Chapter IV: Dangerous and Injurious Processes; Accidents and Safety (1)

“’Tis a sordid profit that’s accompanied with the destruction of
health.”—B. RAMAZZINI, 1678.

Let us turn now from general conditions affecting women and girls in factory life to special dangers due to “any manufacture, machinery, plant, process, or description of manual labour.”[92] Here the aid given by Women Inspectors, though extensive and indispensable, has hitherto been ancillary rather than primary in character. They have not before 1921 been brought into the Factory Department expressly in the capacity of medical, engineering, or chemical experts. And yet their early research into many imperfectly explored causes of injury to health and safety of women and young workers was so steadfast, and their evidence in Annual Reports so freely read and quoted in Parliament and the Press, that they stirred public opinion to a new outlook on women’s needs in these matters. As time went on the Department was able to draw in an increasing number of women candidates with good degrees in science, and with considerable experience in research or in work of an administrative character. The steady pooling of knowledge and experience that went on in the Women’s Branch yielded good fruit.

The Women Inspectors were immediately called on by the Chief Inspector of 1893 to 1895 to share both in enforcing new “special rules” for dangerous and injurious processes,[93] and in conducting enquiries with a view to strengthening these rules. They came into the service practically at the beginning of the new movement for _applying_ scientific knowledge in these matters; knowledge of some of the ills had existed before, but it had not been applied and was therefore incomplete. They entered the Department five years before a Medical Inspectors’ Branch was set up, and three years before the momentous requirement was made that medical practitioners should notify certain diseases (lead, phosphorus, etc., arsenical poisoning or anthrax), contracted in a factory or workshop, to the Chief Inspector.

Before the entry of the Medical Inspectorate, the long-established institution of part-time certifying surgeons[94] had brought some medical observation, largely unco-ordinated, to bear on industrial conditions. From their private practice among industrial workers the certifying surgeons often gathered important records of individual cases of industrial poisoning, respiratory and other diseases, arising from injurious conditions of manufacture. These records could be and were fully utilised by the Medical Inspectors in due course—as may be well seen in the reports and other writings by Dr. T. M. Legge and Dr. E. L. Collis.

Not until after the War (in 1921) was a medical Woman Inspector appointed to the Medical Branch—Dr. E. M. Hewitt. During all the earlier years from 1893 reliance was placed on the initiative of the Women’s Branch of the Department for the highly necessary observation by women of conditions and habits of women and girl workers. An outstanding obstacle to obtaining exact knowledge of industrial mortality and disease amongst women arose from the omission to enter in mortality and hospital records the occupation of married women, whether occupied prior to or during married life. This entailed a closer individual investigation among women than among men for clues to industrial disease and careful following up of their cases outside the factory as well as inside. When information was needed on grave injury and early deaths among, for example, asbestos workers or china scourers, in cases of lead poisoning or phosphorus necrosis, or mercurial poisoning in the days before notification was compulsory, indispensable contributions were made by the investigations of Women Inspectors in many directions, and especially as to the effects of lead processes on maternal functions.

The earlier tentative “special rules” for safeguarding the workers against “dangerous and unhealthy incidents of employment” had been made in 1892 and 1893, under the new powers of the Factory Act of 1891 suggested by the special rules under the Mines Acts. The special rules were made on the proposal of the Chief Inspector to the occupier of the factory after the process, machinery, or manual labour in question had been scheduled by the Secretary of State as being, in his opinion, “dangerous or injurious to health, or dangerous to life or limb, either generally or in the case of women, children, or any other class of persons.” Each occupier had a right of objection to the rules proposed, and provision was made for arbitration. In the absence before 1896 of any medical experts on the staff or of any substantial statistical evidence of cases of industrial poisoning and disease, the earliest special rules could only be few, simple, and experimental in character. Gradually, under the direction of the first Medical Chief Inspector, Sir Arthur Whitelegge, and the very slowly added medical staff, beginning with Dr. T. M. Legge in July, 1898, knowledge and vigour of regulation grew. Administrative methods of establishing regulation were greatly improved, and the uncertainties of arbitration in such highly expert questions were removed by the Act of 1901. The early years of the twentieth century saw what was unquestionably the most remarkable development that had ever yet been attempted in any age or country in applying scientific knowledge and care to the protection of workers from industrial disease and injury. At last the reproach made by many medical observers (and, particularly in our country, by Medical Officers to the Privy Council in 1860) began to be lightened; the reproach that “the canker of industrial diseases gnaws at the very root of our national strength,” that “the sufferers are not few or insignificant, ...” that “the magnitude of the evil is most imperfectly appreciated,” whether by the authorities or by the “slowly suffering artisans themselves”—and that all this was going on for lack of expert advice and the administrative application of scientific methods to the problems involved.[95] It was so long before the idea of industrial labour as a social service began to gain ground that only a few enlightened manufacturers, here and there, could attempt to try remedies.

It was not only medical knowledge that was needed to trace effects on the human frame of poisons (such as lead, arsenic, white phosphorus, mercury, etc.); of anthrax and tetanus germs; of gaseous and acid fumes; of injurious and excessive dust; of excessive moisture or heat; of muscular or nerve overstrain and impure air. The work of experts in engineering, physics, chemistry, and, not least, in patient observation of the habits, working conditions, ways and circumstances of the workers affected, was equally indispensable. This had been to some extent provided for in the reorganisation of the Inspectorate that followed the Consolidating Act of 1878. The Acts of 1883 and 1889 to regulate white lead and cotton cloth factories carried this matter further by exploration of some of the most injurious conditions. Thus, in the ranks of the general Inspectorate knowledge was available for technical work in some of these directions.

