THIRD ANNUAL REPORT UPON THE WORK OF THE STATE INSPECTORS OF HEALTH. BY THE ASSISTANT TO THE SECRETARY OF THE BOARD. Owing to several new legislative provisions, the routine work of the State Inspectors of Health has been considerably modified. When in 1907 the State was divided into fifteen health districts, and one physician was appointed State Inspector of Health in each district, the inspection. of slaughterhouses and provisions did not fall within the province of the inspectors, whose duties at the outset were varied and extensive along three distinct lines of work, namely: (a) watching the incidence of tuberculosis and other communicable diseases, inquiring into their causes, and assisting local health authorities to take the best possible preventive measures for the safety of the public; (b) keeping an eye on all young persons employed in factories, and examining them as to their health; and (c) enforcing, under the direction of the State Board of Health, statutes relative to factory, tenement and school hygiene. In the following year (1908), the State Board of Health and the State Inspectors of Health were specifically charged with certain duties relative. to slaughtering and meat inspection, and in June of the present year the Legislature directed the State Board of Health to investigate the slaughtering of neat cattle, sheep and swine. This investigation occupied the State Inspectors of Health for a period averaging about two months. The report called for by the Legislature is contained in the general report for the State Board of Health, pages 1-5. In the 1908 report mention was made of the difficulty of establishing routine procedures and of classifying the details of the work for certain. purposes, chiefly, perhaps, because of the variety of duties to be performed. Yet, in spite of the interruption caused by the additional statute provisions referred to, the way became clear for the adoption of a scientific schedule consisting of fundamental principles upon which much of the future work relating to factory and occupational hygiene will depend. As to data relating to the health of minors in factories, it was pointed out last year that the discovery of all the minors who had any physical disability was highly improbable, and that it was doubtful whether, without further legislation, the percentage of minors in ill health could be determined with any degree of accuracy. By a recent act of the Legislature the word "minor," as used in all laws relating to the employment of labor, is defined as "a person under eighteen years of age." With this change in legislation, approximately half the number of young persons formerly grouped as minors could no longer be considered such, and it was thought, consequently, that those boys and girls found to be between the ages of fourteen and eighteen years would receive more attention, and that better results would be obtained. While in a measure this proved to be the case, the absence of suitable places for the examination of young persons has proved a serious handicap in the work. Obviously, it is important to gather certain information concerning the health of young persons in factories at their work, and in connection therewith to study the influence of occupation upon health. But without better conveniences for making physical examinations, the work cannot be done properly. Moreover, the examinations of young persons ought to take into account and to record among other things fitness for the particular kind of work done, and ought to be made with sufficient frequency, which in any trade or process should not be less often than once a year, and in some occupations or processes not less often than twice or three times a year. Under existing conditions, however, so thorough a system can be only partially carried out. The principles upon which the study of factory and occupational hygiene is to be based for the immediate future, and the manner of enforcing the existing laws on factory sanitation, may be understood from the following outline: Whenever a State Inspector of Health finds in a factory or workshop in which five or more women or young persons are employed (a) inadequate ventilation, (b) ineffective means for the removal of dust (irritating or poisonous dust, including infective matter), (c) gases, fumes and vapors (irritating, poisonous or offensive), he sends a written notice to the employer in the form of an order for adequate means of ventilation and removal of dust, gases, etc., which order must be complied with within a period of four weeks. Whenever a State Inspector of Health finds that employees in any factory or workshop are not sufficiently protected against dust from emery wheels or belts, or buffing wheels or belts, he issues a written order for such suction pipes and connections as he shall approve. Whenever a State Inspector of Health finds employees in textile factories exposed to (a) impure or foul odors from water used for humid |