D* {^\ UNiv. of ºt:H.
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Occupational Mortality Experience of
94,269 Industrial Workers
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:
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Read before the Section on Vital Statistics,
AMERICAN PUBLIC HEALTH Association,
Rochester, N. Y., September, 1915
Reprinted from AMERICAN Journal of PUBLIC HEALTH, 755 Boylston Street, Boston, Mass.
Vol. 6, No. 7
‘.. BY
LOUIS I. DUBLIN, Ph.D., Statistidan
Metropolitan Life Insurance Company, New York
1916

OCCUPATIONAL MORTALITY EXPERIENCE OF 94,269
INDUSTRIAL WORKERS.
METROPOLITAN LIFE INSURANCE COMPANY EXPERIENCE,
1911–13. & *
A Preliminary Report Read before the Section on Vitah Statistics, American Public Health Association,
Rochester, N. Y., September, 1915.
Louis I. DUBLIN, PH.D.,
Statistician, Metropolitan Life Insurance Company, N. Y.
present the preliminary results
of an analysis of 94,269 death
records of occupied white males, ages
15 and over, with especial reference
to the influence of occupation upon
the causes of death. The material
is from the Industrial Mortality Ex-
perience of the Metropolitan Life
Insurance Company and covers the
three years 1911, 1912, and 1913. The
occupations represented in this ex-
perience are almost entirely industrial
in character. Table I shows that
“laborers” form the largest group of
decedents, with 11.4 per cent. of the
total. All the more important oc-
cupations, in the various industries
are represented. There are large
numbers of clerical employees, farmers,
and farm laborers, workers in the
building trades, in the iron and steel
mills, and in the railway service.
A few words as to method may be
of interest. The occupations re-
turned upon the death certificates
were classified according to a list of
titles abridged and modified from the
one prepared by the Census Bureau
for use in occupational mortality
tabulations. Attention was espe-
I' IS the purpose of this paper to
*.
cially directed to those occupations
which were represented in large num-
bers or which possessed exceptional
interest from the viewpoint of hazard.
The causes of death selected for the
study were likewise those which were
of the greatest interest because of their
numerical importance or because they
indicated the character of the hazard
in the occupation. The number of
deaths from these causes was then
tabulated for each occupation by 10-
year age periods. Table II presents
the general characteristics of the
material for all occupied white males
combined. The remaining table (III,
Parts a-n), is for individual occupa-
tions.
It were well if in addition to these
tabulations there were available cor-
responding figures for the living policy-
holders by occupation and age. We
would then have been able to present
the death-rates occurring in the various
occupations by age period and by
causes of death. Unfortunately, this
is not possible because of the great
cost involved in keeping records in
such detail for over ten million in-
dustrial policyholders. We may,
nevertheless, determine the significant
1
3 # 36535
TABLE I.
OCCUPATIONS OF WHITE MALE DECEDENTS-AGES 15 AND OVER.
METROPOLITAN LIFE INSURANCE COMPANY–INDUSTRIAL DEPARTMENT.
MORTALITY EXPERIENCE, 1911–13.

A º * No. of | Per Cent.
Occupation Deaths. of Total.
All Occupations (excluding “Retired”). . . . . . . . . . . . . . . . . . . . . . . . . . . - 94,269 100.0
Laborers (undefined). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,748 11.4
Teamsters, Drivers and Chauffeurs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,471 6.9
Clerks, Bookkeepers and Office Assistants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,139 4.4
Carpenters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ". . . . . . . . . . . . . . 3,917 4.2
Farmers and Farm Laborers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,890 4.1
Machinists. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : • * * * * * * * * * * * * * * * 3,152 3.3
Painters, Paper-hangers and Warnishers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,722 2.9
Policemen, Watchmen and Guards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,407 2.6
Store Clerks and Salesmen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,396 2.5
Textile Mill Workers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,390 2.5
Merchants and Storekeepers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,260 2.4
Saloon-keepers and Bartenders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,190 2.3
Railway Track and Yard Workers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,932 2. ()
Janitors and Building Employees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,770 1.9
Masons and Bricklayers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,748 1.9
Iron Moulders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,646 1.7
Coal Miners. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,557 1.7
Shoemakers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,452 1.5
Stationary Engineers and Firemen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,443 1.5
Children, Students and Scholars. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,437 1.5
Blacksmiths. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,273 1.4
Professional Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,186 1.3
Agents and Canvassers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,183 1.3
Plumbers, Gas Fitters and Steam Fitters... . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,153 I .2
Tailors and Garment Workers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,095 1.2
Compositors and Printers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,056 1. 1
Railway Enginemen and Trainmen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 947 1.0
Street Railway Employees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 868 .9
Hostlers and Stablemen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 832 .9
Hucksters and Peddlers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 829 .9
Sailors and Marine Workers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 787 ... 8
Iron and Steel Mill Workers. . . . . vº • * - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 762 ... 8
Waiters. . . . . . . . . . . * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * . . . . 758 .8
Cabinet and Furniture Makers. . . . . . . . . 9 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 757 .8
Cigar Makers and Tobacco Workers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 693 .7
Leather Goods Workers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 662 .7
Bakers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 654 .7
Longshoremen and Stevedores. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 651 .7
Tinners and Tinware Workers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 614 .7
Street and Sewer Cleaners. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 609 .6%
Electricians. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 596 ... 6
Barbers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 582 ... 6
Coopers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 521 ... 6
All Other Occupations. . . . . . . . . . ‘. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15,534 16.5

TABLE II.