It must be remembered that the principal Act had long provided for the great safeguard of exhaust ventilation for removal of dangerous and injurious dusts, fumes, or other impurities generated in the processes or handicrafts carried on—though its full preventive scope was only gradually realised. Its significance was explicitly and repeatedly emphasised in later days by the Senior Medical Inspector, Dr. Legge,[96] and the pioneer work of such leaders as the late Mr. E. H. Osborn, H.M. Superintending Inspector of Factories, and the late Mr. C. R. Pendock, H.M. Inspector, in the application of engineering knowledge to these matters, should always be specially remembered. Their work was carried forward in due succession by Mr. Sydney Smith and Mr. Stevenson Taylor.

Under the Cotton Cloth Factories Act of 1889,[97] administered by Mr. E. H. Osborn and by Mr. Williams, now Superintending Inspector, exact standards of ventilation and hygrometers were first introduced in dealing with the dangers to health from excessive humidity of the atmosphere and high temperature in the workshops. Out of these experiences came recognition of methodical tests of chemical purity of the air of workrooms. Later, scientific emphasis was laid—by Dr. Leonard Hill, F.R.S.—on the truth that it is rather the physical than the “chemical conditions of confined atmospheres which influence health and happiness” of the worker. Before it was laid down as a truth that “overheated and still air decrease the activity of the body furnace and so lead to lessened resistance of disease,” Women Inspectors were steadily bringing persuasive pressure to bear on occupiers for introduction of mechanical ventilation to ease the visible strain they saw in industrial work in the stagnant heat of many a factory or workshed.

When Departmental Committees were set up, from 1892 onwards, for enquiry into various dangerous trades, outside medical experts were appointed as members before the advent of the Medical Inspectorate. In 1893 the precedent was first set of appointing a Woman Inspector, Miss Abraham, to such Committees where employment of women in the industries made this specially desirable. Miss Abraham also served on the main Dangerous Trades Committee, 1895 to 1899, on whose recommendations various codes of special rules followed. With Dr. Legge I served in the enquiry into Enamelling and Tinning of Metals, begun in 1901, and reported on for each section separately in 1903 and 1907 respectively. Less than ten years’ application of the first special rules of 1892 for these processes had sufficed to show their inadequacy for controlling the risks of lead poisoning. Separate regulations of the entirely distinct sources of danger in vitreous enamelling and in tinning of metals was not at first seen to be necessary; the obscurity of the sources in the latter led us to a point where our need of chemical assistance was evident, and this was provided when the services of Mr. G. Elmhirst Duckering, H.M. Inspector of Factories and a skilled chemist, were lent to us. A difference of method in the tinning of hollow ware and of the tinning of terne plates had given us a clue. His long studies and exact measurements of the degree of contamination of the air by fumes from the tinning bath, and from the surface of the tinned hollow ware article as it emerged from the tinning bath, led to definite conclusions as to the presence of lead chloride in the fumes breathed by the worker. And so—at last—we reached the possibility of obtaining effectual measures of control.[98] The number of cases of poisoning began to fall in the period 1909–11, and in 1920 only two were reported (both women), and these from a factory where there had been a breakdown in exhaust ventilation. Meanwhile, methods of manufacture had become less dangerous as well as methods of exhaust generally more effectual.[99]

From this experience and from the parallel activities of Inspectors, chemists, manufacturers in the far greater earthenware and china industry, came new methods of determination of dust and poisons in the air of workrooms. There came also re-enforced activity in anemometer tests of mechanical exhaust for poisonous fumes and dusts; amendment of construction of exhaust apparatus, and other detailed progress in what Mr. Pendock well described as “means of cleaning the atmosphere: the science of _air purification_, and a highly important science it is.”[100]

The extent of the work that was waiting, almost untouched, in the last decade of the nineteenth century, to be overtaken by persistent, meticulous application of this science to protection of the health of the industrial worker, may be partly realised by a backward glance at some of the appalling records as to disease and premature death in certain dusty processes. It must be remembered in considering the early figures that they were gathered before the discovery and recognition of the ubiquitous tubercle bacillus.

Let us take, first, flax preparation and carding, where women workers were in the majority:

“Dr. Purdon, in 1872, states the mortality as 31 per 1,000, and Dr.
Whitaker in his report on the health of Belfast, 1892, says the
carder’s average length of life is only 16·8 years of work. If a girl
gets a card at eighteen her life is generally terminated at thirty.
The preparer’s average is 28·7 years of work. The ‘rougher’ and the
‘sorter,’ said Mr. Osborn, work in a continual cloud of dust composed
of particles of the fibre ‘which is inhaled, and irritates and dries
the throat and gradually finds its way into the lungs, producing
chronic inflammation of the lining membrane, which soon manifests its
presence by the worker being attacked each morning with a paroxysm of
dyspnœa and coughing. A worker suffering thus is said to be ‘poucey’
(pouce=dust=_poussière_) ... some roughing rooms have no ventilation
but windows opening at the upper part, and the workers face the wall,
which, of course, reverberates the dust upon them.”[101]

