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probably be desirable to keep the relative humidity between 60° and 70°.

Another point which may be emphasized in the light of current opinion is the importance of "perflation," or the flushing out of a room at intervals, with vigorous drafts of fresh cool air. Where there are no air currents the hot, moist, vitiated air from the body clings round us like an "aerial blanket," as Prof. Sedgwick calls it, and each of us is surrounded by a zone of concentrated discomfort. The delightful sensation of walking or riding against a wind is perhaps largely due to the dispersion of this foul envelope, and it is important that a fresh blast of air should sometimes blow over the body in order to produce a similar effect. The same process will scatter the odors which have been noted as unpleasant and to some persons potentially injurious. The principal value of the carbon-dioxide test to-day lies in the fact that under ordinary conditions high carbon dioxide indicates that there are no air currents changing the atmosphere about the bodies of the occupants.

There is one other problem of atmospheric pollution to which special reference should be made. The presence of noxious fumes, and still more the presence of fine inorganic or organic dust, in the air constitutes a grave menace to health in many processes and is an important contributory cause of tuberculosis. The normal body has its "fighting edge" and can protect itself against the tubercle bacillus if given a fair chance; but the lung tissue, which is lacerated by sharp particles of granite or steel quickly succumbs to the bacterial invader. In dusty trades, like stone cutting and cutlery working and emery grinding, 75 per cent of all deaths among the operatives are often due to tuberculosis, against 25 per cent for the normal adult population. This may be fairly interpreted as meaning that the actual death rate from tuberculosis in these trades is from two to four times as high as in a corresponding average population. In other words, three or four or five out of a thousand of these workers are sacrificed every year to the conditions under which they labor. The elimination of the dust-by special hoods and fans is imperative in such industries and must be supplemented in extreme cases by the compulsory use of respirators.

It is extraordinary how little is known to-day of the actual conditions of factory air, either by manufacturers or by sanitarians. So far as I am aware the New York department of labor is the only State department dealing with factory inspection which collects and publishes exact data in regard to the quality of the atmosphere in the workshops. If the conditions indicated in these reports by Dr. C. T. Graham Rogers are typical, and there is no reason to doubt that they are, for the smaller industries at least, there is urgent need for betterment. The table below shows that of 215 workrooms inspected 156, or 73 per cent, had a temperature of over 72° and 63,

or 29 per cent, exceeded 79°. Relative humidity exceeded 70 per cent in 39, or 18 per cent of the workrooms. In tabulating these analyses I have excluded all cases where the outdoor temperature was over 70°.

Temperature and humidity in New York factories.

[Reports of the Commissioner of Labor for 1908, 1909, and 1910.]

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In the report on the sanitary condition of factories and workshops, made by the Massachusetts State Board of Health in 1907, is the following comment upon the boot and shoe industry:

In the majority of factories visited the ventilation was found to be poor, and in many of them distinctly bad. Of the rooms not especially dusty, 102 were badly ventilated and 26 were overcrowded. In the rooms in which large amounts of dusts are evolved, the number of machines with means for efficient or fairly efficient removal of dust was found to be 1,630; the number either inefficiently equipped or devoid of equipment was 2,769.

Of 84 of the many dusty rooms reported, 40 were also overcrowded, 35 were dark, 21 were overheated, and 18 were overcrowded, dark, and overheated. In more than one-third of the factories visited, the conditions of water-closets were not commendable; most of them were dark and dirty to very dirty.

There is plenty of evidence, though of a scattered and ill-digested sort, that the elimination of such conditions as these brings a direct return in increased efficiency of production. The classic case of the United States Pension Bureau is always quoted in this connection. The removal of the offices of the department from scattered and poorly ventilated buildings to new and well-ventilated quarters reduced the number of days of absence due to illness from 18,736, in the neighborhood of which figure it had been for several successive years, to 10,114.

In an investigation of my own of conditions in the operating room of the New England Telephone & Telegraph Co., at Cambridge, Mass., I found that before the installation of a ventilating system, 4.9 per cent of the force (50 to 60 girls) were absent during the winter months of 1906 and 4.5 per cent in 1907. The ventilating duct which was put in was a simple one and cost only $75 to install,

but in the winter of 1908 following its introduction the absences were cut down to 1.9 per cent of the force employed, without any other change in conditions or personnel so far as I was able to discover.

The vice president of the Manhattan Trust Co. of New York states that by proper ventilation he has so increased the efficiency of his clerical force that he has been able to reduce the number of employees 4 per cent.

In the printing establishment of Mr. C. J. O'Brien, in New York, a ventilating system was installed because of the insistence of the State department of labor that the law be complied with, the order having been resisted for two years. After the system had been in use a year, the proprietor stated that had he known in advance of the results to be obtained no order would have been necessary to have brought about the installation. Whereas formerly the men had left work on busy days in an exhausted condition and sickness was common, now the men left work on all days in an entirely different condition, and sickness had been very much reduced. The errors of typesetting and time required for making corrections were greatly reduced.

