can estimate the amount of muscular work done. We can thus learn
something of the laws of muscular activity and of fatigue in man.
Work is only done by muscle when it is contracting. By means of the
ergograph we can register the character, the frequency, and rhythm
of these contractions, and estimate the weight of a load lifted, or
the amount of work accomplished, in a given time. In addition to the
physical work accomplished, heat is also generated within the muscle,
and certain waste products are formed which escape by the veins and
lymphatics. A healthy fresh muscle responds practically at once to
an electrical stimulus, but when it has been over stimulated so that
the individual muscular contractions follow each other too rapidly,
the tissue becomes fatigued and no longer responds to the induction
shocks. The ergograph shows us the manner in which we become fatigued.
Professor Mosso, of Turin University, found that the instrument
registers very much the same results in the same people over a period
of years, allowing for certain minor modifications depending upon
the conditions of the organism, the state of health at the time,
diet, sleep, and the amount of intellectual fatigue present at the
moment. We are all familiar with the influence of volition upon
muscular contraction. By a strong effort of will we can force our
jaded muscles still to accomplish work, but in doing so we often add
to the muscular tiredness a sense of brain fatigue as well. There
is a marked difference in the character and amount of work done by
muscles that have been gradually trained compared with that done by
those not so prepared. Professor Aducco found that at the end of a
month, after having practised a few hours daily with the ergograph,
he could perform twice the amount of muscular work than he could at
the commencement. A moderate amount of work, physical and mental, is
attended by a feeling of pleasurable satisfaction. It is when work is
carried too far, and when a man’s daily labour becomes too hard, or
makes lengthened and unusual demands upon his strength, that there is
experienced a sense of extreme weariness and fatigue. When a muscle has
become fatigued its irritability is lessened. It no longer contracts
with the same vigour, less energy is set free, and the muscle relaxes
and regains its original form less quickly. Under any circumstances
energy is only liberated at the expense of the nutriment stored up
within the muscle and the oxygen absorbed from the blood. A process
akin to oxidation takes place within the muscle during its contraction
whereby waste products are formed that act as poisons to the muscle
protoplasm. Muscle is only capable of doing work so long as energy
holding explosive compounds are formed within it and the waste products
are excreted.
What, then, causes fatigue? Since during muscular contraction oxygen
is absorbed, and carbonic acid and other waste materials are formed,
fatigue might in the first instance be considered as dependent upon
processes of a chemical nature, and be due to the non-removal of the
harmful substances formed by muscle when doing work. That fatigue is
largely the result of this is shown by passing some simple saline
solution through the blood-vessels of a limb removed from a recently
killed animal, and where the muscles of the limb have been thrown into
a state of fatigue by excessive stimulation. As the liquid percolates
through the muscles and washes out the waste products, fatigue
disappears, and the muscular contractions on stimulation become again
as vigorous as they were before. Over-use of muscles obliges us to
breathe more frequently. By increased frequency of respiration the
temperature of the body is lowered owing to evaporation of water from
the interior of the lungs. Add to this the cooling influence of the air
inspired, for it is of lower temperature than that within the lung.
Respiration too is the medium through which we throw off the excess
of carbonic acid from the blood. As long ago as 1845, Helmholtz, a
German physiologist, demonstrated that when a muscle is in a state of
repose it contains very few substances that are soluble in alcohol.
For the sake of comparison we shall name this amount 1. In fatigued
muscle the quantity of these soluble substances rises to 1.3. Healthy
muscle in repose has an alkaline chemical reaction, fatigued muscle
is acid. Some of the substances formed during muscular contraction
possess distinctly poisonous properties and are toxic to the individual
himself. While fatigue is induced by local conditions in the muscles,
the sense of tiredness which we experience is the result of general
rather than local causes. During the course of a long walk, or a day’s
hard toil, the muscles are constantly forming waste products which it
is the function of the internal organs to throw out of the system. It
is not deprivation of food, for example, that is the cause of fatigue,
although it may be contributory. The real cause is the circulation
in the blood of fatigue products. These act upon the nerve-endings
in muscle and paralyse them, and they also act upon certain portions
of our brain, and create the sense of fatigue. Ranke made an aqueous
extract of fatigued but otherwise healthy muscle, and taking the
poisonous substances he injected them into a living muscle that had
been removed from a recently killed animal, with the result that its
power of doing work at once diminished. Were it not for the watchful
activity of our emunctory organs, _e.g._, the liver, kidneys,
skin, and bowels, the human body would soon be poisoned by the toxic
substances formed within the system. The sensation of fatigue is due
to the temporary retention of these harmful substances. The blood of a
fatigued animal is more poisonous than that of a healthy one which has
been in a state of quietude for some time previously. When some of this
blood is injected into a healthy animal, it induces the phenomena of
fatigue. If, for example, the blood of a fatigued dog is injected into
a healthy one, the receiving dog will shortly afterwards show signs
of fatigue, creep into a corner and go to sleep. The effect of hard
work upon the blood is also shown in a diminution of its hæmoglobin
or colouring matter. When we are mentally tired, it would seem as
if the sensation of fatigue was located in or depended upon certain
conditions of particular portions of our brain, for if we change the
subject of meditation or take up some game that requires even a great
amount of thought, _e.g._, chess, the sensation of tiredness often
disappears. It is difficult to prove whether brain or muscular work
is the more fatiguing. It depends upon the training, the occupation,
and constitution of the individual. The personal element is a factor
in fatigue that cannot be ignored. _Prima facie_, owing to nerve
tissue being the more highly organised, this circumstance suggests
that the brain would be the more easily fatigued. Against that must
be placed the fact that the muscles form a much larger portion of the
body by weight than the nervous system, and consequently within them
must be formed a much larger amount of poisonous waste material. Some
people we know are more easily tired than others, both mentally and
physically. There is for each person apparently a definite rate of
muscular contraction essential to the amount of work accomplished in
a given time. If this is true for the muscular, it is none the less
so for the nervous system. People who have inherited a weak nervous
system become readily exhausted, even with very little work, and
they recuperate slowly. They are said to suffer from neurasthenia,
or nerve weakness. In addition to muscular work being accompanied by
the production of toxic substances, it should be remembered that the
individual is perhaps standing all day at work in a heated factory,
and as a consequence of the fatigue the circulation becomes languid,
and his feet swell. Muscle can after all do only a limited amount of
work, and in order to recover from fatigue there must be a period
of repose or relaxation. This raises the question of the number of
hours per day a man should work, also the length of the break for the
mid-day meal. On the Continent the mid-day break is in some factories
longer than it is in this country, but the work is carried on further
into the evening. It is admitted that in iron works and factories,
where the hours of labour have been unusually long, say ten and eleven
hours, the work done in the latter part of the day is not so good as
that done in the forenoon, and managers say that where the experiment
has been tried, the men have turned out in eight hours an amount of
work equal to what was previously done in nine. The problem can only
be solved by experience. It is right to mention that fatigue does not
always, or necessarily, depend upon the amount of work done. A good
deal depends on the state of the body at the time. We know that good
work can never be done by a tired brain or fatigued muscles, and that
the amount of work accomplished is always greater where the limit of
exhaustion has never been reached. If we are tired and feel that we
have to make a fresh spurt to accomplish something, the end, it is
true, may be gained, but it is by using up a certain amount of reserve
force stored away in our muscles, and by making an additional demand
upon our nervous system. The physical fact of muscular fatigue has its
psychical counterpart in the sensation of tiredness. When muscular
work is light and of short duration there may be only a sense of
weight, but if the labour has been hard there may be a sensation of
actual pain which continues for a time. Intellectual work when carried
on too long and without sufficient recreation, interferes with the
innervation of the heart and blood-vessels. In cerebral fatigue there
are often languor, or its opposite restlessness; the pulse may be small
and excitable; the head hot, the feet cold, and there may be noises
complained of in the head. The nervous control of the blood-vessels
is destroyed, so that while the extremities are cold and their
blood-vessels small and contracted, those of the brain may be dilated
and overfilled. Protracted brain work is followed by irritability
of temper, by inability to concentrate the attention and to reason
out problems. It becomes an effort to think. There is headache, for
the brain is, in a similar manner to the muscles, affected by the
circulation through it of waste products. These at first, like alcohol,
may stimulate and excite the brain, but they end by paralysing it. It
is an interesting fact that while the brain is particularly sensitive
to the action upon it of poisonous substances and of an altered
circulation, as seen, _e.g._, in bilious headache, the headache of
kidney disease, plumbism, etc., the surface of the brain is insensitive
to touch, as is demonstrated in cases of injury to the skull where
the brain is protruding. The brain can be gently touched without any
sensation being experienced; if there is any at all, it is certainly
not one of pain; any effects that follow are the result of pressure.
While insensitive to a great extent to touch, the surface of the brain
will respond to an electrical stimulus. Levy (_British Medical
Journal_, 13th September 1900), after stimulating the motor areas
of an animal’s brain by electricity, found that fatigue was rapidly
induced, and when this occurred, that the brain failed to respond to
fresh stimulation until after a period of rest. When interruptedly
stimulated, so that there are periods of rest, the brain does not
become readily fatigued, but is rendered capable of expending a greater
amount of energy.
Hodge (_Journal of Morphology_, 1892) has studied the effects
of work upon nerve structures. He found after prolonged electrical
stimulation of spinal nerves certain structural alterations in the
cells of the ganglion on their posterior root. When the nerves were
over-stimulated the cells became shrunken, their protoplasm crenated
and vacuolated. The amount of shrinkage was proportional to the length
of stimulation, _e.g._, if it was continued for--
1 hour there was 22 per cent. }
2.5 hours „ 21 „ } Shrinkage in volume
5 „ „ 24 „ } of the nuclei of the
10 „ „ 44 „ } stimulated cells.