Far higher was the mortality per thousand among “china scourers”—a few hundred women exposed to fine flint dust in the china industry. This flint dust also severely affected men in china biscuit-placing shops, in saggar emptying, and other operations.[102] China scouring is a dry process, of which the word is descriptive, to which the ware is subjected after it has been fired in the kiln. Before firing each piece is buried in a bed of fine flint dust in a receptacle known as a saggar, in which it is placed in the kiln, so that it may not adhere to the saggar or other pieces of ware during firing. On coming out of the kiln it is necessary to free each piece from adhering particles of the flint dust by friction of three kinds: scrubbing with a stiff brush moved by hand or by power, rubbing with stiff flannel, and with sand-paper. The extent of the injury from the process was found after patient research by Miss Deane and Miss Paterson in 1898. Rediscovered, one might more precisely say, for the enquiries of the Royal Commission of 1841 on Employment of Children and Young Persons had made it clear that the air of the rooms in which china scouring was carried on was filled with finely pulverised flint, the inhalation of which was “nearly as fatal as that of the grinding stones of Sheffield.” In these 57 years nothing had changed essentially. “Not many scourers live long; we all feel overloaded upon the chest and cough very much; I cannot lie down all night” (Commission of 1841). “Against the danger of this occupation scarcely any provision has been made” (Sir John Simon to the Privy Council in 1860). In their preparation of some evidence for an arbitration in Stoke-on-Trent in 1898 on revised special rules chiefly concerning lead in earthenware and china, the Women Inspectors discovered a remarkable weakness in the rule controlling flint dust. Whereas the stronger rule for elimination of dust by a positive requirement of fans, applied to “towing” of earthenware (i.e., rubbing soft clay dust off the pots with tow), the far more dangerous flint dust of china scouring was controlled only by a rule requiring removal of dust “_as far as practicable_,” by mechanical or other efficient means. With energy they set to work to complete the evidence as to the mortality of this occupation—by examination of all death certificates, during two and a half years, of women between fifteen and seventy years who had died in Longton, the chief china town, from respiratory diseases and phthisis, and by visiting the homes of the persons. Comparing deaths per thousand among all women in Longton attributed by the certificates to these diseases with those, similarly, among women who had worked regularly at china scouring, they found that these deaths per thousand in the two years immediately preceding the enquiry had been nearly fifteen times as great among china scourers as among other women in Longton. The figures were given in detail in the Annual Report for 1898. The Inspectors referred several cases of advanced fibroid phthisis that came under their notice to the newly appointed Medical Inspector, who attributed the physical signs in the lungs to inhalation of flint dust; three of these died within the year.[103]

The Inspectors visited all the factories where china scouring was carried on and found that, whereas efficient fan extraction had been installed in a few, yet generally full advantage had been taken of the permissive character of the rule regarding mechanical extraction of dust by omitting it. Some of the smaller china factories were wholly or in part unfitted for use as workplaces. The rule was amended as from January 1, 1899, with marked results in improved mechanical methods and in reduction of the disease by degrees. I found, by a comparative enquiry, ten years later, that the high mortality from respiratory disease and phthisis was reduced to less than half among china scourers, but this was still far too high a rate, and many extremely sad cases showed the need of strengthened provisions.[104] This information I gave with much other evidence to the Departmental Committee appointed in 1908 by Mr. Herbert Gladstone, since Lord Gladstone, to enquire into dangers from use of lead and injury to health from dust in china and earthenware and incidental processes.[105] The chairman was Sir Ernest Hatch, Bart., and the able secretary, Mr. E. A. R. Werner, a skilled chemist.

To the work of this committee reference must presently be made in dealing with lead poisoning in potteries; here we must recognise the immense advance in control of the dust problem in these works that followed on the adoption of the recommendations of the committee. The age of inactivity on proven ills had passed. Undoubtedly the presence on the committee of leading manufacturers and workers largely conduced to the practical thoroughness with which the problems were handled.

Many other dusty processes affecting women that were not under special rules also engaged the close attention of Women Inspectors, of which the following examples may be given:

(_a_) Asbestos sifting, mixing, and carding; an industry singularly little considered until complaints from the girls employed came in to us year by year, from 1898 onwards. The sharp, jagged edge of the insoluble mineral dust has undoubtedly occasioned much illness, and death, from respiratory diseases. The first asbestos factory I entered was entirely without applied exhaust, one of the dustiest processes being carried on in a cellar. In another, revisited in 1906, on a complaint thoroughly justified by the thick, fog-like atmosphere in the carding room, ineffectual fan extraction had been introduced, but not applied to the points of production of dust. By this date there were good examples of well installed mechanical exhaust in large asbestos factories, and progress could be secured in the smaller works. In 1911 Miss Whitlock, M.B., an Inspector in the Women’s Branch, made careful study for us of this industry, and found a considerable amount of phthisical, bronchial, and gastric trouble still present. The least defect in the working of the applied ventilation was dangerous.

