Chapter IX: Mortality of Occupations

Having undertaken, at the invitation of the editor of the present work, to contribute a section on the mortality of occupations, I think it just to him and to my readers to premise that inasmuch as the results of the forthcoming census cannot possibly be available for a considerable time to come, the statistical _data_ on which I shall have to base my present observations must inevitably be those which were collected some years ago for the purposes of the second volume of my previous work.[42] And, seeing that those _data_ were to a large extent exhausted in the preparation of the work referred to, it follows that I can offer comparatively little that is actually new in the remarks which I am now about to submit. The best that I can hope to accomplish is to select from the mass of statistical matter that was compiled for my larger work such particulars as may seem appropriate for the present article, adding from time to time such explanatory comments as a careful review of my previous book may show to be desirable.

Before entering on a discussion of the special subject with which the present essay is concerned, it may be well to offer a few preliminary remarks on the variations of mortality in general, as affected by conditions other than those of occupation, and in different parts of the country.

In a paper read before the Royal Society in 1859, my distinguished predecessor, Dr Farr, produced evidence to show that in sixty-three of the registration areas of England and Wales, which he designated “Healthy Districts,” the death-rate in 1845–50 did not exceed 17 per 1000 persons living. Improvement in the health conditions of England and Wales has now made it practicable to establish a higher standard for healthy districts: for whereas in 1845–50 less than 6 per cent. of the total population lived in localities where the death-rate was 17 per 1000, we are now able to state that in the years 1881–90 not less than 25 per cent. of the people lived in districts where the death-rate ruled below 17 per 1000, including a proportion of 4.5 per cent. in districts where the death-rate did not reach 15 per 1000. At the same period the general death-rate of England and Wales was 19 per 1000 living: about one-fourth part of the English population experienced a death-rate of from 12 to 16 per 1000, one-half were subject to death-rates ranging from 16 to 22 per 1000, whilst one-fourth part of the population experienced death-rates varying from 22 to as many as 36 per 1000 living, or more than double the rate obtaining in the healthy districts. It is not of course suggested that these enormous differences of mortality are to be accounted for exclusively by circumstances of locality, or even by circumstances of occupation and locality combined. The true causes of excessive local mortality are for the most part well known to the sanitary authorities who are responsible for the health and well-being of the communities among whom such unfavourable conditions prevail; in any case, these causes cannot be specially discussed here.

The foregoing remarks, with respect to fluctuations in general mortality, may have little obvious bearing on the subject in hand, namely, the mortality of occupations. But I adduce them in order to assist in explaining what will be further emphasised later on, _i.e._, the fact that even in the same industry the workers in various places experience wide differences in their mortality--differences which can only be accounted for on the theory that conditions of environment determine, to a greater degree than is usually believed, whether the mortality of a given industry shall be favourable or the reverse.

In connection with each of the last four census enumerations, and with the aid of the death registers for the several intercensal periods, attempts have been made to ascertain the influence of occupation on the health and vitality of the people. The results have been published in successive “Decennial Supplements,” and to these works reference must be made on points of detail. The earlier investigations of Dr Farr, which were based on the census populations and the deaths in 1861 and 1871, were limited to the mortality from all causes incidental to men engaged in certain well-defined occupations--account being taken only incidentally of the diseases to which that mortality was due. This omission, however, was supplied by Dr Ogle in the third Decennial Supplement, which dealt with occupational mortality in 1880–2. On that occasion Dr Ogle undertook the laborious task of abstracting and analysing large numbers of deaths in combination with ages, causes, and occupations, and thus succeeded in preparing the valuable series of tables concerning “causes of death in different occupations” which illustrate his work.

For the last decennial supplement I am myself responsible. In Part II. of that work the calculations were based on the population, as enumerated at the census of 1891, and the deaths registered in the three years 1890–2. Details of age, occupation, and cause of death, with respect to every male over fifteen years of age who had died during these three years, were abstracted from the registers and entered on separate slips of paper: these slips, more than half a million in number, were then examined by specially selected clerks, who had been employed in classifying occupations for the census reports, and each slip was distinctively marked with the heading under which the occupation should fall.

