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WHAT SICKNESS MEAN to Road Transport

7th December 1951
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Page 43, 7th December 1951 — WHAT SICKNESS MEAN to Road Transport
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Which of the following most accurately describes the problem?

A National Survey Shows that (1) the Average Rate of Sickness is 5.41 Per Cent., (2) Colds and Influenza are the Most Common Ailments, (3) Occupational Diseases Do Not Appear to Exist and (4) Sick-pay Schemes Are Not Generally Abused, but (5) Absence Tends to Increase

IS road transport an unhealthy occupation? What are the most common ailments of read transport workers? Are commercial-vehicle operatives subject to occupational diseases? What is the average annual rate of sickness? Are sick-pay schemes abused and do employees absent themselves from duty unreasonably? What can be, and is being, done to keep workers healthy?

These are some of the questions to which I sought answers when I embarked on a survey of the incidence of sickness in the road transport industry. My inquiries covered nearly a score of representative bus undertakings; municipal, company and State-owned, in all parts of Great Britain, as well as the London Transport Executive and the Road Haulage Executive. I have also had the benefit of the experience of Dr. C. H. Andrewes, F.R.S., of the National Institute for Medical Research. This survey thus reflects the experience of employers of many thousands of people, as well as medical opinion.

The preservation of good health is as important to employers as to employees. Undertakings which pay employees during sickness suffer direct financial loss, although it may not be great. For instance, in the year ended March 31 last, Blackpool Transport Department, which has a low rate of sickness, disbursed £1,475 in sick pay, which represented 0.24 per cent. of the total wages bill. During the 12 months to May 28, 1951, Edinburgh Transport Department granted £3,130 in sick pay. These calculations do not, of course, take into ,account any overtime which may have had to be paid to other workers who filled gaps caused by absence.

Value of Health

The value of a healthy staff cannot, however, be measured in terms of money lost directly. It lies more in the avoidance of dislocation of routine. Operators also have a responsibility to their passengers, and to the public in general, to ensure that drivers in particular are fit.

In undertakings which are already understaffed, absence through sickness threatens the maintenance of services to the public. In a recent instance, a bushad to be taken out of service.for nearly two days because a conductor was injured by an assault on his way home. Undue physical and nervous stress is also placed on those who remain to carry on, and domestic friction may be caused when employees are unexpectedly called upon to work overtime. It is possible that excessive overtime causes sickness and creates a vicious spiral. This question alone would be an interesting subject for research.

Apart from the inconvenience and loss caused by absence, the reduction of efficiency arising from the employment of people who are perhaps " under the weather,." or are genuinely sick but will not give up, must be considered. The man who is suffering from some kind of neurosis, or even from a heavy cold, may become dangerous as a bus driver, or may jeopardize his employer's goodwill by lack of consideration for passengers.

An associated problem is that of providing alternative employment for persons who become unfit during service. Fortunately, with the development of laboursaving appliances, men who are, for instance, no longer able to undertake arduous duties, may be found semiskilled work in repair shops or elsewhere.

The legal obligation of businesses with more than 20 employees to employ at least 3 per cent. of registered disabled persons is a further aspect of the responsibility for health which the Nation has assumed. In transport, the opportunities for such people are limited and the emplOyer is often hard pressed to find the necessary outlets, The preservation of good health has indeed become everybody's business and the larger undertakings in road transport are doing their share towards it.

No Special Risk

I have found no evidence to suggest that road trans

port is an unhealthy occupation. The ailments that most commonly afflict transport workers are those from which people in other walks of life suffer—colds, 'influenza, bronchitis, gastritis and tibrositis Mr. T. I. Itinley, deputy general manager of Glasgow Trans. port Department, finds that nervous debility is common among conductresses. "The incapacity of females is frequent and prolonged," he adds. An analysis of 689 cases in which the causes of sickness among the platform staff of Southampton Corporation in the year ended September 9, 1951, were known, yields the following percentages: Colds, chills, etc.; 16.8; influenza, 15.5; gastritis, 9.3; injuries on duty, 8.2; bronchitis, 5; fibrositis, 4.3; enteritis, 3.9; nervous debility, 3; ulcers, 2.6; lumbago, 2.3; and 'tonsilitis, 1.9.

