RESNICK | i i == --> Prº- #1.3%; zºº.º. -º-º: S.A., J. J.J. J. Mºſ J. Jº Jº Jº Jº Jº. 5 J/.5, 5 59.wº U/ \º J, Q, J.J. º.JJ, 3. COLLEGE OF .. ... ENGINEERING ... D G C O f O ſº [] t [. C ſ ſ D O D [] [] [] O º C O ſ C º º O U º º zº º Eº 2 * * º U N D C C U D ſo º º D G C U [i] [. º D U D U i) º U D º [] ſ D ſ U º [] [] ſ º C Q ſ U ſº [T] º f Engin. Library 7& E. 32.5" . R. 4 3 / ºf 4 / EYE HAZARDS IN INDUSTRY EYE HAZARDS IN IN D U S T RY EXTENT, CAUSE, AND MEANS OF PREVENTION By Louis Resnick Published for the N A T I O N A L S O C I E T Y F O R. T H E P R E V E N T I O N O F B L I N D N E S S By C O L U M BIA UNIVERSITY PRESS New York: 1 94 I An earlier edition of this work entitled Eye Hazards in Industrial Occupations, by Louis Resnick and Lewis H. Carris, was published in 1924. Copyright 1941 COLUMBIA UNIVERSITY PRESS, NEW YORK Manufactured in the United States of America J. %. … - ſº. 4 - A. & ex-c__º - ? Y- /... - a Cº-' Cº-º-º-º-º-- * - / 2/ - */2. /s a sy PREFACE THE NATIONAL SOCIETY for the Prevention of Blindness has been concerned with the eye hazards of industrial occupations for more than a quarter of a century. This concern has been serious and active, not academic. As early as 1917 this organization pub- lished the first handbook dealing with these hazards, a volume compiled by Gordon L. Berry. In 1924 a revised and substantially enlarged edition was published, entitled Eye Hazards in Indus- trial Occupations, under joint authorship of the undersigned and the author of the present volume. In the intervening fifteen years much has happened to justify even more intensive activity of the society in this field. Old hazards have been eliminated or effec- tively guarded against, and new hazards have arisen. Progress has been made in many directions, and new problems have developed. Today the National Society for the Prevention of Blindness is more than ever concerned with the eye hazards of industrial occu- pations, because despite all the progress that has been made to- ward their control these hazards still constitute one of the princi- pal causes—if not the One most serious cause—of blindness and defective vision. This society has throughout the past quarter century coöper- ated with the National Safety Council and with other national and regional safety organizations in their programs for sight con- servation in industry. Substantial contributions toward the elimi- nation of industrial eye hazards have been made by the Safety Council, the United States Bureau of Standards, and various other safety organizations. These agencies, however, of necessity direct vi PRE FACE their activities primarily against the whole field of accident pre- vention and health promotion, a field in which eye protection is only one of scores, if not hundreds, of problems. Furthermore, a very large part of American industry—particularly in small plants —is still largely apathetic toward the organized safety movement. Thousands of industrial concerns have no contact with any na- tional or local safety organization. It is in these Concerns particu- larly that workers are blinded, and others suffer partial but serious impairment of vision from causes which are wholly preventable. The National Society for the Prevention of Blindness seeks to bring information about eye hazards and means of their elimina- tion to the owners, supervisors and workers in these plants as well as in larger industrial concerns which may already have well organized safety programs but nevertheless contribute to the annual toll of blindness and near blindness from preventable Call SCS. There is still another important reason for this society's con- cern with the eye hazards of industrial occupations. The problem of eye protection in industry is at innumerable points closely interwoven with the problem of preventing blindness from other causes with which this society is primarily occupied. The audi- ence which this society strives to reach in the conservation of vision generally is in large part an audience which can also help eliminate or control the eye hazards of industry. This audience includes Ophthalmologists, city, state, and Federal health and in- dustrial department officials, industrial physicians and nurses, public health nurses, teachers and school administrators, as well as all those interested in the promotion of better lighting, better Sanitation, and public and industrial health generally. It is with profound sorrow that I must report in this Preface the untimely death of the author, Louis Resnick, on March 18, 1941. Despite a lingering illness he worked assiduously to finish this volume and just three days before his death completed the manu- Script. More than twenty years of staff association with organiza- tions professionally concerned with sight conservation and the PRE FACE vii general safety movement, including the National Safety Council, the American Museum of Safety, the American Standards Associ- ation, the National Bureau of Casualty and Surety Underwriters, the International Labour Office, and the National Society for the Prevention of Blindness, kept Mr. Resnick in close touch with every facet of the large problem of eye hazards in industry and with every development in the many efforts to eliminate these hazards. The author's contacts with the problem were not confined to the swivel chair, but took him directly into factories, mills, mines, railroad shops, utilities, and other work places throughout the country. These first-hand observations of the problem of sight conservation in American industries were supplemented by an extended European tour in which he had opportunity to study what was being done by the industries of England, France, Switzerland, and other European countries to guard the eyes of factory workers. Much attention is given in this volume to the monetary cost of industrial eye injuries and eye diseases, and the reason for this emphasis is explained. In considering the high monetary cost of industrial eye hazards to employer and employee and the great possibilities for money saving there is danger of overlooking the social significance and the human implications of these hazards. This volume not only lays bare the eye hazards present in in- dustries and Occupations of all sorts but also reports on the meas- ures that may be taken to eliminate these hazards and to guard workers against those which cannot be eliminated. It is the hope of the sponsors of this volume that it will serve not only as a handbook for safety engineers, safety inspectors, and all others actively engaged in accident prevention generally and sight Conservation in particular or in industrial efficiency, but also as a textbook by engineering schools, vocational training authorities, and all others engaged in preparing youth for work in industry. At the moment and probably for years to come the country will viii PRE FACE be engrossed in national defense. Conservation of the vision of American workmen is vital to national defense as are the building of armament and the training of men to use defense equipment. Good sight is a prerequisite to skilled Craftsmanship, whether it be in the shop, in the field, in the air, or on the high seas. LEWIS H. CARRIS DIRECTOR EMERITUS NATIONAL SOCIETY FOR THE PREVENTION OF BLINDNESS New York June 15, 1941 AC KNOWLED G MENTS THIS BOOK represents the work not alone of the undersigned but also of many other persons professionally concerned with the prevention of blindness in industry and the general Conservation of vision—safety engineers, physicians, Surgeons, industrial execu- tives, Federal and state government officers, insurance men, Safety equipment manufacturers, dealers, Consumers, and others. The effort has been made to locate, study, and synthesize the best of all that has been written on the subject in recent years by men and women, here and abroad, Out of their own experiences and observations. This editorial digest procedure was supple- mented by numerous personal visits to industrial plants and by interviews with a large number of industrial workers who are ex- posed to eye hazards, with