Hodge’s experiments demonstrate that there is a relation between the
amount of structural change in nerves and the length of time during
which the stimulus has been applied. The influence of rest in restoring
the cells to their normal size was equally apparent. In order to
determine how far these changes were really dependent upon work, Hodge
examined the nerve-cells of birds and bees after a day’s work and after
a night’s rest. At the beginning of the day, when the animal had rested
over night, the nerve-cells were found to be large and turgid, and with
prominent nuclei, but after a day’s work, the contents of the cells
were vacuolated and shrunken, and their nuclei altered in shape.
Dr Guido Guerrini (_Lancet_, 21st October 1899, and 10th November
1900) confirms the statement just made, that as a result of fatigue
the nerve centres exhibit certain alterations of structure. Beyond
being more vascular than usual, a fatigued brain does not exhibit
anything special to the naked eye. Guerrini caused dogs to run a
certain mileage every day, but it was not until they had covered a
distance varying from 22 to 61 miles that they appeared fatigued. On
examining their brain microscopically, he found the lymphatic spaces
around the cells distended, the chromatin network of the brain-cells
changed, and the pigment disintegrated, while the protoplasm exhibited
numerous vacuoles, the outline of the nucleus was irregular, and its
contents vacuolated. These changes were always proportional to the
amount of fatigue undergone by the animal, and were most pronounced
in those parts of the brain known as the motor areas, _i.e._,
those which innervate the muscles. The cause of these alterations of
structure in nerve-cells in fatigue is the circulation in the blood of
waste products formed during work. The presence of this waste material
in the blood not only creates a sense of fatigue, but so alters the
structure of nerve-cells that they require a lengthened period of
repose before they become quite recuperated. Additional changes were
found by Guerrini in the liver and kidneys. On examining these organs
in fatigued dogs, he found that there were changes in the cells of the
convoluted tubules of the kidney, and in the loops of Henle. The cells
were observed to be larger and more brittle than in health, so that
they readily disintegrated and filled the tubules with _débris_,
in the midst of which the liberated nuclei could be seen. The liver
cells too were found to be enlarged, and the seat of cloudy swelling,
which is always one of the earliest indications of pathological change
occurring in cell protoplasm.
In considering the question of work and fatigue, there are in addition
certain other factors that cannot be ignored, for example: (1) the
social conditions in operation upon the individual at birth, and
during his upbringing; (2) habits such as the use of alcohol; (3) the
atmosphere in which his work is carried on; and (4) the nature of his
employment, and the number of hours per day spent at it.
Roughly speaking, the working classes may be divided into artisans, the
majority of whom make good wages, are well housed, well clad, and well
fed; and into labourers, who do unskilled work, whose occupation is
irregular, and who, when out of work, are not well fed.
To some even of the regularly employed labouring classes, when the
family is large and the wages small, or where work is interrupted on
account of recurrent ill-health, life is a hardship, and the children
are occasionally more or less deprived of their proper food; while
in the case of the textile industries where women are employed in
the factories, the infants, bereft of maternal attention and proper
nutriment, necessarily suffer. The children born in the alleys of our
large towns cannot, as they grow to manhood, be possessed of that
well-developed bodily frame required to fit them for undertaking
hard muscular work. The offspring of parents, both of whom work in
textile or jute factories, are inferior in size and general physique
to children born under healthy surroundings and under more normal
conditions. When these grow up and enter the factory as half-timers,
their rate of growth lags far behind that of children of their own
age who still remain at school. The trend of civilisation is for
hard manual labour to be more and more replaced by machinery in all
industries. By some social economists, however, as we shall see later
on, this is not always regarded as an unmixed benefit. When a child
commences work and earns a weekly wage he is to that extent more able
to procure the additional food his growing frame requires. From this
point of view the object is good; and if only the physical labour is
gradually undertaken, is not too long, and is tempered to the strength
of the juvenile worker, the training, like the muscular exercises
alluded to in the earlier part of this paper, may be beneficial than
otherwise. It is not always thus, however, with children who go into
factories. Children brought from the country, and with good physique
to start with, will be found after two years’ work in a mill in a
large town to exhibit a smaller rate of growth than those who engage
in outdoor work. The children of the poorer classes commence life at a
great disadvantage compared with those of the well-to-do. There is more
sickness, and the death-rate among them is higher, owing very largely
to bad feeding, exposure, and neglect. Pagliani found as a consequence
of women continuing to do hard muscular work when _enceinte_,
and commencing their industrial duties again too soon after their
confinement, even though giving their infants the breast, that the
children were of shorter stature and of feebler force than those not
similarly treated. A fairly reliable test of the effect of severe
manual labour upon children in Continental countries is seen in the
large number of conscripts rejected from military service on account of
some physical disqualification. In no place perhaps more than in Sicily
are the harmful effects of fatigue and exhaustion on young people
so apparent. An excessive proportion of the conscripts who had been
in their earlier years engaged in carrying heavy baskets of sulphur
out of the mines near Catania are found to be physically feeble,
ill-developed, and unfit for military service. Is a similar condition
of things, although to a minor degree, not taking place in our own
country? The standard of height and of chest measurement required of
recruits is not rising but falling. The improper feeding, bad housing,
imperfect clothing, and absence of pure air in the home, which are the
lot of an increasing number of the poorer working classes, are not the
conditions that favour the development of such healthy labouring people
as are required to enable us as an industrial community to compete with
other nations, perhaps more favourably circumstanced. The point is,
whether in this respect other nations do not come under the same ban as
ourselves.
After work there must be relaxation, in order that an opportunity may
be given for the muscles to recuperate, and for waste products to
be removed. For working men, physical rest and recreation, sleeping
in good air amid healthy surroundings, are desiderata, and yet how
few there be who find these. With the toil of the day over, home
reached and supper finished, there is little in the immediate dingy
surroundings that is attractive, and so the working men saunter out to
the nearest street corner to converse with their comrades, or adjourn
to a public-house, where in an overheated bar and ill-ventilated
rooms the remaining hours of the evening are spent. Nor is the married
working woman much better off, so far as rest is concerned, for after
her day’s work in the factory she attempts to overtake, often unaided,
her neglected maternal and domestic duties. It is desirable that
healthy recreation for our working classes should be provided to a
greater extent than it is. In this matter employers could do a great
deal. The proper housing of the working classes is even a greater need.
How can the poorer working men have good health, good morals, and be
long lived, when they do not have in their homes and surroundings those
conditions that enable them, during periods of relaxation, to sleep
well, and to eliminate by their lungs and skin the waste materials
formed during toil. After all, we are each of us, physically and
mentally, very much what the circumstances of life make us. Personal,
not less than national character, is partly moulded by external
surroundings.
The habits of the poorer working classes, too, as regards alcohol
are not without their bearing upon this important question. It is a
subject, therefore, upon which there should be some definite expression
of opinion, especially since both at home and abroad there is a belief
that alcohol is a necessity for the working classes. This matter has
been recently brought to the front in France by the socialist leader,
M. Fournière, in an address delivered to working men, the gist of
whose argument is, that alcohol is a hydrocarbon, capable of supplying
during combustion within the body the necessary elements for muscular
work, and that therefore it is a food. Among foods of the hydrocarbon
type Fournière places alcohol in the first rank. He maintains that
the insufficient food of the workman imposes upon him the necessity
for alcohol; his hard work creates a desire for it. Alcoholism as a
social infirmity is therefore regarded as a direct consequence of the
excessive demands made upon the muscular system by present-day labour.
This is dangerous teaching to working men, and cannot be allowed to
pass unchallenged. The insufficient food of the working man is in many
instances the result of his small wages and uncertainty of employment,
but it is a monstrous evil for any political leader to recommend him to
spend more of his wages upon drink. Money purchases less alcohol than
food; besides, what is spent upon alcohol is consumed by the individual
himself, leaving less of the wages, therefore, to be spent on food for
his wife and family. It is pandering to selfishness, and the teaching
tends to encourage the idea that what a man produces by his labour he
has a sole right to spend upon himself, leaving to Society the care
of those who are naturally his own. But quite apart from this side of
the question, what is the teaching of physiology?[41] It can be shown
that the administration of alcohol in more than moderate doses is
followed by a diminution of muscular energy, which fresh doses of the
stimulant do not readily compensate; that to the period of excitement
there succeeds one of depression, so that in a given time the amount
of work accomplished under alcohol is less than that done without
it. I think I may safely say that no literary man ever did his best
work under the influence of alcohol. In moderate quantities alcohol
stimulates the brain for a brief period, and quickens the flow of
ideas, but this is followed by a reaction of depression. In a paper
read before the Académie des Sciences, January 1901, M. A. Chauveau
detailed the results of his experiments upon alcohol and muscular work.
He set himself this problem: how far a man who works and whose blood
is saturated with alcohol obtains from the combustion of alcohol the
energy necessary for the functional activity of his muscles? In order
to estimate this he measured the “respiratory quotient,” that is to
say, the relation existing between the volume of carbonic acid excreted
and the amount of oxygen absorbed. His conclusions are drawn mostly
from dogs. In an ordinary way meat and sugar were administered to these
animals, and subsequently for 84 grammes of sugar 48 of alcohol were
substituted. Under the normal feeding the mean respiratory quotient
was 0.963, but during the period of the administration of alcohol
it only reached 0.922. Chauveau proved by this and other means that
alcohol is not utilised as potential energy either for the execution
of physiological functions acting together in a state of repose or for
muscular work during states of activity. In substituting alcohol for
sugar he found in a given time--(1) a diminution of muscular work; (2)
loss of body weight, and (3) increased expenditure of energy relative
to the amount of work accomplished. We are familiar with the fact of
the large quantities of stout consumed by the London dock labourers,
who, either as the result of experience or imagination, have come to
look upon malt liquor as a necessity and as a food. Without denying the
fact of stout in small quantities when taken with food supplementing,
through its hydrocarbons and the sugar it contains, muscular energy,
it can only to a limited extent contribute to those combustion
processes from which the muscular system derives the necessary energy
for its functional activity. Reverting for the moment to Chauveau’s
experiments, it was found that during the period of normal feeding a
dog ran a distance of 23.924 kilometres every day in two hours, and
that its weight increased 1.245 kilos.; but during an equal length of
time when it was taking alcohol instead of sugar, the distance coursed
in the two hours daily was only 18.666 kilometres, and its weight fell
115 grammes. It is true that we cannot apply _in toto_ the results
of this experiment to man, but they are not without their meaning.