In the course of the work it speedily became apparent that the mortality of men employed in the several occupations is seriously affected by the surroundings in which they work, and, as before mentioned, these surroundings vary considerably, even for the same occupation, in different parts of the country. In order to ascertain, if possible, the extent to which the mortality of certain occupations was modified by these conditions, the following plan was pursued: the slips belonging severally to London, and to certain groups of districts the populations of which are mainly engaged either in industrial, in agricultural, or in mining pursuits, were counted separately from those belonging to the remaining parts of England and Wales, and the mortality of the same occupations was ascertained in each of these areas.

The group of _Industrial Districts_ was constituted as follows--The county of Lancaster was selected as the seat of the cotton industry; the towns of Huddersfield, Halifax, and Bradford, as that of the woollen industry; Wolverhampton, Birmingham, Leeds, and Sheffield, as that of the iron and steel industry; and Leicester as concerned in the manufacture of boots and hosiery.

The _Agricultural Group_ contained all those counties of England and Wales in which at least one-third of the occupied males over ten years of age were returned at the census as farmers and farm labourers; to these were added parts of counties in which, after exclusion of some of their principal towns, a like proportion of the population was found to consist of farmers and their labourers. In order to avoid possible confusion, as between different grades of labourers, it may be mentioned that all those who were described simply as “labourers” in these agricultural districts have been reckoned here as “farm labourers.” For comparison of the mortality among _coal miners_ in different parts of the country, separate statistics for this industry were compiled for the following six local areas: (1) Durham and Northumberland, (2) Lancashire, (3) The West Riding of Yorkshire, (4) Derbyshire and Northamptonshire, (5) Staffordshire, and (6) Monmouthshire with South Wales.

The extracts from the death-register were limited, for the purpose of my Decennial Supplement, to facts concerning males aged fifteen years and upwards. Hitherto no attempt has been made to deal with the occupational mortality of females. The uncertainty attaching to the statement of occupations in the case of females has been urged as a reason against such an attempt. Much importance has also been held to attach to the fact that only 38 per cent. of the women aged between fifteen and sixty-five years were returned at the census as following any definite occupation, whereas 94 per cent. of the men at the same ages were so returned. Having regard, however, to the vastly increased attention which is now devoted to female industries, especially those which are carried on under the control of the Factory Acts, it is much to be desired that the mortality of the more important of these industries, at any rate, should be subjected to careful statistical investigation at the earliest possible opportunity.

The choice of an occupation by a labouring man is not always, nor is it mainly, determined by personal caprice. It is matter of common observation, that in industries of the more laborious type, such as those of railway navvy, engine fitter, boiler maker, blacksmith, etc., only men in the prime of life, or of more than average physique, are to be found. The operatives in these industries are selected men, quite as much so as are soldiers or sailors, but the process of selection is a different one. They can continue their arduous toil only so long as their bodily strength remains at its best: and when, from sickness or from advancing age this gives way, they are forced to relinquish their labour. They then either turn to some employment which makes less exacting demands on their energy, or else fall out of the ranks of definite employment entirely, and descend to the sad lot of those who are described as of no settled occupation. It follows, therefore, that the men in actual work in the laborious occupations above mentioned enjoy a special advantage over the workers in less arduous trades; and their mortality, although high in spite of that advantage, appears far lower than it would do if every individual could be traced from the time of his entry on the occupation to the end of life. But what of the men who, after trial of a laborious calling, perhaps for the best years of their lives, are forced by ill-health or other infirmity to relinquish it? Very many of these will be found struggling to eke out a living either as cab-drivers, omnibus guards, or messengers, and being for the most part broken down in health as well as careworn and ill-nourished, they must further increase the already high apparent mortality of these workers. Failing this, they will go to swell the ranks of the classes indefinitely known as costermongers, dock labourers, street sellers, hawkers, and general labourers, or less fortunate still, they will drift into the yet lower grade of the unoccupied, whose terrible mortality I shall shortly have to describe.

The mortality prevailing in a given industry from time to time can only be regarded as, at best, a rough measure of the healthfulness of that industry. The reason for this will be explained presently. It is, however, beyond question that when the public mind becomes sufficiently appreciative of the economic value of human life, and of the wastefulness of ill-health, to demand a registration of sickness corresponding with that which is now in force with regard to mortality, we shall be in a position to measure with a near approach to accuracy the amount of damage done by the several industries to the health and vitality of the workers, although it may not be practicable to suggest in all cases a remedy for the waste and the suffering so caused.

