Chapter X · DUST-PRODUCING OCCUPATIONS

That the constant inhalation of dust as a necessary condition of daily labour results sooner or later in the appearance of grave and characteristic lesions which lead to premature breakdown and death among the workers, is matter of common medical experience. Through the instrumentality of the Factory Department the conditions of labour in these industries have recently been greatly improved: this has been achieved by the general introduction of ventilating fans and of other expedients for preventing the inhalation of irritating particles by the operatives. Nevertheless the returns of mortality still show that several of these occupations produce a terrible amount of suffering and disablement, whilst they unquestionably shorten the lives of those who follow them.

In the subjoined table will be found a list of those industries in which the labourers suffer exceptionally from the presence of dusty particles or other irritating matters in the air of the apartments in which their work is carried on. In this table the mortality of the several dust-producing occupations is contrasted with that of agriculturists, who have been shown to suffer from the effects of dust to a less degree than any other workers. It is not asserted or believed that the whole of the difference between the respiratory mortality of certain unhealthy trades and that of this more favoured class is to be accounted for by dust irritation alone. There are almost certainly present other contributory factors also, the effects of which it would be difficult to show separately: nevertheless, there is no doubt that an atmosphere constantly charged with mechanical impurities of this kind is the main cause of the excessive mortality indicated in the table.

The aggregate death-rate from tubercular phthisis and diseases of the respiratory system is shown in this table, as also are the figures relating to each affection separately. Columns 3 and 4 give the combined mortality from these diseases among the several classes of workers in comparison with that of agriculturists. In the fourth column the mortality of the latter is taken as 100 and that of the other workers is shown proportionally to that figure.

Comparative Mortality from Specified Causes in certain Dusty Occupations.

Occupation. Comparative Mortality Figure (all Causes). Phthisis and Diseases of Respiratory System. Mortality Figure.

Mortality Figure. Ratio. Phthisis. Diseases of Respiratory System. Diseases of Circulatory System.

Agriculturist 602 221 100 106 115 88

Potter, Earthenware manufacturer 1702 1001 453 333 668 227

Cutler 1516 900 407 382 518 167

File-maker 1810 825 373 402 423 204

Glass-maker 1487 740 335 295 445 157

Copper-worker 1381 700 317 294 406 186

Gunsmith 1228 649 294 324 325 153

Iron and Steel manufacturer 1301 645 292 195 450 162

Zinc-worker 1198 587 266 240 347 126

Stone-quarrier 1176 576 261 269 307 137

Brass-worker 1088 552 250 279 273 126

Chimney sweep 1311 551 249 260 291 142

Lead-worker 1783 545 247 148 397 272

Cotton manufacturer 1141 540 244 202 338 152

Cooper and wood turner 1088 526 238 250 276 137

Rope-maker 928 486 220 219 267 118

Bricklayer, mason 1001 476 215 225 251 130

Carpet manufacturer 873 471 213 226 245 87

Tin-worker 994 451 204 217 234 124

Wool manufacturer 991 447 202 191 256 131

Locksmith 925 428 194 223 205 104

Blacksmith 914 392 177 159 233 136

Baker, confectioner 920 392 177 185 207 130

It thus appears that there are 22 industries in each of which the mortality from tubercular phthisis and respiratory diseases together is more than double that of agriculturists; and further, that these 22 occupations include 8 (giving employment to more than 100,000 men) in which the total mortality from these diseases ranges from three times to as much as four and a half times that of the agricultural class.

Potter, Earthenware, China Manufacture.—“The earthenware manufacture is one of the unhealthiest trades in the country. At the age of joining it is low: but the mortality after the age of thirty-five approaches double the average: it is excessively high; it exceeds the mortality of publicans. What can be done to save the men dying so fast in the potteries and engaged in one of our most useful manufactures?” Thus wrote Dr Farr in 1871, with regard to the pottery manufacture of that day. And Dr Ogle, writing ten years later, confirmed this statement, adding that the mortality of these workers at all ages from twenty-five to sixty-five had increased since 1871. He further stated that at that time (namely, in 1881) their comparative mortality figure was no less than 1742, which was only exceeded by the figures for costermongers, Cornish miners, and inn and hotel servants. In the three-year period 1890–92 things had only slightly improved: the mortality in this occupation from all causes remaining almost unchanged; and although phthisis claimed fewer victims than in 1881, lead poisoning had become more than twice as fatal since the previous record, and diseases of the circulatory and urinary systems had seriously increased in fatality. The excessive mortality of these workers is mainly due to phthisis and diseases of the lungs and heart. Of their entire mortality figure (1706) from all causes, not less than 1001 is contributed by phthisis and other diseases of the lungs. The mortality of potters from bronchitis is more than four times as high, and that from other respiratory diseases is three times as high as the mortality of occupied males in the aggregate.

Potters succumb to non-tubercular disease of the lungs much more rapidly than they do to tubercular phthisis; and it is certain that much of the so-called potters’ phthisis ought properly to be termed cirrhosis of the lung. Deaths from this affection should never be included under the head of phthisis, which term is now restricted, by universal consent, to the tubercular malady of that name.

The mortality figure of potters from lead poisoning is 17, and comes next to that of plumbers, as fourth highest in the list of industries liable to plumbism. The mortality figures, due to diseases of the nervous and urinary systems, in these two occupations, exceed the standard for occupied males by 54 and 50 per cent. respectively.

The term “potter” is a very comprehensive one, and is ordinarily understood to mean any workman employed in a pottery. But Dr Arlidge, the author of the best essay of modern times on the ailments of this class of workers, has shown how widely the operations in pottery manufacture differ from one another in their effect upon health. Speaking of the manufacture of earthenware generally he says: “This manufacture stands foremost among those wherein the employment is distinctly chargeable with the production of disease; and the principal materials to which its unenviable character is due are the clays and the flint used in it. However, these minerals are not the only agents that render the fictile trade one so highly injurious to health, for lead also is largely used for glazing and colour-making, and is a frequent cause of plumbism among the artisans. Again, it is a manufacture having many departments, between several of which no common characters can be said to exist. This holds good of the two principal departments, viz., (1) the making of the articles from potter’s clay; and (2) their ornamentation by painting and gilding. They are often spoken of as the “clay” and the “finishing” departments. It is with the former that we are in the first instance concerned, because in it the production of dust ... is pre-eminently the cause of disease.”[43]

Cutlers, Scissors-makers.—The mortality among cutlers is enormous; at all ages it is very high, but at ages beyond thirty-five years it exceeds the standard among occupied males generally by from 64 to 72 per cent. The comparative mortality figure for cutlers at ages from twenty-five to sixty-five years is 1516, which is higher than the average of other occupations by 59 per cent. Cutlers, although in this respect they have an advantage over potters, are nevertheless among the occupations which suffer excessively from “pulmonary” disease. Their mortality figure for phthisis is 382, and for respiratory diseases is 518, against 106 and 115 respectively, the figures for agriculturists. Taking these diseases together, cutlers sustain a mortality in excess of that of other occupations by 122 per cent. It has been shown by Dr Headlam Greenhow and others that the great mortality among cutlers and grinders arises from the irritation caused by the mechanical particles produced during the process of manufacture, and received into the lungs with the air of respiration.

Cutlers suffer slightly from lead poisoning; their mortality from this cause being represented by 3. The occurrence of lead poisoning among cutlers is a novel feature in the mortality returns for 1890–92, Dr Ogle having found no deaths from that cause in the sample of these workers examined by him in preparing his supplement for 1881. In the mortality figures for diseases of the urinary system there is, among cutlers, an excess of 37 per cent. as compared with the standard among occupied males. From diseases of the nervous system the excess of mortality among these workers is 11 per cent. Taking together the mortality ascribed to alcoholism and to liver disease as a rough measure of the mischief caused by intemperance, there is a slight excess among these workers as compared with the standard.

