PUBLIC HEALTH REPORTS VOL 37 DECEMBER 15, 1922 No. 50 DISABLING SICKNESS AMONG EMPLOYEES OF A RUBBER MANUFACTURING ESTABLISHMENT IN 1918.1919, AND 1290.1 Some Morbidity Statistics from the Department of Health of the B. F. Goodrich Co., Akron, Ohio. Cases of sickness and nonindustrial injuries causing absence from work for one full day or longer up to one year among employees on the factory pay roll were recorded and classified by the department of health of the B. F. Goodrich Co. during the three-year period end- ing October 31, 1920. From the tabulation of these data made by the Equitable Life Assurance Society of the ULTnited States, the ac- companying tables were prepared and are presented herewith through the courtesy of the Goodrich Co. For this specific period of time, unfortunately, no comparable industrial morbidity statistics are available, but knowledge of the amount and causes of disability even in one group of industrial employees, especially when that group is a large one, is of interest from a number of different points of view, not the least important of which is consideration of the data from the point of view of the period itself. The three years ending October 31, 1920, represent a period of unusual conditions from the industrial morbidity standpoint for the following reasons: (1) During the war and for some time after the armistice the.raost physically fit American males were in military service. (2) The shortage of labor, which was acute throughout practically all of the period, appears to have resulted in an increase in absentee- ism for personal reasons, with sickness as the excuse, as suggested by the following figures showing the number of cases of illness lasting one day: Number of cases per 1,000 employees lasting only one day. Year ending Oct. 31- 1918 .276. 5 1919................................................................... 410.0 1920 .--...605.0 (3) A major epidemic (influenza) occurred in each of the three years ending with October 31. In addition to the epidemic, the numerous and serious sequele resulting from the primary cases of influenza should be mentioned. Unusual weather conditions in the early part of 1920 aggravated a health situation that was already unsatisfac- tory. ! From the Statistical Office, U. S. Public Iealth service. 199350-22- 1 (3083) December 15, 1922. 3084 The statistics tlherefore probably do not represent the sickness expectancy of the present time or of the -immediate future. Havin passedl through an extraordinary period, we can expect a return to something like normal health among the employees of industry. TIlE MORTALITY PICTURE. Undler the conditions referred to above, what were the chief causes of death among the company's factory employees? The mortality recor(l for the insured workers goes back to November 1915, whea DISSASIS CAIDSINO ATH(AS sivan NV PVErA caCr1incTwS) of s*2. 1NSlM12P EMAPL& RS OFWrHE RI GO@DPRI@ c.I vY IN>lm 4YEARa TROIA BoY. I*814W TO M^ 6'120D AND TO qq UMINVBED. IN&UESiw S YEAES lt*M MAY to 'd*1 lb MAY 3, 3950, DISEASE PEP. CERT OF TOrAL PEA^THS CAUSI'G DEATH 0 S s0oS 20 I. P%EYUMO_IA 2. hTrLIU!MA- PNEUMONIA 3. NONlNDSTRIAL. ACCIPENJ3 4 TUBE2CULOSIS S. PANCARPITIST(L 6.APPEPaDCTns - PERITodTIT ¶ TYP$OIP.FEVEP 8. CARPCIIOMA e.MENIITIS JO. NEPHIZITJS IIs. HoMIIDE_ 51. CEREBRL )IEORBA4 _ IS IMPUSTOLA ACCIDE4Th S ScARLET FEYEL IS. SUICIDE J(. SEPTIC.EMIA 18 PAALYS*IS 9. AcuTe INicaSsrIOH ) S 2o 2S Tbs lifa *of on *ewqI.y& w% iinsaLvm by lb ew,psuvy sfIea 3 vnwks sarvos. A m_ i to .._ c f bow& sftaesa of wbete-ver _al.u.ea FIG. 1. health conditions were more normal; but even so, nearly lhalf of all the mortality for more than four years was caused by pneumonia or by influenza-pneumonia. When nonindustrial accidents, tuberculo- sis, and pancarditis 2 are added to the toll of pneumonia and influenza pneumonia, we have accounted for 65 per cent of total deaths among a group composed of all the insured employees in the four and one- half years from November 1, 1915, to May 1, 1920, and all the unin- sured workers in the three years from May 1, 1917, to May 1, 1920.' There were more deaths recorded as due to nonindustrial accidents than were caused by tuberculosis, probably because a number died from tuberculosis after their names had been removed from the pay rolls of the company at the end of one year's disability. An inclusive term applied to all deaths from heart atections of whatevcr nature. The life of an employee was insured by the company after three months' serwice. 3085 Decenaber 1, 1922. TABLE L.