Bureau of Labor Statistics, U.S. Department of Labor

INDUSTRIAL HYGIENESource: Monthly Labor Review, Vol. 11, No. 1 (JULY, 1920), pp. 160-164Published by: Bureau of Labor Statistics, U.S. Department of LaborStable URL: http://www.jstor.org/stable/41825592 .

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INDUSTRIAL HYGIENE.

The Importance of Eyestrain in Relation to

Industry.

THAT from a eyestrain very large

as proportion a result

that of the the of

condition

civilized conditions

people under related

are which to

sufferers

various they from eyestrain as a result of the conditions under which they

live and do their work; that the condition as related to various occupations has not received the attention which it deserves; and that the prevention of eyestrain is chiefly dependent upon properly fitted spectacles, position of work both in relation to the vision of the worker and to the posture of his body, and suitable lighting are brought out by Dr. George M. Gould in an article on ' 'Eyestrain in its relation to occupations/' in the January, 1920, issue of the American Journal for Physiological Optics, published at South- bridge, Mass. (Vol. 1, No. 1.)

Eyestrain, Dr. Gould explains, should not be understood - as is often wrongly the case - as the overuse of a pair of optically perfect eyes, but "that use of ametropic eyes which is pathogenic, or pro- ductive of local or systemic derangements." Practically no human eyes are optically perfect; that is, perfectly adapted to the purposes which under present conditions they are expected to serve. The startling truth comes to better recognition when we realize that in the past

the entire complicated mechanism of vision was made and used almost solely for distant vision, while for the majority of its expert and educated workers, modern civilization chiefly and increasingly demands constant and accurate vision at near range. For this the mechanism does not exist, and the attempt to compel the function brings disease.

Much of the ordinary work done under ordinary conditions by civilized people to-day involves placing upon the eyes a severe tax from which result, first, local inflammation and morbidities of the lids, conjunctiva, etc., and later, retinal congestions, myopia, iritis, cataract, and so on.

Worse even than these are the systemic ocular reflexes, the morbid overflows and reactions of the cerebral telegraphic switchboard. There is a long list of these cerebral and mental diseases, the vast majority not caused by organic disease of the brain, and due solely to the morbid reflexes of eyestrain - " nervousness," tics, choreas, neurasthenias, epilepsies, and especially the interminable list of headaches and migraines - with or without giddiness, swoonings or faintings; exhaustion and morbid psychic effects; diseases of memory such as losses of self-knowledge and subsequent findings of self far away, with sudden coming back of memory; so called Meniere's disease; the functional stomachal and digestional diseases witn persistent vomiting, anemia, dénutrition, etc. Lastly, to swell and complicate the horror, between 80 and 90 per cent of the school-educated have lateral spinal curvature, which is largely of ocular origin.

All of these morbid conditions are preventable, according to the author, by the use of two simple devices, scientific spectacle lenses, and proper posture of the head and body, especially during writing, study, and such occupations. Various vocations ana occupations are

160 [160]

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INDUSTRIAL HYGIENE. 161

arranged in five groups in the order of their eyestrain reflexes and diseases, based upon the author's personal experiences, reading, etc. Group 1, which he estimates contains 40 per cent of the population, of whom 1 to 20 per cent are believed to have ocular or eyestrain disease, includes most of those engaged in occupations which were dominant before the invention of printing, such as agricultural workers, soldiers, fishermen, hunters, trappers, lumbermen, etc. Group 5, estimated to represent 20 per cent of the population, of whom 80 to 100 per cent are believed to have ocular or eyestrain diseases, is almost solely made up of the most differentiated or specialized callings of the latest civilization required by learning, litérature, printing, sewing, telephoning, and their ancillary crafts. In the three intermediate groups are classed the remaining 40 per cent of the population whose callings expose them to various degrees of ocular disorder and eyestrain.

Among important considerations governing the arrangement of these groups were the following: (1) The nearer the object habitually observed the greater the eyestrain. (2) The more constant this near focalization the more severe the eyestrain. (3) With decrease of illumination below a high physiological standard there is a geo- metrical increase of eyestrain. (4) The exposure of the eyes, during labor, to wind, cold, heat, dust, excessive illumination, etc., heightens their liability to inflammatory diseases and also to eyestrain and its systemic reflexes. (5) In near work, such as reading, writing, etc., any habitual abnormal position of the head or of the body may add enormously to the ocular injuries and eyestrain. (6) Ťhe age of the workman may govern the degree of eyestrain, everyone needing spectacles, especially for close work, after 43. (7) The synchronous cooperation of the two eyes is also an important factor. (8) Prob- ably 6 per cent of children are naturally left-handed, caused by left- eyedness. (9) A peculiar axis of astigmatism, or the writing pos- ture, may so tilt tne head and body to one side as to set up lateral spinal curvature.

Attention is devoted to the subject of albinism, the tragedy ol which, the author says, "is solely ocular and due to nonpigmentation of the irises"; to a study of eyestrain in telephone operators; and to miner's nystagmus. Concerning the latter the author disagrees with the theory that attributes the nystagmus of the "holing" coal miner to the position of the body and head and to the miner's looking upward, and states his belief that the real cause of the miner's nystagmus is "the extremely pathologic illumination of the retina by the object gazed at. The bare flame of the wretched lamp is often in front of the eyes. There is also quick, tense closing of the lids to avoid corneal injuries by the darting bits of coal; this increases astigmatism, amblyopia, and eyestrain generally. The change to machine holing will end miner's nystagmus."