foremen and safety directors whose job is to protect workers from these hazards, and with doctors and nurses who try to save the workers' sight when their eyes have been injured by accident or disease. The author is especially indebted to the late Dr. Park Lewis, Dr. Ellice M. Alger, Preston S. Millar, and Pauline Brooks William- son, who as a committee of the Board of Directors of the National Society for the Prevention of Blindness read the manuscript, and also to John W. Avirett, 2d, president of the Maryland Society for the Prevention of Blindness, Lewis H. Carris, director emeritus of the National Society for the Prevention of Blindness, and to the staff of the same society, W. Graham Cole, director of safety of the Welfare Division of the Metropolitan Life Insurance Com- pany, Dr. M. Davidson, ophthalmologist of the New York State X ACKNOWLED G MENTS Department of Labor, and Dr. Leonard Greenberg, executive di- rector of the Division of Industrial Hygiene of the New York State Department of Labor, for reading the manuscript, and to the author's son, William S. Resnick, for assistance in the research incident to this volume. LOUIS RESNICK New York City March 15, 1941 II. III. CON TENTS PREFACE BY LEWIS H. CARRIS ACKNOWLEDGMENTS Part I THE PROBLEM . EYE HAZARDS Cost of Eye Injuries to the Employer; Cost of Eye Injuries to the Employees; Cost of Industrial Eye Injuries to the Community; The Eye Injuries of Any One Day; The Profit Motive in Safety; Advances in Elimination of Eye Hazards; Some Remaining Problems; Conclusion. EYE ACCIDENTS The Number of Eye Accidents Occurring Annually in the United States; Where Do Eye Accidents Occurr; Accident Causes—Analysis; The Most Common Types of Eye In- jury; Cost of Eye Injuries to the Employer; Indirect Costs of Eye Accidents; Extent of Industrial Blindness; Blind- ness in One Eye; Cost of Blindness to the Employer; Cost of Blindness to the State and the Employee; Conclusion. EYE DISEASES Scope of Coverage for Occupational Diseases; Diseases Re- sulting from Mechanical Injuries (Diseases of the lachrymal glands, of the conjunctiva, of the cornea, of the iris, of the choroid, of the retina, of the lens); Diseases Resulting from Exposure to Radiant Energy; Diseases Resulting from Use of Industrial Poisons; Diseases Resulting from Poor Light- ing and Other Bad Working Conditions; Venereal and Other Communicable Diseases; Infectious Conjunctivitis– Trachoma; The New Attitude of Industry; Cleanliness an Important Preventive. ix 18 41 xii CONTENTS IV. DEFECTIVE VISION 58 Extent of Subnormal Vision in Industry; Principal Eye De- fects; Effects of Poor Vision; Responsibility for Correction of Defective Vision; Eye Examinations; Recommendations. V. FIRST AID 85 Foreign Bodies in the Eye; Penetrating Bodies; Chemical Burns; Eye Burns from Caustic Soda; Acids and Caustics; “Flashed” Eyes. Part II THE SOLUTION VI. MECHANICAL GUARDS 1 O 1 Goggles or Guards?; Choosing the Proper Mechanical Guards and Goggles; Classifications of Hazards in Na- tional Code; Protection against Relatively Large Flying Objects; Protection against Small Flying Particles; Protec- tion against Splashing Metal; Protection against Gases, Fumes and Liquids; Protection against Reflected Light and Glare; Protection against Injurious Light or Heat Rays; Protection against Miscellaneous Hazards; Protec- tion by Goggles and Guards. VII. PROCESS REVISION 165 Examples of Process Revision Favorably Affecting Eye Hazards. VIII. PROPER LIGHTING 177 Accidents Caused by Poor Lighting; The New Science of Lighting; Lighting Codes; Effect of Lighting on Produc- tion Efficiency; Lighting Problems; New Developments in Modern Lighting. IX. EDUCATION 195 Education of the Employer; Education of Employees; The Accident-Prone Employee; Training Methods; Need for Better Safety Education Facilities. X. ADMINISTRATIVE SUPERVISION 229 The Mandatory Goggle Rule; Supervision (What is safety supervision? Who can best render safety supervision? Su- pervision through safety committees, Reporting and inves- tigating accidents, State safety supervision); Self-inspection for Eye Hazards. C O N TENTS xiii II. III. IV. APPENDICES A SELF-APPRAISAL FOR EYE SAFETY IN INDUSTRY INDUSTRIAL POISONS WHICH ARE HAZARDOUS TO THE EYES RECOMMENDED MINIMUM STANDARDS OF ILLUMINATION FOR INDUSTRIAL INTERIORS SOME NATIONAL ORGANIZATIONS CONCERNED WITH INDUSTRIAL WELFARE BIBLIOGRAPHY INDEX 243 248 275 281 289 305 1 O. 1 1. ILLUSTRATIONS . Normal Eye . Farsighted Eye Farsighted Eye Corrected Nearsighted Eye Corrected . Eye Clinic of the Union Health Center (New York) Courtesy Union Health Center Eye-Clinic Car Courtesy Delaware and Hudson Railroad Company Prečmployment Examination to Determine Muscular Coördination of the Eyes Prečmployment Examination for Depth Perception . Wanted — First Aid' Courtesy American Optical Company A Well-Equipped First-Aid Room with Competent Personnel Courtesy Caterpillar Tractor Company An Eye-Washing Fountain Courtesy Eastern Gas and Fuel Associates Chipper Whose Eyes Are Well Protected by Goggles Workman Whose Sight Was Saved by Goggles 1 2. 13. 14. Riveters at Work under a Pullman Car Courtesy The Pullman Company 64 66 67 76 77 81 82 86 90 xvi ILLUSTRATIONS 15. 16. 17. 18. 19. 2O. 2 1. 22. 23. 24. 25. 26. 27. Double Protection—Goggles on the Man and an Exhaust Unit on the Machine Courtesy The Austin Company Cross Section of a Driving Flange Courtesy American Standards Association Cross Section Showing Driving Flange Secured to Spindle Courtesy American Standards Association Cross-Section of a Tapered Flange Courtesy American Standards Association Cross Section Showing Tapered Driving Flange Secured to Spindle Courtesy American Standards Association A Wooden Model of a Walrus-Hide Eye Protector Courtesy American Optical Company Arc-Welding Booths Courtesy Westinghouse Electric and Manufacturing Company Backing-Out Punch Showing Mushroomed Head A Goggle-Service Man Courtesy Caterpillar Tractor Company Automatic Machine for Welding Propeller Shafts Courtesy Westinghouse Electric and Manufacturing Company A Safe and Efficient Castings-Cleaning Department Courtesy Monarch Machine Tool Company Typesetting Department Excellently Lighted by Units of High Candlepower and Low Surface Brightness Courtesy Chicago Journal of Commerce The Washing of Windows and Skylights as a Means of Reducing Accidents and Eyestrain and Increasing Production Courtesy Ford Motor Company Loading Platform Courtesy General Electric Company 12 1 123 123 124 168 171 18O 181 180 I LLUSTRATIONS xvii 29. 3O. 31. 33. Flood-Lighting for Mine Illumination Courtesy St. Joseph Lead Company Driving an Eight-Penny Nail into a Block of Wood with a Pair of Safety Goggles Courtesy General Electric Company Class of Apprentice Welders and Their Supervisor Courtesy United States Steel Corporation . Typical Industrial Eye Safety Exhibit Student at Emery Wheel Courtesy Center for Safety Education, New York University 193 2O4 5 I O. 1 I . TABLES AND CHARTS TA B L E S . Eye Injuries Reported by State Industrial Commissions . Classification of 58,387 Eye Accidents by Industry in One Recent Year . Ratio of Eye Accidents to All Accidents in Seventeen Plants in the Newark, (N.J.) Industrial Area . Analysis of 3,571 Eye Accidents Occurring in Minne- Sota and Illinois in One Recent Year Comparison of Eye Accidents with All Accidents— Number, Compensation, Medical Cost, and Period of Disability Percentage Distribution of Blindness according to Cause . Workmen's Compensation Workmen's Compensation Vision Examination of 1,000 Applicants for Employ- ment in a Silk Mill Tapered Flange Dimensions in Inches Densities and Transmissions (in Percent); also Toler- ances in Densities and Transmissions of Various 2O 2 1 Shades of Glasses for Protection against Injurious Rays 148 Lighting Conditions in American Industry 178 XX TABLES AND CHARTS 13. II. Percentage of the 2,449 Employees Examined in the New York City Hall and General Post Offices with Certain Eye Conditions 182 CHARTS Industrial Accident Cause Analysis 27 Percentage of Subnormal Vision in Various Occupations 62 Part One