Ailments Analysed

Mr. D. M. Sinclair, general manager of the Birmingham and Midland Motor Omnibus Co., Ltd., assesses influenza at 25 per cent., colds, chills, catarrh, tonsilitis and bronchitis at 15 per cent., injuries at 7 per cent., lumbago, fibrositis and rheumatism at 5 per cent., gastric troubles at 5 per cent., nervous debility at 3 per cent., and other ailments at 40 per cent. Whether fibrositis is allied to rheumatism or not is open to question. In the past, medical opinion has believed that it is, but the theory that it may have psychological origins is now beginning to gain ground.

In his annual report for the year ended May 28, Mr. W. M. Little, general manager of Edinburgh Transport Department, classifies cases of certified illness, and shows that colds and influenza accounted for 17.1per . cent. of cases, afflictions of the respiratory system, 10.2. per cent., digestive ailments, 12.8 per cent., rheumatism, . 10.6 per cent., and nervous disorders, 1.3 per cent. Unclassified complaints completed the total.

The high incidence of colds and influenza among the reasons for absence makes the subject of their prevention or cure of particular importance. Much work has been done in Britain and other countries to identify . their causes. Influenza had been segregated from the common cold and work on vaccines to prevent it has made great strides.

Bugbear of the Cold The common cold has proved. more elusive and little is sal .known about its origins, although a great deal of research has been conducted at the Harvard Hospital, Salisbury. Dr . Andrewes, who has been closely associated with this work, tells me that colds may be induced by dropping virus into the nostrils, but experiments have shown that chilling and exposure alone do not increase a person's susePptibility to colds.

It is possible, Dr. Andrewes thihks, that in ordinary life people catch colds as a result of "a lot of expdsure in the presence of a little virus, or from very moderate 04

exposure if a big dose. of virus is taken in." It appears, therefore, that a driver or conductor cannot legitimately claim that a draughty vehicle alone causes him to catch a cold.

Although colds 'are more common in winter than in summer, as are other respiratory infections, the reason is not known. It is not simply a question of temperature, although sudden changes, particularly abnormal ones, may precipitate colds more in summer than in winter.

Recent evidence suggests that more unpleasant germs are spread from the nose than from the mouth and throat. Many bacteria 'may be shaken out of handkerchiefs and remain for a time in the air. Handkerchiefs used in the later stages of a cold are particularly effective germ distributors. In any event; handkerchiefs may be a danger not merely because of what is shaken off them intothe air, but because germs are spread from them on to the hands and thence on to everything a person touches. A conductor who has a severe cold and issues hundreds of tickets a day may, therefore, be passing on germs wholesale.

Are Vehicles Germ Traps ?

Dr. Andrews considers that research is needed to determine whether public transport vehicles are in fact dangerous places for picking up colds. Presumably, a conductor's daily contact with hundreds 'of people places him in a vulnerable position and he, on his side, can infect many of his passengers. The interest of the road transport industry in the prevention of colds is therefore particularly keen.

The weight of opinion in the industry as to whether shift workers are more prone than others to general

illness seems to be against that supposition. Of 16 operators who expressed their views on this question, only five gave unqualified affirmative answers. Dr. L. Norman, chief medical officer of the London Transport Executive, does not think so. In particular, he does not -believe that shift work causes gastric troubles, although he concedes that if an employee had already contracted a digestive ailment, shift work would not improve his condition.

Dissenting views are expressed by Mr. G. H. Pulfrey, general manager, Hull Transport Department, Mr. F. Broomfield, secretary, Barton Transport, Ltd., Mr.' Kinky, Mr. W. M. Hall, general manager, Liverpool Transport Department, and Mr. Sinclair.

Mr. Pulfrey relies on relative statistics for traffic staff who normally work shifts, and workshop and depot personnel whose hours are more regular. In the year ended August. 1951, the average rate of sickness among traffic staff at Hull was 5.83 per cent., and among workshop and depot staff, 5.13 per cent. Comparable figures from Mr. Walter Luff, general manager of Blackpool Transport Department, are 3.6 per cent. and 3.3 per cent. In both cases, the difference is small. An analysis made by Mr. A. T. Evans, general manager of United Automobile Services, Ltd., is rather more disquieting. It shows that in the year ended August, 1951, the average rate of sickness amongst traffic staff was 4.5 per cent., amongst engineering employees, 1.4 per cent., and amongst clerical grades only 0.4 per cent.

Occupational Diseases

Do occupational diseases exist in road transport? Again, the weight of opinion, including that of Dr.

