Sommerfeld proposes to limit notification to poisoning sharply defined as to the symptoms set up, such as lead, phosphorus, mercury, arsenic, chromium, carbonic oxide, aniline, benzene, nitrobenzene, carbon bisulphide, and nitrous fumes. This simplifies the obligation to notify, but does not dissipate the fears expressed above as to the difficulty, because in the present development of the chemical industries new substances involving new danger to the persons handling them are constantly being discovered, and thus there can be no finality as to which industrial poisonings should entitle to compensation. And if recourse were had from time to time to additions of new substances to the schedule, reliance would have to be placed on experience with regard to each substance added, and thus the actual individual who had suffered would not benefit. Fischer, indeed, acknowledges that any schedule must be incomplete, and emphasises the fact that continual additions would be necessary; otherwise it would be better to refrain altogether from publication of a list. Such lists may be valuable guides, but no sure foundation for insurance legislation. The only possible way to do this is to give as far as possible a correct definition of the industrial diseases entitling to compensation and, in isolated cases, to leave the decision to the expert opinion of competent judges.
Extension of workmen’s insurance to cover chronic industrial poisoning is, however, most desirable in the interest of employers and employed, and also of science. The German accident insurance legislation is especially suited to do this, since the trade organisations direct their attention not only to the prevention of accidents but of industrial diseases also.
III
SPECIAL PREVENTIVE MEASURES FOR WORKERS
SELECTION, CHOICE OF TRADE, ALTERNATION OF EMPLOYMENT, MEDICAL CONTROL, SAFETY APPLIANCES, INSTRUCTION AND CO-OPERATION OF WORKERS, CLOTHING, ATTENTION TO CLEANLINESS, FOOD, GENERAL WELFARE
As a practical measure in protection against trade risk selection of those capable of resisting danger has to be considered. It is obviously desirable to select for employment in a dangerous trade persons possessing powers of resistance, because predisposition and resistance to the action of poisons differ markedly in individuals. To some extent such a selection comes of itself, as those who are very susceptible are obliged by repeated attacks to give up the work. The social and physical misery, undeserved loss of employment, illness, and perhaps early death following on this kind of selection might be checked by timely medical examination so as to weed out the unfit. But medical examination prior to admission into a dangerous trade (actually practised in many industries involving risk of poisoning) inflicts hardship on those seeking employment, and recruits the ranks of the unwillingly unemployed. It would be much better were it possible to meet the need of selection by pertinent direction and guidance in choice of calling. There should be insistence in technical schools especially on the dangers inherent in certain industries, school medical examination as to physical qualifications for certain industries, and careful note made of individual suitability in labour bureaus, apprentice agencies, and the like.
Young female workers, naturally less able to resist, should be excluded from work involving risk of poisoning—a principle which has been acted on in the legislation of civilised countries.
Further, workers engaged in industries involving risk should not be exposed to the pernicious influence for too long a time. Hence the hours of employment should be shortened in occupations proved to be injurious to health. An important aid in this respect is alternation of employment. Change of occupation is particularly recommended where the nature of the poisoning of which there is risk is cumulative in action, because in the intervals from the work the system will rid itself of the accumulated store. In this way a number of skilled resistant workers, familiar with the risk and knowing how to meet it, will be maintained. Casual labour works in a vicious circle—increase of fresh workers increases the danger and the number of cases of poisoning, and, vice versa, these augment again the need of change in the personnel, so that the number of cases of poisoning rises very high. Thus the industry itself may be endangered, since its prosperity depends mainly upon the existence of a skilled staff of workers. In dangerous trades, therefore, Hermann Weber’s words, ‘Change of work instead of change of workers,’ have much force.
Periodical medical examination in these industries cannot well be omitted in order to weed out the physically unfit, and to suspend from work those who show early symptoms. Note should be kept of the state of health of the workers, the results of the periodical medical examination, the duration of symptoms, and the treatment of any illness that occurs. Medical supervision presupposes special training and experience in the medical man entrusted with the task.
Further, in some industries in which poisonous materials are used, especially such as set up acute sudden poisoning, there should be a trained staff competent to recognise the first symptoms of poisoning and to render first aid, and having at its disposal adequate means of rescue.