Meantime it is desirable to indicate briefly some of the chief reasons which detract from the value of mortality statistics as _criteria_ of the healthfulness of occupations. And first with regard to the data concerning the living in the various industries. It might seem at first sight a simple matter to sort out the units of an industrial community according to their occupations as stated in the census schedules: but even a superficial study of the experience of those responsible for the conduct of past censuses will show that even this initial process is, in reality, a highly complex and difficult one.

The number of names of more or less distinct avocations in England is enormous; at the last census it was about 12,000, but at the present time it is probably far greater than this. The vast additions that have accrued to our nomenclature of occupations is due in a great measure to the circumstance that new branches of industry have sprung up amongst us in recent years, and that with advancing times, old trade processes have undergone more and more minute subdivision. Nevertheless a large number of more or less obsolete names are still of necessity retained in the list of occupations, for the guidance of the abstractors, although many of those in current use are scarcely more than ephemeral nick-names, which are of but rare occurrence in the schedules.

In recent years the industries of the English people have come to be very minutely subdivided, each group of workers in the several subdivisions being known by a special name; and what is worse, the same name frequently indicates one thing in the north of England, and another thing in the south. Nay, more, it frequently happens that these arbitrary names give no clue whatever to the character of the industry to which they are assigned. Perhaps the most serious and perplexing difficulty met with in connection with classification is the fact that very frequently one and the same name is used to indicate totally dissimilar occupations. Thus, for example, the term joiner in some places is used to designate a carpenter, but in others it means a maker of lace. By clothier is sometimes meant a cloth-maker, in others it stands for a dealer in clothes. By jobber is understood in some cases merely an artisan, whilst in others it takes a more definite meaning in connection with the exchange of money (stockjobber). A drummer is either a soldier or a blacksmith’s striker. A miller is either a dealer in corn or a stone mason. An engineer may be either a maker or a driver of machinery. A placer may be either a potter or an iron manufacturer. In the above-mentioned cases the confusion is only between two occupations, but there are other instances far more numerous and much more troublesome, in which one particular name is used in common for a similar process in a considerable number of different trades. For instance, there are spinners, weavers, warpers, winders, etc., alike in cotton, silk, wool, and flax factories, and when an operative is returned under one or other of these names, without further distinction, it is impossible to decide to which of the several manufactures he ought to be assigned. Nor is the worker necessarily to be blamed for this; for he, failing to see the importance of precision, and perhaps ignorant of the use in other industries of a designation similar to his own, not unnaturally returns himself under some such familiar heading, without further question. Nevertheless it will readily be understood that the existence in the returns of such indefinite headings as “miner,” “labourer,” “artisan,” makes it difficult to estimate the precise number of workers in any industry, if, indeed, it does not in certain cases seriously reduce the value of such estimates. Fortunately, however, the numbers of workers thus vaguely returned at the census are small when compared with the enormously greater aggregates of those employed in the more important industries, and whose exact occupations are definitely known: so that, with respect to these principal industries, at any rate, the numbers can be ascertained with sufficient accuracy for practical purposes.

Thus far a few of the difficulties and possible errors connected with the returns of the living in the several industries having been considered, we now come to speak of the other factor of relative mortality, viz., the deaths occurring in the several occupations, and their classification according to age and probable cause. The difficulties encountered in relation to estimates of population have already been shown to be considerable; and yet they are not only fewer in number, but also less serious than those we shall now have to notice. The vagueness with which occupations are too often stated in the schedules has already been referred to, but unfortunately even greater vagueness is discoverable in the death returns. In proof of this the large group of men, some six hundred thousand in number, who are designated “agricultural labourers,” may be taken as a case in point. In the census returns of the living these men are doubtless correctly described, but in the death registers they are in many cases entered simply as “labourers,” without qualification of any kind. Consequently there is danger lest these men, who for the most part are remarkably healthy, sober, and well-conducted, should be confused with “general labourers,” a sadly unhealthy, degenerate set of men, whose occupation is uncertain, who live from hand to mouth, and whose mortality is nearly double that of agricultural labourers. Coal miners, again, are a class of workers who are likely to be differently entered in the census returns on the one hand, and in the death registers on the other. In consequence of the very commendable efforts which are made to secure accurate returns of the living at each census, it is probable that for the most part miners are classified accurately according to the mineral in which they work, but in the death registers coal miners and iron miners, tin miners and copper miners, are alike in many cases classed simply as “miners,” without further distinction, and thus much uncertainty results as to the exact class of workers to which a particular death should be assigned.