Sugar is a well recognised muscle food. The experiment shows us that
in dogs, when alcohol is substituted for sugar, the result is not to
the advantage of the individual. There is a diminution in the amount
of work done. More than this, alcohol tends, and the more impure it is
the greater the tendency, to load the blood with harmful substances,
and to induce pathological changes in such of the eliminating organs
of the body as the liver and kidneys. Even admitting that it may
contribute to the production of muscular energy, it imposes upon these
organs a greater burden than a proportional quantity of food, and thus
it happens that as a consequence of the circulation within the body of
the toxic substances formed in muscle during work and of those derived
from alcohol, also the fact that alcohol checks the power of the liver
and kidneys to throw off the toxic material circulating in the blood,
there are induced at an early age in working men who are intemperate,
pathological changes in the liver, kidneys, and nervous system,
structural alterations which play a very large part in the causation of
the high death-rate of the poorer working classes.
In considering the question of fatigue of working people we must not
overlook the nature of their employment, the rooms in which the labour
is carried on, and the number of hours daily spent in work. When the
air in a factory is close, and is not renewed frequently enough,
there is an impediment to the escape of carbonic acid from the lungs,
and when the air is overheated and moist, the natural cooling of the
body through respiration cannot occur. Labour carried on under these
conditions entails an additional tax upon the strength of the workers
and burdens their system with impurities. We live in an age that
creates, because there is a demand for, labour-saving machinery. The
introduction of steam has revolutionised industry. Manufacturers keep
increasing their production and throwing goods in larger quantity
and at lower price upon the market. Machinery acts with unerring
uniformity. At times so simple is its mechanism that a child can almost
guide it, yet how exacting are its demands. While machinery has in
some senses lightened the burden of human toil, it has not diminished
fatigue in man. All through the hours of work in a factory the hum of
the wheels never ceases. Requiring constant attention, to stop the
machinery running is to lose money, and so men and women are obliged
to wrestle with the forces of steam and mechanical ingenuity. While
the machinery pursues its relentless course and is insensitive to
fatigue, human beings are conscious, especially towards the end of the
day, that the competition is unequal, for their muscles are becoming
tired and their brains jaded. In many factories the system of double
shifts allows the work to be carried on by night as well as by day.
It is not urged that where double shifts of men are employed and the
work conducted in well-ventilated factories, the shifts alternating
every fortnight (night being the ordained period for man’s rest) with
no Sunday labour and Saturday afternoons off, that the double shift
system is necessarily prejudicial to health. But what shall we say
of double shifts that practically never know of any interruption? A
short while ago I visited a large iron works on the Continent where
steel rails were being made. By means of a day and night shift the
work went on continuously. On the occasion of my second visit to the
works at eleven o’clock at night I met with a strange sight. The men
were working almost naked; they were only wearing loose, coarse cotton
garments like shortened nightdresses, and even in these they were
bathed in perspiration. As they flitted about in the darkness, lit up
by the lurid glare of the furnaces, they looked more like demons than
men. For nearly seven years had the furnaces been going almost without
cessation. From the first day of one year to the commencement of that
following, Sunday, Saturday, and Christmas Day, the men had worked
their particular shift, never knowing what twenty-four hours’ respite
from labour was unless when off ill. The company pensioned the men
when they were too ill or too old to work, and gave them a house with
a small garden and pasturage for a cow; but what availed these when
the best years of the workmen’s lives had flown and the enfeebling
influences of old age had fallen upon them? The men were old at the
age of forty, and many of them were broken down in health. It is the
continuous demands made by machinery that are so trying, there being
no time left for relaxation. Presentday factory labour is too much a
competition of sensitive human nerve and muscle against insensitive
iron, and yet, apart from an appropriate shortening of the hours of
labour, it is difficult to see how this can be remedied. The greater
the number of hours machinery runs per day the larger is the output for
the manufacturer, but the feebler are the human limbs that guide it. To
the machine time is nothing; to the human being, each hour that passes
beyond a well-defined limit means increasing fatigue and exhaustion.
There are some social economists, Marx among others, who maintain that
while machinery has diminished the price of products it has made the
lot of the worker worse, since by disregarding human strength it has
introduced into factories a larger number of women, thereby reducing
wages and diminishing the number of men required; so that, while there
has followed a diminution in the number of hours of employment, the
tension when at work is greater, and the output larger, thus resulting
in more work being done. Machinery, too, by obliging man to do and to
keep at one particular detail of work, is reducing him to a mere unit,
and causing him to be ignorant of the other processes of manufacture,
and to be less and less the handy man of an age now all but past. It
remains to be seen how far this enforced relegation of man’s labour to
the production of one particular product is for his own ultimate good
and that of Society.
There is, it seems to me, too great a tendency even on the part of
working men themselves to insist upon uniformity in regard to the
number of hours they shall be employed. This is seen in the attempt to
nationalise an eight hours’ day for coal-miners, when it is known that
in Northumberland and Durham they do not work eight hours from bank to
bank. There are local and social conditions that cannot be ignored, and
before which the leaders of working men must bow. As regards dangerous
trades, it goes without saying that the number of hours spent daily
in a factory should be fewer than in healthy trades or in outdoor
occupations; and a similar remark applies to those industries in which
the work is hard and makes severe demands upon the muscular system of
the labourers. It was surely never meant that work should be other
than invigorating to man, and educive of all that is best within him.
Healthy persons, therefore, should work to keep healthy; those who
do not work, miss one of the greatest charms of life and stimuli to
health. Fatigue is not due to work but to overwork, and excess of every
kind is injurious.
THOMAS OLIVER.
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.
CHAPTER X
DUST-PRODUCING OCCUPATIONS
That the constant inhalation of dust as a necessary condition of
daily labour results sooner or later in the appearance of grave and
characteristic lesions which lead to premature breakdown and death
among the workers, is matter of common medical experience. Through the
instrumentality of the Factory Department the conditions of labour in
these industries have recently been greatly improved: this has been
achieved by the general introduction of ventilating fans and of other
expedients for preventing the inhalation of irritating particles by
the operatives. Nevertheless the returns of mortality still show that
several of these occupations produce a terrible amount of suffering and
disablement, whilst they unquestionably shorten the lives of those who
follow them.
In the subjoined table will be found a list of those industries in
which the labourers suffer exceptionally from the presence of dusty
particles or other irritating matters in the air of the apartments
in which their work is carried on. In this table the mortality of
the several dust-producing occupations is contrasted with that of
agriculturists, who have been shown to suffer from the effects of dust
to a less degree than any other workers. It is not asserted or believed
that the whole of the difference between the respiratory mortality of
certain unhealthy trades and that of this more favoured class is to
be accounted for by dust irritation alone. There are almost certainly
present other contributory factors also, the effects of which it would
be difficult to show separately: nevertheless, there is no doubt that
an atmosphere constantly charged with mechanical impurities of this
kind is the main cause of the excessive mortality indicated in the
table.
The aggregate death-rate from tubercular phthisis and diseases of the
respiratory system is shown in this table, as also are the figures
relating to each affection separately. Columns 3 and 4 give the
combined mortality from these diseases among the several classes of
workers in comparison with that of agriculturists. In the fourth column
the mortality of the latter is taken as 100 and that of the other
workers is shown proportionally to that figure.
Comparative Mortality from Specified Causes in certain Dusty
Occupations.
-------------------+-------------+----------------------+
| |Phthisis and Diseases |
| |of Respiratory System.|
-------------------+-------------+----------+-----------+
Occupation. | Comparative | | |
| Mortality |Mortality | Ratio. |
| Figure |Figure. | |
|(all Causes).| | |
-------------------+-------------+----------+-----------+
Agriculturist | 602 | 221 | 100 |
Potter, | | | |
Earthenware | | | |
manufacturer | 1702 | 1001 | 453 |
Cutler | 1516 | 900 | 407 |
File-maker | 1810 | 825 | 373 |
Glass-maker | 1487 | 740 | 335 |
Copper-worker | 1381 | 700 | 317 |
Gunsmith | 1228 | 649 | 294 |
Iron and Steel | | | |
manufacturer | 1301 | 645 | 292 |
Zinc-worker | 1198 | 587 | 266 |
Stone-quarrier | 1176 | 576 | 261 |
Brass-worker | 1088 | 552 | 250 |
Chimney sweep | 1311 | 551 | 249 |
Lead-worker | 1783 | 545 | 247 |
Cotton manufacturer| 1141 | 540 | 244 |
Cooper and wood | | | |
turner | 1088 | 526 | 238 |
Rope-maker | 928 | 486 | 220 |
Bricklayer, mason | 1001 | 476 | 215 |
Carpet manufacturer| 873 | 471 | 213 |
Tin-worker | 994 | 451 | 204 |
Wool manufacturer | 991 | 447 | 202 |
Locksmith | 925 | 428 | 194 |
Blacksmith | 914 | 392 | 177 |
Baker, confectioner| 920 | 392 | 177 |
-------------------+-------------+----------+-----------+
Part 2 of Table.
-------------------+-----------------------------------------
|
| Mortality Figure.
