should make certain provisions to control a 
condition suspected of being inimical to health, a complete health sur- 
vey is in order. Such a health survey should involve at least two cri- 
teria in determining the safety of an operation. First, it is essential 
that the health of those workers exposed to a certain material or con- 
dition should be carefully inquired into. This may involve not only 
an examination of the worker’s health record, but also an examination 
of the worker himself. Second, careful environmental studies should be 
made, which would include not only certain determinations of the 
atmosphere, but also a thorough sanitary survey and occupational 
analysis. All these put together should yield data of real value in help- 
ing to control industrial health hazards. 
90 It is hoped that the material which follows will be given serious con- 
sideration by management, labor, and those governmental agencies re- 
sponsible for industrial hygiene administration. All three groups have 
a large stake in the maintenance of industrial health. All that is needed 
to assure the success of basic rules and regulations such as those sug- 
gested in this paper is that they be administered in a spirit of coopera- 
tion with management and with labor. 
SUGGESTED RULES AND REGULATIONS FOR THE 
PREVENTION AND CONTROL OF 
OCCUPATIONAL DISEASES 
I. Introduction 
A. Authority 
This code has been adopted by the of the 
in the discharge of its duties under the authori- 
ty granted by the 
B. Purpose 
The purpose of this code is to prescribe minimum requirements for 
the prevention and control of occupational diseases, to advance the 
workers’ health, and to furnish information for the use of management 
and employees in attaining these objectives. 
C. Application 
The provisions of this code shall apply to all mines, factories, con- 
struction projects, service industries, and other places of employment. 
The provisions of this code are limited to the prevention and control 
of occupational diseases and do not abrogate existing codes, nor pre- 
vent the adoption of future codes, dealing with general sanitation of 
work places. 
D. Administration 
This code will be enforced by the of the 
E. Appeal for Modification 
When strict compliance with the provisions of the code involves 
undue hardship, the may, upon application in 
writing, permit modification of the requirements when other means 
of equivalent protection are provided. Any modification granted under the provisions of this paragraph shall be limited to the particular case 
covered in the application of appeal for modification. 
F. Penalties 
Any person, firm, or corporation failing or neglecting to comply 
with any rule or regulation of this code shall under the powers con- 
ferred by be guilty of a misdemeanor, and upon 
conviction shall be fined in accordance with the provisions of the above 
law. 
G. Unconstitutionality Clause 
Should any section, paragraph, sentence or clause, or phrase of this 
code be declared unconstitutional or invalid for any reason, the re- 
mainder of said code shall not be affected thereby. 
H. Repeal and Dale of Effect 
All codes and parts of codes in conflict with this code are hereby 
repealed, and this code shall be in full force and effect immediately 
upon its adoption and its publication as provided by law. 
I. Definitions 
(1) A “health hazard” shall be interpreted to exist when exposure 
to any contaminant or condition encountered in the environment is 
sufficient to injure any part of the body or reduce in efficiency the 
normal function of any part of the body. 
(2) “Ventilation” is the process of supplying or removing air by 
natural or mechanical means to or from any space. 
(3) “General Ventilation” means that type of ventilation in which 
air is supplied to or removed from any area. 
(4) “Natural Ventilation” means ventilation which depends upon 
natural air currents to provide air movement in the environmental area. 
(5) “ Mechanical Ventilation ’ ’ means ventilation which depends upon 
the operation of power driven equipment to remove air from or deliver 
air to the desired location or area. 
(6) “Local Exhaust Ventilation” means that type of ventilation in 
which dusts, fumes, vapors, gases, and mists are removed from the 
atmosphere near the sources of their generation. 
(7) “Dusts” are solid particles generated by handling, crushing, 
grinding, rapid impact, detonation and decrepitation of organic or 
inorganic materials, such as rock, ore, metal, coal, wood, grain, etc. 
Dusts do not tend to flocculate except under electrostatic forces; they 
do not diffuse in air but settle under the influence of gravity. 
(8) “Fumes” are solid particlesigenerated by condensation from the 
gaseous state, generally after volatilization from molten metals, etc., 
92 and often accompanied by a chemical reaction such as oxidation. Fumes 
flocculate and sometimes coalesce. 
(9) “Mists” are suspended liquid droplets generated by condensa- 
tion from the gaseous to the liquid state or by breaking up ’a liquid into 
a dispersed state, such as by splashing, foaming, and atomizing. 
(10) “Vapors” are the gaseous form of substance which are nor- 
mally in the solid or liquid state and which can be changed to these 
states either by increasing the pressure or decreasing the temperature 
alone. Vapors diffuse. 
(11) “Gases” are normally formless fluids which occupy the space 
of enclosure and which can be changed to the liquid or solid state only 
by the combined effect of increased pressure and decreased tempera- 
ture. Gases diffuse. 
(12) “Healthful and Comfortable Environment” means atmosphere 
having an effective temperature as near the comfort level as good in- 
dustrial hygiene engineering practices will permit and never at a level 
at which injury to health will result. This does not apply to environ- 
ments where abnormal temperature and/or humidities are encountered 
through the inherent nature of the process and where individual pro- 
tection is given through clothing, supplied air, or other means. 
(13) “Abnormal Atmospheric Pressures” means atmospheric pres- 
sures which when suddenly adjusted to normal atmospheric pressure, 
may produce injury to workers occupying that area. 
(14) “Sanitary Condition” means physical condition of working 
environments such as will tend to prevent the incidence and spread of 
disease. 
(15) “Contaminant” means an undesirable substance or material. 
(16) “An Infectious Agent” is a pathogenic microorganism which 
is capable of producing disease by entrance into and by multiplication 
within the body. 
(17) “Protective Equipment” is a device, a permanent installation, 
clothing or other means for the adequate protection of the worker 
against health and safety hazards. 
(18) The word “shall” where used is to be understood as mandatory. 
11. Rules 
A. General Provisions 
1. Records.—Every employer shall maintain adequate records of 
occupational diseases and other disabling illnesses which occur among 
his employees. In those establishments employing 50 or more persons, 
these records shall be tabulated and analyzed by the employer, and a 
statistical summary of the causes of disability shall be furnished at the 
end of each quarter to the This quarterly sta- 
tistical summary shall be prepared on forms furnished to the employer 
by the 
93 2. Employer Responsibility.— (a) Every employer shall comply 
with the various laws pertaining to the control of industrial health 
hazards and shall maintain a healthful place of employment. 
(h) Every employer shall determine the health hazards in his place 
of employment by means of a survey of his establishment. 
(c) Every employer shall instruct his employees regarding the 
hazards to which they are exposed and the methods which have been 
taken for the prevention and control of such hazards. In all work 
places where special hazards to health exist, employers shall post a 
notice of such hazards in a prominent position in the work place, noti- 
fying the workers of the hazard and the means for safeguarding against 
it. 
(d) Every employer shall install or provide adequate protective 
equipment for the prevention and control of occupational diseases and 
shall maintain such equipment at its highest efficiency and in a sanitary 
condition. 
3. Employee Responsibility.— (a) Every employee shall use the 
protective equipment provided by the employer for the prevention and 
control of occupational diseases. 
(h) Employees shall not abuse or mishandle in any manner equip- 
ment provided by the employer for the workers’ protection against 
health hazards. 
(c) Every employee shall comply with all healthful practices agreed 
upon between the employer and the employee organization. 
4. Labor-Management Committees.—In all establishments having 
50 or more employees, there shall be allowed the formation of a joint 
committee of equal representation from employer and employee groups 
for the exclusive purpose of health maintenance. 
5. Notification of the Creation of New Establishments, Proc- 
esses or Changes of Processes.—Every employer shall notify the 
within 10 days of the establishment of a new 
enterprise, process, or change in process, and whenever practicable 
shall furnish the with plans and specifications 
of such new or changed process. 
within 10 days of the establishment of a new 
B. Environmental Conditions 
1. General.—There shall not exist in any place of employment any 
process, material or condition known to have an adverse effect on health 
unless provisions are present to maintain the occupational environment 
in such a state as to prevent the existence of a health hazard. 
2. Maximum Allowable Concentrations for Atmospheric Con- 
taminants.—There shall not he used any process or material which will 
liberate any contaminant into the atmosphere of occupied area.-, unless 
arrangements are present to prevent the contaminant from injuring 
any part of the body, or reducing in efficiencv the normal function of 
any part of the body. 
94 The maximum allowable concentration for atmospheric contaminants 
in occupied areas should include, but is not restricted to, the following 
substances and their corresponding maximum allowable concentration 
values: 
MAXIMUM ALLOWABLE CONCENTRATIONS 
Gases and Vapors 
(Parts per million) 
Substance Concentration 
Acetone 500 
Acrolein 0.5 
Ammonia 100 
Amyl acetate 200 
Aniline 5 
Arsine 0.05 
Benzene , 35 
Carbon disulfide 20 
Carbon monoxide 100 
Carbon tetrachloride 50 
Chlorine 1 
Ethyl ether 400 
Formaldehyde 5 
Gasoline 500 
Hydrogen chloride 5 
Hydrogen 'cyanide 10 
Hydrogen fluoride 3 
Hydrogen sulfide 20 
Methanol 200 
Naphtha (coal tar) 200 
Nitrogen oxides 25 
Nitroglycerine 0.5 
Phosgene 1 
Stibine 0.1 
Sulfur dioxide 10 
Trichlorethylene 100 
Toluene 200 
Toxic Dusts, Fumes and Mists 
(Milligrams per cubic meter) 
Substance Concentration 
Antimony 0.5 
Arsenic 0.5 
Cadmium ; 0.1 
Chromic acid ! 0.1 
Lead 0.15 
Mercury 0.1 
Zinc oxide 15 
95 Mineral Dusts 
Substance Concentration 
Asbestos 5 
Silica (more than 70%) 5 
Silica (40% to 70%) 10 
Silica ( 5% to 40%) 20 
All dusts (less than 5% silica) 50 
(Million particles per cubic foot) 
Radiation 
X-rays 0.1 roentgen unit per 8 hour exposure 
3. Skin Contact with Hazardous Materials.—Where the sub- 
stances encountered are capable of causing any pathological change in 
the skin, adequate precautions shall be taken to prevent these sub- 
stances from contacting the skin. 
Where the substances encountered are capable of being absorbed 
through the skin or mucous membrane thereby producing injury to 
health, adequate precautions shall be taken to prevent these substances 
from contacting the skin and/or the mucous membrane. 
4. Infectious Agents.—There shall not exist in any occupied area 
any processed or unprocessed material containing infectious agents un- 
less provisions are present to prevent the infectious agents from injur- 
ing any part of the body. 
5. Illumination.—The quality and quantity of illumination in any 
occupied area shall be adequate to permit the performance of all neces- 
sary work in a safe manner and without injury to the eyes. 
6. Temperature, Humidity, and Air Movement.—Natural or me- 
chanical ventilation shall be provided in all occupied areas to insure a 
healthful and, so far as feasible, a comfortable environment as regard 
to temperature, humidity, heat radiation and air movement. 
7. Noise.—There shall not exist in any occupied area any process or 
operation producing noise unless provisions are present to prevent the 
noise from injuring any part of the body or reducing in efficiency the 
normal function of any part of the body. 
8. Vibration.—Wherever any process or operation producing vibra- 
tion is conducted in any occupied area, provisions shall be present to 
prevent the vibration from injuring any part of the body or reducing 
in efficiency the normal functions of any part of the body. 
9. Pressure.—ln occupied areas where the workers are subjected to 
abnormal atmospheric pressures, provisions shall be present to prevent 
injury to any part of the body of the worker upon entering, working 
in, or leaving that area. 
10. Radiant Energy.—Wherever any type of radiant energy is 
emitted into an occupied area, provisions shall be present to prevent 
96 tnese radiations from injuring any part of the body or reducing in 
efficiency the normal functions of any part of the body. 
11. Ventilation.—Where excessive amounts of contaminants may 
be liberated into the atmosphere of occupied areas, adequate ventilation 
systems for their removal shall be installed, maintained in good condi- 
tion, and operated efficiently at all times when work is being done. 
The discharged air of a ventilating system shall not be permitted to 
re-enter the same or other working areas and shall not constitute a 
health hazard or nuisance in the community. 
Plans and specifications for all ventilating systems shall be submitted 
to the for approval prior to their installation. 
12. Respiratory Protective Equipment.—When exposures to exces- 
sive amounts of atmospheric contaminants are intermittent and of brief 
duration, or where ventilation or other control methods are impractical, 
the workers shall be protected by means of respiratory protective 
equipment. Such equipment shall give adequate protection against the 
specific contaminant under the conditions encountered and, shall be of a 
type approved by the 
Respiratory protective equipment shall be employed only under the 
conditions above, stated arid shall not be used in lieu of other control 
methods of a more effective and permanent character. 
