INTERNATIONAL LABOUR OFFICE

STUDIES AND REPORTS
Series F (Industrial Hygiene) No. 16

WORKMEN'S COMPENSATION
FOR SILICOSIS
IN THE UNION OF SOUTH AFRICA,
GREAT BRITAIN AND GERMANY

GENEVA
1937
Published in the United Kingdom
For the INTERNATIONAL LABODB OFFICE (LEAGUE OF NATIONS)
By P . S. K I N G & SON, L t d .
Orchard House, 14 Great Smith Street, Westminster, London, S.W.I

PRINTED BY
IMPRIMERIE POPULAIRE
LAUSANNE

CONTENTS

INTRODUCTION

5

UNION OF SOUTH AFRICA
Legislation
Scope of Legislation
Right to Compensation
Certification of the Disease
Benefits
Review
Procedure for Settling Disputes
Administration of Compensation
Prevention
NOTE

11
11
14
17
22
28
28
29
39
40

GREAT BRITAIN
Legislation
Scope of Legislation
Right to Compensation
Certification of the Disease
Benefits
Review
Procedure for Settling Disputes
Administration of Compensation
Prevention

45
46
48
51
54
57
58
60
65

GERMANY
Legislation
Scope of Legislation
Right to Compensation
Certification of the Disease
Benefits
Review
Procedure for Settling Disputes
Administration of Compensation
Prevention

67
67
67
69
74
79
80
81
85

NOTE 1

87

NOTE 2

88

APPENDICES
I. Compensation of Occupational Diseases by the System of
Blanket Coverage
I I . Terminology of Radiographic Findings in respect of Silicosis
I I I . Radiographic Technique of respect of Silicosis
IV. Stages of Silicosis
V. Silicosis Statistics
VI. Industries and Processes involving Exposure to Silicosis . . .
V I I . Pneumoconioses Legislation

91
100
105
108
115
123
126

INDEX

141

•

INTRODUCTION
The problem of silicosis was one of the first to attract the
attention of the International Labour Office, which directed its
efforts to assembling data relative thereto ; such data were at
that time extremely rare, whether it were a case of medical data
relating to pneumoconioses or of information as to compensation legislation, such as that in force for instance in Great
Britain and in South Africa.
Resolutions presented by the International Stone Workers'
Secretariat calling for compensation of silicosis as far back
as 1921 had been preceded by others adopted by national
associations affected.
In 1925 the Secretariat in question
requested the International Labour Office to inscribe pneumoconiosis in the International Schedule of Occupational Diseases
for Compensation. This request was strongly supported by
similar resolutions emanating from other international organisations of workers, such as the Miners' Federation and the International Stoneworkers' Secretariat. The Office then organised
an enquiry, chiefly bearing upon radiological diagnosis amongst
a certain number of experts competent in the matter, whose
replies were later submitted to the Correspondence Committee on Industrial Hygiene at its Dusseldorf meeting
(September 1926). At that time, however, medical specialists
in the subject did not consider it advisable to propose to the
Governing Body of the Office the inscription of silicosis in the
International Schedule of Occupational Diseases for Compensation,
in view of the fact that the problem in question was complex
and difficult, and so far lacked a sufficiently definite scientific
basis to justify such an important step. The Committee, on
the other hand, invited the Office to continue its research and
to submit to a later meeting data concerned chiefly with the early
diagnosis of the disease and those elements indispensable to the
assessment of the degree of incapacity for work.
Soon, however, as a result of circumstances referred to
elsewhere * the scope of the studies engaged in began to extend
1

INTERNATIONAL LABOUR OFFICE : Silicosis : Records of the International

Conference held at Johannesburg, 13-27 Attgttst 1930. Studies and Reports,
Series F (Industrial Hygiene), No. 13. Geneva, 1930.

— 6 —.
beyond t h e field of activity of t h e Office, leading to t h e organisation
in 1928, with t h e generous co-operation of t h e Transvaal Chamber
of Mines, of a n International Conference on Silicosis, which was
held in 1930 (13-27 August) a t Johannesburg and in which
specialists on t h e subject from eight countries (Australia, Canada,
Germany, Great Britain, Italy, Netherlands, Union of South
Africa, and the United States) took part. The Agenda determined
by the Governing Body of the Office in 1928 comprised t h e
following subjects :
(a) Medical aspects of silicosis (pathological and clinical
phenomena) ;
(b) Preventive measures ;
(c) Compensation.
A collection of about thirty reports presented b y specialists
dealt with the question of silicosis or pneumoconiosis in the
different countries or with certain special scientific aspects thereof.
In adopting its final report on the various aspects of the problem,
the Conference made certain recommendations, intended to serve
as guiding principles for future research, and which might be
grouped under six headings : preventive measures ; standardisation of radiological technique and terminology ; scientific
research (physico-chemical) in regard to dust ; medical research
(aetiology, pathology and diagnosis of silicosis) ; collection and
distribution of new data and of statistics ; bibliography.
From 1931 onwards the Governing Body of the Office made
certain suggestions to the Governments of the States Members
relative to the prevention of silicosis. The Industrial Health
Service submitted a t t h e same time to t h e Correspondence
Committee a plan intended to lay down uniform methods to be
followed with a view to achieving certain objects.
As regards scientific study, t h e Office, which to begin with
had subsidised a certain amount of research either in laboratories
or a t the working post, found itself unable to continue this
practice, b u t directed its attention rather t o problems of
radiological technique and terminology and to the publishing
of a bibliography. The latter, published in 1932 1 , contained
references to t h e existing literature u p t o t h e date of December
1931 arranged under five headings : pneumoconioses ; general
pathology ; experimental research ; clinical aspect ; industrial
pathology (by industry).
1

INTERNATIONAL

LABOUR

OFFICE : Pneumoconioses

:

Bibliography.

76 pp. Studies and Beports, Series F , No. 15. Geneva, 1932.

— 7 —

The Office also recognised the necessity for following with
the closest attention the problem of compensation for silicosis
which it had already studied under various aspects when the
Governing Body decided in 1933 to insert on the Agenda of the
Eighteenth Session of the Conference (1934) partial revision of
the 1925 Convention dealing with compensation for occupational
diseases x with a view particularly to the inclusion of silicosis.
The Office then requested the Correspondence Committee to
examine the Report prepared and to submit Part I I I 2 dealing
with silicosis to those specialists whose work brought them into
closer contact with the scientific and practical problems relative
to compensation for silicosis.
Compensation was inscribed in the schedule appended to
the Convention (Revised) at the International Labour Conference
(1934) in the following terms :
Silicosis with or without pulmonary tuberculosis, provided that
silicosis is an essential factor in
causing the resultant incapacity
or death.

Industries or processes recognised by national law or regulations
as involving exposure to the risk
of silicosis.

Further, the Conference adopted the following resolution :
(1) Each Member of the International Labour Organisation which
ratifies this Convention should, in establishing a list of the trades and
industries in which, in t h e opinion of t h e competent national authority,
there is a risk of contracting silicosis, give due regard to the progress
of scientific and clinical investigations into the etiology of this disease.
(2) Compensation for silicosis should not be considered apart from
prophylactic measures. The most important of these is the prevention
of dust. Consideration should also be given to the importance of
preliminary and periodical examination of employees in at least the
occupations involving practically continuous exposure to silica dust.
(3) Experience proves t h a t for the purpose of compensation of
silicosis it is essential to entrust the diagnosis and certification of silicosis
only to medical men specially qualified for this work, who should be
provided with the necessary equipment, especially with facilities for
adequate radiological examination.
There should be organised by each national authority some suitable
methods of co-ordinating the experience concerning the practice of carrying
out medical radiological and pathological examinations as Well as the
results of scientific investigation.
(4) Special investigations should be made in each country regarding
the possible incidence of silicosis and tuberculosis in the coal-mining
industries, regarding which our knowledge is at present far from complete.
1

INTERNATIONAL LABOUR CONFERENCE : Eighteenth Session, Geneva,

1934, Report V. Workmen's Compensation for Occupational Diseases.
Partial Revision of the Convention concerning Workmen's Compensation
for Occupational Diseases. VIII. 328 pp. Geneva, 1934.
'Ibid., p . 203.

— 8 —

This resolution was the object of a lengthy discussion engaged
in by the Correspondence Committee which met in 1934 at the
end of the Conference. The Committee had under consideration
in particular the report by Dr. Irvine dealing with the radiographic
terminology of silicosis. Being specially concerned as to §§ 1
and 2 of the above resolution, which might represent an obstacle
in regard to the preparation of national legislation for certain
States desirous of ratifying the Draft Convention, the Committee,
in its desire to bring the matter to a satisfactory conclusion,
passed the following resolution :
" The Committee
" Is of opinion t h a t the application of compensation in respect
of the disease Would be greatly facilitated if all possible useful information
were assembled b y the Health Service of the Office and transmitted
to the Governments of those countries which so far do not provide
compensation for silicosis. "

Finally, during its Seventieth Session (April 1935), the
Governing Body adopted the Committee's suggestions and
authorised the publication proposed, thus taking the first step
in giving effect to the resolution passed by the Conference.
A survey of the compensation legislation at present in force
in various countries reveals the fact that silicosis is covered in
accordance with several systems, which may be grouped as
follows :
Compensation afforded by special legislation.
Compensation within the framework of the Workmen's Compensation
Legislation :
(a) Schedule system,
(b) One or several special " schemes " .
Blanket coverage.

In view of the impossibility of analysing all existing legislative
measures, it was considered preferable to present in detail three
typical systems of legislation in force, namely those followed,
firstly in the Union of South Africa (special legislation), secondly
in Great Britain (special schemes) and thirdly in Germany
(schedule).
Analysis of these Acts is given in accordance with a plan
which has been made as uniform as possible in order that the
results may be comparable : legislation, scope of legislation,
right to compensation, certification of the disease, benefits, review,
procedure for settling disputes, administration of compensation,
prevention.

— 9—
In Appendix I the reader will find an account of the
system of " blanket coverage " and, in particular, of its practical
application relative to compensation for silicosis ; as well as data
connected with radiological technique and terminology proposed
or adopted by several specialists ; enumeration of products
utilised and of industries ; statistics bearing on the incidence of
silicosis and the cost of compensation in regard to countries
where such data are available and, finally, a list of countries
which have introduced compensation (pneumoconioses, and in
particular silicosis).
The data presented relative to legislation may be considered
as accurate up till 7 July 1937 \
The Office desires to record here its sincere thanks to certain
specialists on the subject who have been kind enough to revise
parts of the text prior to publication or to furnish information
contained in the text, namely : Dr. J. C. Bridge, Senior Medical
Inspector of Factories, Factory Department, Home Office, London,
for Great Britain ; Dr. A. J. Orenstein, Chief Medical Officer,
Central Mining, Rand Mines Ltd., Dr. L. G. Irvine, Chairman,
Miners' Phthisis Medical Bureau, Johannesburg, and Mr. G. E.
Barry, Legal Adviser, Transvaal Chamber of Mines, for the Union
of South Africa.

1
At the same date the Draft Convention (Revised) of 1934 had been
ratified by the following States : Austria, Brazil, Cuba, Great Britain, Irish
Free State, Japan, Mexico, Norway, Hungary and Sweden. Ratification
had been authorised by the competent authority in the Netherlands and
recommended in 'Irak, Peru, Rumania and Spain.

UNION OF SOUTH AFRICA

LEGISLATION

Compensation for silicosis is accorded in virtue of the following Acts :
(1) Act to consolidate and amend the laws relating to miners' phthisis,
No. 35 of 1925. Assented to 27 July 1925. (L.S.\ 1925, S.A. 2.)
(2) Act to amend the law relating to miners' phthisis, No. 38 of 1930.
Assented to 3 June 1930. (L.S., 1930, S.A. 6.)
(3) Act to amend the law relating to miners' phthisis, No. 60 of 1934.
Assented to 7 June 1934. (L.S., 1934, S.A. 2.)
(4) Act to amend the law relating to miners' phthisis, No. 23 of 1936.
Assented to 24 June 1936. (L.S., 1936, S.A. 1.)
Administrative regulations in virtue of the above Acts are contained
in the following Government Notices :
(1) Government Notice, No. 411. Dated 8 March 1926. Issued
in virtue of the 1925 Act. (Government Gazette, 12 March 1926, page 468.)
(2) Government Notice, No. 1602. Dated 10 September 1926. Issued
in virtue of the 1925 Act. (Government Gazette, 10 September 1926,
page 551.)
(3) Government Notice, No. 1499. Dated 22 August 1930. Issued
in virtue of the 1930 Act. (Government Gazette, 22 August 1930, page 539.)
(4) Government Notice, No. 1744. Dated 30 October 1931. Issued
in virtue of the 1925 Act. (Government Gazette, 30 October 1931, page 263.)
(5) Government Notice, No. 1260. Dated 7 September 1934. Issued
in virtue of the 1925 Act, as amended by the 1934 Act. (Government Gazette,
7 September 1934, page 598.)
SCOPE OF LEGISLATION

The legislation applies to " scheduled mines " and " gazetted
mines " .
" Scheduled mines " comprise those mines wherein the mineral
dust produced by mining operations is or has been, in the opinion
of the Minister, of such a nature as to cause silicosis.
" Gazetted mines " comprise those mines, the names of which
have been published by the Minister in the Gazette for the
purpose of compensation for silicosis 2 .
The list of " scheduled " or " gazetted " mines drawn up
by the Minister of Mines and Industries is published in the form
1
L.8. = Legislative Series ; publication of the International Labour
Office.
2
The difference between these two types of mines is as follows : the
" scheduled mines " are situated on the Witwatersrand and are mines
which produce silicosis. « Gazetted mines " are not on the Witwatersrand
and are mines which produce silicosis, but to a lesser extent. (Both types
of mines are gold mines.)

— 12 —
of a notice in the Government Gazette, and the Minister may
from time to time by like notice add to or withdraw from the
list the name of any mine.
Any holder or lessee of a mine which for the time being is
not included in the said list, or any number of miners not being
less than one-third of the miners employed in any such mine,
or the Miners' Phthisis Board or the Director of Native Labour,
may petition the Minister in writing to include the name of that
mine in the said list on the ground of the mineral dust produced
by the mining operations being of such a nature as to cause
silicosis.
Any employer, or any number of miners may, subject to the
same conditions, likewise petition the Minister on the ground
of the improved health conditions of the mine to withdraw the
name of t h a t mine from the said list.
Subsequent to investigation, the Minister has power in the
first case either to include or refuse to include the name of the
mine in the list, and in the second case to withdraw the name
of the mine from the said list or to reduce the amount of the
contributions payable to the Miners' Compensation Funds 1.
The results of investigations and subsequent decisions must
be published in the Government Gazette.
When a mine has been scheduled as aforesaid, any land
upon which mining operations are thereafter carried on in
conjunction with t h a t mine shall be deemed to form p a r t of the
mine in conjunction wherewith those operations are carried on.
If the question arises whether mining operations are or were
carried on upon any land in conjunction with a scheduled mine
or as to the date from which or the period during which any
such operations were carried on upon such land, the Minister's
decision of t h a t question shall, for the purposes of the above
paragraph, be final and conclusive.
The persons covered by the Act are those employed underground
— t h a t is to say, on any operation connected with underground
work or employment beneath the surface or work or employment
upon or about rock crushers in a rock crushing station operated
for the purpose of ore reduction, or employment in a sample
1
The only ground for reduction of the amount of contribution would
be proof of unquestionable improvement in a given mine as regards the
silicosis rate. In practice no such proof has ever been adduced, and the
clause simply constitutes a proviso in the event of circumstances arising
which might warrant its application.

— 13 —
crushing room or assay office, or in a change house or on any
tailings dump.
The Acts provide a definition of the word " miner " 1 for
the purposes of compensation.
In the event of doubt or dispute as to whether a person is
a miner within the meaning of the Acts, the matter is referred
for decision to the Government Mining Engineer, and his decision
is final and conclusive.
Government inspectors of mines, including assistant inspectors,
deputy inspectors or sub-inspectors, and inspectors of mining
leases, are likewise covered by the Acts.
1
By the term " miner ", the Act designates briefly any person who
is or has been employed underground at a " scheduled " or " gazetted "
mine in any of the scheduled occupations.
(Q.) Any person employed in any occupation which necessitates
spending one hundred or more working hours per month underground or in any of the 51 occupations explicitly enumerated, in
respect of each month in which the incumbent is so employed.
(b) Any person employed on surface operations (13 of which are
explicitly enumerated, and the list of which may be extended
by notice in the Gazette) (repairs and maintenance) and working
occasionally underground but less than one hundred hours per
month, in respect of each day of which the incumbent is employed
underground.
The processes covered are enumerated as follows in the Fourth Schedule
of the 1925 Act.
(a) Occupations included in the term " miner " in respect of each
month in which the incumbent is so employed.
Assayer
Dumpsman
Assistant manager
Dust sampler
Bar-rigger
General miner
Blaster
Hanging inspector
Cageman
Jumperman
Change-house attendant Lasher
Crusher-house attendant Learner
Developer
Mine captain
Drain and track cleaner Mine overseer
Motor attendant
Stoper
Onsetter
Surveyor
Pipeman
Timberman
Platelayer
Traffic man
Pumpman
Trammer
Pump-station man
Truckbuster
Reclaimer
Underground banksman
Sampler
Underground blacksmith
Sandfiller
Underground boilermaker
Sanitary man
Underground drill sharpener
Scrap collector
Underground electrician
Shaft sinker
Underground engine driver
Shaker attendant
Underground fitter
Shift boss
Underground handyman
Skipman
Underground manager
Stope examiner
Underground native supervisor
Wastepacker

[Note continued on next page.]

— 14 —
RIGHT TO COMPENSATION

Despite the fact that the expression Miners' Phthisis is used
in the title of the Acts, this term does not reappear in the text
thereof, where the terms currently employed are silicosis of the
lungs (with or without tuberculosis) and tuberculosis of the
lungs or of the respiratory organs.
Three states of silicosis are distinguished in the Acts :
(a) an ante-primary stage when it is found t h a t the earliest
detectable specific physical signs of silicosis are or have been present ;
whether or not capacity for work is or has been impaired by such silicosis ;
(b) a primary stage when it is found t h a t definite and specific
physical signs of silicosis are or have been present and t h a t capacity
for work is or has been impaired by t h a t disease though not seriously
and permanently ;
(c) a secondary stage when it is found t h a t definite and specific
physical signs of silicosis are or have been present and that capacity
for work is or has been seriously and permanently impaired b y t h a t
disease, or when it is found t h a t tuberculosis with silicosis is or has
been present.

A person is deemed for the purposes of the Act to be suffering
from tuberculosis whenever it is found either :
(a) t h a t such person is expectorating the tubercular bacillus ; or
(b) t h a t such person has closed tuberculosis to such a degree as
to impair seriously his working capacity and render prohibition of his
working underground advisable in the interests of his health ; tuberculosis within the meaning of the Act being tuberculosis of t h e lungs
or respiratory organs.

Compensation is accorded for cases of disease or of death.
(1) Compensation for disease is accorded in cases of : Silicosis
with or without tuberculosis, or tuberculosis without silicosis.
[Note continued from previous page.]

(b)

The
relating
ment of

and any other occupation which necessitates spending one
hundred or more working hours per month underground.
Occupations included in the term " miner " in respect of each
day on which the incumbent is employed underground, but less
than one hundred hours per month.
Carpenter
Surface engine driver
Mechanic
Surface fitter
Surface blacksmith
Surface native supervisor
Surface boiler maker
Surface rigger
Surface drill sharpener
Surface truckbuster
Surface electrician
Surface stonemason \ (added by Government Notice No. 411,
Surface bricklayer . /
dated 8 March 1926)
and any other occupation published by the Minister for this
purpose by notice in the Gazette.
definition likewise covers any miner as defined under any law
to miners' phthisis in foroe at any time prior to the commencethe 1925 Act.

— 15 —
(a) In cases of silicosis with or without tuberculosis :
(i) The miner can at any time claim compensation, provided
that he has worked underground on a scheduled mine for a
period amounting in the aggregate to five years ; that he has
worked for some portion of that period subsequent to 1 August
1908 ; and that he submits his claim within five years from
the date at which he last worked underground at a scheduled
mine within the meaning of the 1925 Act or preceding Acts 1.
However, if such a claimant is a resident in the Union, the
Mandated Territory of South West Africa, or the adjacent
Protectorates of Bechuanaland, Basutoland or Swaziland, he
can submit the claim at any time even after five years provided
that he satisfies the Board that the disease is the result of
underground work at a scheduled mine, and that he had worked
underground at a scheduled mine after 1 August 1908.
Any miner who has not resided in the above countries, but
has worked underground at a scheduled mine after 1 August
1908, can also obtain compensation at any time provided that
the Board is satisfied that he contracted silicosis during and
in consequence of work in a scheduled mine and that he has
not been engaged during the intervening period in an occupation
which in the opinion of the Board is likely to have caused silicosis
or to have aggravated it ;
(ii) The native worker has similar rights to the miner.
(b) In cases of tuberculosis without silicosis :
(i) The miner must have been employed underground during
one or several periods amounting in the aggregate to at least
twelve months at any scheduled mine under the same conditions
and he must be found to have tuberculosis at a prescribed medical
examination within twelve months from the date on which he
last so worked underground.
(ii) In the case of native labourers the prescribed period is
one month's underground work to qualify for compensation,
and the disease must have been certified at the final examination
or within six months of cessation of underground work.
(2) Compensation in case of death is accorded to dependants
of miners or native labourers when death is due to silicosis or
any other cause with which silicosis was present as a contributing
or predisposing factor.
1
These are as follows : the " previous Act " : Act No. 35. of 1924 ;
the " principal Act *' : Act No. 40 of 1919 ; the " prior Law " : Acts No. 19
of 1912, No. 29 of 1914, No. 44 of 1916, No. 44 of 1917 and No. 24 of 1918.

— 16 —
Compensation is likewise accorded to dependants of miners
or natives who have died of tuberculosis.
Right to compensation is, however, subject to the observation of
a certain number of obligations : compulsory medical examination ;
conditions to be observed by persons suffering from silicosis or
tuberculosis in regard to underground employment, and compensation claims. (See Note, "Medical Examinations", p. 40.)
Save as regards certain special cases hereafter referred to,
miners in receipt of benefits in respect of silicosis or tuberculosis
with or without silicosis are prohibited by law from working
underground in mines covered by the Act (" scheduled " or
" gazetted " mines) or in any other occupation specified by the
Minister by means of notification in the Gazette, viz. in other
mines, when such occupations are considered as liable to cause
or aggravate silicosis and they forfeit all rights to additional
compensation if engaged in such work after 1 August 1919 for
having contravened the Act.
A miner who was last granted benefits under the Acts in force
prior to 1 August 1916 (commencement of Act No. 44 of 1916
under which the Bureau was established) is not prohibited from
working underground at a scheduled mine provided that at a
medical examination by the Bureau he is granted an " initial "
certificate (i.e. that he is free from any disease of the lungs and
respiratory organs and is in every respect physically fit for
underground work). If such a miner resumes underground work
at a scheduled mine and is subsequently found to have silicosis
or tuberculosis, or both diseases, he is entitled to benefits under
the Act as if he had not received any compensation previously.
A beneficiary miner who was on examination prior to August
1934 found by the Bureau to have neither silicosis nor tuberculosis
is permitted to resume work at a scheduled mine in certain
occupations and localities (specifically designated by the Minister
by notice in the Gazette for this purpose *) provided that at a
medical examination by the Bureau he is granted a " special
authorisation (i.e. that he has neither silicosis nor tuberculosis
and is suitable for work in such special occupations and localities).
If such a beneficiary is subsequently certified to have silicosis
or tuberculosis, or to be no longer suitable for such work, his
special authorisation lapses and he becomes entitled to additional
benefit provided by the Act for silicosis or tuberculosis.
1
Such operations laid down by the Government Mining Engineer
are those involving the least degree of exposure t o silicosis.

— 17 —
CERTIFICATION OF THE D I S E A S E

The disease may be reported either in course of the initial
medical examination, prior to certification as fit for work, a t a
periodical examination or any other examination provided for
under the Act, or in the course of an examination carried out
upon a claim for compensation having been lodged.
Medical examiners on the list (see p . 37) must report to
the Medical Bureau within three days cases of tuberculosis or
silicosis met with. If upon examination the Bureau confirms
t h a t the workman is suffering from tuberculosis or silicosis, it
must notify immediately the Miners' Phthisis Board or the
Director of Native Labour, according as to whether the patient
is a miner or native labourer.
Apart from the above provision, which in practice applies
only to native labourers, legislation does not require any other
notification of the disease, since its detection, which is a t the
same time confirmed, is entrusted entirely in the case of European
miners to the Medical Bureau.
On the other hand, the miner or native labourer or their
dependants considering themselves entitled to compensation may
submit to the Miners' Phthisis Board an application for
compensation accompanied by the prescribed documents and
particulars 1.
1
A claim for compensation must be transmitted on a prescribed form
which differs according to the category of the patient :
(a) European miner :
Miner (form M.P.B. No. 2) ; widow, or widow and child (form
M.P.B. No. 3) ; other adult dependants (form M.P.B. No. 4) ;
minor dependants (form M.P.B. No. 5).
(It) Non-European miner :
Miner (form M.P.B. No. 6) ; widow, or widow and child (form
M.P.B. No. 7) ; adult dependants (form M.P.B. No. 8) ; minor
dependants (form M.P.B. No. 9).
(c) Native labourer :
Native labourer (form M.P.B. No. 10) ; dependants (form' M.P.B.
No. 11).
(In the case of native labourers the claim is lodged by the Inspector
of Native Labour, or in default of this, by the Magistrate, Native Commissioner or Sub-Commissioner for the district and addressed by them
to the Director of Native Labour, who, in his turn, notifies the Miners'
Phthisis Board.)
The claim must be accompanied by the following documents in the
case of :
(a) A miner (European or non-European) :
Miner's blasting certificate (if any) ; his record of service.
If the miner is still in employment at a mine, when he makes
his claim, he sends instead of these all his old discharge certificates,
his current periodical certificate and, where necessary, an official

[Note continued on next page.]
2

— 18 —

The Board deals with every claim as soon as possible and,
if necessary, has the prescribed medical examinations effected
by the Medical Bureau.
In the case of claims for benefits made by miners subsequent
to periodical medical examination, no further medical examination
is- required. When a miner, however, makes application for
further benefit, he becomes subject to the " benefits examination "
of the Bureau.
Diagnosis of the disease and, in certain cases, confirmation
of diagnosis previously made 1, is entrusted to the Medical Bureau.
It is likewise the duty of this body to grant the requisite
certificates entitling workers to benefit in response to claims
for compensation lodged by the workers or their dependants,
or claims made consequent on the medical examinations
prescribed 2.
Certificates to be lodged with Claims for Compensation
After being notified by the Board, the Medical Bureau in
its turn deals with the cases, and summons for examination those
miners who fulfil the conditions entitling them to compensation.
The result of the medical examination is inscribed on forms

[Note continued from previou» posre.]

certificate of his marriage ; and an official birth certificate for
each child under sixteen.
(b) A widow :
An official certificate of the death of the deceased miner ;
an official certificate of marriage ;
official birth certificate for each child ; and the deceased miner's
records of service and blasting certificate.
(c) All other dependants :
An official certificate of death of the deceased miner ;
his records of service and blasting certificate ;
a statement of the relationship of the dependant to the deceased
miner and of the nature and extent to which the dependant was
maintained by him, at the time of his death ;
such official certificates of birth or marriage as may be necessary
to establish the relationship of the dependant to the deceased
miner.
When application for compensation or payment of funeral expenses
is made by a lawful representative of the deceased miner, it must be accompanied by the official letters of authority issued by the Master of the Supreme
Court or by similar authority in the country where the estate is being
administered.
1
See " Medical Examiners ", p . 37.
1
See Note, " Medical Examinations ", p. 40.

— 19 —
which vary in accordance with the category of the persons
examined and the stage of the disease certified 1 .
In cases of death, whenever the Medical Bureau considers
it necessary, having obtained the consent of the relatives of the
deceased, it nominates and instructs a medical practitioner to
conduct a'post-mortem examination, and he, having made such
examination, forwards his report on a special form (G).
Every medical practitioner who carries out any post-mortem
examination upon the body of any person who was employed
in or about any scheduled mine must, if he finds on such
examination silicosis or tuberculosis to be present in the lungs
of the deceased, send such lungs to the Bureau accompanied
by his report thereon : provided that if any such person was
employed in any occupation within the meaning of the term
" miner ", the medical practitioner must send such person's
lungs to the Bureau accompanied by his report thereon whether
or not he finds silicosis or tuberculosis to be present.
After examination of the lungs and relative documents, the
Medical Bureau makes its report on the post-mortem examination
(form I), stating whether the deceased miner died from silicosis
or a cause other than silicosis and whether silicosis was or was
not present as a contributing or predisposing factor, and whether
at the time of his death he had or had not silicosis (mentioning
the stage) or tuberculosis.

1

The certificates for miners are inscribed on the following forms :

Form»
B. C
B (4)

Diseases certified
Neither tuberculosis nor silicosis.
Silicosis (neither in primary nor secondary stage).
Certificate only issued to cases certified prior to 1916
(beneficiaries under previous legislation) and it indicates that
silicosis in the ante-primary stage is present. (At the time these
cases were originally certified no provision was made in the
Act for cases in the ante-primary stage.) The certificate
further states, contrary to the practice in other certificates,
that the patient is fit or unfit for underground work.
B. A-P.
Ante-primary silicosis without tuberculosis.
B. Pr. .
Primary silicosis without tuberculosis.
B. Sec. .
Secondary silicosis without tuberculosis.
B. E. .
Silicosis with tuberculosis.
B.D. .
Tuberculosis (open or closed) without silicosis.
W i t h t h e e x c e p t i o n of t h e first m e n t i o n e d , t h e certificates i n d i c a t e
t h e e x p e c t a t i o n of life, t h e degree of w o r k i n g c a p a c i t y — o r d i n a r y , m o d e r a t e ,
light, n o w o r k — a n d s t a t e w h e t h e r t h e a p p h c a n t is p h y s i c a l l y fit or unfit
for w o r k o n a n a g r i c u l t u r a l s e t t l e m e n t .
T h e certificate for n a t i v e w o r k e r s is m a d e o u t on form B . N . a n d
indicates w h e t h e r t h e a p p l i c a n t is suffering from silicosis, a t w h a t s t a g e
a n d w h e t h e r w i t h or w i t h o u t tuberculosis, or o n t h e o t h e r h a n d s t a t e s
t h a t t h e a p p l i c a n t h a s n o t silicosis in a s t a g e e n t i t l i n g h i m t o benefits a n d
is n o t suffering from p u l m o n a r y tuberculosis.

— 20 —

Certificates delivered subsequent to Medical Examinations
1. No person is permitted to work as a miner in a scheduled
mine until he has first passed a medical examination and received
from the Medical Bureau an " initial " certificate of fitness.
The so-called " initial " certificate must state that the applicant
is free from disease of the lungs and respiratory organs and is
in other respects physically fit for underground work.
The so-called " special " certificate delivered to workers who,
from time to time, are engaged on underground work (less than
one hundred hours per month) must state that the applicant
is not suffering from tuberculosis.
The certificate must bear mention of the date at which it
expires and beyond which it is of no effect.
Where the Medical Bureau is not in a position to grant a
certificate, it furnishes a notification to the effect that the said
certificate cannot be accorded. In the case of the temporary
rejection of a candidate at an initial examination, the Medical
Bureau fixes the date on which the applicant may present himself
for further examination 1.
2. Subsequent to periodical medical examination, the Medical
Bureau may be required to deliver, according to the conditions
found, the following certificates : absence of tuberculosis ;
tuberculosis with or without silicosis ; silicosis in its various
stages 2.
1
T h e a p p l i c a n t p r e s e n t s his application on form O, t h e certificates are
inscribed on t h e following forms :
Form
Initial Certificate
P
European miner.
P.N.E
Non-European miner.
By " non-European " is meant a person other than a " white"
European. It does not mean a native (negro). It means such
persons as Asiatics, Eurafricans, Eurasians, etc.
Notification of Rejection
R
Temporary rejection.
B.R
Final rejection.
Q
Special certificate (not issued to non-Europeans).
F o r m s P . N . (initial certificate) a n d R . R . N , (notification of rejection)
i n t e n d e d for n a t i v e l a b o u r e r s are n o longer i n use, t h e records being k e p t
on t h e c a r d s y s t e m a t t h e i n d i v i d u a l m i n e on w h i c h t h e n a t i v e seeks e m ployment.
2
F o r m s for certificates g r a n t e d s u b s e q u e n t t o periodical e x a m i n a t i o n s :
European and Non-European Miners
(Examinations carried out by Medical Bureau)
Form
C
No tuberculosis. (Certificate permits examinee to remain
at work.)
D
Tuberculosis without silicosis.
E
Tuberculosis with silicosis.
[Note continued on next page.]

— 21 —
The forms used differ also in accordance as to whether it is
a question of European, non-European miners, or native labourers,
and whether the examination of non-European miners or native
labourers is conducted by a medical practitioner (" examiner ")
or by the Medical Bureau.
The certificate is transmitted directly to the miner, and in
the case of a native labourer to his employer, whose duty it is
to inform him forthwith of the contents thereof.
Further, the Medical Bureau must advise the Miners' Phthisis
Board or the Director of Native Labour, as the case may be,
of any person found to be suffering from silicosis or tuberculosis
or from both diseases a t any periodical examination.
3. The final examination of native labourers is conducted
by " examiners ", who draw up a report in each case of
tuberculosis, silicosis or both diseases, which they submit to the
Bureau on a form AN.
4. The " special authorisation " certificate previously referred
to for underground work in a scheduled mine, in a locality or
occupation denned by the Minister, is made out on a form SA (P)
for a beneficiary miner when a medical examination shows him
to be free from tuberculosis or silicosis and suitable for underground
w o r k 1 . This certificate is valid for a period of six months,
after which re-examination is necessary.
When it is not possible to issue the special authorisation
certificate, the Medical Bureau transmits a notification thereof
on the form SA(R).

[Note continued ¡rom previous page.]
Note. — D and E notifications entail compulsory removal from underground employment.
40B 1
No silicosis (a letter of advice issued only on examinee's request).
40B (AP)
Ante-primary silicosis
"|
Notifications. — not however
40B (Pr)
Primary silicosis
>
entailing compulsory removal
40B (Sec)
Secondary silicosis
)
from work.
Native Labourers
Examination by Examiner on Mines
Examination by Medical Bureau
No forms issued to examinee.
T?„„„ T W . T ,K • ,.i„.i„ .„in,„..iOnly forms AN and 10 are used. Form
. . £ ° ™ D N : Tuberculosis without
AN is a report to the Bureau by an
^ „ . „ T v . rr,.K„>„„i„„i- ...ui, „m „„i„
examiner, and Form 10 is a statement
*£maE*!
^ Ä ^ . ^ J L f l Ä
B
of the industrial history of the native
2 L a n ± S N e n t a i l «"«»P» 180 ^
r<I°™,
DeSmenT* ^ ^
^
" " *
* ° ™ B T Í S ^ " omnibus form for
•ueparuneni.
certification of no silicosis or tuberculosis, tuberculosis, silicosis In all its
stages and tuberculosis with silicosis.
Removal from work is compulsory in
the case of tuberculosis with silicosis.
1
In practice this provision applies only to beneficiaries who were
granted compensation prior to the institution of the Medical Bureau in
1916.

— 22 —

As a general rule the certificates are addressed directly to
the miner in the case of a miner and to the Director of Native
Labour in the case of a native labourer.
The Medical Bureau or the Medical Board of Appeal has
power, apart from the sanctions provided by the Act, to cancel
or amend any medical certificate which has been altered or
forged.
The Miners' Phthisis Board makes its decisions only after
receiving a certificate of the Medical Bureau or the Medical
Board of Appeal. In the case of native labourers, however, it
is the Director of Native Labour to whom is entrusted the task
of following the procedure in regard to compensation (collecting
compensation and transmitting it to those entitled, etc.).
BENEFITS

The Act provides in the case of disease or death for a benefit
which is payable either as a lump sum or as a varying monthly
payment according to the disease in question and its stage of
development and also to the category of the beneficiaries (earnings,
dependants, etc., of miners or native labourers).
Sickness
In cases of ante-primary silicosis the miner and native labourer
receive an amount payable in one sum or in instalments calculated
as follows : twelve times that part of the month's earnings' 1
which does not exceed £29 3s. 4d., and six times that part of
the month's earnings exceeding £29 3s. 4d. but not exceeding
£37 10s. Od., and three times that part which exceeds £37 10s. Od.
1
" Month's earnings " means one-sixth of the amount earned by
the miner or native labourer in question for the 156 days on which he
worked as such last, prior to the date upon which he was first certified by
the Bureau to have developed silicosis or tuberculosis to a degree entitling
him to any benefit under the Acts. In the case of a native labourer, monthly
earnings mean the actual wages paid or credited to him exclusive of any
ex gratia payments or the value of any food, accommodation or any other
thing or service supplied to him by his employers.
Every employer must, upon request by the Miners' Phthisis Board
or the Director of Native Labour, supply a true and correct statement
of the amount earned by the miner or native labourer for the number of
days specified in the request, as well as all other information necessary
relative to duration of employment ; provided that if for any reason the
amount of the month's earnings cannot be ascertained, the amount shall
be taken to be a sum to be determined by the Miners' Phthisis Board or the
Director of Native Labour as the case may be.
Special pxwisions exist in regard to the calculation of the earnings
of miners to whom allowances are payable under the prior law.

— 23 —
Primary

silicosis.

The miner and native labourer receive the amount provided
for silicosis in the ante-primary stage increased by 50 per cent.
Further, miners who have already received an award for
ante-primary silicosis receive under certain conditions the
supplementary 50 per cent, when they are found a t a later
date to be suffering from primary silicosis.
Secondary silicosis including

tuberculosis with

silicosis.