-Diseaes causing death (as given by death certificates) of.392 irsured employees of the B. F. Goodrich Co. in the 44 years from November 1, 1915, to May 1, 1920, and to 99 uninsured employees in the 3 yearsfrom May 1, 1917, to May 1, 1920.' Num- Per cent Num- Per cent Disease causing death. ber of of total Disease causing death. ber of of total deaths. deaths. deaths. deaths. i- -l 26.3 1. PnieumoliSa................ 129. 12. Cerebral hemorrhage. 7 1.4 2. influenza-pneumonia....... 89 18&1 13. Industrial accidents........ 7 1.4 3 Nonindustrial accidents.... 38 7.7 14. Scarlet fever........... 7 1.4 4. TuberculOsi.s -------------- 34 69 15. Suicide..................... 7 1.4 5. Pancarditis '............. 30 6.1 16. Septicmia.................. .6 1.2 22 4.5 17. Diabetes................ 6. Appenadicitis-peritonitis..... 4 .8 7. Typhoid fever........ 22 4.5 18. Paralysis..... 4 .8 s. Carcinoma................. 12 2.5 19. Acute indigestion 3 .6 10 2.1 20. All other causes................ -41 &84 9. Meningitis.................. 2.1 10. Nephrltis ..........- 10 II. Homicide................... 9 1.8 Total.................... 491 100.0 a_ 1 The life of an employee was insured by the company after 3 months' service. An inclusive term applied to all deaths from heart affections of whatever nature. DISEASES AMP CONDrTIONS CAUSINGH GEATT r ff r ras LDIN E1MPIY.CoS OF THE A.V GOO"ACi qo? IN Tt 3.,'uAP5 ocr. 31. l- .. - , . .I.. pJSEASs. OR CONDITION PEIC ,CW OF TWTAL LOT TJ e CASAMING VlaASIIJTV O 5 to10 iS 1 . 2 a I a I a .I I .a . *.. I . .I I 1. INTLUENZA AMP GriPPE 2. TONSILLITIS 5. bOL11 4. NONINDUSTRIAL JNJURIca 5. Bl2ONCHITIS RHEUMTISMe *. PULMONARY TUSERCVI.OSIS a STOMACH DISEASES . APPENDICITIS 1I HEADACHE 11. PNEUMONIA 1I. MUMIPS Is ENTErZATIS 14. FUauNcLE IS. G.ASTI1TIS I; HERNIA I'1. DI5EASES 0WThE EAI I6. SkiN D5EASES OCCIPATIOMAI. PERMArIrIS - -. -. -. -. I- -. -. a . S . a ,- . * @ ,,,- o0 S to IS All Coams of Soi4krs AacwaJev&r Cfr" Abs.enc frsw, Work Te.o Onc % 4r LLWI Aftr 1inqu64aJ,%xaet co.s )stig longe thor Yew WhWi,C W~P Met Follow". B.s1L t, Twt Yew of9 ;01 FIG. 2. TIIE MORBIDITY PICTURE. How does the morbidity picture compare with mortality Were deaths also the diseases causinor0 the greatest number of responsible for the largest amount of 'time lost from work? In Table 11 and Figure 2, influenza is again prominently'at the front; but, whereas influenza and influenza-pneumonia caused 44 per cent of total deaths, influenza, grippe, and pneumonia caused only 19 per cent of all the disability.' The first five causes, of death as listed in Table I December 1, 1922. 3086 accounted for 65 per cent of the mortality, but for only about 26 per cent of the morbidity as expressed in time lost from work. Ton- sillitis, colds, rheumatism, bronchitis, and gastro-intestinal disorders were the outstanding causes of disability in addition to the epidemaic, nonindustrial injuries, and tuberculosis. The prevention of deaths and the elimination of the greatest possible amount of time lost from work on account of disability apparently are not one and the same problem. Nor is the problem of disabling sickness in office and factory the same.4 TA.BLE II.-Disease8 and conditions causing the greatest amount of lost time to employees of the B. F. Goodrich1 Co. in the 3 years ending October 31, 1920.' Work Per _s Work Perr Disease or condition cauls- dascnlfpre0 ies rcniincu day cent of ing disability. othe3 |ost employ- i.n disability. lost in total p 100 ecs per yersetme r years. timDe. year. yer.tm.year. 1. Influenza and grippe 70,067 16.93 143 12. Mumps............... 6,045 L46 12 2. Tonsillitis ............ 31,504 7.61 65 13. Enteritis ............. 5,495 1.33 lt 3. Colds ....25........ 2,952 6.27 53 14. Furuncle ............. 5,441 1.311 4. Nonindustrial injuries 16,826 4.07 34 15. Gastritis ... 4, 408 1.07 Z 5. Bronchitis............ 14,260 3.45 29 16. Heia 4,396 1.06 O 6. Rheumatism......... 13,616 3.29 28 17. Diseases of the ear 3,578 .86 ga 7. Pulmonary tubercu- 18. Diseases of the skin 3,566 .86 07 losis ............. 12,110 2.93 25 19. Oceupationial derma- 8. Diseases of the stom- titis .-------- 3,362 .81 07 ach .... 10,797 2.61 22 20. All others..... 156,562 37.82 321 9. Appendicitis..............10,610 2.56 22. 10. EIcedache ............ 8 581 2.07 18 Total .............. 413,939 100.00 847 11. Pneumonia........... 6,763 1.63 14 Average number of employees, 16,285. 1 All sickness and nonindustrial accident cases causing absence from work for one day or longer are in. cluded, except cases lasting longer than one year, whiclh were not followed beyond the first year of di. ability. MORBIDITY IN EACII OF THE THREE YEARS. hIow tlhe number of days lost per person or per 100 persons varied in the three years under review is shown for each sex in Table III.