13. Personal and Protective Clothing and Equipment.—Workers 
in operations, processes or conditions of work which unduly expose 
them to dampness and wet environments, excessive heat, excessive noise, 
hazardous radiations, and other eye hazards, skin irritants, falls, fall- 
ing material and other hazards, shall be provided with proper protec- 
tive clothing and other devices of a type approved by the 
14. Housekeeping.—The housekeeping in all occupied areas shall 
be such as to promote a healthful environment. 
15. Sanitation.—The sanitation within all places of employment 
shall be such as to promote a healthful environment. No insanitary 
condition shall exist which may increase the incidence or permit the 
spread of disease. The handling, preparation and serving of food and 
drink stiall be conducted in such a manner as to prevent the spread of 
disease. 
C. Medical Provisions 
1. Prevention and Treatment of Occupational Illnesses and 
Injuries.—Arrangements for facilities and services shall be present 
for the prevention and the prompt and early treatment of all illnesses 
and injuries resulting from occupational exposures. 
2. Prevention and Treatment of Nonoccupational Illnesses 
and Injuries.—Arrangements for facilities and services shall be present 
for the prevention and the prompt and early treatment of all emer- 
gency nonoccupational illnesses and injuries. 
97 3. Physical Examinations.—Every employer shall maim available 
at no cost to a prospective worker a preplacement health examination. 
Periodic health examinations shall be given to all workers requesting 
such examinations at no cost to the worker. In the case of workers 
exposed to toxic materials or hazardous conditions of work, such as 
those exposed to siliceous dusts, heavy metal dusts, or toxic solvents, 
the workers shall be examined as often as deemed necessary by the 
examining physician, but such examination must be given at least once 
a year. 
In case the periodic examination shows the worker unfit for further 
work or for certain classes of work, thereby barring the worker’s future 
employment, then the latter may designate a physician of his choice 
and request a review of the findings. If the two physicians cannot agree 
on the findings, then a third physician, agreed on by the two physicians, 
shall be selected and his findings shall be final. If the two physicians 
cannot agree on a third physician, then director of the 
shall make the selection. 
CURRENT PRACTICES FOR COMPLIANCE WITH 
SUGGESTED RULES AND REGULATIONS FOR 
THE PREVENTION AND CONTROL 
OF OCCUPATIONAL DISEASES 
A. General Provisions 
1. Records 
Rule.—Every employer shall maintain adequate records of occupa- 
tional diseases and other disabling illnesses which occur among his em- 
ployees. In those establishments employing 50 or more persons these 
records shall be tabulated and analyzed by the employer, and a statis- 
tical summary of the cases of disability shall be furnished at the end of 
each quarter to the This quarterly statistical 
summary shall be prepared on forms furnished to the employer by the 
Purpose of Rule.—ln order to control and prevent disability among 
workers, it is necessary to determine where, when, and under what 
conditions absenteeism from disability is occurring. 
Practices for Compliance with Rule.—Some plants will find it 
impracticable at the outset to collect data on absences of all durations 
and for all causes. As a minimum it is recommended that data on 
absences lasting eight consecutive calender days or longer be collected 
and that the reasons for absence be confined to sickness and nonindus- 
trial injuries. However, as soon as an industry has had some experience 
98 with regard to this type of statistics, it should give serious considera- 
tion to include absences of shorter duration and from all reasons. 
In the case of industrial injuries and occupational diseases, records 
shall be kept on all disabilities resulting in loss of one or more work 
shifts. 
Regardless of the length of the absence and the reason for it, in- 
formation should be collected on each absence and be considered as a 
minimum for the following items: 
(a) Sex. 
(h) Date absence began. 
(c) Date absence terminated. 
(d) How absence was terminated (returned to work, died, resigned, 
separated, permanent disability, other). 
(e) Reason for absence (sickness, nonindustrial injury, occupational 
disease, industrial injury, other), 
(/) Diagnosis. 
(g) By whom diagnosis was made. 
In addition to these items, it is essential to know the number of 
workmen in the plant by sex, in order that rates may be calculated. 
Form I, attached, is designed to carry information on those absences 
which terminated during a specific month. It is eight inches long by 
10.5 inches wide. 
Form 2 is designed to carry information on those absences which 
may have begun at any time and have not as yet terminated. The 
absences are, therefore, those whose records are carried over into the 
month following the current reporting month. The size of this form 
is the same as Form 1. 
It must be recognized that while theoretically a rate can be made 
specific for department, occupation, age, sex, and for whatever reason, 
1 lie rate will be of questionable value if the number of workmen in the 
plant is small. Thus the number of workers in the group “exposed to 
risk” will determine principally the number of subgroups that may 
be profitably analyzed. 
A periodic analysis of the records, as required by the above rule, will 
serve to call attention to conditions which are in need of correction or 
control. In some instances a study of the conditions in the plant caus- 
ing excessive disability absenteeism will be indicated and may even call 
for the collection of additional data. The sick absences responding most 
readily to control are the minor maladies in which temperament, 
anxiety, lack of sense of responsibility, maladjustment, and physical 
ill health meet and influence each other. The routine supervision of 
such absences should enable the plant physician to suggest appropriate 
remedies. Quite often it is possible for the supervisor of the plant to 
be of considerable assistance in the control of sick absenteeism. He is 
in a position to note not only unhealthful and unsafe working condi- 
99 tions but also early signs of disabling sickness in the worker. Very 
frequently a high sickness rate in a department or plant may be entirely 
due to a few workmen, because of some of the factors indicated above, 
such as temperament, maladjustment or organic disease, in need of 
correction. 
2. Employer Responsibility 
Acceptance of responsibility for industrial health by both manage- 
ment and employees is an important factor in a successful industrial 
hygiene program. This factor has long been effectively utilized in some 
countries in accident prevention and is now equally successful in the 
prevention of occupational and other diseases in industry. 
The interests of management and labor in industrial hygiene arise 
from at least three sources. In the first place, there is the obligation to 
provide the employee with a safe and hygienic place in which to work. 
Second, there is the dollars-and-cents consideration. And third, far 
beyond any minimum law requirement, there is the benefit which comes 
from saving human life for its own sake and from lessening family suf- 
fering. In short, a good industrial hygiene and safety program achieves 
practical results by: (1) decreasing illness, injuries, labor turnover and 
spoilage of materials; (2) decreasing cost to the workers and employers 
through reduction of wage losses, cost of illness, compensation costs, 
and insurance premiums; (3) improving health and efficiency of all 
personnel; and (4) promoting morale. 
Under our present system of government, employers of labor have 
certain responsibilities under the laws of the Nation. These responsi- 
bilities are set forth in the rules which follow: 
Rule.— (a) Every employer shall comply with the various laws and 
codes pertaining to the control of industrial health hazards, and shall 
maintain a safe and healthful place of employment. 
Purpose of Rule.—Management will, of course, meet laws and codes 
pertaining to the control of health hazards in industry, but it must be 
borne in mind that such laws and codes present only minimum require- 
ments, and therefore represent only a starting point in a well-designed 
program of industrial hygiene. It is therefore the duty of management 
to keep informed of the various laws and codes promulgated in the 
interests of industrial health maintenance, and in the various changes 
in them which may be made from time to time. In this way manage- 
ment will be in a position to implement the best known technique in 
industrial hygiene so that they may achieve a healthful working en- 
vironment. 
Rule.— (&) Every employer shall determine the health hazards in 
his place of employment hy means of a survey of his establishment. 
Purpose op Rule.—lt is axiomatic that before a problem can be 
solved, it has to be defined. Employers will be in a position to solve 
their health problems intelligently once they know what they are. 
100 Practices for Compliance with Rule.—ln the absence of occupa- 
tional disease, sickness and accident statistics, health hazards may he 
ascertained by a survey of the working environment. Such surveys are 
conducted by trained engineers and physicians, whose services are 
available from official agencies, insurance companies, and private con- 
sultants. Modern industrial hygiene practice now has the precise tools 
whereby specific diseases of occupation and other hazards may he ascer- 
tained accurately, and, what is more important, information is now 
available for the control or prevention of practically all known indus- 
trial hazards. By taking advantage of such a survey the employer will 
learn the extent of his accident problem, of his requirements as to first 
aid, medical and nursing services, exposure of his workers to various 
toxic materials and other harmful working conditions. He will also 
learn of the best methods for the control of such exposures. The em- 
ployer will find that it will pay him to have such a survey made of his 
establishment, not only because he will be complying with the rules and 
regulations pertaining to this problem, hut also in the savings which 
will accrue to him through the reduction of accidents and disease. 
Rule.— (c) Every employer shall instruct his employees regarding 
the hazards to which they are exposed and the methods which have heen 
taken for the prevention and control of such hazards. In all work 
places where special hazards to health exist, employers shall post a 
notice of such hazards in a prominent position in the work place, noti- 
fying the workers of the hazard and the means for safeguarding 
against it. 
Purpose of Rule.—Experience has shown that the best results in the 
prevention of industrial diseases may be obtained by enlisting the 
cooperation of the worker himself. One method of achieving this objec- 
tive is by instructing employees regarding the hazards incidental to 
their work. Whenever employees have objected or have refused to 
comply with certain regulations, it has been largely due to the fact that 
they have not been informed of the necessity for such regulations and 
the benefit which they themselves will derive from compliance with such 
rules. Workers consider themselves as thinking people and management 
will find it to be of real benefit to take workers into their confidence, 
inform them of the hazards of employment, post warnings of the 
hazards involved and the desirability of the workers’ cooperation in 
combatting such hazards. P>y such intelligent use of worker resources, 
employers will not only do a better production job, with a reduction in 
costs, but at the same time will take a real step forward in establishing 
the worker as an individual, thereby doing away with one of the main 
difficulties in the field of labor relations. 
Practices for Compliance with Rule.—In the instruction of work- 
ers regarding the hazards to which they are exposed, supervising per- 
sonnel, such as foremen, have been found to be the key people to pre- 
101 sent such instruction. This, a foreman can do on an individual basis. 
Naturally the foreman himself must first be informed of the hazards 
and sold on the need for control of such hazards. In some instances, it 
may be found helpful to give the worker a brief and readable pamphlet 
on the safe practices with regard to a specific hazardous exposure. 
Posters have also been found very useful, showing the best practice in 
the prevention of a specific hazard. 
A few of the materials and conditions which require definite instruc- 
tion of employees regarding the hazards which those materials and con- 
ditions present, and the need for posting notices concerning them, 
follow: 
The handling of most chemicals of a toxic or irritating nature, such 
as certain acids, alkalies, and solvents; heavy metals, such as com- 
pounds of lead, manganese, and cadmium; phosphorous compounds; 
and radioactive materials. 
Rule.— (d) Every employer shall install or provide adequate pro- 
tective equipment for the prevention and control of occupational dis- 
eases and shall maintain such equipment at its highest efficiency and in 
a sanitary condition. 
Purpose of Rule.—The desirability for the employer to provide a 
healthful working place through various methods, such as protective 
equipment and devices, is obvious. Information on the best practices 
of this type are at the disposal of the employer through the 
Of equal importance to the provision of protective equip- 
ment and devices is the maintenance of such equipment at its highest 
efficiency and in a sanitary condition. Management has learned the 
value of improving and maintaining its machinery of production. 
Similarly, management will find that it is also essential to maintain 
the machinery installed for the protection of the worker. Failure to 
maintain such equipment at its highest efficiency will only serve to give 
the worker a false sense of security and will contribute materially to 
his loss of confidence in both the device and in management. 
3. Employee Responsibility: 
Rule.— (a) Every employee shall use the protective equipment pro- 
vided by the employer for the prevention and control of occupational 
diseases. 
Purpose of Rule.—Employees should understand that the principal 
function of the protective equipment provided by the employer is to 
protect his health, which is his greatest asset, and that therefore he 
should use such equipment and instruction from the employer in accord- 
ance with regulations. Failure to do so may not only result in an injury 
to the employee and his fellow workers but may also jeopardize the 
worker’s rights under the compensation law in case of injury. 
Rule.—(b) Employees shall not abuse or mishandle in any manner 
102 equipment provided by tlie employer for the workers9 protection against 
health hazards. 
Purpose op Rule.—ln order for the protective equipment to func- 
tion properly, it should not be abused by anyone. The employer has 
both the right and the obligation to compel the use of equipment for the 
prevention of industrial diseases. 
Practices for Compliance with Rule.—Workers should never re- 
fuse to utilize the protective devices given them, nor abuse such devices. 
Goggles furnished workers to protect them against radiant energy, or 
against dusts or other foreign objects which may enter the eye, should 
be worn at all times. The same is true for respiratory protective equip- 
ment designed to protect the worker from toxic atmospheric contami- 
nants. Local exhaust ventilating systems and wet methods for allaying 
dust, such as wet drilling, should be used by the worker in accordance 
with instructions and any failure of such equipment which the worker 
may note should be reported to his supervisor immediately. Protective 
clothing, such as headguards, safety shoes, gloves, aprons, and other 
equipment of this character, should be worn in accordance with instruc- 
tions and maintained in satisfactory condition. The employee should 
remember at all times that occupational diseases are no respecters of 
persons and sooner or later will exact their toll, if the worker fails to 
use the protective measures which have been provided him. 