1. The miner receives a monthly allowance calculated as
follows :
For the miner himself : one-half of t h a t part of his month's
earnings which does not exceed £20 and one-quarter of t h a t
part of his month's earnings which exceeds £20 b u t does not
exceed £28 6s. 8d. and one-twentieth of t h a t part of his month's
earnings exceeding £28 6s. 8d. ;
For his wife : one-fifth of the total amount payable in respect
of the miner ;
For each child under sixteen years (not exceeding three) 1 :
one-tenth of the amount payable in respect of the miner, and
foi each such child in excess of three, one-tenth of such amount.
If a miner formerly certified as suffering from ante-primary
or primary silicosis is not granted any compensation (he having
presumably continued a t underground work) until he is certified
to be suffering from secondary silicosis including tuberculosis
with silicosis he receives the full monthly allowance for the
secondary stage plus the amount payable for the ante-primary
stage of silicosis. That is to say, he receives a lesser amount
in compensation by the difference between the ante-primary
and the primary compensation.
2. The native labourer receives the amount granted for
ante-primary silicosis, augmented by 100 per cent.
Tuberculosis without silicosis.
1. The miner receives the same benefit as in the case of
primary silicosis ;
2. The native labourer receives a benefit similar to the
miner's if the disease is detected a t the " final " visit or within
six months following the cessation of underground employment.
1
" Children " means, in this connection and subject to certain conditions, sons and daughters as well as legitimate step-children of the miner
and adopted sons and daughters if " adopted " in terms of the Act.

— 24 —

Tuberculosis with silicosis (see. above).
As a general rule, benefits are not granted to any miner
who has left the Union on or after 1 August 1917, unless he has
undergone a medical examination at the Office of the Bureau
or unless the Bureau, for good cause shown, authorises an
examination of such miner resident outside the Union by a
medical practitioner approved of by it for that purpose.
Death
1. In the case of the death of a miner his dependants are
entitled to such benefits or further benefits as he was entitled
to at the time of his death, but if he was, before or after his death,
found to have silicosis in a secondary stage or tuberculosis with
silicosis, or if he died from silicosis, or if silicosis was a contributing
or predisposing factor in the causation of his death, they receive
a monthly allowance calculated as follows :
(a) Widow and children under 16 years of age 1 , double the
allowance prescribed for the wife and children in the case of the
allowance to the sick miner (see p. 23).
(b) In default of persons mentioned in (a) persons wholly
dependent 2 on the deceased : the allowance • prescribed for the
widow.
(c) In default of persons mentioned in (a) and (b) persons
partly dependent on a miner : allowance equal to the average
1

" Child under 16 years of age " includes a child who, although over
the age of 16, is in the opinion of the Bureau unable to earn a living by
reason of physical or mental incapacity.
If any child of 16 years and over in respect of whom an allowance has
been granted is in the opinion of the Bureau unable by reason of ill-health
to earn a living, such allowance shall be continued for so long as in the
opinion of the Board it might reasonably have been expected that the
miner would have continued to contribute to the support of such child.
2
Dependants within the meaning of the Act comprise widow, legitimate
or illegitimate children under 16 born prior to the date of the certificate of
the Medical Bureau certifying the presence of the silicosis in the secondary
stage or tuberculosis with silicosis, or before 1 August 1919, whichever date
is later. In default of the above-mentioned persons, the following persons
are likewise considered as dependants : legitimate or illegitimate children
over the age of 16 ; father, mother, step-father, step-mother, brothers,
sisters, half-brothers, half-sisters and any of their children, grandparents
and grandchildren and any other relation by consanguinity or affinity,
provided that in respect of the latter categories of persons payments are
no longer made to anyone who has contracted a marriage after the
death of the deceased person upon whom he was dependent. I n each
particular case it is the Board which decides without review or appeal
which persons are to be considered as dependants.

— 25 —
monthly support given by the miner, but not exceeding the
allowance prescribed for the widow of a miner 1 .
The monthly allowance granted to a dependant (other than
a widow and children under sixteen years) continues for so long
as, in the opinion of the Board, it may have been reasonably
expected that the miner would have continued to contribute
to the support of such dependant. The allowance ceases in the
case of death or marriage of the dependant, and likewise in the
case of death or remarriage of a widow. Should a widow
re-marry, however, she is paid in one sum on such remarriage
24 times her monthly allowance.
Special provisions deal with payment of an allowance to the
widow and children of a miner who has died outside South
Africa and with beneficiaries of monthly allowances (miners or
dependants) who have left South Africa without the written
permission which the Board can grant for temporary purposes,
or outside the period limited by such permission, who are no
longer entitled to any payment when once the sum paid
reaches £750, unless any such miner or dependant has returned
to reside in South Africa before 1 August 1933, in which case
the payment may be continued beyond the said sum ; such
payment ceases, however, should the beneficiary again leave
South Africa without the written permission of the Board.
An allowance for dependants (other than a widow and children
under sixteen years wholly or partly dependent upon the deceased)
is not granted for more than one dependant 2 .
Special provisions apply in certain cases to dependants of a
deceased miner who had been granted benefits under the prior
law and made application after the coming into force of the
1925 Act.
1
Upon the death of a beneficiary (miner or dependant) any balance
of any benefit remaining in the hands of the Miners' Phthisis Board may
be paid to dependants of the deceased, and if there are no such dependants
such balance or portion thereof may at the discretion of the Board be paid
to any heir or legatee of the deceased. Provided t h a t if such deceased
miner left no dependant, the Board may in its discretion pay to any person
who in the opinion of the Board is a creditor of the deceased, any monies
which at the time of his death had accrued to the deceased by way of a
monthly allowance. If not so paid the balance or remainder lapse to the
Compensation Fund or Gazetted Mines Fund.
8
Further, no award of a monthly allowance is granted to the dependants
of a deceased miner where such dependants entitled to claim the allowance
are resident outside of South Africa if at the date of the miner's death
the allowances paid to and in respect of the miner has exceeded the sum
of £750 calculated from the date of the award of a monthly allowance
granted to such miner.

— 26 —

Benefits are payable to dependants or such other persons as
the Board may designate in the interest of the beneficiary or
his dependant, in such instahnents or such other manner as it
may from time to time consider most advantageous to the
beneficiary concerned or his dependants.
No amount payable as a benefit under the Acts is assignable
or transferable or capable of being hypothecated or. pledged,
or liable to be attached or subjected to any form of execution
under a judgment or order of any court of law and in respect
of any debt contracted before the award was made; the same
applies to any property, movable or immovable, purchased with
such amount or any part thereof.
Whenever the whereabouts of a dependant are unknown,
any balance still due to such beneficiary lapses to the Compensation
Fund after a period of three years from the date of the last
payment, until such time as the whereabouts of the said person
may again become known, when the claim may be reviewed.
2. In the case of death of a native labourer two classes of
benefit are provided for :
(a) Where silicosis has not been certified prior to death and
where the medical bureau is satisfied and certifies that
death was due to silicosis or to any other cause, provided
that silicosis was present as a predisposing or contributing
factor (from a post-mortem examination or other valid
satisfactory evidence), dependants of the native labourer
who have not already received benefits are entitled to
a lump sum similar to that provided in the case of
secondary silicosis or tuberculosis with silicosis.
(b) Where the presence of silicosis has been certified prior
to death and where for any reason the deceased had
not received compensation, the dependant is entitled
to the benefit which would have been granted to the
native labourer.
In both the above cases where the deceased leaves more than
one dependant, allocation of the amounts which each person
shall receive is made by the Director of Native Labour.
Upon the death of a native labourer in receipt of compensation,
any balance of an award remaining in the hands of the Director
is paid to the dependants of the native labourer or, in his absolute
discretion, to such persons as he may consider heirs of the
deceased, or in default of these, the balance is repaid to the
employer.

— 27 —

Various Benefits
In addition to the above the Miners' Phthisis Board grants
a certain number of payments either to the miner or his dependants.
Funeral expenses. — A sum not exceeding £25 is payable
in respect of reasonable burial expenses and medical attendance
or other reasonable expenses during the last illness in the case
of a miner who, at the time of his death, was in receipt of benefits
or was entitled to receive such.
Travelling expenses. — A beneficiary in receipt of a monthly
allowance (a miner or the dependants of a deceased miner) who
desires to quit South Africa may, at the discretion of the Board,
be granted a passage to his destination for himself and any
dependants, together with a sum not exceeding £10 for incidental
expenses.
Expenses of .transfer. — A beneficiary miner receives such
expenses as the Board may deem reasonable as incidental to his
transport, together with his wife and children under 16 years
of age, to places within the Union where employment has been
obtained for him.
Special supplementary benefits. — Special grants may be
accorded from the Miners' Phthisis Special Fund (see later) in
favour of a beneficiary miner in necessitous circumstances who
is, in the opinion of the Medical Bureau or Medical Board of
Appeal, unfit for moderate work owing to age, disease or physical
incapacity, or, though not so unfit is, in the opinion of the Board
through no fault of his own, unable to obtain employment or
earn sufficient for his maintenance and that of his dependants.
The amount and duration of such grants are left entirely to the
discretion of the Board.
Similar benefits may be accorded to a deceased miner's
dependants who are beneficiaries, or dependants of deceased
beneficiaries and in necessitous circumstances.
Miners entitled to these grants must have been, from 1 August
1933 or the date on which they became for the first time
beneficiaries (whichever date is the later), resident in the territory
of the Union, Bechuanaland, Basutoland, Swaziland or the
Mandated Territory of South West Africa.
Beneficiary dependants entitled to the above grants must
have resided from 1 August 1933 or the date of death of the
miner, whichever is later, in the territory of the Union,

• — 28 —

Bechuanaland, Basutoland, Swaziland or the Mandated Territory
of South West Africa.
The monthly payments referred to above cease from the time
a t which the beneficiaries no longer satisfy the conditions laid
down.
REVIEW

Revision of benefits granted can take place either :
(a) on an application by the beneficiary or his dependants,
if it is found t h a t he is suffering from a more advanced
degree of silicosis than previously certified by the Medical
Bureau ;
(b) on the Board being satisfied t h a t such benefits have
been obtained by fraud or in other improper manner
or as a result of lack of evidence or again on account
of modification of the certificate granted by the Medical
Bureau.
Subsequent to such revision, benefits may be suspended,
diminished or increased.

PROCEDURE FOR SETTLING

DISPUTES

Administrative. — The decisions of the Miners' Phthisis Board
(or of the Director of Native Labour in the case of native labourers)
upon any question of fact are final and not subject to appeal
or review by any court of law. In the case, however, of a grant
or refusal of benefit or of any other of the functions of the Board
or the Director the decision is subject to review by the Transvaal
Provincial Division of the Supreme Court upon the ground of
illegality or gross irregularity, but not otherwise.
The Board, the Medical Bureau, or the Director of Native
Labour may of their own or his own motion or a t the request of
any person interested state a special case for the decision of the
Transvaal Provincial Division of the Supreme Court. Where
such a request is refused, the said Provincial Division may, on
application made within one month thereafter by any persons
interested, order t h a t such request be complied with. Any
person interested may, without leave being obtained, appeal
from the decision of the said Provincial Division upon a special
case to the Appellate Division in accordance with the rules
governing appeals to the last-mentioned Division.

— 29 —
The Board, Medical Bureau or the Director of Native Labour
may, of their or his own motion or on the application of any person
interested, review any previous decision if such previous decision
is not in accordance with the judgment given upon a special
case so stated as aforesaid and on such review make a n order or
award or issue a certificate in accordance with the said judgment.
Medical. — Any miner * dissatisfied on medical grounds with
the certificate granted by the Medical Bureau subsequent to
periodical examination or any examination for benefit and who
has not accepted a n y benefits under an award made as a result
of such certificate may, within three months after the receipt
by him of the Bureau's certificate of such examination, apply
in writing to the Bureau to reconsider his case in the presence
of his own medical adviser or appeal to the Medical Board of
Appeal.
Every such appellant must be X-rayed if necessary and
clinically re-examined b y the Medical Board of Appeal which
must, if deemed necessary, consult with the members of the
Medical Bureau and carry out a n y other requisite investigations.
Any dependant of a deceased miner, dissatisfied with the
decision of the Medical Bureau as to the cause of such miner's
death or as to whether he did or did not have silicosis or tuberculosis or both these diseases a t the time of his death, may
appeal from t h a t decision to the Medical Board of Appeal within
a delay of three months.
The Medical Bureau and the Board must, if required, produce
to the Medical Board of Appeal all records in their possession
in respect of the appellant.
A certificate of the findings of the Medical Board of Appeal
together with its report thereon are submitted to the Medical
Bureau and to the Miners' Phthisis Board.
The decision of the Medical Board of Appeal is final.

ADMINISTRATION OF COMPENSATION

The system of insurance in force is based on the collective
liability of employers. Nevertheless in the case of native
workers employed in scheduled mines it is the employer himself
1
According to the definition of the term " miner " which means any
person other than native labourers it follows that the latter have no right
of appeal.

— 30 —
who is personally responsible for the compensation (lump sum)
payable.
When a native labourer is found to be suffering from silicosis
or tuberculosis, if he is still employed on underground work
the amount payable is paid by the employer in whose service
the native labourer is registered for underground work. I n any
other case the amount payable is paid by the employer in whose
service the native labourer was last registered for underground
work. The sums due from the employer responsible are paid
to the Director of Native Labour.
Where the mine is closed down or withdrawn from the list
of scheduled mines, the said amount is on application of the
Director of Labour paid to him by the Miners' Phthisis Board
out of the Compensation Fund.
In the case of " miners " (European and non-European)
engaged in scheduled mines and native labourers engaged in
gazetted mines, employers being collectively responsible for compensation, benefits are payable by the following compensation funds.
1. The Miners' Phthisis Compensation Fund is applied principally to the payment of a n y benefits and allowances awarded
to miners and non-European workers engaged in scheduled mines.
I t likewise has power to contribute to the extent of a sum
not exceeding 50 per cent, to the cost of establishing and
maintaining one or more sanatoria for purely silicotic patients
and also to the creation and maintenance of a reserve fund in
cash or investments or both. The Act also provides that the
Fund should organise and maintain an Outstanding Liabilities
Fund (see later) and Trades and Industries F u n d (see later).
The Compensation Fund is also applied to defray certain
expenses : gratuities granted on termination of a certain period
of service, on retrenchment, superannuation or retirement, to
the staff of the Miners' Phthisis Board, the Medical Bureau or
the Medical Board of Appeal ; any expenses incidental to the
carrying out of the provisions of the Act ; payment of any loan
from the Compensation F u n d to the Gazetted Mines Fund (see
later).
The assets of the Fund consist chiefly of contributions levied
quarterly on employers possessing or working scheduled mines. x
1
Accessory payments to the Fund comprise interest from investments,
donations or legacies, fines recovered for infringement of provisions or
regulations dealing with the laying of dust, ventilation and protective
measures against silicosis and tuberculosis.

— 31 —
The Miners' Phthisis Board fixes the amount of the contributions
which it considers necessary and levies the sums in question on
employers as follows :
50 per cent, of the amount in proportion to the silicosis rate
for each mine * ;
30 per cent, of the amount in proportion to the earnings in
a scheduled mine during the previous period of three
months of the miners employed ;
20 per cent, of the amount in proportion to the sum for
which such employer was assessed for normal income-tax
in respect of thé penultimate accounting period of such
employer for that mine.
No variation or inaccuracy shall invalidate any such levy,
but the Board shall so soon as conveniently may be after the
last day of March in every year, correct all such variations and
inaccuracies which may have occurred during the year preceding

1
This rate is ascertained annually by adding together periods of
employment — during the 10 years preceding the dates on which miners
had been certified by the Bureau for the first time to have silicosis in a
stage entitling them to any benefit (under the principal Act, the previous
Act or the 1925 Act) — of all miners who have been so certified during the
6 years ending the 31st day of July last previous ; and by distributing
the total period thus obtained among the employers in proportion to the
aggregate period during which such miners were employed at each employer's
scheduled mine.
Provided that if the silicosis rate as thus ascertained for each mine
when divided by the average number of miners employed on that mine
during the 10 years ending 31 July last previous yields a quotient which
is greater than double the corresponding quotient yielded by treating all
scheduled mines as one unit, the silicosis rate in respect of that mine shall
be reduced in the proportion which double such corresponding quotient
bears to such quotient.
Further the Minister may add each or all of the following considerations
to which regard may be had in computing the silicosis rate :
the results of dust-sampling investigations ;
conclusions drawn by an actuary appointed by the Minister from
records of the periods worked by beneficiaries in each scheduled
mine ;
the reports of inspectors of mines as to breaches in any scheduled mine
of any law or regulation prescribed for the laying of dust or for
the improvement of ventilation or generally for the prevention
of silicosis in mines ;
the prevalence of silicosis as revealed by the periodical examination
of miners and native labourers.
The Medical Bureau on the first day of October in every year informs
the Board of the silicosis rate for the year of each mine. Records of service
or any information as to the service of miners suffering from silicosis during
the preceding five years must be furnished on request of the Medical Bureau
or the Miners' Phthisis Board.

— 32 —
such last day of March by imposing a further levy upon, or
granting a refund to, any employer affected by such variation
or inaccuracy.
Every employer must lodge with the Board for inspection
the receipt issued by the Commissioner for Inland Revenue in
respect of the normal income-tax assessed upon such employer
for the penultimate accounting period. He must likewise transmit
to the Board quarterly a true and correct statement showing
the amount of earnings of the miners employed by him during
the preceding three months ; the accuracy of such statement
shall, if necessary, be verified by the Board.
Whenever for any reason the amount of the earnings of any
miner is not evident, the Board may fix such amount.
The Board may call upon any employer to give security to
its satisfaction for the payment of all amounts payable in respect
of the Compensation Fund and the other Funds under the various
Acts on miners' phthisis. In the event of such security not
being given within a period specified by the Board it may
demand payment of the whole of the employer's outstanding
liability as if the mine had closed down.
Any amount not paid to the Compensation Fund or the
Outstanding Liabilities Fund may be recovered together with
costs and interest a t 5 per cent, per annum from the employer
by action in a competent court a t the suit of the Chairman of
the Board. Any claim of the Board for sums due to it by an
employer a t the date of sequestration or assignment of his estate
or a t the date of the commencement of the winding up if the
employer is a company shall have priority over all other debts
whatsoever, except debts due as wages or which are préfèrent
to wages (Insolvency legislation).
2. The Outstanding Liabilities Fund, depending on the Compensation Fund but distinct from it, has to meet obligations
incurred by scheduled mines which are closed down or withdrawn
from the list of scheduled mines x.
Each year an Actuary appointed by the Minister determines
the total amount of the outstanding liabilities of the Compensation
Fund and apportions the amount thus obtained amongst the
employers. In making such apportionment the Actuary must

1

This Fund levies contributions only on " scheduled mines ".

— 33 —
consult any Actuary whom the employer may appoint for the
purpose 1.
The amount thus apportioned to each employer is payable
immediately to the Outstanding Liabilities Fund whenever the
mine in question is closed down or withdrawn from the list of
scheduled mines.
3. The Gazetted Mines Fund assures the payment of benefits
to miners and native labourers (and on their behalf) employed
in gazetted mines 2 .
I t s assets are represented by quarterly contributions from
employers the amount of which is fixed for each mine by the
Miners' Phthisis Board, after taking into consideration :
(a) the earnings of miners and native labourers 3 employed
on the mine during the previous three months ;
(b) the sum for which the person working the mine was
assessed for normal income-tax in respect of the penultimate
accounting period ;
(c) the number of miners or native labourers found by the
Medical Bureau to have contracted silicosis or tuberculosis
on such mine and the amount of the benefits granted
to or in respect of such miners or native labourers.
In the event of the amount paid into the Fund being
insufficient to meet the payment of benefits the difference is
covered by the Consolidated Revenue Fund of the Union 4.
Where a miner or native labourer has worked partly in a
gazetted mine and partly in a scheduled mine the liability for
compensation of the Gazetted Mines Fund and the Compensation
Fund in respect of such miner or native labourer is apportioned
1
In determining the total outstanding liabilities the Actuary must
include in his calculations : existing monthly allowances, other awards
and outstanding balances of such awards, such further allowances and
awards arising from silicosis or tuberculosis as the Actuary may estimate
as likely to be awarded in the future. The Actuary in assessing the portion
due by the employer must include in his calculations in addition to the
above such other matters and circumstances as in his opinion can rightly
be considered as influencing the determination of such portion.
2
Whilst in scheduled mines the benefits to natives are payable by the
employers, in the case of " gazetted mines " they are payable by the Gazetted
Mines Fund.
3
The quarterly statement of wages transmitted by the employer to
the Board must show the earnings of native labourers as well as of miners.
* The Consolidated Revenue Fund is the moneys obtained by the
Treasury from all revenue. The two gazetted mines closed down years
ago and in practice all benefits granted from the Gazetted Mines Fund
are recovered from Consolidated Revenue.

3

— 34 —
by the Board whose apportionment is final. The same holds
good of grants made in respect of funeral expenses.
The benefits paid to a Government inspector are paid out
of the Consolidated Revenue Fund provided t h a t if such inspector
was a t any time employed as a miner the Board must refund
to the Consolidated Revenue Fund such portion of the amount
so paid as it may deem equitable under the circumstances.
4. The Miners' Phthisis Special Fund referred to as the
" Special Fund " has been established for the purpose of paying
special grants already referred to (see p . 27). Its assets are :
amounts received by the Board from the Consolidated Revenue
Fund for the relief of distress among beneficiary miners
. and their dependants ;
such sums (" lapsed balances ") as the Board may in its absolute
discretion transfer from the Compensation Fund 1 to the
Special Fund. When these lapsed balances are exhausted
the Board may transfer amounts not exceeding £75,000
in any one financial year.
5. Miner's
Phthisis
Board. The administration
of compensation and the application of the Acts are entrusted to an
organisation entitled the " Miners' Phthisis Board ".
Apart from levying contributions on employers and paying
benefits the Board has the following functions :
(a) to provide for training in trades or industries of beneficiary
miners, their wives and children and beneficiary widows
and children ;
(b) to conduct a bureau or co-operate with other bureaux
for the purposes of obtaining employment for such
persons as those mentioned in the preceding paragraph ;
(c) to assist financially in establishing or carrying on any
undertaking in which beneficiary dependants or dependants
of beneficiary miners are employed, and to co-operate
with any individual or institution, Government Department, municipality or provincial administration in any
of the undertakings referred to above or other activities
entrusted to it ;
1
These comprise : any balance of an award (other than a monthly
allowance) which has lapsed to the Compensation Fund on the death of
a beneficiary miner who left no dependants, or on the death or marriage
of a beneficiary dependant where there are no other dependants of the
deceased miner ; any amount which has lapsed to the Compensation Fund
in other circumstances (fines, donation, legacies to the Board or the funds
under its control unless made or bequeathed for a specific purpose).

— 35 —
(d)

to establish or assist in establishing workshops for such
persons as are mentioned in paragraph (a) 1.

To give effect to these different aims there has been created
the " Trades and Industries Fund " 2 which is administered by
the Board.
The Miners' Phthisis Board consists of a chairman and not
less than three, nor more than six, other members appointed by
the Minister of Mines and Industries for a period of three years,
the members being appointed by reason of their special knowledge
or experience and being eligible for reappointment. The Minister
may appoint alternate members or chairman to act during
temporary absences. Remuneration and conditions of service
are fixed by the Minister.
The Board, subject to confirmation by the Minister, appoints
a secretary and such other persons as may be necessary for carrying
out effectively its functions.
The Board may delegate any of its functions or powers other
than those of granting benefits to a Committee consisting of not
less than two of its members, but any resolution or action taken
by any Committee of the Board must be confirmed by the Board.
A meeting of the Board is held as often as required but a t least
once a week. Three members of the Board form a quorum and
matters which come up for decisions are decided by a majority
of members present and, in the case of equality of votes, the
chairman or member acting as chairman has a casting vote in
addition to his deliberative vote.
All salaries or other remuneration paid to any member of the
Board, to its secretary or other officers (with the exception of
gratuities accorded to the staff of the Board after a continuous
period of five years' service, on retrenchment, superannuation or
retirement which are payable from the Compensation Fund),
as well as all expenses incurred in connection with the
administration, valuation, adjustment and audit of the funds,
are paid out of the Consolidated Revenue Fund.

1

The measures of prevention in respect of beneficiary miners entrusted
to the Board are enumerated on p . 39.
2
Its assets consist principally of moneys appropriated from the Compensation Fund from time to time as it may require, but not exceeding
an amount of £5,000 quarterly ; any amounts accruing to the Board in
carrying out its functions ; and of any donations or legacies to the Trades
and Industries Fund.

— 36 —

6. The application of legal measures for compensation are
based on active collaboration between the Board and several
health organisations mentioned below :
(a) The Medical Bureau consists (October 1936) of a Chairman,
Vice-Chairman and nine examining officers, as well as a
radiologist and pathologist, all full-time officials appointed by
the Minister.
Its activities comprise (a) conducting, directing and controlling
all the prescribed medical examinations required by the Act
(see Note p. 40), excepting those entrusted to the Medical
Board of Appeal and the Joint Medical Board ; (b) assisting
the Board in collecting, compiling and tabulating statistics and
information relating to the incidence or cause of silicosis and
tuberculosis, and itself collecting, compiling and tabulating such
statistics and information ; (c) submitting to the Minister an
annual report on its activities.
The Bureau, subject to the confirmation of the Minister,
appoints a secretary and such other officers as may be necessary
for effectively carrying out its functions.
The remuneration of members of the Bureau and its staff
and the expenses incurred in carrying out its functions are paid
out of the Consolidated Revenue Fund with the exception of
gratuities accorded to members of the staff which, as in the case
of members of the staff of the Board, are paid by the Compensation
Fund.
Final decisions are taken on a majority vote of the members
present at a meeting of the Bureau. The legal quorum at
meetings is five members. The Chairman has a deliberative
and casting vote unless in the case of decisions relating to the
state of health or disease of an examinee, when he has a casting
vote only.
On all purely medical questions the advice and decision of
the Bureau are accepted by the Board and by all persons
mentioned in the Act.
(b) The Medical Board of Appeal consists of three medical
practitioners (one of whom is the chairman), with special
knowledge of diseases of the lungs and respiratory organs
appointed by the Minister, consideration being given by him to
a list of medical practitioners submitted by the unions representing
the underground workers. The Medical Board of Appeal meets
as often as is required, but at least once a month to examine

— 37 —

appeals relative to medical questions lodged with it by miners
or their dependants (see p. 28).
The remuneration of the members of the Board is determined
by the Minister and paid out of the Consolidated Revenue Fund.
(c) The Joint Medical Board consists of two members of
the Medical Bureau appointed by the Chairman thereof, two
medical practitioners appointed by the War Pensions Board
and a chairman appointed by the Minister. This Board has
ceased to function for some years.
I t deals with cases of miners who, having been refused
benefits under previous legislation (prior Law and principal Act),
on the ground that they had not tuberculosis or silicosis in a
stage entitling them to such benefits and were volunteers during
the war (as defined in the War Special Pensions Act, No. 42 of
1919), and whose application for a benefit under that Act in
respect of lung disablement or aggravation thereof was refused
on the ground that such disablement or aggravation thereof
was due to their occupation as miners. According to circumstances
such miners are entitled to benefits either under silicosis
compensation legislation or under the War Pensions Act, and
decisions of a majority of the Joint Medical Board are without
appeal.
Certificates of the Medical Board of Appeal or the Joint
Medical Board, as the case may be, are deemed for the purposes
of the Act to be certificates of the Bureau.
(d) The medical organisation is completed by a body of
" Medical Examiners ", who have power to carry out prescribed
examinations (initial, periodical and final) x of native workers,
to deliver the medical certificates under the Act and to attend
natives, i.e. those employed in or about scheduled or gazetted
mines.
Every mining employer is obliged to engage the services of
a t least one, or where necessary, several such examiners, except
in the case of the less important mines in regard to which the
Minister may grant exemption from this provision. In practice
approval is made by the Chairman of the Miners' Phthisis Bureau.
When so gazetted the mine medical officer becomes a " medical
1
These " medical examiners " must notify the Medical Bureau of
all cases of tuberculosis and silicosis met with and forward to it subsequent
to any post-mortem examination the lungs of the deceased for anatomopathological examination.

— 38 —

examiner " under the Miners' Phthisis Act x. The list published
in the Government Gazette may be amended by notice likewise
published.
Whilst all the medical examinations required in view of
compensation are exclusively dealt with by the Medical Bureau
(or Medical Board of Appeal, or Joint Medical Board), all other
medical examinations may be effected either by the Bureau or
by mine medical officers.
I t is the Medical Bureau which supervises and controls this
work chiefly by means of periodic visits of inspection in the
different mines.
In certain cases however the Medical Bureau may, where
good cause is shown, arrange for the examination of an applicant
for benefits resident in the Union by a medical practitioner
approved of by it for that purpose.
Likewise in the case of an applicant for benefits resident
outside the Union, the medical examination may be entrusted
to a medical practitioner duly registered or likewise legally
authorised to practise as such in the country where such applicant
resides.
Every member of the Board or of the Bureau or the Medical
Board of Appeal or any other Committee, appointed as well as
the examiners, has the right to enter upon any scheduled mine
premises in the exercise of any powers or in the performance
of any duty conferred or imposed upon him.
*

*

*

Under the compensation scheme in force the obligations of
employers are, generally speaking, as follows :
(a) to grant entry to all scheduled mine premises to any
member of the Miners' Phthisis Board, of the Medical
Bureau or of a scientific research committee (campaign
against dust or any other problem relative to hygiene
in mines) as well as to any authorised medical practitioner ;

1
I n 1935 there were about forty medical examiners. The number
obviously varies with the number of mines in operation and the number
of workers employed. Theoretically it is possible to have a mine medical
officer who is not empowered by having been gazetted to be an examiner
under the Miners' Phthisis Act, but in practice such circumstances do not
arise.

— 39 —
(b)
(c)

(d)
(e)
(f)

to abstain from employing underground in a scheduled
or gazetted mine any person suffering from tuberculosis ;
to afford to any person covered by the Act every facility
for submitting himself to the medical examinations
prescribed by the Act ;
to abstain from engaging for underground work a
beneficiary miner prohibited from such work ;
to carry out any Order given by the competent authority
for the prevention of silicosis or tuberculosis ;
to carry out in general all legal provisions.

Infringements of these requirements make the offender liable
to conviction and payment of a fine not exceeding £50 (where
no penalty is specially provided) in respect of each person the
subject of the offence, and, if the offender is an incorporated
company, every director, manager, mine manager or mine
overseer knowingly a party to the offence is liable to be prosecuted
therefor.

PREVENTION

Medical examinations on admission (initial and special
certificates) and periodical examinations represent an effective
means for detecting the disease a t an early stage and organising
the requisite means of prevention.
The Miners' Phthisis Board may furnish from the revenue
of the Compensation Fund an amount not exceeding half the
cost of establishing and maintaining one or more sanatoria for
purely silicotic patients and exercises likewise the function of
collecting, compiling and tabulating statistics and information
relating to the incidence and cause of silicosis and tuberculosis
and the results of the grant of benefits to those affected.
The Act explicitly states t h a t the Governor-General of South
Africa may, out of the moneys specially appropriated by
Parliament for the purpose, incur expenditure for investigating
the means of preventing and for the better carrying out of any
regulations lawfully made to prevent silicosis or tuberculosis on
any mine.
For this purpose the Minister may appoint a commission to
investigate and report and to advise him upon the means of
prevention of dust and on matters affecting health conditions

— 40 — •

in and upon any mine. Such a committee has power to enter
and examine any mine at any time and to take samples of air
therein and to make experiments or observations with a view
to determining the amount of dust and the health conditions
in such mine. The fees prescribed for members of this committee
are paid out of the Consolidated Revenue Fund.

Note
MEDICAL EXAMINATIONS

Miners and native labourers are obliged under the terms of the
Act to submit themselves to a certain number of medical examinations, and employers are likewise obliged to afford facilities for such
examinations.
Examination on Engagement
(a) Any person desiring to engage for the first time in underground
employment as a miner is obliged to submit himself to an initial medical
examination 1.
If fit he receives the " initial certificate " certifying t h a t he is
" free from any disease of the lungs and respiratory organs and in other
respects physically fit for underground work " .
This initial certificate, which bears the date at which it expires, is
valid for six months, at the end of which the holder thereof, provided
t h a t he has been employed in the interval as a full-time miner, is entitled
to submit himself to periodical examination as a " working miner " .
If the applicant is not fit he receives a notification t h a t the Bureau
is unable to grant to him the initial certificate.
The " special " certificate is granted to persons engaged in work
which necessitates them going underground from time to time (less
than 100 hours per month) and who are not " miners " as defined by the
Act : surface artisans going underground now and then for repairs or
similarly intermittent duties, some mine managers, inspectors and
others (see p. 20).
This certificate certifies t h a t the holder is not suffering from tuberculosis and must also bear mention of the date at which it expires. If
the examinee is not fit the Medical Bureau furnishes a notification t h a t
it is unable to grant him the certificate.
(b) On the occasion of the initial examination of native labourers
the initial certificate or the notification indicating t h a t the certificate
cannot be granted is transmitted to the Director of Native Labour.
1
I t should be noted that in the case of European miners a radiographic
examination is part of the medical examinations (initial, periodical and
benefit) but in the case of natives such radiographs are only made when
the clinical examination shows a suspicion of silicosis or tuberculosis or
after five years' service (see later).

— 41 —
Periodical

Examinations

(a) All working miners (within the meaning of the Act) are obliged
to submit themselves to periodical medical examination at intervals
not exceeding six months.
Miners not in employment remain eligible for the periodical
examination for an indefinite period provided t h a t they present themselves for examination at intervals of not more than two years from
the date of expiry of the last periodical certificate issued to them. If
they fail to do so they are again subjected to an " i n i t i a l " examination.
Any person other than a native labourer, resident throughout in
South Africa who was granted an initial certificate and has thereafter
been employed underground in scheduled mines for an aggregate period
of at least three years, who has not yet been found to have silicosis or
tuberculosis and whose capacity for Work is not in the opinion of the
Bureau seriously impaired by any other disease or disability, is eligible
for periodical examination notwithstanding the lapse of a period of
two years.
At every periodical examination the miner is required to deliver
to the Bureau the last periodical certificate issued to him.
The periodical medical certificate indicates t h a t the miner is not
suffering from tuberculosis, and entitles him to continue in or offer
himself for employment in any of the occupations specified in the Act.
Every periodical certificate must bear the date of its expiry.
Once granted, the periodical certificate is renewed in the case of
all miners who remain eligible and submit themselves for examination,
unless the holder is found upon examination to be suffering from
tuberculosis or tuberculosis with silicosis.
When the miner is found to have silicosis or tuberculosis a certificate
is granted stating t h a t he is suffering from silicosis and in what stage,
or from tuberculosis with or without silicosis, and in the event of his
being found to have tuberculosis * he is excluded from underground
work and from further examination for the periodical certificate.
Any miner suffering from silicosis unaccompanied by tuberculosis,
whether in the ante-primary, primary or even secondary stage, and
notified of this fact, may continue to work and refrain from claiming
compensation without thereby forfeiting his right to compensation later
should he develop secondary silicosis in the case of the first two
alternatives or silicosis accompanied by tuberculosis in the case of
all three alternatives *.
(b) In the case of a native labourer the periodical examination
as a matter of fact takes place approximately every five weeks. I t
consists essentially of weighing the natives naked and making a rapid
clinical examination ; further a medical examination of such as have
lost 5 lbs. weight between two weighings, or 6 lbs. in all between three
weighings ; all natives whose clinical examination leads to suspicion of
silicosis or tuberculosis are examined radiographically. Natives on
1
Any person who goes underground in any scheduled mine knowing
that he is suffering from tuberculosis is guilty of an offence.
2
The 1934 amendment did in fact nullify the former provisions of
the Act which granted any miner suSering from silicosis and notified of
this fact a maximum delay of three months in which to give up his work
and file his claim for compensation under pain of forfeiting for good all right
to compensation in excess of the amount granted him when first notified
of his condition.

— 42 —
reaching five years ' service are examined medically and radiographed.
Thereafter these are kept under special observation by the mine medical
officers and radiographically re-examined when considered necessary.
This is the present practice.
After every examination or re-examination the native labourer is
certified as (a) suffering from silicosis and in what stage, and is granted
a periodical certificate t h a t he is not suffering from tuberculosis ; or
(b) a certificate that he is suffering from tuberculosis and stating whether
with or without silicosis. In case of tuberculosis, the native labourer
is compulsorily removed from work.
Periodical medical examination of native labourers is effected by
" examiners " who report the results of their observations on special
forms and must send to the Medical Bureau for further examination
any native labourers in whom they detect signs of tuberculosis and
silicosis.
Subsequent to each initial, special or periodical examination, the
examinee is informed of the results, except in the case of a native
labourer, in which case t h e information is transmitted to his employer
whose duty it is to inform him forthwith.
After a periodical examination the Medical Bureau or the
" examiners " notify to the Miners ' Phthisis Board or the Director
of Native Labour as the case may be all cases of silicosis or tuberculosis
or both diseases.
Apart from the certificates transmitted to them the examinees are
always free to request information as to their condition x.
The initial, special or periodical certificate is absolutely necessary
for all engaging in underground work.
Final

Examinations

The employer of any native labourer must notify the Bureau or
medical practitioner nominated by it of the date upon which such native
labourer ceases to be employed on underground work, or goes on leave.
Any native labourer having worked underground for a period of
not less than thirty days, whether continuously or otherwise, must be
stethoscopically examined by the Medical Bureau or by a medical
practitioner nominated (either generally or specially b y the Bureau)
whenever he ceases to work. If during this examination the native
labourer is found to be suffering from silicosis or tuberculosis the Medical
Bureau must notify the Director of Native Labour immediately, and
further if at such examination or at any other medical examination
held within six months from the date upon which he ceased to work
underground he is found to be suffering from tuberculosis without silicosis
he is entitled to the benefits provided.
Medical Examination

for " Special Authorisation

"

This examination is intended for beneficiary miners who had received
benefits under previous legislation and who in reality are no longer
1
This request is inscribed on form 40A and the corresponding forms
for replies furnished by the Miners' Phthisis Board are as follows : Anteprimary silicosis : 40B (AP) ; primary silicosis : 40B (Pr) ; secondary
silicosis : 40B (Sec) ; no silicosis : 40B (1).
I n certain cases the miner however receives a letter of notification
(form 40C) informing him that underground work constitutes a risk for
his health and that he would do well to consult his doctor.