-------------------+-------------+-------------+-------------
Occupation. | | Diseases of | Diseases of
| Phthisis. | Respiratory | Circulatory
| | System. | System.
| | |
-------------------+-------------+-------------+-------------
Agriculturist | 106 | 115 | 88
Potter, | | |
Earthenware | | |
manufacturer | 333 | 668 | 227
Cutler | 382 | 518 | 167
File-maker | 402 | 423 | 204
Glass-maker | 295 | 445 | 157
Copper-worker | 294 | 406 | 186
Gunsmith | 324 | 325 | 153
Iron and Steel | | |
manufacturer | 195 | 450 | 162
Zinc-worker | 240 | 347 | 126
Stone-quarrier | 269 | 307 | 137
Brass-worker | 279 | 273 | 126
Chimney sweep | 260 | 291 | 142
Lead-worker | 148 | 397 | 272
Cotton manufacturer| 202 | 338 | 152
Cooper and wood | | |
turner | 250 | 276 | 137
Rope-maker | 219 | 267 | 118
Bricklayer, mason | 225 | 251 | 130
Carpet manufacturer| 226 | 245 | 87
Tin-worker | 217 | 234 | 124
Wool manufacturer | 191 | 256 | 131
Locksmith | 223 | 205 | 104
Blacksmith | 159 | 233 | 136
Baker, confectioner| 185 | 207 | 130
-------------------+-------------+-------------+---------------
It thus appears that there are 22 industries in each of which the
mortality from tubercular phthisis and respiratory diseases together
is more than double that of agriculturists; and further, that these 22
occupations include 8 (giving employment to more than 100,000 men) in
which the total mortality from these diseases ranges from three times
to as much as four and a half times that of the agricultural class.
_Potter, Earthenware, China Manufacture._--“The earthenware
manufacture is one of the unhealthiest trades in the country. At
the age of joining it is low: but the mortality after the age of
thirty-five approaches double the average: it is excessively high;
it exceeds the mortality of publicans. What can be done to save the
men dying so fast in the potteries and engaged in one of our most
useful manufactures?” Thus wrote Dr Farr in 1871, with regard to the
pottery manufacture of that day. And Dr Ogle, writing ten years later,
confirmed this statement, adding that the mortality of these workers at
all ages from twenty-five to sixty-five had increased since 1871. He
further stated that at that time (namely, in 1881) their comparative
mortality figure was no less than 1742, which was only exceeded by
the figures for costermongers, Cornish miners, and inn and hotel
servants. In the three-year period 1890–92 things had only slightly
improved: the mortality in this occupation from all causes remaining
almost unchanged; and although phthisis claimed fewer victims than in
1881, lead poisoning had become more than twice as fatal since the
previous record, and diseases of the circulatory and urinary systems
had seriously increased in fatality. The excessive mortality of these
workers is mainly due to phthisis and diseases of the lungs and heart.
Of their entire mortality figure (1706) from all causes, not less than
1001 is contributed by phthisis and other diseases of the lungs. The
mortality of potters from bronchitis is more than four times as high,
and that from other respiratory diseases is three times as high as the
mortality of occupied males in the aggregate.
Potters succumb to non-tubercular disease of the lungs much more
rapidly than they do to tubercular phthisis; and it is certain that
much of the so-called potters’ phthisis ought properly to be termed
cirrhosis of the lung. Deaths from this affection should never be
included under the head of phthisis, which term is now restricted, by
universal consent, to the tubercular malady of that name.
The mortality figure of potters from lead poisoning is 17, and comes
next to that of plumbers, as fourth highest in the list of industries
liable to plumbism. The mortality figures, due to diseases of the
nervous and urinary systems, in these two occupations, exceed the
standard for occupied males by 54 and 50 per cent. respectively.
The term “potter” is a very comprehensive one, and is ordinarily
understood to mean any workman employed in a pottery. But Dr Arlidge,
the author of the best essay of modern times on the ailments of this
class of workers, has shown how widely the operations in pottery
manufacture differ from one another in their effect upon health.
Speaking of the manufacture of earthenware generally he says: “This
manufacture stands foremost among those wherein the employment is
distinctly chargeable with the production of disease; and the principal
materials to which its unenviable character is due are the clays and
the flint used in it. However, these minerals are not the only agents
that render the fictile trade one so highly injurious to health,
for lead also is largely used for glazing and colour-making, and
is a frequent cause of plumbism among the artisans. Again, it is a
manufacture having many departments, between several of which no common
characters can be said to exist. This holds good of the two principal
departments, viz., (1) the making of the articles from potter’s clay;
and (2) their ornamentation by painting and gilding. They are often
spoken of as the “clay” and the “finishing” departments. It is with the
former that we are in the first instance concerned, because in it the
production of dust ... is pre-eminently the cause of disease.”[43]
_Cutlers, Scissors-makers._--The mortality among cutlers is
enormous; at all ages it is very high, but at ages beyond thirty-five
years it exceeds the standard among occupied males generally by from 64
to 72 per cent. The comparative mortality figure for cutlers at ages
from twenty-five to sixty-five years is 1516, which is higher than the
average of other occupations by 59 per cent. Cutlers, although in this
respect they have an advantage over potters, are nevertheless among the
occupations which suffer excessively from “pulmonary” disease. Their
mortality figure for phthisis is 382, and for respiratory diseases is
518, against 106 and 115 respectively, the figures for agriculturists.
Taking these diseases together, cutlers sustain a mortality in excess
of that of other occupations by 122 per cent. It has been shown by Dr
Headlam Greenhow and others that the great mortality among cutlers and
grinders arises from the irritation caused by the mechanical particles
produced during the process of manufacture, and received into the lungs
with the air of respiration.
Cutlers suffer slightly from lead poisoning; their mortality from this
cause being represented by 3. The occurrence of lead poisoning among
cutlers is a novel feature in the mortality returns for 1890–92, Dr
Ogle having found no deaths from that cause in the sample of these
workers examined by him in preparing his supplement for 1881. In the
mortality figures for diseases of the urinary system there is, among
cutlers, an excess of 37 per cent. as compared with the standard
among occupied males. From diseases of the nervous system the excess
of mortality among these workers is 11 per cent. Taking together the
mortality ascribed to alcoholism and to liver disease as a rough
measure of the mischief caused by intemperance, there is a slight
excess among these workers as compared with the standard.
Since the previous record the mortality among cutlers has increased;
and this not only at the higher ages, as appears to have been the rule
in most other occupations, but also among men under forty-five years of
age. Their mortality attributed directly to alcoholism, which had been
much below the average in 1881, has risen above the average in 1891,
but there has been no corresponding increase under the head of liver
diseases. Since the former period the mortality of cutlers from heart
disease has increased by 58 per cent., from lung diseases other than
phthisis by 38 per cent., and from tubercular phthisis by 9 per cent.
_File-cutters._--Judged by their general death-rate, file-cutters
are the least healthy men included in our list of occupations,
with the exception of publicans (in certain districts) and of dock
labourers--their comparative figure being 1810, or three times as high
as that of agriculturists. As compared with the standard mortality of
occupied males, that of file-cutters is in excess by not less than 90
per cent. At each of the age-groups of the working period of life the
mortality among file-cutters is appalling, and this is especially the
case at ages above thirty-five years, when the death-rate exceeds the
average by from 93 to 110 per cent.
As with cutlers, so with file-cutters--their great mortality appears
to depend on the irritation caused by particles of stone or of metal
which find their way into the air passages with the respired air. Dr
Headlam Greenhow, writing so long ago as 1858, stated that file-cutters
owe their enormous mortality from lead poisoning to the circumstance
that the files are cut on blocks of lead: their mortality figure for
plumbism, in 1890–2, was no less than 75!
Diseases of the urinary system cause a mortality among file-cutters
which is above the average by 154 per cent., and diseases of the
nervous system a mortality in excess by 159 per cent.
Intemperance does not seem to be especially rife among file-cutters,
but they are addicted to suicide in about double the normal proportion.
The comparative mortality figure of file-cutters has increased
considerably since 1871: the increase being relatively greatest since
1881. At the age-group 45–65 the increase in the death-rate has been
steady throughout the entire period of twenty years, but at ages under
forty-five, although between 1871 and 1881 there had been a fall in the
death-rate, this has been followed since the latter year by a rise of
considerably greater amount.
The mortality from tubercular phthisis, which had been 407 in 1881, has
still further increased to 414 in 1891. According to recent experience,
file-cutters die from diseases of the circulatory and respiratory
systems even more rapidly than they did in 1881.
_Glassmakers._--The making, blowing, and engraving of glass
occupies a prominent place among unhealthy trades, for several reasons.
In the first place, the workers are exposed to extreme variations of
temperature--in some processes, that of glassblowing especially, the
operatives are constantly exposed to the intense heat of the furnace,
as well as to that which radiates from the pots of molten glass which
they are engaged in blowing. The intense heat and profuse sweating
naturally induce painful thirst, which the workmen evidently allay by
excessive drinking: this is shown by the fact that their mortality from
alcoholism and from nervous disorders is nearly double that experienced
by operatives in other trades. In the next place, glass-makers are
subject to plumbism, their mortality figure attributed to this cause
being no less than 12, or sixth highest in the list of industries
subject to this complaint. According to Dr Arlidge, who has contributed
much valuable information on this subject, it is in the cutting and
engraving of glass that the operatives are exposed to contact with
lead. In these processes “putty powder,” which is a compound of
lead and tin, is constantly used, and as the men are careless as to
ventilation and cleanliness, often taking their food with unwashed
hands, it is easy to understand how lead finds its way into the system.
The comparative mortality figure for glass-makers is 1487, and is,
therefore, in excess of the average by 56 per cent. Phthisis and
diseases of the respiratory system are especially fatal to workmen in
this industry, and they suffer more severely than other occupied males
from diseases of the circulatory, digestive, and urinary systems, as
well as from cancer. Since 1881 the mortality of glass-workers has
increased considerably, and this is true of the younger as well as the
older workers in this industry.
_Copper-workers._--As the number of operatives engaged in the
working of copper is small (scarcely exceeding 8000), only general
remarks can be made concerning their health.