NUMBER OF DEATHS FROM PRINCIPAL CAUSES AND PER CENT. EACH CAUSE OF ALL CAUSES IN ALL OCCUPATIONS (EXCLUDING
“RETIRED")—BY AGE PERIODS OVER FIFTEEN YEARS–WHITE MALES.
METROPOLITAN LIFE INSURANCE COMPANY–INDUSTRIAL DEPARTMENT—MORTALITY EXPERIENCE, 1911–1913.
/
Ages 15 and Ages Ages Ages Ages Ages Ages
& Inter OVer. 15–24. 25–34. 35-44. 45–54. 55–64. 65 and over. Av.
Cause of Death. national Age
List No. No. of | *Per | No. of | Per | No. of | Per | No. of | Per | No. of Per | No. of | Per | No. of | Per pº
Dths. cent. | Dths. cent. | Dths. cent. | Dths. cent. | Dths. cent. | Dths. cent. | Dths. cent. e
All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94,269| 100.0| 11,116 100.0 12,953| 100.0|| 15,242 100.0| 16,696 100.0 19,135| 100.0| 19,127 100.0| 47.9
Typhoid fever. . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1,390 1.5 581 5.2 356 2.7 211 1.4 128 8 81 4 33 .2. 31.1
Influenza. . . . . . . . . . . . . . . . . . . . . . . . . . . ... • . . . 10 769 .8 64 ... 6 65 .5 94| . .6 113 7 189 1.0 244 1.3| 53.3
Tuberculosis of the lungs. . . . . . . . . . . . . . . . . . 28, 29 19,349| 20.5 3,753| 33.8 5,292; 40.9| 5,017| 32.9| 3,084| 18.5| 1,640 8.6 563 2.9| 37.1
Cancer (all forms). . . . . . . . . . . . . . . . . . . . . . . . 39–45 4,578 4.9 76 7 103 .8 357 2.3 989 5.9| 1,665 8.7| 1,388 7.3, 57.8
Acute articular rheumatism. . . . . . . . . . . . . . . . 47 380 4 105 .9 46 .4 * 3 75 4 51 3 51 .3| 41.1
Chronic rheumatism and gout. . . . . . . . . . . . . 48 69 ... 1 4!. . . . . . 6!. . . . . . 6l. . . . . . 10 ... 1 20 ... 1 23 . 1| 54.9
Diabetes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 913 1.0 110 1.0 92 .7 100 .7 171 1.0| 249 1.3 191 1.0|| 49.7
Alcoholism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 889 .9 21 .2 182 1.4 314 2.1 227 1.4 106 .6 39 .2| 43.1
Chronic lead poisoning. . . . . . . . . . . . . . . . . . . . 57 81 1 31. . . . . . 8 1 24 .2 24 ... 1 14 ... 1 8]. . . . . . 47.5
Other occupational and chronic poisonings. . . . 58, 59 31. . . . . . . 4] . . . . . . 41. . . . . . 71. . . . . . 71. . . . . . 4] . . . . . . 5l. . . . . . 45.8
Cerebral hemorrhage, apoplexy and paralysis. 64, 66 5,825 6.2 52 . 5 160 1.2 350 2.3 864 5.2 1,845 9.6| 2,554|| 13.4| 60.9
Organic diseases of the heart. . . . . . . . . . . . . . . 79 11,323| 12.0 640 5.8 697 5.4| 1,181 7.7| 1,850 - 11.1] 3,048. 15.9| 3,907| 20.4 55.6
Acute and chronic bronchitis. . . . . . . . . . . . . . 89–90 804 .9 30 .3 36 .3 52 .3 103 ... 6 º 1.1 370 1.9| 59.9
Preumonia (lobar and undefined) . . . . . . . . . . 92 6,776 7.2 599 5.4 952 7.3| 1,228 8.1. 1,369 8.2 1,431 7.5. 1,197 6.3| 48.1
Pleurisy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 276 .3 46 .4 30 .2 40 .3 59 .4 55 3 46 .2 46.1
Cirrhosis of the liver. . . . . . . . . . . . . . . . . . . . . . 113 2,136 2.3 22 .2 154 1.2 389 2.6 635 3.8 593 3.1 343 1.8| 52.0
Bright's disease. . . . . . . . . . . . . . . . . . . . . . . . . . 120 9,059 9.6 276 2.5 577 4.5] 1,190 7.8 1,851] 11.1| 2,553| 13.3| 2,612 13.7. 55.1
Suicide (all forms). . . . . . . . . . . . . . . . . . . . . . . . 155–163 2,150 2.3 308 2.8 402 3.1 436 2.9 428 2.6 383 2.0 193 1.0| 43.1
Accidental violence....................... { ;: } 8,752 9.3| 2,130 19.2 1,616 12.5| 1,516 9.9} 1,419 8.5. 1,236 6.5, 835, 4.4, 39.3
All other causes of death. . . . . . . . . . . . . . . . . . 18,719 19.9| 2,292. 20.6| 2,175 16.8. 2,678 17.5 3,290. 19.7| 3,759 19.6; 4,525, 23.9|......