— 43 —
suffering from tuberculosis or silicosis. With the written permission
of the Miners' Phthisis Board such miners may submit themselves to
a prescribed medical examination by the Medical Bureau which thereafter
transmits to them a special authorisation or, as the case may be,
notification t h a t the Bureau is unable to grant them such authorisation.
Benefits Examinations

(Miners)

Every miner who may, as the result of a prescribed examination,
become entitled to any benefits or increased benefits can claim the
following medical examinations (whether he has undergone an examination
by the Medical Board of Appeal or not) if he is not entitled to the
periodical examination provided for working miners :
(a) Not less t h a n six months after the last periodical examination ;
(b) Not less than one year after an examination under previous
legislation, or under the above legislative provisions ;
(c) If so directed by the Bureau or at the request to the Bureau
by the Chairman of the Board, a working miner or a beneficiary
miner may submit himself to medical examination by the
Bureau at shorter intervals *.
Subsequent to such examinations the Medical Bureau notifies the
Board whether the person so examined has tuberculosis with or without
silicosis or silicosis and in what stage.

' T h e delays imposed under (1) and (2) signify that a miner who is
not subject to periodical examination, that is to say who is not actively
employed, may not ask for a special examination until six months have
expired from his last periodical examination and until not less than one
year has expired after any special examination, such as an examination
for benefit. I n other words, the purpose of this is to prevent miners frivolously asking for examinations at frequent intervals, but as a matter of
fact enables a miner by showing good cause to obtain an examination at a
shorter interval.

GREAT BRITAIN

LEGISLATION

Compensation for silicosis is provided in Great Britain by various
" Schemes " issued under Section 47 of the Workmen's Compensation
Act, 1925, extended by the Workmen's Compensation Act, 1930 l .
These Schemes, applying to different industries or groups of industries,
have been developed by stages in the light of increasing knowledge of the
disease, and after discussion with representatives of the industries concerned
which accounts for some of the differences between one Scheme and
another. The first Scheme, made in 1919, was for the " Refractories
Industries ", a small group including ganister mining and silica brick
making in which there is exposure to dust containing a high percentage
of free silica. A special feature of the Scheme for this group of industries
is a limited form of compulsory insurance — all the compensation is paid
from a special fund to which employers in the industries have to subscribe,
thus tending to distribute the liability among employers whose work has
contributed to the slowly developing disease in question. The Scheme
was somewhat revised in 1925 on a review of its working, after which
Schemes were made for metal grinding (1927) and various other industries
(1928), the most important being certain mining and quarrying operations,
dressing, etc., of certain kinds of stone in the building trade, and certain
processes in pottery manufacture. In 1929 sandstone quarrying was
taken out of this Scheme and made the subject of a special Scheme with
a compensation fund, on the same lines as the Refractories Scheme. In
1931 the medical arrangements for all the Schemes were developed and
co-ordinated under a Silicosis and Asbestosis (Medical Arrangements)
Scheme, the other Schemes being at the same time reissued with the
omission of various medical provisions.
This Scheme was further
extended in 1934.
The Schemes now (1937) in force in addition to the Medical Arrangements Schemes are as follows :
(1) The Metal Grinding Industries (Silicosis) Scheme, dated 30 April
1931. S. R. <fc O., 1931, No. 343. (Came into force on 1 June 1931 in
substitution for the Schemes of 1927, No. 380, and 1930, No. 118.)
(2) The Refractories Industries (Silicosis) Scheme, dated 11 May 1931.
S. R. & 0., 1931, No. 345. (Came into force on 1 June 1931 in substitution
for the Schemes of 1919, No. 12, and 1925, No. 79.)
(3) The Sandstone Industry (Silicosis) Scheme, dated 20 May 1931.
S. R. & O., 1931, No. 346. (Came into force on 1 June 1931 in substitution
for the Scheme of 1929, No. 171.)
1
Act of 22 December 1925, to consolidate the law relating to compensation to workmen for injuries suffered in the course of their employment.
(L.S., 1925, G.B. 3), came into operation 1 May 1926 and is substituted as
regards Silicosis for the Acts of 30 July 1918 and 7 August 1924 providing
for compensation for this disease, which have been incorporated in section
47 of the 1925 Act. Act of 1 August 1930, to extend section 47 of the
Workmen's Compensation Act 1925 to industries involving exposure to
asbestos dust and to amend the provisions of that section relating to medical
arrangements and examinations (L.S., 1930, G.B. 7).
The present study dealing exclusively with Silicosis, all provisions
relative to Asbestosis have been expressly omitted.

— 46 —
(4) The Various Industries (Silicosis) Scheme, dated 30 April 1931.
S. R. & O., 1931, No. 342. (Came into force on 1 June 1931 in substitution
for the Schemes of 1928, No. 975, and 1930, No. 1095.)
(5) The Various Industries (Silicosis) Amendment Scheme, dated
22 October 1934. S. R. & O., 1934, No. 1155. (Came into force on the
date of the Order.)
(6) The Various Industries (Silicosis) Amendment Scheme, dated
29 January 1935. S. R. & O., 1935, No. 69. (Came into force on 1 March
1935.)

SCOPE OF LEGISLATION

Compensation for silicosis is therefore provided for workmen
employed in processes or industries recognised as involving
exposure to the risk of the disease, as follows :
(1) The Metal Grinding Industries. — The grinding of metals
by means of a grindstone composed of natural or manufactured
sandstone and certain incidental processes, and also racing or
trueing up of the grindstone. I t does not apply to grinding
which is occasional only and for not more than eight hours in
any week ; or to the manufacture, repair or sharpening of tools
or implements for use in the factory, unless the workman is
mainly employed in such work ; or to file grinding by machine
in which the grindstone is completely enclosed and the metal
being ground is immersed in water.
(2) The Refractories Industries. — Processes carried on a t
mines, quarries, factories and workshops at which refractory
material containing not less than 80 per cent, total silica (Si0 2 )
is got or manipulated with a view to manufacture or sale :
namely, all processes in or in connection with the getting,
handling, moving, breaking, crushing, grinding and sieving of
such material and all processes in the manipulation of such
material in the manufacture of bricks or other articles containing
not less than 80 per cent, total silica (Si0 2 ).
[The limit of 80 per cent, silica (Si0 2 ) in the definition
excludes the fireclay industry.]
Not included : mines and quarries in which refractory
material is only occasionally worked ; iron or steel works in
which refractory material is crushed, ground or pugged for use
only in the works ; quarries of natural sand.
(3) The Sandstone Industry.
— This Scheme covers all
processes in or incidental to the getting òr manipulation of

— 47 —
%
sandstone x with a view to manufacture, sale or use, which are
carried on at mines or quarries or on premises worked in
conjunction with a mine or quarry, provided t h a t the sandstone
got, manipulated or worked contains more than 50 per cent.
silica (free and combined).
Not included : mines and quarries in which sandstone is
worked occasionally only ; premises not being part of a mine
or quarry in which sandstone is manipulated for the purpose
of the manufacture of silica flour ; processes in the manufacture
of artificial stone (except breaking, crushing or grinding of
sandstone and any handling in or incidental to such process) ;
employment as craneman, engineman, fitter, blacksmith, where
the workman is employed exclusively in such occupation.
[Workers contracting silicosis in mines and quarries exempted
from the scheme would have a claim under the Various Industries
Scheme.]
(4) The Various Industries. — Any processes specified in the
following industries : mining and quarrying of silica rock2 ;
getting of silica rock ; drilling and blasting of silica rock in or
incidental to the mining or quarrying of other minerals with
the exception of certain specified processes under certain
conditions ; getting and manipulation
(dressing) of granite
(including any igneous roch) ; all underground operations in
coal mines and iron ore (hematite) mines;
all underground
operations and the breaking of ore above ground in tin mines;
manipulation
and working of silica rock : sawing, planing,
dressing, shaping, cutting or carving ; working and manipulation
(breaking, crushing, grinding, sieving, mixing or packing), and
handling or moving of silica rock or other siliceous products (dried
quartzose sand, dry residue of silica, flint) or any dry admixture
containing such material ; certain specified processes in potteries,
in milling of flint or crushing or grinding of silica rock or dried
quartzose sand ; in the manufacture of china or earthenware
including sanitary earthenware, electrical earthenware and
earthenware tiles ; polishing, sorting or grinding on a powerdriven wheel in connection with grinding of glostware or tileslabbing ; foundries and metal works : (a) in manufacture of steel
1
" Sandstone " includes ganister, gritstone and quartzite rocks, but
does not include rotten stone or natural sand.
a
Silica rock means quartz, quartzite, ganister, sandstone, gritstone and
chert but does not include natural sand or rotten rock.

— 48 —
or in steel foundries : crushing, grinding or handling of silica
rock, bricks or other articles containing not less than 80 per cent.
total silica (Si0 2 ) ; freeing of steel castings from adherent sand ;
(b) sandblasting of metal or metal articles by means of
compressed air with the use of quartzose sand or crushed silica
rock or flint.
The scope of application of each Scheme being expresslydefined, the provisions of one Scheme do not apply to employment
in the processes enumerated in the other Schemes. For this
reason each claim for compensation must indicate the Scheme
under which it is made.
Under the Act of 1925 the expression " workman " means
any person who has entered into or works under a contract
(expressed or implied, oral or in writing) of service or apprenticeship,
whether by way of manual labour, clerical work or otherwise,
provided the contract is valid or treated as such for compensation
purposes under certain special provisions (Section 3 (3)).
The Act applies equally to workmen employed by or under
the Crown, when engaged in the industries or processes covered.
I t does not apply to any person employed otherwise than
by way of manual labour, whose remuneration exceeds £350
per annum, or to any person whose employment is of a casual
nature and who is employed otherwise than for the purpose of
the employer's trade or business, or to out-workers, or to any
member of the employer's family dwelling in his house.

R I G H T TO COMPENSATION

Compensation for silicosis, t h a t is to say, fibrosis of the lungs
due to silica dust, as well as silicosis accompanied by " tuberculosis "
(this means, as stated in the different Schemes, tuberculosis of
the lungs), if due to employment in an industry or process
covered by the Schemes, is provided, subject to conditions
enumerated below, in cases of :
(a) compulsory suspension from employment ;
(b) total disablement ;
(c) death.
(Compensation is not given for tuberculosis alone or
suspension merely on account of inadequate physique.

for

— 49 —
Further compensation is only accorded subject to the following
provisions :
(1) The workman must within three years previous to the
date of the injury have been employed in an industry or process
covered by the Scheme under which compensation is claimed,
or have been in receipt of weekly payments under the Scheme
(or under a previous Scheme 1 for the same group of industries).
Beyond this time limit the worker is not entitled to compensation.
The " date of the injury " is the date of suspension or of
total disablement indicated in the certificate issued by the Medical
Board or, in cases where a workman dies without having been
certified as totally disabled or suspended, the " d a t e of the
injury " is the date of death.
Where compensation is paid by agreement between the parties
without a certificate from the Medical Board the date of suspension
is deemed to be the date of the agreement or such other date
as may be agreed upon between the parties (Metal Grinding
Industries, Various Industries) 2.
(2) I n cases where the workman has been employed in an
industry or process covered by the Scheme for a period or
periods amounting to not less than five years, silicosis, or silicosis
accompanied by tuberculosis, is deemed to be due to employment
in t h a t industry or process unless the employer proves the
contrary. In other cases the onus of proof t h a t the disease is
due to the employment is on the workman or dependants. The
Silicosis Medical Board may, however, if satisfied t h a t the disease
cannot have been contracted in a particular industry or process
owing to the shortness of the time the workman has been
employed therein, give a certificate to this effect which is conclusive
on the point.
(3) The workman or his dependants must not be in receipt
of compensation for silicosis under any other Scheme or enactment
providing compensation whether in Great Britain or elsewhere
(e.g. compensation for miners' phthisis, South Africa).
(4) Obligation on the part of the workman (where required)
to submit himself to a medical examination on admission, and
1
The Schemes are not retrospective, that is to say, they apply only
to workers employed in the processes covered on or after thè date on
which they came into force respectively.
8
In theory under the other two Schemes also.

4

— 50 —
periodically thereafter as provided for by the Medical Arrangements
Scheme and any of the other Schemes 1.
(5) Obligation on the part of the workman certified as totally
disabled or suspended from employment not to re-engage in
processes involving exposure to the risk of silicosis2, except so
far as may be allowed by certificate of the Medical Board.
(6) Obligation on the part of the workman to furnish to the
employer certain information as to previous employment in any
process covered by the Schemes, and as to whether he is in
receipt of compensation under any other Scheme or enactment
for the disease whether in Great Britain or elsewhere.
Failure to comply with any of these last three requirements
involves loss of right to compensation except in certain
circumstances (bona-ftde mistake or other reasonable cause)
appreciation of such being left to the County Court Judge, Joint
Committee, or other arbitrator under the Scheme.
Further, right to compensation is subject to special provisions
included in the different Schemes thus, for example :
(7) As regards the Refractories Industries, the three-year limit
does not apply provided the workman proves to the satisfaction
of the Joint Committee (see under " Review ") t h a t since his
last employment in the refractories industries he has not been
employed in any of the occupations covered by the other Schemes
(metal-grinding, sandstone, various industries) or in any process
in South African mines 3.
(8) As regards the Sandstone Industry, right to compensation
is forfeited when the workman has left the industry unless he
can prove to the satisfaction of the Joint Committee that, since
his last employment therein, he has not been employed in any
of the occupations covered by other Schemes.

1
Initial and periodic examinations are only prescribed for workmen
employed in certain industries and occupations as specified in the First
Schedule to the Medical Arrangements Scheme.
" That is to say, processes covered by any of the Schemes as well as
work in South Africa in those mines scheduled under the Miners' Phthisis
Acts.
8
See p . 13, footnote.

— 51 —
CERTIFICATION OF THE D I S E A S E

Unless the employer agrees to pay compensation on some
other medical certificate 1, compensation can only be claimed on
a Certificate of the Silicosis Medical Board. Such a certificate
may be issued as a result of medical examination made on
commencement of the employment (initial examination) 2 or one
of the examinations made periodically thereafter in accordance
with the Medical Arrangements Scheme, or it may be issued
on an application to the Medical Board lodged by the workman
or his dependants.
A certificate issued as a result of an initial or periodic
examination is given free of charge to the workman. Where
application for a certificate is made by the workman or his
dependants a fee has to be paid but a proportion of it is returned
if the compensation claim is successful (a fee being then charged
to the employer or Compensation Fund).
In practice, a workman before making an application to the
Board for a certificate, applies to his Society under the National
Health Insurance Act, which arranges for him to be examined
by the regional medical officer. If the officer in question is
satisfied that there is " reasonable cause for suspecting the
existence of silicosis " he certifies to this effect, and this certificate
entitles the workman to be examined by the Medical Board a t
a reduced fee. The workman transmits the certificate and the
prescribed fee to the Medical Board stating the Compensation
Scheme under which the claim is made, the name and address
of the employer who last employed him in a process included
in the Scheme, the nature and duration of employment, and
the date when he left such employment.
If the regional medical officer refuses a certificate the workman
may still proceed with his application for examination by the
Medical Board.
1
The Metal Grinding Industries and the Various Industries Schemes
indicate that payment of compensation may be effected without a certificate
from the Medical Board where the employer agrees that he is liable for
payment of compensation to the worker. I n the Refractories Industries
and Sandstone Industry Schemes the right exists, but the Company Funds
have never agreed to exercise it.
2
The examination on commencement of employment may be made
by another doctor (e.g. local tuberculosis officer) authorised by the Secretary
of State ; but if he thinks the workman has silicosis or tuberculosis or does
not satisfy certain other requirements as to physique he must refer the case
to the Medical Board for their decision.

— 52 —
In case of death the dependants or their representatives
desiring a certificate apply direct to the Medical Board.
The Medical Board issues certificates, on Forms prescribed
under the Medical Arrangements Scheme, (1) of compulsory
suspension from employment ; (2) of total disablement for
employment ; (3) t h a t death was caused by silicosis, or silicosis
accompanied by tuberculosis.
(1) The certificate of compulsory suspension from employment
is issued either on account of failure to satisfy certain requirements
with respect to physique 1 a t the first examination after entering
the employment (Form F.), or on account of silicosis or silicosis
accompanied by tuberculosis (Form C.) or on account of tuberculosis
unaccompanied by silicosis (Form E.). Suspension normally
follows when the workman, though not totally disabled, is found
by the Board to be suffering from silicosis or tuberculosis or
silicosis accompanied by tuberculosis to such a degree as to make
it dangerous for him to continue work in the industry or processes
covered by the Scheme ; where tuberculosis is present (alone
or with silicosis) suspension is also a measure of protection for
other workers. In certain cases, however, the Board are not
bound to suspend but the wishes of the worker are ascertained.
Thus, the provision with regard to suspension on account of
failure a t the initial examination to satisfy the requirements as
to physique does not apply (unless tuberculosis is found) to a
skilled mason over 21 years of age entering the sandstone industry
from the building or other industry in which he has been
employed as a mason. Again, a workman is not liable to
suspension, except on his written application, when found a t
the periodical examination to be suffering from silicosis not
accompanied by tuberculosis, if (a) he is aged 45 (40 in the
sandstone industry) and has been employed for at least 20 years
in the industry concerned or (b) he is a skilled craftsman 2
engaged in the pottery industry.
In the case of compulsory suspension due to silicosis or silicosis
accompanied by tuberculosis, the certificate (Form C.) indicates
1
These are : (i) the chest must be at least of average development
and the respiratory passages must be free from obstruction ; (ii) there
must be no signs of disease of the lungs or heart ; (iii) there must be no
tuberculosis of any region.
2
Skilled craftsmen are defined as including all persons carrying on
any of the processes covered, excepting assistants and apprentices, and
mill men, china biscuit odd men, and china biscuit warehouse workers.

— 53 —
also the stage which the disease has reached and further, whether
the workman's general physical capacity for employment is
impaired by reason of the disease, and if so, to what degree,
and the class or character of work outside the dangerous industry
or process for which the workman is fit.
(2) In cases of total disablement from silicosis or silicosis
accompanied by tuberculosis, the certificate (Form B.) requires
the Medical Board to certify the date from which the total
disablement is to be reckoned as having commenced. If they
are unable to certify such date, the date of total disablement
is deemed to be the date on which the certificate is issued.
(3) The certificate of death (Form A.) is furnished by the
Medical Board after a post-mortem examination of the deceased
workman. The only exception to this rule is in cases in which
weekly payments under the compensation scheme were payable
to the workman ; and only then if the Medical Board is satisfied
t h a t a post-mortem examination is unnecessary. The postmortem is not necessarily made by a member of the Board but
he must, if possible, be present, and, particularly if he is not,
arrangements are usually made to enable the Board to examine
the lungs and other "material from the body if desired. I t will
be observed t h a t the Board only certifies as to whether or not
the death was caused by silicosis or by silicosis accompanied
by tuberculosis ; it does not certify the actual cause of death
apart from the disease.
If in any class of case (i.e. fatal or other) the Medical Board
is satisfied t h a t the silicosis or silicosis accompanied by tuberculosis
cannot, owing to shortness of employment, have been contracted
in the industry or process in question, the certificate must bear
an indication to this effect.
Before deciding on an application for a certificate the Medical
Board must send notice of the application to the employer from
whom the compensation would appear to be recoverable or to
the managers of the Compensation Fund (Refractories Industries
and Sandstone Industries Schemes) and must consider any
statement made or submitted to them on behalf of the employer,
or the Compensation Fund, within 10 days from the date of notice.
The Medical Board addresses the certificate
(a) to the injured worker or his dependants in the case of
the Metal Grinding Industries Scheme or the Various
Industries Scheme ;

— 54 —
(b)

to the competent Joint Committee in the case of the
Refractories Industries or Sandstone Industries Scheme.

I n case (a) the ordinary provisions of the Act are applied
as to giving notice of disablement by an industrial disease and
of claim to compensation, i.e. it rests with the claimant to see
t h a t the appropriate employer or his representative is made
aware as soon as practicable of the effect of the Board's certificate
(sending a copy if demanded), and to lodge the claim to
compensation within six months of the date of the injury or
date of death ; but failure to notify, or any defect or inaccuracy
in such notice, is not a bar to the maintenance of proceedings in
regard to the claim for compensation if the employer is proved
to have had knowledge of the disease from any other source,
or if it is found that such failure, defect or inaccuracy does not
prejudice the employer in his defence, or was occasioned by
mistake, absence from the United Kingdom, or other reasonable
cause.
In case (b) the Secretary of the Joint Committee sends to the
workman or his representative a copy of the Board's certificate
and a copy of the appropriate form on which to submit his claim
to compensation, which will be investigated and adjudicated
upon by the Joint Committee.

BENEFITS

Benefits are substantially the same as in the case of disablement
or death from accidents and other industrial diseases under the
Workmen's Compensation Act, but there are also some benefits
in cases of suspension from the dusty employments a t an early
stage of the disease when the workman's general physical capacity
for employment is not impaired. The liability is to make
monetary payments, but in assessing these regard may be had
to payments, allowances or other benefits which the workman
may receive from the employer during incapacity. I t should be
noted t h a t the workman will generally obtain medical attention
and treatment from other sources, e.g. National Health Insurance.
Benefits are the same irrespective of whether the case is one
of silicosis or one of silicosis accompanied by tuberculosis.
(1) The amount of compensation in cases where the workman
though not totally disabled is suspended from employment on

— 55 —
account of the disease varies according to whether the workman's
general physical capacity for employment is or is not impaired
by the disease, as certified by the Medical Board.
A. I n cases where the general physical capacity is impaired :
(i) Metal Grinding Industries and Various Industries : the
workman receives during impairment by reason of the
disease a weekly payment fixed in the same way as
compensation for partial incapacity due to an accident
under the 1925 A c t 1 .
(ii) Refractories Industries and Sandstone Industry :
(a) if the workman is unable to obtain immediately
other suitable employment a t a rate or remuneration
not less than he was earning in the processes, a
weekly payment, for a period of two weeks from the
date of suspension, equal to the full amount of his
wages ;
(b) thereafter during the impairment, a weekly payment
for partial incapacity calculated substantially in
accordance with the 1925 A c t 1 ;
(c) such sum as the Joint Committee may consider
reasonable for the expenses of removal where the
workman is compelled on suspension to leave the
district in order to obtain other suitable employment,
the sum in question not to exceed five pounds.
B. I n the case of suspension without impairment of general
physical capacity due to the disease.
If the workman is unable to obtain suitable employment
(other than t h a t prohibited) at a rate of remuneration not less
than what he was earning in the processes, he is entitled while
he remains out of such employment, to a weekly payment the
rate and duration of which vary according to the Scheme under
which compensation is obtained.
(a) Metal Grinding Industries and Various Industries :
payment to be fixed by agreement or, in the absence
of such agreement, by the County Court judge or other
1
Total incapacity benefits. If the workman's average weekly earnings
were 50s. or upwards he is entitled during total disablement to a weekly
payment, up to a maximum of 30s., of not more than one-half of these
earnings. If the average weekly earnings were less than 50s. he is entitled
to an addition on a sliding scale which in effect increases the percentage
progressively above 50 per cent, up to 75 per cent, where the earnings
were 25s. a week or less.

— 56 —
arbitrator, provided that the amount does not exceed
50 per cent, of the workman's average weekly earnings
before the suspension and is not payable for more than
13 weeks in all.
(b) Refractories Industries and Sandstone Industry : if the
workman is unable to obtain immediately other suitable
employment at a not less rate of remuneration, a weekly
payment for a period of two weeks from the date of
suspension equal to the full amount of his wages ;
thereafter, if still unable to obtain aforesaid employment,
a weekly payment not exceeding 50 per cent, of his
average weekly earnings before the suspension for a
further period or periods not exceeding 11 weeks in all.
(c) A sum to meet the expense of removal as in A (ii) (c).
(2) Compensation for total disablement : a weekly payment
payable during the period of total disablement on the same scale
as is allowed under the Act for injury by accident 1 .
Redemption of weekly payments.
When a weekly payment
has continued for not less than six months, the liability may
be redeemed for a lump sum, of such amount as will be sufficient
to purchase a Post Office annuity for the workman equal to three
quarters of the annual value of the weekly payment. This
provision is however seldom used in practice.
(3) Payment in case of death. I n cases of death the amount
of compensation is determined in accordance with the provisions
of the Workmen's Compensation Act, 1925, as to compensation
for death by accident.
(i) If the workman leaves a total dependant or dependants,
the compensation is £200 or 3 years' earnings, whichever
is the higher, up to a maximum of £300.
(ii) If the workman leaves only partial dependants, the
compensation is such sum not exceeding the amount
specified under (i) as is reasonable and proportionate
to the loss sustained by such dependants.
1
Partial incapacity benefits. Where the average weekly earnings are
50s. a week or upwards, a weekly payment, up to a maximum of 30s. equal
to one-half the difference between his average weekly earnings before
suspension and the average weekly amount which he can earn in a suitable
employment thereafter ; and where the earnings were less than 50s. a week
the percentage is progressively increased up to 75 per cent, for earnings
of 25s. a week or less.

— 57 —
(iii) If no dependants are left, reasonable expenses of medical
attendance and burial are payable up to a maximum
of £15.
Where the dependants include a child or children under the
age of 15 (as well as a totally dependant widow or some other
member of the family over 15), in addition to the compensation
mentioned above, an allowance is payable in respect of each
child varying according to the child's a g e 1 . The total
compensation, however, payable to the dependants, including
the children's allowance, must not exceed £600. If any of these
dependants were only partially dependant on the deceased
workman's earnings, the additional compensation for children
under 15 is such proportion of that above-mentioned as may
be agreed or in default of agreement, as may be determined by
arbitration to be reasonable.
The amount of the weekly payments, if any, made to the
workman before his death (or the sum paid in redemption of
such payments) is deducted from the amount payable to the
dependants provided the lump sum is not reduced below £200.
No deductions are allowed from the children's allowance on
account of weekly payments made to the workman during life,
but deductions may be made in respect of any lump sum paid
in redemption thereof.
Under the Metal Grinding and Various Industries Schemes
the compensation payable in the case of death is not paid direct
to the dependants but is paid into the County Court to be
invested, applied or otherwise dealt with as it thinks best for
the benefit of the dependants.
Under the Refractories Industries and Sandstone Industry
Schemes it is payable to the Public Trustee or other person
nominated as trustee by the Secretary of State, except t h a t where
the sum payable is less than £50, it may be paid over to the
persons entitled thereto as the Joint Committee may direct.
REVIEW

The amount of the weekly payment in respect of suspension
from employment or of total incapacity may be reviewed from
1
This sum is fixed as follows : 15 per cent, of the product of the workman's average weekly earnings and the number of weeks elapsing between
the workman's death and the child's fifteenth birthday ; for the purpose
of this calculation earnings are deemed to be £1 or £2 if actually less or
greater than these rates respectively.

— 58 —
time to time on change of circumstances on application by the
beneficiary, the employer or the Compensation Fund. For the
purpose of deciding whether there has been a change in the
workman's physical condition there may be a reference to the
Medical Board, if no agreement is reached on reports from
employer's and workman's doctors (Various Industries and Metal
Grinding Schemes), or application direct to the Medical Board
for re-examination and a certificate (on Form D) stating whether
since the last examination the impairment of the general physical
capacity of the workman is altered or not and, if it has, indicating
what changes in condition and fitness for work on account of
the disease have occurred since the previous examination. The
fee for such reference or re-examination is payable by the applicant.
A workman cannot be required to submit himself to medical
examination for this purpose more frequently than once in every
three months (six months in cases of total disablement).
Review of an award may, according to the circumstances,
involve cessation, reduction or increase of the weekly payment.
I n the Refractories Industries Scheme and the Sandstone Industry
Scheme the decision is taken by the Joint Committee ; in the
other Schemes, decision as to the amount payable is settled by
agreement or in default of agreement by arbitration under the
Act.
Review on workman reaching 21 years of age. — Where the
workman was at the date of the injury under twenty-one years
of age and the review takes place more than six months thereafter
and the application for the review is made before or within six
months after the workman attains the age of twenty-one years,
the amount of the weekly payment may be increased to such
an amount as would have been awarded if the workman had
a t the date of the injury been earning the weekly sum which
he would probably have been earning a t the date of the review
if he had remained uninjured.

PROCEDURE FOR SETTLING

DISPUTES

The procedure for settling of questions varies according to
the different schemes.
A. Under the Schemes for the Metal Grinding Industry and
for Various Industries the procedure for settling questions is
t h a t provided in the Act as regards accidents and any regulations

— 59 —
(except those determining the fees payable to medical referees)
and rules of Court made in pursuance thereof, which apply
accordingly.
The functions of medical referee are, however, fulfilled by
the Medical Board, except that the provision of the Act relative
to the appointment of a medical referee to sit as assessor with
the judge is not applicable in the cases coming within the Schemes.
Questions arising in any proceedings as to compensation
(right to compensation, the amount and duration of compensation
or any indemnity and determination as to who are dependants
within the meaning of the Act) are, in default of agreement between
the parties, settled by arbitration (generally by the County Court
Judge).
The rules of Court make provision for the conditions under
which the parties seeking the decision may be represented during
the arbitration procedure. Any question settled by means of
an agreement, by a committee or by an arbitrator must be made
the subject of a memorandum to be registered with the County
Court.
Any Committee, arbitrator or judge may submit to a medical
referee — in this case the Medical Board — for report any matter
material to any question arising in the arbitration.
B. Under the Refractories Industries Scheme and the
Sandstone Industry Scheme the procedure for the settling of
matters in dispute is twofold.
If any question arises under Part I I of these Schemes as to
the application to any particular process or to any individual
workman, t h a t is whether a levy is payable by the employer
to the Compensation Fund in respect of such employment, the
question is referred for decision to the Secretary of State or, if the
parties prefer, to a single arbitrator approved (or failing agreement
appointed) by the Secretary of State in accordance with the
rules made by him for this purpose.
When the question a t issue is as to the amount and
apportionment of compensation (if any) it is decided by a Joint
Committee whose decision is final except that, where either the
Company administrating the Compensation Fund or the workman
is aggrieved by any determination of the Joint Committee on
the ground that it is based on a misinterpretation of the
provisions of the Scheme and makes representation to the Secretary of State within twenty-eight days, the Secretary of State

— 60 —
may, if he thinks fit, give a ruling on t h e point raised and if the
Committee's decision is not in accordance with such ruling the
Committee are required to revise it so as to bring it into conformity with the ruling.
Joint Committees 1 are composed of an equal number of
representatives 2 of employers and workmen, presided over in
each case by an independent chairman. The chairman and
members are appointed b y the Secretary of State.
Each Joint Committee appoints a secretary subject to the
approval of the Secretary of State on such terms and a t such
remuneration as he may approve.
Each Joint Committee deals with all cases arising within the
area assigned to it in accordance with the provisions of the
Scheme and rules of procedure made by the Secretary of State.
Any question arising in an area for which no Joint Committee
has been established may be assigned for settlement to such
Joint Committee as the Secretary of State may select. Decisions
of the Committee are decided by a majority of the votes of the
members present a t the meeting, or in case of an equality of
votes by a casting vote of the independent chairman. The
chairman and members of the Joint Committee are unpaid, but
they are entitled to reimbursement from the Fund of travelling
expenses incurred.
ADMINISTRATION

OF COMPENSATION

Liability
Compensation for silicosis is based on the principle of the
employers' liability :
(a) Individual liability 3 for those employers who are subject
to the Metal Grinding Industries (Silicosis) Scheme, and
the Various Industries (Silicosis) Scheme ;
1
There are (September 1934) seven Joint Committees established
under the Refractories Industries Scheme and six under the Sandstone
Industry Scheme.
2
These representatives are appointed after consultation with any
employers' associations and trade unions affected, or otherwise as the
Secretary of State may think most suitable for the purpose of ascertaining
the views of the employers and workmen concerned.
3
The employer may insure against his liability by entering into a
contract with an insurance company, or may belong to a mutual insurance
association of employers. I n the coal-mining industry one of these two
alternatives is compulsory unless the employer maintains a special trust
fund for meeting all his compensation liabilities ; but this third method
is only appropriate in the case of fairly large undertakings employing
a considerable number of workers.

— 61 —
(b)

Collective responsibility for those subject to
Refractories Industries (Silicosis) Scheme and
Sandstone Industry (Silicosis) Scheme.

the
the

(a) Individual
Liability.
In the schemes for the Metal Grinding Industries and for
Various Industries, compensation is recoverable from the employer
who last employed the workman in one of the processes coming
within the Scheme, except that under the Various Industries
Scheme if the workman is suspended from further employment
a t the initial examination after taking up a new engagement,
the liability (if any) falls on the employer who last previously
employed him in the processes.
Nevertheless, any other employers who employed the workman
in the processes during the five years preceding the date of the
injury are liable to make to the employer from whom compensation
is recoverable such contributions towards compensation as, in
default of agreement, may be determined by arbitration. This
latter provision does not, however, apply in any case where the
employer from whom compensation is recoverable has admitted
liability to pay such compensation without requiring a certificate
from the Medical Board.
(b) Collective Liability.
I n the case of the Refractories Industries and the Sandstone
Industry, the Scheme provides for the creation of a General
Compensation Fund to which all employers in the industry are
bound to subscribe and from which all the compensation is
payable. There are also met out of this Fund such fees as may
be payable by or on behalf of any employer in respect of any
medical examination made or certificate given under the Silicosis
(Medical Arrangements) Scheme. This Fund is administered
and compensation claims are (where in dispute) contested by a
company managed by employers in the industry, and the company
cannot be dissolved without the consent of the Secretary of State.
I t is the duty of the company in compliance with any directions
given by the Secretary of State to fix, levy and enforce the
subscriptions from the employers, to invest or otherwise deal
with all moneys received by the Fund, and to secure t h a t no
moneys or securities belonging to the Fund are applied directly
or indirectly for any purposes other than those authorised under
the Scheme. The company is required by the Secretary of State
to prepare in prescribed forms a revenue account, balance sheet

— 62 —
and statement of cases dealt with. The accounts of the Fund
are audited a t least once per annum by one or more chartered
accountant(s), and a copy of the report of the auditor or auditors
is lodged with the Home Office.
The liability of the Fund to pay compensation in any particular
case is not affected b y any failure on the part of an employer
to pay the sums due to the Fund or by the employer ceasing to
be engaged in the industries.
The subscriptions payable to the Compensation Fund by
the employers subject to the Scheme take the form of periodical
levies based on the wages of the workers employed ; and employers
are obliged to give such guarantees as the company may, with
the approval of the Secretary of State, determine. Any sum
due by an employer to the Fund under this Scheme may be
recovered by the company summarily as a civil debt.
No alteration in the rate of levy shall take effect until
approved by the Secretary of State.
The company may, if the Secretary of State so requires,
adopt different rates of levy for different risks, such rates being
determined, for instance in the case of the Sandstone Industry,
by the composition of the sandstone, the conditions under which
it is got or manipulated, etc., and such rates may be applied to
different classes or groups or works or processes or to any
particular works or process 1.
Every employer commencing to carry on any process to
which the Scheme applies, or recommencing to carry on a n y
such process after having discontinued it for a period of twelve
months, must notify the company accordingly.
Further, every employer must keep a correct record of every
workman employed by him in the industries, showing the number
of days of employment in each year, the nature of the work on
which he is from time to time engaged and the wages paid.
This record must be available for inspection by the officers of
the company administering the Compensation Fund.
In the event of failure on the part of the employer to furnish
adequate information, the company is entitled to assess the
amount of the subscription to be paid by the defaulting employer
on such information, from whatever source, as it may have in
1
The levies were at September 1935 as follows : Refractories Industries : 6 YJ per cent, of the wages ; Sandstone Industry : variable according
to the type of occupation and risk": 3d. in the £ for labourers, 6d. in the
£ for rock-getters, and lOd. in the £ for dressers of stone and masons.

— 63 —
its possession, provided t h a t if, within fourteen days from the
date on which notice of assessment is served on him, the employer
furnishes the company with the requisite record of information,
the company may, after inspection, revise the assessment in
accordance with such record.
An employer who fails to comply with any duty expressly
imposed upon him by the Scheme or the Silicosis and Asbestosis
(Medical Arrangements) Scheme (see " Procedure for Settling
Disputes ") is liable to pay to the Fund an additional subscription
not exceeding £5 for every day on which the contravention or
failure occurs or continues 1.
Medical

Procedure

As will be seen from the foregoing, medical procedure as
regards compensation for silicosis is based on the operations
and decisions of the Medical Board, the organisation of which
is regulated by the Silicosis and Asbestosis (Medical Arrangements)
Scheme dated 1931, and subsequent amendments 2 .
The Medical Board consists of specially qualified medical
practitioners 3 appointed by the Secretary of State under the
1
The provisions of the 1925 Act concerning civil liability also apply
to the various Schemes.
2
The Silicosis and Asbestosis (Medical Arrangements) Scheme dated
30 April 1931. S. R. & O., 1931, No. 341 (came into force on 1 June 1931).
The Silicosis and Asbestosis (Medical Arrangements) Amendment
Scheme 1934, dated 4 August 1934. S. R. & O., 1934, No. 889 (came
into force on 1 September 1934).
The Silicosis and Asbestosis (Medical Fees) Regulations, 1931, dated
18 May 1931, made by the Secretary of State with the approval of the
Treasury as to the fees to be paid in respect of examinations made and
certificates given under the Silicosis and Asbestosis (Medical Arrangements)
Scheme 1931. S. R. & O., 1931, No. 412 (came into force on 1 June 1931).
The Silicosis and Asbestosis (Medical Fees) Amendment Regulations,
1933, dated 15 September 1933, made by the Secretary of State with the
approval of the Treasury as to the fees to be paid in respect of examinations made and certificates given under the Silicosis and Asbestosis (Medical
Arrangements) Scheme, 1931. S. R. da O., 1933, No. 930 (came into force
on 1 September 1933).
The Silicosis and Asbestosis (Medical Fees) Amendment Regulations,
dated 24 September 1934, made by the Secretary of State with the approval
of the Treasury as to the fees to be paid in respect of examinations made
and certificates given under the Silicosis and Asbestosis (Medical Arrangements) Scheme, 1931. S. R. & 0., 1934, No. 1063 (came into force on 1
October 1934).
3
I n 1935 the Board consisted of a Chief Medical Officer and eight
Medical Officers and was divided up into four " panels " of two Medical
Officers each, with centres a t Bristol, Manchester, Sheffield and Stoke-onTrent, the Chief Medical Officer being stationed at Sheffield. I n addition
part-time members of the Board have also been appointed to assist in cases
in the London area (two), in Cornwall one and Aberdeen (one).