(_b_) Silk waste carding and spinning gave rise to woeful complaints of dust from women, from 1898 onwards. Increased injuriousness of the excessive dust in preparatory processes coincided with the introduction of an inferior quality of silk. Dr. Legge found, in samples referred to him by Miss Squire, débris of silkworms containing “an enormous number of hook-like structures, probably portions of the thoracic and abdominal segments of the pupa case.” This gave support to the apparently strange opinion of the workers expressed to Miss Squire that they were coughing up not silk but silkworms; and it led us back to Ramazzini’s account, in 1678, of the effect on silk workers of the combing of “grosser filaments, which have parts of the bodies of silkworms mixed with them,” that they were troubled with “a vehement cough and great difficulty of breathing ... and few of them live to an old age.”[106] Again and again the need for scientifically applied exhaust had to be pressed for in this side of the silk industry, something inadequate was repeatedly tried, and choked-up ducts to fans even led to the beating back of dust on the workers. Eventually the introduction of machinery for cleaning the material before carding—steadily urged on the occupiers—helped to solve the problem of efficient extraction of dust.[107]

(_c_) Teazle brushing in hosiery factories, a finishing process for smaller articles in Leicester and Nottingham, produced excessive dust of broken powdery wool and cotton fibre, causing great discomfort in eyes, and choking sensations in throat and chest. The trouble was removed and valuable surplus dust for reselling was saved by applying exhaust with closely fitting cover to the machine and also a patent delivery roller at the back. Excellent results were reported in the following year, to the satisfaction not only of workers, but also manufacturers and foremen.[108]

(_d_) Mercerised cotton yarn dust was first noticed in 1902 as giving rise to what was known as “mercerised fever,” shivering and sickness with cough and oppression in the chest. It was attributed to strong caustic soda in the cotton fibre, which was irritating to the bronchial and nasal passages. The trouble was removed by requiring exhaust ventilation.[109]

(_e_) Miss Squire and her staff, when localised in Manchester from 1908, had their attention drawn (by complaints) to excessive dust in the making-up warehouses in which girls were employed in “hooking and lapping” heavily “sized” grey shirting and stiffened muslin. “Stuffed- up” chests and throat trouble and sickness were the results, and great discomfort was felt even by the Inspectors on their visits. They systematically served notice on the occupiers to provide localised exhaust ventilation, which removed the trouble.[110]

(_f_) Buffing of plated articles—_i.e._, mechanical friction with Trent sand sometimes mixed with lime—in Sheffield electro-plate works was the subject of a careful study by Miss Whitlock, M.B., to whose interesting report reference may be made by those desirous of following up the subject.[111] In the majority of buffing shops the women stayed in for their meals, and application of exhaust ventilation was only found in one shop. She found that the cases of phthisis among them were more than double the rate per thousand of those amongst women over fifteen years in the town, and that anæmia was prevalent.

(_g_) Dust as well as other injurious features in little scattered country flax scutch mills was specially followed up by Miss Martindale from 1907 onwards in North Ireland. Ineffective fans were fixed in many of these mills, and described by the workers as “a pest and a torment,” through their alternative capacity for stirring up the injurious dust and for getting choked up with fibre! In 1914 I took part in a conference in Belfast between representatives of the Factory Department and the Irish Board of Agriculture and Technical Instruction with the aim of concerted action as regards mechanical ventilation of the scutch mills. These mills, being mostly situated near flax fields for the first stages of preparation of the dried fibrous material for manufacture, concerned both Departments. The War intervened, and these problems have there fallen to the charge of a new administration. The question was again raised for the Factory Department during the War, when flax growing and scutching was initiated by Government action in various parts of England.

Many other dusty processes and the health of women in them engaged our attention; in rag and refuse sorting, fur-pulling, in hatters’ furriers’ factories and horsehair factories, in starch rooms of confectionery works, hemp-rope works, sackmending, cotton waste works, india-rubber works, eiderdown and kapok-filling factories, clay pipe scouring, embossed paper lace-making, etc. In a lace-tinting business for dressmakers we called in Dr. Collis’s aid for investigation of marked injury to health of all the workers; he not only found the soreness of nostrils and pharynx associated with inhalation of dust, but also phthisical results from the finely divided dust shaken out by hand from the lace. Here the occupier at great expense provided efficient exhaust, drawing off dust from the lace without this shaking by hand. Improved methods of working were in our experience a frequent consequence of our demands for extraction of dust.

In connection with an enquiry in Sheffield into the association of phthisis and dusty trades Miss Whitlock found that the system of compulsory notification of consumption already in practice there in 1911, combined as it was with enquiry into occupation of the patient, greatly facilitated her work.

Bronzing,[112] whether by hand or machine, of all kinds of paper programmes, showcards, prospectuses, Christmas cards, etc., in lithographic works or departments of works, affected workers in ways that almost perennially commanded our attention. Dust from bronzing was on the border line between those that are simply mechanical in action on the respiratory passages and those that are either irritant or poisonous. In the earlier years the work itself was generally intermittent, not continuous. Although the Dangerous Trades Committee in 1896 made recommendations in their first interim report for control of risks in this process by special rules, the apparent absence of permanent injury to health among those engaged in it led in the first place to the application by the Home Office of voluntary, not compulsory, rules for protection of the workers. Our activities, conjointly with District Inspectors, in pressing questions of dust extraction, means of maintaining personal cleanliness, overalls, supply of milk, examination of workers by the certifying surgeon, and so on, fortunately led to improvement in bronzing machines with vacuum arrangements for dust. Probably they led also in part to the concentration of the work in the hands of a few occupiers that followed; finally, special regulations were made compulsory in April, 1912.