Norman, is in the negative. The medical officer of Liverpool Transport Department, however, takes a contrary view. Mr. C. H. S. Pickett, director and general manager of Eastern Counties Omnibus Co., Ltd., suggests that fibrositis and gastritis might be regarded as occupational diseases, and Mr. W. H. Smith, general manager of Birmingham Transport Department, thinks that "the high rate of sickness due to ulcers, both gastric and duodenal, indicates that this appears to be an occupational disease." Mr. Kinley claims that peptic ulcers are slightly more prevalent in transport than in other industries.

Since the Medical Research Council issued its report No. 276 (Occupational Factors in the Aetiology of Gastric and Duodenal Ulcers, Stationery Office, 2s. 6d.), the peptic ulcer has, however, largely lost its bargaining power in transport. The investigation described in the report was sponsored by the Industrial Health Research Board of the Medical Research Council, and 6,047 men and women were included in the survey. They were engaged in many different vocations.

False Rumour

" Foremen and others in posts of special responsibility in industry were found to be particularly prone to peptic ulcer . . . No confirmation was obtained of the widespread belief about bus drivers, among whom peptic ulcers were found to occur no more frequently than among those occupied in a score of other ways," says the report. "Anxiety over work appeared to be aetiologically significant, but not irregularity of meals or shift work."

Transport is included among occupations with an

average incidence of peptic ulcers. "Particular care was taken to ensure the inclusion of adequate groups of bus conductors and drivers of motor vehicles," says the report. "Neither group showed an abnormal incidence of ulcers above that expected" [drivers 44 observed against 42.6 expected, and conductors 12 observed against 16.7 expected]. "At two depots of a passenger transport concern, bus drivers and conductors• showed the same incidence of ulcers as the other employees... . Other checks failed also to provide any evidence that a high incidence of ulcers might really exist in these groups."

Referring to the effect of irregular meals, the report says: "The two places of employment included in the survey at which a majority of the employees had irregular meals, failed to show a significant excess of ulcers." No evidence was obtained of any harmful effect from shift work. My investigations suggest that the national annual average rate of sickness among passenger transport workers is 5.41 per cent. It has been impossible to obtain figures relating to lorry drivers and others. The monthly rate varies from 3.92 per cent. in July to 9.53 per cent. in January. The figures in the accompanying table reflect the effects of the influenza epidemic last January and February, which was particularly severe in the Midlands, on Merseyside and in the north-east. This was the only occasion when the Road Haulage Executive was in danger of being unable to run all its vehicles because of a shortage of staff. The table also shows how peak periods of sickness vary in different undertakings and opens up several other interesting lines of thought.

It would be entirely false to assume that organizations having a high rate of sickness provide unhealthy working conditions. Many considerations have to be taken into account in comparing figures of sickness, among them the average age of the staff. Colds and allied complaints, which are the biggest cause of absence, attack young people more readily than older. Young people are absent more frequently, although older men and women are incapacitated for longer periods.

It is the frequent, short absences which cause the greatest inconvenience and dislocation in transport undertakings. Arrangements can be made more easily to fill the gaps brought about by long periods of illness.

Women Vulnerable

It is also established that on an average, the rate of sickness among single, women, as compared with men, is twice as great, and .among married women, three times as large. The experience of undertakings which employ many conductresses, such as Birmingham Transport Department, Glasgow Transport Department and Ribble Motor Services, Ltd., supports this finding. The L.T.E is investigating the incidence of sickness by groups and expects to reach some valuable conclusions.

A general manager told me that the percentage of inspectors absent through sickness was higher than that of any other classification. Inspectors are officers and have a much more favourable sick-pay scheme than workmen.

That observation leads to the question: "Are sick-pay schemes abused?" The general opinion is that they are not, except perhaps by a minority of workers. Mr. Luff told me that abuse was not so great as was expected when sick pay was introduced at Blackpool.

Longer Absence

Nevertheless, 11 undertakings out of 17 find that staff are more prone to absent themselves for reasons of sickness, or for longer periods, than before the war. This is not to suggest that the more frequent or longer absence are unreasonable. Sick pay removes financial anxiety, and it may have been the case before the war that workers who should have been in bed stayed at their posts because they could not afford to be absent. The increased employment of women would also account partly for the tendency towards a higher rate of sickness than before the war.

Although road transport is far from an unhealthy occupation, the incidence of sickness is serious enough to cause grave concern in an undermanned industry. Big operators, at least, realize the importance of safeguarding the health of their employees, and many of them take active steps to do so. The value or otherwise of some of the measures already in .force, and of others that might be introduced, will be discussed next week.

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