THE PROBLEM Chapter I THE PROBLEM OF EYE HAZARDS URING THE MINUTE it will take you to read this page two American workmen will suffer eye injuries. Every thirty sec- onds thereafter another workman will clasp his hand, in pain, to one or both eyes, while fellow workers rush to his aid. At the end of an eight-hour day, today and every other work day, a thousand men and women in American factories, mills, mines, utilities, and other places of work will have suffered eye injuries. Some will have their eyes pierced by fragments of metal, wood, stone, or cinders; others will have the delicate tissues of their eyes ripped or crushed by larger flying objects; the eyes of still others will be burned by acids or caustics, by white-hot molten metal, or by the more subtle infra-red and ultra-violet rays of the welding torch; finally the eyes of some workers will go bad or stop working alto- gether because of the cumulative effect of the absorption of poisonous substances. This goes on every working day with the result that some 300,000 eye injuries occur in American industries each year." These injuries cost the employers more than $100,000,ooo a year;” they Cost the injured workmen and the communities in which they live an additional $100,000,000 yearly.” Most of this $200,- OOO,Ooo annual loss and most of the human suffering resulting from these eye injuries—98 percent, in the opinion of those who * See p. 19, below. “See p. 33, below. “See p. 36, below. 4 EYE HAZARDS have made the most detailed study of the subject'—are wholly un- necessary. Of the 1,000 eye injuries which will occur today, all but 20 could be prevented. There, in a nutshell, is the reason for a book on the eye hazards of industrial occupations. The inadequacies of available statistics make it impossible to say precisely what the eye hazards of indus- try cost in terms of blindness and defective vision. We do, how- ever, have information about particular states, about certain large groupings of industries and other data developed by the United States Public Health Service and the United States Department of Labor, which together make possible some reasonable esti- IIlateS. On the basis of these estimates it may be conservatively stated that there are in the United States today more than 80,000 persons who have lost the sight of one eye as a result of industrial hazards and close to 8,000 who have lost permanently the sight of both eyes as a result of these accidents.” To this total there are probably added each year 1,000 or more who lose the sight of one eye and a hundred or more persons who lose the sight of both eyes as the result of Occupational hazards. In Pennsylvania, for example, the State Department of Labor and Industry reports that during the period of 1916 to 1936, in- clusive, there was an average of 472 cases per year in which one eye was lost and an average of 30 cases per year in which both eyes were lost. In this one state 9,920 workers lost the sight of one eye and 628 workers lost the sight of both eyes during this twenty- one-year period. In New York State during 1931 to 1935, inclu- sive, an average of 12 workmen lost the sight of both eyes each * See p. 27, below. * In United States Public Health Service, “Blindness—Amount, Causes and Rela- tion to Certain Social Factors,” National Health Survey, 1935–36, the United States Public Health Service estimated the number of persons who had lost the sight of one eye to be 425,000, of whom 19.1 percent, or 81,175, lost the sight of an eye as the result of some occupational accident, and the number of persons totally blind to be 100,000, of whom 7.8 percent, or 7,800, were blinded as the result of occupational accidents. These estimates do not include the persons who have lost the sight of one or both eyes as the result of occupational diseases or the effects of industrial poisons. EYE HAZARDS 5 year and some 2,000 workers suffered compensable eye injuries, most of which resulted in permanent partial loss of vision. The number of men and women who have lost permanently part of the vision of one eye or of both eyes as the result of indus- trial accident or health hazards undoubtedly runs into hundreds of thousands, and this total is augmented each year by a number probably in excess of 10,000. These are Conservative estimates even if it is assumed that the records on which they are based represent a complete reporting of industrial eye injuries. We know, however, that the injuries reported are only part of the total number of eye injuries which actually occur. In many instances the injured worker does not know he is entitled to compensation, and no one enlightens him. Often the seriousness of an eye injury or the fact that it has or will result in permanent loss of vision does not become apparent until long after the injury has occurred, and in many such cases, for one reason or another, no official record of the accident is made. In still other cases the worker is more Concerned about security of his job than in possible compensation for an injury, and so he does not press his claim for compensation. These are but a few of the many circumstances which account for failure to re- port eye injuries to the proper state authorities or to any other source which might lead to their inclusion in a compilation of the total picture of industrial eye injuries. More serious than all the foregoing, among the factors con- tributing to the inadequacy of official records of eye injuries, is the rapidly spreading use in industry of poisonous chemicals and Other deleterious materials which cause damage to the eyes. In many instances neither the workman whose eyes have been af- fected nor his physician knows that the worker has been exposed to poisonous fumes, liquids, or dusts. In many other cases damage to the eyes develops after the worker has left the employment of the Company in which he, knowingly or unknowingly, worked with or near poisonous substances. In either event the true cause of blindness or of other serious damage to the eyes does not be- 6 EYE HAZARDS come a matter of record in the state industrial commission or in any other source of data Concerning industrial injuries or dis- €a S6S. In view of all this some of the most experienced safety engineers and labor law administrators are of the opinion that the total of eye injuries reported to the industrial commissions of the 48 states represents a 50 percent understatement of the real situation. COST OF EYE INJURIES TO THE EMPLOYER A recent analysis of the records of more than 4,000,000 indus- trial injuries representing the combined experience of at least half the casualty insurance companies of the United States dur- ing the years 1936 to 1939, inclusive, revealed, first, that 20 per- cent of all the accidents were compensable and, second, that these compensable accidents cost the employer or his insurance under- writer an average of $351 per injury for compensation and medi- cal care. Applying these two findings to the estimate of 300,000 eye injuries per year, it develops that 60,000 of the eye injuries are compensable and that they cost the employers more than $20,000,000 a year for compensation and medical care. These twenty million dollars represent just the beginning of the cost to the employer. H. W. Heinrich, of the Travelers In- surance Company, has pointed out that the hidden or indirect Costs of industrial accidents are usually four times the cost of Com- pensation and medical service." If we accept the ratio of hidden costs to direct costs as four-to- one, the total annual cost of compensable eye accidents assumes tremendous proportions: $20,000,000 for direct costs; $80,000,000 for indirect costs—a total of $100,000,000 paid each year by the employers of America for compensable eye injuries to their em- ployees. All or most of this $100,000,000 of needless cost is ulti- mately paid by the consumer, the public at large. Even the most trivial eye injuries—those involving no perma- nent damage to the eyes, no payment of workmen's compensation, * Heinrich, Industrial Accident Prevention, pp. 18–19. See p. 31, below. EYE