Since the previous record the mortality among cutlers has increased; and this not only at the higher ages, as appears to have been the rule in most other occupations, but also among men under forty-five years of age. Their mortality attributed directly to alcoholism, which had been much below the average in 1881, has risen above the average in 1891, but there has been no corresponding increase under the head of liver diseases. Since the former period the mortality of cutlers from heart disease has increased by 58 per cent., from lung diseases other than phthisis by 38 per cent., and from tubercular phthisis by 9 per cent.

File-cutters.—Judged by their general death-rate, file-cutters are the least healthy men included in our list of occupations, with the exception of publicans (in certain districts) and of dock labourers—their comparative figure being 1810, or three times as high as that of agriculturists. As compared with the standard mortality of occupied males, that of file-cutters is in excess by not less than 90 per cent. At each of the age-groups of the working period of life the mortality among file-cutters is appalling, and this is especially the case at ages above thirty-five years, when the death-rate exceeds the average by from 93 to 110 per cent.

As with cutlers, so with file-cutters—their great mortality appears to depend on the irritation caused by particles of stone or of metal which find their way into the air passages with the respired air. Dr Headlam Greenhow, writing so long ago as 1858, stated that file-cutters owe their enormous mortality from lead poisoning to the circumstance that the files are cut on blocks of lead: their mortality figure for plumbism, in 1890–2, was no less than 75!

Diseases of the urinary system cause a mortality among file-cutters which is above the average by 154 per cent., and diseases of the nervous system a mortality in excess by 159 per cent.

Intemperance does not seem to be especially rife among file-cutters, but they are addicted to suicide in about double the normal proportion.

The comparative mortality figure of file-cutters has increased considerably since 1871: the increase being relatively greatest since 1881. At the age-group 45–65 the increase in the death-rate has been steady throughout the entire period of twenty years, but at ages under forty-five, although between 1871 and 1881 there had been a fall in the death-rate, this has been followed since the latter year by a rise of considerably greater amount.

The mortality from tubercular phthisis, which had been 407 in 1881, has still further increased to 414 in 1891. According to recent experience, file-cutters die from diseases of the circulatory and respiratory systems even more rapidly than they did in 1881.

Glassmakers.—The making, blowing, and engraving of glass occupies a prominent place among unhealthy trades, for several reasons. In the first place, the workers are exposed to extreme variations of temperature—in some processes, that of glassblowing especially, the operatives are constantly exposed to the intense heat of the furnace, as well as to that which radiates from the pots of molten glass which they are engaged in blowing. The intense heat and profuse sweating naturally induce painful thirst, which the workmen evidently allay by excessive drinking: this is shown by the fact that their mortality from alcoholism and from nervous disorders is nearly double that experienced by operatives in other trades. In the next place, glass-makers are subject to plumbism, their mortality figure attributed to this cause being no less than 12, or sixth highest in the list of industries subject to this complaint. According to Dr Arlidge, who has contributed much valuable information on this subject, it is in the cutting and engraving of glass that the operatives are exposed to contact with lead. In these processes “putty powder,” which is a compound of lead and tin, is constantly used, and as the men are careless as to ventilation and cleanliness, often taking their food with unwashed hands, it is easy to understand how lead finds its way into the system.

The comparative mortality figure for glass-makers is 1487, and is, therefore, in excess of the average by 56 per cent. Phthisis and diseases of the respiratory system are especially fatal to workmen in this industry, and they suffer more severely than other occupied males from diseases of the circulatory, digestive, and urinary systems, as well as from cancer. Since 1881 the mortality of glass-workers has increased considerably, and this is true of the younger as well as the older workers in this industry.

Copper-workers.—As the number of operatives engaged in the working of copper is small (scarcely exceeding 8000), only general remarks can be made concerning their health.

At all ages the mortality of copper-workers exceeds that of other occupations; their comparative mortality figure is 1381; it is therefore considerably above that of metal-workers generally, and is also above the standard for occupied males in the aggregate by 45 per cent. That copper-smelting is an injurious occupation is proved by the pallid, sickly appearance of the workers. It has been noticed by Dr Arlidge, as a result of personal experience, that the hair of copper-smelters (especially where this was originally fair or white) becomes much discoloured; but this discoloration is caused, not by absorption of the metal, but simply by adhesion of copper particles to the hair. Nevertheless, he thinks that cupreous salts do eventually find their way into the circulation, and when this is the case the characteristic symptoms of colic, vomiting, and purging with extreme prostration are produced. A greenish or purplish red line is also noticed in the gums, in the same position as that which is occupied by the blue line in cases of lead poisoning. The operations of filing, turning, and polishing of copper are especially injurious to the workmen, and like other dust-inhaling processes, lead to fatal results by interference with the respiratory functions—lung diseases being much more common among these operatives than the average, whilst their mortality from pulmonary phthisis is in excess by 59 per cent. Copper-workers die much more rapidly than other operatives from diseases of the circulatory, digestive, and urinary systems, their mortality from all these forms of disease being greatly in excess of the average among workers in metals generally.

Iron and Steel Workers.—At the census of 1891, more than 200,000 workers in iron and steel, above the age of fifteen years, were enumerated, but the number had decreased since the preceding census by 2 per cent. The labour of iron and steel working is heavy and exhausting. The operatives, whether at the blast furnaces or at the rolling mills, whether puddlers or moulders, are exposed to intense heat, as well as to great vicissitudes of weather, for most of their work is done in the open air, or at any rate in outdoor sheds unprotected from cold and draughts. The men are for the most part sturdy and of powerful build: the arduous nature of their occupation making it impossible for any but the most vigorous to follow it. In spite of these natural advantages, however, statistics show that iron and steel workers are by no means so healthy and long-lived as they ought to be.

The death-rates of these operatives are higher than the corresponding rates among occupied males generally, and also higher than the rates of other metal workers, at all stages of life up to sixty-five years. They have a comparative mortality figure of 1301, which is higher than that of occupied males, as a standard, by 37 per cent. Iron-workers suffer more severely than do other occupied males from influenza and from diseases of the nervous, circulatory, respiratory, digestive, and urinary systems; their mortality figure from diseases of the lungs being more than double the standard figure, and that from phthisis also greatly exceeding the average.

Since 1881 there has been a considerable increase in the mortality of iron and steel workers: the increase has affected both divisions of the working period of life, but has been far the greatest among men over the age of forty-five years.

Zinc-workers.—The number of men engaged in this industry is small, although it has increased by 50 per cent. within the last decennium. Nevertheless, the vital statistics of zinc-workers are important, as showing excessive mortality from all the diseases enumerated in the table on page 135. The evidence is conflicting as to the evolution of noxious matter during the process of extracting zinc from the ore; but the workmen are exposed to great heat, and to the inhalation of irritating particles, in consequence of which they are said to suffer exceptionally from digestive and respiratory troubles. Zinc is coming more and more into use in the process of galvanising sheet-iron, so as to protect it from rust; and in this operation the workmen are exposed to the fumes of sal-ammoniac and to other substances which are said to produce a form of nervous derangement that is apparently peculiar to this process.

Zinc-workers are subject to a mortality considerably above the average. Their comparative mortality figure is 1198, and at ages beyond middle life they die more rapidly than occupied males generally. Their mortality from respiratory diseases and pulmonary consumption together is more than double the standard figure, and they die faster than the average from diseases of the circulatory system.