The article concludes with a consideration of the lighting in factories, workrooms, schools, etc., about which surprisingly little is actually understood. Dr. Gould says: It is, in truth, most strange that the science of illumination as related to ocular

physiology and pathology has scarcely been thought of. We are in a state of utter barbarism' concerning it. With all the writing upon occupational diseases plainly due to understimulation, overstimulation, and morbific stimulation of the eyes by light, the essential and basic principles and sciences of photology and photometry

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162 MONTHLY LABOE REVIEW.

have not even been asked for. The tragedies of the albinos, of the nystagmics, of the glass blowers, and other cataractous patients, of welders and workers with electricity, of millions of school children in dark schoolrooms, of the snow-blinded - these show that a new world of truth as to the proper light stimulus for the eyes remains to be dis- covered and systematized for humanity's benefit. The use, the nonuse, and the misuse, the world over, of burnooses, hoods, turbans, head wrappings, shades, parasols, fans, hats, caps, etc., are crude attempts to shade the eyes from hurtful illumination. The whole problem of the tropical diseases of the Caucasian, and of occidental control of tropical civilizations and barbarisms, is not one of heat but of illumination, coupled, of course, with eyestrain and the secondary reactions of the organism against light in the pigmentations of the skin, irises, and retinas.

Industrial Unrest a Problem for the Psychiatrist.

"fT^HE modern specialist in unrest - Place of the psychiatrist in I industry" - is the title of an article by Dr. E.E. Southard in

Industrial Management (Chicago) for June, 1920 (pp. 462-466). It forms the third of a series of papers by the author on " Mental hy- giene in industry," resulting from studies supported by the Engineer- ing Foundation, and was read at the fortieth anniversary of the Boston Society of Psychiatry and Neurology, January 15, 1920.

The paper was addressed to psychiatrists with the purpose of awakening their interest in what the author called "the new field of social psychiatry - a field wherein the problems of the probate court and the problems of the consulting office are amplified and developed by a hundred ramifications in the social web." This new field embraces not only psychiatry strictly speaking, as encountered in industry, but the wider application of psychiatry to industry which the author prefers to call the " mental hygiene of industry." Industry, according to the article, is the most immediate problem before the mental hygienist to-day, above all that phase of the situation commonly referred to as "industrial unrest."

For the study and relief of this problem there is urgent need of what the author describes as "a mental hygiene working party," the function of each part of which is clearly outlined and the intelli- gent cooperation of all members of which is needed in order to secure the best results. The members of such a working party are the psychologist, the psychiatrist, the psychiatric social worker, and a fourth person skilled in tabulation and statistics. Such a working party is not intended to supplant the employment or personnel manager or any other major or minor executive in an mdus trial

Slant, eing the that

idea of "an

designed investigation

to be conveyed occasional

by the rather

term "working than permanent,

party" eing that of "an investigation occasional rather than permanent,

carried out by special officers having the weight of certain connections outside of the industrial plants themselves."

The psychological examiner, it is supposed, will become a relatively permanent part of the organization of an industrial plant, his value at present being chiefly in the interpretation of the discharge rate or turnover in the plant, but probably extending gradually to advice upon the problem of promotion upon lines of vocational psychology. The consulting psychiatrist should be in complete touch with the psychological examiner. He should have at his disposal all records

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INDUSTRIAL HYGIENE. 163

of mental testings or other recorded impressions, on the one hand, and on the other the records of the social worker, particularly those made in connection with discharged employees. The psychiatric social worker will probably be a permanent element in the plant, although her work may be chiefly done outside in the community, and especially in the families of those employees who become industrially disabled or discharged.

It is particularly in the grievances that come to the attention of the employment manager that the psychiatrist will find his work laid out. The following entries will readily suggest to the psychia- trist what sort of investigation ought to be carried out, especially with the aid of the psychiatric social worker:

Certain causes of removal from pay roll: Certain causes of removal from pay roll - Did not like supervision. Concluded. Refused to be transferred. Dishonesty. Resented criticisms. Drinking. Did not like working conditions. Fighting. Work too hard. Indifference. Agitator. Insubordination. Carelessness. Too slow.

There is also a paragraph called " Superintendent's private file" among the " unsatisfactory" groups of removals that might well be looked into by the consulting psychiatrists. Where do all these grudge bearers, agitators, drinkers, fighters, and lazy persons go? Some of them figure in the discharge files and turnover analyses of not distant plants within a comparatively short time. We may talk of the solution of such problems as a duty of the community; but it should not be long before industrial plants themselves recognize the efficiency and welfare virtues of attending as strictly to their human outgo as to their human intake.

The author's main thesis is that the psychiatrist has a place in industry -

" a place in the routine of industrial management, not as a permanent staff member (save in the instances of very large firms and business systems) but as a consultant at stated periods relative to the matter of grievances, complaints, and dissatisfactions, actual and potential.

" This consultant would serve in a preventive, rather than in a curative, capacity.

It is found that unrest is a matter of both group and individual psychology. It is with the latter phase of the subject that the psychiatrist is properly concerned. In company with the psychia- tric social worker, the modern psychiatrist more or less definitely supervises many so-called psychopathic personalities, who do not require commitment to an institution but will benefit from com- munity supervision.

The opportunity of psychiatrists to be of service to industry lies in the fact that most of their patients have either come out of in- dustry or will return to industry in some capacity. "Special inves- tigations of the individual patients with respect to their industrial status and future should be made. The information which the psychiatrist possesses concerning personality, temperament, and special abilities, as modified by mild mental disease and defects, should be at the call of the employment manager." Cooperation

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164 MONTHLY LABOR REVIEW.

between psychiatric social workers of the State institutions and those from industrial plants will greatly facilitate the placing of particular discharged workmen. The author declares that experience has shown that psychopathic persons can be fitted into industry far more successfully than is ordinarily believed, and that the success of psychopathic hospital clinics for employment managers in the sum- mer of 1919 fully proved the value of spreading these practical doctrines of mental hygiene among industrialists.

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