* Percentage, deaths from specified causes, of deaths from all causes in age period.
facts in the relation between occu-
pations and causes of death by the
method of proportionate mortality,
that is, by comparing the per cent. of
total deaths from any one cause in a
given age period and in a specified
occupation with the corresponding
figure for all occupied persons. For
example, at the age period 25 to 34,
28.7 per cent. of the deaths among
blacksmiths were due to tuberculosis
of the lungs (see Table III, a *). For
the same age period, the corresponding
proportion of deaths from tuberculosis
of the lungs among all occupied males
was 40.9 per cent (Table II). The
ratio of these two percentages may be
conveniently called the index of mor-
tality for the specified cause. In
this instance the index of mortality
for tuberculosis of the lungs among
blacksmiths in the age period 25 to
34 is 70.2 per cent. It is quite evi-
dent, therefore, that pulmonary tuber-
culosis among blacksmiths at the age
period 25 to 34 does not require the
same relative attention from hygienists
as it does in certain other occupations.
The fuller paper will take up in this
manner each of the occupations and
consider the causes of death which
present the greatest variations from
the standard of “all occupations.”
In this paper we shall refer only to a
few of the more interesting consider-
ations which arise out of the study.
Thus we find that pulmonary tuber-
culosis was the most represented cause
of death in ten out of the fourteen oc-
cupations referred to in these tables.
It was found most common among
* Owing to limitations of space, it has been con-
sidered inadvisable to print the tables for individual
occupations in full; only those causes of death are
given to which reference is made in the text.
clerks, bookkeepers, and office assist-
ants (Table III, c) where it was re-
sponsible for 35 per cent. of all the
deaths. In the age period 25 to 34,
51.2 per cent. of all the deaths were
from this disease, whereas, among all
occupied males in this age period,
only 40.9 per cent. of the deaths were
from pulmonary tuberculosis. The
index of tuberculosis mortality among
clerks, bookkeepers, and office assist-
ants is, therefore, 125, the index for this
disease was also found high among com-
positors and printers (Table III, e) and
among teamsters, drivers, and chauf-
feurs (Table III, m). It was found least
represented among coal miners (Table
III, d), where it was responsible for
only 5.8 per cent. of all the deaths. In
the age period 25 to 34 we find only
11.9 per cent. of all the deaths due to
this disease. The index of tuberculosis
mortality, therefore, is 29 per cent.
This low index is characteristic of the
disease among coal miners at all age
periods up to 65. It might appear
that the low proportionate mortality
from pulmonary tuberculosis among
coal miners is the result of the high
proportion of deaths from other causes,
notably accidental violence. Yet
other respiratory diseases such as pneu-
monia and acute and chronic bron-
chitis are even more prevalent among
coal miners than among all occupied
males. A fairly large proportion of
tuberculosis is found among railway
employees, who suffer from a higher
proportion of accidents than do the
coal miners. A high percentage from
accidents is, therefore, not incom-
patible with a fairly normal propor-
tionate mortality from pulmonary
tuberculosis. Coal miners seem to
TABLE III.