HAZARDS 7 and little or no loss of time after the day of the injury—cost mil- lions of dollars annually. After analyzing the experiences of its members with more than 4,000,000 industrial accidents, an asso- ciation of casualty insurance companies found that the noncom- pensable accidents cost an average of $9.26 each for first-aid and medical care. On this basis the 240,000 noncompensable eye injuries which occur in American factories each year cost the employers $2,222,400 for first-aid and medical service. Applying the Heinrich formula (the indirect cost of accidents equals four times the direct or visible costs) we find that these so-called trivial accidents Cost employers $10,000,000 a year. Some further idea of the huge financial loss resulting to em- ployers and employees from preventable eye injuries lies in the fact that eye injuries lead to the loss of more than 53,000,000 man- hours of work yearly." This amounts to the full time of 26,880 men. In effect then, there are in the United States at any time 26,880 men and women who, though employed, are unable to work because of eye injuries. Exactly how much this enforced un- employment costs either the employers or the employees no one will ever know. When it is considered that among the workers most likely to receive eye injuries are machinists, tool makers, die and pattern workers, drill operators, lathe operators, and other skilled mechanics, most of whom are not easily replaceable, the seriousness of the loss to the employer becomes apparent. And when it is recalled that the compensation paid for industrial in- juries is always a fraction of the regular salary of the individual injured, some idea is had of the dollar loss to these workers. COST OF EYE INJURIES TO THE EMPLOYEES Much publicity has been given in past years to the large sums industry can save by preventing accidents. Little progress has been made, however, in bringing to workmen a realization of what accidents cost them in lowered earning capacity and of the money saving they can make by doing their part in safeguarding * See p. 30, below. 8 EYE HAZARDS their eyes. Few workmen, for example, realize that the maximum compensation for total loss of vision of one eye is less than $2,000 in most states and as low as $1,000 in some. The skilled shopworker who loses an eye in industry and re- ceives $1,000 compensation—as he would in Oregon—is likely to lose that or more in the first year after the injury. He loses this in the difference between the wage he can earn with one good eye and the wage he would have been able to earn with two good eyes. The skilled workman living in the average American state which pays $2,000 for total loss of one eye loses that amount or more in the first two or three years after his injury, and thereafter his earnings steadily decline. How many workmen would be willing to sell both of their eyes for $6,000 or less, the maximum compensation payable for loss of the sight of both eyes in a majority of states? Few workmen realize that at the very least they are risking a 33% percent Cut in salary for the rest of their lives every time they risk an eye injury. In the most liberal states the maximum compensation paid for total loss of vision is two-thirds of the wage received by the in- jured workman at the time of the accident. In some states the maximum compensation for total loss of sight is as low as $30 a month for life, as in Oregon. COST OF INDUSTRIAL EYE INJURIES TO T H E CO M M UNITY Over and above the heavy cost of eye injuries to industry and to the injured workmen themselves is the incalculable, but very large, cost to the community—the counties, cities, states, and the nation—of having in its midst an ever-increasing number of blind and partially blind men and women who, until their sight was impaired or destroyed, were for the most part, efficient industrial workers, self-supporting and usually the chief or sole support of a family. Some notion of the magnitude of this cost may be had from the fact that in 1940 the Federal and state Social Security agencies spent more than $13,000,000 for aid to 48,000 needy blind persons, many of whom lost their sight in occupational pur- EYE HAZARDS 9 suits. At the same time, other relief agencies spent millions more to aid families whose breadwinners were unemployed or whose earning capacity had been greatly reduced in either case because of total or partial blindness resulting from Some occupational eye hazard. Such huge round figures as $200,000,000, representing the Cost of eye injuries, are so far beyond the everyday affairs of most of us they do not present as realistic a picture of the seriousness of the situation as may be had from the smaller, more specific figures of one day's eye injuries. THE EYE INJURIES OF ANY ONE DAY Of the 1,000 workers whose eyes will be injured today, 200 will be so seriously injured as to be entitled to compensation. This compensation and the cost of medical care will average $351 per injury, or a total of $70,200 for the day. In most of these cases the injury will result in some permanent loss of vision; in some— no one can tell how many—today's eye injuries may result in total blindness of one eye or of both eyes. Each case of total loss of vision of one eye resulting from today's injuries will add $1,000 to $5,000 to the compensation costs, depending on the states in which the accidents occur. Each case of total blindness of both eyes which may result from today's accidents will add between $6,000 and $30,000 or more to the day's compensation costs. Then there are the 800 minor, or noncompensable, eye injuries on this one day; these will cost an average of $9.26 each for medical care, or $7,408 for the day. Taking the most optimistic view and assuming that none of to- day's accidents result in total loss of vision of one eye or of both eyes, we are nevertheless confronted with a direct cost (for com- pensation and medical care) of $77,608 to the employers as a result of today's eye injuries. The indirect costs of these injuries are four times as great, and so the total cost to the employers is $378,040. At the same time, if today's eye injuries are typical, the 1,000 workmen will suffer permanent total or permanent partial loss of vision which eventually will cost them and the communi- 1 O EYE HAZARDS ties in which they live a sum equal to the employers' losses. This will bring the grand total of financial loss resulting from today's eye injuries to more than $750,000. T H E PRO FIT MOTIVE IN SAFETY The reader may well wonder about this emphasis on the mone- tary cost of industrial eye injuries. The reason for this emphasis is to be found in a statement by E. R. Granniss, director of the Industrial Engineering Division of the National Conservation Bureau: The most notable advances in the safety movement have been made, not through humanitarian agitation, but by producing factual data to show that accidents involved important expenditures and that it was far cheaper to pay for accident prevention than to have to pay the costs of accidents. Unfortunately, every employer is not yet convinced of the economic advantage of a safety program.” Some progress in the industrial safety movement and in other comparable campaigns can be directly traced to “humanitarian agitation.” Thus, the picture of a blind child and the caption “This Child Need Never Have Been Blind” in the report of a state commission to investigate the condition of the blind so stirred the emotions of Louisa Lee Schuyler that the movement for the prevention of blindness was organized thirty-three years agO. No amount of descriptive or imaginative writing can describe what really happens to the workman who has been blinded by an accident, an occupational disease, or exposure to poisons which gradually or suddenly cut off his power to see. The blind do not like to be pitied or to be spoken of as “the handicapped.” Many men, women, and even children deprived of sight have neverthe- less developed into happy, self-supporting, and efficient citizens. This should not, however, obscure the fact that when suddenly robbed