— 64 —
chief medical officer, whose duty it is to supervise the working
of the medical arrangements with a view to securing a uniform
standard of efficiency. Their duties are to carry out the various
medical examinations required on commencement of the
employment or periodically thereafter, or on thè applications
of persons desiring to claim compensation or in connection with
arbitration proceedings and reviews of weekly payments ; and
to issue the various certificates required under the Compensation
Schemes.
They have power to arrange for radiographic
examinations.
The Board are required to keep a record of every examination
made under the Scheme.
Certificates and reports issued by the Medical Board for the
purposes of the Schemes must be signed by not less than two
members of the Board. Their certificates form conclusive evidence
of the matters therein certified.
The Board is financed from a special Medical Expenses Fund,
which is administered by trustees, assisted by an executive officer,
all appointed by the Secretary of State, the officer in question
acting as secretary of the Fund. I t is the d u t y of the Secretary
to collect and recover any fees due to the Fund and to make the
payments 1 authorised, keeping full and true accounts which are
audited once a t least in every year by a n auditor appointed by
the Secretary of State.
The Fund is maintained by (1) an annual State contribution
and (2) fees payable mainly by the employers, but in some cases
paid in part (see " R i g h t to Compensation", and "Benefits") by
workmen or dependants applying for an examination, fees so
deposited with the Medical Board being paid over by the Board
into the Fund.
Any sum due to the Fund under the Scheme may be recovered
summarily or otherwise as a civil debt.
Under the Silicosis and Asbestosis (Medical Arrangements)
Scheme it is the duty of employers :
1
These payments are : remuneration of the members of the Medical
Board or of duly qualified medical practitioners appointed by the Secretary
of State ; any expenses necessarily incurred by them in the exercise of
their duties under the Scheme : cost of radiological or post-mortem examinations arranged for by the Board ; any travelling or other expenses reasonably incurred by workmen in submitting themselves for examination
when so required by the Medical Board (subject to any scale approved
by the Secretary of State) ; such other expenses incurred in the administration of the Fund as are approved by the Secretary of State.

— 65 —
(1) to give notice to the Medical Board of commencing to
carry on any industry or process in which medical
examination of workmen on entering employment and
periodically thereafter is compulsory ;
(2) to make the arrangements necessary for the medical
examination of new entrants and furnish certain facilities
to enable the Medical Board to carry out these and the
periodic examinations a t the works, or other convenient
place approved by the Medical Board ;
(3) not to engage or to continue to employ in any industry
or process coming within the Schemes any workman who
has refused or wilfully neglected to submit himself to the
examinations in question, or, except so far as may be
allowed by certificate of the Medical Board, a workman
who has been suspended or certified to be totally disabled ;
(4) to furnish and renew where necessary, for each workman
subject to periodical medical examination, a personal
register, in which are entered certain particulars as to
present and previous employment and as to his medical
examinations. A duplicate of this register is kept by the
employer and forwarded by him to the Medical Board
when the workman leaves his employment.
In the case of contravention or non-compliance on the part
of an employer with these provisions the employer is liable on
summary conviction to a fine not exceeding £5 for every day
on which the contravention or failure occurs or continues.
Alternatively, in the case of the Refractories Industries and
Sandstone Industry there may be substituted for the above fine
such additional subscription to the Compensation Fund as may
be fixed by the Secretary of State.
PREVENTION

There are requirements under other Statutes for the prevention
of dust, etc., but the Compensation Schemes also provide for
preventive and prophylactic measures. The periodic medical
examinations 1 and records of the Medical Board afford useful
1
The prescribed interval between periodic medical examinations
varies according to the degree of danger found to exist in different occupations and other circumstances. In some cases (e.g. ganister miners, silica
brickmakeo, masons in the sandstone industry and certain occupations
in potteries) it is eighteen months ; in others it is three years.

5

— 66 —

information not only as to the diagnosis of the disease but also
as to where the conditions of employment are especially dangerous,
so that additional precautionary measures may be considered ;
while compulsory suspension from employment in the light of
periodic and other examinations is valuable for checking the
entry of persons of defective physique into processes in which
they are specially likely to contract silicosis, for transferring to
less dusty occupations men found to be suffering from tuberculosis
or silicosis in its early stages, and for preventing the spread of
tuberculosis among other workers.

GERMANY

LEGISLATION

Third Order dated 16 December 1936 to extend accident insurance
to cover occupational diseases (L.S., 1936, Ger. 3).

Silicosis is compensated in virtue of the third Order of 16
December 1936 relative to the extension of accident insurance
to cover occupational diseases which came into force on 1 April
1937 \ the Order being issued in pursuance of Articles 547, 922
and 1057 (a) of the Federal Insurance Code (text of 9 J a n u a r y
1926). (L.S., Ger. 1, amended by the Act of 20 December 1928
(L.S., 1928, Ger. 3 c.)
SCOPE

OF

LEGISLATION

The Order covers persons engaged in industrial, agricultural
and maritime employment in those establishments covered by
the accident insurance scheme (see Note 1).
Accident insurance covers the following persons : workers,
assistants, journeymen, apprentices, works' officials inclusive of
foremen and technicians in the establishments covered, as well
as those engaged in domestic and other services to which insured
persons employed mainly in the establishment or in insured
activities are assigned by the owner of the undertaking or his
authorised representative.
The owner of an undertaking and the husband or wife of the
owner as the case may be are, if employed in the undertaking,
likewise liable to insurance but may be declared exempt therefrom
when not exposed to special risk.

RIGHT

TO

COMPENSATION

According to the terms of column I I of the schedule appended
to the Order, compensation is provided for :
(a) serious pneumoconiosis (silicosis) ;
1
On this date the second Order of 11 February 1929 (L.S., 1929, Ger. 1)
was repealed. Cases in course of settlement, however, are dealt with in
accordance with the provisions of the repealed Order.

— 68 —
(b) pneumoconiosis (silicosis) occurring in conjunction with
pulmonary tuberculosis when the general clinical picture
is serious and the pneumoconiotic lesions constitute the
essential cause of the active and progressive evolution
of tuberculosis.
In terms of the Order simple silicosis or silicosis accompanied
by pulmonary tuberculosis resulting in serious illness are assimilated
to an injury due to an accident and death by such disease to
death resulting from an accident and are compensated as such.
There is " serious silicosis " when there are found in the lungs
pneumoconiotic neoformations of the connective tissue (nodules
and coalesced nodules) — shown on the radiograph in the form
of pictures of intense and disseminated mottling (snowstorm
pictures) or compact and diffuse opaque pictures — and injuries
causing reduction of the respiratory capacity affecting the
circulation to such an extent as to involve a marked reduction
of the working capacity of the individual.
This definition expressly refrains from a description of the
radiographic picture, the reference thereto above given in
parentheses being merely inserted by way of example. The
Order simply declares t h a t the state of health entitles the
worker to compensation, leaving out of account symptoms which
often lead to differences of interpretation.
As regards silicosis occurring in conjunction with tuberculosis,
right to compensation does not depend on the presence of a
state of serious silicosis as above defined (see Note 2), but
it suffices t h a t the general state of health resulting from the
coexistence of the two diseases should be serious, and t h a t there
are revealed in the lungs marked silicotic changes such as may
constitute an essential cause of the general morbid condition.
" Essential cause " within the meaning of the Order exists
when it can be affirmed that, in the absence of the injury
considered as the cause, the state of the disease would not have
been produced a t all, or would not have been produced so quickly,
or would have followed a definitely less serious course. (For
the history of the interpretation in virtue of the second Order
see Note 2.)
Compensation is in general accorded a t the earliest from the
date on which the Order came into force, i.e. from 1 April 1937 1.
1
Retrospective effect. •— Nevertheless provided that at this' date an
insured worker is suffering from an occupational disease which could not be
compensated in virtue of the second Order, compensation will be accorded

— 69 —
CERTIFICATION OF THE D I S E A S E

Certification of the disease is subject to detailed procedure
outlined in the Insurance Code and which applies both to
notification of the disease and to supervision of cases lodging
claims.
Notification of the Disease
Notification of the disease must be effected both by the
employer of the insured worker and by the doctor who makes
the diagnosis.
Notification by the Employer.
The owner of an establishment or his representative are
obliged to notify cases of silicosis coming to their knowledge
which have occurred in their establishment and which involve
total or partial incapacity for more than three days or death,
whether the disease be due to employment in the establishment
in question or in any other.
Notification made within three days after the owner of the
establishment is aware of the occurrence of the case is made
on a form prescribed by the Federal Insurance Office (Form A).
The notification must be submitted to the local police authorities,
and to the office of the accident association 1. In the case of
failure to make the necessary notification or to do so within the
prescribed time, a disciplinary fine may be imposed on the
person responsible by the accident association. The police
authorities* must without delay forward notifications received
to the appropriate accident association.
when the insured case occurred subsequent to 30 January 1933. More
explicitly the commencement of the disease within the meaning of the
sickness insurance provisions (date of the first medical treatment, of the
first delivery of medicines, etc., date of incapacity for work), or the commencement of loss of earning capacity within the meaning of the accident
insurance, must be later than the date above referred to.
As regards silicosis in particular, the retroactivity clause shall apply
to cases which were not covered by the second Order and which will be
covered by the third Order (silicosis complicated by tuberculosis) for which
compensation is no longer subject to the presence of serious silicosis ;
cases of silicosis occurring in occupational categories which were not
inscribed in the second column of the schedule appended to the second
Order. Compensation in these various cases will on no account be accorded
prior to 1 April 1937. There is no special delay in regard to notification
of these retroactive cases to which the general provisions of the Federal
Insurance Code apply.
1
The accident association of undertakings is the institution responsible
for insurance. Besides these associations there are in certain cases special
institutions sot up by the Reich, the States, the communes and other public
bodies (for details see footnote, p. 81).

— 70 —
Notification by the Doctor.
Any medical man 1 who diagnoses or suspects the presence
of silicosis must a t once notify this disease on a special form (B) 2
to be submitted by him to the appropriate accident association
or to the Government medical inspector 3 for the establishment
employing the insured worker.
Where several medical men diagnose or suspect the presence
of silicosis in a worker, each one of them is obliged to make the
requisite notification ; they may, however, come to an agreement
t h a t one of them shall undertake this task on behalf of the others.
Should a medical man be aware t h a t the necessary notification
has already been made by a colleague, he is not obliged to make
a further notification himself. All t h a t is required of him is
t h a t he should forward to the local insurance office a short
communication to the effect t h a t the notification has been made.
The medical man notifying the disease must base his diagnosis
on sufficiently definite objective symptoms leaving out of account
t h e possibilities of medical treatment or other means of effecting
a cure, and the consideration as to whether the patient is capable
of continuing work or whether the disease is serious or not.
No time limit is fixed with regard to the lodging of the
notification, the legal provisions being confined to requirement
of notification " without delay ", t h a t is to say, without delay
subsequent to diagnosis. The notifying medical man is not
obliged to provide detailed information or to engage in
supplementary research with a view to confirming diagnosis of
silicosis or suspected silicosis, which is a matter entirely for the
Insurance Office (control of diagnosis by a skilled medical man)
or for the accident association affected.
At the demand of the medical inspector or the accident
association the competent medical association may reprimand
any medical practitioner who fails to make the requisite notification
or does not make it in due time.
1
Doctor attending the case as well as any other qualified doctor
whether in practice or not who may be called upon to diagnose silicosis :
hospital doctor or doctor attending a clinic, doctor called in to give expert
opinion (even though diagnosis of the silicosis is not the result of such
expert opinion), factory doctor, medical official, medical inspector of
factories, medical examiner in connection with war pensions (Versorgungsarzt.).
2
The Federal Insurance Office intends to introduce certain changes
in the forms a t present used.
3
Translation of the term " Staatlicher Gewerbearzt " used in the Order.

— 71 —
The medical practitioner may claim from the accident
association a fee in respect of the notification, the amount of
which is fixed in accordance with the provisions in force ; at
present (January 1937) fixed at 4 marks.
Notification is also compulsory whenever the medical man
(doctor in charge of the case, doctor called in to certify death
or to effect autopsy without having treated the patient) discovers
the existence of the disease subsequent to death during autopsy
or otherwise. Nevertheless, no legal provision exists in regard
to autopsies apart from the entry 15 of the medical certificate,
in accordance with which the doctor is requested to state whether
an autopsy has been carried out or not and to indicate the results
thereof.
Notification by the Sickness Fund.
Further, Sickness Funds are obliged to notify to the accident
associations all cases of disease which they suspect of being of
occupational origin. The director of the Sickness Fund informs
the accident association to which the establishment where the
case has occurred belongs.
*

*

*

The accident association must within the two days following
the receipt of notification of a case of occupational disease send
the original notification to the competent Government medical
inspector, and a copy to the factory inspector 1 in charge of the
district in which the insured worker was employed.
The attention of the inspector is thus drawn to the disease
in question, and in the case of the occurrence of numerous cases
of the same disease he will thus be in a position to adopt the
requisite measures in collaboration with the Government medical
inspector and the accident association.
The Government medical inspector who receives such
notification directly (for instance, from another medical inspector
not competent with regard to the particular case, or from any
authority with the exception of the accident association) sends
a copy of this notification to the accident association affected
and carries out the measures of control referred to below.
1
The current English expression " factory inspector " is used, though
maritime work and agriculture and other occupations are covered by the
Order.

— 72 —

Should he not be competent in the matter (case occurring
outside of his district) he sends the original notification either
to the accident association or to the competent medical inspector.
In the case of diseases occurring in undertakings working
under contract for the Federal Government, or affecting workers
engaged on the Federal railways, a copy of the notification is
sent to the officials of these administrations, or to any persons
designated by them for this purpose.
I t is the management
of these administrations which in its turn transmits a copy or an
abstract of the notification to the Government medical and
factory inspectors.

Examination

of the Claim

The method of enquiry provided for by the Insurance Code
for accidents does not apply to occupational diseases, but is
replaced by a special enquiry in their case. I n fact, whatever
method is followed the notification of the disease by the doctor
or by the accident association is always received by the
Government medical inspector, whose task it is to examine the
case. This includes examination of the sick worker and, where
necessary, the carrying out of an enquiry by the accident
association. In the first instance the medical inspector confirms
the doctor's notification with a view to its completion, where
necessary.
Examination of the Insured Worker.
In accordance with the provisions of the Order, it is the
duty of the medical inspector to examine the insured worker
without delay, or have him examined a t the expense of the
accident association by a medical man appointed for the purpose,
and transmit his report to the accident association.
I n practice, however, medical inspectors are requested not
to examine the insured workers themselves, though they have
a right to do so, b u t to entrust such examination to medical
men residing either within or beyond their district who appear
to them specially qualified for this task.
The report of the medical man so appointed is addressed to
the medical inspector who draws up the final report, or if he
does not do so, completes t h a t of the appointed medical man
either by providing a covering letter or by a supplementary

— 73 —
report. I n any case the medical inspector must in an explicit
manner express his opinion as to the causal relation existing
between the disease and the occupational activity exercised by
the insured worker.
Substitutes for the Government Medical Inspector. — I n certain
exceptional cases — districts having no medical inspector, absence
or illness of the medical inspector or of the medical man so
appointed — the Federal Minister of Labour may entrust to other
health officials control of the cases notified as occupational diseases
and carrying right to compensation. Medical men thus acting
as substitutes are in the case in question considered as medical
inspectors within the meaning of the Order on compensation of
occupational diseases without, however, being invested with the
other powers of such officials. For their duties in carrying out
the provisions of the Order, medical inspectors and their
substitutes a t present receive remuneration from the accident
association.
Enquiry.
I n certain cases the medical man who notifies the disease
and the medical inspector (or his substitute) may easily discover
the occupational origin of the disease. This, however, is not
always so, and it is then essential to effect an enquiry. Though
the medical inspector cannot do so himself, nor can he entrust
it to other officials, he has nevertheless power in virtue of the
Order to demand the accident association to proceed with the
enquiry, the accident association being obliged to comply with
any demand of this nature. As regards the enquiry, the hearing
of witnesses or of experts, examination of workers on the spot
or other similar procedure the accident association is obliged
to inform the medical inspector in good time as to the time and
place a t which such occur.
When the accident association itself undertakes an enquiry
prior to submission of the report by the medical inspector, it
is obliged to inform the latter of the proposed measures, and
to acquaint him with the results of the enquiry.
The medical inspector may always, moreover, in his capacity
of medical official and inspector, confirm during his visits of
inspection to the undertakings coming within his competence
the information provided in the notification of the disease.

— 74 —
BENEFITS

For the purposes of benefits, the date of the outbreak of the
disease is the day on which the disease commences within the
meaning of the accident insurance provisions 1 , or where the
latter is more advantageous for the insured worker, the day on
which the loss of earning capacity commences within the meaning
of the accident insurance provisions.
If the disease or loss of earning capacity commenced whilst
the insured worker was still employed in an undertaking subject
to insurance, in respect of the application of §§ 1546 and 1547
of the Insurance Code 2, the date of commencement of the disease
is t h a t of the termination of employment of the insured worker
in the establishment subject to insurance.
Silicosis may, however, commence when the insured worker
is no longer employed in an undertaking liable to insurance.
I t is with a view to giving consideration to this fact t h a t the
date of the outbreak of the disease is, in accordance with the
provisions of the Order, deemed to be the date of the last day
on which the insured worker was employed in an undertaking
liable to insurance against silicosis. Benefits accorded are of
two types : in kind or in cash :
Benefits in

Kind

Benefits in kind comprise medical treatment and vocational
rehabilitation.
Medical treatment comprises medical attendance, provision
of medicaments or other necessary therapeutic means, or any
means adopted with a view to alleviating the consequences of
the disease, and the provision of attendance.
Attendance b y nurses or other attendants is accorded where
the insured worker cannot dispense with such attendance which
may be provided in his own household or family or by means
of payment of a monthly allowance made for this purpose.
Attendance in the worker's home is accorded when for a
sufficient reason (number of children, illness in family, or other
1
Within the meaning of the sickness insurance provisions, the
beginning of the disease dates from the first medical treatment, provision
of medicaments, or other means of treatment, or where more favourable
for the insured worker, from the date of disability.
2
If compensation is not assessed ex officio, the claim must be lodged
within a delay of two years from the outbreak of the illness, under penalty
of forfeiture of right to bring action.

— 75 —
adequate family reason) treatment and care cannot be given
by the insured worker's relatives, or again where admission to
hospital is impracticable.
Insured workers have free choice of a doctor from among
those inscribed in the list or authorised for the purpose by the
insurance organisation. Where the insured worker is not insured
with a Sickness Fund, the doctor may be chosen from a list
of medical men authorised for the purpose as the result of an
agreement arrived a t between the Sickness Fund and the accident
association.
Hospital treatment is only imposed with the consent of the
insured worker except where the nature of the case demands
treatment or care which it is not possible to provide in the
worker's home, or where the insured worker has repeatedly
disobeyed the rules for sick persons (§ 347) or the instructions
of the medical practitioner in attendance.
Benefits in kind are supplied by :
(1) the sickness insurance scheme during the first 45 days,
provided the benefits ^involved are payable under the
sickness insurance scheme. All other charges are borne
by the competent accident association.
(2) I t is the accident association which is thereafter responsible
for further charges.
Medical treatment is at all times subject to revision by the
accident association when it considers t h a t a new course of
curative treatment may result in increased working capacity of
the insured worker in receipt of occupational disease compensation
or likewise by the Sickness Fund which, independently of the
insured worker under treatment, may demand resumption of
curative treatment.
Vocational rehabilitation is provided for in the legislative
provisions with a view to ensuring recovery or improvement of
working capacity in the exercise of the occupation involved or
to aiding the insured worker towards obtaining work in an
occupation which may be reasonably assigned to him. Where
necessary, training in an entirely new occupation may be provided.
Refusal on the part of the worker to undergo vocational
rehabilitation does not involve reduction of the pension.
The Federal Minister of Labour may within the framework
of the Insurance Code issue any complementary provisions relative
either to medical treatment or to vocational rehabilitation.

— 76 —

Cash
Sickness

Benefits

Benefits.

These benefits comprise, in accordance with the stage of
evolution of the disease, a daily allowance or pension for
incapacity.
(a) Daily Benefit. — Daily benefit or so-called sickness benefit,
equalling half of the basic wage for every calendar day, is paid
to the insured worker from the fourth day of the illness onwards
or from the day in which incapacity for work commences if
this is later.
The allowance is suspended during maintenance in hospital.
Where hospital treatment is granted to an insured worker who
has hitherto maintained relatives wholly or mainly out of his
earnings, a family allowance is paid in addition to the relatives.
The payment of money benefits is effected as in the case of
benefits in kind by : (i) the Sickness Fund, during the first
45 days ; (ii) the accident association is responsible for payment
of benefits from the forty-sixth day to the twenty-sixth week.
I t should, however, be recalled t h a t at the twenty-seventh
week, the last week for sickness insurance benefit payable by
the accident association, there arises in general the question of
invalidity within the meaning of the accident insurance legislation
and of the granting of a pension. The latter may, however, be
accorded earlier, t h a t is to say as soon as the daily benefit ceases
to be paid under the sickness insurance provisions.
(b) Pension for Incapacity. — From the twenty-seventh week,
or even earlier, from such date as may. be fixed by the accident
association, the insured worker receives, (i) during the whole
period of his total earning incapacity, a pension equal to two-thirds
of his annual earnings (full pension) 1 ; (ii) during the whole
period of his partial earning incapacity, a pension equal to a
proportion of the full pension corresponding to the extent of
the loss of earning capacity (partial pension).
1
The amount of the annual earnings is established by multiplying the
average daily earnings by 300. Where it is not possible to ascertain the annual
wage of the insured worker, the amount is fixed by taking the wage earned
in the course of the year preceding the date of the outbreak of the disease
by a worker belonging to the same category in the establishment, or in an
establishment which is identical, similar, or as similar as possible. The
average salary of this insured worker for one working unit is multiplied by
the number of days during which work was being carried on in the
establishment in the course of the year preceding the date of the outbreak
of the disease.

— 77 —

When a pension for incapacity amounts to 50 per cent, or
upwards of the full pension, it is increased 10 per cent, for each
legitimate child or each child legally recognised as legitimate
under the age of 15, or 18 in case of a child still under vocational
training and maintained by the insured worker.
The total amount for the pension and children's allowance
must not exceed the total annual earnings.
When the insured worker is sent for treatment on the decision
of the association to a curative institution, the pension is
suspended. Nevertheless, the association is authorised to grant
a special subsidy to the insured worker and his dependants when
its statutes permit of this being done.
On the other hand, so long as the worker in receipt of a
pension for partial incapacity is unemployed through no fault
of his own as a result of his occupational disease, the accident
association may temporarily increase the partial pension to an
amount not exceeding the full pension.
If, a t the moment of the outbreak of the disease, the injured
person was already permanently and totally incapacitated for
work, only medical attendance is granted 1 .
(c) Allowance for Suspension from Work. — When, in the
course of medical examinations effected in pursuance of the
Factory Act, there is reason to fear t h a t continuation of work might
be likely to cause, aggravate, or occasion a further outbreak of
an occupational disease, the accident association must, subsequent
to enquiry, order suspension from the work in question of the
insured worker, the occupation being regarded as a menace to
his health. In order to compensate the reduced wage thus
caused and all other eventual economic consequences to the
worker, the accident association accords a pension to him, known
as the " transitional pension " (Übergangsrente) amounting to
the half of the entire annual pension, or an indemnity known
1
Temporary allowance : Should there be delay in fixing the amount
of the permanent pension allocated to an insured worker, the accident
association is authorised to accord a provisional pension during the first
two years following the occurrence of the disease, and to modify the rate of
this pension in accordance with any changes in circumstances. In the case
of disputes (see below) the competent insurance authorities (superior
Insurance Office and the Federal Insurance Office) have power to assess
within the same time limit a provisional pension where a claim which the
responsible accident association has disallowed is recognised as legitimate.
The permanent pension must be assessed not more than 2 years after
the outbreak of the disease. A chango in the circumstances is not a
prerequisite of this assessment ; and the previous assessment of the bases
for the calculation is not binding in respect of it.

— 78 —

as the "transitional benefit" (übergangsgelt) amounting to half
the amount of the entire pension for one year.
The payment of this indemnity in either of the above forms
is subject to the presence of risk for the health, on the one hand,
and, on the other, to the existence of economic loss sustained
by a cessation of employment.
The accident association is not strictly bound to deliver the
allowance for suspension from work ; it is, however, required
to ascertain in each case whether the necessary conditions are
complied with, and if so to grant the allowance. The supervisory
authority (for the accident associations, the Federal Insurance
Office) may examine the decision reached in each case, and
where necessary compel the accident association to accord the
allowance. On the other hand, the applicant is not entitled
to appeal to the social insurance courts against a refusal on the
associations's part, but may draw the attention of the supervisory
authority to his case. In any case, the association exercises
freedom of decision as to what form the allowance shall take —
pension or lump sum (the latter for instance in the case of
migration to another district which may offer possibilities of
suitable employment). This decision is not subject to control
by the inspection service.
The possibility of a transitional pension being ultimately
granted in addition to a transitional benefit, the amount of which
is restricted, is not excluded.
Death Benefits.
I n fatal cases benefits granted to dependants from the date
of death are as follows :
(a) A pension equal to one-fifth of the annual earnings to
the widow until her death or remarriage.
The pension may be raised to two-fifths should the widow
as a result of illness or other infirmity have lost the half of her
earning capacity for a period exceeding three months.
If the widow remarries, she receives three-fifths of the annual
earnings by way of commutation of the pension.
On the other hand, the widow of an insured worker whose
death is due to a cause other than the disease receives a lump
sum equal to two-fifths of the annual wages of the deceased.
(b)

A widower receives a pension equal to two-fifths of the
annual earnings so long as he is in want until his death

— 79 —

(c)

(d)

or remarriage, provided that the deceased wife maintained
him wholly or mainly out of her earnings on account
of his incapacity for work.
Every legitimate child or every child legally recognised
as such receives a pension equal to one-fifth of the annual
earnings up to the age of 15, or 18 if still under vocational
training.
Relatives in the ascending line for whose maintenance
the deceased worker was responsible receive a pension
equal to one-fifth of the annual earnings so long as they
are in need thereof.

Pensions to survivors must not exceed in all two-thirds of
the annual earnings. If they exceed t h a t amount they must
be reduced, pensions of a widow, widower, children and grandchildren being reduced by equal amounts. Relatives in the
ascending line have a claim only in so far as the pensions of the
above do not exhaust the maximum amount. On the withdrawal
of any one of the survivors, the pensions of the others are
increased up to the permissible amount.
No pension is granted to the widow or widower of a deceased
worker if marriage was contracted after the commencement of
the disease or if death occurs during the first year of the marriage.
The accident association may, however, grant a pension in special
circumstances.
Funeral Expenses.
A sum equal to one-fifteenth of the annual earnings, with
a minimum fixed a t 50 RM. is granted to cover funeral expenses.
REVIEW

Where there occurs an essential change in the circumstances
on the basis of which the pension was fixed, the accident association
or the worker himself may demand that a new rate should be
fixed.
The claim for revision lodged by the insured worker must
be addressed to the accident association or the local insurance
office. I n the latter case the application is forwarded without
delay to the accident association together with the date of receipt.
During the first two years following the outbreak of the
disease a new assessment of the benefit may be made or demanded
whenever any change occurs in the condition of the beneficiary.

— 80 —

If within the two years a permanent rate of pension has been
assessed, or if this period has expired, a new assessment cannot
be made or demanded at intervals of less than a year ; nevertheless
these intervals may be reduced by agreement with the worker
concerned.
When, subsequent to revision, the accident association finds
that benefits have without due grounds been totally or partially
refused, withdrawn or suspended, a reassessment may be effected.
The local insurance office informs the accident association
when a pension has to be reassessed or withdrawn owing to a
change in the circumstances.
When the demand of the worker has been previously rejected
because the silicosis was only of average severity, the procedure
is similar to that laid down in regard to a first demand for
compensation, but the insured worker must produce proof that
the disease has become " serious " to an extent entitling him
to compensation. Generally this proof takes the form of a medical
report accompanied by a radiograph.

PROCEDURE FOR SETTLING DISPUTES

The 1936 " Order provides for the possibility of appeal by
those affected, whenever disagreement exists as to whether a
disease is entirely or partly occupational within the meaning
of the Order or in regard to the substance of the claim for
compensation 1 . This appeal is addressed to the Federal Insurance
Office which always passes legal judgment in regard to compensation'
cases in the form of statements of principle. The decisions of
the insurance office are arrived at on the basis of reports requested
from the most qualified experts whose conclusions the office is
not, however, obliged to accept.

1
For instance : existence of a morbid condition ; assessment of incapacity ; assessment of benefits, of pensions, etc. ; conditions relative to
insurance (undertakings not coming within the Act ; diseases not included
in the schedule, etc.) ; connection between the occupation and the disease,
etc.

— 81 —
ADMINISTRATION OF COMPENSATION

Liability
The accident association in its role of accident insurance
carrier is likewise liable for diseases of occupational origin within
the meaning of the accident insurance legislation 1 .
The accident associations are bodies with legal personality
for the joint covering of risks to which undertakings employing
insurable workers are obliged to belong. They are under the
supervision of the Federal Insurance Office, and they comprise
the owners of insured establishments and include all undertakings
belonging to the branches of the industry in which they have
been set up. Where an establishment comprises important
departments belonging to different branches of industry it is
allocated to the accident association to which the main
establishment belongs.
Some of them comprise all the undertakings of a particular
kind in the whole of Germany, others only those to be found
in a limited area. The associations for the building industry
have branches covering non-industrial building.
The owner of the undertaking must affix a notice in every
establishment showing the accident association and section thereof
to which his establishment belongs.
The accident association must pay compensation for
occupational diseases described in the schedule occurring in an
establishment liable to insurance carried on on account of an
owner not belonging to the association, provided t h a t an owner
belonging to the association has ordered the work to be done
and is liable for payment of the remuneration.
The accident association is managed by a leader assisted
by an advisory council. The leader may modify, in consultation
with the advisory council, the statutes of the association, and
examine and adopt its annual accounts, etc.
1
There are also special insurance institutions set up by the Reich
and the States responsible for undertakings carried on on their own account ;
or by the communes, federations of communes and other public bodies,
under certain conditions, in particular for operations carried on on their
own account, in connection with certain work. The liability of the special
institutions is subject to similar principles of insurance. The law requires
that compensation payable by these institutions shall be the same as that
allowed by the associations of undertakings, and the institutions are subject
to the same judicial authorities in the case of disputes. Nevertheless, in
respect of certain given undertakings the Federal or other administrative
authorities may become affiliated to the competent accident associations.

6

— 82 —

Membership of heads of undertakings in the association
commences with the opening of an establishment or with the
date on which it becomes liable to insurance l.
The head of an establishment who becomes a member of
an association must, within the delay of one week, notify the
local insurance office in the district of the purpose and nature
of the establishment, the number of insured persons employed
and the accident association to which the establishment belongs.
The local insurance office must, within one week therefrom,
transmit a copy of the notification assigning the establishment
to the accident association specified therein.
Should the local insurance office consider t h a t the establishment
belongs to an accident association other than the association
specified, it must inform the first association, the owner of the
undertaking, and likewise the other association involved.
The accident association must keep registers of establishments
on the basis of the register communicated to them by the Federal
Insurance Office, and likewise of establishments subsequently
assigned to them.
The owner of an undertaking must notify the accident
association within a fixed time limit of any change in the person
on whose account the establishment is carried on as well as of
any alteration in his establishment which might affect its
membership of the accident association.
The accident association may, where it considers it advisable
on the application of the owner or ex officio transfer an establishment
to another accident association and in this case must communicate
the fact to the accident association concerned and to the owner,
through the local insurance office, stating the reasons for the
transfer.
Distribution of Liabilities.
Accident associations may agree to bear jointly all or part
of their liabilities in respect of compensation ; the agreement
made in this connection requires the approval of the Federal
Insurance Office.
Thus in the case of silicosis where several accident associations
are involved distribution of the liabilities is, in the absence of
other factors, determined in accordance with an agreement adopted
1
For the Reich and States, communes, federations of communes and
other public bodies, the date of the beginning of membership is regulated
by special provisions of the Insurance Code.

— 83 —
on 7 September 1933 on the basis of the duration of employment
in each industry 1 . (Varied coefficient of risk from exposure to
dust, for instance.)
Administrative
Procedure
The payment of benefits through the intermediary, as provided
in the Insurance Code, of the association or of the managing
committee of the local sections or special committees, is effected
by the accident association subsequent to any further investigations
which it may consider necessary. The participation of a t least
one representative of the insured person is required in the formal
assessment of benefits.
The accident association must inform by written decision the
insured worker where a formal assessment is prescribed, such
decision being completed by a statement t h a t it is irrevocable,
unless the claimant lodges an appeal with the superior Insurance
Office within a month of the communication of the decision.
The accident association may issue rules to govern the conduct
and supervision of beneficiaries suffering from occupational
diseases, such rules to be 'established after consultation with
and approval of the Federal Insurance Office. The latter may
fix a time limit for issue of rules and may itself issue such rules
in case of failure to issue them before the time limit has expired.
Financial Resources : Contributions
The accident associations obtain money to cover their
expenditure 2 by contributions from their members which cover
the requirements of the preceding financial year. Members'
contributions are assessed annually according to the remuneration
paid to insured workers in their establishment, and graduated
in accordance with a schedule calculated in proportion to the
1
Further, certain accident associations in 1919 concluded an agreement
in regard to which the burden of procedure and compensation in regard to
a caso of silicosis devolved on the accident association to which belonged
the establishment in which the insured worker had last worked whatever
the duration of employment, in the case of workers who had worked successively in undertakings, members of the accident associations, signatories
to the convention.
In the Miners' Association when the insured worker has worked in
several undertakings belonging to different sections, that section to which
belongs the undertaking in which the worker was last engaged for a
continuous period of at least one year is liable for compensation.
2
Payment of benefits, expenses of management, accumulation of
reserve, prevention, procuring of employment for sick workers, creation
of institutions for vocational rehabilitation, establishment of curative or
convalescent institutions or institutions or homes for orphans or invalid
workers.

— 84 —
class of risk determined for each establishment. This system
of assessment of risk is subject to the control of the Federal
Insurance Office.
The schedule of risks is revised for the first time after not
more than two financial years, and thereafter a t intervals of
five years with reference to the accidents and diseases which
have occurred. The schedule of risks and all amendments thereof
require the approval of the Federal Insurance Office, which after
hearing the administrative body of the accident association has
power to draw up the said schedule, where the accident association
has failed to do so, within the prescribed time limit, or should
it not have been approved.
The accident association may reallocate any establishment
for the duration of the schedule of risks, should it appear t h a t
the data supplied by the owner were incorrect or should a change
have taken place in the establishment. The accident association
may impose supplementary contributions on owners or authorise
rebates for the next schedule period or a p a r t thereof, according
to the number of cases which have occurred in their establishment.
With a view to assessment of contributions every member
must transmit to the accident association within six weeks after
the close of the financial year a wages return showing the insured
persons employed in their establishment during the preceding
financial year, the number of working days, the remuneration
paid ; where the remuneration paid is not taken as the standard,
a calculation of the remuneration which is to be taken into
account in the assessment of the contribution and finally the
class of risk to which the establishment is allocated. I n certain
instances and under certain conditions the accident association
may base the calculation of the contribution on a fixed sum or
may levy uniform contributions.
The owner of an establishment has the right of appeal against
allocation of risk or fixing of supplementary contributions, and
such appeal must be lodged with the superior Insurance Office
within a time limit of 60 days.
Civil

Liabilities

Owners of undertakings or their authorised agents or
representatives are not liable under other legal provisions towards
insured persons and their dependants (even where the latter
have no claim to a pension) for payment of compensation due

— 85 —

to occupational disease unless it has been established by a
criminal verdict t h a t they have intentionally caused such disease.
In this case the liability of the owner is limited to the amount
by which such compensation exceeds the compensation under
the scheme for compensation of occupational diseases. Further,
where it has been established by criminal verdict t h a t the owners
of establishments or their representatives have caused the said
disease intentionally or by negligence through a failure to observe
the care which they were specially bound to exercise in virtue
of their office, occupation or industry in regard to measures of
prevention, they are liable for all expenditure entailed upon
communes, sickness, relief and other funds as a result of the
occupational disease in question. Owners of undertakings and
their representatives are liable to the accident association for
its expenses even in the absence of a criminal verdict.
PREVENTION

The Order of 1929 as well as the Insurance Code outline
certain measures of prevention for occupational diseases. Thus,
for example, the former contains measures concerning compulsory
notification by the medical man of any suspected or confirmed
case of silicosis, transmission of this notification by the local
insurance office to medical officials and the department of the
factory inspectorate with a view to collaboration with the
administrations particularly affected in regard to the prevention
of disease of occupational origin (measures of prevention).
The competent administrative authority may further draw up
for medical officials the necessary guiding principles enabling them
to assemble the elements relative to notification or to amplify
the latter, and likewise provisions relative to withdrawal from work
of the sick worker and to the allocation of a transitional benefit.
The Federal Insurance Code enumerates in Article 848 the
obligations incumbent on the accident associations requiring
them to engage in efforts of prevention and in case of accident to
provide effective first aid in so far as this is permitted by technical
and medical progress and the economic resources of the industry.
The accident association must therefore issue the necessary regulations respecting : (1) arrangements to be made and rules to be
issued by members with a view to the prevention of occupational
diseases in their establishments ; (2) the precautions to be
observed by the insured people themselves for the same purpose.