Lead-workers.—The occupation of lead-working is pursued by but very few in this country; only about 2000 men above the age of fifteen years having been thus returned at the census of 1891, and even this number is rapidly decreasing. But the injurious effects of lead-working are by no means limited to the operatives designated lead-workers in the census returns. In the list of one hundred occupations prepared for my larger work on occupational mortality, not fewer than thirteen were selected as showing unmistakable evidence of plumbism. These occupations are as follows (the figures represent the comparative mortality figures from lead poisoning in the several trades)—

Lead-worker 211

File-maker 75

Plumber 21

Painter and Glazier 18

Potter 17

Glass-maker 12

Copper-worker 8

Coach-maker 7

Gasfitter, Locksmith 6

Lead-maker 5

Printer 3

Cutter 3

Wool manufacturer 3

Occupied males 1

The above occupations are arranged in order according to their mortality from lead poisoning, as shown in the tables. A little consideration, however, will show that these figures represent but very imperfectly the relative damage sustained by the several operatives as a result of their occupations. If, for the sake of example, we compare the mortality figure of lead-workers with that of potters, it would appear, by the table, that the former workers die from plumbism more than twelve times as rapidly as do the latter. But, on closer examination, we find that whilst the whole body of lead-workers are constantly in contact with lead as a necessary condition of labour, not more than a twelfth part of the potters are so circumstanced. It is the dippers and the glost-placers among potters who are the chief, if not the only, serious sufferers from lead poisoning; but as these workers are not distinguished in the census returns from other potters, their deaths are distributed over the whole class of potters, and thus a false impression is conveyed as to the amount of mischief done by absorption of lead, in those branches of the industry where the workers are actually exposed to contact with this metal. Again, when the figures for painters and glaziers are compared with the figure for file-cutters, a great disparity becomes evident; the file-cutters suffering apparently more than four times as severely from plumbism as do the painters and glaziers. But on inquiry, we find that whilst, on the one hand, file-cutters handle lead continuously in the course of their work, on the other hand, painters and glaziers are by no means so constantly exposed to this danger—much of their time being spent on labour which does not involve contact with lead, or inhalation of particles or fumes of that metal. If the death-rates attending those processes in the occupation of potters and of painters which are continuously subject to lead poisoning could be separately ascertained, there is no reason to doubt that they would show results quite as unsatisfactory as those experienced by lead-workers.

Although lead-working is known to be a very unhealthy trade, it is evidently impossible to deduce from the vital statistics of only 2000 workers more than very general conclusions. Speaking generally, however, the mortality returns warrant the statement that, in the main working period of life, these operatives sustain a mortality which is about 90 per cent. above that of other workers, on the average. Their comparative mortality figure from all causes is no less than 1783, and is therefore nearly three times that of agriculturists. Of the total deaths occurring among lead-workers, one-third are from “pulmonary disease,” i.e., from tubercular phthisis and diseases of the respiratory system taken together, and one-eighth are from lead poisoning. As compared with the standard for occupied males, the mortality among lead-workers is excessive from diseases of the urinary, nervous, circulatory, and digestive systems, in addition to the causes above specified.

Stone-Quarriers.—The aggregate of men above the age of fifteen years returned under this heading, at the last census, amounted to nearly 50,000, but the numbers had decreased by about 3 per cent. since the previous enumeration. The comparative mortality figure of quarrymen is 1176, which, as compared with the figure for occupied males, is in excess by 25 per cent. At all stages in the working period of life the death-rate of these labourers exceeds that of other occupations in the aggregate. As stone-quarrying is an outdoor industry, and consequently the workers are not exposed to the unhealthy conditions of sedentary work, the vital statistics of this class should obviously be compared with those of agriculturists, rather than with those of males of all occupations. So compared, we find that stone-quarriers experience a mortality from all causes which is little short of double the standard figure. From respiratory diseases and also from tubercular phthisis, their mortality is at least two and a half times as high as the standard, and from diseases of the circulatory system they die faster than agriculturists by 50 per cent. At ages between twenty-five and forty-five years the mortality of stone-quarriers has fluctuated considerably during the last twenty years; but at ages from forty-five to sixty-five it has steadily increased throughout that period. Since 1881 the increase has been principally under the head of pulmonary and circulatory diseases. During the same interval the mortality of quarriers from phthisis and also from digestive diseases, as well as that from alcoholism and from diseases of the liver, has decreased considerably, and so likewise has their liability to fatal accident.

Brass-workers.—At the 1891 census there were enumerated 33,000 persons over fifteen years of age under the head of brass-workers, braziers, etc., the number having increased since the previous enumeration by little short of one-third.

If death returns alone be relied on, there is little in the mortality of brass-workers that does not apply equally to other allied industries; but from the investigations of Dr Headlam Greenhow in 1858, and more recently those of Dr Simon and Dr Hogben of Birmingham, we learn that brass-workers suffer very seriously from ailments which are not experienced by the workers in copper or in zinc, the chief metals of which brass is an alloy. The disease to which these workers are exceptionally subject is known locally as “brassfounders’ ague,” which, according to Greenhow and some other authorities, is caused by the inhalation of oxide of zinc, whilst others of equal repute attribute it to copper poisoning. That brass-workers are exposed to conditions inimical to health is fully recognised by employers and employed alike, who agree in describing the trade as a most unhealthy one. Dr R. Simon (in a thesis for his degree at Cambridge) says that brass-workers rarely attain old age, and that formerly provident sick societies either altogether refused to enrol them in their lists, or accepted them as members at greatly increased rates. The workers who deal with molten metal—the founders, the mixers, and the casters—are those who are exceptionally liable to “ague.” The “mixers,” who bring together the two metals, suffer most severely. The copper is first molten, and the zinc is then added to it. When the metals come into contact the zinc deflagrates, and some of it, combining with oxygen, flies off in dense white clouds of oxide of zinc. This, of course, is of necessity inhaled by the operatives who, experiencing discomfort from the process, tightness of the chest, and other respiratory troubles, attempt to avoid it by covering the mouth and nostrils with a handkerchief.

Although, as has been previously stated, the deaths registered afford little evidence of the exceptional unhealthiness of brass-workers as compared with the workers in other metals, nevertheless we find that they sustain a mortality from “phthisis” which is in excess of that of “occupied males” by 50 per cent., whilst they die more rapidly than the average from diseases of the nervous, urinary, and respiratory systems. Brass-workers as a class are, like copper-makers, pallid, ill-nourished, and unhealthy-looking: they suffer from anæmia, dyspepsia, constipation, colic, and other digestive troubles. Happily, however, these symptoms do not permanently injure their health, for on changing their occupation, as they commonly do, for a less unhealthy one, the above symptoms rapidly subside, and their usual health is soon restored.

Gunsmiths.—The only remaining metal-workers in the list whose mortality exceeds the average for the class are the gunsmiths. Their comparative mortality figure is 1228, and is exactly 100 in excess of that of metal workers in the aggregate. Gunsmiths die faster than the average of metal-workers at ages from twenty-five to forty-five, but less rapidly both before and after that period of life.

On reference to the extended tables in my larger work, it will be found that gunsmiths die from alcoholism about two and a half times as fast as do other workers in metal. Most of the processes in which gunsmiths engage are of an unhealthy nature, and the workers are exposed to the harmful effects of metallic and flinty dusts which set up in the lungs very similar disorders to those which have been noticed in connection with the Sheffield “grinding” trades. This industry demands expert workmanship and high finish, especially in the later processes, and involves a great deal of filing and polishing of metal, and these operations are frequently carried on in workshops which are ill-ventilated and otherwise unsuited for the purpose. As a consequence, the mortality of gunsmiths from phthisis (much of which is probably fibroid) stands at 324 against 206, the figure for metal-workers generally, and 185, the standard figure for all occupied males. From other diseases of the respiratory system and from diseases of the heart, gunsmiths sustain a mortality which exceeds the standard for occupied males by 47, and by 21 per cent., respectively. During the last twenty years, and especially during the more recent half of that period, the mortality of gunsmiths has increased considerably, and this is true whether we consider their mortality during the earlier or during the later half of the main working period of life.