At all ages the mortality of copper-workers exceeds that of other
occupations; their comparative mortality figure is 1381; it is
therefore considerably above that of metal-workers generally, and is
also above the standard for occupied males in the aggregate by 45
per cent. That copper-smelting is an injurious occupation is proved
by the pallid, sickly appearance of the workers. It has been noticed
by Dr Arlidge, as a result of personal experience, that the hair of
copper-smelters (especially where this was originally fair or white)
becomes much discoloured; but this discoloration is caused, not by
absorption of the metal, but simply by adhesion of copper particles to
the hair. Nevertheless, he thinks that cupreous salts do eventually
find their way into the circulation, and when this is the case the
characteristic symptoms of colic, vomiting, and purging with extreme
prostration are produced. A greenish or purplish red line is also
noticed in the gums, in the same position as that which is occupied by
the blue line in cases of lead poisoning. The operations of filing,
turning, and polishing of copper are especially injurious to the
workmen, and like other dust-inhaling processes, lead to fatal results
by interference with the respiratory functions--lung diseases being
much more common among these operatives than the average, whilst
their mortality from pulmonary phthisis is in excess by 59 per cent.
Copper-workers die much more rapidly than other operatives from
diseases of the circulatory, digestive, and urinary systems, their
mortality from all these forms of disease being greatly in excess of
the average among workers in metals generally.
_Iron and Steel Workers._--At the census of 1891, more than
200,000 workers in iron and steel, above the age of fifteen years, were
enumerated, but the number had _decreased_ since the preceding
census by 2 per cent. The labour of iron and steel working is heavy
and exhausting. The operatives, whether at the blast furnaces or
at the rolling mills, whether puddlers or moulders, are exposed to
intense heat, as well as to great vicissitudes of weather, for most of
their work is done in the open air, or at any rate in outdoor sheds
unprotected from cold and draughts. The men are for the most part
sturdy and of powerful build: the arduous nature of their occupation
making it impossible for any but the most vigorous to follow it. In
spite of these natural advantages, however, statistics show that iron
and steel workers are by no means so healthy and long-lived as they
ought to be.
The death-rates of these operatives are higher than the corresponding
rates among occupied males generally, and also higher than the rates
of other metal workers, at all stages of life up to sixty-five years.
They have a comparative mortality figure of 1301, which is higher than
that of occupied males, as a standard, by 37 per cent. Iron-workers
suffer more severely than do other occupied males from influenza and
from diseases of the nervous, circulatory, respiratory, digestive, and
urinary systems; their mortality figure from diseases of the lungs
being more than double the standard figure, and that from phthisis also
greatly exceeding the average.
Since 1881 there has been a considerable increase in the mortality of
iron and steel workers: the increase has affected both divisions of the
working period of life, but has been far the greatest among men over
the age of forty-five years.
_Zinc-workers._--The number of men engaged in this industry is
small, although it has increased by 50 per cent. within the last
decennium. Nevertheless, the vital statistics of zinc-workers are
important, as showing excessive mortality from all the diseases
enumerated in the table on page 135. The evidence is conflicting as to
the evolution of noxious matter during the process of extracting zinc
from the ore; but the workmen are exposed to great heat, and to the
inhalation of irritating particles, in consequence of which they are
said to suffer exceptionally from digestive and respiratory troubles.
Zinc is coming more and more into use in the process of galvanising
sheet-iron, so as to protect it from rust; and in this operation
the workmen are exposed to the fumes of sal-ammoniac and to other
substances which are said to produce a form of nervous derangement that
is apparently peculiar to this process.
Zinc-workers are subject to a mortality considerably above the average.
Their comparative mortality figure is 1198, and at ages beyond middle
life they die more rapidly than occupied males generally. Their
mortality from respiratory diseases and pulmonary consumption together
is more than double the standard figure, and they die faster than the
average from diseases of the circulatory system.
_Lead-workers._--The occupation of lead-working is pursued by but
very few in this country; only about 2000 men above the age of fifteen
years having been thus returned at the census of 1891, and even this
number is rapidly decreasing. But the injurious effects of lead-working
are by no means limited to the operatives designated lead-workers in
the census returns. In the list of one hundred occupations prepared
for my larger work on occupational mortality, not fewer than thirteen
were selected as showing unmistakable evidence of plumbism. These
occupations are as follows (the figures represent the comparative
mortality figures from lead poisoning in the several trades)--
Lead-worker 211
File-maker 75
Plumber 21
Painter and Glazier 18
Potter 17
Glass-maker 12
Copper-worker 8
Coach-maker 7
Gasfitter, Locksmith 6
Lead-maker 5
Printer 3
Cutter 3
Wool manufacturer 3
Occupied males 1
The above occupations are arranged in order according to their
mortality from lead poisoning, as shown in the tables. A little
consideration, however, will show that these figures represent but
very imperfectly the _relative damage_ sustained by the several
operatives as a result of their occupations. If, for the sake of
example, we compare the mortality figure of lead-workers with that
of potters, it would appear, by the table, that the former workers
die from plumbism more than twelve times as rapidly as do the latter.
But, on closer examination, we find that whilst the whole body of
lead-workers are constantly in contact with lead as a necessary
condition of labour, not more than a twelfth part of the potters
are so circumstanced. It is the dippers and the glost-placers among
potters who are the chief, if not the only, serious sufferers from lead
poisoning; but as these workers are not distinguished in the census
returns from other potters, their deaths are distributed over the whole
class of potters, and thus a false impression is conveyed as to the
amount of mischief done by absorption of lead, in those branches of the
industry where the workers are actually exposed to contact with this
metal. Again, when the figures for painters and glaziers are compared
with the figure for file-cutters, a great disparity becomes evident;
the file-cutters suffering apparently more than four times as severely
from plumbism as do the painters and glaziers. But on inquiry, we find
that whilst, on the one hand, file-cutters handle lead continuously
in the course of their work, on the other hand, painters and glaziers
are by no means so constantly exposed to this danger--much of their
time being spent on labour which does not involve contact with lead,
or inhalation of particles or fumes of that metal. If the death-rates
attending those processes in the occupation of potters and of painters
which are continuously subject to lead poisoning could be separately
ascertained, there is no reason to doubt that they would show results
quite as unsatisfactory as those experienced by lead-workers.
Although lead-working is known to be a very unhealthy trade, it is
evidently impossible to deduce from the vital statistics of only
2000 workers more than very general conclusions. Speaking generally,
however, the mortality returns warrant the statement that, in the main
working period of life, these operatives sustain a mortality which
is about 90 per cent. above that of other workers, on the average.
Their comparative mortality figure from all causes is no less than
1783, and is therefore nearly three times that of agriculturists. Of
the total deaths occurring among lead-workers, one-third are from
“pulmonary disease,” _i.e._, from tubercular phthisis and diseases
of the respiratory system taken together, and one-eighth are from
lead poisoning. As compared with the standard for occupied males, the
mortality among lead-workers is excessive from diseases of the urinary,
nervous, circulatory, and digestive systems, in addition to the causes
above specified.
_Stone-Quarriers._--The aggregate of men above the age of fifteen
years returned under this heading, at the last census, amounted to
nearly 50,000, but the numbers had decreased by about 3 per cent. since
the previous enumeration. The comparative mortality figure of quarrymen
is 1176, which, as compared with the figure for occupied males, is in
excess by 25 per cent. At all stages in the working period of life
the death-rate of these labourers exceeds that of other occupations
in the aggregate. As stone-quarrying is an outdoor industry, and
consequently the workers are not exposed to the unhealthy conditions
of sedentary work, the vital statistics of this class should obviously
be compared with those of agriculturists, rather than with those of
males of all occupations. So compared, we find that stone-quarriers
experience a mortality from all causes which is little short of double
the standard figure. From respiratory diseases and also from tubercular
phthisis, their mortality is at least two and a half times as high as
the standard, and from diseases of the circulatory system they die
faster than agriculturists by 50 per cent. At ages between twenty-five
and forty-five years the mortality of stone-quarriers has fluctuated
considerably during the last twenty years; but at ages from forty-five
to sixty-five it has steadily increased throughout that period. Since
1881 the increase has been principally under the head of pulmonary
and circulatory diseases. During the same interval the mortality of
quarriers from phthisis and also from digestive diseases, as well as
that from alcoholism and from diseases of the liver, has decreased
considerably, and so likewise has their liability to fatal accident.
_Brass-workers._--At the 1891 census there were enumerated 33,000
persons over fifteen years of age under the head of brass-workers,
braziers, etc., the number having increased since the previous
enumeration by little short of one-third.
If death returns alone be relied on, there is little in the mortality
of brass-workers that does not apply equally to other allied
industries; but from the investigations of Dr Headlam Greenhow in 1858,
and more recently those of Dr Simon and Dr Hogben of Birmingham, we
learn that brass-workers suffer very seriously from ailments which
are not experienced by the workers in copper or in zinc, the chief
metals of which brass is an alloy. The disease to which these workers
are exceptionally subject is known locally as “brassfounders’ ague,”
which, according to Greenhow and some other authorities, is caused
by the inhalation of oxide of zinc, whilst others of equal repute
attribute it to copper poisoning. That brass-workers are exposed to
conditions inimical to health is fully recognised by employers and
employed alike, who agree in describing the trade as a most unhealthy
one. Dr R. Simon (in a thesis for his degree at Cambridge) says that
brass-workers rarely attain old age, and that formerly provident sick
societies either altogether refused to enrol them in their lists, or
accepted them as members at greatly increased rates. The workers who
deal with molten metal--the founders, the mixers, and the casters--are
those who are exceptionally liable to “ague.” The “mixers,” who bring
together the two metals, suffer most severely. The copper is first
molten, and the zinc is then added to it. When the metals come into
contact the zinc deflagrates, and some of it, combining with oxygen,
flies off in dense white clouds of oxide of zinc. This, of course, is
of necessity inhaled by the operatives who, experiencing discomfort
from the process, tightness of the chest, and other respiratory
troubles, attempt to avoid it by covering the mouth and nostrils with a
handkerchief.
Although, as has been previously stated, the deaths registered afford
little evidence of the exceptional unhealthiness of brass-workers
as compared with the workers in other metals, nevertheless we find
that they sustain a mortality from “phthisis” which is in excess
of that of “occupied males” by 50 per cent., whilst they die more
rapidly than the average from diseases of the nervous, urinary, and
respiratory systems. Brass-workers as a class are, like copper-makers,
pallid, ill-nourished, and unhealthy-looking: they suffer from anæmia,
dyspepsia, constipation, colic, and other digestive troubles. Happily,
however, these symptoms do not permanently injure their health, for on
changing their occupation, as they commonly do, for a less unhealthy
one, the above symptoms rapidly subside, and their usual health is soon
restored.