Rule.— (c) Every employee shall comply with all healthful prac- 
tices agreed upon between the employer and employee organization. 
Purpose op Rule.—The employee should realize that the healthful 
practices recommended by management and by his own organization 
are designed to prevent injury to himself and to his fellow workers. 
The employee is often in a position to note unhealthful practices among 
his fellow workers and is therefore in a position to utilize his influence 
on his fellow workers to secure compliance with the regulations. 
4. Labor-Management Committees 
Rule.—ln all establishments that have 50 or more employees there 
shall be allowed the formation of a joint committee of equal representa- 
tion from employer and employee groups for the exclusive purpose of 
health maintenance. 
Purpose op Rule.—-The increasing interest of labor unions in the 
health of their members has indicated conclusively the need of a joint 
approach on the part of management and labor to a solution of indus- 
trial health problems. 
Practices for Compliance with Rule.—lt is conceded that there 
are difficulties in the way of effective labor-management cooperation in 
industrial hygiene which must be recognized at the outset in attempting 
to bring these two groups together. Since management and labor both 
have so much to gain by cooperative and intelligent application of 
103 industrial hygiene methods, it is tragic that so much misunderstanding 
and resistance on both sides still exists in many industries. Manage- 
ment often introduces health rules without consulting the workers. The 
workers have at times used their union strength to oppose measures 
which would benefit them. There are still many firms and unions whose 
activities show no evidence of consideration of the health needs of the 
workers and the necessity for a healthful working environment. De- 
spite new signs of increased interest in workers’ health on the part of 
unions, some segments of labor are apparently still more concerned for 
compensation benefits than for prevention of conditions which caused 
the compensable injuries—injuries which can never be compensated by 
cash benefits. On the other hand, attitudes of management towards in- 
dustrial health run the entire gamut from paternalism to neglect. In 
general, most large industrial establishments have adopted an enlight- 
ened approach to industrial health measures, which ensure to their 
workers high quality service and constant attention to the working 
environment. 
What is therefore needed on the part of both labor and management 
is a new attitude towards the problems of industrial health. The expe- 
rience in some industrial countries has shown that formula can be 
devised which will harness the power of labor organizations with the 
splendid organization which management has created in many plants, 
so that the two will not oppose each other, but pull together as a team 
towards the common goal. This was not only true in the held of pro- 
duction, but also in regard to industrial hygiene which is so intimately 
related to production. We have on record many instances of the effec- 
tiveness of labor-management interest in the field of industrial health. 
These committees, through their joint effort, have been the means of 
instituting improvements in the medical service and in bringing posi- 
tive health to the workers through such modern methods as tuberculosis 
and venereal disease case finding programs, nutrition programs, and 
welfare programs. There is sufficient evidence to show that health and 
working conditions are subjects of vital importance to the worker. 
Labor and management will find that a joint committee to advise both 
groups on the health needs of the workers and on ways and means to 
meet these needs will pay dividends. Information on the organization 
of such a committee can be obtained from the 
5. Notification of the Creation of New Establishments, Processes, 
or Changes of Processes 
Rules—Every employer shall notify the 
within 10 days of the establishment of a new enterprise, process or 
change in process, and whenever practicable, shall furnish the 
with plans and specifications of such new 
or changed processes. 
104 Purpose op Rule.—Many serious occupational diseases have oc- 
eured in industry because of a lack of knowledge on the part of both 
management and the workers regarding hazards involved through the 
introduction of new machinery, new chemicals or new processes. It is 
obvious, therefore, that it would be of distinct benefit to management 
to keep the fully informed of all the inti- 
mate details of operations, especially with regard to the use of new 
materials and processes, since the has in- 
formation concerning the control of industrial hazards. 
A firm building a new plant will find it of distinct advantage to in- 
clude at the blueprint stage, health protection features of such a new 
enterprise. The review of plans and specifications for new operations 
or changes in operation by the trained technical stall' of the 
will save management and labor both in costs and 
difficulties. 
15. Environmental Conditions 
1. General 
Rule.—There shall not exist in any place of employment any process, 
material or condition known to have an adverse effect on health unless 
provisions are present to maintain the occupational environment in 
such a state as to prevent the existence of a health hazard. 
Practices for Compliance with Rule.—One of the major causes 
of lost time in industry is workers’ ill health, some of it caused by 
physical conditions in the job environment. Although industrial 
hygienists now have the techniques to prevent almost any kind of 
occupational disease, unfortunately, the application of this knowledge 
has not progressed as rapidly as it has been acquired. The task, then, is 
the promotion of industrial hygiene techniques, so that they reach every 
industry in the nation. 
Compliance with the general rule enunciated above will enable in- 
dustry to maintain the health of its workers at a high level. It is also 
felt that the rule is sufficiently reasonable so as to be reconciled with 
the chief aim of industry, which is to turn out goods and services in 
the most efficient way possible, in order to achieve maximum produc- 
tion at a minimum cost. 
One way for industry to comply with the above rule is to survey its 
problems and then take the necessary steps for their control. 
To ensure compliance with the rule mentioned above, management 
will find that it requires three types of services: (1) Medical, (2) En- 
gineering, (3) Welfare. 
The medical service should consist of a well-qualified physician or 
physicians, the necessary nursing service, and other technical assistance 
from ancillary professions, such as dentistry, medical technicians, and 
105 so on. In order to carry out the medical program there will be required 
an adequate and well-equipped dispensary. 
The engineering service may be obtained from the 
and will serve to present and control environmental con- 
ditions in the plant which endanger health. Some industries may find 
it useful to have health committees to advise and assist in the investiga- 
tion of diseases and to help to formulate health rules and regulations 
for the industry, and to see that such recommendations are followed. 
Some industries will also find it desirable to have at least one trained 
first aid worker. 
In every modern industry there are one or more conditions peculiar 
to the particular process and operation, which are potential threats 
to the health of the workers. Most of these can be eliminated or reduced 
to harmless limits by engineering methods. Further protection of the 
worker must sometimes be provided by supplying approved devices and 
clothing. The most important occupational hazards are: 
(1) Exposure to poisonous fumes, dusts and gases, which may result 
in serious, acute or chronic illness; 
(2) Excessive noise and vibration ; 
(3) Poor illumination, such as insufficient lighting, or glare; 
(4) Excessive heat, cold, or humidity; 
(5) Contact with chemicals and other substances which produce 
sickness and diseases; 
(6) Operations which may result in accidental injuries, burns, cuts, 
crushing, and so forth; 
(7) Overcrowding in the work room; 
(8) Poor ventilation in the work room; 
(9) Poor housekeeping. 
By means of an industrial hygiene engineering survey of all these 
hazards, they may be appraised by scientific means and fhe necessary 
recommendations for controlling them may be obtained. It is wise, 
once the recommendations have been complied with, to request a re- 
survey in order to learn whether the recommended changes have accom- 
plished the purpose for which they were made. 
There are many other problems in industrial hygiene in addition to 
those specifically caused by unhealthful conditions. Many of these may 
be solved or controlled by the application of certain welfare provisions. 
Industries have found it of distinct advantage to see to it that their 
workers have proper housing, sewage disposal, safe water supply, safe 
milk supply, safe and nutritious food, and at times to have programs 
to advise workers on their personal problems, and a general health 
education program. 
With regard to the environmental control of working conditions, it 
is desired to emphasize once more the importance of investigating, in 
advance of installation, all the processes, materials, or modifications, in 
106 order to prevent the introduction of unexpected exposures; and finally, 
too much stress cannot he given to the importance of maintaining con 
trol measures through periodic plant inspections and maintenance. 
2. Maximum Allowable Concentration for Atmospheric 
Contaminants 
Rule.—There shall not be used any process or material which will 
liberate any contaminant into the atmosphere of occupied areas, unless 
arrangements are present to prevent the contaminant from injuring 
any part of the body or reducing in efficiency the normal function of 
any part of the body. The maximum allowable concentration for atmos- 
pheric contaminants in occupied areas shall include, but is not re- 
stricted to, the following substances and their corresponding maximum 
allowable concentration values. 
GASES AND VAPORS 
(Parts per million) 
Substance Concentration 
Acetone 500 
Acrolein 0.5 
Ammonia 100 
Amyl acetate 200 
Aniline 5 
Arsine 0.05 
Benzene 55 
Carbon disulfide 20 
Carbon monoxide 100 
Carbon tetrachloride 50 
Chlorine 1 
Ethyl ether 400 
Formaldehyde 5 
Gasoline 500 
Hydrogen chloride 5 
Hydrogen cyanide 10 
Hydrogen fluoride ' 3 
Hydrogen sulfide ; 20 
Methanol 200 
Naphtha (coal tar) 200 
Nitrogen oxides 25 
Nitroglycerine 0.5 
Phosgene 1 
Stibine 0.1 
Sulfur dioxide 10 
Triehlorethylene 100 
Toluene 200 
107 TOXIC DUSTS, FUMES AND MISTS 
Substance Concentration 
Antimony (metal and oxide) 0.5 
Arsenic (metal and oxide) 0.5 
Cadmium 0.1 
Chromic acid 0.1 
Lead 0.15 
Mercury 0.1 
Zinc oxide 15 
(Milligrams per cubic meter) 
MINERAL DUSTS 
(Million particles per cubic foot) 
Substance Concent ration 
Asbestos 5 
Silica (more than 70%) 5 
Silica (40% to 70%) 10 
Silica ( 5% to 40%) 20 
All dusts (less than 5% silica) 50 
RADIATION 
X-rays 0.1 roentgen unit per 8 hour exposure 
Purpose of Rule.—By limiting the exposure of workers to the con- 
centration values listed in the rule, reasonable assurances will be ob- 
tained that the workers will not be injured or their efficiency and well- 
being impaired. 
Practice for Compliance with Rule.—There is at present available 
a sufficient body of knowledge regarding the toxicity of many materials 
employed in industry, so that they may be limited in the atmosphere 
of occupied places to safe concentrations. Some of the limits for atmos- 
pheric contaminants are based on clinical and physical information, 
while others find their basis in what can be accomplished through 
good engineering practice. Industrial hygienists feel that it is their 
duty not only to prevent injury to the worker’s health but also to make 
him reasonably comfortable and efficient in his working environment. 
In other words, not only must we prevent a worker from being 
poisoned, but we must also prevent physiological responses which cause 
discomfort and unpleasantness, but not necessarily injury to health. 
Enlightened management has found that it is good operating practice 
to control the working environment, so that even mild physiological 
responses that are causing discomfort are kept at a minimum. In fact, 
it is a good practice to keep them at a minimum because quite fre- 
quently such uncomfortable conditions make a worker accident-prone, 
as, for example, when a worker becomes inebriated from inhaling cer- 
tain kinds of solvent vapors. No one in industry has questioned, for 
108 example, the standards adopted in the United States for chromic acid 
mists resulting from chromium electro-plating operations. These mists 
do not cause systemic injury, but do produce, under certain conditions, 
irritation of the mucous membranes and destruction of part of the 
nasal septum. Through educational efforts in the electroplating indus- 
try itself, it has been a relatively simple matter to obtain good operating 
techniques, so that chromic acid levels are kept well below the point 
where these minor injuries and discomforts can occur. 
The limits set forth in the above rule are capable of attainment 
through good engineering practice. They have been found, on the 
other hand, to cause no serious handicap to industry in the matter 
of compliance. Administrative agencies, however, should realize in the 
enforcement of this rule that the determination of whether a working 
condition is safe or unsafe, depends on other factors besides that of 
maximum allowable concentration in the atmosphere. Before an indus- 
try is told that it should make certain provisions to control conditions 
suspected of being inimical to health, a complete survey is in order. 
Such a survey should involve at least two criteria in determining 
the safety of an operation. First, it is essential that the health of those 
workers exposed to a certain material or condition should be carefully 
investigated. This may involve not only an examination of the worker’s 
health record, but also an examination of the worker himself. Second, 
careful environmental studies should be made which would include not 
only certain determinations of the atmosphere, but also a thorough 
sanitary survey and occupational analysis. The sampling and deter- 
mination of atmospheric contaminants should be made by approved 
and standard procedures. All these, put together, should yield data of 
real value in helping to control industrial health hazards. 
Certain sections of this -discussion present details for maintaining 
safe atmospheric concentrations. 
3. Skin Contact with Hazardous Material 
Rule.—Where the substances encountered are capable of causing 
any pathological change in the skin, adequate precautions shall be 
taken to prevent these substances from contacting the skin. 
Where the substances encountered are capable of being absorbed 
through the skin or mucous membrane thereby producing injury to 
health, adequate precautions shall be taken to prevent these substances 
from contacting the skin and/or the mucous membrane. 
Purpose of Rule.—Most chemicals either in the pure form or in 
solution can cause dermatitis when in contact with the skin over a 
prolonged period of time; consequently, most chemicals may be haz- 
ardous for repeated daily industrial contact. Although dermatoses are 
usually not serious, they may be prolonged and cause considerable 
economic loss both to workers and employers. Furthermore, a few 
chemicals may be absorbed through the skin and cause systemic poison- 
109 ing. Most notable among these are tetraethyl lead, mercury, and 
hydrogen cyanide. The purpose of the rule is therefore to prevent 
injury by repeated contact with such agents. 