It is much to be desired that this problem should be studied by careful quantitative methods as a definite factor in the profit and loss account. The National Electric Lamp Association is approaching the question of sanitary conditions in this manner, comparing in detail the temperature and humidity of its workrooms with the hours of work, the pay and the efficiency of its employees. Only by such systematic study can it be determined how much factory sanitation is really worth in any given case. The evidence is already strong enough, however, to warrant some investigation. In cases where preliminary study shows its value, why should not the sanitary inspection of a factory be made a part of its routine operation just as supervision of its mechanical features is a part of its organization to-day? It is not solely or chiefly the problems of ventilation as ordinarily understood that should be studied; and it must be remembered that there is never anything magical in a "ventilating system." "Systems" are as dangerous in sanitation as quackery in medicine. The problem must be approached from a broad biological viewpoint, and should include all the conditions which make for lowered vitality. Temperature and humidity come first and foremost and dust and fumes must be guarded against in certain processes. The cleanliness of the factory, the purity of drinking water, the quality of lighting, the sanitary provisions, and a dozen other points will suggest themselves to the skilled investigator when on the ground. He may find in many of these directions economic methods by which efficiency can be promoted.

The consulting factory sanitarian will be a new factor in industry, but the progress of industrial economy and of sanitary science unite in pointing to the need for such an expert.

THE PHYSIOLOGICAL INFLUENCE OF OZONE.1

By LEONARD HILL, F.R.S., and MARTIN FLACK.

(From the laboratory of the London Hospital Medical College.)

Ozone has been extolled as the active health-giving agent in mountain and sea air, its virtues have been vaunted as a therapeutic agent, until these have, by mere reiteration, become part and parcel of common belief; and yet exact physiological evidence in favor of its good effects has been hitherto almost entirely wanting. Ozone has been found occasionally in traces in the atmosphere, it has been proved to have active oxidizing properties, and on these facts the superstructure of its therapy has been reared.

Popular attention has been fixed on the mysterious and the unknown, and has neglected the prepotent power of cold wind and sunlight to influence the nervous health and metabolism of man. The only thoroughly well-ascertained knowledge concerning the physiological effect of ozone so far attained is that it causes irritation and edema of the lungs, and death if inhaled in relatively strong concentration for any time, e. g., 0.05 per cent, death in two hours (Schwarzenbach); 1 per cent in one hour (Barlow).

A. Loewy and N. Zuntz write that "the physiological foundations of an ozone-therapy can scarcely be discussed, so little is the extent of our exact knowledge on this subject." The old idea that ozone passing into the blood acts as an oxidizing agent there, thus destroying organized and unorganized poisons, was exploded by Pflüger who pointed out that ozone is immediately destroyed on contact with blood; even if it were not, there is no reason why it should oxidize toxins rather than normal constituents of the blood.

3

C. Binz observed that "animals submitted to ozone became quiet and appeared to sleep." W. Sigmund also noted this effect in white mice, gold fish, and insects. He considered that ozone is not a very dangerous substance, for even small animals could bear for a time a relatively large amount without serious effect; warm-blooded animals were the more sensitive.

1 Reprinted by permission from the Proceedings of the Royal Society, London, B. vol. 84, 1911, pp. 404–415. Received by the Society July 6; read Dec. 7, 1911.

2 Handbuch der Sauerstofftherapie, Michaelis, Berlin, 1906, p. 61

3 Pflüger's Archiv, vol. 10, p. 251.

4 Berl. Klin. Wochensch., 1882, Nos. 1, 2, 43.

Cent. f. Bakter. (ii), 1905, vol. 14, p. 635.

Filipow1 found weak concentrations had no effect on men or animals, while a higher concentration of ozone caused irritation of the respiratory tract.

Schultz confirmed this irritative effect, and found long-continued breathing of ozone caused pathological changes, particularly in the lungs, which were the cause of death. Schultz considered that the ozone passed into the blood and injured the lung secondarily. Bohr and Maar overthrew this supposition by the ingenious experiment they devised of making one lung breathe ozonized air and the other normal air. They found this lung remained normal while the ozonized lung became œdematous.

Using a concentration of ozone which produced no visible change in the pulmonary structure, these observers found that it caused a diminished uptake of oxygen; the other lung compensated for the deficiency by an increased uptake. This occurred in both coldblooded (tortoise) and warm-blooded animals. In the former the initial effect of ozone was occasionally a slightly increased oxygen uptake. If the inhalation of ozone were continuous the increased uptake by the lung ventilated with normal air finally fell away and became deficient; this occurred sooner in the mammal than in the tortoise.

The CO, output was also diminished, but not so markedly as the oxygen uptake, thus the respiratory quotients often rose over 1. The effect of ozone on the respiratory exchange came on gradually, and with weak concentrations often reached its height after the cessation of the ozone inhalation-there was, in fact, an after-effect which took some little time to pass off. The effect was not modified by a preliminary division of the vagi and pulmonary sympathetic nerves.

The blood of the ozonized animal had no toxic effect when transfused into another. Bohr concluded that the effect was primarily on the lungs, and as the oxygen uptake was affected more than the CO, output, he claimed that his results supported his view that the pulmonary epithelium by its secretory activity controlled the passage of the respiratory gases. Butte and Peyron likewise record that ozone when inhaled diminishes the metabolism.

One of the obstacles in the way of investigation has been the difficulty of obtaining pure ozone free from oxides of nitrogen, and another has been the want of an accurate method of estimating the concentration of ozone. There has been devised lately an ingenious apparatus for producing ozone, which eliminates the production of the oxides of nitrogen, and allows the ready use of ozone for bleaching, sterilizing water or ventilating purposes. The ozone is generated by

1 Arch. f. d. Ges. Physiol., vol. 34, p. 335.

2 Arch. f. exper. Path., 1882, vol. 29, p. 364.

Skand. Arch. f. Physiol., 1904, vol. 16, p. 41.

Comp. Rend. Soc. Biol., vol. 46; Progrès Médical, 1894, No. 30, p. 61.

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