Chimney Sweeps, Soot Merchants.—Recent statistics agree with those of earlier records in attributing to this industry a very unsatisfactory position in the scale of health. Compared with those of other occupations, the death-rates of chimney sweeps are excessive at all ages below the sixty-fifth year. Their comparative mortality figure amounts to 1311, and is therefore higher than the standard by more than one-third part.

Chimney sweeps are, by the nature of their calling, much exposed to the inhalation of particles of soot and of other irritating matters which seriously affect the respiratory functions. They die more rapidly than the average from pulmonary tuberculosis, and from other diseases of the lungs, as well as from diseases of the heart and urinary organs. Their mortality from suicide is also more than double the average, and their figure for intemperance is more than four and a half times that of occupied males generally. But it is in regard to their extreme liability to malignant disease that chimney sweeps are deserving of special consideration. Their mortality from different forms of cancer amounts to 156 as compared with 44, the figure for occupied males in the aggregate. In the list on p. 135 there is no other occupation in which the ravages of cancer at all approach those to which chimney sweeps are subject. Of the 512 deaths from all causes among chimney sweeps, as many as 61, or about 1 in 8, were from cancer, and 18 of the 61 were returned as from chimney sweeps’ cancer. Of these 61 deaths 3 were ascribed to sarcoma, and the rest to carcinoma or other forms of malignant disease. In the course of the last twenty years the mortality of these workers has decreased considerably. Between 1871 and 1881 their mortality figure, modified for purposes of comparison, had fallen by 11 per cent., the fall in the death-rate having been common to both divisions of the main working period of life, but much greater at ages under than at ages over forty-five years. In the interval between the two last censuses, on the contrary, the fall has been greater at ages above forty-five years. Although chimney sweeps still die from cancer in enormous over-proportion, there has happily been a great abatement in their fatality from this disease since the previous record. In 1880–82 the mortality figure had been 290, whilst in 1890–92 the figure, modified to allow of comparison, was 157, showing a reduction of nearly half within that interval.

Textile workers.—In the accompanying list there still remain several dust-producing occupations in which the mortality from pulmonary diseases is in excess of the average, notwithstanding that the workers are not exposed to the action of metallic irritants. Of these there are four which may be taken to represent the textile trades—viz., the manufacture of cotton, wool, rope, and carpets—in all of which the mortality figure from respiratory diseases is not only vastly in excess of the figure for agriculturists, but is also considerably above that of other occupied males. Among textile workers, cotton operatives (especially those of Lancashire) are the most unhealthy. Their mortality figure from all causes is higher than that of occupied males generally, by from 20 to 23[A] per cent., whilst from diseases of the respiratory system exclusive of phthisis, their mortality is in excess by proportions varying from 53 to 65[44] per cent. The workers in cotton mills suffer severely from the presence, in the air, of “fluff” and “flue” that escapes from the cotton, especially in the preparation of the yarn. The amount of this and the degree of irritation to which it gives rise when inspired, varies with the quality of the material used; inferior and brittle cotton, being more liable to breakage in the course of manufacture, gives off more dust than do the finer kinds, and requires for its successful working a warmer and moister air. The workers in the lower-class cottons therefore suffer more seriously in health, and require more perfect arrangements for ventilation than do those who deal with materials of higher quality. Cotton spinners have to work all the year round in a very warm and humid atmosphere, and accordingly suffer from debility and exhaustion caused by profuse sweating. The temperature and moisture of the sheds are maintained at a high standard both night and day, in order to prevent brittleness in the cotton fibres, and as a consequence the operatives become peculiarly sensitive to chills, brought about, perhaps, by injudicious exposure to draughts. From personal experience in Manchester, for a period of twenty-five years, I can testify that these workers are exceptionally liable to acute rheumatism, and this statement may be confirmed by reference to the mortality tables in my larger work, which show that the mortality of cotton spinners from this disease exceeds the average by not less than 70 per cent. The operation of “sizing,” preparatory to the weaving of cotton, introduces a new element of danger. The size contains, in addition to flour or farina, a very large proportion of china clay, which finds its way into the air passages, and there produces its well-known mischief. It is pleasant to record that cotton operatives do not add to the evils of their occupation by undue recourse to alcohol: their mortality from intemperance being below the average by 23 per cent.

Wool, Worsted Manufacturers.—Wool-workers suffer much less severely from their occupation than do cotton operatives. In the weaving of woollen materials, a lower and drier temperature is required than in the case of cotton-weaving, and the mischief caused by “sizing” with china clay and other irritants has no place in woollen manufacture. Nevertheless, in certain of the processes, especially where inferior foreign wools are manufactured, a good deal of dust is disengaged, and this produces its ill-effect on the lungs of the workers. It is also in connection with dirty or blood-stained foreign wools that the majority of cases of anthrax or wool-sorters’ disease have been observed from time to time, which have been the subject of inquiry in past years by the Medical Department of the Local Government Board.

It is worthy of notice that wool-sorters are even more careless as regards exposure to cold and draughts than are even cotton workers, and their mortality from rheumatic fever is much higher, being double that experienced by agriculturists as a class. Wool-workers have a comparative mortality figure from all causes, which is somewhat above the average for occupied males generally, but is below that of other textile trades. Workers in wool appear to be remarkably free from intemperance, their mortality figure being less than one-fourth of the average. From diseases of the digestive system other than the liver, wool-workers die half as fast again as do occupied males generally, whilst from diseases of the nervous, respiratory, and urinary systems, as well as from cancer, the mortality of these workers is from 10 to 22 per cent. in excess of that standard.

Other Workers in Dusty Trades.—The accompanying list includes a few industries, the workers in which have not yet been alluded to as regards their health: such as the rope-makers, carpet-makers, coopers, bricklayers, bakers, etc. These industries, although not remarkable for the production of other serious forms of illness, have this feature in common, that being essentially dust-producing processes, they one and all induce among the workers excessive suffering from pulmonary affections. Although the mortality of these workers from phthisis and other lung diseases is considerably below that of metal-workers, nevertheless it is in every case inordinately high, exceeding the mortality of agriculturists by proportions varying from 77 to 120 per cent.

EFFECTS OF BREATHING FOUL AIR.

In my larger work on occupational mortality, detailed vital statistics are given respecting those workers whose occupation is not in itself necessarily unhealthy, but who are the victims of unwholesome conditions of labour, either self-inflicted, or else caused by the ignorance or the parsimony of persons in authority. The evils here alluded to are the result partly of the accumulation of respiratory and other impurities in the air breathed, from neglect of suitable methods of ventilation, and partly of the cramped posture adopted in certain cases (notably by tailors and shoemakers) in their sedentary indoor labour. Considerations of space preclude the insertion here of a complete list of these occupations; but in the following table a selection has been made of those industries in which the workers are liable, in the greatest degree, to damage from the inhalation of foul air in the course of their employment. For each of these occupations the figures indicating the mortality from phthisis and from diseases of the respiratory and circulatory systems are separately shown, and in another column the combined mortality of the several occupations from the first two of these forms of disease is compared with that of agriculturists, the latter being taken as 100. The occupations have been arranged in the descending order of their mortality from tubercular phthisis and respiratory diseases together.

Comparative Mortality from several causes in certain unhealthy occupations.

Occupation. Comparative Mortality Figure (all Causes). Phthisis and Diseases of Respiratory Organs. Mortality Figure.

Mortality Figure. Ratio. Phthisis. Respiratory Diseases. Circulatory Diseases.