of the faculty of seeing an adult workman, more often than not in the prime of life, is confronted with one of the most * In an address before the convention of the Greater New York Safety Council, New York City, March 27, 1939. EYE HAZARDS 1 1 bitter tragedies possible. There is stark tragedy merely in the in- ability to see loved ones, customary daily surroundings, and all the little or big things which have given particular pleasure. To this there is added in the case of most workmen blinded by Occu- pational hazards the further tragedy of being suddenly deprived of the ability to work and to earn a livelihood for himself and his family. It is true that American states are more liberal than those of any other land in monetary compensation to workmen who have lost all or part of their sight in industry, but even in the most liberal of our states this compensation does not begin to equal the normal earning capacity of the individual prior to the injury to his eyes. We know that the sight conservation program, and in some cases the entire safety program, of particular plants have been in- spired by humanitarian motives. No one familiar with the in- dustrial safety movement will, however, seriously dispute the statement that realization of the high cost of accidents and of the great money savings possible through their prevention has been— and is today—the most effective force for accident prevention and health promotion within industry. The principal difficulty has been that of bringing this realization to busy and often skeptical business executives, more particularly to the plant managers, Superintendents, foremen and other subexecutives to whom they delegate responsibility for plant management. Irrespective of whether the impelling motive has been mone- tary or humanitarian, the fact remains that in the 15-year interval since the publication of the earlier edition of this handbook, great progress has been made by American industry in protecting the eyes of its workers. A DVA N C ES IN E LIMINATION OF EYE HAZARDS First among the many indications that progress has been made in eyesight conservation in industry during the past 15 years is the fact that there are in the industries of America today far fewer amateur “shop oculists”—the kind who use toothpicks, matches, pocket knives, files, screwdrivers, and other infection- | 2 EYE HAZARDS bearing instruments to remove particles from the eyes of injured fellow workers. The tremendous damage done to eyes of indus- trial workers in the past by crude and bungling first-aid can hardly be overemphasized. There are fewer of these amateur “shop oculists” because of the greater appreciation by workmen and by management of the im- portance of avoiding infection even in the most minor eye injury and because there are now far more well-equipped first-aid rooms, with doctors or nurses in charge, in industrial properties than there were fifteen years ago. The American Medical Directory now records 345 physicians who are limiting their work to indus- trial medicine, and 1,000 others who report industrial practice as their special interest. That there is still far to go in this respect is indicated by the fact that the bulk of medical service to men and women injured in in- dustry is rendered by general practitioners, many of whom have little knowledge of conditions in industry which lead to the in- juries or industrial diseases they are called upon to treat. This lack of information about the industrial conditions often handi- Caps the doctor in diagnosing or treating an industrial patient and certainly limits his ability to tell the patient or his employer how best to protect the worker's health on his return to employment. There is great need for bringing to general practitioners of medi- cine throughout the country, particularly in industrial areas, more information about the accident and health hazards of indus- try. This, the National Society for the Prevention of Blindness is endeavoring to do with respect to those accident and disease hazards which affect the eyes. Progress has been made in eliminating accident and disease hazards which affect the eyes by increased use of ventilation, ex- haust systems, and air conditioning. Use of exhaust systems to re- move poisonous gases and dangerous dusts has saved thousands of workmen from daily exposure to working conditions which eventually, and often suddenly, result in seriously impaired vi- sion, if not total blindness. Ventilation, air-conditioning, and ex- haust systems installed for this purpose more than pay for them- EYE HAZAR DS 13 selves through the increased efficiency of the workers they protect, to say nothing of lowered workmen's Compensation costs. Substantial progress has been made in the provision of proper industrial lighting which, like ventilation, has both increased the efficiency of employees and conserved their sight. While it may not be possible to point to particular individuals who have be- come blind through working under poor lighting Conditions, there is substantial evidence of the direct relation between bad lighting and bad eyesight. One striking bit of such evidence is the report of a study made by the United States Public Health Serv- ice of the relation of good lighting to occupational efficiency in two New York City post offices, details of which will be found in Chapter VIII. In the field of ophthalmology great strides have been made in the treatment of eye injuries and diseases. For example: the edi- tion of Eye Hazards in Industrial Occupations which appeared fifteen years ago opened with the statement: “No one has yet pro- duced an artificial eye that can see; nor does anyone dare predict the day will ever come when it will be possible to replace the hu- man eye with an artificial eye that will see.” This is still true, but Something almost as miraculous as an artificial eye that can see has happened during the intervening fifteen years. That something has been mistakenly referred to in newspaper and magazine arti- cles as “the transplanting of human eyes.” Successful transplanta- tion of a whole eye has never been accomplished. What actually has happened has been the transplanting of small segments of eye tissue—an operation which has restored considerable sight to some who had little vision left and has saved others from impending blindness. More than 100 such operations have been performed in one New York hospital, many with good results. Less spectacular, but even more effective, procedures for sav- ing the eyes of workmen after slivers of steel have pierced their eyes have been developed, and treatment of industrial eye injuries of various sorts has been greatly improved in the past decade or tWO. The discovery and the correction of defective vision among em- 14 EYE HAZARDS ployees also have seen great progress in American industry. More plants have pre-employment examinations and follow-up eye ex- aminations; the quality of eye examinations in industry has great- ly improved. Plants once content to have an employment clerk test vision by a chart and end the eye examination there, now recognize the desirability of having an oculist examine the eyes of every worker before he is put on the pay roll and periodically thereafter. Despite all the progress in this direction there is still the need of reminding the managers of many industries that poor vision— whether due to insufficient light or to uncorrected eye defects—is one of the principal causes of fatigue, not of the eyes only, but of the entire body. Frank Gilbreth, one of the earliest authorities on fatigue in industry, said: “No fatigue is more wearing than eye fatigue.” Today the situation in many plants—with respect to both lighting and the visual acuity of workers—indicates that the managers of these plants are still either unaware of this or are un- concerned about it, despite the fact that it costs them very sub- stantial sums. Marked progress has been made in the education of workers and management as to the wearing of goggles. Fifteen years ago few employers were willing even to ask workers such as carpen- ters