_Gunsmiths._--The only remaining metal-workers in the list whose
mortality exceeds the average for the class are the gunsmiths. Their
comparative mortality figure is 1228, and is exactly 100 in excess of
that of metal workers in the aggregate. Gunsmiths die faster than the
average of metal-workers at ages from twenty-five to forty-five, but
less rapidly both before and after that period of life.
On reference to the extended tables in my larger work, it will be
found that gunsmiths die from alcoholism about two and a half times
as fast as do other workers in metal. Most of the processes in which
gunsmiths engage are of an unhealthy nature, and the workers are
exposed to the harmful effects of metallic and flinty dusts which
set up in the lungs very similar disorders to those which have been
noticed in connection with the Sheffield “grinding” trades. This
industry demands expert workmanship and high finish, especially in the
later processes, and involves a great deal of filing and polishing of
metal, and these operations are frequently carried on in workshops
which are ill-ventilated and otherwise unsuited for the purpose. As
a consequence, the mortality of gunsmiths from phthisis (much of
which is probably fibroid) stands at 324 against 206, the figure for
metal-workers generally, and 185, the standard figure for all occupied
males. From other diseases of the respiratory system and from diseases
of the heart, gunsmiths sustain a mortality which exceeds the standard
for occupied males by 47, and by 21 per cent., respectively. During
the last twenty years, and especially during the more recent half of
that period, the mortality of gunsmiths has increased considerably, and
this is true whether we consider their mortality during the earlier or
during the later half of the main working period of life.
_Chimney Sweeps, Soot Merchants._--Recent statistics agree
with those of earlier records in attributing to this industry a very
unsatisfactory position in the scale of health. Compared with those of
other occupations, the death-rates of chimney sweeps are excessive at
all ages below the sixty-fifth year. Their comparative mortality figure
amounts to 1311, and is therefore higher than the standard by more than
one-third part.
Chimney sweeps are, by the nature of their calling, much exposed to the
inhalation of particles of soot and of other irritating matters which
seriously affect the respiratory functions. They die more rapidly than
the average from pulmonary tuberculosis, and from other diseases of
the lungs, as well as from diseases of the heart and urinary organs.
Their mortality from suicide is also more than double the average,
and their figure for intemperance is more than four and a half times
that of occupied males generally. But it is in regard to their extreme
liability to malignant disease that chimney sweeps are deserving of
special consideration. Their mortality from different forms of cancer
amounts to 156 as compared with 44, the figure for occupied males in
the aggregate. In the list on p. 135 there is no other occupation in
which the ravages of cancer at all approach those to which chimney
sweeps are subject. Of the 512 deaths from all causes among chimney
sweeps, as many as 61, or about 1 in 8, were from cancer, and 18 of the
61 were returned as from chimney sweeps’ cancer. Of these 61 deaths 3
were ascribed to sarcoma, and the rest to carcinoma or other forms of
malignant disease. In the course of the last twenty years the mortality
of these workers has decreased considerably. Between 1871 and 1881
their mortality figure, modified for purposes of comparison, had fallen
by 11 per cent., the fall in the death-rate having been common to both
divisions of the main working period of life, but much greater at ages
under than at ages over forty-five years. In the interval between the
two last censuses, on the contrary, the fall has been greater at ages
above forty-five years. Although chimney sweeps still die from cancer
in enormous over-proportion, there has happily been a great abatement
in their fatality from this disease since the previous record. In
1880–82 the mortality figure had been 290, whilst in 1890–92 the
figure, modified to allow of comparison, was 157, showing a reduction
of nearly half within that interval.
_Textile workers._--In the accompanying list there still remain
several dust-producing occupations in which the mortality from
pulmonary diseases is in excess of the average, notwithstanding that
the workers are not exposed to the action of metallic irritants. Of
these there are four which may be taken to represent the textile
trades--viz., the manufacture of cotton, wool, rope, and carpets--in
all of which the mortality figure from respiratory diseases is not
only vastly in excess of the figure for agriculturists, but is also
considerably above that of other occupied males. Among textile workers,
cotton operatives (especially those of Lancashire) are the most
unhealthy. Their mortality figure from all causes is higher than that
of occupied males generally, by from 20 to 23[A] per cent., whilst
from diseases of the respiratory system exclusive of phthisis, their
mortality is in excess by proportions varying from 53 to 65[44] per
cent. The workers in cotton mills suffer severely from the presence,
in the air, of “fluff” and “flue” that escapes from the cotton,
especially in the preparation of the yarn. The amount of this and the
degree of irritation to which it gives rise when inspired, varies with
the quality of the material used; inferior and brittle cotton, being
more liable to breakage in the course of manufacture, gives off more
dust than do the finer kinds, and requires for its successful working
a warmer and moister air. The workers in the lower-class cottons
therefore suffer more seriously in health, and require more perfect
arrangements for ventilation than do those who deal with materials of
higher quality. Cotton spinners have to work all the year round in a
very warm and humid atmosphere, and accordingly suffer from debility
and exhaustion caused by profuse sweating. The temperature and moisture
of the sheds are maintained at a high standard both night and day, in
order to prevent brittleness in the cotton fibres, and as a consequence
the operatives become peculiarly sensitive to chills, brought about,
perhaps, by injudicious exposure to draughts. From personal experience
in Manchester, for a period of twenty-five years, I can testify that
these workers are exceptionally liable to acute rheumatism, and this
statement may be confirmed by reference to the mortality tables in my
larger work, which show that the mortality of cotton spinners from
this disease exceeds the average by not less than 70 per cent. The
operation of “sizing,” preparatory to the weaving of cotton, introduces
a new element of danger. The size contains, in addition to flour or
farina, a very large proportion of china clay, which finds its way
into the air passages, and there produces its well-known mischief. It
is pleasant to record that cotton operatives do not add to the evils
of their occupation by undue recourse to alcohol: their mortality from
intemperance being below the average by 23 per cent.
_Wool, Worsted Manufacturers._--Wool-workers suffer much less
severely from their occupation than do cotton operatives. In the
weaving of woollen materials, a lower and drier temperature is required
than in the case of cotton-weaving, and the mischief caused by
“sizing” with china clay and other irritants has no place in woollen
manufacture. Nevertheless, in certain of the processes, especially
where inferior foreign wools are manufactured, a good deal of dust
is disengaged, and this produces its ill-effect on the lungs of the
workers. It is also in connection with dirty or blood-stained foreign
wools that the majority of cases of anthrax or wool-sorters’ disease
have been observed from time to time, which have been the subject of
inquiry in past years by the Medical Department of the Local Government
Board.
It is worthy of notice that wool-sorters are even more careless as
regards exposure to cold and draughts than are even cotton workers,
and their mortality from rheumatic fever is much higher, being double
that experienced by agriculturists as a class. Wool-workers have a
comparative mortality figure from all causes, which is somewhat above
the average for occupied males generally, but is below that of other
textile trades. Workers in wool appear to be remarkably free from
intemperance, their mortality figure being less than one-fourth of the
average. From diseases of the digestive system other than the liver,
wool-workers die half as fast again as do occupied males generally,
whilst from diseases of the nervous, respiratory, and urinary systems,
as well as from cancer, the mortality of these workers is from 10 to 22
per cent. in excess of that standard.
_Other Workers in Dusty Trades._--The accompanying list includes
a few industries, the workers in which have not yet been alluded to as
regards their health: such as the rope-makers, carpet-makers, coopers,
bricklayers, bakers, etc. These industries, although not remarkable for
the production of other serious forms of illness, have this feature
in common, that being essentially dust-producing processes, they one
and all induce among the workers excessive suffering from pulmonary
affections. Although the mortality of these workers from phthisis and
other lung diseases is considerably below that of metal-workers,
nevertheless it is in every case inordinately high, exceeding the
mortality of agriculturists by proportions varying from 77 to 120 per
cent.
EFFECTS OF BREATHING FOUL AIR.
In my larger work on occupational mortality, detailed vital statistics
are given respecting those workers whose occupation is not in itself
necessarily unhealthy, but who are the victims of unwholesome
conditions of labour, either self-inflicted, or else caused by the
ignorance or the parsimony of persons in authority. The evils here
alluded to are the result partly of the accumulation of respiratory
and other impurities in the air breathed, from neglect of suitable
methods of ventilation, and partly of the cramped posture adopted in
certain cases (notably by tailors and shoemakers) in their sedentary
indoor labour. Considerations of space preclude the insertion here of
a complete list of these occupations; but in the following table a
selection has been made of those industries in which the workers are
liable, in the greatest degree, to damage from the inhalation of foul
air in the course of their employment. For each of these occupations
the figures indicating the mortality from phthisis and from diseases
of the respiratory and circulatory systems are separately shown, and
in another column the combined mortality of the several occupations
from the first two of these forms of disease is compared with that
of agriculturists, the latter being taken as 100. The occupations
have been arranged in the descending order of their mortality from
tubercular phthisis and respiratory diseases together.
Comparative Mortality from several causes in certain unhealthy
occupations.
+----------------+---------------+-----------------------+
| | | Phthisis and Diseases |
| | Comparative | of |
| | Mortality | Respiratory Organs. |
| Occupation. | Figure +------------+----------+
| | (all Causes). | Mortality | Ratio. |
| | | Figure. | |
+----------------+---------------+------------+----------+
|Agriculturists | 602 | 221 | 100 |
| | | | |
|Bookbinder | 1060 | 543 | 246 |
|Printer | 1096 | 540 | 244 |
|Musician | 1214 | 522 | 236 |
|Hatter | 1109 | 511 | 231 |
|Hairdresser | 1099 | 489 | 221 |
|Tailor | 989 | 466 | 211 |
|Draper | 1014 | 441 | 200 |
|Shoemaker | 920 | 437 | 198 |
+----------------+---------------+------------+----------+
Part 2 of Table.