Practices for Compliance with Rule.—Continuous or repeated 
contact with dermatitis-producing agents such as organic chemical 
solvents, solutions of or solid caustic, and organic chemical dusts may 
be prevented by isolation of the worker from the material, by exhaust 
ventilation, by the nse of protective clothing, and by supplementary 
washing facilities. 
By isolation is meant complete removal of contact of the skin with 
chemical agents. Thus, liquid chemicals should be handled in pipes 
and closed vessels rather than in buckets or other open vessels. This 
procedure not only eliminates contact, but also reduces the likelihood 
of spillage of material on the clothing which may cause continuous 
contact. Another manner of isolation is the use of mechanical equip- 
ment for dipping parts into solutions. This may be a mass production 
arrangement of the use of tongs or other manual handling devices. 
These arrangements are particularly useful for dip painting, for pick- 
ling and metal cleaning in general, and for impregnating operation^. 
Exhaust ventilation should be used to remove from the working 
environment irritating chemical dusts which may settle on the skin 
of the worker thereby causing dematitis or other injury. Processes 
involving the use of alkali powders or organic dusts which may escape 
into the atmosphere should be ventilated. (See section on ventilation. ) 
Protective clothing should be used when other means fail to prevent 
the contact of the skin with harmful chemicals. The purpose of such 
equipment is to prevent such material from touching the skin when 
splashed, settled, or reached into. 
Protective clothing for this purpose includes gloves, gauntlet gloves, 
full arm covering, face shields, full head covering, aprons, jackets, 
pantaloons, and footwear. The clothing must be impervious to the 
material in question, otherwise, it may soak in and be in continuous 
contact with the skin. Impervious clothing includes that made of 
rubber, synthetic rubber, synthetic plastics, or cloth impregnated 
with these materials. It may also include items made of asbestos for 
protection against physical burns. The use of protective skin ointments 
is not recommended except for very brief exposures to relatively mild 
chemicals. In connection with the use of such protective equipment, 
guidance should be sought from the plant physician. 
Supplementing the previously mentioned means, adequate washing 
facilities should be available for workers exposed to dermatitis hazards. 
After every work shift and at least once during the shift, such workers 
should wash extraneous chemicals from the skin. This implies that the 
employer should furnish hot and cold running water, an adequate 
basin, washing soap, and drying facilities. In cases where the poten- 
110 tially irritating material may contact the body as a whole, shower 
baths should be furnished. It is clearly the responsibility of the worker 
to use these facilities. 
In some instances when it is impossible to avoid irritating chemicals 
getting on the clothing, clean clothing should be furnished to the 
workers at regular intervals to prevent repeated contact of the skin 
with contaminated clothing. Such clothing may be furnished at in- 
tervals of from one day to one week depending on the severity of the 
hazard. 
In all of the above mentioned recommendations, good housekeeping 
and cleaning up of the spilled chemicals is implied. (See section on 
housekeeping.) 
The handling of tetraethyl lead must be done with the utmost care 
to prevent skin contact. Tetraethyl lead or its mixture with other 
organic liquids should be contained in closed vessels and pipes and 
all contact with the chemical must be avoided by the means mentioned 
above. Exposure to hydrogen cyanide should not be over 1 percent 
by volume in the air even for the worker protected from breathing 
such a concentration, since the gas is absorbed through the skin in 
such concentrations. 
4. Infectious Agents 
Rule.—There shall not exist iii any occupied area any processed or 
unprocessed material containing infectious agents unless provisio?is are 
present to prevent the infectious agents from injuring any part of the 
body or reducing in efficiency the normal function of any part of the 
body. 
Purpose of Rule.—ln certain types of industry such as animal 
husbandry, tanning, hide-handling, and cattle slaughtering it is pos- 
sible that infections, present in the animals, may be transmitted to 
workers. The purpose of the rule is to prevent the occurrence of such 
infections in workers handling potentially infected animal products. 
Practice for Compliance with Rule.—Of primary importance is 
the prevention of diseases in the animals. To this end, herds should 
be inspected for anthrax and glanders, and infected animals should be 
disposed of in such a way that the infection cannot be transmitted. 
In the handling of animal carcasses and hides, protective clothing 
should he used for two purposes. In the first place, direct contact of 
workers with hides and carcasses should be prevented as far as pos- 
sible. In the second place, protective clothing should he used to pre- 
vent the occurrence of cuts and abrasions among workers handling 
the materials. Every precaution should he taken to thoroughly disin- 
fect cuts and abrasions when they do occur, since the infecting or- 
ganism usually enters the human body through the broken skin. Pro- 
tective clothing should be kept clean and in a sanitary condition. Some 
111 industries may find it necessary to thoroughly disinfect hides, wool 
or carcasses before processing them. 
In addition good personal hygiene must be practiced by the workers. 
This implies that the employers in establishments where such infectious 
diseases may occur should provide adequate lockers, change rooms, 
soap and towels, and washing facilities with running water. All cloth- 
ing which comes in contact with potentially infected material should 
be laundered and disinfected. It is preferable that the employer 
furnish clean clothing to workers at regular intervals. 
5. Illumination 
Rule.—-27ie quality and quantity of illumination in any occupiedl 
area shall he adequate to permit the performance of all necessary work 
in a safe manner and without injury to the eyes. 
Purpose of Rule.—lllumination is a necessary factor in the environ- 
ment where any type of work is done, and it must be available when- 
ever work is in progress. Since most tasks require visual effort to a 
greater or less degree, the amount of illumination available must be 
sufficient for the eyes to see the work. However, it is possible for 
excessive quantities of light to reach the eyes without improving the 
illumination on the work being done. Such excessive illumination may 
injure the eyes over a period of time. 
On the other hand, lack of illumination is a potential cause of acci- 
dents, loss of efficiency, inaccuracy, and reduced production. The pur- 
pose of the rule therefore is to insure that the working environment 
is satisfactorily illuminated in agreement with reasonable standards. 
Practices for Compliance with Rules.—Lighting may be from 
natural sources during daylight hours or from artificial sources. In 
some cases a combination of both is required. The most easily accom- 
plished illumination is by the use, during daylight hours, of windows 
and skylights. It should be assured, however, that no working place or 
other occupied area is at too great a distance from the source of illu- 
mination to be adequately lighted. 
Artificial illumination may be provided by electrical lighting or other 
equivalent means. For such artificial illumination, two general ar- 
rangements are possible; namely, general illumination and local or 
spot illumination. The latter should be used primarily as a means 
of supplementing general illumination at those work points where 
especially good lighting is needed. General illumination means that 
lighting is available over a more or less large area. Lights for this pur- 
pose should be placed at least three meters above the floor and should 
diffuse the light downwards. Lighting fixtures for this purpose should 
be spaced at such intervals that the illumination at an elevation of 
one meter above the floor level is approximately equal in all parts of 
the working area. This same general standard should apply to natural 
illumination provided by windows and skylights. 
112 Spot illumination implies the stronger lighting of a small area and 
is usually accomplished by means of electrical fixtures. Such illumina- 
tion should be used for tasks requiring greater visual effort than is 
needed in other parts of the working area. The light should be so 
arranged that it produces the necessary effective illumination at the 
point of work. 
In all cases, the quality of the light must be such as not to impair 
the vision. The major lighting difficulty is that of glare which is either 
a reflection or a direct radiation of the light to the eyes from its source. 
Such glare greatly reduces the visual acuity. It may be overcome by 
facing the worker away from the source of illumination or by inter- 
rupting reflections from smooth surfaces. Such a smooth surface may 
be painted a dull light-absorbing color or may be replaced by a rough 
surface. Direct glare from light sources should be reduced by means 
of properly shaded light fixtures or by interposing a barrier in front 
of the light source. 
Another quality of illumination is the color, not only of the source 
but of the surrounding reflecting surfaces. In general, the darker 
colors are more comfortable for the eyes, but the lighter colors reflect 
and make useful more of the light. Walls and ceilings should Ik1 
painted with light colors, whereas work benches, floors and other sur- 
faces on which the work is done should be painted with darker colors. 
It is possible also to simplify visual tasks by means of contrasting 
colors. This implies that the background is of a different color than 
the parts being worked on, or that the different parts of moving ma- 
chinery are painted with contrasting colors so that they are readily dis- 
tinguished one from another. In such cases the moving parts which 
create the danger should be painted a light color against a dark back- 
ground. 
The maintenance of the source of illumination should be carefully 
attended to. This implies that windows, lights, and light fixtures 
should be washed at frequent intervals in order to maintain their 
efficiency. Walls, ceilings, and other light-reflecting surfaces similarly 
should be kept clean. Burned out light bulbs should be immediately 
replaced. 
Illumination may be measured by means of instruments which in- 
dicate the number of foot-candles of incident light at a given point. 
Therefore, it is suggested that specific quantities of illumination should 
be available for various types of work depending on the visual re- 
quirements of the work. Attention to fine details, for example, requires 
a relatively high level of illumination, whereas the simple act of walk- 
ing on cleared floors or stairways requires a low level of illumination. 
The following table should be considered as a guide to the minimum 
quantity of illumination which should be available for different general 
types of visual tasks : 
113 Visual task Foot-candle 
1. Walkaways—and near moving machinery 3-5 
2. Stockroom and low seeing requirements 5-10 
3. Coarse work (such as casting, machine tending) 10-20 
4. Coarse work at hazardous machinery (and moderate seeing tasks)— 20-30 
5. Fine machine and bench work, fine inspection (and other exacting 
seeing tasks) 30-50 
6. Temperature, Humidity and Air Movement 
Rule.—Natural or mechanical ventilation shall be provided in all 
occupied areas to insure a healthful and, so far as feasible, a com- 
fortable environment with regard to temperature, humidity, heat 
radiation and air movement. 
Purpose of Rule.—This rule implies that attention should be given 
to the temperature and humidity of the air in workrooms even when 
no possibility exists of the persons in the room being exposed to harm- 
ful contaminants. It has been found that the physical conditions of 
the air affect the efficiency of the workers, and in extreme conditions 
their health as well. The most comfortable conditions for specific types 
of work are usually those under which the work is best performed. 
Arduous labor, for example, may be accomplished at relatively low 
temperatures, whereas sedentary work is best done at a temperature of 
about 21° centigrade. 
The humidity and motion of the air also has its effect upon com- 
fort and upon health. Certain combinations of air temperature and 
humidity make work impossible and injurious, although the addition 
of a strong localized air movement may alleviate the conditions. 
The purpose of this rule is to suggest conditions and limitations con- 
cerning temperature, humidity and air movement as related to the 
environment of work places. 
Practices for Compliance with Rule.—Aside from the special 
ventilation required in some working locations to remove atmospheric 
contaminants from the environment, general ventilation should be 
available to provide some fresh air in all occupied areas. This may be 
accomplished by means of natural ventilation, which implies that a 
sufficient number of openings are available in the building or other 
structure, or by mechanical means. The latter implies that power- 
driven fans are used to force air into or to remove air from the oc- 
cupied enclosures or structure. 
On the average, approximately one-half cubic meter of air per 
person per minute should be changed within an occupied area in order 
to maintain comfortable conditions. If natural ventilation is utilized 
to accomplish this air change, the relative area of windows and other 
openings used for ventilation should be about 10 percent of the floor 
area served by the ventilation. Since ventilation is related to the 
occupancy of the building, it is suggested that the space volume per 
person in the workroom or place should be at least 10 cubic meters. 
114 When outdoor conditions are very cold, it is preferable that the 
entering air be heated almost to the room temperature and that it enter 
the space without creating a draft in areas occupied by workers. This 
may be accomplished by placing bathes inside the windows or by 
placing the air inlets at a height of at least 3 meters above the floor 
level and directing the air current upwards. 
The entrance of fresh air into a building or space implies that an 
equivalent amount of air leaves the building or space. Thus air outlets 
as well as inlets must be furnished if general ventilation is to be 
operable. 
The temperature of occupied areas may be raised by the use of 
heating devices such as unit electric heaters, central heating systems, 
gas, oil, wood or coal burning unit heaters, or other means. Care 
should be taken that unit furnaces have good stacks and draft, so that 
carbon monoxide and other gases do not escape into the working area. 
(See section on maximum allowable concentrations.) 
Humidity is closely related to temperature as it affects the air 
conditions of an environment. Relative humidity means the actual 
amount of Avater vapor in the air as related to the maximum amount 
of vapor which could be present at a given temperature. With high 
atmospheric humidities, it is impossible to cool the human body by 
evaporation. This implies that certain combinations of air temperature 
and humidity may be injurious to health. Quantitatively, the wet bulb 
temperature should not be above 32° centigrade, if the dry bulb tem- 
perature is as high as 49° Fahrenheit. For the most part, a relative 
humidity between 30 and 70 percent is the most comfortable for tem- 
perature ranging from 5 to 27° centigrade. 