— 86 —
These regulations are drawn up by the accident association
in collaboration with representatives of the insured persons and
submitted for approval to the Federal Insurance Office. They
may impose obligations on members with respect to first aid
and on insured persons with respect to their conduct in case
of accident. Regulations may also be issued for particular districts,
branches of industry or only for certain classes of establishments.
The accident association communicates the regulations to
the superior administrative authorities in the districts affected
(Federal Inspectorate).
A suitable time limit is fixed within which members must
make the arrangements prescribed in regard to prevention. The
regulations prescribe the manner in which they are to be brought
to the notice of insured persons by being posted up in the
establishments in question in German and, where other nationalities
are employed, in any other language corresponding to the
nationality of such workers.
The accident associations must provide for the carrying out
of the regulations dealing with the prevention of accidents.
With this in view accident associations are entitled or, if
requested by the Federal Insurance Office, are bound to appoint
a sufficient number of technical inspection officials to supervise
the observance of the regulations for the prevention of accidents
and to take cognisance of the equipment of the establishments
where this affects membership of the accident association or
the allocation of establishments to classes of risk. The Federal
Insurance Office issues regulations for technical inspection officials
relative to their co-operation with representatives of the
establishment, and the Federal Ministry of Labour with the
consent of the Federal Council may issue regulations respecting
collaboration between the accident associations and the industrial
inspection authorities.
The accident association communicates to the superior
administrative authorities concerned the names and addresses
of the technical inspectors.
Owners of undertakings are bound, under pain of a fine, to
allow access to their premises a t any time during working
hours to the permanent members of the Federal Insurance Office
whose duty it is to supervise the carrying into effect of the
regulations in regard to prevention.

— 87 —
Notel
UNDERTAKINGS S U B J E C T TO ACCIDENT INSURANCE

1.
2.
3.

4.
4. a
4. 6

4. c
4. d

'
5.

Mines, salt works, ore-dressing works, quarries, pits (open workings).
Factories, shipyards, metallurgical works, pharmacies, breweries
and tanneries.
Builders' yards, industrial establishments in which building,
decorating, stonemason's, locksmith's, smith's or well-sinking
work is carried on, stonebreaking establishments, and building
work done otherwise than in building establishments carried on
by way of trade.
The chimney-sweeping, window-cleaning and butchering trades,
and bathing establishments.
Fire brigades and undertakings for giving assistance in accidents.
Hospitals, convalescent and nursing homes, maternity homes
and other institutions receiving persons for curative treatment
or nursing, also institutions and organisations connected with
public and free social welfare work and health services.
Natural science, medical and technical research and experimental
laboratories.
Theatrical undertakings, exhibitions, performances, musical productions, singing and declamatory recitals, all irrespective of the
artistic value of the performance, cinematograph businesses (manufacture, production and presentation of cinematograph films) and
wireless broadcasting.
The whole establishment of the railways and the postal and telegraph departments, establishments belonging to the department
for the Federal defence forces (army and navy), and establishments
belonging to the former military and naval departments which
have been transferred to civil departments of the Federal
Government.

5. a Undertakings under the Air Ministry, including undertakings for
aerial defence and for exercises in aerial defence, or undertakings
for instruction in aerial defence recognised by the Air Ministry.
6. Inland navigation, timber floating, barge and ferry undertakings,
towing (tracking), fishing in inland waters, pisciculture, fishpond
management and icecutting, if these operations are carried on
by way of trade or are managed by the Federation, a State, a
commune, a federation of communes or other public body ;
dredging operations, and the keeping of vessels on inland waterways.
7. Cartage and carriers' establishments, livery stables (vehicles and
animals for riding), and stabling establishments, if they are carried
on by way of trade ; the keeping of conveyances other than
those for water transport, if they are propelled by natural forces
or animal power, and the keeping of animals for riding.
8. Warehousing, storing and cellarage establishments, if they are
carried on by Way of trade.
9. The packing, loading, handling, sorting, weighing, measuring,
inspecting and stowing of goods by Way of trade.

— 88 —
10.

11.
12.

Establishments for the transport of persons or goods and treefelling establishments, if they are connected with a commercial
establishment the operations of which extend beyond the scope
of a small-scale establishment.
Subject to the same proviso (No. 10), establishments for the
handling and manipulation of goods.
Undertakings for guarding industrial and private property.

Note 2
SILICOSIS AND SILICOSIS COMPLICATED B Y TUBERCULOSIS

The following pages were drafted before the Third Order had been
issued. I t should be remembered t h a t the Second Order reads as
follows :
" Serious pneumoconiosis
(silicosis)
" If serious pneumoconiosis occurs simultaneously with pulmonary tuberculosis, the tuberculosis shall, for the purpose of
compensation, be deemed to be pneumoconiosis. "
Interpretation of the above text gave rise to much discussion. The
first interpretation was as follows : pneumoconiosis is considered
" serious " only when accumulation, in the lungs of dust containing
silica causes nodulation, distributed in a more or less uniform manner
throughout both lungs, the nodules being fairly large, at least of the
size of a pea. Pneumoconiosis can only be detected radiographically
in the form of pictures which are partly spherical or partly flat-surfaced ;
being clinically manifested b y dyspnoea resulting from pulmonary
sclerosis accompanied in certain cases by disturbance of the circulation
even to the point of marked cardiac deficiency. I t is only where
" serious pneumoconiosis " occurs in conjunction with pulmonary
tuberculosis t h a t the latter is considered to be pneumoconiosis for the
purposes of compensation.
Though this definition already referred to radiological, functional and
clinical symptoms, nevertheless it happened in practice t h a t undue
stress was laid on the radiological symptoms and the functional state
was on the other hand generally neglected. Further, certain authorities
have adopted as radiological criteria some two, others three, " stages "
or degrees of pulmonary shadows showing :
(a) pictures with slight mottling ;
(b) macronodular pictures (serious pneumoconiosis), or
(i) the presence of ill-defined isolated spots with a reticular
and honeycombed pattern and thickening of the hilar
shadows ;
(ii) the presence of more numerous small nodules With more
dense shadows and approaching the snowstorm or lead
shot picture, and distributed more symmetrically throughout both lungs ;
(iii) the presence of clearly outlined spots with thick shadows
distributed more or less symmetrically on both sides and
giving a marked snowstorm or lead shot picture ; or in
rounded agglomerations giving extensive flat-surfaced,
massive shadows.

— 89 —
In time a certain evolution occurred in
authorities were time and again obliged to
the functional condition, more especially of
at rest and during physical effort (climbing
dumb-bell exercises).

the sense t h a t the medical
refer to the significance of
respiration and circulation,
a stair, bending the knees,

This resulted naturally in creating a certain number of difficulties
in regard to assessment of cases, more particularly as a result of the
criteria of invalidity adopted in Germany, t h a t is to say, the reduction
in the earning capacity by more than 6 6 a / , per cent. " Serious "
silicosis should in fact present a symptomatology sufficiently grave
to involve invalidity, t h a t is to say a reduction in the earning capacity,
of more than 66 2/s P e r cent. Numerous authorities, however, deduced
the presence of serious silicosis from serious radiographic symptoms
With, however, only slight functional reduction, for instance a reduction
in the earning capacity of 35 and 40 per cent.
These conceptions Were contradictory. The radiographic picture
of the third stage should be accompanied by a reduction in functional
capacity of at least 50 per cent. Inversely, there exist cases in which
serious functional incapacity precedes radiographic changes in the lung.
Further, even Were the definition of " serious silicosis " unaccompanied by tuberculosis to be established, other difficulties would be
met with in the case of silicosis accompanied b y tuberculosis.
According to the clear and definite description given in the Order,
tuberculosis accompanying silicosis could not be considered as an
occupational disease unless co-existing with " serious " pneumoconiosis.
In practice, these combined nosological forms, more particularly in the
case of advanced tuberculosis, do not always render possible accurate
assessment of the degree of silicosis which is present. Thus a Standing
Commission for Occupational Diseases established within the Federal
Insurance Office decided t h a t a combination of silicosis and pulmonary
tuberculosis should be considered as a " serious " occupational disease
even when it Was only possible to diagnose silicosis of average severity
on condition t h a t the whole nosological picture Was a serious one.
(Decision of 25 February 1930. Entschl. und Mitteilungen d. RVA,
Vol. 26, page 523.)
In accordance with this decision the German factory doctors on the
occasion of the Conference held 13 J u n e 1933 drew up the following
definition of " serious pneumoconiosis " :
" Serious silicosis " as interpreted for the purposes of compensation
legislation is present in the following cases :
(a) presence of pulmonary changes typical of silicosis of the
third stage (lead shot or tumourlike pictures), involving
considerable derangement of respiration and of the
circulation ;
(b) in the absence of pulmonary changes characteristic of
silicosis of the third stage, presence of serious functional
derangement of the respiratory and circulatory systems,
due essentially to silicosis alone or in conjunction with
other diseases of the respiratory or circulatory systems ;
(c) presence together With considerable, but so far not definitely
serious, silicotic changes, of tubercular lesions, association
of the two giving rise to a serious nosological picture.

— 90 —
These guiding principles served for a fairly long time as the basis
of assessments.
At the end of 1933, however, a decision made by another Standing
Commission Within the Federal Insurance Office once more established
the description given in the Order and made it valid.
The Order prescribed the existence of " serious " pneumoconiosis.
I t Was therefore still necessary to determine t h a t this condition existed
and it Was only subsequent thereto t h a t assessment of accompanying
tuberculosis could be made. Accompanying tuberculosis could therefore
not be recognised unless the picture of " serious " silicosis had been
first of all established. (Decisions of 6 September and 8 November 1933.)
Since then all assessments have been made on this basis.
The formula inscribed in the third Order (see pp. 67-68) constitutes
a return to the first interpretation adopted b y the Federal Insurance
Office dated 28 February 1930.

APPENDICES

Appendix I
COMPENSATION O F OCCUPATIONAL DISEASES B Y T H E
SYSTEM OF B L A N K E T COVERAGE

In accordance with the Report submitted by Lewis R. Thompson,
Assistant Surgeon-General, Chief of the Scientific Research Division,
U.S. Public Health Service, to the tenth Meeting of the Correspondence
Committee on Industrial Hygiene this method of compensation may
be described as follows :
Workmen's Compensation Acts as originally adopted by the various
States concerned themselves primarily with accidents and made little
or no provision for occupational disease. Thus, in a few States all
occupational diseases come under workmen's compensation laws, in
other States only certain specified diseases, and in the greater number
of States no diseases at all come under compensation.
At the present time, eight States (California, Connecticut, Illinois,
Massachusetts, Missouri, New York, North Dakota and Wisconsin — one
Territory — Hawaii, and the Philippine Islands have Workmen's
Compensation Acts t h a t cover occupational diseases generally 1 . Blanket
coverage for diseases is also provided by three Federal laws administered
by the United States Employees' Compensation Commission *.
Whether a State shall adopt blanket coverage or a limited number
of compensable diseases listed in a schedule is still a subject of controversy.
I t is frequently stated that any system other t h a n blanket coverage
is unfair, unjust, illogical and ineffective. On the other hand, the
opponents of complete coverage state that with laws having no schedules
the advantage of prompt payment of compensation is often lost, and
t h a t confusion frequently arises through legal and other entanglements.
In the matter of the additional cost necessitated in changing to blanket

'According to an article published in May 1937 (C. O. SAPPINGTON:
" Medico - Legal Trends in Occupational Diseases", Industrial Médecine,
p. 233) compensation for occupational diseases is said to be accorded in
the United States in the following States : California, Connecticut, District
of Columbia, Illinois, Indiana, Massachusetts, Missouri, New York, North
Dakota, Wisconsin. I n Maryland, where the definition of occupational
disease has been fixed by the Courts, and in the following States which
have adopted the schedule system : North Carolina, Kentucky, Ohio,
Washington, Western Virginia, Minnesota, Nebraska, New Jersey, Rhode
Island. In the last four, silicosis is not, however, included in the schedule.
2
The same system is also in force in the following countries : Costa
Rica, Ecuador, Guatemala, Paraguay, Salvador.

— 92 —
coverage casualty insurance rate-makers have stated t h a t the change
would involve not more than one per cent, increase in the rates of a
State t h a t already has a compensation law but without occupational
disease coverage ; the increase from a schedule to blanket coverage
would, of course, be less.
In no other State has a Workmen's Compensation Act been operating
longer than in Wisconsin where it became effective in 1911. Eight
years later, in 1919, occupational diseases in the form of blanket coverage
were included in the Act.
The Law pertaining

to Occupational Disease in

Wisconsin

A. Definitions. — " Injury " is mental or physical harm to an
employee caused by accident or disease. " Date of onset of disease "
is the last day of work for the last employer whose employment caused
disability.
B. Conditions of Liability. — (1) Liability shall exist against an
employer only where the following five conditions occur :
(a) Where the employee sustains an injury ;
(b) Where, at the time of the injury, both the employer and
employee are subject to the provisions of this chapter ;
(c) Where, at the time of the injury, the employee is performing
service growing out of and incidental to his employment.
Every employee going to and from his employment in the
ordinary and usual way, while on the premises of his employer,
shall be deemed to be performing service growing out of and
incidental to his employment ;
(d) Where the injury is not intentionally self-inflicted ;
(e) Where the accident or disease causing injury arises out of
his employment.
(2) Where such conditions exist the right to the recovery of
compensation pursuant to the provisions of this chapter shall be the
exclusive remedy against the employer.
(3) In the case of disease, intermittent periods of temporary
disability shall create separate claims, and permanent partial disability
shall create a claim separate from a claim for any subsequent disability
which latter disability is the result of an intervening cause.
C. Incidental Compensation. — (1) Treatment. The employer shall
supply such medical, surgical and hospital treatment, medicines, medical
and surgical supplies as may be reasonably required for ninety days
immediately following the injury to relieve from the effects of the injury,
and for such additional period of time as in the judgment of the
Commission will tend to lessen the period of compensation disability,
or in the case of permanent total disability for such period of time as
the commission may deem advisable, not to exceed the period for which
indemnity is payable.
(2) Physician, Selection. — The employee shall have the right to
make choice of his attending physician from a panel of physicians to
be named by the employer.
Results
In discussions of blanket coverage it may be asked, " What per
cent, of all compensated injuries is due to occupational diseases ? "

— 93 —
and " What per cent, of all costs is represented by occupational diseases ? "
In Wisconsin during the ten-year period, 1920—1929, the total number
of compensated cases, t h a t is all injuries including occupational diseases,
was 200,791 ; of this number, 3,019 or 1.5 per cent, were listed as
occupational diseases. During the calendar year 1929, there were
22,630 compensated cases of which 414 or 1.8 per cent, were occupational
diseases.
Respecting the relationship of occupational disease costs to all costs,
reference will be made to the experience of Wisconsin for the period
1920—1933. During these fourteen years a total of $59,595,901 was
paid for all industrial cases ; of this total, $1,423,569 or less than
2.4 per cent, were paid for occupational diseases. In the tabulation of
occupational disease statistics the Wisconsin Industrial Commission
has included the cost figures for those types of occupational disease
that under the law of t h a t State and of most States are rated as
accidental. For example, compressed air illness, carbon monoxide
poisoning, typhoid fever, sunstroke, freezing, and ivy, oak, hemlock
and similar poisonings are usually compensable regardless of legislation
covering occupational disease. This group of disease cases usually
produces from 30 to 40 per cent, of the total cost, so t h a t the Wisconsin
experience, for cases depending on the blanket provision for relief, cost
materially less than 2 per cent, of the whole.
Available data make it possible to present material on occupational
diseases compensated during the years 1920—1929. This materia]
concerns (1) proportionate incidence, (2) proportionate indemnity paid,
and (3) average indemnity per case. During the ten years there were
3,019 cases of occupational diseases t h a t were compensated ; of this
number approximately 100. resulted in death or in permanent or partial
disability, and the remaining cases were classified as temporary injuries.
Taking exclusively hazards believed to be associated with ten or more
per cent, of the total cases it is found t h a t the largest number, namely,
840 cases or 27.8 per cent, of the total, was related to toxic fluids,
396 cases (13.1 per cent.) to irritant dusts and fibres, 353 cases (11.7 per
cent.) to toxic vapours, gases and fumes, and 320 cases (10.6 per cent.)
to miscellaneous irritants. This order with respect to proportionate
incidence is not necessarily the same as the order of the hazards when
arranged according to the amount of indemnity paid. A total of
$575,052 was paid in the case of all occupational diseases. Hazards
t h a t necessitated the expenditure of ten or more per cent, of the total
indemnity paid may be written in decreasing order of magnitude as
follows ; toxic vapours, gases and fumes (25.4 per cent.), irritant dusts
and fibres (20.5 per cent.), and " g e r m s " (11.3 per cent.). The average
indemnity paid per case for all occupational disease hazards was $191.
When the hazards referred to above are arranged in decreasing order
of magnitude with respect to the average indemnity paid per case, they
read as follows : toxic vapours, gases and fumes ($414), " g e r m s " ($322),
irritant dusts and fibres ($298), toxic fluids ($52) and miscellaneous
irritants ($47).
The Workmen's Compensation Acts under the system of blanket
coverage adopted in those States mentioned above (in Missouri
insurance is elective on the part of employer and employees) may
— according to Keiser — enable silicosis to be deemed an occupational
disease.
Silicosis and particularly accompanying tuberculosis have for several
years been made subject to compensation in the States of California,
Connecticut, Massachusetts and Wisconsin.

— 94 —
Attention here will, however, be confined to the measures adopted
by Wisconsin, giving a general idea of the methods of administration
and the results obtained.
For details relative to this system the reader is referred to the
s t u d y 1 by H. A. Nelson, Director of the Workmen's Compensation
Wisconsin Industrial Commission, from which the following passages
have been extracted and summarised :
Compensation boards and commissions are established as expert
bodies with the task of studying compensation problems, bothjrom scientific
and from ordinary factual standpoints, so that skilled interpretations and
conclusions may be made in a manner not possible under the old common
law system. The fear of mistake or incompetency in a decision has been
demonstrated to be largely fanciful, and it may be said that the degree
of intelligent and capable administration characteristic of the great majority
of commissions and boards does not give ground for the apprehension which
formerly existed.
I t is the belief in Wisconsin that any programme which falls short
of compensation benefits on the same basis for occupational disease as
for accidental injury is inadequate. When it is appreciated t h a t silicosis
in its later stage often develops into tuberculosis, involving the necessity
for prolonged medical and sanatorium treatment, the inadequacy of any
other method than a full medical and compensation provision will be
comprehended.
Since the passage of the Occupational Diseases Act in Wisconsin in
1919, the silicosis problem has been largely solved in this State. Had it
not been for the depression with so many persons out of employment,
the burden to industry would not have been as great as it has been. During
a period of several years many silicosis claims were made to the commissions, many of which had little or no foundation, whilst others were genuine
cases calling for benefits. In some months as many as 30 or 40 applications
were filed. Since May 1935 only 6 applications per month have been
filed on an average, and in the last 3 months the applications have averaged
only one. That means that the liability in the numbers of potential cases
which existed a few years ago has been determined ; that industry has
discharged its current obligations to silicotics without incurring the undue
expense so often loudly threatened, and that the future holds forth the
highest hope that the burden will be in fact a very moderate one indeed,
and one involving little contention as to its assumption by the industries
involved.
By far the greatest objective attained by legislation in force in Wisconsin
is that those industries which have dust hazards have installed apparatus
or adopted working methods which have enabled them to reduce the silicosis
hazard to a remarkable degree. That is, after all, the outstanding desideratum and one which can only be achieved when the expense of continuance
of the hazard has been so great that the employer finds it economical to
adopt means for its eradication.
One of the most fascinating pages in the history of industrial hygiene
could be written on the methods utilised by industries in combating the
hazard of deleterious dust : catching of dust at its point of origin ; its
removal ; automatic working in enclosed apparatus with exhaust device ;
dangerous processes effected mechanically ; cleansing of the dusty atmosphere by various systems and under certain circumstances by the Cottrell
System ; replacement of silica by less harmful products ; hygiene of the
workshops, etc.
Other measures have also been adopted in addition to those mentioned
above. Employers have introduced the practice of medical examinations ;
1
Cf. The American Labour Legislation Review, June 1936, pp. 52-60,
New York.

— 95 —
rotation of employees from dusty work to non-hazardous occupations,
the employees being kept in the dusty environment for periods so short
that no damage can be incurred. Medical examinations are necessary
both on admission to dusty industries and periodically thereafter, since
mildly incipient silicosis may still be rendered harmless by removal from
exposure to dust and transference of the workers, a t least temporarily, to
work in which the dust hazard is absent.
To condemn an employee to continue at work which involves daily
exposure to a toxic substance certain to cause disability or death if continued,
is not in keeping with humanitarian ideals, or with the admirable social
legislation which has attained almost worldwide acceptance in the last
25 years.
Wisconsin industries since 1919 have assumed the compensation
costs which should have been included by coverage in the first draft of all
compensation Acts. I n order to accomplish this purpose the following
supplementary legislative measures have had to be adopted :
(a) General measures of prevention deal with liberation of dust fumes,
vapours and gases (adopted in 1932) in addition to safety measures and
equipment, setting up a maximum content of deleterious dust which may
be maintained in any plant depending both upon quantitative and qualitative
elements. I t has been graphically shown that the code reforms are not
only possible of realisation, but that with proper devices even better conditions may be attained.
(b) Insurance carriers must cover by compensation insurance any
employer who is in good faith entitled to insurance coverage. This is
accomplished by a statutory provision constituting all insurers carrying
workmen's compensation insurance as members of the Workmen's Compensation Bureau, and imposing upon the Bureau the duty of designating
a member to issue a policy containing usual and customary provisions,
but for each undertaking all members of the Bureau are to be reinsurers
as among themselves, in the amount which the compensation insurance
written in the State during the preceding calendar year by such member
bears to the total compensation insurance written during that year by all
members of the Bureau. In other words, every insurance carrier, as a
condition precedent to the writing of compensation insurance, agrees to
assume its proportion of insurance for unwanted risks. The employer who
complies with safety and hygiene provisions and pays his premium is
entitled to coverage and will have no difficulty in obtaining it. If he
fails to do so he will find it difficult to procure insurance and will be required
to close his business because of its operation in contravention of the law.
(c) Merit rating accords to an employer a lower insurance rate when
it is shown that he has reduced the dust hazard to a certain point, and a t
the same time penalises the employer who fails to institute similar measures.
The law wisely places all employers initially on the same basis and rewards
employers who are able to improve their plant conditions as to dust hazards.
As soon as employers required to pay a higher rate realise that they can
place themselves in a better position without undue expenditure, they
fall into line.
(d) Any employer instituting oppressive medical examinations is
penalised. This provision was adopted following a conference with representatives of both labour and industry, and aims at medical examination
which has for its purpose elimination of employees from work which would
be dangerous to them and to their fellow-workers, while avoiding any
suggestion of selection for work of workers possessed exclusively of a high
degree of physical fitness. The writer of the article here summarised believes
that the silicosis problem can never be successfully handled without adequate
medical examination of those exposed in the course of their occupation
to the inhalation of harmful dust. No other means exists of detecting
in its initial stages a diseased condition which may be arrested if discovered
in time and properly treated. That does not, however, mean abuse of the

— 96 —
privilege of medical examination, and for this reason legislation in Wisconsin
provides that any employer who applies or promotes any oppressive plan
of physical examination and rejection of employees or applicants for
employment shall forfeit the right to the advantage of experience rating
(rating which permits a lower prernium in the case of those employers
whose record for injuries or cases of occupational disease is below a given
standard). The determination of the Industrial Commission in this connection is subject to review in court, so that the employer is fully protected.
Though this provision was first passed in 1933, it has never been found
necessary to carry it into execution. A mere suggestion to an employer
tempted to institute oppressive examinations has sufficed. In the case of
self-insurers, the Commission would under no circumstances permit exemption from carrying insurance where oppressive medical examinations were
made. I n the case of insured risks, employers would find it too expensive
even to consider the institution of such examinations.
(e) There is further provided payment of compensation for non-disabling
silicosis on a rehabilitation basis. Compensation Acts provide for payment
of wage loss arising from injury or disease. Some courts have held that
unless the physical condition of the employee is impaired to such an extent
as to interfere with his work at least to some degree, no compensation may
be awarded. This leaves out of consideration any worker whose injury
has produced a reputed stigma which, although not impairing his manual
capacity for work, nevertheless causes wage loss because of inability to
procure work, or of the necessity for accepting work at a lower wage than
he has previously earned. I n many States, therefore, compensation is
provided for disfigurement which may involve discrimination against the
employee in securing employment. Analogus to the disfigurement provision
is the one which provides for compensating of non-disabling silicosis. If
an employee is discharged by his employer because of physical examination
disclosing silicosis which has not yet proved disabling (and may never
prove disabling), but which is such as to cause discrimination against him
in other employment for fear of the disease progressing and entitling him
to compensation, the employee may receive an award not to exceed compensation based on one year's wage with a view to enabling him to rehabilitate himself and to find work which will not prove dangerous to him in
view of his condition. This provision does not prohibit further payment of
compensation should actual disability develop, nor does it entitle the nondisabled employee to payment of compensation unless wage loss can actually
be established because of his discharge from work, his inability to procure
other work by reason of such discharge, and the consequent loss suffered
by him on account of early silicosis.
The effects of the legislative enactments applied by the commission,
as approved, modified, or reversed by the Supreme Court of Wisconsin
may be summarised as follows 1 :
1. Prior to the amendment in 1935, to have a valid claim, a worker
had to prove t h a t his disability occurred while the employer-employee
relationship existed.
2. Subsequent to the amendment in 1935, making the date of
liability " the last day of work for the last employer whose employment
caused disability " , an employee who became disabled subsequent to
discharge had a valid claim against the last employer whose employment
was a contributing factor to his silicosis.
3. Disability prior and subsequent to the 1935 amendment must
be demonstrable in wage loss, and not simply potential wage loss or
medical disability.
1
Max D. KOSSOBIS and O. A. FBTJBD : " Experience with Silicosis
under Wisconsin Workmen's Compensation Act, 1920 to 1936. " Monthly
Labor Review, May 1937, pp. 1089-1101, Washington.

— 97 —
4. The employer in whose employment a worker is at the time
of his disability, or the last employer whose employment was a
contributing factor in his disabüity, must bear the full cost of
compensation even though t h a t period of employment was not sufficiently
long to cause the condition, it being sufficient if it contributed thereto.
As a result of these rules, the 1935 legislature enacted the following
amendments to the compensation law :
(a) A final award dismissing a claim because the disease had not
as yet caused disability was not to be a bar to a claim for
disability developed subsequently. (Sec. 102.18.)
(b) In cases of discharge from employment because of non-disabling
silicosis, thus occasioning wage loss, the commission may allow
compensation not to exceed 70 per cent, of the employee's
average annual earning * ; but a payment of such a benefit was
to bar any subsequent recovery from silicotic disability. (Sec.
102.505.)
The purposes of these amendments obviously were (1) to safeguard
the right of an employee to be entitled to compensation when actually
disabled, even though an earlier claim had been dismissed because no
disability could be proved at the earlier date, and (2) to provide for
a method of rehabilitating workers barred from following their regular
occupations because they had contracted silicosis, even though not
disabled. They represent an attempt to couple wage loss with the
termination of employment and thus to meet the standard prescribed
by the Supreme Court.
Neither of these two amendments has as yet run the gauntlet of
judicial opinion.
Incidence of

Silicosis.

During the 17-year period from 1920 to 1936 inclusive, 799 claims
(a subsequent recheck has raised this figure to 893) for disability resulting
from silicosis were filed and passed upon by the Industrial Commission
of Wisconsin.
In 469 of the 799 cases compensation was paid, although sometimes
in small amounts as compromises. In 330 the claims were disallowed
or, in some instances, withdrawn by the claimants themselves. Fully
55 per cent, of all compensated claims and 62 per cent, of those rejected
were filed in the two years 1933 and 1934.

1
This allowance of 70 per cent, has been changed by a recent amendment
to a sum of $3,500.

7

1.

COMPENSATED SILICOSIS CASES I N WISCONSIN, CLASSIFIED B Y I N D U S T R Y ,

1920 TO 1936
Number of cases
Industry

Stonecutting and quarrying

. . . .

M a c h i n e r y i n d u s t r y (including t r a n s Miscellaneous m a n u f a c t u r i n g
tries

Fatal

Non-fatal

Total

159

310

469

14
47
9
27
14
8

28
52
6
19
87
28

42
99
15
46
101
36

36

89

125

4

1

5

indus-

C O M P E N S A T E D S I L I C O S I S CASES I N W I S C O N S I N , C L A S S I F I E D B Y
OCCUPATION,

1920

TO 1936

1

Number of cases
Occupation

All o c c u p a t i o n s
Blacksmiths
Carvers, h a n d (stone)
Chippers
Core m a r k e r s , core b l o w e r s
. . . .
C u t t e r s (stone)
Drillers, m a c h i n e
Enamellers
Foremen, superintendents
. . . .
Grinders, finish
Grinders, r o u g h (machine s h o p ) . .
Grinders, s n a g , r o u g h g r i n d e r h a n d s ,
swing g r i n d e r s
Labourers
L e t t e r e r s a n d e n g r a v e r s (stone) . .
Miners
Moulders
Polishers, h a n d (stone)
Polishers, m a c h i n e (stone)
Polishers (metal)
Sand blasters a n d sand-blast-machine
o p e r a t o r s (foundry)
S a n d - b l a s t - m a c h i n e o p e r a t o r s (stone)
Sand dryers
Sand mixers
Shake-out m e n
Stone-crusher o p e r a t o r s
Welders, acetylene cutters
. . . .
Unclassified

Fatal

Non-fatal

Total

159

310

469

1
12
2
29
1
2
1

10
2
14
10

20
7
40
3
6
5
10
22
1
28
76

10
32
3
42
86
4
3
1

25

57
2
1
8
5
2
6
72

•4

32
2
1
1
2
1
26

1
1
32
9
69
1
2
4
6
10

7
5
5
46

1
The data to be published later by the Industrial Commission of Wisconsin will also contain an
analysis by length of exposure. Errors in the preliminary data made inadvisable the inclusion of
such an analysis here.

— 99 —
3 . COMPENSATED SILICOSIS CASES IN WHICH PAYMENTS WEBE MADE IN WISCONSIN,

1920
Year of Number of cases
first Information to
industrial
commis- JTatal Nonfatal Total
sion
All cases
1920«
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936*

159
1
3
2
7
4
4
4
9
12
17
18
24
15
27
9
3

310 469
1
3
2
2
3
2
1
3
3
12
16
101
117
40
4

1
4
5
9
6
7
6
10
15
20
30
40
116
144
49
7

1936

TO

Payments for—

Death

PermaTemponent dis- rary disability
ability
8408,870

8119,313

16,366
20,992

14,050

5,639
2,829
2,147
3,636

15,711
17,200
36,205
65,130
68,004

2,500
20,809
1,950
4,742

71,467
55,443
36,288
32,272
4,531
6,000

30,681
46,219
102,987
80,063
78,836
26,042

8452,138
6,529

Medi- Funeral Comprocal care expenses mise l

$26,589

818,735

185
95
1,533
511
1,765
742
420
3,120
2,706
4,073
4,541
2,043
1,177
1,299
2,176
203

200
200

Í2.703
2,723
4,982
11,358
14,695
15,162
28,670
10,876
1,534
1,869
490

600
800
600
800
1,350
2,200
2,795
2,550
2,640
1,800
1,400
400
400

Total •

Average
per
case

8588,994 81,614,648 $3,443
3,750
3,350
6,650
12,441
2,500

4,135
15,813
11,012
32,065
43,743

4,135
3,953
2,202
3,563
7,291

1,550
500
6,800
7,000
15,800
21,225
58,440
182,261
191,226
71.501
4,000

33,806
42,452
54,407
93,136
105,367

4,829
7,075
6,441
6,209
5,268

145,626
193,455
335,389
307,794
159,313
37,135

4,854
4,836
2,891
2,137
3,251
5,305

1
I t was not possible to separate the amounts paid as compromises into payments for various types of
disabilities and medical and funeral expenses.
* More complete data showed a total of 81,856,663 paid from 1920 through 1936.
* No silicosis claims filed in 1921.
* Data incomplete.

4 . COMPABISON OF COST OF ALL INJTJBY CASES AND SILICOSIS CASES IN WISCONSIN,

1920
Number of
cases

TO

1934 !

Cost of medical
care

Compensation

Average cost
per case

Total cost
Silicosis »

Year
All
Sili- AU injuries
injuries cosis

Total

285,742 413

1920
1921
1922
1923
1924

16,246
15,898
16,705
20,941
22,766

1925
1926
1927
1928
1929

21,137
22,177
20,473
21,818
22,630

1930
1931
1932
1933
1934

20,070
16,943
16,195
14,563
17,180

1
4
5
9
6
7
6
10
15
20
30
40
116
144

Silicosis

All injuries Silicosis All injuries
Amount

847,968,891 81,393,990 815,233,037
1,970,513
2,257,255
2,410,529
2,794,998
3,047,147

3,950

3,490,021
3,725,860
3,662,406
3,885,850
4,308,571

15,718
9,479
31,554
41,978
33,064
42,032
51,287
90,430

4,447,141
3,486,195
3,126,912
2,711,320
2,644,173

101,294
141,085
191,412
334,212
306,495

569,571
661,562
746,429
924,032
1,153,332
1,100,852
1,122,624
1,114,056
1,250,216
1,433,552
1,398,338
1,101,978
945,953
857,992
852,550

Non- 1
PerSilicosis
cent. silicosls
of
total

824,210 $63,201,928 81,418,200

2.24

2,540,084
2,918,817
3,156,958
3,719,030
4,200,479

0.16

156.11
183.60
188.08
177.11
183.17

4,135.00

16,813 0.50
11,012 0.30
32,065 0.76

4,590,873
4.848,484
4,776,462
5,136,066
6,742,123

43,743
33,806
42,452
54,407
93,136

0.95
0.70
0.89
1.06
1.62

215.19
217.17
231.30
233.02
249.79

7,290.50
4,829.43
7,075.33
5,440.70
6,209.07

6,845,479
4,588,173
4,072,865
3,569,312
3,496,723

105,367
145,626
193,455
335,389
307,794

1.80
3.17
4.75
9.40
8.80

286.29
262.67
240.14
223.85
187.19

5,268.35
4,854.20
4,836.38
2,891.28
2,137.46

185
95
1,533
511
1,765
742
420
3,120
2,706
4,073
4,541
2,043
1,177
1,299

4,135

8216.54 $3,433.90

3,953.25
2,202.40
3,562.78

1
Data on all injuries apply to cases settled during the year. Silicosis data apply to settled cases tabulated according to
year of filing of claim with industrial commission. The tabulation was made to disclose general trends, but is not to be taken
as an accurate measure of annual silicosis cost relative to over-all injury cost, even though percentages to that end are given.
» To arrive at the non-silicosis data, the silicosis data were deducted from the all injuries data,

Appendix II
TERMINOLOGY OF RADIOGRAPHIC FINDINGS
IN RESPECT OF SILICOSIS

The Correspondence Committee on Industrial Hygiene of the
International Labour Office in course of its Eighth Session (21 to 23
June 1934) discussed the following draft terminology of radiographic
findings in respect of silicosis submitted b y Dr. Irvine, Chairman of the
Miners' Phthisis Bureau in Johannesburg (South Africa) :
Proposed

General Terminology

of Radiographic Findings in Cases of
Silicosis
I . The matter of devising a generally acceptable terminology descriptive of the radiographic appearances met with in cases of silicosis
presents considerable difficulty in view of the many variations in the
radiographic picture of the disease, produced by variations in the underlying
pathological condition arising from differences in the character of the
inhaled dust, the intensity and duration of exposure to such dust, and the
varying amount of modification produced by the intrusion of an infective
element, particularly by a tuberculous infection.
Owing to differences in one or other of these factors, the pathological
types of the disease may and do differ in different silicosis-producing
industries, and even under changing occupational conditions in the same
industry at different times. The radiographic picture will necessarily
reflect these differences in pathological type, so that complete uniformity
in the radiographic appearances of the disease is not to be expected,
particularly when the causative occupational conditions differ considerably.
I I . The main object of an agreed terminology of radiographic findings
would be their rapid, but approximately accurate, classification into a
limited number of groups, the general character of which would be readily
intelligible. The employment of such a terminology would be found to
be of particular value in succinctly reporting the results of large-scale
investigations of men engaged in any silicosis-producing industry, as a
means of indicating the general nature and proportion of the predominant
types of radiograph found.
With this object, and in view of the differences in the type of the
disease, the proposed terminology should conform to two simple principles :
(a) it should be drawn up upon very general lines, and should not
aim at too minute a sub-division of types ; and ;
(b) it should be succinctly descriptive simply of the appearances
seen in the radiograph, and should not in itself convey any
implication regarding the pathological character of the conditions
producing these appearances, or be regarded as affording, per se,
a classification of cases of silicosis for medico-legal purposes K
1

In a contribution to the discussion on the radiological appearance
of the lungs in different varieties of pneumonoconiosis, held by the
Pathological Section of the British Medical Association at the London
meeting in 1932 (British Medical Journal, 6 August 1932, p . 256), Dr.
Tattersall described four main groups :
(a) " sharply defined nodular " —• typically seen in true silicosis ;
(b) " striate " —• after exposure to silicates, asbestosis being the
most typical ;
[Note continued on next page.]