In his Decennial Supplement for the period 1871–80, Dr Ogle dealt with this subject very thoroughly; and inasmuch as his opinion is deserving of great weight, I make no apology for quoting here the following extract from that work. Speaking of the difficulties which occasion flaws in the calculations of occupational mortality, he says:--“There are many trades and occupations which require a considerable standard of muscular strength and vigour to be maintained by those who follow them; such occupations, for instance, as those of a blacksmith, of a miner, and the like; and so soon as from any cause the health and strength of a man fall below this standard, he must of necessity give up the occupation, and either take to some lighter form of labour, or, if his health be too much impaired for this, retire altogether from work. And even in those industries where no excessive amount of muscular strength is required, there must nevertheless be always a certain time beyond which continuance in the business becomes an impossibility. The weaker individuals, and those whose health is failing them, are thus being drafted out of each industrial occupation, and especially out of those which require much vigour; and the consequence is that the death-rates in these latter occupations are unfairly lowered, as compared with the death-rate in occupations of an easier character, and still more, as compared with the death-rates among those persons who are returned as having no occupation at all. A very considerable proportion of those who are forced to give up harder labour take to odd jobs of a more or less indefinite character, and are returned both in the census schedule and eventually in the death registers as general labourers, as messengers, or as costermongers, street sellers, etc.; and thus it comes about that the death-rates of general labourers, of messengers, and of street sellers ... appear to be of appalling magnitude, as also do those of persons returned as of no occupation. Under these headings, however, are comprised the broken-down and the crippled, who have fallen out of the ranks from all the various industries, as well as those who have been throughout life debarred, by natural infirmities or other causes, from following any definite occupation. Another very serious flaw in these death-rates, when taken as measures of the relative healthiness of different industries, is due to the fact that these several industries do not start on equal terms as regards the vitality of those who follow them. A weakling will hardly adopt the trade of a blacksmith, a miner, or a railway navvy, but will preferentially take to some lighter occupation, such as that of a tailor, a weaver, or a shopman. This defect in the death-rate gives an unfair advantage to such industries as demand much strength or activity in those that follow them. Such industries are in fact carried on by a body of comparatively picked men; stronger in the beginning, and maintained at a high level by the continual drafting out of those whose strength falls below the mark.”

In comparing the mortality of occupations at different and perhaps remote periods of time, it is important to ascertain whether any epidemic or pandemic diseases have been seriously prevalent among the general population during either of the periods compared; for in that case considerable allowance will have to be made for this fact, if anything like accuracy of result is aimed at. Thus, for example, in any comparison that may be instituted between the mortality of 1891 and that of 1881, it is necessary to take into account the far-reaching effects of the influenza epidemic which exceptionally and with great severity prevailed throughout the more recent period. It is unquestionable that the fatality of diseases not only of the respiratory but of the nervous and circulatory systems also was seriously increased by this complication, and that the value of any comparison between the mortality statistics of the two periods has been considerably diminished as a consequence.

The foregoing are a few of the more important defects which are unavoidably present in the data from which comparative statistics of occupational mortality are prepared. They are serious and far-reaching. In using such statistics as a means of distinguishing between different industries with respect to their healthfulness, it is necessary to recognise the existence of these defects, and to make suitable allowances for them. Nevertheless when this has been done, it is beyond question that the rates of mortality furnish reliable measures of the healthfulness of different occupations, especially of those in which the number of workers is sufficient to furnish trustworthy rates, and the period of investigation is adequate for the purpose.