Processes within the working place may add either to the tempera- 
ture or to the humidity of the area. It is not intended that these sug- 
gestions should limit this effect except to the extent that unhealthy 
conditions should not exist. Where furnaces or other high temperature 
equipment are in use, ceilings should be high and extra amounts of 
fresh air should be brought into the working environment by ventila- 
tion. When excessive humidity is created by processes or conditions 
which are not necessary to the process, extra ventilation should also 
be provided above the suggested amounts, in order to maintain reason- 
ably comfortable conditions. 
In specific hot locations snch as work areas in front of high tem- 
perature furnaces, a blast of air may be directed on the workers in 
order to make their work more comfortable provided that the humidity 
of the air is not excessive. Such an air blast should be of approximately 
the same temperature as that of the air in the working <irea in order 
not to create unhealthy conditions. Other means are also available to 
cool individual workers in particularly hot environments, such as the in- 
side of partially cooled boilers or kilns. These consist of asbestos suits 
115 within which a blast of fresh air is introduced by hoses from a cooler 
environment. 
For protection of workers against heat radiation from high tempera- 
ture sources such as furnaces, reflecting metal shields may be imposed 
between the worker and the source of heat without interfering with 
the work to be done. Asbestos clothing such as gloves, arm coverings, 
aprons, and face shields may be provided to protect the worker in- 
dividually. 
It is not intended that these practices should imply the need for 
air conditioning in hot climates or in hot environments. However, 
where hot environments occur industrially in cool or cold climates, 
change houses or rooms should be provided, so that workers may change 
clothing and bathe with warm water before being exposed to the 
cold conditions after the work shift. 
7. Noise 
Rule.—There shall not exist in any occupied area any process or 
operation producing noise unless provisions are present to prevent the 
noise from injuring any part of the hody or reducing in efficiency the 
normal function of any part of the hody. 
Purpose of the Rule,—Noise may be defined as an excess of sound 
of any pitch. Such sound excesses are known from experience to pro- 
duce over a long period of time, not only fatigue and inefficiency in 
exposed persons, but, in extreme cases, impaired hearing. The hearing 
may be impaired for a small range of the wave lengths which constitute 
sound or for nearly all of the audible wave lengths, in which case a 
condition approaching total deafness occurs. The purpose of the rule 
is to reduce the possibility of such injury. 
Practices for Compliance with Rule.—Industrial noise is usually 
the result of machinery operation, of the escape of the use of com- 
pressed air in pneumatic tools, or of fabricating heavy metal parts. 
Friction and vibration frequently play a major part in the production 
of noise. The first approach to noise reduction, therefore, is the reduc- 
tion by maintenance of friction and vibration in moving parts of ma- 
chinery. This elimination of noise at its source includes the replacing 
of worn parts and oiling of moving parts such as gears and bearings. 
Other means of eliminated source noises include the mounting of ma- 
chinery on rubber or on solid foundations, the use of direct or belt 
drives in place of open gears, or the enclosing of such gears in non- 
vibrating housings. 
Other means of noise reduction are the isolation of noise producing 
operations, the use of sound insulation, and the use of personal pro- 
tective devices. Frequently, the noise producing equipment may be 
removed from a main workroom to another location where a relatively 
small number of persons will be exposed. If such a location is sound 
116 insulated, very little sound will escape to the main workroom and the 
noise exposure of the operators will be reduced to a minimum. 
Sound insulation may be used not only in small enclosures such as 
mentioned above but also in large workrooms. Sound insulation is a 
means for reducing reverberations within a workroom or other en- 
closed space. By sound insulation is meant the lining of the enclosure 
or room with sound-absorbing materials. Such materials may be heavy 
tapestry or cloth hanging one or two inches away from a Avail, or soft 
perforated material, such as composition board, lightly but firmly at- 
tached to the walls and ceiling. Such sound insulation will appre- 
ciably reduce sound levels in noisy areas. 
For protection of individuals unavoidably exposed to excessive noise, 
personal protection should be provided. This protection may take the 
form of lightly oiled cotton plugs which may be placed in the outer 
ear canal, or of commercial ear defenders, which will serve the same 
purpose of reducing the intensity of noise vibration reaching the ear- 
drum. As in the case of other personal protective equipment, the more 
permanent means of noise elimination should be used as much as pos- 
sible. These more permanent methods include elimination of noise at 
its source, isolation of noisy operations, and the use of sound insulation. 
8. Vibration 
Rule.—Wherever any process or operation producing vibration is 
conducted in any occupied area, provisions shall be present to prevent 
the vibration from injuring any part of the body or reducing in effi- 
ciency the normal functions of any part of the body. 
Purpose of Rule.—Certain industrial operations, particularly those 
requiring the use of pneumatic tools, create rapid and vigorous vibra- 
tion which without adequate precautions may be translated directly to 
the person performing the work. Excessive vibration of this type may 
produce injury to the peripheral nervous system and to the joints of 
the body. The purpose of the rule is to prevent such injury. 
Practices for Compliance with Rule.—Vibration as interpreted 
in this rule should not be confused with noise associated with the use 
of pneumatic tools. (See section on noise.) 
The first means of preventing excessive vibration is to change the 
process where possible. For example, welding may be practical in 
place of riveting. 
Insofar as possible pneumatic tools should be held in position 
mechanically, particularly in the case of the medium weight tools 
which have a high impact. Such mechanical holding will prevent the 
translation of the vibration to the worker. Where it is not possible 
to hold the tools mechanically, workers should be provided with padded 
gloves or with other resilient padding which prevents direct contact 
of the tool with his person. In cases where direct contact of the vibrat- 
117 ing tool can not be avoided, the length of daily contact with the 
vibrating mechanism should be kept at a minimum. 
9. Pressure 
Rule.—-In occupied areas where the workers are subjected to 
abnormal atmospheric pressures, provisions shall be present to prevent 
injury to any part of the body or reduction in efficiency of the normal 
function of any part of the body of the worker upon enterijig, working 
in, or leaving that area. 
Purpose of Rule.—Both excessive and diminished air pressures may 
have a profound physiological effect on the human body. With 
diminished pressures, such as are encountered at high altitudes, the 
lack of oxygen may produce excessive fatigue and other effects. Exces- 
sive air pressure may be encountered where work is done under water 
or under ground when the pressure must be increased to exclude water. 
Subsequent effects of such increased pressure may cause the condition 
known as “bends.” The purpose of the rule is to prevent the oc- 
curence of such physiological maladjustment. 
Practices fob Compliance with Rule.—Life and work may be ac- 
complished at altitudes as high as 5,500 meters, provided that time is 
allowed for adjustment of the individuals to such altitudes. At high 
altitudes the oxygen available for respiration is considerably reduced, 
and the lack of oxygen is partially compensated for by changes in the 
blood physiology. These changes require several months’ time before 
complete adjustment is made. 
For any kind of work in altitudes above 5,50(1 meters oxygen should 
he furnished from a known safe supply. This implies that a source 
is available at all times and in a portable manner. 
Increased air pressure, greater than that encountered at sea level, 
may be used for tunneling and shaft sinking where water must be 
kept out of the working place. Under no conditions should the pres- 
sure be more than 5 atmospheres if the work is to continue for a full 
8 hour shift. Persons should not be subjected to pressures greater 
than 5 atmospheres for more than 1 or 2 hours at a time. 
In no case where work must be done under increased atmospheric 
pressure should the increase or decrease of pressure be made at a rapid 
rate. The pressure decrease to normal should be made according to 
standard practices in time intervals such as shown below. 
This stepwise decrease of pressure largely eliminates the possibility 
of occurrence of “bends.” In addition there should be available an 
auxiliary compressed air chamber in which affected individuals may 
he recompressed and returned to atmospheric pressure at even slower 
rates. A supply of oxygen should bfe available in such a recompression 
chamber for additional relief of pressure effects. 
118 Table I.—Pressure shifts and intervals of work for each 24-hour period 
Pressure 
I lours 
Column 1 
Column 2 
Column 3 
Column 4 
Column 5 
Column 6 
Minimum 
number 
of 
pounds 
Maximum 
number 
of 
pounds 
Maximum 
total 
Maximum 
first 
shift 
in com- 
pressed 
air 
Minimum 
rest 
interval 
in open 
air 
Maximum 
second 
shift 
in com- 
pressed 
air 
(') 
18 
8 
4 
H 
4 
18 
20 
0 
3 
i 
3 / 
20 
33 
4 
9 
2 
2 
33 
38 
3 
l H 
3 
I'A 
38 
43 
9 
l 
4 
1 
43 
48 
IH 
H 
5 
K 
48 
50 
i 
}^2 
0 
1 Normal 
DECOMPRESSION 
No person employed in compressed air shall be permitted to pass 
from the place in which the work is being done to normal air, except 
after decompression in the intermediate lock as follows: 
A stage decompression shall be used in which a drop of one-half 
of the maximum gauge pressure shall be at the rate of 5 pounds per 
minute. The remaining decompression shall be at a uniform rate and 
the total time of decompression shall equal the time specified for the 
original maximum pressure. 
(a) Where the air pressure is greater than normal and less than 
15 pounds to the square inch, decompression shall be at the minimum 
rate of 3 pounds per minute. 
(h) Where the air pressure is 15 pounds or over and less than 20 
pounds to the square inch, decompression shall be at the minimum rate 
of 2 pounds per minute. 
(c) Where the air pressure is 20 pounds or over and less than 30 
pounds to the square inch, decompression shall be at the minimum rate 
of 3 pounds every 2 minutes. 
(d) Where the air pressure is 30 pounds or over to the square inch, 
decompression shall be at the minimum rate of a pound per minute. 
The time of decompression shall be posted in each man lock. 
(e) Where air pressure reaches seventeen pounds, a record of all 
men working in the air chamber shall be kept by a man detailed for 
that purpose, who shall remain outside the lock, near the entrance. 
This record shall show the period of stay in the air chamber of each 
person and the time taken for decompression. 
10. Radiant Energy 
Rule.—Wherever any type of radiant energy is emitted into an 
occupied area, provision shall he present to prevent these radiations 
119 from injuring any part of the body or reducing in efficiency the normal 
function of any part of the body. 
Purpose of Rule,—Outside of visible light there are a number of 
known types of radiation which by their physical effect may injure 
the eyes, the skin, or the body mechanism as a whole. The principal 
radiations in this category are infra-red and ultraviolet which are very 
close in wave length to visual light, and X-radiation, which has an 
extremely short wave length. Classified with X-radiation and having 
similar effects are gaseous emanations from radioactive materials and 
other radiations such as alpha, beta and gamma rays. Although X- 
radiation and its associated components are the most dangerous, (see 
maximum allowable concentrations), infra-red and ultraviolet are the 
most frequently encountered. The purpose of the rule is to reduce the 
likelihood of injury to workers using equipment producing radiation 
or to other workers who may be exposed due to their proximity to such 
equipment. 
Practices for Compliance with Rule.—Two general methods are 
available for reducing exposure of workers to radiation; namely, shield- 
ing and personal protection. In the first place, all equipment pro- 
ducing radiation should be isolated from the general work area by 
means of proper barriers. This will reduce the possibility of radiation 
reaching persons who are not intimately concerned with the equip- 
ment which produces the radiation. 
Ultraviolet radiation is encountered industrially principally in weld- 
ing, either electrically or with gas. Although the intensity of such 
ultraviolet radiation is reduced inversely as the square of the distance 
from the source, enclosures or barriers should be provided for welding 
work to prevent the radiation reaching others in the vicinity. At 
stationary welding operations, permanent or semi-permanent fire re- 
sistant walls should be erected around the operation, extending from 
a distance of one-half meter from the floor level to approximately 
2 meters above the floor. The inside of such enclosures should be 
painted dull black to reduce reflection. For portable welding equip- 
ment movable shields painted dull black should he placed around the 
welding operation to prevent radiation from reaching other persons 
in the vicinity. 
Infra-red radiation is that produced by high temperature heat 
sources, such as glass furnaces, metal furnaces, and other types of in- 
dustrial heating equipment. These are usually permanent installa- 
tions, and either permanent or movable fire resistant shields should be 
so placed as to prevent the radiation from reaching the workroom in 
which they are located. 
Sources of X-radiation, either industrial or medical, should be 
located within enclosures which prevent the incident of potentially 
reflected radiation from reaching other workers or the general public. 
120 Enclosure for such equipment may be of concrete or lead, or of other 
material of equivalent capacity to absorb the radiation. For X-ray 
equipment up to 500 milliamperes capacity, a 2 millimeter thickness 
of lead or a 2 centimeter thickness of concrete will provide protection; 
up to 1,000 milliamperes, 3 millimeters of lead or 3 centimeters of con- 
crete are needed. 