NUMBER OF DEATHS FROM PRINCIPAL CAUSES AND PER CENT. EACH CAUSE OF ALL CAUSES, IN FOURTEEN OCCUPATIONS
BY AGE PERIOD OVER FIFTEEN YEARS–WHITE MALES.
METROPOLITAN LIFE INSURANCE COMPANY–INDUSTRIAL DEPARTMENT—MORTALITY EXPERIENCE, 1911–1913.

Age Period.
*. 15 and over 15-24. 25–34. 35-44. 45-54. 55–64. | *.*.* | ****
Part, Occupation. Cause of Death. g ſº & * e Over. Age at
Death.
No. of *Per Per Per Per Per Per Per
Deaths. cent. Cent. cent. cent. cent. cent. cent.
f(1,273) (47) (87) (165) (235) (337) (402)
3. Blacksmiths All causes. . . . . . . . . . . . . . . . . 1,273 100.0 100.0 100.0 100.0 100.0 100.0 100.0 55.4
Tuberculosis of the lungs. . . . . . . . 178 14.0 29.8 28. 7 35.8 17.0 8,3 3. 43.9
* z e (693) (66) (98) (95) (121 (158) (155)
b Cigar Makers and Tobacco All causes. . . . . . . . . . . . . . . . . 693 100.0 100.0 100.0 100.0 100.0 100.0 100.0 49.5
Workers Tuberculosis of the lungs. . . . . . . . 167 24. 1 48.5 44.9 41 .. 1 25. 6 11.4 1.9 37.9
Suicide (all forms) . . . . . . . . . . . . . 22 3.2 3.0 2.0 4.2 3.3 3.8 2. 6 49.3
(4,139) (1,307) (893) (695) (518) (431) (295)
C Clerks, Bookkeepers and Office All causes. . . . . . . . . . . . . . . . . 4, 139 100. 100.0 100.0 100.0 100.0 100.0 100.0 36.5
Assistants Tuberculosis of the lungs. . . . . . . . 1,449 35.0 46.3 51.2 33 - 4 21.6 8.8 1. 7 29.4
(1,557) (151) (135) (182) (319) (407) (363)
d Coal Miners CallSèS . . . . . . . . . . . . . . . . . 1,557 100.0 100.0 100.0 100.0 100.0 100.0 100.0 51.3
Tuberculosis of the lungs. . . . . . . . 91 5. S 4.0 11.9 12. 1 6.6 3.4 3.3 45.8
Acute and chronic bronchitis. . . . 49 3.1 & e e º f * * * * * * * * 1. 1 1.6 4.2 6.9 63.6
Pneumonia (lobar and undefined) 161 10.3 4.6 7.4 10.4 14.7 11 .. 3 8.8 53.1
Suicide (all forms). . . . . . . . . . . . . 18 1.2 .7 2.2 2.2 2.2 ... 7 * * * * 44.6
Accidental violence. . . . . . . . . . . . . 317 20.3 62.9 43.7 30. 7 15.7 10.3 || 4.1 36.6
(1,056) (217) (221) (225) (176) (120) (97)
e Compositors and Printers All causes. . . . . . . . . . . . . . . . . 1,056 100.0 100.0 100. 100. 100.0 100.0 100.0 40.2
Tuberculosis of the lungs. . . . . . . . 360 34. 1 45.2 49. 39.1 23.9 15.8 3.1 33.5
(3,890) (239) (198) (266) (431) (1,008) (1,748)
f Farmers and Farm Laborers All causes. . . . . . . . . . . . . . . . . 3,890 100.0 100,0 100.0 100.0 100.0 100.0 100.0 58.5
Organic diseases of the heart. . . . 641 16. 5 5.9 3. 5 6.8 13.7 18.5 20.4 63.6
* (10,748) (622) (1,026) (1,453) (2,049) (2,732)] (2,866)
g Laborers All causes... . . . . . . . . . . . . . . . 10,748 100.0 100.0 100.0 100.0 100 - 0 100,0 100 . () 52.8
Suicide (all forms). . . . . . . . . . . . . 186 1.7 4.8 2. 1 1.5 1.7 44.9
sº - | (3,152) (573) (565) (500) (509) (516) (489)
h Machinists All causes. . . . . . . . . . . . . . . . . 3,152 100.0 100.0 100.0 100.0 100.0 100 0 100.0 43.9
|Suicide (all forms). . . . . . . . . . . . . 81 2.6 1.6 3. 5 3.2 3.3 1.4 2.5 43.8
(2,722) (166) (368) (552) (592) (592) (452)
i Painters, Paperhangers and War- All causes. . . . . . . . . . . . . . . . . 2,722 100.0 100. 100.0 100.0 100.0 100.0 100.0 48.6
