WHAT SICKNESS MEANS to Road Transport
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Measures that Can be Taken to Reduce Absence Through Colds and Influenza: Care in Designing Buildings and Vehicles, as well as the Provision of Welfare Amenities, is Necessary to Create Contentment Among Staff
WI1AT. can he done to reduce the burden which sickness imposes on transport undertakings, particularly in these days of acute labour shortage? The problem is only partly clinical. The maintenance of health is intimately bound up with welfare work. Much illness is psychological in origin, and in treating and preventing it, the welfare officer and the medical officer must combine. The creation of a congenial atmosphere is a valuable way of reducing absence, and as Mr. S. E Raymond, chief staff and welfare officer of the Road Haulage Executive, points out, contentment can be promoted only by avoiding unnecessary change.
The introduction of politics into transport, with all the uncertainty that it has created, cannot have failed to disturb the minds of employees in road transport. That is part •of the price that has to be paid for the luxury of State interference with industry. '
Lord Florder's Plan
With its great resources, the London Transport Executive is able to apply specialized skill to staff problems, and it is .building up a comprehensive health service based on the recommendations of Lord Herder. At present, there are nine full-time medical officers working under the direction of Dr. L. Norman, and a tenth will be appointed shady. Medical centres are located at• ..Marylebone Road, Finsbury Park and Peckham. Next month, a fourth centre will be opened at Chiswick. There will then be a clinic in each of the four divisions.
The doctors spend about 75 per cent, of their time on clinical work and the Test in studying. working conditions. Great emphasis is laid on hygiene in the Executive's 181 canteens, and a food hygiene code of 20 rules is exhibited in each._
. The L.T.E. is one of the few:road passenger transport organizations to employ full-time staff medical officers. Others which do so are, 1 believe, the transport departments of Liverpool. Glasgow and Manchester, and their -doctors and Dr. Norman meet informally to discuss matters of mutual interest.
Doctors Nominated
Some Undertakings, such as Birmingham and Cardiff Transport Departments, Devon General Omnibus and louring Co., Ltd., Ribble Motor Services, Ltd., and the • . Birmingham and Midland Motor Omnibus. Co., Ltd., nominate certain_ doctors to examine staff.' .
The -problem of cutting down sickness is best tackl ti at the beginning. by careful selection of 'applicants and by placing einployees in work that is suitable .to -their .'• physical capacity ; the tindertakings'-whieh hic co-oPerated in this survey have sorne:SYstein of.MediCal -examination on ..-appointment, at least for drivers, as well as for juveniles in Workshops, • ••The L.T.Efs. methods are particularly thorough.
• n16 Staff receive a full medical examination on appointment, and drivers have their eyes tested at various ages over 50. Like Glasgow Transport Department, the L.T.E. also requires that anyone who has been absent for More than four weeks should be medically examined. Juveniles under 18 receive an annual overhaul, and employees over 65 Who stay in service are examined.
Ribble drivers are examined at the age of 60, as well as on appointment. Liverpool Transport Department has maintenance, in addition to platform, staff examined, and the Midland Red" includes canteen workers.
Some undertakings have already taken advantage of the Ministry of Health mass radiography service, and Certain others have encouraged 'employees to be X-rayed when mobile units have been in their areas. The L.T.E. and most other operators have found that the reaction of employees to this opportunity is favourable, although Mr. James Amos, chairman of Scottish Omnibuses, Ltd:, reports that "the staff have shown a marked reluctance to avail. themselves of these facilities." At Liverpool, radiography is an accepted part of the medical" examination.
Mass Radiography
Applications for the services of a mobile mass radiography unit should be made to the secretary of the Regional Hospital Board. In the case of a large under. taking with suitable accommodation, the unit would probably be set up on the premises. A smaller company would be asked to send its employees to a convenient centre in the district during certain hours reserved exclusi'vely for them. The unit would provide propaganda material to enable the employer to explain to the workers the wisdom of submitting to examination. The process of X-ray takes only a minute or so; and there is no charge to either the employer or the worker. The use of mass radiography has revealed that three or four persons in every, thousand are in the early stages of tuberculosis and are in need of treatment.
The high incidence of colds and influenza constitnies a specially important problem. The common cold is particularly, intractable, because so little is known about
its origins. On this subject, I can quote no higher authority than Dr.' C, Andrewes, F.R.S., of the
National Institute for Medical Research. He assures me that there is no effective vaccine against the common cold, and he doubts the value of patent cold preventives and cures. Dr. Narman 'supports this view, and adds that there is no evulenee that 'vitamin tablets prevent
colds. : •
-Mr % P. .N ..Gray, general manager of Aldershot anti District Traction CO., Ltd., says that his company tried
• anti-bisarr treatment for a period 'of sevdral.weeks anit
found the results ." very disappointing." Mr. A. S. Woodgate, assistant general manager of Ribble Motor
Services, Ltd., adds that the experience of individual members of the staff who have tried cold preventives was " not convincing."