Dr Farr has indicated the period of life between the twenty-fifth and the sixty-fifth year as that in which “the influence of profession is most felt.” Dr Ogle, in his Decennial Supplement to the 45th Report, adopted the same view, supporting it by the argument, that in the earlier periods the effect of occupation is not as yet fully developed: and that the last age period (sixty-five and upwards) is that which is more especially affected by the retirement from the industry of such men as have become too weakly to follow it. My own inquiries having tended to confirm these opinions, I have retained in my recent work the same interval, namely, that of the forty years between the twenty-sixth and sixty-sixth birthdays, as marking the period of life during which the effects of occupation are most conspicuous. In the majority of industries this is generally held to be the term of years which most accurately corresponds with the period of man’s greatest capacity for effective labour. There are, however, several occupations in which this is not so. Instances may readily be adduced of occupations in which the actual task of bread-winning both begins and ends at an earlier age than it does in most other industries; so that it would be impossible to specify any limit of age which should apply equally well to all occupations in this respect. Inasmuch, however, as it is necessary for our present purpose to select some one interval for general adoption, the age twenty-five to sixty-five is that which has been adopted as the “main working period of life” in the following pages.

The mortality of any given occupation is influenced very decidedly by “the age and sex distribution” of the workers. The examples following will show how great is this influence: the figures indicate the rates of mortality in each thousand males living in groups of ages: (1) among men in general, (2) among farmers as a class (see table on next page).

From this table it will be seen that the mortality of farmers is below that of males in general at every age-group, and that from the first stage of life to the last it averages from 50 to 60 per cent. of the mortality of males generally. If, however, the total deaths of farmers above fifteen years be calculated on the total number of farmers living above fifteen years, and without further distinction of age, the mortality of farmers would be represented

---------------+---------------+----------+---------------------------+
Ages | General Male | | Mortality of Farmers to |
(Years). | Population. | Farmers. | that of Males generally, |
| | | the latter taken as 100. |
---------------+---------------+----------+---------------------------+
15–20 | 4.14 | 1.30 | 31 |
20–25 | 5.55 | 2.40 | 43 |
25–35 | 7.67 | 4.29 | 56 |
35–45 | 13.01 | 7.03 | 54 |
45–55 | 21.37 | 11.20 | 52 |
55–65 | 39.01 | 23.97 | 61 |
65 and upwards | 103.53 | 87.81 | 88 |
---------------+---------------+----------+---------------------------+

by a rate of 19.58 per 1000, or 0.84 per 1000 above that of males in the aggregate. It therefore appears that although farmers do not die so fast as other men at each of the age-groups here specified, nevertheless farmers in the aggregate, _i.e._, without distinction of age, die faster than other men. This apparent contradiction will, however, be explained when the differences in age constitution are taken into account between farmers on the one hand and males in the aggregate on the other. Reference to the census report will show that there are nearly three-fourths as many farmers above sixty-five years old, when the mortality is 88 per 1000, as there are at ages between twenty-five and fifty-five, when it is only 4½ per 1000: whilst among the male population generally the number living at ages above sixty-five years, when the mortality exceeds 103 per 1000, is less than one-third of the number between twenty-five and thirty-five, when it does not exceed 8 per 1000. From the foregoing example, then, which is by no means a solitary one, it is clear that crude rates of mortality, _i.e._, rates computed without reference to age differences of population, are untrustworthy as a means of comparing one occupation with another on the score either of health or of longevity.

In dealing with the occupational mortality of 1880–2, Dr Ogle adopted the plan of “deaths in standard population,” which fairly represents the mortality of a given occupation as compared with the general mortality. The same plan has been followed (_mutatis mutandis_) in the present work. It may be thus explained. The standard population here used is the number of men between the ages of twenty-five and sixty-five years in the population of England and Wales, amongst whom 1000 deaths would occur in a single year; the population in 1891 and the deaths in 1890–2 being taken as the basis. The comparative mortality figure, therefore, is the number of deaths that would occur in a year, according to the death-rates ascertained for a given occupation among 61,215 men of standard age constitution: it represents very fairly the mortality in the given occupation as compared with that among males generally.

