AND

JOURNAL OF THE COAL AND IRON TRADES.

Vol. CVII.

FRIDAY MARCH 20, 1914.

No. 2777.

The Hygienic Aspect of the Coalmining Industry.

(Concluded from page 564).

BEAT HAND, &C.-A NEW DISEASE: MINERS’ ITCH—THE INFLUENCE OF
LEGISLATION ON THE HEALTH OF MINERS.

Dr. Shufflebotham delivered his fifth and con-
cluding lecture on Thursday, March 5. In this lecture
he dealt with such complaints as beat hand, beat knee,
beat elbow, beat buttock, sprained wrist, and teno-
synovitis about the wrist joint, miners' itch or miners’
rash, miners’ back, and occupational fatigue, complaints
to which miners are subject as a consequence of their
occupation ; and in conclusion he spoke of what
legislation has done to improve the health of miners,
and what further can be done to improve miners’
conditions by legislation and in other ways.

Beat Hand, &c.

Speaking of beat hand, Dr. Shufflebotham said the
course of the disease depended entirely upon the treat-
ment, and, if early treatment were applied the inflam-
mation cleared up in a comparatively short time. Soft
hands were a predisposing cause of the disease, and,
after a long strike, during which the skin over the
hand had become softened, an unusual number of cases
might arise when work was resumed. The most important
etiological point with regard to beat hand was the
fact that there was no history of an accident in any case,
and some colliery doctors called it idiopathic cellulitis
of the hand. Complete recovery took place in the vast
majority of cases, but in some instances permanent
deformities of the fingers or hand might result, and the
lecturer cited a case in which a man was permanently
incapacitated as a result of septic trouble associated
with the condition of beat hand.

To treat cases of beat hand successfully, it was most
important to recommend hot fomentations from the
onset of the treatment. The hand and arm should be
kept in a sling, and if there was any increase of
temperature the patient should be kept indoors. To
break down adhesions, massage and passive movements
were of the greatest value. It was most important to
realise in all these cases that it was not only necessary
to treat the acute septic inflammation, but also to
ensure the function of the hand being restored if
possible.

The lecturer then described typical cases of beat
elbow, which, he said, was an acute inflammation, also
of non-traumatic origin, that might spread and
practically involve the whole limb. Here again, serious
complications might set in, resulting in some permanent
disability to the structures round the elbow joint.

The history of cases of beat knee was similar to that
of beat elbow, and there were cases of a severe type
with constitutional disturbances, and with some
permanent disability due to thickening and adhesions
round the knee joint. In these cases, there might be
some permanent lameness, even when the patient had
had the knee moved under an anaesthetic.

Beat buttock was a very uncommon condition, due to
irritation and friction, and there was never any
permanent disability.

Dr. Shufflebotham next considered these affections
with special reference to the Workmen’s Compensation
Act, and pointed out that the same condition was to be
found in other occupations. Every case of beat hand
that occurred among miners was one for which compen-
sation was bound to be paid, on account of the impossi-
bility of tracing the cause to any other source outside
that of the man’s employment, but it was not impossible
for compensation to be paid for cases of beat hand
where the trouble had been set up in carrying out work
outside that of mining. The same remarks would apply
to beat elbow and beat knee.

A New Disease: Miners’ Itch.

After dealing with the inflammation of the synovial
membrane of the wrist joint due to the jerking and
jarring of the pick in the hewing of hard coal, Dr.
Shufflebotham discussed the prevalence in certain dis-
tricts of a complaint termed miners’ itch or miners’
rash. He observed that in many colliery districts coal-
miners working in certain pits or seams were known to
be affected by skin eruptions, which they attributed to
their employment underground. These eruptions were
known as miners’ itch or miners’ rash, or, in some cases,
they might take their name from the pit where workers
in that pit were commonly affected by them.

The lesion might be of an erythematous nature or it
might consist of boils, and the parts affected were
generally those which were exposed to the greatest
extent to the coaldust—that is, the lower part of the legs
and the forearms, and also those parts where there was
the greatest pressure, such as just round the ankles at
the upper level of the clog or boot, and also round the
waist at the level of the waistbelt. The disease generally
began, as in erythema, between the ankles and the
knees ; there was intense itching, not only while the men
were at work, but also when they returned home and
had washed and gone to bed. Other parts might be
affected, but the feet, arms and neck, as a rule, escaped.
Following the erythema, the patient vas frequently
affected by boils, which were most frequently found on
the legs and forearms, but might also be found on the
back, the chest, and the back of the neck. The only
pain experienced was when the patient was suffering
from the discomfort of large boils and from any
affection of the lymphatic vessels or glands which might
follow. Dr. Shufflebotham added that the disease was
one of considerable frequency, and during the last
12 months he had seen 40 such cases.