Personal protection tor the operators of equipment which produces 
radiation should also be provided. Welders and helpers working with 
either electric or acetylene equipment should wear both eye protection 
and fire resistant clothing which covers the hands and body. Eye pro- 
tection may be provided by means of goggles or helmets, the latter 
being preferable, having a lens shade of sufficient density to allow 
clear vision of the object being welded while reducing intensity of 
light to the eye to the point where there is no glare. Suggested filter 
densities are shown in the following table : 
“Shade Nos. 3 and 4 filter lenses are intended for glare for reflected 
sunlight from snow, water, roadbeds, roofs, sand, etc., for stray light 
from nearby cutting and welding operations, and for metal pouring 
and furnace work. 
“Shade No. 5 filter lenses are intended for light gas cutting and 
welding, and for light electric spot welding. 
“Shade No. 6 filter lenses are intended for gas cutting, medium gas 
welding, and for arc welding up to 30 amperes. 
“Shade No. 8 filter glasses are intended for heavy gas welding, and 
for arc cutting and welding exceeding 30 but not exceeding 75 amperes. 
“Shade No. 10 filter lenses are intended for arc welding and cutting 
exceeding 400 amperes. 
“Shade No. 12 filter glasses are intended for arc welding and cutting 
exceeding 200 but not exceeding 400 amperes. 
. “Shade No. 14 filter glasses are intended for arc welding and cutting 
exceeding 400 amperes.” 
Persons intimately working with X-ray equipment may be partially 
protected by the use of leaded clothing, particularly gloves and aprons. 
So far as possible, persons operating X-ray equipment should work 
from behind the enclosing barrier. This implies that the controls for 
such equipment are outside of the room which houses it. It should be 
emphasized that, as far as possible, protection from X-rays and similar 
radiations should be of a permanent nature and should be obtained 
by engineering control measures incorporated in the design and instal- 
lation of the equipment. 
(See tables 3 and 4, pp. 28 and 29, in American Standards Associa- 
tion: Safety Code for the Industrial Use of X-rays. Part I. Z54.1, 
1946. 70 East Forty-fifth Street, New York 17, N, Y.) 
11. Ventilation 
Rule.—Where excessive amounts of contaminants may he liberated 
121 into the atmosphere of occupied areas, adequate ventilation systems 
for their removal shall be installed, maintained, in good, condition. and, 
operated, efficiently at all times when work is being done. 
The discharge air of a vent Hating system shall not be permitted to 
re-enter the same or other working areas and shall not constitute a 
health hazard or nuisance in the community. Plans and specif cations 
for all ventilating systems shall be submitted to the 
for approval prior to their installation. 
Purpose of Rule.—One of the accepted means for reducing atmos- 
pheric contamination is by the use, of ventilation. Many materials and 
processes used industrially have been found to have harmful effects 
on the body (see section of maximum allowable concentrations). The 
purpose of this rule is different from that in the section Temperature, 
Humidity, and Air Movement. In many cases, ventilation must be 
provided to remove from the working atmosphere industrial con- 
taminants which may be harmful. It is essential that such ventilation 
systems be properly designed and adequately maintained to accomplish 
their purpose. Any contamination removed from the working environ- 
ment by such ventilation systems should not be allowed to re-enter the 
working place nor should it enter any other inhabited area in suffi- 
cient concentration to be harmful or to create a nuisance. 
Practice for Compliance with Rule.—Two types of ventilation may 
be used for removal of contaminants from occupied areas; namely, 
general dilution ventilation and local exhaust ventilation. General 
ventilation implies that the air in occupied areas is changed frequently, 
so that fresh air replaces contaminated air. Such air changes must in- 
sure that contamination in the workroom is maintained below the 
maximum allowable concentration. Usually this requires a larger 
volume of air than the amount suggested in the section on Tempera- 
ture, Humidity, and Air Movement. Frequently general ventilation 
alone is not a satisfactory means of providing a safe environment but 
is only supplemental to other means. For example, in mining opera- 
tions wet methods of dust control should be utilized to prevent exces- 
sive contamination of the air, and general ventilation as a supple- 
mental means to remove from the working space the incidental dust 
which is produced even with the proper use of wet methods. 
General ventilation may he induced either by natural means or by 
the use of fans and blowers to force air into or out of the work place. 
Where either general or local exhaust ventilation is used, it is neces- 
sary to insure that the air inlets are approximately equivalent to the 
air outlets. This will insure that excessive resistance to air motion does 
not occur over the ventilation system as a whole. 
Local exhaust ventilation is a means for removing air contamination 
at or near its source so that such contamination does not enter the air 
of the working area. The component parts of a local exhaust ventila- 
122 tion system are: (1) the hood into which the contaminant is directed; 
(2) the piping system for transportation of the contaminant to a 
point of safe dissipation; (3) the air moving mechanism to move air 
and contaminants through the system; and (4) in some cases a collec- 
tor for preventing dispersal of the contaminant into the surrounding 
atmosphere. 
The hood of a local exhaust ventilating system may take many forms, 
but must be designed properly to collect the contaminant at its source. 
The more nearly a hood encloses the source of contamination, the 
more nearly it will accomplish its purpose. Complete enclosure is not 
always possible because of the requirements of the work. Other types 
of hoods include partial enclosures, canopy types, booths, open-end 
pipes, and open-end pipes with flanges. The variations of these hood 
types must be specifically adapted to the work for which they are 
designed. 
The piping system should be so designed that the air and contamina- 
tion moving through it does not encounter excessive resistance. The 
piping system should extend from the hood to a safe point of discharge 
in the atmosphere outside of the working place. It should be main- 
tained so that all joints are tight and so that solid material does not 
collect inside, thus reducing the flow of air. Removal traps may be 
installed in the piping system to collect solid materials. Clean-out 
openings may be installed at such points that cleaning of the inside 
of the piping is possible. 
The air-moving force may be either natural or induced by fans or 
ejectors. A natural air-moving mechanism implies that a temperature 
deferential exists which will create a movement of air into the hood 
and piping system or that some other natural force such as wind may 
be utilized. In such installations, the stack must always be of a large 
diameter and vertical, without bends, which impose resistance to the 
air movement. For the most part, induced air movement by the use 
of blowers is the most satisfactory means for removing contaminants. 
The fan or ejector should be of sufficient capacity to move the 
necessary volume of air through the hood, piping system, and collec- 
tor. Resistance to air movement will be encountered at the hood open- 
ing, within the pipe, at pipe bends and at transition points. The volume 
of air which must be removed through the system will depend upon 
the proximity to the source of contamination. 
Collectors may be utilized in this type of system to remove dusts, 
fumes, vapors, or gases from the air in the system before it is dis- 
charged to the atmosphere. They are not a necessary part of the sys- 
tem provided that the air is discharged in such a way that it will not 
reenter a working area or contaminate the general environment. For 
the most part, the discharge point of a ventilation system should be 
completely outside of the working area and preferably above the roof 
123 line. If ventilating systems discharge horizontally, the discharge point 
should be at least three meters distant from the nearest building 
opening. 
12. Respiratory Protective Equipment 
Rule.— When exposures to excessive amounts of atmospheric con- 
taminants are intermittent and of brief duration, or where ventilation 
or other control methods are impractical, the workers shall he pro- 
tected by means of respiratory protective equipment. Such equipment 
shall yive adequate protection against the specific contaminant under 
the conditions encountered and shall be of a type approved by the 
Respiratory protective equipment shall be employed only under the 
conditions above stated and shall not be used in lieu of other control 
methods of a more effective and permanent character. 
Purpose of Rule.—In the absence of more permanent types of con- 
trol procedures as a protection against atmospheric contaminants, ap- 
proved respiratory protective equipment will ensure the health of 
the worker. 
Practices for Compliance with Rule—lt is generally conceded 
that in the control of exposures to harmful atmospheric contaminants, 
first consideration should be given to procedures for preventing con- 
tamination of the air to a harmful degree in the breathing zone. How- 
ever, there are situations where for various reasons such procedures 
may be inapplicable, impracticable, or not effective. For these situations 
respiratory protective equipment may be indicated, either as a primary 
method or as an adjunct or supplement to other procedures. 
The following classification of respiratory protective equipment will 
serve to elucidate the various types of respirators, their general design 
features and the protection provided in various situations: 
RESPIRATOR CLASSIFICATION 
Respirator 
General design features 
Protection provided 
I. Air-purifying- respira- 
Filter (chemical or mechanical, 
Against specific contami- 
tors 
for removing contaminant or 
contaminants from inha'.ed 
air) and face piece attached to 
nants or types of con- 
taminants. No protec- 
tion against atm os- 
filter directly or by means of 
short length of flexible rubber 
tubing. Entire device is car- 
ried by the wearer. 
pheres deficient in oxy- 
gen. 
A. Chemical-filter re- 
Canisters or cartridges contain- 
Against gaseous contami- 
spirators 
ing suitable chemicals at- 
tached directly or by means 
of short length of rubber tub- 
ing to full face piece or half 
mask. 
nants. 
1. Gas Mask 
Canisters with chemicals for in- 
dividual gases or combina- 
tions thereof. 
Up to 3 percent ammonia 
and 2 percent most 
other gases and/or 
vapors. 
124 RESPIRATOR CLASSIFICATION Continued 
2. 
Chemical-cartridge 
respirators 
Cartridges with chemicals for 
individual gases or combina- 
tions thereof. 
Against very low or nui- 
sance concentration of 
gases and/or vapors. 
B. 
Mechanical-filter re- 
spirators (commonly 
called dust respira- 
tors) 
Fibrous filter attached to half 
mask face piece directly or by 
means of a short length of 
flexible rubber tubing. 
Against particulate con- 
taminants. 
1. 
Dust 
Fibrous filter attached to half 
mask face piece directly or by 
means of a short length of 
flexible rubber tubing. 
Against dusts of all kinds. 
2. 
Fumes 
Fibrous filter attached to half 
mask face piece directly or by 
means of a short length of 
flexible rubber tubing. 
Against fumes of various 
metals. Since fumes are 
probably more difficult 
to remove by mechani- 
cal filtration than other 
kinds of particulate 
matter with the pos- 
sible exception of 
smokes, this respirator 
will protect against 
such particulate matter 
as dusts and mists. 
3. 
Mist 
Fibrous filter attached to half 
mask face piece directly or by 
means of a short length of 
flexible rubber tubing. 
Against mists as pro- 
duced by spray-coating 
with paint and vitreous 
enamels, chromic acid 
mist as produced in 
chromium plating, and 
mists of other materi- 
als whose liquid vehicle 
does not produce harm- 
ful gases or vapors. 
C. 
Chemical and me- 
chanical-filter 
respirator 
Chemical and mechanical filter 
attached to face piece directly 
or by means of a short length 
of flexible rubber tubing. 
Against combinations of 
gaseous and particulate 
contaminants. 
II. 
A. 
Supplied-air respira- 
tors 
Hose mask with 
blower 
Blower (manual or power-op- 
erated) large diameter hose, 
harness, and face piece. 
Against any atmosphere. 
B. 
\ 
Hose mask without 
blower 
Large diameter hose, harness 
and face piece. 
Against any atmosphere, 
but should not be used 
in immediately harmful 
atmosphere. 
c. 
Air-line respirators.. 
Air supplied from special sys- 
tem or compressed air line to 
wearer through small diam- 
eter high pressure hose, re- 
ducing valve, short piece of 
flexible rubber tubing and 
face piece. 
Against any atmosphere, 
but should not be used 
in immediately harmful 
atmosphere. 
D. 
Abrasive blasting. .. 
\ 
Features same as 1, 2, 3 above 
(3 is more common) but in 
addition this device has suit- 
able hood to protect wearer 
against rebounding abrasive. 
Same as 1, 2, or 3 above, 
depending upon fea- 
tures but in addition 
has protection against 
impact and abrasion 
from rebounding abra- 
sive material. 
125 At the present time there has been developed in the United States 
by the United States Bureau of Mines a very rigid approval schedule 
for the testing of respirators of all kinds. Out of the extensive studies 
and tests made by this agency have resulted the standards necessary 
to determine the effectiveness and suitability of the various types of 
respiratory protective equipment. 
In selecting respiratory protective devices care should be taken to 
ensure that each device is designed and approved for use against the 
specific foxic material encountered and under the condition in which 
it is encountered. No gas mask, chemical cartridge type respirator or 
mechanical filter type respirator will sustain life in an atmosphere 
deficient in oxygen, and even supplied-air respirators or hose masks 
should not be used in such locations unless the worker is protected by 
a lifeline operated by another worker located in a safe place. 
Personal respiratory protective devices must be maintained in a 
condition 1 hat is substantially the same as when received from the 
manufacturer. Proper maintenance requires a thorough knowledge of 
the device and should be performed by a responsible person. Failure to 
keep such devices clean and in efficient operating condition is re- 
sponsible for much of the resistance of workers to wearing the equip- 
ment, and thus for failure to provide the protection intended. Neglect 
also makes it necessary to replace the equipment more frequently. The 
equipment should be stored in a clean, dry place where it will not be 
tampered with and where it will be conveniently available when the 
emergency arises. Where a good deal of such equipment is in use, it 
is a good plan to give definite responsibility to one person for the 
periodic inspection, checking, and maintenance of such equipment. 