Agriculturists 602 221 100 106 115 88

Bookbinder 1060 543 246 325 218 115

Printer 1096 540 244 326 214 133

Musician 1214 522 236 322 200 191

Hatter 1109 511 231 301 210 141

Hairdresser 1099 489 221 276 213 179

Tailor 989 466 211 271 195 121

Draper 1014 441 200 260 181 135

Shoemaker 920 437 198 256 181 121

From this table it will be seen that, roughly speaking, the combined mortality from phthisis and respiratory diseases varies from twice to two and a half times that of agriculturists. It may further be stated (although the figures are not given in the table) that the workers in four of the above-mentioned occupations die from these diseases alone more rapidly than farmers in the agricultural districts die from all causes put together. Contrary to the experience of two-thirds of the occupied male population of England and Wales, tubercular phthisis is more fatal than are diseases of the respiratory organs other than phthisis, to all the workers in the table, except agriculturists.

Bookbinders, Printers.—Writing in 1881 of the sanitary condition of these workers, Dr Ogle speaks of both of them in common as “carrying on their industries under notoriously unhealthy conditions, in ill-ventilated rooms, and in an atmosphere unduly heated by engines, stoves, and flaring gas-lights.” The decline in the death-rates, as compared with the earlier records, he attributes to the improvements effected by the Factory Inspectors since these trades came under their supervision. Further on he writes, with respect to their mortality: “Excepting costermongers ... and those industries in which the workman is exposed to the inhalation of dusts, such as file-makers, potters, and Cornish miners, there is no industry in the table in which the mortality from phthisis approaches to that of printers.” “As for bookbinders,” he writes, “so far as can be judged from the 77 deaths of which the causes are recorded, in this industry also the high mortality is due to phthisis, for of the 77 deaths no less than 30 were caused by this disease.”[45]

In both of these trades the conditions of work have still further improved under the supervision of H.M. Factory Inspectors since the above was written. Taking bookbinders first—The returns show that their death-rates are still considerably above those of agriculturists, and, indeed, above those of other occupied males at most of the ages in the working period of life, their comparative mortality figure being above the firstnamed standard by 76 per cent. Bookbinders still die very rapidly from pulmonary consumption, their mortality figure from that disease being no less than 325, or more than three times as high as that of agriculturists. Their mortality from cancer and from diseases of the respiratory, circulatory, and urinary systems also shows excess. Bookbinders are more addicted to suicide than are agriculturists, in the proportion of 26 to 10. Ever since 1871 the mortality of bookbinders has steadily decreased, and there has been a fall in the death-rates at ages under as well as above the forty-fifth year.

Printers experience a death-rate at the various age-groups which is above the standard at all the age-groups dealt with in the table. Their mortality figure is 1096, as against 953 for all occupied males, and 602 for agriculturists. Like bookbinders, printers die very rapidly from phthisis, and probably for a similar reason—namely, because of the excessively unhealthy conditions under which their work is carried on—their mortality from diseases of the respiratory organs other than phthisis is, however, below the average, but from diseases of the nervous, circulatory, digestive, and urinary systems it is above the average. Printers suffer only about one-third as much from fatal accident as do other workers, but they are somewhat more addicted to suicide. Their mortality figure from lead poisoning is represented by 3. In the course of the last twenty years the mortality of printers from all causes together has decreased considerably. Both the age divisions in the main work time of life have shared in the fall, but in unequal proportions. As compared with that of 1881, the mortality of these workers from alcoholism in 1891 has fully trebled, and that from suicide has more than doubled. The most important decrease occurs in the case of phthisis, the mortality from which has fallen, since 1891, by one-sixth part of the former rate.

Musicians.—The mortality of the class of men who, by a euphemism, are styled “musicians,” is very high. At all ages in the working period of life it greatly exceeds that of agriculturists, and also exceeds that of the working population in the aggregate. Their comparative mortality figure amounts to 1214, or more than double the figure for agriculturists, and is about one-third part in excess of that of occupied males generally. Compared with both these standards, musicians die more rapidly from alcoholism and from diseases of the liver. Their mortality figure from phthisis is enormous, amounting to not less than 322, or fully three times that of agriculturists, and almost double that of male workers in the aggregate.

In addition to the above, musicians sustain very heavy mortality from diseases of the nervous, circulatory, digestive, and urinary systems, and their mortality figure from suicide is 23, as compared with 10 for agriculturists and 14 for other occupied males. From these statistics it is certain that many of those who are included in this class are sadly addicted to intemperance, whilst others suffer from want of the bare necessaries of life. “It must be remembered,” writes Dr Ogle in 1881, with reference to the mortality of this class, “that under this heading are comprised all sorts and conditions of men, and that a large portion of them are organ-grinders, ballad-singers, and street musicians generally, many of whom are of intemperate habits, and exposed by their mode of life to cold and want, while no few have merely taken to the occupation as a refuge, after their health has broken down in more regular occupations.”

Within the last twenty years the mortality of musicians has declined very considerably, both at the earlier and at the later ages. Their comparative mortality figure in 1891 was lower than it had been in 1871 by more than one-fifth part: nevertheless, their vital statistics still continue to be very unsatisfactory, and their nomadic habits are a serious hindrance to improvement.

Hatters.—As compared with agriculturists, the mortality of hatters is enormously greater at all stages of the working period of life, and their comparative mortality figure from all causes is in excess of that standard by 84 per cent. At ages under thirty-five years, hatters experience a death-rate which barely exceeds the average among occupied males, but at each subsequent age-group their mortality is greatly in excess. As far as we know there is little in the employment of hat-makers which of necessity acts prejudicially to their health. Their work, however, like that of too many other trades, is frequently carried on in overcrowded and ill-ventilated apartments, and the men suffer accordingly. Thus we find from the tables that hatters die from tubercular phthisis about three times as rapidly as do agriculturists, and that their mortality from this complaint considerably exceeds the average in other occupations. Hatters appear to be much addicted to intemperance, their mortality figure from alcoholism, and also from liver disease, showing serious excess. Their mortality from suicide stands at 28, as compared with 10 for agriculturists and 14 for other occupied males. Among hatters under the age of forty-five years there has been a decline in mortality within the last twenty years, but at ages from forty-five to sixty-five there has been but little change.

Hairdressers.—The mortality of hairdressers is higher than that of other occupied males at each of the age-groups of the working period; it is, consequently, greatly in excess of that of agriculturists. Their mortality figure from all causes at ages twenty-five to sixty-five is 1099, and, therefore, exceeds that of the standard last mentioned by 82 per cent. The life of a hair-dresser is for the most part a town, or at least a village, life; the work being carried on indoors for long hours together, in an atmosphere heated and polluted by gas. In addition to this, the occupation is a dusty one, and the men are exposed to the effects of particles of hair and other irritants which find their way into the lungs. Their mortality figure from alcoholism, liver diseases, and gout, as well as from pulmonary tuberculosis, shows serious excess; it therefore appears that hairdressers, as was the case in 1881 also, are still excessively addicted to intemperance. They fall victims to suicide almost as rapidly as do even the least fortunate workers included in the list of occupations. Hairdressers experienced almost the same rate of general mortality at the census periods of 1871 and 1881, but since the latter year there has been a fall in their mortality to the extent of about one-seventh part.

Tailors.—The occupation of tailors is a typically sedentary one. The men work for the most part in overcrowded, ill-ventilated, and overheated rooms, and consequently suffer in general physique and appearance, as well as in health. In recent years the introduction of machinery, whilst in some respects an advantage, has produced its counterbalancing ill-effects by rendering it possible for any man or woman who can work a sewing machine to take the place of the regularly skilled tailor, and thus to depreciate the market value of his labour. In consequence of this the tailor and his family are only too frequently reduced to great poverty, if not to a state approaching starvation. The mortality of tailors at the several age-groups does not greatly differ from that of other occupied males. Tailors die more rapidly than agriculturists at ages between twenty-five and sixty-five, but at ages below and above these limits their mortality does not greatly exceed this standard.