— 101 —
One stresses the importance of this second principle, since similar
radiographic appearances do not necessarily represent identical pathological
conditions.
I t should be noted that the agreed terminology would in no way
supersede the careful study of radiographs as an aid to diagnosis in individual
cases. The radiograph is an invaluable adjunct to diagnosis. But the
only method by which full value can be obtained from the indications
which it gives is by an extensive correlation of the results of clinical, radiological and pathological evidence based upon the investigation of a large
series of individual cases, and it is essential that such a correlation should
be effected separately and in detail in each silicosis-producing
industry.
I I I . Following upon the discussions at the Silicosis Conference, a
terminology based upon the principles suggested has been adopted by
the Miners' Phthisis Medical Bureau at Johannesburg, at which some
150 radiographs of gold miners have to be reported upon every day, and
it has been found to be of great practical value as a means of rapidly
classifying these radiographs into their appropriate general groups as
a preliminary to detailed study. The terminology adopted by the Medical
Bureau is based upon the results of a correlation of clinical, pathological
and radiological evidence which has been carried out as a routine measure
for a considerable number of years and which has been of cardinal value
in enabling the Bureau to attain reliable standards of diagnosis in respect
of the predominant types of silicosis which have been met with during
the past sixteen years on the Witwatersrand.
Among these cases one meets with three main distinguishable clinical
and pathological types :
(1) Silicosis of simple or uncomplicated type ;
(2) Silicosis of infective type ; and
(3) Silicosis with tuberculosis.
IV. I n cases of Silicosis of simple type the essential pathological feature
of the silicotic process is the progressive development of a discrete miliary
nodulation or nodular fibrosis originating at certain defined sites at which
silica dust has been aggregated in the lung substance and under the visceral
pleurae, together with a corresponding fibrosis of the root glands, the latter
indeed being usually the first sites to show obvious fibrosis. There is
always an accompanying bronchitis of dry type, and in well-marked cases
a varying degree of emphysema. This condition tends to progress, even
after cessation of exposure to dust and without the intervention of infection,
up to a point determined apparently by the amount of dust retained in
the lung.
From the pathological aspect, cases of silicosis of this simple nodular
type can readily be grouped in a continuous series in terms of the number,
size and density of the palpable (at necropsy) fibroid nodules present.
The radiographic picture corresponds pari passu, and there is a general,
although by no means an exact, correspondence between the degree of
nodular fibrosis indicated by the radiograph and the amount of disability
revealed by clinical examination.
I n this type of case therefore a consistent terminology of the radiographic appearances met with can be readily drawn up, which can be
applied to the appearances shown by radiographs ranging from that of
the normal thorax up to those shown by the various degrees of silicosis
of this simple type.
[Note continued from previous page.]

(c)

" light mottling with increased striation " — coal miners and
trimmers ; and
(d) " coarse mottling, striation and large dense opacities " — underground workers with machine-drills in coal and haematite mines
and some coal trimmers.
This is not a systematic classification, but it complies in general with
the two principles indicated and has the essential value of at once suggesting
to the mind the type of radiograph described.

— 102 —
The following terminology is employed by the Medical Bureau to
define this gradation. I t is fully described and illustrated 1in the publication
Silicosis in South Africa by Simson, Strachan and Irvine .
The first three types —
(1) Normal Thorax ;
(2) Slight Increase in Linear Radiation (or Striation) ;
(3) Moderate Increase in Linear Radiation (or Striation), are within
normal limits, the first being really that of the " ideal " normal thorax ;
(4) Generalised Arborisation (well-marked general increase in linear
radiation or striation) ;
(5) Generalised Arborisation, with partial small mottling ;
(6) Generalised small — medium —- large or coarse —• mottling.
The definitely " specific " sign of a miliary silicotic nodulation is
the appearance in the negative of the familiar discrete " mottling " of the
lung fields caused by the shadows thrown by individual nodules. In
the above terminology Type No. 5 is the first which shows this indication
and is the general standard accepted by the Medical Bureau as definitely
indicative of a slight degree of simple silicosis. Type No. 4 is a borderline type, which may or may not be associated with a slight degree of
nodular fibrosis, and due allowance is made in practice for this circumstance.
The types grouped under No. 6 are indicative respectively of moderate,
well-marked, and advanced degrees of silicosis of simple type — subject
to the qualification that the first description may also apply to the appearances shown in cases of miliary tuberculosis, which may very closely
simulate those of a moderate degree of simple silicosis.
V. If the discrete nodular type of silicosis were all one had to deal
with, the question of terminology would be a simple one. Largely, however,
although not solely owing to the frequent intrusion of an infective factor
and notably of tuberculous infection in cases of the disease, one meets
with many variations from the orderly picture so far described.
(1) In many instances, both in those of the above general types
which are not definitely indicative of silicosis and in those which are, the
radiograph may present indications of minor modifications which, particularly if present in combination, are usually indicative of " old " or latent
(and usually tuberculous) infection — namely such appearances as
" increase in hilus shadows " 2, " enlarged or apparently calcareous root
glands ", " peribronchial thickening " and an " asthenic type of heart ".
In certain cases where these characteristic signs are associated
with a generalised arborisation or " striation " they are indicative of a
slight degree of tubérculo-silicosis, found on autopsy, but may be found
also in individuals who have never been exposed to dust.
I t is difficult to find a single term distinctive of this characteristic
combination, which is almost invariably associated with the general physique characteristic of the " phthinoid " type of individual, who is not of
robust type but may be perfectly healthy. The Medical Bureau makes
the distinction by adding to the term descriptive of the general type into
which the radiographs falls the expression " partly or mainly infective
in type " and has found this procedure useful, not least so in the assessment
of the condition of non-silicotic recruits as suitable or unsuitable for mining
work.
1

SIMSON, F . W., SUTHEBLAND STBACHAN, A. and IBVESTE, L. G. : Silicosis

in South Africa ; A Symposium on the Histopaihology, Pathological Anatomy
and Radiology of the Disease. Special Supplement to Proceedings of the
Transvaal Mine Medical Officers' Association, Johannesburg, March 1931.
Reprinted by South African Institute for Medical Research, Johannesburg.
2
Admittedly increase in the hilus shadows may be due to simple fibrosis
of root glands. I t is the combination of the above appearances which is
characteristic of the type under discussion.

— 103 —
(2) In cases of silicosis major modifications due to grosser pathological
changes, and indicated in the radiograph by definite areas of diffuse opacity,
are frequently met with.
Leaving aside, however, appearances produced by acute intercurrent
infection, such as pneumonia, pleurisy with effusion, empyema, etc., one
finds the appearance of areas of diffuse opacity in the silicotic lung is due
in the main to one or other of the following conditions :
(a) To a simple massive fibrosis produced by a localised close aggregation of nodules in advanced cases of silicosis of simple type. In types
of silicosis in industries in which exposure to dust is very intense, diffuse
opacities of this mode of origin, but associated with a greater amount of
interstitial fibrosis in the neighbourhood of the nodules than is usual in
Witwatersrand cases and with simple inflammatory changes, are common.
(b) To the presence of chronic indurated areas of consolidation of
mixed infective and silicotic type. Lesions of this nature are very common,
owing to the characteristic modifications in the direction of excessive
fibroid reaction which certain infections and particularly a local tuberculous
infection tend to produce and to undergo in a silicotic lung. Such lesions
are in general slowly progressive, but frequently undergo prolonged periods
of virtual arrest. They are not associated with the customary local signs
of active disease or with general toxic symptoms or significant deterioration
in the general health. The Medical Bureau is accustomed to distinguish
these cases on clinical and pathological grounds as cases of Silicosis of
infective type. Some cases show these features from the outset, and the
radiograph may then present the characteristic appearances of a chronic
fibroid tuberculosis, without any evidence of a generalised silicotic nodulation. In others a condition of infective silicosis may form an intermediate
stage, often however of long duration, between a condition of silicosis of
simple type and one of active " tuberculosis with silicosis ".
(c) To a condition in which silicosis is associated with a clinically
detectable active and physically deteriorating tuberculosis. I t is to this
type of case that the Medical Bureau on clinical and medico-legal grounds
applies the term silicosis with tuberculosis.
A distinction between the first two conditions specified and the third
is frequently possible on radiographic grounds, provided that repeated
examinations are made. On a single examination, however, it is difficult
or impossible to draw such a distinction, and the final interpretation of the
case can only be made on clinical grounds.
Hence it would appear that, for the purposes of a simple general terminology, the most feasible plan would be to group all cases showing wellmarked diffuse opacities under some such general heading as
Limited
Ì
( in the apical / middle / basal
Moderately extensive > diffuse opacity I zone of the right / left / both
Extensive
j
\ lung fields.
I t would then remain for the radiologist to append a provisional diagnosis
in each individual case.
I n a case in which the plate would be indicated as " Generalised
small mottling, with extensive diffuse opacity in the apical and middle
zones of the right lung " the " provisional diagnosis " of the radiologist
would be " Moderate degree of silicosis, with active tuberculosis right ".
VI. One is led by the foregoing considerations to suggest the following
simple scheme for radiological report in order to comply with the objects
aimed at and with the degree of simplicity desired :
Name
Date
Place
Initials of
Radiologist.

Serial No.

— 104 —
No.
1.
2.
3.
4.

The radiograph shows :
Normal thorax.
Slight increase in linear radiation (or " striation ").
Moderate increase in linear radiation (or " striation ").
Generalised arborisation (well-marked general increase in linear
radiation or " striation " ) .
5. Generalised arborisation, with partial small mottling.
6.* Generalised mottling, sparse / close / small / medium / large or
" coarse ".
7.* With hilus shadows increased :
— enlarged / apparently calcareous root glands ;
— peribronchial thickening ;
— heart shadow... of asthenic type ;
— mottling irregular in size and distribution.
8.* With diffuse opacity : light / moderately dense / dense ;
limited / moderately extensive / extensive in area ;
in apical / middle / basal zone of right / left / both lung fields.
9. Other changes, viz :
(e.g. heart enlarged ; aorta enlarged ; pneumothorax, etc.)
10. Provisional diagnosis of radiologist :
Signature :
* Underline terms which are relevant.
In the practice of the Medical Bureau a report form of this type has
been found of great practical value in rapidly classifying the large number
of radiographs handled daily into their appropriate general groups, as a
preliminary to further study. The scheme shown above is the simplest
practical report form which would suit the work, and is the outcome of
sixteen years' experience of the examination of some 36,000 radiographs
of miners in each year.
What is wanted is not a terminology which would attempt to define
pathological " stages " of silicosis from the radiograph, but a system which
would enable one to visualise with approximate accuracy the general type
of radiograph described. A reliable interpretation of the radiograph in
terms of the underlying pathology is quite another matter and can only
be satisfactorily worked out in each silicosis-producing industry by means
of the method of correlation described above, which alone can furnish
reliable standards of diagnosis.
VII. With regard to radiographic technique in use by the Bureau, see
the following Appendix.

Appendix III
RADIOGRAPHIC TECHNIQUE IN RESPECT OF SILICOSIS

SOUTH AFRICA
The radiograph technique at present in use at the Medical Bureau 1
is as follows (1934) :
Generator, 3 phase, rectified by kenetron valves.
Tube 20 Kw. Film focus distance, 36 inches.
Current through tube, 200 milliampères. Kilovolts applied to tube
terminals, 55.
Films Kodak lOin. x 12in. and 12in. x 15in., with double " Agfa "
intensifying screens.
Developing solution according to Kodak's formula ; temperature of
developer 65°F., checked by recording thermometer ; time of
development, 5 minutes in each case.
The average number of radiographs taken is 150 during the morning
hours of each working day.
Exposures are made in the prone position. The upright position is
in many respects preferable, but by adopting the horizontal method there
is less likelihood of movement during exposure and fewer adjustments
have to be made, thus saving time in securing the correct position, a consideration of much practical importance in dealing with large numbers of
examinees.
As all the conditions, viz., focal distance, kilo volts and milliampères
remain constant, the length of exposure is dependent on the depth of the
man's thorax and varies from 0.05 sees, for a thin individual to seven times
that duration for a large robust man.
The film focus distance is 36 inches. The general tendency in radiographical work at present is to work 72 inches. The Medical Bureau, however,
has found that small nodules which cast a shadow up to 36 inches may tend
practically to disappear with a greater film focus distance. Accordingly the
72 inches technique was abandoned and 36 inches adopted as the Bureau
standard. A further advantage is that only one-fourth of the exposure is
required at 36 inches as compared with that required at 72 inches.
Owing to the improvements in apparatus and adjuncts the technique
is being constantly altered and adjusted to suit new conditions, and finality
has not yet been reached. At the moment the chief difficulty is in obtaining
tubes and valves to stand up to the heavy work they are required to perform
owing to the number of examinations made within a limited time : on the
average an examination is made every two minutes.
After the exposure a stencil plate recording the appropriate number
of the individual, the class of examination, and the date is placed on the
cassette, and the current turned on again. The stencil record is superimposed on the heart shadow so that each item is clearly shown. The name
of the examinee and length of exposure are subsequently pencilled on
the film in the dark room before the negative is developed. The double
check eliminates possible errors in identification.
1

Op. cit., pp. 38-39.

— 106 —
GREAT BRITAIN
The Sub-Committee on Radiograms of the Committee on Industrial
Pulmonary Diseases set up by the Medical Research Council has
established a plan of standardisation of technical methods of radiology
recommended for radiologists called upon to collaborate as experts in
regard to compensation for silicosis (May 1924).
This technique is as follows :
(1) Patient standing with the back towards X-ray tube, and the arma
in front around the cassette.
(2) Tube centred opposite the 4th-5th dorsal vertebra or 3rd rib
cartilage.
(3) Double screen film (12 X 15) in cassette in front of patient at a
distance of 4 ft. from the centre of the X-ray tube.
(4) The cassette should be as nearly as possible in contact with the
chest, i.e. where the abdomen is prominent, the cassette should be inclined
backwards — the patient should not bend forwards in order to obtain
contact, as this leads to distortion. A simple wooden stand with an adjustable
cassette carrier is quite efficient for this purpose and it takes little floor
space.
(5) Breasts to be drawn aside before the patient comes forward in
contact with the cassette. Occasionally it may be advisable to bandage
pendulous breasts in order to displace them effectively.
(6) Exposure to be made in full inspiration. N.B. I t is important
to educate the patient in this before the exposure is made, preferably under
screen observation.
(7) Radiographic technique will vary within wide limits with the
apparatus in use and it is not possible to set any standard. The exposure
will vary with the apparatus, but if possible should not be more than 1/10 sec.
at a kilovoltage of 50-70, the milliamperage varying from, say, 50 to 150.
With less powerful apparatus it m a y be necessary to increase the kilovoltage to perhaps 90 K.V. to obtain the necessary speed, but the result
will be much less satisfactory and it will be found more satisfactory to
increase the time of exposure rather than to increase the kilovoltage, even
though there may be some loss of detail owing to movement. The exposure
will vary not only with the apparatus and the size of the patient, but with
the individual; it does not follow t h a t two subjects of exactly the same
build, radiographed under identical conditions, will give identical films.
Development of Film.
A very large proportion of unsatisfactory results is due to faulty darkroom technique.
The safety lights of the dark room should be tested by exposing a
film for a minute in the usual position where films are manipulated.
Films should be handled as little as possible.
Developer should be reasonably fresh and must be at a standard
temperature of 65°. This is a vital factor for uniform results.
The time of development will vary from 4-7 minutes, according to
whether the developer is fresh or used up.
I t is very strongly recommended that the developer be purchased
ready made to dissolve in water for tank development. Subjoined is a
method for testing the developer.
The Type of Film.
The type of film to be aimed a t is one that shows the intervertebral
discs as far as the arch of the aorta, but shows practically no trace of the
vertebrae below this. Bone structure should be seen in the ribs.
If detail is required in a grossly diseased area of the lung, it will be
shown by giving a little longer exposure, but this will obliterate finer detail
in the unaffected areas.

— 107 —
Method of testing Developer.
Place a metal band across a film and give it a standard exposure,
e.g. such as will give a satisfactory radiograph of a hand. Cut this film
into strips across the line of the shadow of the metal and store in a light
tight box for use.
Take two strips. Develop one for 20 sees., the other for 25 sees.,
and fix.
There is a time factor for each developer. Usually this factor is 12,
and if the time taken for the first faint appearance of the image on the
film is multiplied by the factor, it gives the proper length of development to obtain the optimum result ; e.g. if the shadow of the band fails
to show on the strip developed at 20 sees, but is just discernible on that
developed for 25 sees., the time t h a t the chest film should be left in the tank
is 25 X 12 = 300 sees. = 5 mins.
Developer should be changed before 7 mins. if necessary.

Appendix IV
STAGES OF SILICOSIS

BELGIUM
Dr. E. Streignart of the Hortense Dispensary at Montegnée, Liège,
on the basis of his experience of 600 to 700 lung cases which he has
examined radiologically, draws attention to the interest attaching to
certain outlines which, whilst signifying merely normal wear and tear
in the case of older subjects, when met with on the other hand in a
young subject denote definite pathological broncho-vascular sclerosis.
This observation acquires a certain importance when it is considered
t h a t the signs of premature wear and tear of the broncho-vascular
system are more frequent among workers in dusty industries.
In the case of pneumoconioses the radiological pictures may be
described as follows :
Pictures of the miliary nodular type : most frequently these occur,
whether taken individually or together, with dimensions, contour details,
differentiation one from another, and manner of distribution throughout
the pulmonary field, which are all highly variable. They imitate more
or less all types of generalised miliary tuberculosis.
This miliary aspect in the uncomplicated state may occur not only
at the outset of the disease as in the case of certain workers chosen for
the enquiry on account of the excellent state of their health, b u t
may equally be present in the final stage of evolution of forms of
pneumoconiosis.
Pictures of sclerosis striation : the pulmonary outline being naturally
highly variable, the picture of sclerosed broncho-vascular arborisations
may also be very variable.
Sclerosis on the other hand varies equally, from slight accentuation
of the so-called normal outline up to formation of thick dense striation
in the large and small trunks and marked accentuation of the fine
pulmonary reticulum. The latter may occur in such a form t h a t it
is no longer easy to distinguish it from certain so-called acinonodular forms.
There may also be met with lesions which produce bundles of thin
lines in juxtaposition at times confluent at certain places, situated right
inside the parenchyma and forming an extension of the sclerosed
broncho-vascular arborisations.
Finally, certain sclerosis striation occuring in pictures with compact
formations produces images having the appearance of the shrouds of
a mast or of tent ropes.
These forms of fibroses may in numerous cases represent the final
stage in the radiological evolution of pneumoconioses.
Massive shadows : two types of these may be distinguished :
(a) true pseudo-tumoural pictures, real mass formations with welldefined borders, very variable forms often elongated, drawn out here
and there into long pointed shapes towards their angles. These points

— 109 —
meet either at the diaphragm, at the thoracic wall or at the mediastinum
in sclerosis stria? which appear to subtend the fibrous block formations ;
(b) dense flat-surfaced pictures more or less extensive, with
truncated angles and a flaky, fuzzy aspect except the contours which
are more or less definite, a blurred picture though often becoming clearer
towards the periphery, passing imperceptibly into the picture of finely
mottled nodulation.
Combination of the above pictures : all these pictures may further be
found more or less combined.
The author is of the opinion, t h a t in certain cases the radiological
picture, though not free from difficulty of interpretation, nevertheless
may in itself at times suffice to give an idea of the aetiology.
Further, whilst more or less simple nodular pictures, sclerosis
striation, certain pictures of mass formations, or of dense flat-surfaced
formations may and do give rise to confusion with various diseases
encountered in the population in general, there exist nevertheless
pictures of a type not found elsewhere than in silicotic subjects, i.e.
pictures of mass formations with sharp angles extending into sclerosis
striœ. The author emphasises the importance of clinical examination
and recalls t h a t certain workers working in certain surroundings where
the atmosphere is polluted with dust, show a special nosological picture
which is more or less constant, though not present to the same degree
in the case of all individuals (who spend a fairly similar period of time
in the working surroundings in question). It is characterised by a good
general state of health with a frequent tendency to stoutness, dyspnoea
on effort, at times continual dyspnoea, most usually thoracic pains
with or without expectoration and without a very definite character,
absence of Koch bacillus in the sputum after repeated analysis, ordinary
signs of emphysema on sounding, bronchitis, sclerosis at times with
consolidation, and with a pleuro-pulmonary radiological and cardiac
picture which is at times typical, though variable within certain limits,
but which mostly is not even suspected on account of the lack of
objective clinical symptoms.
The relation between the clinical symptoms and the radiological
picture justifies the statement that there is more frequently definite
and absolute discrepancy between the clinical manifestations both
objective and subjective, and the extent as well as t h e form of the
injuries as revealed by radiology.
Thus for instance, a serious clinical picture and very distressing
subjective symptoms do not always, or even in the majority of cases,
correspond to the pseudo-tumoural picture, characteristic of the third
stage in the classification by stages of silicosis radiograms. The contrary
is not of infrequent occurrence and subjects showing a radiological
picture of the first or second stage are clinically at times found in a
rather precarious state of health.
Thus it is seen t h a t cases with intense dyspnoea, poor general
condition, thoracic pains, abundant bloodstained expectoration without
Koch bacillus (tested for on various and repeated occasions) are seen
to present merely radiological pictures of emphysema with sclerosis
showing moderate striation, relatively few nodules, of small volume
and non-confluent, as compared with other cases.
According to the author, in order to effect diagnosis of pneumoconioses,
it is essential in the case of any affection whatsoever to give due
consideration to all circumstances and data, and even to the aetiological
conception.

— 110 —
GERMANY
Silicosis

Tuberculosis

1. Radiological changes in slight and serious
cases of silicosis and
tuberculosis.

Symmetrical in the
sagittal plane.

2. Changes
accompanying :
(a) slight
silicosis
or incipient tuberculosis.

I n both central fields
irregularly distributed
mottling. Absence of silicosis striation proceeding from there to the
hilus.

At the apices mottling arranged in series
in presence of striation
directed towards the
hilus.

(b) serious silicosis
and
advanced
tuberculosis.

Large nodes isolated
from the hilus.

Well - defined confluence of the relatively
blurred mottling towards the hilus, assuming a
wedge-shaped
form the point of which
is directed towards the
hilus.

Hilus ganglia especially in advanced cases
small and often invisible.

Hilus ganglia mostly
enlarged and definitely
recognisable.

Streaks running from
the nodes towards the
diaphragm.

Absence of striation
running from the shadow foci to the diaphragm.

Upward
movement
and peaking of the diaphragm.

Copious
flake-like
adhérences with the diaphragm.

Shrinkage of the thorax and lungs mostly
bilateral and of slight
extent.

When present, unilateral and often extensive shrinkage.

Formation of cavities
only at an advanced

Often formation of
cavities at an already
early stage.

Asymmetrical.

(RBIOHMANN. Handbuch der Gesamten Unfallheilkunde. Enke, Stuttgart, 1933. Vol. II. Berufskrankheiten. V. " Schwere Silikose ", C. Klin. Teil. P. 202, table.)
GREAT BRITAIN
Stages of

Silicosis

Silicosis is divided into three stages by workers on the subject in
this country.
The first stage is characterised by :
(a) The appearance of the earliest detectable physical signs of the
disease : poor expansion ; a somewhat hyper-resonant percussion note ;
prolonged expiration, coarse râles and rhonchi on auscultation.

— Ill —
(b) Radiographic films presenting large root areas, in which there
are nodular shadows, and a generalised enlargement of the trunk shadows
and pulmonary reticulum — more marked at the base than at the apex.
The diaphragm is not altered at this stage, although on screening it
may be noted t h a t the medial area is restricted in movement on deep
inspiration. This may be due to the enlarged roots and the thickened
trunks.
There may or may not be impairment of capacity for work. The
patient usually only complains of shortness of breath and a slight cough.
The second stage is characterised by :
(a) Further development of the physical signs found in the first
stage : very poor expansion at apices and bases particularly, clubbing
of fingers, hyper-resonance, weakened breath sounds or broncho-vesicular
breathing, and numerous râles and rhonchi.
(b) Radiographic films showing an increase of the area of the
nodular shadows, with a tendency to confluence of the individual nodules.
Typically small rounded areas, varying in size from a pinhead to a pea,
are scattered throughout the lungs, more marked on the right side t h a n
on the left to begin with, and more dense round the root areas. The
diaphragmatic excursion is lessened, but irregularities of the contour
and peaking are not noted ; these belong to the third stage. The hilar
and trunk shadows at this stage do not necessarily show a further
increase in size. As the lymph stream is diverted from the roots, the
dust cells cease to accumulate further there. The snowstorm-like picture
presented at this stage is typical, and is not likely to be confused with
anything else, except miliary tuberculosis and possibly broncho-pneumonic
tuberculosis. The clinical examination readily differentiates the condition.
At this stage the patient is to some degree, but not totally,
incapacitated for work.
The third stage it is almost unnecessary to define. I t implies a
total incapacity for work. There are present marked cyanosis, clubbing
of fingers, well-marked dyspnoea, and evidences of extensive dullness,
of cavity formation and of pleurisy.
Radiograms of cases in the third stage are of three types :
(1) In the first there are large irregular masses due to coalescence
of the pseudo-tubercles. I t may be difficult to say whether a patient
is in the second or third stage — in deciding the diaphragm should be
looked at.
(2) In the second there are more or less diffuse masses, in which
nodules may be seen. The picture may be indistinguishable from t h a t
presented by a case of chronic ulcerative phthisis. There may be
associated a diffuse snowstorm-like effect.
(3) In the third, very dense masses of consolidation are noted,
often symmetrical. These are more strikingly brought out by the
associated emphysema.
In all types at this stage, fibrotic thickening of the normal
arborisation is seen, and dense bands may extend in various directions,
particularly towards the base. They may be connected to the diaphragm.
The diaphragm is always altered in contour. There may be peaking.
As the condition progresses, marked retraction of the organs occurs.
Briefly, the three stages radiographically are these :
(1) Large hilar shadows and trunk shadows. No nodules.

—

112

—

(2) N o d u l e s p r e s e n t , b u t d i s c r e t e . N o d e f o r m i t y or a l t e r a t i o n of
diaphragm.
(3) Coalesced n o d u l e s a n d a l t e r e d d i a p h r a g m a t i c c o n t o u r s .
It is not right to give a definite opinion
or a decision
regarding
silicosis without a good
radiogram.
T u b e r c u l o s i s does n o t u s u a l l y d e v e l o p i n t h e first s t a g e .
When
i t does, i t is u s u a l l y a c u t e , a n d m i l i a r y or b r o n c h o - p n e u m o n i c i n
c h a r a c t e r . T u b e r c u l o s i s s h o u l d b e s u s p e c t e d i n t h e second s t a g e if
t h e r e is a s u d d e n o n s e t of t o x a e m i a , loss of w e i g h t , i r r e g u l a r i t y of
t e m p e r a t u r e , a n o r e x i a , n i g h t s w e a t s , e t c . T u b e r c u l o s i s is v e r y c o m m o n l y
p r e s e n t in t h e t h i r d s t a g e . T h e s p u t u m is f r e q u e n t l y l a d e n w i t h t u b e r c l e
bacilli.
the

A s a g e n e r a l r u l e , i n t h e r a d i o g r a p h y of silicosis one s h o u l d :
(1) N e v e r d i a g n o s e definitely unless fine m o t t l i n g is seen.
(2) A l w a y s give r a p i d e x p o s u r e s — m o v e m e n t of t h e h e a r t m a y
blur the picture.
(3) R e m e m b e r t h a t a silicosis case is c h a r a c t e r i s t i c a l l y dyspnoeic ;
h e c a n n o t t a k e a d e e p b r e a t h a n d h o l d i t for a n y l e n g t h of t i m e . T h e
b r e a t h s h o u l d b e h e l d a t a p o i n t s h o r t of d e e p i n s p i r a t i o n d u r i n g t h e
t a k i n g of t h e r a d i o g r a m .
. (4) A l w a y s i n t e r p r e t w h a t is p r e s e n t on t h e film i n t h e l i g h t of
o n e ' s k n o w l e d g e of t h e a n a t o m y , p h y s i o l o g y , a n d p a t h o l o g y of t h e
l u n g s . A n y t h i n g a b n o r m a l s h o u l d b e c o n s i d e r e d i n t e r m s of p a t h o l o g y ,
a n d deductions should be m a d e on a pathological basis.
Superimposed
t u b e r c u l o s i s m a y give d o u b t f u l r a d i o g r a m s .

Silicosis

and

Tuberculosis

N o t o n l y does silicosis f a v o u r t h e d e v e l o p m e n t of t u b e r c u l o s i s ;
t u b e r c u l o u s infection a c c e n t u a t e s t h e p r o d u c t i o n of silicosis.
M a v r o g o r d a t o considers t h a t m a s s i v e a r e a s p r e s e n t e d o n r a d i o g r a m s
in t h e t h i r d s t a g e a l w a y s i n d i c a t e s u p e r i m p o s e d t u b e r c u l o u s infection.
F o c i of t u b e r c u l o s i s f o r m b e t w e e n c o n g l o m e r a t e d m a s s e s of p s e u d o t u b e r c l e s . Alveolitis a n d fibrosis follow, a n d a d e n s e m a s s r e s u l t s , i n
w h i c h t h e silicotic n o d u l e s a r e i n c o r p o r a t e d .
S e v e r a l o t h e r i n t e r e s t i n g facts a r e n o t e d i n t h e c o m b i n a t i o n of
t h e s e t w o diseases — t u b e r c u l o s i s a n d silicosis :
(1) T h e t u b e r c u l o s i s u s u a l l y is r e l a t i v e l y n o n - t o x i c , m u c h less t o x i c
t h a n t h e e x t e n t of t h e d u l l n e s s w o u l d l e a d o n e t o e x p e c t .
(2) T u b e r c u l o s i s i n t h e p r e s e n c e of silicosis seems t o b e less
infective t o o t h e r s ; t h e d e a t h - r a t e f r o m t u b e r c u l o s i s of t h e families
of s u c h w o r k e r s is r e l a t i v e l y low.
(3) I n first a n d second s t a g e s of silicosis, a c u t e t u b e r c u l o u s
conditions are commonly m e t w i t h : tuberculous pneumonia a n d
broncho-pneumonia, and miliary tuberculosis.
(4) I n a d v a n c e d silicosis c h r o n i c t u b e r c u l o u s c o n d i t i o n s o c c u r :
v e r y r a r e l y are a c u t e lesions seen. T h e w i d e s p r e a d fibrosis m a y l i m i t
t h e s p r e a d of t h e c o n d i t i o n .
(CROCKET, James " The Physical and Radiological Examination of the Lungs ". Pp. 223-227.
2nd Ed., 296 pp. H. K. Lewis and Co., Ltd., London, 1931.)

— 113 —
UNITED STATES OF AMERICA
Correlation between the Histopathological Anatomy
and Radiological Findings in Silicosis
A Committee composed of Dr. Pancoast, Dr. Pendergrass, Dr.
Riddell, Dr. Lanza, Dr. Sayers, Dr. McConnel, Dr. Sampson and Dr.
Gardner drew up on 18 November 1934 a table containing, in one column,
the radiological changes found in silicosis and in the opposite column
the corresponding pathological lesions.

RADIOLOGICAL FINDINGS

HISTOLOGICAL FINDINGS

Healthy Lungs and Adnexa
1. Healthy lungs as defined b y
the National Tuberculosis
Association Committee's report 1 .

1. Essentially the normal tissues
of the vascular tree, the mediastinum, the bronchi and trachea.

2. Irregular exaggeration of the
linear-markings with possibly some
beading confined to the trunks.

2. Cellular
connective
tissue
proliferation about lymphatic trunks
in the walls of vessels and bronchi.
Beading may be due to various
causes, such as blood vessels seen end
on, arteriosclerosis, minute areas
of fibrosis in lymphoid tissues
along the trunks.
3. Cellular reaction in the tracheobronchial lymph nodes with extensions along
afferent lymphatic
trunks.

3. Increased root shadow.

These changes come within normal variations when not accompanied
by recognised organic disease.

Simple
4. Nodulation. Discrete shadows
not exceeding 6 mm. in diameter,
tending to uniformity in size, density
and bilateral distribution, with welldefined borders surrounded by apparently normal lung shadows. The
outer and lower lung fields characteristically show fewer nodules.

1

Silicosis
4. Circumscribed
nodules
of
hyaline fibrosis located in the parenchyma of the lung. Occasionally
some of these nodules may show
microscopic foci of central necrosis.

Cf. PANCOAST, B A E T J E R , DUNHAM. "Studies on Pulmonary Tubercu-

losis. n . The Healthy Adult Chest". The American Review of Tuberculosis,
1927, Vol. XV, p p . 429-471. Baltimore.

— 114 —
5. Conglomerate shadows that
appear to result from a combination
or consolidation of nodules, usually
with associated emphysema manifested by :
(a) localised increased transparency of the lung with loss
of fine detail ;
(b) intensification of the trunk
shadows by contrast ;
(c) depression of the domes with
possible tendency towards
individualisation of the costal
components
of the diaphragm ;
(d) lateral view :
increase in
the preaortic and retrocardiac
space with exaggerated backward bowing of the spine.
Widening of the spaces between the ribs may or may
not be present.

5. The result of coalescence of
discrete nodules ; an area in which
the nodules are closely packed and
most of the intervening lung is
replaced by more or less hyaline
fibrous tissue. The lung architecture
is partially obscured. No demonstrable
evidence
of
infection.
Emphysema is a compensatory
dilatation of the air spaces with
or without thickening of the septa.

Silicosis with

Infection

The characteristic appearances described under simple silicosis are
modified by infection as follows :
6. Localised discrete densities
and or string-like shadows accompanying those of simple silicosis
described above.
7. Mottling. Shadows varying in
size with ill-defined borders and
lacking uniformity in density and
distribution, accompanying simple
silicosis.
8. Soft nodulation. The nodular
shadows above described under simple silicosis (4) have now assumed
fuzzy borders and or irregularities
in distribution. The change may,
or may not, accompany the simple
mottling of 7.
9. Massive shadows of homogeneous density not of pleural origin
symmetrically or asymmetrically
distributed.

6. Strands of fibrous tissue often
along trunks and septa, with or
without areas of calcification indicative of " healed " infection.
7. (a) Areas of broncho-pneumonia with or without caseation, i.e.
acute infection.
(b) Lobular areas of proliferative
reaction with or without caseation ;
chronic infection.
8. Perinodular cellular reaction
either exudative or proliferative in
character.

9. Extensive areas of fibrosis
probably due to organised pneumonia of tuberculous or non-tuberculous origin, superimposed upon
a co-existing silicotic process. Outlines of normal structures may be
partially destroyed.

(American Public Health Association Year-Book, 1935-36. New York, 1936, pp. 66-67.)

Appendix V
SILICOSIS

STATISTICS

GERMANY
1. — Silicosis Statistics from 1929 (Date of the Inscription of this Disease
in the Schedule of Occupational Diseases) up to 1934 inclusive
Sequelae of the disease
Cases notified
Year

1929
1930
1931
1932
1933
1934
1935

Cases compensated
for the first time

PercentPerof all
Abso- centage Abso- age
lute occupnl.
lute
of all
diseases
number occupnl. number compendiseases
sated
14,482
6,101
3,076
1,904
1,509
1,268
1,601

65.06
41.06
31.77
28.54
21.16
16.54
17.83

1,209
2,280
1,397
1,079
681
522
627

61.40
70.05
61.01
61.94
54.13
50.05
54.01

Percentage
of all
occupnl.
diseases
notified
8.35
37.01
45.42
56.67
45.13
41.17
39.16

Total
disablement

Fatal cases

Partial
disablement

Abso- Per- Abso- Perlute
lute centage
num- centage
num- of
of
cases
cases
ber
ber

303
474
267
201
143
126
146

25.06
20.79
19.11
18.63
21.00
24.14
23.28

94
190
79
70
49
44
62

7.78
8.33
5.66
6.49
7.19
8.43
9.89

Abso- Perlute
num- centage
ber of cases

812
1,616
1,051
808
489
352
419

67.16
70.88
75.23
74.88
71.81
67.43
66.83

(Amtliehe Nachrichten für Reichsversicherung. Heft 12, 1930, and following.)

2. — Ruhr

Miners

RESULTS OF THE EXAMINATION OF MINERS CARRIED OUT BETWEEN
1927 AND 1935
Duration of work on rock-cutting

1-5 years

Total number of
workers examined : 10,867
No silicosis
Slight silicosis
Average silicosis
Serious silicosis

6-10 years

%
3,662
2,793
823
46
0

= 100
= 76.3
= 22.5
=
1.2
=
0

10-15 years

%

%
2,171
1,020
1,054
89
8

= 100
= 47
= 48.5
=
4.1
=
0.4

15-40 years
(with an average
of 20)

2,126
644
1,278
184
20

= 100
= 80.2
= 60.1
=
8.7
=
1.0

%
2,908
452
1.760
579
117

= 100
= 15.6
= 60.5
19.9
=
4.0

— 116 —
At the end of 1933 the workers employed in the Ruhr district
amounted to 217,000 men, of whom 11,500 were chiefly engaged in
rock cutting.
From 1930 t o 1933 in the mining district (Oberbergamtsbezirk) of
Dortmund more t h a n 2,400 miners died of serious silicosis.
During the same period 4.4 million marks were paid to t h e
dependants of these workers and further, from 1 J a n u a r y 1934 benefits
were paid t o over 2,100 workers suffering from serious silicosis, as well
as about 2,500 widows and 1,100 orphans.
In all, payments for silicosis amounted from 1930 to 1933 to
17.4 million marks and in 1934 t h e total paid in benefits amounted
to 5.3 million m a r k s 1 .