nishers Chronic lead poisoning. . . . . . . . . . 54 2.0 1.1 3.4 2.5 1.9 , 9 47.7
º f(947) (203) (300) (173) (109 (94) (68)
j Railway Enginemen and Train- All causes. . . . . . . . . . . . . . . . . 947 100.0 100.0 100.0 100.0 100.0 100.0 100.0 37.4
Inen Tuberculosis of the lungs. . . . . . . . 133 14.0 11.8 14.7 24.9 13.8 7.4 e ſº ſº & 34.8
Crganic diseases of the heart . . . . 51 .4 1.0 1.3 5.2 10. I 13.8 17.6 52.2
º Suicide (all forms). . . . . . . . . . . . . . 23 2.4 2.5 2.3 2.9 2. 2.1 1.5 36.7
...sº Accidental violence . . . . . . . . . . . . . 401 42.4 66.5 57.7 30.0 18.3 17. 1 7.4 30.1
(1,932) (177) (243) (232) (334) (475) (471)
k Railway, Track and Yard All causes. . . . . . . . . . . . . . . . . 1,932 100.0 100.0 100.0 100.0 100.0 100.0 100.0 50.7
Workers Accidental violence . . . . . . . . . . . . . 402 20.8 43, 5 34.6 32.3 19.5 13.0 8.3 41.4
(2,190) (57) (492) (775) (535) (243) (88)
I Saloon-Keepers and Bartenders All causes. . . . . . . . . . . . . . . . . 2,190 100.0 100.0 100.0 100.0 100.0 100.0 100.0 42.6
Alcoholism. . . . . . . . . . . . . . . . . . . . 75 3.4 3.5 4. 7 4.5 2.2 1.2 & e = & 38. 8
Cirrhosis of the liver. . . . . . . . . . . 165 7.5 tº £ tº e 4. 5 8.3 10.7 6, 6 6.8 44.4
Bright's disease. . . . . . . . . . . . . . . . 267 12, 2 3.5 6.3 10. 7 17.4 18.1 15.9 46.8
Suicide (all forms) . . . . . . . . . . . . . 60 2.7 3.5 3.9 2.3 1.9 3.7 2.3 41.2
(6,471) (768) (1,498) (1,579) (1,152) (818) (656)
IT) Teamsters, Drivers and Chauf- All causes. . . . . . . . . . . . . . . . . 6,471 100 100.0 100.0 100. 100.0 100.0 100.0 42.2
eulºs Tuberculosis of the lungs. . . . . . . . 1,825 28, 36.6 42.7 35.7 20. 2 10.0 4.0 35. 5
t - (2,390) (383) (282) (310) (399) (495) (521)
Il Textile Mill Workers All causes. . . . . . . . . . . . . . . . . 2,390 100.0 100 0 100.0 100.0 100.0 100.0 100.0 47.6
Suicide (all forms) . . . . . . . . . . . . . 43 1 .. 8 2.3 1. 1 - 0 3. 5 1.4 1.2 45.4
*Per cent. deaths from specified causes, of deaths from all causes in age period.
f Superposed figures denote total deaths, all causes, in specified age period.
enjoy a very definite immunity from
pulmonary tuberculosis. Future med-
ical research, in determining just what
the protective factor in the environ-
ment of the coal miner is, will make an
advance that will be of great practical
value.
Organic disease of the heart ranks
next in importance in our investiga-
tion. It is responsible for 12 per cent.
of all deaths in all age periods com-
bined. Unlike tuberculosis, which is
most prevalent at the younger ages,
this disease reaches its highest point
in the advanced age periods, namely,
65 and over, where 20.4 per cent. of all
deaths are due to it. It is also the
leading cause of death in the age
period 55 to 64. It is found most
prevalent among farmers and farm
laborers (Table III, f), among whom it
was responsible for one death out of
every six. This is not an indication
of poor health conditions among
farmers, however, for farmers live to
a ripe old age, and organic disease
of the heart is, as we have shown,
primarily a disease of the older ages.