Although in past times tailors have been considered an intemperate class, the figures for 1890–92 lend little support to that opinion. Their mortality figure from alcoholism as well as from liver disease scarcely differs from that of occupied males generally, although, of course, it considerably exceeds the low figure of agriculturists.

The mortality of tailors from tubercular phthisis is greatly in excess of that of other occupied males, and is more than two and a half times as high as the mortality of agriculturists; it is also worth mention that they die more rapidly than other workers from diseases of the nervous system. On the other hand their mortality from influenza and from diseases of the respiratory organs, and of the heart, is in each case below the average. During the last twenty years there has been a notable increase in the mortality of tailors at ages from forty-five to sixty-five years, and an equally notable decrease at ages from twenty-five to forty-five. Although the mortality directly ascribed to alcoholism is now slightly higher than it was in 1881, nevertheless the mortality from diseases of the liver and other digestive organs has undergone a more than equivalent reduction, so that the total mischief caused by intemperance has probably decreased since 1881. The mortality of tailors from gout as well as from phthisis, and from diseases of the nervous system, has fallen since the same year.

Drapers, Manchester Warehousemen.—The large body of men included under this heading appear to enjoy but poor health, when allowance is made for the fact that the greater part of them are under twenty-five years of age. Drapers and Manchester warehousemen, who are here grouped together because of the similarity of their occupation and mode of life, are credited with a mortality which is higher than that of any other occupation save one in the category of shopkeepers. Their comparative mortality figure from all causes is 1014, which, as compared with that of agriculturists, is in excess by 68 per cent. Even when compared with the low standard of “occupied males,” drapers are subject to a mortality which is considerably above the average. Confinement in close, ill-ventilated shops for very long hours together, and an almost exclusively indoor life, is the unlucky fate of these workers. They are exposed to the heat and fumes of gas and cotton “fluff” and dust which escapes from the bales of goods in process of sale, and their health suffers accordingly. Their death-rate from tubercular phthisis exceeds that of other occupations by not less than 41 per cent., and is more than two and a half times as high as that of agriculturists; but the fact previously mentioned, that drapers’ assistants are for the most part youths or young men, may account to some extent for their exceptional liability to this scourge. Drapers die faster than the average from influenza, rheumatic fever, and diabetes, as well as from alcoholism, diseases of the liver and nervous system, and from suicide. During the main working period of life, the mortality of drapers has decreased somewhat since the earliest record. In the first twenty years of this period, i.e., from twenty-five to forty-five years of age, their death-rate has fallen considerably since 1871; whilst at ages from forty-five to sixty-five years, although it had fallen between 1871 and 1881, it has since returned to its former level. Since 1881 the mortality of drapers from all causes has increased by 18 per cent. Between 1881 and 1891 their mortality from phthisis remained stationary, whilst that from other lung disease and heart disease showed a considerable increase. Their mortality from suicide has increased threefold since 1881, and that from alcoholism has increased by nearly two-thirds.

Shoemakers.—Although the contrary is generally held to be the fact, shoemakers are shown by the figures now at our disposal to enjoy a degree of health which is at least equal to that of the average working man.

As the occupation of shoemaking is an indoor one, involving sedentary labour for many hours together, in closely confined and ill-ventilated apartments, the workers suffer inordinately from those ailments which are commonly associated with such environment. Up to the thirty-fifth year of age shoemakers die faster than other occupied males, but more slowly at later ages. Compared with agriculturists the mortality of shoemakers at all ages is in excess by 53 per cent.

Shoemakers die much less rapidly than the average from lung diseases (except phthisis) as well as from accident, and their mortality from intemperance is remarkably low. Cancer and pulmonary consumption, however, play sad havoc among shoemakers, their mortality from the first-mentioned disease being in excess of the average by 14 per cent., and from the last-mentioned, by 38 per cent. Throughout the three decennia, commencing with 1861, the mortality of shoemakers above the age of forty-five years has steadily increased, whilst below that age it has steadily decreased; the balance showing a slight increase in the total mortality figure. Under the head of alcoholism their mortality has increased since the earlier record, although that from liver disease has decreased. Shoemakers die as rapidly as ever from pulmonary consumption, and more rapidly than ever from diseases of the lungs and heart. Their mortality from diseases of the nervous system has, however, shown a decided improvement, and they are at the present time less addicted to suicide than was formerly the case.

THE MINING INDUSTRY.

At the census of 1891 more than half a million men above the age of fifteen years were returned as miners, their number having increased since the previous census by more than a fourth part. As the proportion is still probably increasing, we may safely calculate that at the present time one in every 17 males between the ages of twenty-five and sixty-five years is a miner. In round numbers it may be stated that of the 524,000 miners in England and Wales, 482,000 work in coal, 18,000 in ironstone, 9000 in tin, 6000 in lead, 2000 in other minerals, and 1000 in copper; whilst the remaining 6000 are classed under the head of “mine service.” With a few noteworthy exceptions, miners are not, as a whole, an unhealthy body of men, but from the nature of their employment they are necessarily more exposed than are other workers to certain forms of violent death. The various groups of miners, however, have, of course, this feature in common, that most of their time, for a great part of their life, is spent underground. Accordingly their work is carried on under conditions of heat, moisture, etc., which are exceptionally artificial, and for this reason it is desirable that their mortality should be studied with especial care. The following table shows the death-rates of miners at several ages, compared with the corresponding rates of occupied males. The figures in each column represent proportions of the standard figure, the latter taken in each case at 100.

15— 20— 25— 35— 45— 55— 65 and upwards

Occupied Males. 100 100 100 100 100 100 100

Mining Industry 148 112 87 78 95 121 147

Coal miner 150 111 86 77 94 119 143

Coal Miners Durham and Northumberland 154 111 75 66 79 97 152

Lancashire 163 107 88 94 110 140 150

West Riding 115 92 76 77 89 126 138

Derby and Notts 93 68 69 59 73 96 118

Staffordshire 95 109 82 70 95 135 180

Monmouth and Wales 227 141 118 97 117 140 129

Ironstone miner 134 90 82 66 83 91 144

|Copper miner ... 158 129 146 118 127 170

Tin miner 116 139 111 115 161 180 178

Lead miner 118 127 130 109 116 182 240

Mine service 127 264 129 98 95 113 155

The table shows that at ages from fifteen to twenty, and from twenty to twenty-five, as well as at both the age-groups above fifty-five years, miners in the aggregate die more rapidly than do other occupied males, whilst at intervening ages they die less rapidly. Miners, however, are a picked class of men in a more especial sense than are the toilers in most other industries. Their labour is so arduous that those only who possess exceptional physical endurance are able to continue it, and this may account for the fact that when they are barely past the prime of life many of them become enfeebled, and subject to a mortality which is considerably in excess of that incidental to other occupations.

On attempting to trace the causes of mortality in the various groups of miners, and to compare those industries, in this respect, with one another and with other occupations, it readily appears that a large, though very inconstant, proportion of the total mortality is contributed by “accident.” It is accordingly desirable to isolate this factor, so that we may arrive at a fair judgment as to the loss of life by disease alone occurring amongst these workers in their several fields of labour. This has been done in the following table, where the comparative mortality of the various groups of miners is given (a) from all causes except accident, (b) from certain prevalent diseases, (c) from accident or violence, and (d) from disease and accident together.

All Causes except Accidents. Alcoholism. Liver Diseases. Phthisis. Respiratory Diseases. Bright’s Diseases. Accident. Disease and Accident together.