+----------------+---------------------------------------+
| | |
| | Mortality Figure. |
| | |
| Occupation. |-----------+-------------+-------------+
| | Phthisis. | Respiratory | Circulatory |
| | | Diseases. | Diseases. |
+----------------+-----------+-------------+-------------+
|Agriculturists | 106 | 115 | 88 |
| | | | |
|Bookbinder | 325 | 218 | 115 |
|Printer | 326 | 214 | 133 |
|Musician | 322 | 200 | 191 |
|Hatter | 301 | 210 | 141 |
|Hairdresser | 276 | 213 | 179 |
|Tailor | 271 | 195 | 121 |
|Draper | 260 | 181 | 135 |
|Shoemaker | 256 | 181 | 121 |
+----------------+-----------+-------------+-------------+
From this table it will be seen that, roughly speaking, the combined
mortality from phthisis and respiratory diseases varies from twice to
two and a half times that of agriculturists. It may further be stated
(although the figures are not given in the table) that the workers in
four of the above-mentioned occupations die from these diseases alone
more rapidly than farmers in the agricultural districts die from all
causes put together. Contrary to the experience of two-thirds of the
occupied male population of England and Wales, tubercular phthisis
is more fatal than are diseases of the respiratory organs other than
phthisis, to all the workers in the table, except agriculturists.
_Bookbinders, Printers._--Writing in 1881 of the sanitary
condition of these workers, Dr Ogle speaks of both of them in common as
“carrying on their industries under notoriously unhealthy conditions,
in ill-ventilated rooms, and in an atmosphere unduly heated by engines,
stoves, and flaring gas-lights.” The decline in the death-rates, as
compared with the earlier records, he attributes to the improvements
effected by the Factory Inspectors since these trades came under their
supervision. Further on he writes, with respect to their mortality:
“Excepting costermongers ... and those industries in which the workman
is exposed to the inhalation of dusts, such as file-makers, potters,
and Cornish miners, there is no industry in the table in which the
mortality from phthisis approaches to that of printers.” “As for
bookbinders,” he writes, “so far as can be judged from the 77 deaths of
which the causes are recorded, in this industry also the high mortality
is due to phthisis, for of the 77 deaths no less than 30 were caused by
this disease.”[45]
In both of these trades the conditions of work have still further
improved under the supervision of H.M. Factory Inspectors since the
above was written. Taking _bookbinders_ first--The returns
show that their death-rates are still considerably above those of
agriculturists, and, indeed, above those of other occupied males at
most of the ages in the working period of life, their comparative
mortality figure being above the firstnamed standard by 76 per cent.
Bookbinders still die very rapidly from pulmonary consumption, their
mortality figure from that disease being no less than 325, or more than
three times as high as that of agriculturists. Their mortality from
cancer and from diseases of the respiratory, circulatory, and urinary
systems also shows excess. Bookbinders are more addicted to suicide
than are agriculturists, in the proportion of 26 to 10. Ever since
1871 the mortality of bookbinders has steadily decreased, and there
has been a fall in the death-rates at ages under as well as above the
forty-fifth year.
_Printers_ experience a death-rate at the various age-groups which
is above the standard at all the age-groups dealt with in the table.
Their mortality figure is 1096, as against 953 for all occupied males,
and 602 for agriculturists. Like bookbinders, printers die very rapidly
from phthisis, and probably for a similar reason--namely, because of
the excessively unhealthy conditions under which their work is carried
on--their mortality from diseases of the respiratory organs other
than phthisis is, however, below the average, but from diseases of
the nervous, circulatory, digestive, and urinary systems it is above
the average. Printers suffer only about one-third as much from fatal
accident as do other workers, but they are somewhat more addicted to
suicide. Their mortality figure from lead poisoning is represented by
3. In the course of the last twenty years the mortality of printers
from all causes together has decreased considerably. Both the age
divisions in the main work time of life have shared in the fall, but in
unequal proportions. As compared with that of 1881, the mortality of
these workers from alcoholism in 1891 has fully trebled, and that from
suicide has more than doubled. The most important decrease occurs in
the case of phthisis, the mortality from which has fallen, since 1891,
by one-sixth part of the former rate.
_Musicians._--The mortality of the class of men who, by a
euphemism, are styled “musicians,” is very high. At all ages in the
working period of life it greatly exceeds that of agriculturists, and
also exceeds that of the working population in the aggregate. Their
comparative mortality figure amounts to 1214, or more than double the
figure for agriculturists, and is about one-third part in excess of
that of occupied males generally. Compared with both these standards,
musicians die more rapidly from alcoholism and from diseases of the
liver. Their mortality figure from phthisis is enormous, amounting to
not less than 322, or fully three times that of agriculturists, and
almost double that of male workers in the aggregate.
In addition to the above, musicians sustain very heavy mortality from
diseases of the nervous, circulatory, digestive, and urinary systems,
and their mortality figure from suicide is 23, as compared with
10 for agriculturists and 14 for other occupied males. From these
statistics it is certain that many of those who are included in this
class are sadly addicted to intemperance, whilst others suffer from
want of the bare necessaries of life. “It must be remembered,” writes
Dr Ogle in 1881, with reference to the mortality of this class, “that
under this heading are comprised all sorts and conditions of men, and
that a large portion of them are organ-grinders, ballad-singers, and
street musicians generally, many of whom are of intemperate habits,
and exposed by their mode of life to cold and want, while no few have
merely taken to the occupation as a refuge, after their health has
broken down in more regular occupations.”
Within the last twenty years the mortality of musicians has declined
very considerably, both at the earlier and at the later ages. Their
comparative mortality figure in 1891 was lower than it had been in 1871
by more than one-fifth part: nevertheless, their vital statistics still
continue to be very unsatisfactory, and their nomadic habits are a
serious hindrance to improvement.
_Hatters._--As compared with agriculturists, the mortality of
hatters is enormously greater at all stages of the working period of
life, and their comparative mortality figure from all causes is in
excess of that standard by 84 per cent. At ages under thirty-five
years, hatters experience a death-rate which barely exceeds the
average among occupied males, but at each subsequent age-group their
mortality is greatly in excess. As far as we know there is little in
the employment of hat-makers which of necessity acts prejudicially to
their health. Their work, however, like that of too many other trades,
is frequently carried on in overcrowded and ill-ventilated apartments,
and the men suffer accordingly. Thus we find from the tables that
hatters die from tubercular phthisis about three times as rapidly
as do agriculturists, and that their mortality from this complaint
considerably exceeds the average in other occupations. Hatters appear
to be much addicted to intemperance, their mortality figure from
alcoholism, and also from liver disease, showing serious excess.
Their mortality from suicide stands at 28, as compared with 10 for
agriculturists and 14 for other occupied males. Among hatters under the
age of forty-five years there has been a decline in mortality within
the last twenty years, but at ages from forty-five to sixty-five there
has been but little change.
_Hairdressers._--The mortality of hairdressers is higher
than that of other occupied males at each of the age-groups of
the working period; it is, consequently, greatly in excess of that
of agriculturists. Their mortality figure from all causes at ages
twenty-five to sixty-five is 1099, and, therefore, exceeds that of the
standard last mentioned by 82 per cent. The life of a hair-dresser is
for the most part a town, or at least a village, life; the work being
carried on indoors for long hours together, in an atmosphere heated
and polluted by gas. In addition to this, the occupation is a dusty
one, and the men are exposed to the effects of particles of hair and
other irritants which find their way into the lungs. Their mortality
figure from alcoholism, liver diseases, and gout, as well as from
pulmonary tuberculosis, shows serious excess; it therefore appears
that hairdressers, as was the case in 1881 also, are still excessively
addicted to intemperance. They fall victims to suicide almost as
rapidly as do even the least fortunate workers included in the list of
occupations. Hairdressers experienced almost the same rate of general
mortality at the census periods of 1871 and 1881, but since the latter
year there has been a fall in their mortality to the extent of about
one-seventh part.
_Tailors._--The occupation of tailors is a typically sedentary
one. The men work for the most part in overcrowded, ill-ventilated,
and overheated rooms, and consequently suffer in general physique and
appearance, as well as in health. In recent years the introduction
of machinery, whilst in some respects an advantage, has produced
its counterbalancing ill-effects by rendering it possible for any
man or woman who can work a sewing machine to take the place of the
regularly skilled tailor, and thus to depreciate the market value of
his labour. In consequence of this the tailor and his family are only
too frequently reduced to great poverty, if not to a state approaching
starvation. The mortality of tailors at the several age-groups does
not greatly differ from that of other occupied males. Tailors die more
rapidly than agriculturists at ages between twenty-five and sixty-five,
but at ages below and above these limits their mortality does not
greatly exceed this standard.
Although in past times tailors have been considered an intemperate
class, the figures for 1890–92 lend little support to that opinion.
Their mortality figure from alcoholism as well as from liver disease
scarcely differs from that of occupied males generally, although, of
course, it considerably exceeds the low figure of agriculturists.
The mortality of tailors from tubercular phthisis is greatly in excess
of that of other occupied males, and is more than two and a half times
as high as the mortality of agriculturists; it is also worth mention
that they die more rapidly than other workers from diseases of the
nervous system. On the other hand their mortality from influenza and
from diseases of the respiratory organs, and of the heart, is in each
case below the average. During the last twenty years there has been a
notable increase in the mortality of tailors at ages from forty-five
to sixty-five years, and an equally notable decrease at ages from
twenty-five to forty-five. Although the mortality directly ascribed to
alcoholism is now slightly higher than it was in 1881, nevertheless the
mortality from diseases of the liver and other digestive organs has
undergone a more than equivalent reduction, so that the total mischief
caused by intemperance has probably decreased since 1881. The mortality
of tailors from gout as well as from phthisis, and from diseases of the
nervous system, has fallen since the same year.