Good rules to follow with regard to the maintenance of respiratory 
protective equipment are: 
(a) Always give the same device to the same person. 
(J>) Have a definite place to leave dirty’devices and to pick up clean 
ones. 
(c) Establish a maximum length of time the respirator may be used 
before it must be serviced and cleaned, and keep a record of the dates 
when inspected. 
(d) Establish a simple effective method of sterilization at regular 
intervals. 
In those cases where workmen have been properly informed regard- 
ing the need to wear respiratory protective equipment and have been 
trained in the proper use of such equipment, very little resistance to 
the wearing of the equipment is encountered. For this reason it is 
important that an educational program be inaugurated among the 
workmen with regard to the acceptance and use of respiratory protec- 
tive devices. In this case, as with the general use of hygiene in indus- 
try. there is a definite responsibility to be assumed by both the em- pioyer and the employee. The employer should understand the opera- 
tion performed by the workman and the hazards involved. He should 
be acquainted with the design, use, and limitations of protective 
equipment. Where such equipment is needed he should provide it and 
it should be of good and approved quality. The workman should also 
be instructed personally as to the need for wearing the equipment and 
how to use it properly. The employer should maintain the equipment 
in good, clean, serviceable condition, and its use should be carefully 
supervised. If the employer faithfully and properly responds to these 
responsibilities, the workmen, on the other hand, should accept the 
responsibility for wearing the device in the most effective manner. 
Satisfactory use of personal respiratory protective devices cannot be 
obtained without this mutual acceptance of responsibility and coopera- 
tion. 
All too frequently employers are prone to fall back on respiratory 
protection as the only means of safeguarding the health of employees. 
It should be considered that, at best, respiratory protective equipment 
is only a stop-gap, or a temporary means of protection, and should 
never be employed where other more permanent methods can be used, 
such as local exhaust ventilation or wet methods as in the case of 
dusts, supplemented perhaps by general ventilation. It is unfair to 
request any workman to use a respiratory protective device through- 
out an 8-hour day, especially in warmer seasons, when even the best 
devices are uncomfortable and may at times be responsible for skin 
diseases. 
13. Protective and Personal Clothing and Equipment 
Rule.—Workers in operations, processes or conditions of work which 
unduly expose them to dampness and wet environments, excessive 
heat, excessive noise, hazardous radiations, and other eye hazards, skin 
irritants, falls, falliyig material and other hazards, shall he provided 
with proper protective clothing and other devices of a type approved 
hy the 
Purpose of Rule.—Some industrial operations require a potential 
exposure of the workmen to various hazards. Where protection is not 
possible by other methods, proper protective clothing should be pro- 
vided to the individuals so that the exposure will be reduced. The 
purpose of the rule is to insure that such devices are of the proper 
type for the exposure and are properly maintained. 
Practices for Compliance with Rule.—Personal protective devices 
have been mentioned in the sections on Temperature, Noise. Radiant 
Knergy, and Skin Contact. Further protective devices include those 
which give protection against falling materials, against splashes of 
liquid chemicals, against excessive dampness and against falls. 
Head protection against falling material may be provided by means 
of hard hats. Such head gear should be of a rigid material which will 
127 deflect falling objects and will protect the head from the shock from 
such objects. 
Facial protection may be provided by means of goggles, shields 
which cover the entire head and shoulders or face shields. Such facial 
protection should allow full vision and comfort. Full head shields may 
be made of various fabrics with a transparent face piece allowing 
vision. Face shields may be of plastics which allow full and undis- 
torted vision and which are provided with head band for support or a 
handle for holding it in position. Goggles may be used for protection 
of the eyes alone against flying objects, radiation, or splashed liquids. 
The lenses of such goggles may be of a hardened shock-resistant glass, 
or of other durable material which allows free and undistorted vision. 
They should give actual protection against the hazard, and, if neces- 
sary, should be of a cup type which closely fits the face to exclude 
extraneous materials completely. 
Protective clothing for the body may include: gloves, armlets, 
jackets, aprons, or complete body covering such as coveralls. Such 
items should be designed to protect the parts of the body which may 
be exposed to the hazard. As a guide for selection of types of materials 
which best protect against certain types of hazards, the following list 
of materials is cited: asbestos fabrics—flame resistant; treated cotton 
fabrics—flame and alkali resistant; chrome leather—heat and flame 
resistant; woolen fabrics—heat, flame, and acid resistant; rubber- 
water, acid, mild alkali, and electric current resistant; neoprene— 
solvent and oil resistant; other synthetic plastics—water, solvent, oil, 
and acid resistant. 
Protection for the legs and feet may be provided by means of leather 
and rubber shoes and boots and by leggings. 
The maintenance of protective clothing and equipment is a very 
important part of its use. Without proper maintenance such equip- 
ment may in itself become a hazard or may completely fail to provide 
the protection for which it was designed. Furthermore, protective 
equipment which contacts the body must be kept clean in order not to 
create a nuisance or any insanitary condition. 
As criteria for the selection of protective clothing and equipment, 
the following items must be considered: (a) the equipment should be 
reasonably comfortable under the temperature conditions in which il 
is to be used; (b) it should fit well and not interfere with the workers’ 
activities; (c) it should afford adequate protection against the hazard 
involved; and (d) it should be durable. 
14. Housekeeping 
Rule.—The housekeeping in all occupied areas shall be such as to 
promote a healthful and safe environment. 
Purpose of Rule.—Good housekeeping is. through order and cleanli- 
ness, an essential factor in assuring a healthful environment. 
128 Practices fob Compliance with Rule.—The effectiveness of any 
good housekeeping program depends in a large measure upon the 
thoroughness with which each person involved does his part. It is 
essential that such a program be inaugurated by management and that 
the workers be trained in their respective duties and obligations in the 
use of equipment, methods and practices installed for the prevention 
of health and safety hazards. Another essential in a good housekeeping 
program is a schedule of frequent inspection to determine the degree of 
compliance with good practices. 
One of the important factors in introducing a good housekeeping 
program in a plant is the securing of orderliness. The plant should be 
so designed that the flow of raw materials into it and the various stages 
of manufacture are arranged in such a manner that no congestion will 
result. Disposal of scrap and waste material must be adequate. In 
addition to a well-planned manufacturing process, it is important that 
proper storage facilities be provided for equipment, tools, and raw 
materials. Unnecessary equipment and materials should be removed 
from working floors and surroundings. 
Thorough housekeeping means the removal of accumulations of dust 
from beams, pipes, and overhead structures, from shelving, from open 
storage platforms and from the top of mechanical equipment. It also 
means the removal of accumulations of dust and spilled materials from 
floors. Wherever possible, vacuum cleaning methods should be used. 
All cleaning should be done outside of working hours, or at such times 
as will keep the exposure to dust to a minimum number of employees. 
Workmen engaged in cleaning operations and all others who may be 
exposed where dust is the offending agent, should be provided with 
approved dust respirators. 
In general, one may summarize good housekeeping for the control of 
occupational hazards by stating that in the first place it is everybody’s 
job. In simple terms it means maintaining an orderly and workman- 
like shop, indoors and out. Some industries have found it useful to 
make someone in each workroom responsible for the housekeeping in 
that room. Others delegate that responsibility to shop health and safety 
committees. Whichever procedure is used, special attention should 
be paid to the following: (a) Tools should be kept in their assigned 
place. (h) Work benches should be orderly, (c) Materials should be 
brought to the operators and stacked in an orderly fashion. (d) Floors 
should be kept free of trash, spilled oil. and other waste, (e) Aisles, 
stairways, and halls should be kept free of obstructions. (/) Containers 
should be kept closed, except when in actual use. (g) Windows should 
be kept clean, (h) Lights should be cleaned and bulbs renewed prompt- 
ly when indicated, (i) Safety equipment should be kept in assigned 
places, repaired and cleaned regularly, (j) Plant exterior, yards, store- 
houses, garages, etc., should always be kept clean, (k) Floors and other places where dust may settle should he kept clean by either wet 
sweeping or vacuum methods. 
15. Sanitation 
Rule.—The sanitation within all places of employment shall be such 
as to promote a healthful and safe environment. No insanitary condition 
shall exist which may increase the incidence or permit the spread of 
disease. The handling, preparation and serving of food and drink shall 
be conducted, in such a manner as to prevent the spread of disease. 
Purpose of Rule.—Good plant sanitation is essential in the preven- 
tion of communicable and other diseases. 
Practices for Compliance with Rule. Plant sanitation is essen- 
tially concerned with (a) Water supply, (b) Waste disposal, (c) Wash- 
ing facilities, (d) Toilet facilities, (e) Personal services, and (/) House- 
keeping. The latter subject has already been treated in this code. 
Water Supply.—Every place of employment should have a supply of 
clean, cool, wholesome and safe drinking water, approved by the local 
health authorities. The temperature of the water supply for drinking 
should not be lower than 4° C. nor higher than 27° C. and should be 
preferably between 7° C. and 10° C. If the water is cooled by ice, the 
ice should not come into direct contact with the water. 
Where sanitary drinking fountains are provided, they should be of 
an approved type and construction and there should be at least one 
such fountain for each 50 employees. The common drinking cup is 
prohibited. Containers for drinking water from which the water must 
be dipped or poured should not be allowed, even if they have covers. 
Where water from an unapproved source is used for industrial proc- 
esses or for lire protection, distinct notices should be posted stating 
clearly that such water is unsafe for drinking. 
Waste Disposal.—Waste receptacles of the type which can be kept 
clean and sanitary should be provided in all places of employment. 
There should be an adequate number of such receptacles, and these 
should be provided in or near all eating places. Receptacles should be 
covered, unless they contain nothing which will attract flies or rodents. 
All waste receptacles should be cleaned as often as is necessary to main- 
tain them in a sanitary condition. All waste, including sewage, should 
be disposed of in a manner approved by the local health authorities. 
Washing Facilities.—Adequate facilities for maintaining personal 
cleanliness should be furnished in every place of employment and 
should he maintained in a sanitary condition. Separate washrooms 
should be provided for each sex. At least one wash basin with adequate 
water supply should be provided for every 10 employees or portion 
thereof up to 100 employees, and one wash basin for each additional 
15 employees or portion thereof. Twenty-four inches of sink with indi- 
vidual faucet may be considered equal to one basin. At least one wash basin should be provided in each toilet room, unless general washing 
facilities are on the same floor or near to the toilet room. Where 
employees are exposed to skin contamination with poisonous, infectious, 
or irritating materials, then there should be provided for them, one 
wash basin with hot and cold water for every five employees and one 
shower with hot and cold water for every 15 employees. The common 
towel is prohibited. Soap, in a suitable dispenser, should be provided 
at each wash place. Oils or solvents used for removing contaminants 
from the skin should be used sparingly. 
Toilet Facilities.—Every place of employment should have adequate 
water closets, chemical closets or privies, separate for each sex, in ac- 
cordance with the following table in which the number of persons is 
the maximum of each sex. 
Number of persons Minimum number of 
employed toilet facilities 
1 to 9 1 
10 to 24 2 
25 to 49 3 
50 to 100 5 
over TOO 1 for each additional 
.40 persons 
Chemical closets and privies should not be permitted except where no 
sewer is accessible and only when they can be kept under careful super- 
vision. An adequate supply of toilet paper in proper holders should be 
provided in each toilet room. Toilet rooms should be fitted with self- 
closing doors which should be screened from workrooms. The construc- 
tion and maintenance of toilet structures should comply with local 
health authority requirements. 
Personal Services.—ln all places of employment where it is neces- 
sary for male employees to change clothes or where females are em- 
ployed, separate dressing rooms with lockers should be provided and 
maintained in a sanitary condition. Dressing rooms should be provided 
for men whenever the type of work is such that it involves exposure to 
excessive dust, fumes, heat, vapors and other contaminants. 
Retiring- rooms should be provided in all places where 10 or more 
women are employed. Where less than 10 women are employed and a 
retiring- room is not furnished, some equivalent space should be pro- 
vided, which should be screened properly and made suitable for the 
use of women workers. 
In every establishment where it is incc nvenient for the employees to 
eat lunch away from the premises, there should be provided a special 
lunch room. No employee should be permitted to eat lunch at his place 
of work or in the workroom. Lunch rooms should be maintained in 
clean and sanitary conditions. 
131 C. Medical Provisions 
I. Prevention and Treatment of Occupational Illnesses and 
In juries 
Rule.—Arrangements for facilities and services shall he present for 
the preventfoii and the prompt and early treatment of all illnesses and 
injuries resulting from occupational exposures. 
Purpose op Rule.—The purpose of medicine in industry is to pro- 
mote the health and physical well-being of industrial employees. 
These objectives may be accomplished by : 
(a) Prevention of disease or injury in industry by establishing 
proper medical supervision over industrial materials, processes, en- 
vironments and workers. 
(h) Health conservation of workers through physical supervision 
and education. 
(c) Medical and surgical care to restore health and earning capacity 
as promptly as possible following industrial accidents or disease. 