GREAT BRITAIN
1. — Compensated Cases
The total number of cases in which compensation Was paid under
the schemes has gone on increasing since 1930 as shown by the
following table :
SILICOSIS CASES COMPENSATED Ï B O M 1 9 3 0 TO 1 9 3 4

Year

1930
1931
1932
1933
1934

Number of

Amount
of compensation
in £ stg.

662
889
1,084
1,399
1,560

53,235
83,628
93,777
109,286
122,198

Since the Act came into force t h e total number of cases has
amounted to 4,620 and t h e sum paid in compensation to £ 457,025.
The following table shows t h e number of cases of silicosis and the
amount of compensation paid under the respective schemes in force
in t h e various industries covered by the Act.

1

SCHULTE, G., and H U S T E N , K . : Röntgenatlas der

kungen der Ruhrbergleute. Verlag Thieme, Leipzig, 1936.

Staublungenerkran-

— 117 —

COMPENSATED CASES CLASSIFIED BY INDUSTRY FROM 1 9 3 0 TO

1930
Disablement
Number
of cases
Contd. New

1931
Fatal cases

Cost
in
£ stg.

1934

Number
of
cases

Disablement
Number
of cases

Cost
In
£ stg.

Contd.

New

Fatal cases

Cost
in
£ stg.

Number
of
cases

Cost
in
£ stg.

Refractories Industries . . . .
Sandstone Industries
. . . .
( China and Earthenware InMetal
dustry . . .
Grinding
Industries
Industries • Metal
Coal-mining Inand Various
dustry . . .
Industries
Builders, etc. .
i. Miscellaneous .

247
3

22
69

12,105
2,281

12
13

1,552
3,300

256
56

11
82

12,132
5,228

14
21

1,496
5,580

36
20

98
15

8,008
2,270

34
13

12,284
8,062

107
25

91
15

22,940
1,987

37
19

8,830
6,534

11
1
4

22
7
17

2,198
361
1,058

8
1
9

2,417
303
2,036

18
6
11

43
13
28

3,942
2 049
2,763

17
4
15

5,003
1,146
3,998

Total . . .

322

250

28,281

90

24,954

4,79

283

51,041

127

32,587

1932

1933

Disablei nent
Number
of cases
Contd. New
Befractories Industries

. . . .

China and Earthenware InMetal
dustry . . .
Grinding
Metal Industries
Industries - Coal-mining Industry . . .
and Various
Builders, etc. .
Industries
V Miscellaneous .
Total. . . .

Disablement

Fatal cases

Cost
in
£stg.

Number
of
cases

Cost
In
£stg.

Number
of cases

Fatal cases

Contd.

New.

Cost
in
£stg.

Number
of
cases

Cost
in
£stg.

247
110

11
78

11,235
9,118

10
23

1,369
4,528

257
166

13
76

12,134
10,620

6
29

1,911
6,699

122
26

98
13

22,524
2,621

30
13

5,869
8 769

142
30

99
16

15,415
2,384

31
13

7,300
3,988

54
18
30

75
32
37

8,953
4,504
3,704

30
10
17

8,661
1,818
5,104

103
49
50

126
45
73

16,451
7,113
5,701

28
17
30

7,142
4,787
7,591

607

344

62,659

133

31,118

797

448

69,868

154

39,418

1934
Disablement
Number
of cases

( China and Earthenware Industry . . .
Metal
Industries
Metal Grinding Industries and \ arlous Indust riesCoal-mining Industry . . .
Builders, etc. .
1, Miscellaneous .
.
To tal

Fat!ú cases

Cost Number
in
of
£ stg.
cases

Cost
In
£ stg

Cont.

New

257
216

24
68

12,921
13,284

6
25

1,887
5,034

180

67

18,806

24

4,797

35
192
72
55

16
155
39
46

3,363
26,899
7,923
6.700

8
38
14
23

2,156
9,855
3,205
6,368

1,007

415

89,896

138

32,302

(HOME OFFICE : Worhmen's Compensation : Statistics of Compensation and Proceedings under the Workmen's
Compensation Acts and the Employers' Liability Act, ISSO. H. M. Stationery Offlee, Xondon. 1930 et seq.)

— 118 —

2. — Deaths from
Industry

Silicosis
1930

Sandblasting
10
Steel dressing and cleaning
of castings
1
Flint and pebble crushing
1
Refractories industries . . .
11
Scouring powders and abrasive soaps
Enamel maker
35
Metal grinding
Glaziers' diamond setter. .
Sandstone quarrying and
17
dressing
35
Sandstone masons
. . . .
1
Gravediggers . . ,
Tunnel
mining
works)
2
Granite quarrying and dress1
ing
Slate quarrying and dressing
24
Slate dressing with sand . .
10
Gold mining (South Africa)
2
Tin mining
Lead mining
Copper mining
Iron ore (haematite) raining
Barytes mining
Fluorspar niining
41
Mining engineers
53
Diamond mine manager . .
1
Coal mining
Fireclay niining
Pottery, mfr. of
. . . .
247
Leather dressing
1
Metallurgist
MISDIEION : The Lancet, 4 July 1936, p. 2.
Total . . . .

(England
1931

and Wales)

1932

17

1933

10

4
1
19

1
2
5

1

3

37

31

21

25
48

13
44

29
75

1
2
28
18
4
2
10
1
1
2

5
1
16
28
6
1
7

1
4
7

3
3
18
17
1
6
1

50

76

57

63

74
1
53

308

329

1
330

1

— 119 —

3.
Coal

Various '

Mines.

Certificates issued b y the Medical Board for silicosis and silicosis
with tuberculosis during t h e period 1 June 1931 to 31 December 1935.

Mines

Total

Pottery

Number of
wage-earners
on 14 December 1935

Number of certi Acates
issued for
Suspension
Total
disablement

Death

531,694
139,228
84,238

22
147

66
512
3

35
198
4

755,160

169

581

237

Industry.

Fatal cases (silicosis with or without tuberculosis) during the five
years 1930 to 1934.

Occupations exposing workers to dust of

Numbers
employed

Flint
Sanitary ware (body)
. . . .
General earthenware (body)

1,015
736
3,688
1,178
975
947
608

Tiles (body)

1

Deaths in
5 years

44
25
107
17
12
11
1

MTDDELTON, The Lancet, 4 J u l y 1936, p p . 7-8.

Annual mortality
rates per 1,000
employed

8.66
6.78
4.17
2.89
2.46
2.32
0.33

—

120

—

UNION OF SOUTH AFRICA
1.

—

Original Awards made by the Board during the Period 1 August
1919 to 31 March 1936, classified according to the Various Stages
of Silicosis and Tuberculosis,
differentiating
in respect of Miners
between those born in South Africa and those born elsewhere.

Miners

Anteprimary
silicosis

Primary
silicosis

Secondary
silicosis or
Tuberculosilicosis
sis without
with
silicosis
tuberculosis

Special
awards.
silicosis

Periods

S.A.

O.

S.A.

O.

S.A.

O.

210 206
229 99
8
116
7
165
3
135
3
5
213
199 14
3
251
8
158
4
121 10
3
108
1
93
2
81
5
66
3
54
62 384
2,909 2,323
62

482
166
43
19
12
11
9
33
11
9
10
2
7
1
4
8
832
5

10
8
5
10
18
19
13
11
6
5
8
9
4
2
7
7
144
7

59
21
19
15
9
22
14
11
11
8
9
4
3
5
8
8
229
3

26
15
22
14
11
11
37
36
29
30
30
28
20
17
24
16
26

22
23
14
6
10

S.A.

1.8.19-31.3.20"
1.4.20-31.3.21
1:4.21-31.3.22
1.4.22-31.3.23
1.4.23-31.3.24
1.4.24-31.3.25
1.4.25-31.3.26
1.4.26-31.3.27
1.4.27-31.3.28
1.4.28-31.3.29
1.4.29-31.3.30
1.4.30-31.3.31
1.4.31-31.3.32
1.4.32-31.3.33
1.4.33-81.3.34
1.4.34-31.3.35
1.4.35-31.3.36
Total . . .

126
140
110
147
120
245
275
288
216
181
217
140
154
148
134
121
147

O.

392

10
13
13
10
7
11
9
.8
4
6
7
173

S.A.

—

O.

—

— —

Dependants
of deceased
non-beneficiary miners

Silicosis
with
or
without
tuberculosis
9
6
8
6
7
10
15
58
59
38
35
37
27
21
28
35
440
41

Total
Tuberculosis

1
2
2
3
1
1

1,150
707
345
389
320
534
578
718
607
410
428
335
310
271
268
269
302

15

7,841

1
3
1

S.A. = South African born.
O. = Born elsewhere.
1

UNION OF SOUTH AFKIOA. DEPARTMENT OF MINES : (Report of the Miners' Phthisis Board
tor the Period 1 April 1935 to 31 March 1936, p. 43.)
' Figures for period of eight months.

— 121 —
2. — Awards and Expenditure,

1 August 1919 to 31 March 1936
Expenditure under awards
(other than one-sum awards)
Monthly
Instalments,
all Acts

Period

Ante-

Primary
silicosis

BiliCOsiS

Tuberculosis

Monthly allowances.
1919 and 1925 Acts

Beneficiary
miners,
Miners and
Dependants
dependants secondary of deceased
silicosis
of deceased
miners
or silicosis
miners
with
tuberculosis

£

1.8.19-31.3.20
1.4.20-31.3.21
1.4.21-31.3.22
1.4.22-31.3.23
1.4.23-31.3.24
1.4.24-31.3.25
1.4.25-31.3.26
1.4.26-31.3.27
1.4.27-31.3.28
1.4.28-31.3.29
1.4.29-31.3.30
1.4.30-31.3.31
1.4.31-31.3.32
1.4.32-31.3.33
1.4.33-31.3.34
1.4.34-31.3.35
1.4.35-31.3.36

£
127,378
155,462
100,751
131,008
102,137
176,306
179,901
204,100
142,595
116,241
124,363
87,372
93,622
78,822
69,974
55,307
64,813

£
410,828
190,105
37,267
27,469
23,455
37,441
49,734
78,010
62,897
61,543
45,521
36,437
40,869
38,845
42,394
43,689
29,514

24,133
21,544
18,939
11,453
10,547
5,155
23,740
25 671
19,692
21,240
20,495
18,419
17,281
11,595
14,929
9,990
6,412

£
93,517
72,086
38,759
23,952
16,136
12,847
258,446
170,055
103,456
81,120
70,597
56,626
33,639
25,362
16,529
15,486
14,057

£
147,586
215,978
206,999
201,117
206,293
213 938
236,846
267,822
292,039
306,108
310,364
802,418
294,795
295,988
313,998
333,314
325,338

£
74,861
127,474
128,970
127,607
127,047
259,484
196,852
212,880
225,206
233,432
234,087
232,221
235,901
234,275
236,778
240,578
247,847

Total £

1,999,652

1,256,018

281,325

1,102,670

4,470,941

8,375,500

(UNION OF SOUTH AFRICA.

DEPARTMENT] OF MINES : Report of the Miners' Phthisis

Board

tor the Period April 1935 to 31 March 1936, p . 41.)

3. — Total Monetary Benefits paid under the Acts up to 31 March 1936
Dependants of
deceased miners

Miners
In receipt
of
allowance?

Less than £1,250
£1,250 to £1,499 .
£1,500 to £1,999 .
£2,000 to £2,499 .
£2,500 to £2,999 .
£3,000 to £3,499 .
£3,500 to £3,999 .
£4,000 to £4,499 .
£4,500 and over
Total in £ stg..
Maximum amount pa id iri
each class (£ stg.)
(UNION OF SOUTH AFRICA.

In receipt

Payment«
of
ceased allowances

Payments
ceased

Total

675
178
208
249
165
88
66
48
17
1,694

565
64
73
31
20
7

1,046
482
693
546
307
129
58
21

1,048
274
292
104
34
9
6

760

3,282

1,767

3,334
998
1,266
930
526
233
130
69
17
7,503

4,760

3,305

4,471

3,849

4,760

DEFARTMENT OF MINES : Report of the Miners' Phthisis

lor the Period 1 April 1935 to 31 March 1936. p . 17.)

Board

— 122 —

4. — Cost of

Compensation

The income and expenditure of the Miners' Phthisis Compensation
Fund from 1 April 1933 to 31 March 1934 was as follows.

Income

Expenditure
£

Employers' contributions
Interest
Fines
Other revenue . . .
Transfer from Outstanding Liabilities
Fund

Total

800,000
93,073
279
4,978
66,193

964,523

£
Awards granted under
previous legislation
Awards granted under
Act No. 40 of 1919
Awards granted under
Act No. 35 of 1925
Medical treatment and
funeral expenses . .
Interest
Other expenditure . .
Transfer to " Trade
and Industries F u n d "
Total . . .

219
147,737
544,866
5,076
989
9,020
16,000
723,907

(INTEBNATIONAL LABODB OFFICE : International Survey of Social Services, 1933. Studies
and Reports, Series M, No. 13. Geneva, 1936. Vol. I, p. 612.)

UNITED STATES OF AMERICA
For United States (Wisconsin) see p p . 98-99.

Appendix VI
I N D U S T R I E S AND PROCESSES INVOLVING
E X P O S U R E TO SILICOSIS

The most important industries and processes exposing workers
to silicosis may be enumerated as follows 1 :
Uses of Silica

Types of Silica used

Stone industries

Getting and rough working :
quarrying, cutting, sculpture, paving
blocks, manufacture of grindstones,
etc. (granite, sandstone, flint, alabaster, slate, marble, diatomaceous
earths, tripoli, etc.).
Preparation of artificial products,
for
instance,
sandlime
bricks
involving use of moderately pure
sharp angular sand preferably finer
than 20 mesh, together with a
small percentage of finely pulverised
silica.

Mining :

Coal.
Metal (gold, tin, copper,
etc.).

Construction of tunnels, mine
galleries and underground workings
I n the pottery industry :
As an ingredient of bodies and
glazes
Making of silica firebricks and
other refractories

As a lining for acid towers
Manufacture of ordinary glass
Manufacture of fused quartz
(chemical apparatus such as tubes,
crucibles and dishes)
Cements :
Silicate, mica, sericite and talc
industries.
1

iron,

Flint, tripoli, and chert, amorphous silica preferred, also all other
categories of very pure silica all
finely ground.
Fairly pure quartz known as
ganister (containing a t least not
less than 97 per cent, of SiO, nor
more than 0.40 per cent, of alkalis.
Tightly interlocking grains desired.
Massive quartz or quartzite.
Pure quartz sand.
Very pure massive quartz preferred.

The data in this table are taken from the following article : N E W

YORK STATE DEPARTMENT OF LABOR : Industrial

Bulletin

Silicosis ", b y A. Ross Smith, 1933, Vol. 12, pp. 32-33.

" Review of

— 124 —
Uses of Silica
Abrasives :
I n scouring and polishing soaps
and powders
In sand paper
In sand blasting
Products used for :
Metal buffing, burnishing and
polishing
For sawing and polishing of
marble, granite, etc.
As whetstones, grindstones (buhrstones, pulpstones, oilstones)
Tube-mill lining
Tube-mill grinding pebbles
Lithographers' graining sand
In toothpowders and paste
Wood polishing and finishing
Metallurgical uses :
In making silicon,
and silicon alloys

ferro-silicon

As a flux in smelting basic ores
Foundry-mould wash
Foundry parting- sand
Chemical industries :
As a filtering medium

In the manufacture of sodium
silicate
I n the manufacture of carborundum
Paint :
As an inert spreader
Mineral fillers

Types of Silica used
Quartz, quartzite, flint, chert,
sandstone, sand, tripoli and diatomaceous earth : all in finely ground
state.
Quartz, quartzite, flint, sandstone and sand :
Quartz, quartzite, sandstone and
sand, crushed into sharp angular
grains uniform in size.
Ground tripoli and other forms
of ground silica.
Sharp, clean sand graded into
various sizes.
Massive sandstone from very fine
to moderately coarse grained,
Chert, flint, quartzite in dense,
solid blocks.
Rounded flint pebbles.
Medium to fine sand or rather
coarsely ground silica and tripoli.
Various forms of pure silica
finely ground.
All forms of silica ground to
medium fineness.
Moderately pure sand, massive
crystalline quartz, sandstone, quartzite or chert.
Massive quartz and quartzite.
Ground sandstone, quartz and
tripoli.
Fine sand and ground tripoli.
Massive and finely ground diatomaceous earth and tripoli, sand ;
finely granulated quartz or quartzite,
finely ground tripoli and other forms
of silica.
Finely pulverised quartz sand,
pure tripoli and diatomaceous earth.
Pure quartz sand.
Finely ground crystalline quartz,
quartzite and flint ; also finely
ground sandstone, sand and tripoli.
Finely ground crystalline quartz,
quartzite, flint, tripoli and other
types of ground silica.

— 125 —
I n fertilisers and insecticides
As a filler in rubber, hard rubber,
pressed and moulded goods, phonograph records, etc.
In road asphalt surfacing mixtures
Decorative materials :
In the manufacture of gems,
crystal balls, table tops, vases,
statues, etc.
Insulating materials :
Heat insulation for pipes, boilers,
furnaces, kilns, etc.
Sound insulation in walls, between
floors, etc.
Optical materials :
Optical quartz for the manufacture of lenses and accessories
for optical instruments

As above.
Finely ground silica of all types.
As above.
Rock crystal, amethyst, rose
quartz, citrine, quartz, smoky
quartz, Chrysoprase, agate, chalcedony, opal, onyx, sardonyx, jasper,
etc.
Massive and ground diatomaceous
earth.
As above.
Clear, colourless, flawless rock
crystal or massive crystallised
quartz.

Appendix VII
PNEUMOCONIOSES

LEGISLATION

The following table simply contains a list of the compensation
enactments in force relative to pneumoconioses, taken from documents
in the possession of the International Labour Office at the end of 1937.
The second column shows diseases enumerated in the text of the
schedules appended to the Acts or in the text of the Acts themselves.
Where an explicit definition of silicosis or of tuberculosis accompanying
it is provided in the Act, this is indicated in a footnote.
Where a system of blanket coverage is in force which may include
silicosis, the relative information will be found in the appendices.
The information contained in the fourth column includes no
reference to amendments to the principal Act unless such amendments
involve any change in the definition of the disease (column 2) or in
the enumeration of the occupations covered (column 3).

Countries
(1)

Argentine
Republic

Diseases
(2)

Anthracosis.
Pneumoconiosis.
Siderosis.
Tabacosis.

Silicosis
and
other pneumoconioses with or without p u l m o n a r y
tuberculosis provided that silicosis
or pneumoconiosis
is an essential factor in causing the
resultant incapacity or death.
Australia
Commonwealth

Trades, industries
or processes
(3)

Pneumoconiosis.

All
operations
which involve presence of the worker in surroundings
in which solid particles of siliceous
material or industrial dust are liberated, inhalation
of which is a
spécifie cause of
pneumoconioses.
Quarrying
stone-crushing
cutting.

or
or

Legislative

Eeference Nos.

(4)

Series, I.L.O.
(5)

Act No. 9688
relative to liability
for industrial accidents, dated 11
Oct. 1915.
Decree dated 14
Jan. 1916.
Preliminary
Draft Decree dated 22 Nov. 1935.

Act No. 24 relating to compensation to employees
of the Commonwealth for injuries
suffered in course
of their employment, dated 14
August 1930Regulation No.
134 dated 6 Nov.
1930.
Order No. 22
(Gazette 12 Nov.
1931).
Applies to the
territory of the seat
of the Government.

L. S.. 1930,
Austral. 5.

— 127 —

Countries
(1)

Diseases
(2)

Trades, industries
or processes
(3)

Australia (ctd.)
New South
1. The whole State
Wales
Disease contracted by gradual
process other than
a disease caused
by silica dust '.
2. Districtn ol Cumberland, Camden
and
Northumberland
Fibroid phthisis
or silicosis of the
lungs.
Silicosis accompanied by tuberculosis or
any
other disease of
the pulmonary or
respiratory organs
caused by exposure to silica or
other d u s t ' .

3. Broken Bill
Pneumoconiosis
and or tuberculosis.

Workmen employed
in
the
sandstone industry
as
stonemasons,
quarrymen, rockchoppers or sewer
miners.

Legislative
measures
(4)

Reference Nos.
of Legislative
Series, I.L.O.
(5)

Workers' Compensation
Act
1926-1929 (Act No.
36 dated 29 Nov.
1929).

L. S., 1929,
Austral. 9-A.

Act No. 13 to
provide payment
of compensation
for fibroid phthisis
or silicosis of the
lungs dated 19 Nov.
1920.

L. S., 1926,
Austral. 5, Appendix.

Act No. 15 dated
18 March 1926.

L.S., 1926,
Austral. 5.

Act No. 13 dated
20 May 1936.

L.S., 1936,
Austral. 1.

Workmen's (silicosis) compensation scheme in
application of the
above Acts. No. 1
dated 16 Sept.
1927 and subsequent amendments
pub'ished in the
Oazette, 7 June
1929, 14 March
1930, 24 Feb. 1933,
21 and 28 Feb.
1936.
Metalliferous mines at Broken Hill.

Act No. 36 dated
31 Dec. 1920, to
provide payment
of compensation
(metalliferous mines) for pneumoconiosis or tuberculosis.

L.S., 1929,
Austral. 9-C.

Act No. 22 dated
1 March 1927.

L.S., 1929,
Austral. 9-D.

Act No. 36 dated
29 Nov. 1929.

L.S., 1929,
Austral. 9-A.

Act No. 43 dated
23 Dec. 1929.

L.S., 1929,
Austral. 9-B.

Act No. 55 dated
28 Dec. 1934.

L.S., 1934,
Austral. 12.

1
By a recent decision of the High Court of Australia, if any worker is incapacitated for work
by inhalation of dusts other than silica dust, he is entitled to claim compensation under the Act and
the onus of proving that tho dust disease which disables the worker was caused by silica
dust rests upon the employer. I.L.O. : Industrial and Labour Information, 20 May 1935, p. 242.
' See Scheme of 1927, Article 3.

128

Countries
(1)

Australia (cid.)
Victoria

Queensland

Western
Australia

Diseases
(2)

Trades, industries
or processes
(3)

legislative
measures

Miners' phthisis
defined as fibrosis
of the lungs caused
by inhalation of
dust and including
such a condition
accompanied
by
tuberculosis
but
not including
tuberculosis 1 only.

Mining or dry
crushing or rock
crushing about any
mine only when :
- (a) two or more
miners are employed below surface ;
( b) where metalliferous
mining
(other than alluvial mining) is
being carried on
at a depth of not
less than 20 feet
from the surface.

Act No. 4438,
for relief of persons suflerins from
miners' phthisis,
dated 21 Dec. 1936
(not yet proclaimed 1 Jan. 1937).«

Silicosis of the
lungs.
Miners' phthisis.
Pneumoconiosis.
Pulmonary tuberculosis.
Bakers' phthisis.
Millers' phthisis.
1. Svecial Act
Silicosis.
Tuberculosis. "

Mining or quarrying or stonecrushing or cutting

Acts dated 19161923.

2. General Act
Pneumoconiosis.
Miners' phthisis.

Tasmania

Silicosis.
Pneumoconiosis.
Fibrosis ".

<«

Eeference Nos.
of Legislative
Series, I.L.O.
(5)

L.S., 1936,
Austral. 6.

Act dated 5 Nov.
1925.

L.S., 1925,
Austral. 5, Appendix.

Act No. XXXVII
dated 30 Dec. 1932
respecting the relief of mineworkers.
Act No. XXXIV
dated 27 Dec. 1933.
Act No. XLI
dated 4 Jan. 1935.

L.S., 1932,
Austral. 6.

Baking.
Hour-milling.
Mines

Mining or quarrying or stonecrushing or cutting.

Article 2 of the
Act defines as follows the operations covered :
The term " mining operations "
means:
(1) disturbing,
removing, carting,
carrying, silting,
smelting, refining,
crushing or otherwise dealing with
or trading in rock,
stone, quartz, clay,
sand, soil, ore or
minerals by any
mode or method
whatsoever for the
purpose of obtaining metal or mineral therefrom ;

L.S.,
Austral.
L.S.,
Austral.

1933,
5.
1935,
2.

Act No. 69 dated
21 Dec. 1912.

L.S., 1935,
Austral. 2, Appendix.
L.S., 1925,
Act No. XL of
Austral. 2.
1924.
Act No. XXXIV
L.S., 1927,
dated 28 Dec. 1927. Austral. 10.
L.S., 1935,
Act No. XXXV
dated 4 Jan. 1935. Austral. 1.
L.S., 1929,
Act No. 52,
known as the Work- Austral. 2.
ers' (Occupational
Diseases)
Belief
Fund Act 1928,
assented to 15
Jan. 1929, for
the establishment
of a relief fund in
connection
with
mining and allied
industries and for
payment of compensation in respect of certain
occupational
diseases.

1
Tuberculosis means tuberculosis of the lungs or of the respiratory organs.
• See Article 5 of the Act of 1932.
* See section 34 a Inserted under the Act No. 47, dated 10 Jan. 1934, for définition of stages
of silicosis.
4
Not yet proclaimed.

129 —

Countries
(1)

Diseases
(2)

Australia (chi.)
Tasmania

Trades, industries
or processes
(3)

Legislative
measures

(2) any process
in connection with
the dealing with,
trading or handling of the above
substances for the
purposes aforesaid;

Act No. 40 dated
16 Dec. 1929 to
amend the above.

(3) dealing with,
trading or handling in connection
with such process
as aforesaid of any
by-products or residues produced by
or arising from
such process ;

(4)j

Act No. 27 dated
8 Dec. 1931.
Act No. 47 dated
10 Jan. 1934.

Reference Nos.
of Legislative
Series, I.L.O.
(5)

L.S., 1934,
Austral, 13-AB-C.

(4) Cutting.dressing, shaping or
working upon any
stone,
granite,
marble or similar
substance ;
(5) Quarrying of
blue metal, freestone or limestone;
(6) The manufacture of cément
— but the term
" mining
operations " does not
include
sluicing,
dredging or any
similar operations,
nor does it include
mining of coal or
shale, or quarrying
or crushing of any
material required
for the construction or maintenance of roads.
Northern
Territory
Austria

Pneumoconiosis.

Pneumoconiosis.
(silicosis) with or
without
pulmonary tuberculosis
where the pneumoconiosis (silicosis)
causes incapacity
for work (or service) or death of a
worker (or employee).

Quarrying
stone-crushing
cutting.

or
or

Ordinance No. 6
dated
13 May
1931.

L.S., 1931,
Austral. 1.

(1) mines and
stone quarries containing quartz including s o r t i n g ,
grinding and collecting of sand ;
(2) manufacture
and manipulating
of glass and porcelain as well as
manufacture
of
refractory products
and abrasives ;
(3) metal work
when substances
containing quartz
are used ;
(4)
Chemical
works
(services)
which
involve
liberation of dust
from
substances
containing quartz.

Federal
Act
No. 107 respecting
social insurance in
industry dated 30
March. 1935.

L.S., 1935,
Aus. 2.

Second Order in
application of the
above. No. 263/35
dated 28 June
1935.

L.S., 1935,
Aus. 6.

9

130

Countries
(1)

Belgium

Bolivia

Brazil

Diseases
(2)

Trades, industries
or processes
(3)

Legislative
measures
(4)

Reference Nos.
of Legislative
Series, I.L.O.
(6)

Pneumoconioses
due to industrial
dusts when such
pneumoconioses
involve death or
permanent, total
or parlial incapacity for work, and
arise out of or in
course of employment,
together
with the direct
sequelae of such
diseases '.

Manufacture of
pottery
tiles ;
manufacture
of
earthenware ; manufacture of china
and of refractory
products.

Act respecting
compensation for
occupational
diseases dated 24
July 1927.
Royal Order dated 10 Sept. 1937.

L.S., 1927,
Bel. 7.

Pneumoconiosis
(mines disease).
Anthracosis.
Siderosis.
Tabacosis.
Pulmonary
sclerosis.
Pulmonary tuberculosis
and
chronic bronchitis.
Diseases due to
the inhalation of
organic or mineral
dust.
Pneumoconiosis.
Tabacosis.

L.S., 1937,
Bel. 3 s .

Act respecting
occupational
diseases dated 18
April 1928. Decree
dated 11 June
1928.

L.S., 1928,
Bol. 1.

Decree No. 3724
on liability concerning industrial
accidents, dated 15
Jan. 1919.

L.S., 1920,
Braz. 1-2.

Decree No.13499
dated 12 March
1919.
Act No. 24637
on liability concerning industrial accidents, dated 10
June 1934.
Bulgaria

Anthracosis.

Miners and foundry workers.
Stove-setters.

Chronic
chitis

bron-

Byssinosis
Chalicosis
Siderosis
Chalicosis,
Siderosis and tuberculosis.

Millers, bakers,
tobacco workers,
wood sawyers and
other wood workers, workers engaged in the manufacture of wool,
buttons, horn, feathers, brushes, saddlery, hats and
furs.
Cottons-spinners
and carders.
Grinders.

L.S., 1924.
Act respecting
social insurance, Bulg. 1.
dated 6 March 1924.
Regulation dated 25 June 1924.
Act dated 28
June 1933 (Art.
13-B).

L.S., 1933,
Bulg. 3.

Administrative
Decree dated 5
Jan. 1935.

L.S., 1935,
Bulg. 1.

Needle grinders,
sculptors, polishers, slakers of lime.

1
A Departmental Ordes will fix the conditions of a medical ordes to be fulnlled by forms
of pneumoconioses in order that they may be considered as occupational diseases entitling
those affected to compensation.
1
Information received when going to press.

— 131 —

Countries
(1)

Diseases
(2)

Trades, industries
or processes
(3)

Legislative
measures
(4)

Chalkosis and
tuberculosisSilicosis or by8s'nosis.

Jax and hemp
workers.

Pneumoconiosis
which shall be
deemed to be :
silicosis ',
siderosls,
lithosis.

Quarrying, cutting,
crushing,
grinding or polishing of stone or
grinding or polishing of metal.
Mining.

The Workmen's
Compensation Act
dated 1918 and
Amendment thereto dated 21 March
1928. Act No 23
assented to 14
April 1937.

Mining,
steel and
foundries.

iron,
metal

The Workmen's
Compensation Act
(Consolidated 1924)
as amended by
the Act dated 7
April 1938.

Quarrying, cutting,
crushing.
grinding or polishing of stone ; or
grinding or polishing of metal.

Workmen's Compensation Act of
Ontario 1927. Ch.
179 as amended by
Act dated 3 April
1928 (Ch. 26 of
the Statutes).

Stone

workers.

Canada
Alberta

Manitoba

Silicosis :

Stone workers'
or grinders' phthisis.

Ontario

Act (Ch. 37 of
the Statutes) dated 2 April 1931.
Silicosis3

Pneumoconiosis.

Saskatchewan

Miners' phthisis.

Stone workers'
or grinders' phthi-

Silicosis '.
Pneumoconiosis.

'For
See
See
4
See

2
3

Mining

Act (Ch. 70 of
the Statute«) dated 18 April 1933.

Quarrying, cutting,
crushing,
grinding or polishing of stone ; or
grinding or polishing of metals.
Mining.

The Workmen's
Compensation (Accident Fund) Act
dated 2 Feb. 1929.
Statute* 19281929, Ch. 73.)

Quarrying, cutting,
crushing,
grinding or polishing of stone, or
grinding or polishing of metals.
Mining.
Quarrying, cutting,
crushing,
grinding or polishing of stone, or
grinding or polishing of metals.

definition of silicosis, see Article 11 of the 1937 Act.
Article 6 of the Act of 7 April 1936 for definition of silicosis and tuberculosis.
Article 4 of the Act of 1933 for definition of silicosis and tuberculosis.
Article 113 of the 1929 Act for definition of silicosis and tuberculosis.

132 —

Countries
(1)

Chile

Diseases
(2)

Trades, industries
or processes
(3)

Diseases caused
by the inhalaUon
of dust ; pneumoconiosis.

Legislative
measures
(4)

Eeference Nos.
of legislative
Series, I.L.O.
(5)

Decree No. 379
dated 18 March
1925.

L.S., 1925
Chile 4.

Eegulat'ons relative to occupational diseases.
Decree dated 21
April 1927.

L.S., 1927,
Chile 2.

Lerislative Decree No. 178 dated
13 May 1931. to
ratify the Labour
Code and repeal
and consolidate the
1925 Act and the
1927 Decree.

L.S., 1931,
Chile 1.

The Kegulations
(Legislative Decree
dated 1931) remain nevertheless
in force.
Cuba

Cxecho»lovakia

Silicosis with or
without
pulmonary tuberculosis
where silicosis is
the cause of incapacity or death.

Pottery
industries, sand (excavating, loading
and selling), pottery and bottle
making, quarries,
cement factories,
work on demolition and excavating (in siliceous
ground), scouring
powders, bricks, artificial marble (manufacture of), marble works : sawing
of, and operations
in the workshop ;
mixing machines
for chemical manures, mines (surface and underground work), mosaic work, stone
work (crushing machines),
navvy's
work, tiles.

Tobacco pneumoconiosis or pulmonary tabacosis.

Handling
manufacture
tobacco.

Serious pneumoconiosis caused by
quartz or iron
dust.
If serious
pneumoconiosis
occurs simultaneously with pulmonary tuberculosis, the tuberculosis is for the purposes of compensation deemed to
be a disease caused
by dust.

(a) Undertakings
for
quarrying,
rough
working
and finishing of
sandstone ;
(b) Chinaware
undertakings ;
(c)
Undertakings for metalgrinding ;
(d) Mining undertakings in which
the work is usually
in hard quartz.

Act
respecting
industrial
accidents, Decree No.
2687 dated 15 Nov.
1933.

L.S., 1933,
Cuba 3.

Legislative Decree No. 596 dated
18 Feb. 1936.

L.S., 1936,
Cuba 1-A.

Decree No. 1049.
dated 22 April
1936.

L.S., 1936,
Cuba 1-B.

Act respecting
compensation for
occupational disease's dated 1 June
1932.

L.S.,
Cz. 1.

and
of

1932,

— 133 —
Reference Nos.
of Legitlative
Serie», I.L.O.
(5)

Diseases
(2)

Trades, industries
or processes
(3)

legislative
measures

Danzig

Serious pneumoconiosis (silicosis).
If serious pneumoconiosis occurs simultaneously with
pulmonary tuberculosis, the tuberculosis is for the
purposes of compensation deemed
to be pneumoconiosis.

((^Undertakings
for
quarrying,
rough working and
finishing of sandstone ;
(b) undertakings
for metal-grinding;
(c)
chinaware
undertakings ;
(d) mining undertakings.

Order to amend
the Federal Insurance Code dated
3 Nov. 1933.
Second Orders
to extend accident
insurance to cover occupational
diseases, dated 3
Nov. 1933.

L.S., 1933,
Danz. 6.

Denmark

Diseases of the
lungs caused by
the inhalation of
stone dust and
dust of mineral
substances.

Manufacture of
scouring powder,
porcelain and pottery
industries,
stone industry, certain branches of
the metal industry.
(grinding,
sandblasting, casting,
scouring), cement
industry, brick and
tile works, millstone industry.

Act No. 183
respecting
insurance against accidents, dated 20
May 1933.

Ii.S., 1933,
Den. 5.

Pulmonary disease which can be
shown by means
of X-ray examination to be due
to the influence of
stone dust ( silicosis).
Increasing dyspnoea in conjunction
with
pulmonary
changes accompanied by the X-ray
picture characteristic of silicosis.
Pulmonary tuberculosis accompanied by pulmonary changes and
an X-ray picture
characteristic
of
silicosis.

Stone dust : dry
boring in mines
and
quarries ;
crushing and working up of minerals and rocks in a
dry
condition ;
grinding with natural or artificial
stone ;
crushing
and mixing in a
dry condition of
materials for glass
manufacture.
Sand blasting.

Act respecting
compensation for
certain occupational diseases, dated
12 April 1935.

L.S.,
l'in. 2.

1935,

Order dated 31
Dec. 1935.

L.S.,
Fin. 3.

1935,

(a J
Serious
pneumoconiosis
(silicosis).
(b) Pneumoconiosis (silicosis) in
conjunction with
pulmonary tuberculosis when the
general
clinical
picture is serious
and
the pneumoconiotic lesions
constitute
the
essential cause of
the active and progressive evolution
of tuberculosis.
(r.) Serious pneumoconiosis due to
asbestos (asbestosis).

Undertakings,
establishments and
services subject to
accident insurance.

Third Order respecting compensation for occupational diseases, dated
16 Dec. 1936.

L.S., 1936,
Ger. 3.

Countries
(1)

•

Finland

Germany

W

— 134 —

Countries
(1)

Great
Britain

Diseases
(2)

Trades, industries
or processes
(3)

Silicosis (that is
to say, " fibrosis
of the lungs due
to silica dust ")
or " fibrosis of the
lungs due to asbestos dust, or
either of these
diseases accompanied by tuberculosis " *. The various
schemes specify as
follows the diseases to be compensated :

Eeference Nos.
of Legislative
Series, I.L.O.
(5)

Legislative
measures
(4)
22

L.S., 1925,
G.B. 3.

Act dated 1 Aug.
1930.

L.S., 1930,
G.B. 7.

Act dated
Dec. 1925.

Compensation
schemes :

Silicosis or silicosis accompanied
by tuberculosis ;

G r i n d i n g of
metals on grindstones composed
of natural or artificial sandstone
and certain incidental
processes
(racing and trueing up of the
grindstones).

No. 343 dated
20 April 1931 (Metal-grinding).

Silicosis or silicosis accompanied
by tuberculosis ;

Processes carried
on at mines, quarries, factories and
workshops at which
refractory material containing not
less than 80 per
cent, total silica
is got or manipulated with a view
to manufacture or
sale, and all processes in the manipulation of such
material and in
the
manufacture
of bricks and other
articles containing
not less than 80
per cent, of silica.

No. 345 dated
11 May 1931 (Refractories
Industries).