Mining Industry 800 4 18 109 267 19 135 935

Coal miners 784 4 17 97 269 18 141 925

Coal Miners Durham & Northumberland 678 5 23 94 156 15 96 774

Lancashire 914 5 17 102 389 17 155 1069

West Riding 798 4 16 123 288 16 114 912

Derby and Notts 638 2 18 69 159 8 89 727

Staffordshire 817 2 8 83 319 22 135 952

Monmouth and Wales 902 7 16 107 345 27 243 1145

Ironstone miners 688 4 20 90 204 15 86 774

Copper miners 1195 ... 28 331 347 68 35 1230

Tin miners 1361 4 28 508 377 29 48 1409

Lead miners 1267 5 34 380 325 33 43 1310

Mine service 946 6 42 114 216 20 75 1021

Farm labourer 590 4 13 115 129 12 42 632

Occupied males 897 13 27 185 221 27 56 953

This table shows that miners, as a class, are a temperate body of men; their mortality directly attributed to alcoholism being less than one-third, and that from liver disease being only two-thirds, of that of occupied males generally. In this respect they scarcely differ from farm labourers; their mortality from alcoholism is the same, and that from liver disease is only slightly higher.

Miners, as a class, suffer less than other occupied males from phthisis, as well as from cancer and diabetes, their mortality from the first-mentioned disease being below the average by 41 per cent., from the second by 16 per cent., and from the last by 29 per cent. Among miners, diseases of the nervous, circulatory, and urinary systems are less fatal than the average, but, with few exceptions, respiratory diseases are more fatal.

Coal Miners.—As a class, colliers compare favourably with men in most other occupations on the score of health. During the first thirty years of the main working period of life their mortality is substantially lower than is the mortality in other industries, although at ages under twenty and over fifty-five they die faster than the average.

The excessive mortality of colliers under twenty years of age may be accounted for by the fact that from 40 to 50 per cent. of the total deaths are due to violence, caused by the waggons and “tubs” in which coals are conveyed from the underground workings to the shafts. This form of accident falls mainly to the lot of the younger and less experienced colliers who are employed in “tramming” and “hurrying” the coals. When their mortality from accident is deducted, the residual death-rate of colliers under twenty years of age does not greatly differ from the average.

The comparative mortality figure of colliers, without distinction of age, from all causes including accidents, averages 925; but whilst on the one hand it does not exceed 727 among the colliers of Derbyshire and Nottingham, and 774 among those of Durham and Northumberland, on the other hand it ranges upwards to 1069 among colliers in Lancashire and 1145 in Monmouthshire and South Wales.

It is not easy to explain why it is that colliers in the several coalfields, working as they do in the same material, and spending an equal portion of the day underground, should differ so widely from one another in their mortality. For example, on reference to the accompanying table we see, with regard to miners under twenty years of age, that whilst on the one hand, among colliers in the counties of Derby and Nottingham, and also in Stafford, the mortality is lower than among “occupied males” by 7 and 5 per cent. respectively; on the other hand, among colliers in Durham and Northumberland, the mortality exceeds that standard by 54 per cent., in Lancashire by 63 per cent., and in Monmouthshire and South Wales by not less than 127 per cent. Again, in the counties of Derby and Nottingham colliers between their fifty-fifth and sixty-fifth years die less rapidly than the average by 4 per cent., but colliers of the same age in Staffordshire die more rapidly than the average by 35 per cent., and in Lancashire and Monmouthshire more rapidly by 40 per cent.

Various theories have been advanced to account for the great disparity just alluded to in the local death-rates among colliers. In the first place, we know that coal-pits differ greatly in geological character, in depth, in the grittiness or dustiness of the rock which has to be worked in order to get at the coal, in the amount and composition of gas present, in the quantity of water permeating the strata, in the thickness of the coal seams, in the temperature of the workings; and last, but most important, in the perfection or otherwise of the ventilation of the coal-pit. Again, it is known that the habits and consequently the health and comfort of coal miners vary extremely according as the colliery is situate in a country district, or, as is frequently the case especially in the Lancashire coalfields, in what is practically an urban district, perhaps bordering on a large town. These variations in the circumstances of life are certainly sufficient to account for wide differences in the health and longevity of coal miners.

Aged colliers, wherever they are employed, sustain a mortality which is considerably in excess of the standard; yet even among them the mortality varies greatly with locality. For whereas in the counties of Derby and Nottingham the mortality of colliers aged sixty-five years and upwards exceeds that of occupied males by 18 per cent., the excess amounts to 50 per cent. in Lancashire, 52 per cent. in Durham and Northumberland, and 80 per cent. in Staffordshire.

In the list of principal causes of death amongst colliers there are two diseases which have been the subject of exceptional comment, both in this country and abroad—namely, pulmonary phthisis on the one hand, and ordinary inflammatory diseases of the lung on the other. Almost all writers on the subject, whether in recent or in earlier years, agree in attributing to colliers an unusually low mortality from tubercular, and a correspondingly high mortality from non-tubercular, disease of the lungs. The accompanying table, which gives statistics for the years 1890–92, confirms the general opinion. Thus, taking coal miners in the aggregate we find that their mortality ascribed to phthisis is only about half of that to which other occupied males are subject, whilst their mortality from respiratory diseases exceeds the same standard by 21 per cent. If we take farm labourers as a standard by which the mortality of colliers should be judged, we find that whilst colliers suffer from fatal phthisis in the proportion of 97 as against 115 for farm labourers, colliers die rather more than twice as rapidly from diseases of the respiratory system other than phthisis. Although, as has already been stated, colliers as a class enjoy special immunity from pulmonary phthisis, nevertheless the disease prevails amongst them very unequally. The highest mortality figures from phthisis among colliers are 123 in the West Riding of Yorkshire and 107 in Monmouthshire, whilst the figures do not exceed 83 in Staffordshire and 69 in Derbyshire. In no English county does the mortality of colliers from phthisis even approach 185, which is the figure for occupied males in the aggregate.

In the West Riding of Yorkshire the mortality of colliers from phthisis has increased since 1881 by one-fifth part; but in other counties it has decreased by proportions in some cases as high as one-third of its former amount. Non-tubercular diseases of the lungs are excessively fatal to the colliers of Monmouthshire and South Wales, and still more so to those of Lancashire, where the mortality from these diseases is 76 per cent. above that of occupied males generally, and is more than double of what it is among the colliers of Northumberland, Durham, Derby, and Nottingham. These diseases have very considerably increased in fatality since 1881 in all the coalfields of England: the increase being equal to two-thirds of the former amount among the colliers of Lancashire, and to more than one-half among those of the West Riding of Yorkshire. Colliers nowhere appear to readily fall victims to intemperance. In Derby and Nottingham, as well as in Staffordshire, the colliers are especially free from that vice, their mortality from alcoholism being only half the low figure for colliers generally. Even in Monmouthshire and South Wales, where the figure for alcoholism is the highest, only 7 of the colliers die of this disease for every 13 that die from it in other occupations. Since 1881 the mortality due to intemperance has slightly increased among the coal miners of Lancashire, but has decreased in all other counties respecting which comparison is possible.

Ironstone mining.—This is one of the industries that are declining in this country. Miners of ironstone numbered barely 18,000 at the last census, and were fewer by nearly one-third part than at the census of 1881. More than half of these workers are to be found in the counties of Cumberland and York, and about an eighth part more are scattered over the counties of Stafford and Northampton. Speaking generally, iron-workers are a healthy body of men. They experience rates of mortality which are lower than those of “occupied males” at all periods of life between twenty years and sixty-five, and also lower than the rates for coal miners at the same ages. Both ironstone miners and colliers, however, suffer a much higher mortality than other workers at ages under twenty and over fifty-five years; the reason for this has not as yet been satisfactorily explained. It has been shown by Dr Ogle and other writers that the vital statistics of ironstone miners bear a general resemblance to those of coal miners. Recent investigations confirm this statement thus far, that in both cases the mortality from tubercular phthisis and from all other diseases except those of the respiratory system are below the average, and even this reservation does not apply to the statistics of 1890–2. Their comparative mortality figure from all causes is 774, and therefore considerably below that of coal miners in the aggregate. From disease alone (excluding accident) their mortality is slightly higher than that of colliers in Northumberland and Durham, but they suffer somewhat less severely from accident. Ironstone miners are a temperate body of men, their mortality figure from alcoholism being practically the same as that of colliers.