In 1911 an important step was taken for more systematic work by Women Inspectors in the field of dangerously dusty processes. In conference with Mr. Pendock, as District Inspector and ventilating expert, arrangements were made by Miss Lovibond (Mrs. Moorcroft) for the taking of records, on tabular cards, of anemometer tests at hoods connected with mechanical exhaust ventilation, so as to bring steady pressure to bear on occupiers of factories for testing and maintaining efficiency in their installations. As I said then: “There can be no question that supervision of the provision of really efficient exhaust, and steady maintenance of it, when provided, in thorough working order is the supremely important task of the Inspectorate in all dusty trades where dust is of a kind inhaled, whether the dust is simply mechanical or irritant or poisonous in contact with the mucous membrane or respiratory tracts.”[113] The taking of these records, of which copies were supplied to occupiers, fortunately aroused much interest, and among workers as well as employers. In the next year about 1,000 records were made in the Potteries alone, including all places where workers, reported for lead poisoning, were working at or near the exhaust ventilation. Miss Whitlock took over this work at the close of that year and added an invaluable enquiry into nearly all the reported lead cases among women in potteries in 1913, giving us careful studies of the conditions and ways of workers, with suggestions for future prevention. Early in 1914 we lost her increasingly valuable aid in medical questions concerning women through her transference to the Industrial and Reformatory Schools Department. Then the great upheaval of the War turned us away from quiet, fruitful, concentrated activities of this nature to the many problems arising from the intensified industrial production by women for national needs.

I have been here led from point to point by following up one kind of protection, which is a fundamental one, against risks in industry from the various types of dust and from lead fumes. This will suggest, perhaps, as well as any other method of approach, something of our share as Women Inspectors on behalf of women workers in the immense work that was carried on by the Factory Department during the years 1893 to 1914 in striving to lessen the special risks of injurious and dangerous processes. It is impossible, except by devoting a whole book to it, to do more than give samples of our service in this side of Factory Act administration.

Some notion of the magnitude and complexity of dangers to be regulated and injuries to be prevented, with the chief preventive measures embodied in “special regulations,” can be gathered from Appendix I.—a tabular summary that I made in 1913 (and which has been brought up to the present date by Miss Squire, O.B.E.), giving these details in alphabetical order for all the trades, processes, and descriptions of manual labour, that are certified by the Secretary of State as “dangerous or injurious to health or dangerous to life or limb.”

In addition to the research needed before regulations were made, to the giving of evidence to Committees, Arbitrators, and Commissioners appointed by the Secretary of State, when objections to draft regulations had to be reviewed—besides instruction to occupiers and workers, and prosecution when necessary—we gave a great deal of attention to another side: the exclusion, or proposed exclusion, from very dangerous processes of classes of persons whose age or sex made them specially susceptible to poison or other risks. The special interest of the whole community in protection of maternity and health of young workers, for example, was the chief point on which we had influence in developing regulations for the white lead industry, in which the extraordinarily dangerous character of the main processes had led to special control years before Women Inspectors entered the Factory Department. Those who desire to follow out the history of regulation in this industry, originally the foremost among “occupations injurious to health,” might begin with the account in the Annual Report of the Chief Inspector for 1879, when it was already illegal to employ in it any person under eighteen years of age; and might further consult a complete concise account of the various processes, their dangers and prevention, in “Lead Poisoning and Lead Absorption,” by Dr. T. M. Legge and Dr. K. W. Goadby, Chapter XVI.[114] On and after July 1, 1899, it became illegal under special rules to employ a woman in the peculiarly dangerous processes in white beds, stoves, etc. And, so far as _this_ industry is concerned,[115] most of the effect of the Women and Young Persons (Employment in Lead Processes) Act, 1920, passed in pursuance of the Washington Convention of 1919, had been long ago attained in our country.

Other dangerous lead processes, originally highly serious for young women workers, are found in the electric accumulator industry. Here again our evidence supported the exclusion of these workers from such risks, and since 1903 “no woman, young person, or child” may be employed “in the manipulation of dry compounds of lead or in pasting.”[116]

Although it was not until 1908 that the primary investigation by an Inspector of reported cases of industrial poisoning or anthrax cases affecting women and girls was assigned by the Home Office to the Women Inspectors, we had always used these reports for supplementary enquiries. We had already, before 1900, a wide knowledge of the conditions under which lead, phosphorus, and mercurial poisoning had occurred, and had brought to light unreported cases, particularly of lead and phosphorus necrosis, and some secondary effects of lead poisoning in women.

The latter point was strongly exemplified in some information that I presented in the Annual Report for 1897, gathered by Miss Paterson and Miss Deane during that year. They enquired into seventy-seven reported cases of plumbism amongst married women employed in lead processes in the Potteries of Staffordshire, where the most injurious lead processes— _e.g._, colour dusting, ware-cleaning—fell to women. They found among these a high degree of childlessness, stillbirths, and miscarriages; that thirty-six only had had living children averaging three each, and of the total number of children two-fifths had died, the majority succumbing to convulsions in infancy. Two sample cases gave a tragic warning as to the social as well as individual physical effects of employment in lead processes on maternity: “A.B., aged twenty-nine, married seven years, had worked in lead ten years, had three miscarriages, five stillborn children, and one child alive who died in convulsions when a few weeks old. C.D., aged twenty-five, married seven years, began to work in lead in her seventeenth year, had had four miscarriages and three stillborn children; her one living child was born after she was absent from her work.”[117]

Other cases as sad and sadder were found first by Miss Martindale, then by Miss Vines, during their successive and systematic work in the Potteries from 1903 to 1908. The latter visited practically all women reported for lead poisoning, and a striking example was the case of Mrs. B., colour duster and paintress, aged thirty-eight, married fifteen years, who had nine miscarriages and one living child, ill all the three years of its life; was herself disabled with wrist drop of both hands. She had to take her case into court to obtain compensation due to her.[118]