Mr. D. M. Sinclair, general manager of the Midland "Red," says: " A few years ago we supplied to a small section of our staff a proprietary brand of cold-preventive capsule which was claimed to give immunity from colds for three months. Approximately 60 per cent. of these employees caught a cold within three months, and tve discontinued the experiment." Glasgow Transport Department, on the other hand, reports that good results were obtained from a cold-preventive course, for which a charge of Is. was made. The Midland " Red " continues the practice of obtaining supplies of halibutoil capsules and allowing employees to buy them at cost price: Dr. Andrewes says that there is no evidence of susceptibility to colds andinfluenza in relation to diet, and thus scotches any suggestion that irregular and inadequate meals lay shift 'workers open to these particular infections.
Preventing Colds The practical possibilities of reducing the spread of colds are, he .thinks, more likely to be offered by air • hygiene than by other means. Large particles of infectious matter emitted by sneezing fall down and become incorporated in dust, later to disperse again into the air. Scrupulous cleanliness in vehicles—which implies good design and adequate maintenance—will eliminate many of the hiding places of cold.nuclei, and an efficient ventilation system should assist in dispersing • germs into the outer atmosphere, where they will do leSS, harm than in a crowded vehicle.
' –The` use of sprayed chemicals is not a practical proposition," he adds, although some operators spray the interiors of their buses. The Corridors of the
• R.H.E. headquarters building were sprayed last winter and Mr. Raymond found that the psychological effect was good, although it probably contributed little to the prevention of the spread of colds. .
More constructive steps can be taken to deal with • influenza outbreaks. Vaccination against it is effective and, in Dr. Andrewes's words, " may be. very well worth .:while." Glasgow Transport Department has used it with success, and the treatment was provided free. Dr. Norman says that he would recommend vaccination for key personnel in an outbreak if they could be satisfactorily defined.
• No Influenza Epidemic Dr. Artdrewes does not expect an epidemic this winter and he suggests that November, 1952, would be approximately the time to undertake vaccination. One of the difficulties is that influenza is of three different kinds, and the appropriate vaccine must be used. It therefore follows that vaccination cannot usefully be undertaken until the type of epidemic has been identified. Moreover, the period of immunity is only six to eight weeks.
• 'Nevertheless, havingyegard to the havoc which influenza caused in transport--and particularly on the railways • last winter, vaccination merits serious consideration by fleet operators.
• The problem of. accidents to staff on duty is more tangible than many and is easier to solve. As I said last week, accidents caused 9.3 per cent. of absences through sickness among employees of Southampton Transport Department in the year ended August last, and 7 per cent. of those of Midland " Red " staff. The L.T.E. records accidents and takes the necessary remedial action. A succession of sprained ankles or knee injuries to drivers, for instance, might suggest the need for a larger step up to the cab. In the interests of safety, as well as of health in general, inspection pits in maintenance shops should obviously be clean, well illuminated, heated and designed to prevent men from becoming trapped. Garage floors should be treated to resist oil, be non-slip And dust free. Other precautions in garages and workshops will readily suggest themselves. Liverpool Transport Department, which enforces a high medical standard, has medical inspections of the workshops.
Cleanliness in vehicles and premises is of the utmost importance and in preparing new designs, its promotion should receive close attention. It is particularly stressed by Mr. A, J. White, general manager of the "Devon General." The importance of hygiene is also emphasized by other operators.
Comfort for Operatives
Operators and bodybuilders have co-operated in producing vehicles that are more comfortable for drivers and conductors. Eastern Counties Omnibus Co., Ltd., and the Midland " Red " are among those which have taken positive action to prevent draughts in cabs. Ribble Motor Services, Ltd., has also tackled the subject. and points out that it has, in addition, introduced doors on double-deckers, so that the conductor is better protected. The R.H.E. is experimenting with cab design. and is trying to evolve a type which is warm, well ventilated without draughts, and has an easily cleaned floor. In most forward-control vehicles, it is almost impossible to clean the cab floor properly, because of the nooks and crannies.
Facilities for drying wet clothes are also desirable. especially in rural areas: where operatives may cycle some distance to work.-The issue of adequate protective clothing is another way of promoting good health---a matter to which Mr. J. F. Siddall, general manager of Cardiff Transport Department, and Mr. Woodgate draw attention.
In even the cleanest depot, proper arrangements for washing. with ample hot water and soap, are essential.
Cheerful Canteens Staff cannot be expected • to work well on an empty stomach, and canteens assume a high priority, in welfare services. Most of the larger bus undertakings serve hot meals at depot canteens and some, such as the L.T.E. and Southampton. Corporation; provide also mobile. canteens. • It is truly said that man cannot live by bread alone, and the surroundings in which workers eat are as important as the content of the meals served. Dr. Norman has a strong belief in cheerful colour schemes and experience has shown that he is right.
Accepting that some sickness is inevitable, employers can help to speed the patient's recovery and prevent the recurrence of the complaint. Birmingham Transport Department's sickness and benevolent funds provide for convalescence, payment of consultants' fees and the supply of sun-ray and massage treatment. Glasgow Transport Department does its best to prevent the recurrence of disease by allowing a period of rehabilitation on light duty before normal work is resumed. Liverpool Transport Department also ensures that after sickness employees receive medical supervision.
Enlightened employers readily accept responsibility for the well-being of their workers. In road transport, in which workers are dispersed in small units over a wide area, the task is far more difficult than in normal industry. That disadvantage has been accepted as a challenge by the larger road transport undertakings, and they have gone a long way towards providing staff amenities which compare with those offered by industrial organizations in which all the workers are housed under one roof.