Out of 61,215 men aged from twenty-five to sixty-five at the census of 1891 there were enumerated:--

22,586 at the age-group 25–35 years
17,418 „ „ 35–45 „
12,885 „ „ 45–55 „
and 8,326 „ „ 55–65 „

In order to ascertain the number of deaths that would occur among 61,215 men engaged in a particular industry, all that is necessary is to apply to these four totals the corresponding rates of mortality occurring in that industry: the resulting sum of deaths will be the comparative mortality figure for that industry; and if the calculated deaths in each of the four age-groups be distributed proportionally according to the causes of death in such age-group, the parts of the comparative mortality figure that are due to the several causes will be obtained. By means of the tables which follow in the letterpress, and which have been prepared according to this principle, the mortality of men engaged in the stated occupations may be studied. I now proceed to illustrate, by means of a particular example, the manner in which dissimilar rates may be used for the purpose of comparing the mortality of men engaged in different occupations. In my larger work it was shown that in the three years 1890–2 there occurred among gardeners and nurserymen, between the ages before mentioned, 3462 deaths out of 339,225 years of life. If the age constitution among gardeners had been the same as that among the general English male population, the mortality of 61,215 males taken (1) from among the general male population, and (2) from among gardeners, would stand as follows:--

--------------+-------------------------------+---------------------+
| General Male Population. | Gardeners and |
| | Nurserymen. |
Age in years. +---------+---------+-----------+-----------+---------+
| Numbers | | Mortality | Mortality | |
| Living. | Deaths. | per 1000. | per 1000. | Deaths. |
--------------+---------+---------+-----------+-----------+---------+
25–35 | 22,586 | 173 | 7.67 | 4.14 | 94 |
35–45 | 17,418 | 227 | 13.01 | 6.59 | 115 |
45–55 | 12,885 | 275 | 21.37 | 11.63 | 150 |
55–65 | 8,326 | 325 | 39.01 | 23.29 | 194 |
--------------+---------+---------+-----------+-----------+---------+
25–65 | 61,215 | 1000 | | | 553 |
--------------+---------+---------+-----------+-----------+---------+

The true ratio of mortality among gardeners to that among the general male population is thus seen to be 553 to 1000, and this may be expressed by designating 553 the “comparative mortality figure” for gardeners.

_Unhealthy Trades._--A simple and rational classification was that of the late Dr Guy, the accomplished physician of King’s College Hospital, by which occupations were divided into (1) indoor, and (2) outdoor. It is matter of common knowledge, at least among medical men, that outdoor occupations are, for the most part, more healthful than indoor; which is tantamount to the statement that a life of labour in the open air, in spite of the danger of exposure to inclement weather, is more conducive to health and longevity than is indoor labour, with its ordinary (though by no means necessary) concomitants of foul air, sedentary habits, and want of exercise.

Having ventured to estimate, with the sole assistance of mortality statistics, the amount of damage to health, as well as of waste of life, which is encountered by workmen of different grades, as a result of their employment, it is of course necessary, _in limine_, to determine the maladies whose inordinate fatality is to be regarded as evidence that mischief has resulted from any particular trade process. The organs which are affected, not only earliest, but also most seriously, by dusty air and by air which is organically impure, are the lungs: and we naturally look to these organs as being those which will probably exhibit the chief indications of injury. Here, however, we are met by an initial difficulty. Unfortunately, the returns of death, as registered, do not in all cases furnish the means of discriminating between the various kinds of ailment. For example, medical experience shows that under circumstances frequently existing, especially amongst the poor, it is difficult to distinguish accurately between one form of lung disease and another, and there is reason to believe that a considerable number of deaths actually caused by simple inflammatory diseases of the lungs and air passages are erroneously returned in the registers, and consequently in the classified tables, as due to tubercular phthisis. In remote parts of the country, where the populations are for the most part ill-provided with medical attendance, it is the fashion to attribute to what is locally termed “consumption” or “decline,” all cases of illness that are accompanied by cough, expectoration, or shortness of breath. It must, however, be remembered that deaths are not in all cases certified as to cause by medical men: many of them are attested by coroners, and a certain proportion are registered without certificate of any kind. This is exceptionally the case in certain parts of Wales, where the mortality _ascribed_ to phthisis is very high, and where the proportion of persons who die without medical attendance is likewise excessive.