Silicosis or silicosis accompanied
by tuberculosis ;

All processes in
or incidental to
getting or manipulation of sandstone containing
not less than 50
per cent, of silica
(free and combined) with a view to
manufacture, sale
or use, at mines
or quarries or on
premises worked in
coniunction with
these with a view
to
manufacture,
sale or use-

No. 346 dated
20 May 1931 (Sandstone Industry).

1
See Article 47 of the 1925 Act and Articles 3 and 4 of the Schemes for the Metal-Grinding
Industry, Various Industries, Sandstone Industry, Refractories Industries.

— 135 —

Countries
(1)

Diseases
(2)

Trades, industries
or processes
(3)

Legislative
measures
W

Silicosis or silicosis accompanied
by tuberculosis.

Mining
and
quarrying of silica
rock ; getting and
manipulation
of
granite (including
any igneous rock ;
all
underground
operations in coalmines and Iron ore
mines (hematite) :
all
underground
operations
and
breaking of ore
above ground in
tin mines ; manipulation and working of silica rock
(sawing, packing,
dressing,
etc.) ;
the working and
manipulation
(breaking, crushing, grinding, sieving, mixing and
packing)
and
handling or moving of silica rock
or other siliceous
products, or any
admixture thereof;
certain
specified
processes in potteries : milling of
flint or crushing
or grinding of silica
rock or dry quartzose sand In the
manufacture
of
china or earthenware ; polishing,
sorting or grinding
on a power-driven
wheel in connection
with
the
grinding of glostware or tile slabbing ; work in
foundries
and
metal works : steel
manufacture :
crushing, grinding
or handling of
silica rock, bricks
or other articles
containing not leas
than 80 per cent.
total silica ; freeing of steel eastings from adherent
sand ; sand blasting of metal or
articles of metal
by means of compressed air with
the use of quartzose sand or crushed silica rock or
flint.

No. 342 dated
30 April
1931
(Various
Industries).
Amendment No.
1155 dated 22 Oct.
1934.
Amendment No.
«9 dated 29 Jan.
1935.

Reference Nos.
of Legislative
Sériée, I.L.O.
(5)

136

Countries
(1)

Hungary

Diseases
(2)

Trades, industries
or processes
(3)

legislative
measures

Asbestosis
or
asbestosis accompanied by tuberculosis '.

Asbestos industry : all processes
involving manipulation of asbestos,
manufacture and
preparation of asbestos textiles and
other articles made
of asbestos. (Abridged text.)

No. 344 dated
30 April 1931 (Asbestos Industry).

Silicosis with or
without
pulmonary tuberculosis,
provided that silicosis is an essential factor in causimi the resultant
incapacity
or
death.

All processes of
extraction and manipulation of sandstone involving exposure of the workers to the action
of dust with a
silica content.
Polishing
and
grinding of metals
on
grindstones composed
of natural or artificial stone with a
silica content.
All
operations
in the manufacture Of china or
earthenware articles involving exposure of workers
to the action of
dust with a silica
content.

Irish Free
Slate

Silicosis or silicosis accompanied
by
tuberculosa.
(See Col. 4.)

la pan

Silicosis and silicosis accompanied
by tuberculosis.

1

Act No. x x n
dated 23 Oct. 1935
embodying in the
legislation
the
Draft Convention
on
Workmen's
Compensation (Occupational Diseases) (Revised) 1934
Ministerial Order dated 30 Dec.
1936.

The Workmen's
Compensation Act
dated 22 March
1934 provides for
(Art. 79) schemes
of
compensation
(similar to those
in force in Great
Britain). So far no
scheme of this kind
has been issued.
Mines.
Factories.

Mines Act No. 45
dated 8 March
1905, amended by
the Act No. 22
dated 2 July 1924,
and later Amendments (miners' relief). Factory Act
No. 46 dated 28
March 1911 (amended by various Imperial Orders.
The
Schedule
common to both
these Acts will be
found in the Ministerial Circular
No. 55 dated 3 Julv
1936.

See Schedule appended to the 1930 Act and Articles 3 and i of the Asbestos Scheme.

— 137 —

Countries
(1)

Diseases
(2)

Silicosis.

Mexico, United' States of

Trades, industries
or processes
(3)

Legislative
measures
(4)

Reference Nos.
of Legislative
Series, I.L.O.
(5)

Quarrying, building and transport
industries.

Act No. 54 respecting first aid to
workers in case of
accident,
dated
1 April 1931, and
Imperial Ordinances No. 276 dated
27 Nov. 1931 and
No. 599 dated 28
Nov. 1935.

L.S., 1931,
Jap. 1-A.
L.S., 1931,
Jap. 2-A.

Tederai Act dated 18 Aug. 1931,
Part VI, § 326.

L.S., 1931,
Mex. 1.

Act No. 56 respecting pensions,
dated 9 Sept. 1926
(Article 33).

L.S., 1926,
N.Z. 4.

Act on Workmen's Compensation, dated 24 June
1931, and Hoyal
Eesolution, dated
11 Jan. 1935.

L.S., 1931,
Nor. 3.

Anthracosis.

Miners (in coal
mines), coalmen,
stokers using coal,
chimney sweeps.

Silicosis.

Miners (mineral
and metalliferous
mines) q u a r r y men, lime burners, cement factory
workers, grinders
and masons, workers in sand pits
and workers employed in chinaware factories.

Tuberculosis.

Miners (when silicosis has been
incurred previously).

Siderosis.

Iron
workers
(file cutters, metal
turners and persons engaged in
handling iron oxide).

Tabacosis.

Workers in the
tobacco industry.

Other lung diseases due to the
inhalation of dust.

New Zealand

MinerB' phthisis
(pneumoconiosis).

Noiway

Silicosis with or
without
pulmonary tuberculosis,
provided that silicosis is an essential factor in causing the resultant
incapacity
or
death.

Í.S., 1935,
Jap. 2-B

Carpenters,
workers employed
in the cotton, wool,
jute, silk, skin and
feather industries ;
workers cleaning
by means of a
blow-pipe ; painters and cleaners
using compressed
air (sprayers).
Miners.

Industries
covered by the Workmen's
Accident
Compensation Act.

— 138

Countries
(1)

Peru

Reference Nos.
of Legislative
Series, I.L.O.
(5)

Diseases
(2)

Trades, industries
or processes
(3)

Legislative
measures
(4)

Pneumoconiosis
(with or without
tuberculosis).

Industrial
undertakings in which
dust is liberated
(silica).

Act No. 7975
respecting compensation for occupational diseases dated 12 Jan. 1935.

L.S., 1935,
Peru 2A.

Decree dated 27
Dec. 1935.

L.S., 1935,
Peru 2B.

Portugal

Injuries due to
the action of dust.

Mining industry,
cement factories,
glass polishing, industries in which
dust
containing
silica, silicates or
tobacco is liberated.

Act No. 1942
dated 27 July 1936.

L.S., 1936,
for. 2.

Rumania

Silicosis with or
without
pulmonary tuberculosis
provided that silicosis is an essential
factor in causing
resultant Incapacity or death.

Industries
or
processes in which
silica is worked
or employed.

Act to unify the
social
insurance
system dated 7
April 1933. Decision No 20349 of
the Ministry ot Labour respecting occupational diseases,
dated 13 June 1935.

L.S., 1933,
Rum. 3.

Spain

Pneumoconiosis
(silicosis with or
without tuberculosis, anthracosis
and other respiratory diseases due
to dust).

Any industry or
process involving
exposure to risk
of silicosis. Coal
industry and sterling of coal. Any
industry or process
involving exposure
to the risk of a
disease caused by
mineral, metallic,
vegetable or animal dust.

Act respecting
occupational diseases, dated 13 July
1936.

L.S., 1936,
Sp. 2.

Sweden

Pulmonary disease which can be
shown by means
of an X-ray examination to be due
to the influence of
stone dust (silicosis) ;
increasing
dyspnoea or obstinate catarrh of the
respiratory passages in conjunction
with
pulmonary
changes accompanied by X-ray picture characteristic
of silicosis : pulmonary tuberculosis accompanied by
pulmonary changes
and an X-ray picture characteristic
of silicosis.

Stone dust : dry
boring in mines
and
quarries ;
crushing and working up of minerals
and rocks in a dry
condition ; grinding with natural
or artificial stone ;
crushing and mixing in a dry condition of materials
for glass manufacture.

Act No. 131 respecting insurance
against certain occupational diseases,
dated 14 June
1929, amended by
the Act No. 335,
dated 12 Sept.
1930. Royal Notification No. 398,
dated 7 Nov. 1930.
amended by Royal
Notification dated
13 M a r c h 1 9 3 1 .
(Act No. 384 dated
26 June 1936.)

L.S., 1929,
Swe. 1.

Switzerland

Specific occupational forms of
pneumoconiosis '
(occurring exclusively in covered
industries).

Manufacture of
china.
Sand blasting.

L.S., 1930,
Swe. 4.
L.S., 1930,
Swe. 4-B.
L.S., 1931,
Swe. 2.
L.S., 1936,
Swe. 6.

Tederai Act respecting
sickness
and accident insurance, dated 13
June 1911, and
later Amendments.

1
Voluntary compensation is accorded in virtue of the decision of the governing body of the
Swiss National Accident Insurance Fund, dated Mny 1932.

— 139 —
Heference Nos.
of Leaùlative
Series, I.L.O.
(5)

Countries
(1)

Diseases
(2)

Trades, industries
or processes
(3)

Legislative
measures
(4)

Union of
South Africa

Silicosis or tuberculosis or both
of these diseases *.

Scheduled mines
and gazetted mines (underground
operations specified in the Act).

Act
No. 35,
dated 27 July 1925.

L.S.. 1925,
S.A. 2.

Act No. 38,
dated 3 June 1930.

L.S., 1930,
SA. 0.

Act
No. 60,
dated 7 June 1934.

L.S., 1934,
S.A. 2.

Act
No. 23,
dated 24 June
1936 (and Government Notices pertaining thereto).

L.S., 1936,
S.A. 1

Order No. 75 on
compensation for
occupational diseases, dated 4 Jan.
1929, with instructions for application appended thereto.

L.S., 1929,
Buss. 8.

U. S. S. R.

Pneumoconiosis
(prolonged
inhalation of considerable
quantities
of dust).

Such operations
as, for instance,
coal miners, oreminers,
persons
employed in the
silicate industry,
grinders and Bharpeners.

United States
of America
Illinois

Blanket
coverage (all diseases
arising out of and
in course of employment),
with
special provisions
relative to diseases
caused by inhalation of silica and
asbestos dusts.

Workmen's Occupational Diseases Law, dated 10
March 1930.

Indiana

Do.

Indiana Workmen's Occupational Diseases Law,
approved 0 March
1937.

Kentucky

New York

North
Carolina

Silicosis.

Silicosis
and
other dust diseases.

Asbest osis.
Silicosis ".

Glass manufacturing
plants,
quarries, sand mines, or in the manufacture, trading
and handling of
Band.

Law on Workmen's Compensation, dated 1916,
Ch. 33.
Statutes of 1934,
Section 4880 '.

Operations enumerated in Section
3, paragraph 2,
of the Workmen's
CompensationLaw.

Workmen's Compensation
Law
amended by Chapter 887 of the Laws
of 1936 (6 June
1936).

The employment
subject to the hazards of asbestosis
and or silicosis
to be determined
by the Industrial
Commission.

States Compensation Law, Chapter 120 of the
Public Laws of
1929,
Section
50 Vi (26 March
1935).

1
See Article 76 of the 1925 Act.
• Insurance is elective.
* See paragraph K of the Law of 1935.

— 140 —

Trades, industries
or processes
(3)

Diseases
(2)

Countries
(1)

Ohio

Silicosis (silicosis
shall
mean
a
disease
of
the
lungs caused by
breathing
silica
dust (silicon dioxide)
producing
fibrous
nodules,
distributed through
the
lungs
and
demonstrated by
X-ray examination
or by autopsy).

Washington

Diseases
specified.

West

Virginia

not

Eeference Nos.
of Legislative
Series, I.L.O.
(5)

Act of 1937 to
amend
section
1465-68 A of the
General
Code,
pertaining to the
Workmen' Compensation Law.

Any
industry
Workmen's
where intense dust Compensation for
Occupational Disprevails.
eases, Ch. 212,
approved by the
Governor,
18
March 1937.
Without specifying processes affected ».

Silicosis '.

Legislative
measures
(4)

Ch. 79 of the
1935 Laws (Law
of silicosis, dated
8 March 1935) to
amend Article VI,
Ch. 23 of the 1931
Code.

1
See Article 5 of the Law of 1935.
• Insurance is elective.

ADDEND

UM

(1)

(2)

(3)

(4)

Canada
British
Columbia

Uncomplicated silicosis or silicosis
complicated with
tuberculosis.
(Silicosis means a
flbrotic condition
of the lungs caused by dust containing silica and
evidenced by specific X-ray appearances accompanied by a substantially lessened
capacity for work).

Metalliferous mining industry (underground
work
in any mine ; ore
or rock crushing
except where wet ;
excluding employment in or about
a coal or other
mine not involving
exposure to dust
containing silica 1 ).

An Act to amend
the
Workmen's
Compensation Act.
Assented to 20
Nov. 1936. Now
incorporated
in
Workmen's Compensation, llevised
S t a t u t e s , 1936,
Chap. 312, sections 2 and 8.

1

Abridged text.

(5)

INDEX
Brush manufacture : Bulgaria 130.
Building trade : Japan 137.

A
Abrasives : Austria 129.
Accident associations : Germany 69,
81.
Administration of compensation :
Germany 81 ; Great Britain 60 ;
Union of South Africa 29.
ALBERTA : 131.

Anthracosis : Argentine Republic 126 ;
Bolivia 130 ; Bulgaria 130 ; Mexico
.137 ; Spain 138.
Appeal, Medical Board of : see under
Medical.
Argentine Republic : 126.
Asbestos : Great Britain 45, 136 ;
Germany 133 ; Illinois 139 ; Indiana
139.
Asbestosis : Germany 133 ; Great
Britain 45, 134 ; North Carolina 139.
AUSTRALIA : Commonwealth 126 ; see

also under each separate State.
AUSTRIA : 129.

B

130.

Blanket coverage : 91.
and asbestosis : Illinois
139, Indiana 139.
and silicosis :
Illinois
139, Indiana 139.
Blowpipe : Mexico 137.
Blue metal : see under Quarrying.
BOLIVIA : 130.

Bottle-making : Cuba 132.
BRAZIL : 130.

Bricks : Cuba 132.
, Silica : Great Britain 46, 134,
135.
Brick and tile works : Denmark 133.
BRITISH COLUMBIA : Addendum 140.

Broken Hill : 127.
Bronchitis, Chronic :
Bulgaria 130.

c
CAMDEN : 127.

CANADA : 131 ; see also under each
separate Province.
Carpenters : Mexico 137.
Cement : Cuba 132 ; Denmark 133 ;
Mexico 137 ; Portugal 138 ; Tasmania 129.
Certification of the disease : Germany,
see under Disease, notification of;
Great Britain and Union of South
Africa, see under Disease, Certification of.
Chalicosis : Bulgaria 130.
Chemical manures : Cuba 132.
Chemical works : Austria 129.
Chert : Great Britain 47.
CHILE : 132.

Bakers : Bulgaria 130 ; Queensland
128.
Benefit : see under Transitional.
Benefits : Germany 74 ; Great Britain
54 ; Union of South Africa 22.
, Death : see under Death.
BELGIUM : 108,

BULGARIA : 130.

Buttons : Bulgaria 130.
Byssinosis : Bulgaria 130.

Bolivia

130 ;

Chimney sweeps : Mexico 137.
China : Belgium 130 ; Czechoslovalda
132 ; Danzig 133 ; Great Britain
135 ; Hungary 136 ; Mexico 137 ;
Sweden 138.
Clay : Tasmania 128.
Cleaners using compressed air (sprayers) : Mexico 137.
Coal : Great Britain 47, 135 ; Mexico
137; Spain 138; see also under
Mines.
Commission for investigation : Union
of South Africa 39.
Company administering the Fund :
Great Britain 61.
Compensation, Administration of :
Germany 81 ; Great Britain 60 ;
Union of South Africa 29,
, Claim for : Germany 69 ; Great
Britain 51 ; Union of South
Africa 17 (footnote), 18.
, Cost of : see under Statistics.
Fund (General) : Great Britain
61.
——•
(Miners' Phthisis) : Union
of South Africa 30.

— 142 —
Compensation (Minimum duration of
employment required) : Great
Britain 49 ; Union of South
Africa 15.
, Procedure in respect of : Germany 69 ; Great Britain, see
under certification
of the
Disease.
—•—, Retrospective effect of : Germany 68 ; Great Britain 49
(footnote).
, Right to : Germany 67 ; Great
Britain 48 ; Union of South
Africa 14 ; Wisconsin 92.
: Time limit for presenting claim:
Great Britain 49 ; Union
of South Africa 15.
Compressed air : see under Cleaners.
Conditions of liability : Wisconsin 92,
——• —— Residence :
Union of
South Africa 15.
Contravention : see under Fines.
Contributions : Germany, see under
Financial resources ; Great Britain,
see under Subscriptions ; Union
of South Africa 30, 31, 34.
Convention,
International
Draft
(Revised) 1934 : Text of inscription
relative to silicosis : 7.
Cost : see under Compensation.
Cotton : Bulgaria 130; Mexico 137.
Covering of the general occupational
hazard : see under Blanket coverage.
Crushing : see under Minerals and
Bocks, Stone.
CUBA :

132.

Cumberland : 127.
CZECHOSLOVAKIA :

132.

Date of outbreak
under Disease.

of

DANZIG :

disease : see

Disease, Notification of : Germany 69 ;
Great Britain 54 ; Union of South
Africa 17.
Disputes, Procedure for settling : Germany 80 ; Great Britain 58 ; Union
of South Africa 28.
Draft Convention (Revised) of 1934 —
Text in respect of silicosis : see
under Convention.
Dry-boring : Finland 133 ; Sweden
138.
Dust : Czechoslovakia 132 ; Peru 138 ;
U.S.S.R. 139.
, Asbestos : Great Britain 134 ;
Illinois 139.
, Pulmonary diseases due to
action or inhalation of unspecified : New South Wales 127
Chile 132 ; Denmark 133
Mexico 137 ; New York 139
Portugal 138.
, Industrial : Argentine Republic
126.
, Intense : Washington 140.
, Iron : Czechoslovakia 132.
, Mineral : Bolivia 130 ; Denmark
133.
——, Organic : Bolivia 130.
, Prevention of : Union of South
Africa 39.
, Quartz : Czechoslovakia 132.
——, Silica : New South Wales 127 ;
Great Britain 134 ; Hungary
136 ; Illinois 139 ; Ohio 140 ;
Peru 138.
, Stone : Denmark 133 ; Finland
133 ; Sweden 138.
Duties : see under Employees, Employers, Obligations of.

133.

Death : Union of South Africa 24.
benefits : Germany 78.
, Payment in case of : Great
Britain 56.
Demolition work : Cuba 132.
DENMARK :

133.

Dependants : Germany 78 ;
Great
Britain 56 ; Union of South Africa
24.
Disablement : Great Britain 54.
, Total : Great Britain 48, 53,
54, 56.
Disease, Certification of : Great Britain 51 ; Union of South Africa
17.
•——, Date of outbreak of : Germany
69 (footnote), 74 (footnote) ;
Great Britam 49.

Earthenware : Belgium 130 ; Great
Britain 47, 135 ; Hungary 136.
Electrical : Great Britain 47.
Employers, Obligations of : Germany
69, 86 ; Great Britain 64 ; Union
of South Africa 37, 38, 42.
, Liability of : see under Liability.
Employees, Obligations of : Great
Britain 49 ; Union of South Africa
16, 40, 41.
Enquiry : Germany 72.
Examination of claim : Germany 72.
Excavating : Cuba 132.
Expenses : see under Funeral, Medical,
Transfer,
Travelling.

— 143 —
F
Feather industry : Mexico 137.
Feathers, Manufacture of : Bulgaria
130.
Federal Insurance Code : Germany 67,
69, 82 (footnote).
Office : Germany 69, 70
(footnote), 81, 83, 85.
Fibrotic condition of the lungs :
British Columbia Addendum 140.
Fibrosis : Tasmania 128.
of the lungs : Victoria 128,
Great Britain 134.
Financial liability : see under Liability.
Financial resources : Germany 83 ;
Great Britain, see under Subscriptions ; Union of South Africa, see
under Contributions.
Fines : Germany 69, 86 ; Great Britain 65 ; Union of South Africa 39.
(additional subscription) : Great
Britain 63.
FINLAND :

133.

Flax (work) : Bulgaria 130.
Flint : Great Britain 47, 135.
Flour milling : Queensland 128 ; see
also under Millers.
Form for compensation claim : Union
of South Africa 17-18 (footnote).
for medical certificates : Great
Britain 52, 53 ; Union of
South Africa 19-21, 42 (footnote).
, Notification of disease : Germany 70.
Foundries : Great Britain 47, 135 ;
Manitoba 131.
Foundry workers : Bulgaria 130.
Freestone : see under Quarrying.
Fund : see under Compensation, Gazetted Mines, Medical
Expenses,
Miners' Phthisis Special, Outstanding Liabilities, Trades and Industries, Sickness.
Funeral expenses : Germany 79 ;
Great Britain 57 ; Union of South
Africa 18 (footnote), 27.
Furs, Manufacture of : Bulgaria 130.
G

67,

110,

GREAT BRITAIN : 45,

115,

110,

116,

H
H a t manufacture : Bulgaria 130.
Hematite : Great Britain 47, 135.
Hemp workers : Bulgaria 130.
Horn : Bulgaria 130.
HUNGARY :

136.

I
ILLINOIS :

139.

Incapacity, Total earning : Germany
76.
——, Partial earning : Germany 76.
——• for work : Germany 76 ; Great
Britain 55.
INDIANA :

139.

Industries and processes involving
exposure to silicosis : 123.
Insured workers : Germany 67 ; Great
Britain 46-48 ; Union of South
Africa 12, 14.
IRISH F R E E STATE :

136.

Iron dust : Czechoslovakia 132.
ore : Great Britain 47.
oxide : Mexico 137.
mines : see under Mines.
workers : Mexico 137.

J
136.

Joint Committee : Great Britain 59.
Joint Medical Board : see under
Medical.
Jute : Mexico 137.

133.

Glass : Austria 129 ; Finland 133 ;
Sweden 138 ; Kentucky 139.
polishing : Portugal 138.

106,

134.
Grinders : Bulgaria 130 ; Mexico 137 ;
U.S.S.R. 139.
, Needle : Bulgaria 130.
Grinding : Finland 133 ; Sweden
138 ; see also under Metal-grinding.
Grindstone, Racing and truing up
of : Great Britain 46, 134.
Gritstone : Great Britain 47 (footnote).

JAPAN :

Ganister : Great Britain 47 (footnote).
Gazetted Mines Fund : Union of South
Africa 33.
General occupational risk (covering
of) : see under Blanket coverage.
GERMANY :

Glass bottles : see under Bottle-making.
Glostware, Grinding of : Great Britain 47, 135.
Granite : Great Britain 47, 135 ;
Tasmania 129.

K
KENTUCKY :

139.

— 144 —

Legislation, Scope of : Germany 67 ;
Great Britain 46 ; Union of South
Africa 11, see under Pneumoconiosis
Legislation p. 126.
Length of employment : see under
Compensation, Minimum
duration
of employment.
Liability : Germany 81, 84 ; Great
Britain 60.
, Civil : Germany 81.
, Collective : Great Britain 61 ;
Union of South Africa 29.
, Distribution of : Germany 82.
, Individual : Great Britain 61.
Fund , Outstanding : see under
Outstanding liabilities.
Lime-burners : Mexico 137.
Lime-slakers : Bulgaria 130.
Limestone : see under Quarrying.
Lithosis : Alberta 131.

M
MANITOBA :

131.

Marble: Cuba 132; Tasmania 129.
Masons : Great Britain 62 (footnote) ;
Mexico 137.
Medical Arrangements Scheme : Great
Britain 63.
Board : Great Britain 63.
, Joint : Union of South
Africa 37.
of Appeal : Union of
South Africa 36.
Bureau : Union of South Africa
36.
certification : Germany 69.
certificates : Great Britain 51 ;
Union of South Africa 18,
39, 40.
examination : Germany 72 ;
Great Britain 64 ; Union of
South Africa 20, 36, note
p p . 40-43.
examiner : Union of South Africa
37, 70 (footnote).
officers : Great
(footexpenses
: GreatBritain
Britain63 57.
—note).Fund : Great Britain 64.
Officer, Chief : Great Britain 63
(footnote).
, Mine : Union of South
Africa 37.
, Regional : Great Britain
51.
practitioners : Great Britain 63.
treatment : Germany 70, 74.
Metal-grinding : Alberta 131, Ontario
131, Saskatchewan 131 ; Czecho-

slovakia 132 ; Denmark 133 ; Danzig
133 ; Great Britain 134 ; Hungary
136.
Metal industry : Denmark 133.
work : Austria 129.
works : Great Britain 47, 135.
Metal-polishing : Alberta 131, Ontario
131, Saskatchewan 131 ; Hungary
136.
MEXICO,

U N I T E D STATES OE :

137.

Millers : Bulgaria 130.
Mill stone industry : Denmark 133.
Miner, Definition of : Union of South
Africa 13 (footnote).
——
•: 29 (footnote).
Miners : Victoria 128 ; Bulgaria 130 ;
Mexico 137 ; New Zealand 137.
, Coal : U.S.S.R. 139.
— , Sewer : New South Wales 127.
Mineral mines : Mexico 137.
Minerals : Tasmania 128 ; Finland
133 ; Sweden 138.
Minerals and rocks : (crushing) :
Sweden 138.
Miners' Phthisis Board : Union of
South Africa 28, 34, 39, 42.
Miners' Phthisis Compensation Fund :
Union of South Africa 30.
Miners' Phthisis Special Fund : South
Africa 34.
Mines : Western Australia 128 ; Austria 129 ; Cuba 132 ; Finland 133 ;
Great Britain 134 ; Japan 136 ;
Sweden 138.
, Coal : Great Britain 47, 135 ;
Mexico 137.
, Gazetted : Union of South
Africa 11, 33, 39 (footnote),
139.
, Gold : Union of South Africa 11.
, Iron ore : Great Britain 47, 135.
, Metalliferous : New
South
Wales 127, Victoria 128 ;
Mexico 137.
, Sand : Kentucky 139.
, Scheduled : Union of South
Africa 11, 21, 32, 39, 139.
, Tin : Great Britain 47, 135.
Mines disease : Bolivia 138.
Mining : Victoria 128, Queensland
128, Western Australia 128 ; Alberta
131, Manitoba 131, Ontario 131,
Saskatchewan 131 ; Great Britain
135.
industry : Portugal 138.
(Metalliferous industry) : British Columbia Addendum 140.
operations : Tasmania 128.
undertakings : Danzig 133.
(presence of hard quartz);
Czechoslovakia 132.

— 145 —
Mining, Gold : Great Britain 118.
Mosaic work : Cuba 132.

N
Native labourer (s) : Union of South
Africa 15, 17 (footnote), 23, 26,
28, 30, 33, 40.
worker (s) : Union of South
Africa 15, 19 (footnote), 37.
Navvy's work : Cuba 132.
N E W SOUTH WALES :
N E W YORK : 139.
N E W ZEALAND : 137.

127.

Non-compliance : See under

Fines.

NORTH CAROLINA : 139.
NORTHERN TERRITORY OF AUSTRALIA : 129.
NORTHUMBERLAND : 127.
NORWAY : 137.

Notification : See under Disease.

O
Obligations : See under

Employers.

OHIO : 140.
ONTARIO : 131.

Ore : Tasmania 128.
—•— crushing : British Columbia Addendum 140.
Miners : U.S.S.R. 139.
Outstanding Liabilities Fund : Union
of South Africa 32.

P
Payments : See under Benefits.
, Redemption of : Great Britain
56.
Pension : See under Transitional.
Persons' covered by compensation
insurance : See under Insured workers.
PERU :

138.

Phthisis, Bakers' : Queensland 128 ;
see also under Bakers.
, Fibroid : New South Wales 127.
, Grinders' : Ontario 131, Saskatchewan 131.
, Millers' : Queensland 128.
Phthisis, Miners' : Victoria 128, Queensland 128, Western Australia 128 ;
Saskatchewan 131 ; New Zealand
137 ; Union of South Africa 14 and
footnote.
, Stoneworkers' : Ontario 131,
Saskatchewan 131.

Pneumoconiosis : Argentine Republic
126; Australia (Commonwealth) 126,
New South Wales 127, Queensland
128, Western Australia 128, Tasmania 128, Northern Territory 129 ;
Austria 129 ; Belgium 130 ; Bolivia
130; Brazil 130; Alberta 131,
Ontario 131, Saskatchewan 131 ;
Chile 132; Germany 133; New Zealand 137 ; Peru 138 ; Spain 138 ;
Switzerland 138; U.S.S.R. 139.
legislation 126.
, Serious : Czechoslovakia 132 ;
Danzig 133 ; Germany 133.
Polishers : Bulgaria 130.
Porcelain : Austria 129 ; Denmark 133.
PORTUGAL :

138.

Pottery industry : Cuba 132 ; Denmark 133 ; Great Britain 135.
Pottery tiles : Belgium 130.
Prevention : Germany 85 ; Great Britain 65 ; Union of South Africa 39 ;
Wisconsin 95.
Processes covered : See under Legislation, Scope of. See also Pneumoconiosis Legislation 126.
Processes excluded : Great Britain 46,
47 ; Tasmania 129; British Columbia
Addendum 140 ; See under Pneumoconiosis Legislation.
Pulmonary tuberculosis : Bolivia 130 ;
see
also
under
Tuberculosis.
sclerosis : Bolivia 130.

Q
Quarries : Cuba 132 ; Finland 133 ;
Great Britain 46, 134 ; Kentucky
139.
, Stone : Austria 129 ; Sweden
138.
Quarrying : Australia
(Commonwealth) 126, Queensland 128, Western Australia 128, Northern Territory 129 ; Great Britain 47 ; Japan
137.
, Blue metal, freestone, limestone:
Tasmania 129.
, Sandstone : Czechoslovakia 132;
Danzig 133.
, Silica rock : Great Britain 47,
135.
, Stone : Alberta 131, Ontario
131, Saskatchewan 131.
Quarrymen : Mexico 137.
, Sandstone : New South Wales
127.
Quartz : Tasmania 128 ; Austria 129 ; "
Great Britain 47 (footnote).
dust : See under Dust.
, Hard : Czechoslovakia 132.

— 146 —
Quartzite : Great Britain 47 (footnote).
Quartzose sand : see under Sand.
QUEENSLAND :

128.

R
Radiographic terminology : Union of
South Africa 100.
technique : Union of South
Africa 105 ; Great Britain 106.
R a t e of silicosis : see under Silicosis.
Redemption of payments : see under
Payments.
Refractories Industries : Great Britain 46, 134.
Refractory material : Great Britain
46, 134.
articles : Great Britain 46, 134.
products : Austria 129 ; Belgium 130.
Regional Medical Officer : see under
Medical.
Retrospective application : see under
Compensation.
Review : Germany 79 ; Great Britain
57 ; Union of South Africa 28.
Rock : Tasmania 128.
choppers : New South Wales
127.
crushing : Victoria 128 ; British
Columbia Addendum 140.
, Igneous : Great Britain 135.
, Silica : Great Britain 135.
Rocks : Finland 133 ; Sweden 138.
Rumania : 138.
S
Saddlery : Bulgaria 130.
Sand : Tasmania 128.
excavating, loading and selling :
Cuba 132.
, Freeing steel castings from :
See under Steel castings.
, Handling of : Kentucky 139.
mines : See under Mines.
pits : Mexico 137.
, Quartzose : Great Britain 47,
135.
, Sorting, grinding and collecting :
Austria 129.
Sandblasting : Finland 133 ; Great
Britain 48, 135 ; Sweden 138.
Sandstone : Czechoslovakia 132 ;
Danzig 133 ; Great Britain 46, 47
(footnote) ; Hungary 136 ; New
South Wales 127.
- SASKATCHEWAN :

131.

Schemes : Great Britain 45, 60, 134.
Scope of legislation : see under Legislation.

Scouring, Metal : Denmark 133.
powders : Cuba 132 ; Denmark
133.
Sculptors : Bulgaria 130.
Sewer miners : see under Miners.
Sickness fund : Germany 71, 75.
Siderosis : Argentine Republic 126 ;
Bolivia 130 ; Bulgaria 130 ; Alberta
131 ; Mexico 137.
Silica : British Columbia Addendum
140 ; Great Britain 46, 134, 135 ;
Hungary 136 ; Portugal 138 ; Rumania 138.
—•—• rock : See under Rock.
Silicate industry : U.S.S.R. 139.
Silicates : Portugal 138.
Siliceous material : Argentine Republic 126.
ground : Cuba 132.
products : Great Britain 47, 135.
Silicosis : Argentine Republic 126 ;
New South Wales 127, Queensland
128, Western Australia 128, Tasmania 128 ; Austria 129 ; Bulgaria
130; Alberta 131, British Columbia Addendum 140, Manitoba 131,
Ontario 131, Saskatchewan 131 ;
Cuba 132 ; Danzig 133 ; Finland
133 ; Germany 67, 133 ; Great
Britain 45, 134 ; Hungary 136 ;
Irish Free State 136 ; Japan 136 ;
Mexico 137 ; Norway 137 ; Rumania
138 ; Spain 138 ; Sweden 138 ;
Union of South Africa 11, 139;
Kentucky, 139, New York 139,
North Carolina 139, Ohio 139,
Western Virginia 139.
, Definition of : Great Britain 48 ;
Germany 68 ; Union of South
Africa 14.
, Incidence of : Wisconsin 97.
, Number of cases : Germany 84.
, Rate of : Union of South Africa
12 (footnote), 31.
——, Stages of : Union of South
Africa 14 ; Belgium 108 , Germany 110 ; Great Britain 110 ;
United States 113.
statistics : see under Statistics.
Silk : Mexico 137.
Skin industry : Mexico 137.
Slakers of lime : Bulgaria 130.
Society National Health Insurance
Act : Great Britain 51.
Soil : Tasmania 128.
SPAIN :

138.

Special authorisation : see under Work.
Sprayers : see under Cleaners.
Statistics: Germany 115; Great Britain 116; Union of South Africa 120;
Wisconsin 98.

— 147 —
Steel : Great Britain 47, 48, 135.
Steel castings (freeing from adherent
sand) : Great Britain 48, 135.
Stokers : Mexico 137.
Stone : Tasmania 128.
cutting : Australia (Commonwealth) 126, Queensland 128,
Western Australia 128, Tasmania 129, Northern Territory 129 ; Alberta 131, Ontario 131, Saskatchewan 131.
crushing : Australia (Commonwealth) 126, Queensland 128,
Western Australia 128, Tasmania 128, Northern Territory 129 ; Alberta 131, Ontario
131, Saskatchewan 131.
dust : See under Dust.
industry : Denmark 133.
masons : New South Wales 127.
work : Cuba 132.
workers : Bulgaria 130.
Stovesetters : Bulgaria 130.
Subscriptions : Germany, see under
Financial Resources ; Great Britain 62 ; Union of South Africa,
see under Contributions.
Substitute for medical inspector :
Germany 55.
S W E D E N : 138.
SWITZERLAND :

u
Undertakings subject to compulsory
insurance : Germany 87 ; Great Britain 46 ; Union of South Africa 11.
UNION OF SOUTH AFRICA : 11,

100,

105, 120, 139.
U.S.S.R. : 139.
UNITED

STATES

OF

AMERICA :

113,

139 ; see also under each separate
State.

138.

V

T

Various Industries : Great Britain 47,
135.

Tabacosis : Argentine Republic 126 >
Bolivia 130 ; Brazil 130 ; Mexico 137TASMANIA :

Wales 127, Victoria 128, Queensland
128, Western Australia 128 ; Austria 129; Bolivia 130; Bulgaria
130 ; British Columbia Addendum
140 ; Cuba 132 ; Czechoslovakia
132 ; Danzig 133 ; Finland 133 ;
Germany 68, Note 2, 88, 133 ;
Great Britain 48, 51 (footnote), 52,
66, 134 ; Hungary 136 ; Irish Free
State 136 ; Japan 136 ; Mexico 137 ;
Norway 137 ; Peru 138 ; Rumania
138 ; Spain 138 ; Sweden 138 ;
Union of South Africa 14, 19 and
footnote, 20 and footnote, 21 and
footnote, 23, 30, 33 and footnote,
36, 39, 40, 101, 110, 112, 119, 120,
121.

128.

Tile slabbing : Great Britain 47, 135.
works : Denmark 133.
Tiles : Cuba 132 ; Great Britain 47.
, Pottery : see under Pottery.
Time limit (for presentation of claim) :
see under Compensation.
Tin mines : Great Britain 47, 135.
Tobacco dust : Portugal 138.
pneumonoconiosis : Cuba 132.
workers : Bulgaria 130.
Trades and Industries Fund : Union
of South Africa 35.
Transfer, Expenses of : Union of
South Africa 27.
Transitional benefit : Germany 78.
Transitional pension : Germany 77.
Transport industries : Japan 137.
Travelling expenses : Union of South
Africa 27.
Tuberculosis : Introduction 7 ; Argentine Republic 126; New South

VICTORIA :

128.

Vocational rehabilitation : Germany
75.
W
WASHINGTON : 140.
WESTERN AUSTRALIA : 128.
WESTERN VIRGINIA : 140.
WISCONSIN : 92.

Woodworkers : Bulgaria 130.
Wool: Bulgaria 130; Mexico 137.
Work, Right to continue : Union of
South Africa 41.
, Special authorisation certificate
for : Union of South Africa 16,
41.
Work, Suspension from : Germany 77.
, Exclusion from : Great Britain
48, 50, 52 ; Union of South
Africa 41.
, Removal from : Union of South
Africa 42.