_Drapers, Manchester Warehousemen._--The large body of men
included under this heading appear to enjoy but poor health, when
allowance is made for the fact that the greater part of them are under
twenty-five years of age. Drapers and Manchester warehousemen, who are
here grouped together because of the similarity of their occupation
and mode of life, are credited with a mortality which is higher than
that of any other occupation save one in the category of shopkeepers.
Their comparative mortality figure from all causes is 1014, which, as
compared with that of agriculturists, is in excess by 68 per cent.
Even when compared with the low standard of “occupied males,” drapers
are subject to a mortality which is considerably above the average.
Confinement in close, ill-ventilated shops for very long hours
together, and an almost exclusively indoor life, is the unlucky fate of
these workers. They are exposed to the heat and fumes of gas and cotton
“fluff” and dust which escapes from the bales of goods in process of
sale, and their health suffers accordingly. Their death-rate from
tubercular phthisis exceeds that of other occupations by not less than
41 per cent., and is more than two and a half times as high as that
of agriculturists; but the fact previously mentioned, that drapers’
assistants are for the most part youths or young men, may account to
some extent for their exceptional liability to this scourge. Drapers
die faster than the average from influenza, rheumatic fever, and
diabetes, as well as from alcoholism, diseases of the liver and nervous
system, and from suicide. During the main working period of life, the
mortality of drapers has decreased somewhat since the earliest record.
In the first twenty years of this period, _i.e._, from twenty-five
to forty-five years of age, their death-rate has fallen considerably
since 1871; whilst at ages from forty-five to sixty-five years,
although it had fallen between 1871 and 1881, it has since returned to
its former level. Since 1881 the mortality of drapers from all causes
has increased by 18 per cent. Between 1881 and 1891 their mortality
from phthisis remained stationary, whilst that from other lung disease
and heart disease showed a considerable increase. Their mortality from
suicide has increased threefold since 1881, and that from alcoholism
has increased by nearly two-thirds.
_Shoemakers._--Although the contrary is generally held to be the
fact, shoemakers are shown by the figures now at our disposal to enjoy
a degree of health which is at least equal to that of the average
working man.
As the occupation of shoemaking is an indoor one, involving sedentary
labour for many hours together, in closely confined and ill-ventilated
apartments, the workers suffer inordinately from those ailments which
are commonly associated with such environment. Up to the thirty-fifth
year of age shoemakers die faster than other occupied males, but more
slowly at later ages. Compared with agriculturists the mortality of
shoemakers at all ages is in excess by 53 per cent.
Shoemakers die much less rapidly than the average from lung diseases
(except phthisis) as well as from accident, and their mortality from
intemperance is remarkably low. Cancer and pulmonary consumption,
however, play sad havoc among shoemakers, their mortality from the
first-mentioned disease being in excess of the average by 14 per cent.,
and from the last-mentioned, by 38 per cent. Throughout the three
decennia, commencing with 1861, the mortality of shoemakers above the
age of forty-five years has steadily increased, whilst below that age
it has steadily decreased; the balance showing a slight increase in the
total mortality figure. Under the head of alcoholism their mortality
has increased since the earlier record, although that from liver
disease has decreased. Shoemakers die as rapidly as ever from pulmonary
consumption, and more rapidly than ever from diseases of the lungs
and heart. Their mortality from diseases of the nervous system has,
however, shown a decided improvement, and they are at the present time
less addicted to suicide than was formerly the case.
THE MINING INDUSTRY.
At the census of 1891 more than half a million men above the age of
fifteen years were returned as miners, their number having increased
since the previous census by more than a fourth part. As the proportion
is still probably increasing, we may safely calculate that at the
present time one in every 17 males between the ages of twenty-five and
sixty-five years is a miner. In round numbers it may be stated that of
the 524,000 miners in England and Wales, 482,000 work in coal, 18,000
in ironstone, 9000 in tin, 6000 in lead, 2000 in other minerals, and
1000 in copper; whilst the remaining 6000 are classed under the head
of “mine service.” With a few noteworthy exceptions, miners are not,
as a whole, an unhealthy body of men, but from the nature of their
employment they are necessarily more exposed than are other workers to
certain forms of violent death. The various groups of miners, however,
have, of course, this feature in common, that most of their time, for
a great part of their life, is spent underground. Accordingly their
work is carried on under conditions of heat, moisture, etc., which are
exceptionally artificial, and for this reason it is desirable that
their mortality should be studied with especial care. The following
table shows the death-rates of miners at several ages, compared with
the corresponding rates of occupied males. The figures in each column
represent proportions of the standard figure, the latter taken in each
case at 100.
+-------------------------------+----+----+----+----+----+----+-------+
| | 15 | 20 | 25 | 35 | 45 |55 | 65 and|
| | | | | | | |upwards|
+-------------------------------+----+----+----+----+----+----+-------+
| Occupied Males. |100 |100 |100 |100 |100 |100 | 100 |
| | | | | | | | |
|Mining Industry |148 |112 | 87 | 78 | 95 |121 | 147 |
| | | | | | | | |
|Coal miner |150 |111 | 86 | 77 | 94 |119 | 143 |
|C M {Durham and Northumberland |154 |111 | 75 | 66 | 79 | 97 | 152 |
|o i {Lancashire |163 |107 | 88 | 94 |110 |140 | 150 |
|a n {West Riding |115 | 92 | 76 | 77 | 89 |126 | 138 |
|l e {Derby and Notts | 93 | 68 | 69 | 59 | 73 | 96 | 118 |
| r {Staffordshire | 95 |109 | 82 | 70 | 95 |135 | 180 |
| s {Monmouth and Wales |227 |141 |118 | 97 |117 |140 | 129 |
|Ironstone miner |134 | 90 | 82 | 66 | 83 | 91 | 144 |
|Copper miner |... |158 |129 |146 |118 |127 | 170 |
|Tin miner |116 |139 |111 |115 |161 |180 | 178 |
|Lead miner |118 |127 |130 |109 |116 |182 | 240 |
|Mine service |127 |264 |129 | 98 | 95 |113 | 155 |
+-------------------------------+----+----+----+----+----+----+-------+
The table shows that at ages from fifteen to twenty, and from twenty to
twenty-five, as well as at both the age-groups above fifty-five years,
miners in the aggregate die more rapidly than do other occupied males,
whilst at intervening ages they die less rapidly. Miners, however, are
a picked class of men in a more especial sense than are the toilers in
most other industries. Their labour is so arduous that those only who
possess exceptional physical endurance are able to continue it, and
this may account for the fact that when they are barely past the prime
of life many of them become enfeebled, and subject to a mortality which
is considerably in excess of that incidental to other occupations.
On attempting to trace the causes of mortality in the various groups
of miners, and to compare those industries, in this respect, with
one another and with other occupations, it readily appears that a
large, though very inconstant, proportion of the total mortality is
contributed by “accident.” It is accordingly desirable to isolate
this factor, so that we may arrive at a fair judgment as to the loss
of life by disease alone occurring amongst these workers in their
several fields of labour. This has been done in the following table,
where the comparative mortality of the various groups of miners is
given (_a_) from all causes except accident, (_b_) from
certain prevalent diseases, (_c_) from accident or violence, and
(_d_) from disease and accident together.
+---------------------------+-------------------+-------------+
| | All Causes | Alcoholism. |
| | except Accidents. | |
+---------------------------+-------------------+-------------+
| =Mining Industry= | =800= | =4= |
| Coal miners | 784 | 4 |
| Durham & Northumberland | 678 | 5 |
| Lancashire | 914 | 5 |
| West Riding | 798 | 4 |
| Derby and Notts | 638 | 2 |
| Staffordshire | 817 | 2 |
| Monmouth and Wales | 902 | 7 |
| Ironstone miners | 688 | 4 |
| Copper miners | 1195 | |
| Tin miners | 1361 | 4 |
| Lead miners | 1267 | 5 |
| Mine service | 946 | 6 |
| Farm labourer | 590 | 4 |
| Occupied males | 897 | 13 |
+---------------------------+-------------------+-------------+
Part 2 of Table.
+---------------------------+-----------+-----------+-------------+
| | Liver | Phthisis. | Respiratory |
| | Diseases. | | Diseases. |
+---------------------------+-----------+-----------+-------------+
| =Mining Industry= | =18= | =109= | =267= |
| Coal miners | 17 | 97 | 269 |
| Durham & Northumberland | 23 | 94 | 156 |
| Lancashire | 17 | 102 | 389 |
| West Riding | 16 | 123 | 288 |
| Derby and Notts | 18 | 69 | 159 |
| Staffordshire | 8 | 83 | 319 |
| Monmouth and Wales | 16 | 107 | 345 |
| Ironstone miners | 20 | 90 | 204 |
| Copper miners | 28 | 331 | 347 |
| Tin miners | 28 | 508 | 377 |
| Lead miners | 34 | 380 | 325 |
| Mine service | 42 | 114 | 216 |
| Farm labourer | 13 | 115 | 129 |
| Occupied males | 27 | 185 | 221 |
+---------------------------+-----------+-----------+-------------+
Part 3 of Table.
+---------------------------+-----------+-----------+-------------------+
| | Bright’s | Accident. | Disease and |
| | Diseases. | | Accident together.|
+---------------------------+-----------+-----------+-------------------+
| =Mining Industry= | =19= | =135= | =935= |
| Coal miners | 18 | 141 | 925 |
| Durham & Northumberland | 15 | 96 | 774 |
| Lancashire | 17 | 155 | 1069 |
| West Riding | 16 | 114 | 912 |
| Derby and Notts | 8 | 89 | 727 |
| Staffordshire | 22 | 135 | 952 |
| Monmouth and Wales | 27 | 243 | 1145 |
| Ironstone miners | 15 | 86 | 774 |
| Copper miners | 68 | 35 | 1230 |
| Tin miners | 29 | 48 | 1409 |
| Lead miners | 33 | 43 | 1310 |
| Mine service | 20 | 75 | 1021 |
| Farm labourer | 12 | 42 | 632 |
| Occupied males | 27 | 56 | 953 |
+---------------------------+-----------+-----------+-------------------+