Having regard to the tendency which not infrequently exists to confuse tubercular with non-tubercular affections of the lungs, it is probable that the most reliable evidence derivable from the registers as to the evil effects, on the one hand of irritating atmospheric dust, and on the other of organically contaminated air, will be attained by the adoption of the late Dr Headlam Greenhow’s plan, which was to include the deaths from phthisis under the same heading with those of the respiratory system. This plan has accordingly been adopted here, and in the following tables the order of occupations has been determined by their combined mortality from these diseases. The mortality figures, however, from phthisis as well as those from other lung diseases are separately shown in the tables.

In my larger work on occupational mortality the varying incidence of phthisis and of respiratory diseases among certain classes of workers, in different localities, was treated of in considerable detail. I must here revert somewhat briefly to this subject, in order to explain what follows at a later stage. In the work referred to I showed that among _occupied males_ as a class between the ages of twenty-five and sixty-five the mortality figure from respiratory diseases exceeds that from phthisis by about one-fifth part: among _unoccupied males_, on the contrary, the mortality from phthisis greatly exceeds that from respiratory diseases. The main causes of this difference are probably: (1) that occupied males who are attacked by phthisis are especially prone to drift into the unoccupied class; and (2) that certain portions of the unoccupied class--the insane, for example--suffer a very high mortality from phthisis. The normally prevailing excess of mortality from respiratory diseases over that from phthisis does not obtain among occupied males in all parts of the country. In the industrial districts that excess is very clearly marked, but London and the agricultural districts are exceptions to the rule, their mortality from phthisis being greater than that from respiratory diseases. In London the mortality from respiratory diseases is high, but that attributed to phthisis is higher still; in the agricultural districts, on the other hand, the mortality ascribed to phthisis is low, but that ascribed to respiratory diseases is still lower. Turning to the separate groups of occupations, it appears that about one-third part of these groups, containing about the same proportion of the occupied male population at ages above fifteen years, differ from occupied males generally, in this respect, that they encounter higher mortality from phthisis than they do from respiratory diseases. This third part of the occupational groups may be arranged in two sections: the first section comprising those occupations which deviate from the general rule because of a special tendency among the workers to succumb to phthisis; the second section comprising those occupations which deviate from the rule for the reason that the workers enjoy unusual immunity from death by respiratory diseases.

The first section may be subdivided thus:--

(_a_) Occupations which are carried on in close and confined
air--commercial clerks, bookbinders, tailors, and tin-miners
afford examples of this kind.

(_b_) Occupations in which excessive mortality from phthisis
appears to be associated with alcoholic intemperance--as in the
case of law-clerks, inn-servants, and costermongers.

The second section may be subdivided as follows:--

(_c_) Occupations in which relative immunity from respiratory
mortality appears to depend on the circumstance that the workers
are protected from inclemency of the weather--instances of this
kind are furnished by barristers, school-masters, and domestic
servants.

(_d_) Healthy outdoor occupations characterised by low mortality
from both descriptions of lung disease--this sub-section
consists of farmers and labourers in agricultural districts,
and of gardeners; it is probable, however, that the excess of
mortality from phthisis above that from respiratory diseases
among these workers is, wholly or in part, only apparent.

The above remarks must be understood to apply only to such occupations as _depart_ from the rule, which is that the mortality from respiratory diseases exceeds that from phthisis. Among the occupations which _conform_ to this rule, there are some in which either impure or dust-laden air is one of the conditions of working; and there are others in which either alcoholic excess or exposure to weather is accompanied by enormous mortality from respiratory diseases. On the other hand, there are also included some occupations in which the workers experience low mortality from respiratory diseases, and still lower mortality from phthisis.

With respect to the standard by which the healthfulness of the several industries is to be determined, only a few words are necessary. The standard should be a high, but for obvious reasons it should be an attainable one, and the men composing it should be of a class not widely different from that of those with whom they are placed in comparison. The men engaged in agricultural pursuits form a group numbering more than a million, and consisting of farmers, graziers, gardeners, and farm labourers. They are for the most part a hard-working and healthy body of men, who spend the greater part of their time in the open air of the country: they may therefore be considered typical of that section of the population which suffers injury in the least degree from the inhalation either of dust-laden air or of air contaminated by organic effluvia. For these reasons agriculturists have been chosen as the class with which the occupations now to be specified shall be compared, so as to render appreciable the serious waste of life which is still experienced by the workers in certain selected occupations.