and painters to wear goggles. Today, in a number of com- panies where almost every trade and craft is represented, every employee, every foreman and superintendent, and every visitor is required to wear and does wear goggles all the time they are in the plant. While there is far more widespread and more consist- ent wearing of goggles than ever before, the progress made in this direction is still merely a beginning. If every industrial plant did require all employees and visitors to wear goggles, millions of dollars now paid as compensation for eye injuries in American industries each year would be saved; scores of workers would be saved from blindness each year; and thousands more would be saved from serious eye injuries which, while not producing blind. ness, leave them with vision in one eye only or with limited vi. sion in both eyes. EYE HAZARDS 15 Great progress has been made in training factory inspectors— both insurance and state government inspectors. Fifteen years ago it was a commonly voiced opinion that the average safety in- spector, whether he worked for a state department or an insur- ance company, could have little influence with management ex- cept through his reporting of safety Code violations, and even that part of his work was done by rote. Today more and more safety inspectors are genuine experts in the detection and the control or elimination of accident and health hazards in industry. The United States Department of Labor has assumed leadership in the training of state safety inspectors, and the insurance Companies have done much to make their inspectors safety engineers rather than mere field clerks or reporters. The importance of all this lies in the fact that in the last analysis the battle for safety is carried on by the safety inspector. In thousands of plants too small or too backward to employ a safety engineer it is the safety inspector— whether he be a state inspector or an insurance inspector—who has the opportunity to put vitality into the safety program or to allow it to lapse into a mere paper program. SO M E RE MAIN IN G. PRO B L E M S Much has been accomplished, but much more remains to be done. At this late date, after 25 years of safety campaigns, there is still to be found in some plants a pair of goggles on a nail beside the grinding wheel for the use of all men who may have occasion to work at the wheel. The tremendous progress that has been made in the design, manufacture, and promotion of goggles and in education as to their use makes the lone pair of dust-accumulat- ing goggles on a nail or in a cigar box over the emery wheel for Common use an inexcusable, obsolete, and wasteful gesture to- ward eye protection. Almost as much can be said for towels used in common, even greater carriers of eye disease than the goggles. The old-fashioned roller towel was long ago legislated out of existence, and general sanitary conditions in most work places have been greatly im- proved. But there still are hundreds of thousands of industrial 16 EYE HAZARDS workers for whom no clean wash rooms and no clean towels are available. So long as such conditions exist, workers are exposed to diseases which may seriously affect their sight—and their em- ployers' Compensation Costs. There is another most important hazard to sight Concerning which it is not clear whether the past fifteen years have seen prog- ress or retrogression. Fifteen years ago the second edition of Eye Hazards in Industrial Occupations listed 22 industrial poi- sons, the use of which presented hazards to the eyes. The present edition lists more than 90 industrial poisons involving hazards to the eyes. Whether this represents progress in the recognition of the dangers involved in the handling of poisons or merely the in- troduction of new poisons injurious to the eyes is not clear; it probably represents both. Of this we can be sure: the growing use of poisonous chemicals in industry presents one of the most serious hazards to the eyes of workers. This hazard is aggravated by the fact that thousands of men and women who are working with these poisons are unaware of that fact, unaware of the disease hazards to which they are ex- posed, and unaware of the steps they should take to guard against the harmful effects of these poisons. This is so because in many plants the poisonous chemical mixtures are trade secrets known to most of the persons who handle them only by some such symbol as “Solution B3” or “Solution C4,” the precise make-up of the Solution being known to only a few persons in the plant. As industry comes to be held responsible for the effects of these poisons through their designation as compensable occupational disease hazards, progressive employers will use every known means to protect the workers exposed to these poisons. Mean- while, it is the responsibility of every safety engineer, of every physician or surgeon having any industrial practice, and of every industrial nurse to become familiar with all the poisonous sub- stances used in their respective plants and to take all possible steps to protect the employees exposed to these poisons. EYE HAZARDS 17 C O N C L U S I O N Conditions observed during the past twenty years in American factories, mines, mills, railroads, and other work places leads inevitably to the conviction that accidents are not inherent in industry, that they are almost 100 percent preventable, that the dividends on investments in accident prevention may be propor- tionately greater than the dividends on the primary business of an industry. There is no need for the blinding of any worker in American industry. The industrial accident and disease hazards affecting the eyes are now commonly known; methods of elimi- nating these hazards or of protecting workers against them have been thoroughly demonstrated; devices which provide protection against almost every type of eye accident are now available. Practically all the financial loss and the human suffering result- ing from the blinding of industrial workers, could be averted by coöperation of employers and employees in the utilization of demonstrated methods of preventing accidents and diseases. Not only would these losses be averted but also the efficiency and the earnings of both employees and employers would be substantially increased if all industry did what is being done successfully in a few plants in America to prevent eye injuries. The obligation to put into effect the methods, devices and prac- tices which experience has demonstrated to be successful in protecting the eyes of workers belongs to many groups. It is an obligation first of all on the owners and managers of industry and on all their executives and sub-executives. It is a responsibility of employees individually and collectively through their labor union and other Organizations concerned with the health and welfare of workers. It is an obligation of government administra- tors—Federal, state, municipal, and county alike. It is an obliga- tion of public and private health and welfare agencies which have any Contact either with industry or with industrial workers. It is most directly the responsibility of safety engineers, safety inspec- tors, industrial physicians, ophthalmologists, general physicians, Surgeons, nurses, and local sight conservation agencies. Chapter II THE PROBLEM OF EYE AC CIDENTS A. Y STUDY of the means of eliminating eye hazards from indus- trial occupations or of counteracting their effect would be helped by knowing when, where, how, why, and to what extent eye injuries occur as a result of these hazards. Relatively little authentic statistical information is to be found on these subjects, and what is available is fragmentary and so little standardized that worth while comparisons are impossible in many instances. While a majority of states have industrial commissions charged with the responsibility of recording at least compensable indus- trial injuries, most of these commissions report they are so handi- capped by lack of funds and staff as to be unable to analyze or publish such statistics while they still have any timeliness. In little