This disease is found least represented
among railway enginemen and train-
men. Inferences must not be drawn
too readily from the relative proportion
of heart disease in various occupations,
since it is one of the more unsatis-
factory returns of cause of death found
on certificates, obscuring in many in-
stances more definite conditions which
autopsy could determine.
Alcoholism is one of the minor causes
of death in our tabulation; yet it is
so significant socially that reference
will be made to it. It was responsible
for only .9 per cent. of all the deaths
among all occupied males. This fig-
ure is clearly an understatement, be-
cause deaths which are due to alcohol-
ism are often assigned to its major
effects. Thus we find that those
occupations which are most subject
to alcoholism show also a higher rate
from Bright’s disease and cirrhosis of
the liver. Alcoholism is found most
prevalent among saloon-keepers and
bartenders (Table III, l). Among
them it was responsible for 3.4 per
cent. of the total deaths. In the age
period 25 to 34, it caused 4.7 per
cent. of all deaths and, in the age period
35 to 44, 4.5 per cent. If we add to
this the proportionate mortality from
cirrhosis of the liver and Bright’s
disease we obtain 23.5 per cent. of all
the deaths. Among all occupied males,
on the other hand, these three diseases
in the age period 35 to 44 are respon-
sible for only 12.5 per cent. of all the
deaths. The unfavorable effect of
occupation is, therefore, quite clear
in the case of saloon-keepers.
A strong positive correlation, in all
probability, exists between the inci-
dence of alcoholism and that of sui-
cide. This latter cause was responsible
in our investigation for 2.3 per cent.
of all the deaths at all ages (Table II).
The proportion varies somewhat in
the various age periods, but is greatest
at ages 25 to 34. It is most prevalent
among cigar makers (Table III, b),
saloon-keepers and bartenders (Table
III, 1), machinists (Table III, h) and
railway enginemen and trainmen
(Table III, j); in other words, among
occupations where the wear and tear
on the nervous system is greatest. Its
importance as a cause of death is least
noted among coal miners (Table III,d),
laborers (Table III, g) and textile mill
workers (Table III, n). Recent in-
vestigators have urged that suicide is
a form of insanity. On this basis, it
would appear that the high incidence
of suicide among saloon-keepers and
bartenders may be in part the result
of the insanity induced by alcoholism.
This opens up a fertile field of inves-
tigation for both the statistician and
the psychiatrist.
Accidental violence is found to be
most prevalent among enginemen and
trainmen (Table III, j), coal miners
(Table III, d) and railway, track,
and yard workers (Table III, k). It
is most highly represented at the
younger ages in all these occupations.
Thus, among railway enginemen and
trainmen, the index of mortality for
accidental violence in the age period
25 to 34 is 461.6; in the age period 55
to 64 this index is reduced to 263.1.
These indices, when compared with
similar figures for European mortality
experiences, show how inadequate
American methods of accident pre-
vention still are.
Occupational diseases are repre-
sented in small numbers. Lead poi-
soning is found significant among
painters, paper hangers, and varnish-
ers (Table III,i). In this occupational
group 2 per cent. of all the deaths
occurring were due to chronic lead
poisoning, and in the age period 35 to
44 this proportion rose to 3.4 per cent.
Other occupational diseases are so
rarely recorded as not to warrant any
special mention.
In this preliminary statement I
have been able to review only a few
of the more important causes of death,
as represented in a small number of
occupations. Sufficient has been said,
however, to show that this method of
investigation is a profitable one for
furthering industrial hygiene. - I
would therefore suggest that health
officers of states and cities take note of
the recommendations made last year
by the Committee on Occupational
Mortality of this Section on Vital
Statistics, American Public Health
Association, and that they attempt to
analyze and report their mortality re-
turns by occupation, cause of death,
and age period. Local communities
often have certain hazardous occu-
pations largely developed in their
midst, and enjoy splendid opportuni-
ties for the intensive investigation of
the effects of occupation upon the life
and health of the worker. They
can, at small expense, determine the
number of workers in any particular
industry, their age, their occupational
environment, the character of the
illnesses which are treated by the
local physicians, the evidence of phys-
ical deterioration during service, and
finally the mortality as shown by the
death certificates which they receive.
Such local reports prepared over a
series of years would extend the find-
ings of the Census Bureau and of life
insurance companies, and would often
have enormously important practical
results in improving the hygienic
conditions of the industry studied. It
is also hoped that this Section will
again take active steps in urging the
Federal Government to bring to a
successful conclusion the investigation
of occupational mortality begun by
the Census Bureau in connection with
the returns for the year 1910.