The course of the disease depended entirely upon
whether the man gave up work from the onset or not,
and the nature of the treatment. In many cases the
patient was totally incapacitated for work for a period
of several weeks. The cause of this trouble was one of
great complexity. Some of the miners attributed it to
the high temperature of the workings, and the irritation
of the coaldust, with profuse sweating. Others
attributed it to the excessive amount of liquid
taken in consequence of the great heat of the workings,
while a third theory was that the complaint was caused
through drinking the pit water. Dr. Shufflebotham said
he had investigated the subject to some little extent,
and had found that the seams of coal in which the men
worked who were liable to this disease were invariably
of a bituminous nature, the seams were invariably
hot, temperatures varying from 80degs. Fahr, to 90
and 95 degs. Fahr., and, he thought that, under such
conditions, there would be to some slight extent con-
tinual, though slow, distillation of the bituminous coal
with the formation of not exactly coal tar products,
but, at all events, bodies which were the result
of decomposition of this coal. This explanation
might account for both the erythema and the boils,
but when the effect of the high temperature upon
the worker by producing profuse perspiration was
taken into account, one could see that the tendency
for these eruptions to form and to develop was increased.
As soon as irritation was produced, the mechanical
irritation of the coaldust itself v, as also another factor
in the aggravation of the complaint. The lecturer had
had coal taken from these seams examined bacteriologi-

cally, and had invariably found that it was infected to a
most considerable extent with staphylococci. This would
explain the formation of boils on a skin that was
irritated, and he had also examined the pus taken from
the boils and found it to be caused by the same micro-
organism.

In a paper on industrial dermatitis which the
author read before the British Medical Association at
Sheffield in 1908, he made a reference to the skin
affections found among miners, but, with this solitary
exception, he was not aware that the subject had been
referred to in medical literature in this country.

There was another explanation, however, that would
account for this form of skin irritation. Prof. Cadman
had pointed out to the lecturer that, in the seams in
which this disease was found, iron sulphate was present
to a considerable extent. During the process of
oxidation and in the presence of water free sulphuric
acid might be produced, and the mine water in some of
these seams was most irritating and acid to the taste.
Sulphate of iron was known to be an irritant, and one
got actual smarting of the eyes immediately after
exposure to the dust. Cadman and Whalley had noticed
that pit water might produce an irritable rash and
ulcers upon the skin, and in one pit the water upon
analysis was shown to contain :—

Per c^nt.

Alumina and oxide of iron........ 0’02

Barium chloride ................. 0 15

Calcium chloride................. 2 38

Magnesium chloride .............. 0’86

Sodium chloride ................. 12 93

Concluding this portion of his subject, Dr. Shuffle-
botham said: “ These skin affections, having not yet
been recognised, are not covered by the Workmen’s Com-
pensation Act, but, in view of the trouble being
undoubtedly occupational in nature and causing, in
many cases, complete incapacity for work, it seems that
these conditions should be included in the schedule to
this Act in the same way that eczematous eruptions are
when acquired by workpeople in the nature of their
employment.”

The Influence of Legislation on the Health of Miners.

The lecturer went on to deal with the general aspects of
the question. From the time that coalmining came to
be recognised as an industry in this country, he said,
laws were passed to regulate it, but they had special
reference to the possession of mining property and for
the protection of owners against the violence of their
workpeople, and it was not until the year 1842 that any
legislation was passed that had direct bearing upon the
health of those employed. In this year the employment
of female labour underground was forbidden, and regu-
lations were made to improve the conditions of the boys
who were engaged in underground workings. From
this time onwards many Acts of Parliament have been
passed with the object of improving the conditions of
labour, and in this way bettering the health of the
workers. In 1850 the law provided for the inspection
of coalmines.; inspectors were appointed by the Secretary
of State, and they were given power to enter and inspect
the works of any colliery both above and below ground,
and to enquire into all matters relating to the safety of
the persons employed. For the first time it was neces-
sary for notices of accident causing loss of life to be
sent within 24 hours to the Home Office, and it was
incumbent upon the owners of pits to provide proper
plans of the workings and to maintain them in an
accurate condition. Subsequent legislation provided
for improved ventilation of the workings, and that all
pits should have two exits.

The laws with regard to the regulation of coalmines
were revised and consolidated in the Coal Mines Regu-
lation Act, 1911. This Act of Parliament makes special
provisions for increased protection for the workmen by
a more systematic method of timbering, by regulations
which control the use of electricity in the mines, by
restrictions with regard to the use of explosives and the