more than half a dozen states is it possible to secure statistics of eye injuries according to nature, causes, and costs for recent years. The situation within individual industrial plants is even worse. After 25 years of effort by the various safety organizations, govern- mental departments, and public-health agencies to secure some form of standardization in record keeping, there is still an endless variety of interpretation within individual properties as to what constitutes a serious injury and what constitutes a lost-time injury and as to methods of recording the accidents of the plant. Some of the largest industrial corporations of America do not even analyze injuries by causes within their own properties. Despite the limited and incomplete statistics available, some EYE AC CIDENTS 19 helpful estimates can be made of the number, extent, nature, causes, and cost of industrial eye accidents in the United States. T H E N U M BER OF EY E A C C ID E N T S O C C U RRING ANNUALLY IN THE UNITED STATES Dr. Louis Schwartz, of the United States Public Health Service, estimated in 1932 that 300,000 industrial eye accidents necessitat- ing a layoff from work of one day or more occur each year in the United States. More recent data indicate there has been little change in this respect. The industrial commissions of Indiana, Kentucky, Massachusetts, Minnesota, Ohio, and South Dakota— the only states recording all eye injuries—reported 50,963 eye in- juries in one recent year. These six states are fairly representative with respect to geographic location, urban and rural areas, indus- trial and argicultural distribution, and they represent 16.2 per- cent, or nearly one-sixth of the national population. If we regard the 50,963 eye accidents reported by these six states as 16.2 per- cent of the total number of eye accidents occurring annually, the total for the United States would be 315,000, a figure at slight variance to that arrived at by Dr. Schwartz on an entirely different basis. The closest approach to a statistical picture of the extent of eye injuries in industry, nationally, may be had from the data re- ported to the United States Department of Labor by 23 of the states and summarized in Table 1: It should be noted that some states classify only permanent in- juries, others only compensable cases, still others only those of Certain particular industries or causes, and that there is a variance of five years in the statistics reported by the various states as their most recent analysis of eye injuries. The fact that Ohio reports more accidents than all other states combined does not indicate a proportionately higher accident rate, but merely that Ohio reports all accidents necessitating a layoff of one day or more. Illinois, New York, and Pennsylvania— states having larger populations than Ohio—all report consider- ably fewer accidents than Ohio because only compensable cases 2O EYE AC CIDENTS TABLE I EYE INJURIES REPORTED BY STATE INDUSTRIAL COMMISSIONS Percentage of State Year Cases Reported All Injuries Georgia . . . . . . . . 1933 44" 6.5 Idaho . . . . . . . . . 1936 863.” 1 O.O Indiana . . . . . . . . 1934 1,229 7.0 Illinois . . . . . . . . . 1937 1,064” 2.5 Iowa . . . . . . . . . . 1936 2O3° 5.O Kansas . . . . . . . . . 1937 352" 3-5 Kentucky. . . . . . . . 1936 788 7.0 Maryland . . . . . . . 1937 387" 3.0 Massachusetts . . . . . . 1937 1, 184 3.0 Michigan . . . . . . . . 1933 2,205” 16.7 Minnesota . . . . . . . 1936 2,374 8.7 Missouri . . . . . . . . 1932 1,474" 6.3 New York . . . . . . . 1935 1,618" 2.3 Ohio. . . . . . . . . . 1937 44,876 18.8 Oklahoma . . . . . . . 1934 268” 5.4 Pennsylvania . . . . . . 1936 320° 10.3 Rhode Island . . . . . . 1935 49” 2. 1 South Dakota . . . . . . 1935 5 12 1 1.4 Utah. . . . . . . . . . 1938 19° 5.9 Vermont . . . . . . . . 1936 16* 8.3 Washington . . . . . . 1936 648" 3.4 West Virginia . . . . . . 1936 98" 8.O Wisconsin . . . . . . . 1937 Q92" 4.O " Permanent injuries only. * Compensable injuries only. * Coal-mine and railway train service accidents not included. * Injuries caused by foreign matter in the eye only. are recorded by the commissions of these states. Table 1 indicates, if nothing more, the need for greater uniformity in the recording of accident statistics by the various state industrial commissions. These reports from the industrial commissions of approxi- mately half the states are chiefly valuable for the light they throw on the relation of eye injuries to all injuries. It will be noted that this ratio varies from a low of 2.1 percent, in Rhode Island, to a high of 18.8 percent in Ohio. Michigan, another heavy-industry state, reports that compensable eye injuries constitute 16.7 per- EYE AC CID ENTS * 2 I cent of all compensable injuries. Pennsylvania, reporting only those accidents which result in permanent disability, finds that eye injuries constitute 10.3 percent of all such accidents. These are considerably higher percentages than have been generally assumed to represent the ratio of eye injuries to all injuries. They appear all the more significant in the light of a comparison of TABLE 2 CLASSIFICATION OF 58,387 EYE ACCIDENTS BY INDUSTRY." IN ONE RECENT YEAR Industry Agriculture . . . . . Automobile manufac- turing, repairing, and garaging . Building and general Construction Clerical and profes- sional Service . Food products manu- facturing . . . . . Metal and metal prod- ucts manufacturing Lumber and wood products manufac- turing * - - Mining and quarrying Paper manufacturing Public utilities Smelting and refining; oil and gas products Stone, clay, and glass manufacturing Textiles, leather, and laundry Trade and finance . Transportation All Others Total Illinois | 1 490 } Kan- Michi- sas gan 203 I 2 188 I 2 () 6 7 41 320 40 | 3 | 2.005 Mis- souri 2O 38 I 30 r: 7 396 34 68 90 390 1.4 1-1 Ohio 7o 1.0 l 1 i : : s2. 2 5 2 3 6 1 Tennes- S62(? 39 83 Utah Total I 1 1.4 2 3 () Q 2 3 5 ... I 8 7 I 1,724 9 1,800 91 O 1,987 784 3,232 2,650 4,339 18 58,387 " From data reported to the Bureau of Labor Statistics, United States Depart- ment of Labor, by the various state industrial commissions. 22 EYE AC CIDENTS the medical and compensation costs of eye injuries with the costs of all injuries, which is presented later in this chapter. WHERE DO EYE ACCIDENTS OCCURP Analysis of 58,387 eye accidents occurring during one recent year in the seven states that reported accidents by industry— Illinois, Kansas, Michigan, Missouri, Ohio, Tennessee, and Utah (see Table 2) shows that 35,187, or 60 percent, occur in metal and metal-products manufacturing industries. In six of these seven states metal and metal-products manufacturing was responsible for the largest number of eye accidents. Building and general- construction industries were responsible for the largest number of eye accidents in one state and the second largest number in four states. Lumber and wood-products manufacturing, mining, and quarrying also accounted for large numbers of eye accidents. Such supposedly nonhazardous occupations as clerical and pro- fessional service accounted for 273 eye injuries in one year in these seven states, while trade and finance, also among pursuits considered nonhazardous, at least so far as eye injuries are Con- cerned, are credited with 3,232 such injuries in one year in these SeVen StateS. Further light on where eye injuries occur and on their relation to all injuries is cast by an analysis of eye accidents in seventeen industrial plants in and near Newark, N.J., made by Dr. Elbert S. Sherman, Surgeon of the Newark Eye and Ear Infirmary. The chart which follows represents the accident experience of these Seventeen plants during 1934–1936. The extraordinarily high ratio of eye accidents to all accidents shown in Table 3 undoubtedly reflects the wisdom of regarding any eye injury, no matter how slight, as serious enough to warrant the attention of a doctor. As is to be expected, the three highest ratios of eye injuries to all injuries—52.3 percent, 42.8 percent, and 42 percent—represent machine shops and machine-tool plants. In fact, all those plants having abnormally