Although such enquiries dealt with a grave evil to some extent understood before, the subject gives a good example of ways, arresting to the general onlooker, in which women investigators seized on features or consequences of industrial employment of women that concerned the nation. Their consequent action and recommendations emphasised the need of steady investigation by qualified women of absenteeism among women workers in lead processes, and the extremely unsuitable conditions of publicity under which medical examination in these early days sometimes took place in the factory. “This led, not infrequently,” said Miss Deane, “to failure in detecting the very evils which it is the object of the examination to find out and eliminate.”[119] It appeared in 1900, when I took some prosecutions against leading employers for neglect of duties regarding medical examination, that there was a strong tendency for girls who felt ill to leave a pottery without the suspension by the certifying surgeon provided for in the special rules of 1899. Poverty, dread of loss of employment without compensation—which was later made available for them in such cases by the voluntary action of the manufacturers themselves—seemed to me the strongest cause of that tendency. Records of poignant individual cases accumulated by the Inspectors made this factor very clear.

In the remarkable Pottery Code of Regulations, 1913, which followed on the general lines of drastic recommendations made by the Departmental Committee under Sir Ernest Hatch,[120] careful requirement was made that a private room should be provided for the examination of workers by the certifying surgeon, and other safeguards of privacy were laid down. Some other provisions needed to secure effectual use by the workers of safeguards provided for them followed the lines indicated by complaints of women workers to the Women Inspectors. On these they had accumulated evidence, sometimes with the aid of information given by officials of the “Potteries Fund,” a voluntary fund for assistance of women and girls suffering from lead poisoning in this industry. For example, separate washing conveniences were now required for the sexes; women had explained to me in detail how they could not use the same conveniences as men coming from hot and dusty processes such as “glost placing,” in which a large proportion of the men and boys were employed. New detailed care was given in the regulations to provision and maintenance of protective clothing and messroom arrangements; suppression of dust by methods and means additional to those of exhaust ventilation; better control of temperature; control of heavy weight carrying by young workers, cleaning of floors, boards, and benches; new limitation of hours for men as well as women in dangerous processes; exclusion of women and young workers from certain processes. These and other matters, particularly rules against heavy weight carrying, and for better methods of cleaning floors, boards, etc., which were strongly supported by the evidence arising out of our long researches, were remarkably thoroughly dealt with in the code. An entirely fresh stimulus was applied to the sense of responsibility in the occupiers of potteries by a requirement that the occupier himself should appoint a competent person to carry out systematic inspection of the working of all the regulations, and to keep records of the inspection. This was truly a novel requirement in so ancient an industry, relying as it too long had done on traditional methods. How much it was needed may be seen in a sample prosecution by Miss Martindale in 1913. She had found that, so far, the tendency had been to note and record only breaches of the code by workers. She said: “Undoubtedly this is salutary, but not, I take it, all that regulation 27 was intended to do. I revisited with Miss Whitlock a factory in which in October she had noted not less than twenty-six breaches of the regulations. The record of self-inspection showed no irregularities since July.... The Works Inspector stated that he ‘had not observed any,’ although the irregularities were such palpable ones as: not providing milk, not affixing thermometers and placards, not painting boards red.”[121] Conviction and heavy penalties followed the taking of proceedings.

In addition to the industries above touched on, where women and girls have run risk of lead poisoning, litho transfer making for decoration of earthenware china gave us much thought in the past owing to the exposure of young, anæmic girls to finely powdered dust containing lead. Inclusion of the process under the stringent Pottery Regulations, and improved methods of dust extraction, have greatly reduced the risks. The glazing of bricks with lead in the glaze, later shown to be unnecessary, was found by Miss Squire in 1898 to be causing fits among the girls who were scraping the edges of the bricks. These attacks had been thoughtlessly attributed to hysteria until brought under medical observation. Heading of yarn dyed by lead chromate and painting of perambulators still take prominent place amongst other industries from which lead cases affecting female workers are notified. This may be seen in the Table given below in Appendix II., which is included in order to enable readers to appreciate the reductions in industrial poisoning that have followed the changes indicated since 1900. The interesting liability of lead to turn up in miscellaneous industries, in quite unexpected ways and places, and especially in the great range of small metal industries in the Midlands, is too wide a subject for further consideration here. Sample cases and a long list of industries may be seen in the Annual Report for 1913.[122]

The great general fall in number of reported lead cases, particularly in potteries, that had come about by 1914 (see Appendix II.), and is still more marked in later years, is no doubt due in the main to the preventive measures I have so briefly indicated. Foremost of all came improved methods of exhaust ventilation, but very important also were cleanliness and reduction in hours of work. Until trade is quite normal, however, the true effect of these measures and of the great aid given first by legal compensation and then by National Health Insurance—which enable workers to obtain treatment and rest from work at an early stage of illness—cannot be fully known. The detailed, thorough investigation done among the women exposed to lead by Women Inspectors (and particularly in 1912 to 1914 by Miss Whitlock), which culminated in a series of prosecutions for numerous contraventions of the new regulations affecting them in potteries, no doubt led to a fresh start for them. Of industrial poisoning Miss Whitlock wrote in 1913: “Poverty with its attendant worry and lack of nourishment appears to be a predisposing cause in many cases. The youth of many of the workers is noticeable.... Apart from the painful character of the illness, the length of time the cases last is a serious matter.... I often came across cases which had been over a year on compensation.” “A woman in a warehouse told me that she had been over three years at work after three years on compensation and still suffered from pains in her limbs, and was obliged sometimes to absent herself from work.” Of cases of serious illness among women heading yarn dyed in lead chromate, Miss Tracey observed: “Without home visits it would have been impossible to gauge the extent and severity of the illness.”[123] Unquestionably specialist work by Women Inspectors still remains to be done for women workers in dangerous trades, even though the figures of poisoning seem to show them to be now in a much safer position than men. The figures alone do not disclose the whole matter. Much may yet be learned by following up “absent” or “left” women workers, as well as by seeing reported cases in their homes. A marked mobility of women’s labour in lead processes in potteries was found in 1911 by Miss Sadler. In sixty-eight potteries at the time of inspection (between January and September) no less than 258 were marked in the special register as “absent” or “left,” apart from suspensions and reported cases. Out of forty cases diagnosed as lead, she found twenty-four still suffering and in receipt of compensation; and also that the majority were under thirty years and not suffering from accumulated effect of bygone conditions.[124] When compulsory compensation began to take effect it was gratifying to watch the growth of realisation among manufacturers of the poverty caused by plumbism. In the past much had been hidden in obscurity by the tendency of the poor to suffer in silence. Manufacturers showed increasing recognition of the importance of utilising compensation to the best advantage for the individual cases.