The extended tables of causes of death in my larger work show that ironstone miners suffer more severely than the average from influenza and from accident, but that under all other headings their mortality is below that of other occupations.

As compared with miners generally, the only diseases which show an excess among these workers are influenza, cancer, diseases of the liver, and suicide. Since 1881, the mortality of ironstone miners has decreased; but, as in the case of many other occupations, the improvement is limited to the lower ages, the rate having slightly increased at ages above forty-five years. Since 1881 the mortality of ironstone miners from alcoholism has decreased by more than half. There has also been a substantial decrease in their mortality from pulmonary consumption, and a slight decrease in that from other diseases of the lungs and air passages. Diseases of the nervous, circulatory, digestive, and urinary systems are, however, more fatal than formerly amongst these workers, and they are now more addicted than they were to suicide.

Copper Miners.—The number of men engaged in this industry is so small that it is scarcely safe to express an opinion as to their healthiness or otherwise, especially when, as in the present case, the period covered by the statistics does not exceed three years. At the last census scarcely more than 1000 copper miners above fifteen years were enumerated, their number having dwindled to less than a third part of what it had been at the preceding census.

If one may hazard an opinion from so small a number of deaths, it would appear that copper miners are an unhealthy body of men: their comparative mortality figure is 1230, or 295 above that of miners in the aggregate. Pulmonary consumption and other lung diseases appear to be very destructive to these workers, and the survivors certainly do wisely in endeavouring to find a healthier field for their labour by emigrating to other and more prosperous regions. At the next census it is probable that the copper-mining industry in England will have practically ceased to exist.

Tin Miners.—This is another unhealthy occupation; it is limited almost exclusively to the counties of Devon and Cornwall. The miners of tin at the last census numbered rather fewer than 10,000, and as the deaths in the course of three years did not exceed 336 in all, no very detailed observations on their mortality would be profitable. In consequence of the very general emigration of tin miners in recent years to South Africa and elsewhere, the age constitution of tin miners as a class has become exceedingly abnormal. Adults in the prime of life having left their homes in search of more profitable work abroad, the tin miners who are left at home are the least robust and healthy of their tribe, and this fact has a considerable effect on their mortality. Reference to the table on page 156 shows that tin miners sustain rates of mortality which are excessive at all ages. Their comparative mortality figure is 1409, or nearly half as high again as the average. Tin miners die two and three-quarter times as fast from phthisis, and one and three-quarter times as fast from other lung diseases as do occupied males generally; their mortality from cancer and from diseases of the nervous and urinary systems is also in excess of the average.

MORTALITY OF UNOCCUPIED AND OCCUPIED MEN.

In my previous work on occupational mortality, the death-rates of unoccupied men were compared, in considerable detail, with those of men following various occupations, in different parts of the country. A brief summary of what was then advanced at much greater length may fitly close the present section.

At the census of 1891 the number of unoccupied males living between the ages of twenty-five and sixty-five years was returned as 208,857. Of these, 35 per cent. were classed as “retired from business,” 6 per cent. as pensioners, and 23 per cent. as “living on their own means,” whilst 21 per cent. were referred to the class of “unoccupied persons,” including an unknown proportion of paupers and prisoners. Careful investigation of the facts leads to the surmise that somewhere between one-third and one-half of the unoccupied males, as above defined, experience a mortality which probably does not exceed that of occupied males at the same ages. If this be so, it follows that the mortality of the remaining two-thirds, or one-half, as the case may be, must greatly exceed even the high rates of unoccupied males in the aggregate. In the following table the rates of unoccupied males are contrasted with those of occupied males at the several stages of life.

Age- Groups. Occupied Males. Unoccupied Males. “Unoccupied” Rates per cent. of “Occupied” Rates.

15–20 2.55 35.86 1406

20–25 5.07 29.58 583

25–35 7.29 27.05 371

35–45 12.43 35.71 287

45–55 20.66 37.77 183

55–65 36.66 59.44 162

Over 65 years 102.32 105.86 103

The comparative mortality figures of occupied and of unoccupied males between twenty-five and sixty-five years of age are 953 and 2215 respectively. In other words, the number of males of definite age constitution, within these limits, that would give 1000 deaths among the general population, and 679 deaths in the healthy districts, would give 953 deaths among occupied, and 2215 among unoccupied, males. The comparative mortality figure of unoccupied males, therefore, exceeds that of occupied males by 132 per cent. The following table shows the chief causes of death that go to make up the comparative mortality figures for occupied males and unoccupied males respectively.

Cause of Death. Occupied Males. Unoccupied Males. Excess of Mortality of Unoccupied over Occupied Males.

All Causes 953 2215 1262

Diseases of Nervous System 82 630 548

Phthisis 185 448 263

Diseases of Heart 126 240 114

Influenza and Respiratory Diseases 254 350 96

Cancer 44 96 52

Diseases of Urinary Organs 41 82 41

Alcoholism and Liver Diseases 40 76 36

Accidents, including Lead Poisoning 57 81 24

Suicide 14 28 14

It thus appears that nearly two-thirds of the enormous excess in the mortality of unoccupied as compared with occupied men is due either to diseases of the nervous system, or to phthisis. The heavy mortality from both these diseases would appear to partly depend on the circumstance that the unoccupied class includes a large proportion of insane persons who are exceptionally prone to phthisis. Among other causes of death, diseases of the heart account for 114, and influenza (with respiratory diseases) accounts for 96 of the excess in the mortality figure of unoccupied men.

The mortality attributed to cancer is double, and that attributed to intemperance and liver disease, to diseases of the urinary system, and to suicide, is about double as heavy among the unoccupied as it is among the occupied class. The excess of mortality from accident among unoccupied males possibly results from the addition to their ranks of men who, having been permanently disabled whilst at work, drift into the unoccupied class, and finally die from their injuries.

At the census of 1891 London contained 1,230,010 occupied males aged fifteen years and upwards, while the industrial districts contained 1,833,295, and the agricultural districts contained 1,246,156 at the same ages. More than half of the occupied males in England and Wales are therefore included in these three sections of the population.

The mortality of occupied males exhibits very wide variations in different parts of the country. These variations are exemplified severally by London, by the group of districts representing Industrial England, and by the areas representing Agricultural England.

At each of the seven age-groups, between fifteen and sixty-five years, the highest death-rates occur in the industrial, and the lowest in the agricultural, districts, London occupying an intermediate position.

The comparative mortality figure among occupied males, at ages from twenty-five to sixty-five years, is 1147 in London, 1248 in the industrial districts, and 687 in the agricultural districts; these figures being respectively 20 per cent. above, 31 per cent. above, and 28 per cent. below, the figure for all occupied males.

Phthisis and respiratory diseases are more fatal than any other causes of death to occupied males, both in London and in the industrial districts. In London these two headings contributed almost equally to the mortality figure. The industrial districts, on the other hand, show less mortality than does London from phthisis, but the difference is more than made up by the heavy death-roll from respiratory diseases. In the agricultural districts the mortality figure for phthisis is less than half of that of London, and the figure for respiratory diseases is still lower. After due correction for age constitution, these two classes of disease in the aggregate cause 48 per cent. of the total mortality among occupied males in London, 47 per cent. in the industrial districts, and 36 per cent. in the agricultural districts, against 43 per cent. for all occupied males within the same age limits.

John Tatham.