high percentages of eye accidents, with two exceptions, were in the metal and metal- products manufacturing industries. The two exceptions were a EYE AC CIDENTS 23 TABLE 3 RATIO OF EYE ACCIDENTS TO ALL ACCIDENTS IN SEVENTEEN PLANTS IN THE NEWARK, (N.J.) INDUSTRIAL AREA Kind of Industry Tank manufacturing . Machine tools . Rolling mill . Foundry º Textile printing . Bakery . Plastic molding Woodworking . Machine shop opera- tions . . . . Machine shop and boiler works . Machine shop opera- tions . º Machine shop . Metal goods . Metal goods . Machine shop . Printing . . . Radio manufacturing Totals Number of Employees 2OO 300 I OO 2OO 2OO 50 125 400 3,000 700 300 I OO 25 2O 1 O 25 4O Number of Years 2 2% 2% 2 2% 2% 2 2 : 2 1% 1% 2% Total Accidents 163 248 48 145 2 I I 252 166 45 14 14 7 8 19 3,215 Eye Accidents 38 IO5 6 44 12 2 6 16 864 : 1, 2 1 O Percentage of Eye Accidents as Related to Total Accidents 23.3 42.O 12.5 30.3 5.6 3.4 13.3 13.2 52.3 21.8 26.0 2O.O 28.5 14.2 42.8 O 5.2 37.6 plastic molding plant (13.3 percent) and a woodworking plant (13.2 percent). It is significant that size of plant apparently does not influence the ratio of eye accidents to all accidents. Of the three plants having the highest percentages of eye injuries, one employed 10 men, one employed 300 men, and one employed 3,000 men. Neither Table 2 nor Table 3, however, can be re- garded as an accurate representation on a national basis of the ratio of eye injuries to all injuries in different industries; both tables are heavily weighted by the preponderance of certain in- dustries in particular states. In Table 2, for example, Michigan 24 EYE ACC IDENTS is shown to have more eye accidents in the automotive industries than do the six other states combined. This is so simply because these industries are centered in Michigan. Pennsylvania has a disproportionately large number of eye injuries in mining and metals industries because of the preponderance of steel and min- ing operations in that state. While no accurate statement can be made as to the ratio of eye injuries to all injuries in spe- cific industries for the country as a whole, it is evident that the most hazardous industries, so far as eyes are Concerned, are metal and metal-products manufacturing, mining and quarrying, building and general construction, lumber and wood-products manufacturing. Just what specific operations make these industries so hazard- ous to the eyes? The answer can be found in part in the tabulation of 3,571 eye accidents which occurred during one recent year in Minnesota and Illinois (see Table 4). More than 50 percent of these accidents were caused by flying particles set in motion by hand tools, machinery, and various unclassified sources. The next most common causes were abrasive wheels, corrosive substances, electric flashes, and molten metal. It is significant that all these— the most hazardous operations—are to be found in metal and metal-products manufacturing—the most hazardous industry. Fly- ing particles—chips of steel, iron, brass, and copper—set in motion by chisels, pneumatic hammers, mechanical drills, hand files, and the like cause more than one out of every two eye accidents in industry. From the Drop Forging Association, an individual trade asso- ciation, comes confirmation of the fact that a large number of eye injuries occur in that branch of the metal-working industry and that these injuries are caused principally by flying particles. The Drop Forging Association, analyzing the accident experi- ence of 47 of its member plants during 1940, reports a total of 2,234 lost-time and minor accidents, of which 746, or 33 percent, were eye accidents. Of these 746 eye accidents, 696, or 93 percent, were caused by chips, scales, dust or dirt, and only 7 percent by all other causes combined. EYE AC CIDENTS 25 TABLE 4 ANALYSIS OF 3,571 EYE ACCIDENTS OCCURRING IN MINNESOTA AND ILLINOIS IN ONE RECENT YEAR" NUMBER OF CASES CAUSE OF ACCIDENT Illinois Minnesota Total Flying particles (not classified) . . . . . 163 1,267 1,43O Flying particles set in motion by hand tools . . . . . . . . . . . . . 185 789 974 Abrasive wheels . . . . . . . . . . . 17 239 256 Corrosive substances . . . . . . . . . 30 88 1 18 Molten metal . . . . . . . . . . . . Not reported 36 36 Acids . . . . . . . . . . . . . . . . 13 35 48 Electric flash, including welding . . . . Not reported 51 51 Flying particles set in motion by machinery. . . . . . . . . . . . . Not reported 47 47 Stripping of hand tools . . . . . . . . 4 22 26 Hot Substances . . . . . . . . . . . 25 26 5 I Falling objects . . . . . . . . . . . . 28 18 46 Flames . . . . . . . . . . . . . . . 1 1 9 2O Striking against objects . . . . . . . . 19 17 36 Handling sharp objects . . . . . . . . 16 8 24 Falls of persons . . . . . . . . . . . 7 4 H 1 Blasting and explosions . . . . . . . . 13 6 19 Lime and cement . . . . . . . . . . 25 24 49 All others . . . . . . . . . . . . . . 268 56 324 Grand total . . . . . . . . . . . 824 2,742 3,566 * Based on data provided by the industrial commissions of Illinois and Minnesota. ACC ID E N T CAUSE S — A NALYS IS The classification of eye-accident causes used by the industrial commissions of Illinois and Minnesota is, with minor variations, the commonly accepted classification of eye-accident causes. These are, however, merely the immediate or surface causes, not the un- derlying or fundamental causes. Flying particles, abrasive wheels, Corrosive substances are not the real causes of accidents; they are the agents or the means by which accidents occur. More often the true cause of an accident and of the resultant eye injury is faulty instruction by a foreman or disobedience of rules by an employee 26 EYE AC CIDENTS leading in turn to such unsafe practices as exposure to flying par- ticles, improper installation or use of an abrasive wheel, and so forth. Chart I and the accompanying explanatory notes offer a picture of the fundamental causes of accidents as seen by H. W. Heinrich, of the Travelers Insurance Company, after studying detailed records of many thousands of accidents. Mr. Heinrich discusses at length what he describes as “true cause-analysis of accidents.” This analysis of the true causes of industrial accidents is based on a study of detailed reports of accidents occurring over a period of 17 years. Chart I is reproduced through the Courtesy of the McGraw-Hill Book Company, Inc., publishers of Indus- trial Accident Prevention, by H. W. Heinrich, Assistant Super- intendent of the Engineering and Inspection Division of the Travelers Insurance Company, and originator of the chart. Explaining his industrial-accident-cause analysis chart, Mr. Heinrich says:" 1. Both supervisory and physical causes may be controlled by the employer. It is apparent that in the last analysis the employee also may avoid accidents, even though he is exposed to unsafe conditions. 2. Accidents due to mechanical or physical exposures should be assigned to causes in the supervisory group, where the foreman had authority to install or maintain guards. In such cases the chief cause is laxity in supervision. This line of reasoning produced the total of 10 percent shown in the “physical” group. As ordinarily analyzed, the physical total is 25 percent. 3. The value of analysis by the causes listed in the chart, as com- pared to the existing method of allocation as slips and falls, eye in- juries, and others, is apparent. It permits concentration upon the things that count. It directs attention to supervisory responsibility or to physical hazards, both of which are controllable. 4. Supervisory item 2, refers to chronic poor judgment, ignorance, and lack of skill, since temporary inability in these respects sometimes applies to properly qualified employees and would therefore be more likely to Come under items 3, 4, or 5. 5. Terms such as “carelessness,” “poor supervision,” and “improper Selection of employees,” have deliberately been omitted because of ambiguity. * Heinrich, Industrial Accident Prevention, p. 47. ſ"r r A r + T V-4 T1A A TV. J. L. 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