From time to time, though rarely, mention was made in Annual Reports of the appointment of a medical woman by employers to supervise the health of women and girls in a large factory. This movement passed into a new phase during the War, when national munition factories set the example of appointing whole-time women medical officers. In 1920 we learned that in “a growing number of factories medical women are appointed to supervise health of women and girls.”[125] In the same year the first appointment of a woman as certifying surgeon was made by the Chief Inspector—in West London.

These developments in drawing medical women into official contact with industry, and particularly the appointment of a woman as one of the Medical Inspectors of Factories, have a greater significance for future protection of the health of women workers since the absorption of the Women Inspectorate, from August 1, 1921, onwards, into the general district work of the whole country. Instead of concentrating enquiries and action on behalf of working women, the Women Inspectors must necessarily give their time largely to men and boy workers, male workers being not less than 65 per cent. of all persons employed in factories and workshops.

Meanwhile the whole pottery industry, the matchmaking industry, and others with features that concerned the health and safety of women in a special degree, have reorganised themselves on lines recommended by the Whitley Report. Their Councils have happily immediately concerned themselves with improving conditions of health and welfare. When one sees, as I have, the admirable detailed work done for health and safety in a factory with the aid of workers on a works’ committee in an industry with a National Council—particularly in a factory with an experienced welfare superintendent working harmoniously with the works’ committee—one realises what a long way has been travelled since 1893. Each year, since 1919, has seen contact of the Factory Department with new Councils, in questions relating to health, safety, and welfare—a matter to which we may revert in Chapter VIII.

The pursuit of certain salient developments in control of foremost industries responsible for lead poisoning where women are concerned has led me so far to pass by absorbingly interesting work of Women Inspectors on varied risks and injuries during the twenty-seven years under review, thus only (as in the question of control of dust and fume by mechanical means) could I, in so enormous a subject, sketch some kind of picture, that might remain, of the women’s claim and our lines of response.

It is necessary, however, in order to have any true picture of the work of the Women Inspectors to sketch rapidly some other of its less closely interwoven features. The effects of bisulphide of carbon as a solvent in the making of rubber articles; of white phosphorus for the dipping paste in matchmaking, producing phosphorus necrosis, called, with a sinister familiarity, “phossy jaw”; of a solution of mercury to assist felting in hatters’ and furriers, causing varying degrees of mercurial poisoning; these took even more of our time and thought in early years than did many of the injurious dusts already mentioned. As for white phosphorus, considerable as was our share in tracking down hidden cases of necrosis and other ill-health in lucifer match girls, and in helping to build up special rules against the horrible risk of painful and disfiguring disease, yet all that is now only of historical interest, for statutory prohibition of the deadly ingredient in matches, whether manufactured in our country or imported, came in 1908 by an Act which took effect from January 1, 1910. And the active Joint Council of this reformed industry and intelligent works’ committees in some factories, with their highly developed mechanical methods, fittingly bear moral responsibility for seeing that no such risks ever arise again. Our last reference to any cases of necrosis was in the Report for 1909, when three young women were (all from one factory) under treatment in a local hospital—one for her first operation on the jaw, another for her fourth, while the third, seen at home, had had two operations. All had suffered much. Some cases arose during the War among men employed in manufacture of phosphorus. In india-rubber works of recent years we have seen and dealt more with the effects of naphtha fumes, dust, lead, great heat, and heavy weights, than with bisulphide of carbon covered by special rules. The last bad case we had was in 1911, from a factory where press of work led to employment of girls for a longer consecutive spell than the two and a half hours permissible under special rules. Hysteria, bordering on insanity, followed, and the poor girl was summarily dismissed for “insobriety and rowdyism.” She recovered quickly on separation from the work, and was restored to her usual quiet self-control.[126] In the following year we had some cases of mercurial poisoning in a hatters’ furriers’ workshop due to particles of dust from rabbit fur previously brushed with a solution of mercury, the process being known as “carotting.” These were attributed to a failure to maintain, in good repair and efficiency, the otherwise excellent system of exhaust ventilation, and to the use of an extra strong solution of mercury to assist the felting property of inferior fur.[127]