Practices for Compliance wutii Rule.—There is no industrial 
establishment too small to have an organized medical service. This has 
been definitely demonstrated in many countries where organized med- 
ical services have been developed for very small plants, say those em- 
ploying less than 500 workers, by organizing several small plants in 
close proximity to each other and furnishing them with an industrial 
medical service by the utilization of local resources. Without such a 
medical organization and supervision, additional time is lost from acci- 
dental injuries, medical compensation costs are increased, and the 
establishment itself lacks the supervision and advice it needs in order 
to have adequate measures for health conservation. 
The scope and type of an industrial medical service will obviously 
depend upon the nature of the industry, its location, and the number 
of workers. In isolated communities it may be necessary to provide 
complete medical and hospital service for the workers and their 
families. 
The bulk of industrial medical service in a plant is given in the first 
aid room or dispensary. In order to maintain an adequate service, an 
industrial establishment will have to provide itself with one or more 
well qualified physicians to provide such service in the plant. The 
number of physicians and whether or not they serve full or part time 
will depend upon the number of workers in the plant. As previously 
indicated, small plants may combine to employ one or more physicians, 
or to secure the services of a group of physicians in the community on 
a rotating service plan. The dispensary should have one or more full- 
time or part-time qualified nurses who shall work at all times under the 
supervision of the physician. In case the physician is not present in the 
plant dispensary throughout the working period, then the nurse should 
have written standing orders signed by the physician. 
132 Other assistants, such as dentists, technicians, etc., whether on part- 
time or full-time basis, shall be employed as determined by the medical 
director. 
Each plant shall have a dispensary of a size and arrangement and 
with equipment in accordance with the needs of the industry it serves. 
Detailed information on this score may be found in the references at the 
end of the appendix. 
Some of the functions and services performed at the plant dispensary 
are as follows: 
(a) Emergency medical care of all employees who are injured on 
the job. 
(b) Continued treatment of employees suffering from occupational 
diseases or accidents. 
(c) Maintenance and analysis of all disability records in order to 
know how, when, and why, lost time due to disability occurs in the 
plant; these records should be tabulated monthly, according to cause, 
nature and duration of disabilities, and the department of occupation 
of the patient. 
(d) All employees returning to work after an absence due to illness 
or injury should be examined in order to determine their capacity to 
work safely and efficiently. 
(e) The medical department in the plant has an unusual opportunity 
to promote health education among the employees, since an employee 
who is ill is in a receptive mood to absorb good health practices. 
(/) The medical department should cooperate with, and, if indi- 
cated. supervise all other services in the plant which relate to the health 
of the workers, such as food service, welfare service, and recreation 
programs. 
Adequate industrial health conservation depends on cooperation be- 
tween employers and employees. The medical department should there- 
fore strive to give these two groups the same courtesy and professional 
honesty as they would to private patients. Industrial nurses and non- 
professional assistants should be supervised by the physicians, and 
their duties and functions should be described in clear and concise 
language, posted in the medical department. The physician should 
utilize the services of special consultants in the various branches of 
industrial medicine and surgery and in the control of the working 
environment. The latter service may be obtained from the 
Medical and surgical care of the worker should aim to restore the 
disabled employee to his former power and occupation as completely as 
science, skill, and nature will permit. It is the physician’s responsi- 
bility to furnish concise and dependable medical reports promptly to 
those agencies responsible for the compensation and rehabilitation of 
the worker. The early diagnosis and treatment of any injury or disease is ex- 
tremely important. No attempt will of course be made here to outline 
the diagnostic and treatment procedures, but it may be well to mention 
that progressive medical departments have found it useful as an aid in 
diagnosis and treatment to utilize techniques of clinical laboratories, 
X-ray equipment and other useful adjuncts in the field of industrial 
medicine. 
2. Prevention and Treatment of Nonoccupational Illnesses and 
Injuries 
Rule.—Arrangements for facilities and services shall he present for 
the prevention and the prompt and early treatment of all emergency 
nonoccupational illnesses and, injuries. 
Purpose of Rule.—First aid to the patient suffering from a non- 
occupational injury or illness will ofttimes permit him to remain on the 
job and will also serve to advise him regarding the need for outside 
medical care for an illness or an injury which, if not properly taken 
care of, may result in considerable loss of time from work. 
Practices for Compliance with Rule.—Ordinarily a plant medical 
service should not invade the field of private medical practice by pro- 
longed treatment of nonoccupational disabilities. Exceptions to this 
statement are those instances where industrial plants are located in 
isolated communities where no other medical services are available, save 
those in the plant itself. In most instances, treatment on nonoccupa- 
tional injuries or illnesses should be limited to what is necessary to keep 
the employee on the job until he can see his own physician. 
3. Physical Examination 
Rule.—Every employer shall make available af no cost to a prospec- 
tive worker a preplacement health examination. 
Periodic health examinations shall he given to all workers requesting 
such examinations at no cost to the worker. In the case of workers 
exposed to toxic materials or hazardous conditions of work, such as 
those exposed to siliceous dusts, heavy metal dusts, or toxic solvents, 
the workers shall he examined ax often as deemed necessary hy the 
examining physician, hut such examination must he given at least mice 
a year. 
In case the periodic examination shows the worker unfit for further 
work or for certain classes of work, thereby barring the worker’s future 
employment, then the latter may designate a physician of his choice 
amd request a review of the findings. If the two physicians cannot agree 
in the findings, then a third physician, agreed'■ on hy the two physicians, 
shall he selected and his findings shall he final. If the two physicians 
cannot agree on a third physician, then the director of the 
shall make the selection. 
Purpose op Rule.—Health examinations in industry are a means to 
134 promote and maintain the physical and mental well-being of the work- 
ers. More specifically, the objects of industrial health examinations are : 
(a) To facilitate placement and advancement of workers in accord- 
ance with individual physical and mental fitness. 
(b) To acquaint the worker with his physical status and to advise 
him in improving and maintaining personal good health. 
(c) To safeguard the health and safety of others. 
(d) To determine and control Ihe effects of unhealthful working 
environments. 
(e) To promote cooperative support and understanding of indus- 
trial health practices by employer and employee alike. 
Practices for Compliance with Pule.—Unjust or questionable 
exclusion from work through the employer’s application of the findings 
of the health examinations in industry is against the public welfare 
and is contrary to sound industrial health principles. From the public 
and industrial health viewpoint, the only absolute bars to immediate 
employment in nonhazardous occupations are: communicable diseases, 
mental illness in which impaired judgment or action prevents coopera- 
tive effort, and incapacitating injury or disease. 
In scope, the industrial health examination should include such con- 
siderations as the worker’s past medical, family, and occupational his- 
tory. This latter is extremely important, in that it may throw con- 
siderable light on the worker’s present physical condition, which may 
have been impaired by previous hazardous employment. For example, 
a worker who has been exposed for a prolonged period of time to the 
inhalation of silica dust may, upon careful physical examination, show 
evidence of lung impairment, which would preclude his employment in 
a dusty trade. It is essential, therefore, that the examining physician 
not only determine from the prospective employee bis past occupations, 
but he should also determine either from the employee or from other 
sources, the nature of the hazardous exposures which may be associated 
with the various occupations. 
In addition, the examination should include physical findings, per- 
sonality appraisal, laboratory data, and the physician’s summary of 
findings and recommendations. 
One of the important objectives of the industrial health examination 
is the proper placement of the worker. For this reason, the examiner 
will find that he may obtain best results when he is thoroughly familiar 
with the industry he serves and the hazards of the industry. Such 
familiarity will only be obtained by the physician through periodic 
inspection of the industrial establishment he serves. Such inspection 
will also serve to locate hazardous plant conditions which may be in 
need of correction. 
No attempt will be made in this discussion to set forth the equip- 
135 ment necessary to conduct a thorough health examination, nor to specify 
the routine procedure involved. 
It is important, however, to indicate briefly the use to which records 
of industrial health examinations may he put. In the first place, all 
major findings should be discussed with the worker, emphasizing the 
necessity for the latter to obtain immediate and adequate medical care, 
if this be indicated, A transcript of the record may be supplied to the 
employee’s personal physician, or to an official health agency, on re- 
quest or consent of the employee. The employer is entitled to receive 
information regarding the man’s physical and mental capacity for 
work, so that the worker may be readily placed or promoted. A special 
simple form can he used for this purpose. The employer should spe- 
cifically be told of any condition or disability, found on the worker 
which may have been caused by the working environment. Govern- 
mental agencies which require the results of a physical examination in 
connection with compensation procedure should be furnished with a 
report, but only after presentation of a legally enforceable official order. 
In all other cases there should be rigid observance of the confidential 
character of the health examination record and it should not be revealed 
to anyone except on consent in writing of the worker himself. 
One ot‘ the most controversial points in labor-management relations 
in the field of industrial hygiene has been the physical examination. 
Until recently, neither management nor labor has fully understood how 
to utilize properly the physical examination as a technique for the 
improvement of health of the industrial worker. In the past, and in 
some instances even today, routine preplacement and periodic physical 
examinations have been made a management requirement, in order to 
protect it in compensation litigation and to reduce the cost of insurance 
premiums. Labor, 071 the other hand, has insisted on contract clauses 
or laws designed only to protect workers against unfair use of the 
examination rather than making it a health service to the worker. We 
must recognize first that the physical examination is more than a 
medical problem. It is also a socioeconomic problem. The man who has 
spent his working life in one industry, and has acquired seniority and 
a higher wage scale cannot be expected willingly to accept placement 
in a less arduous but less remunerative job, even though it may save 
him from premature death due to a health condition discovered in the 
examination. Enlightened employers recognize this problem even 
though they have not yet provided the answer. These problems can be 
solved if all interested groups get together and put their minds to it. 
The above rule dealing with the subject of physical examinations is, in 
the opinion of competent authorities, workable, and is an enlightened 
approach to this problem. Certainly that portion of it dealing with the 
review of a periodic physical examination is reasonable and it should 
serve to protect both the employer and the employee. 
136 The purpose of periodic health examinations is to assist in maintain- 
ing the health of the worker and to assure that his physical condition 
is compatible with the requirements of the job. For these reasons 
periodic physical examinations should be made with sufficient thor- 
oughness and frequency, so as to permit early recognition of disease 
while it is still in its incipient stage. Such examinations are especially 
indicated for personnel in key positions and in the adult age group. 
For those workers who are not exposed to hazardous conditions, an 
annual physical examination should be sufficient. On the other hand, 
there are many industrial operations and exposures which require more 
frequent examinations. Although in the final analysis, the frequency 
with which examinations are made will depend in a large measure on 
the judgment of the examining physician who, it is assumed, will have 
a thorough knowledge of plant conditions and exposures, certain ex- 
periences have led to uniform practice in the matter of physical ex- 
aminations for workers exposed to toxic substances. 
These workers exposed to solvents, such as carbon tetrachloride, 
benzene and toluene, should be examined at the beginning of exposure 
and thereafter once a month. This monthly examination, however, need 
not be a thorough one, but only one which will indicate any early signs 
of poisoning. If good engineering practices are in vogue and if ex- 
posures are slight, then the examination need only be every 3 to (i 
months. Similarly, workers handling in any phase, compounds of lead, 
arsenic, mercury, cadmium, antimony, manganese, or other highly toxic 
material should be examined at least every 3 to 6 months. Workers 
exposed to mineral dusts such as silica, asbestos, etc., should be examined 
at least once a year, and this examination should include an X-ray, 
preferably 14 by 17 inches in size. 
Workers exposed to radiation, such as from X-rays or radium paint, 
should be examined every 6 months. 
The examining physician will acquaint himself with the early diag- 
nostic procedures for all of these highly toxic materials, so that his 
periodic examination will be directed specifically toward the search for 
any deleterious effects which the exposure may have on certain organs 
of the body. For example, in the case of exposure to radium there are 
now available sensitivity tests to determine the amount of radium in- 
gested by the body. Blood studies may be utilized for these workers ex- 
posed to certain organic solvents. Certain precise criteria are available 
for determining if injury is resulting from lead exposures and for 
many other of the heavy metals. 
In closing this discussion of preplacement and periodic physical 
examinations, it is essential to reiterate the objective of the examina- 
tion, which is to utilize every available worker. The old idea that an 
industrial worker must have the physical requirements of a military 
applicant is outmoded. Recent experience has demonstrated in no un- 
137 certain terms the fact that people with certain physical handicaps can 
perform useful work. A new concept has emerged from the intensive 
study of jobs and workers, and from the results obtained in the place- 
ment of the handicapped, by the rehabilitation clinics in highly indus- 
trialized countries. A new and, positive approach has been developed 
which has made it possible to employ men and women with all types 
of physical handicaps. It has stimulated the use of scientific methods 
for assessing the capacities of the individual, the limitations of the job. 
and the means for matching the two. In this connection, applicants 
found infected with syphilis should be employed, provided the disease 
is at a noninfectious stage, and they have no other disqualifying com- 
plication, and that they remain under treatment. 
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•fc U. S. GOVERNMENT PRINTING OFFICE: 1949—818948