As for anthrax, owing to the supreme importance of bacteriological research and technical remedies requiring specialists in this industrial disease, such services as we were able to render, in investigation of the circumstances in reported cases affecting women, although far from negligible as regards conditions in factories, were entirely subsidiary to the work of the medical branch. Sometimes, too, we disclosed hidden risks to women, engaged at home in cleaning and mending of a husband’s clothing when he was employed in handling hides or other infective material. Two out of six cases affecting women in 1914 occurred amongst women not working in industry, one the wife of a tanner. The prosecution of a brush manufacturer for breach of regulations in his factory brought out the fact that one of his outworkers, who had suffered from an attack of anthrax, was not covered by protective regulations. The obscure origin of some cases, even among factory workers, appeared in a case affecting a cotton spinner engaged in cotton that had been shipped from Alexandria, and in various cases among women sorting or mending sacks that had conveyed bone dust.[128]

Carbonic oxide poisoning, particularly in laundries, traceable to escape of gas through defective fittings of ironing machinery, was a subject that repeatedly engaged the attention of Women Inspectors receiving complaints of illness among the girls employed on this work. In one laundry, which had escaped inspection through failure of the occupier to notify its existence, girls were found to have been gravely ill with severe symptoms of this form of poisoning. Proceedings instituted against the occupier for the failure to notify occupation and for using a gas iron emitting noxious fumes led not only to conviction, but to a special penalty (on account of the injury to health due to his neglect of provisions of the Act), which was applied to the benefit of the injured worker.[129]

The use of bichromate of potassium, causing “chrome holes” in the hands of workers taking a very long time to heal, in dye works and in wholesale photography works, was also brought under our observation.

In these kinds of risks, in cases of illness in tobacco works attributed to nicotine poisoning, and in numerous cases and varieties of trade eczema (inflammation of the skin or dermatitis), we brought much information to the Senior Medical Inspector, and received his help in taking action to secure remedies. Among the trades and processes in which we gathered or discovered instances of dermatitis—some severe and obstinate, others quickly yielding to treatment—were lime-juice manufacture, fancy biscuit finishing in confectionery works, electro- plating with use of potash, mercurial processes in electric meter fitting, enamel dipping in metal hollow ware works, use of oil in tobacco twist rolling, spinning and “batching” with use of shale oil for softening the fibre in jute works, use of naphtha as a solvent for paint on the hands, lacquering in brass foundries, claret bottling, gut preparing at salt machines. In fish curing, where salt sores from the brine have been an affliction for centuries for the workers engaged in pickling herring, we did but turn fresh powers of observation on to a well-known industrial ill; and in this seasonal calling the making of a Home Office Welfare Order providing for first-aid as well as rest rooms and other amenities, has brought remedies that should be thoroughly effective in Yarmouth and Lowestoft.

At the outbreak of the War the whole position as regards the control of dangerous and injurious trades and processes stood in complete contrast to the almost stagnant conditions of legislation for hours of labour. Just when a new stage was set for new risks as well as new experiments, the Factory Department held the great advantage-point secured by the long scientific work, described above, in many different kinds of dangerous and injurious occupations. A markedly successful reduction in industrial poisoning had been achieved. Having this body of knowledge and experience it was a comparatively simple matter to supply the same methods of control, when serious new kinds of industrial poisoning appeared during the War, in connection with the rapid development of aircraft and explosives manufacture. Cases of “toxic jaundice,” popularly known as “dope poisoning,” which occurred in the varnishing of the wings of aeroplanes by means of a solution containing tetrachlorethane and, later, in the manufacture and use of trinitrotoluene for high explosive known as T.N.T., could be quickly studied and the causes regulated. In the varnishing of wings of aeroplanes the ingredients of the solution were ultimately changed.[130] In the case of T.N.T. poisoning, resulting also in toxic jaundice, the Factory Department were able to supply to the Ministry of Munitions and Explosives Supply Department a sufficient body of evidence and the example of special regulations, for them to develop their own necessary safeguards in the national and the controlled factories. In the national and some of the controlled factories medical officers were specially appointed at the works,[131] and the whole of the evidence was reviewed both by Dr. Legge, Senior Medical Inspector at the Home Office, and the Medical Officers at the Ministry of Munitions. The remarkable reduction in cases of toxic jaundice may be seen in Appendix II.

Let us turn from disease or injury, the causes of which—such as dust, poison, germs, irritants, or a combination of any of these—could be definitely ascertained and controlled, and let us glance at more general features and conditions of work that tend to impair the strength or diminish the resisting capacity of the worker. Under this category the items on which the Women Inspectors concentrated energy and action, with marked results, were many. Some I have already dealt with, such as excessive hours, bad general sanitation, extremes of temperature, uncertain and low wages (leading to grave insufficiency of food and other necessaries). Foremost among those with which I have not yet dealt were heavy weight lifting, carrying or moving, beyond the physical strength or growth of the worker; long hours of unnecessary standing; heavy treadling or other undesirable use or strain of parts of the body in processes where adapted appliances should be substituted; excessive vibration from heavy machinery; excessively monotonous specialised parts of processes that could not be carried on for long without nervous strain; excessively wet or humid conditions of work; lack of means of preparing or taking food at the works, or of maintaining personal cleanliness in dirty or offensive processes (by suitable washing appliances and protective clothing).

It is impossible to enlarge on the study and action of the Inspectors in all these directions. The questions of messrooms and food, washing conveniences, cloakrooms, protective clothing, and seats are touched on in the last two chapters of this book. A few words may be said here on heavy weights which—in their great strain on children and adolescent girls and on mothers—made a special appeal to the Women Inspectors, and on undesirable use of parts of the body for certain processes.