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nd so also be able to bring its methods to the attention of somewhat ess progressive companies. (1) At Gary the housing conditions tre good, considerable attention is paid to sewage disposal, and in numerous ways there is evidence of welfare work. All of this, barring he influence of the importation of labor and the migrating of miners from one camp to another, the results of which could not be determined until investigation, would make for a healthful community.
Tables 1 and 2 will show that a wide range of nationalities is represented in good sized groups. Table 1 shows that at least twenty nationalities are represented, along with American white and colored from fifteen different states of the Union. A glance at the densest part of the table will show that the Americans come chiefly from West Virginia, Virginia, and North Carolina, and the foreigners for the most part represent Russian and Austria-Hungarian provinces and Italy.
In regard to Italians, it has been talked not a little in our press that a certain class of them is being introduced into the United States who make very undesirable citizens. This fact was evident while endeavoring to instruct certain classes in some of the rudimentary principles of decent living. Indeed, nothing but police force would seem to appeal to certain families that make proximity, even to the poorer class of colored people, intolerable. Something must be done with this class, for aside from their low moral tone, many of them are infected with various types of intestinal parasites, and their filthy manner of living is such as to endanger the other members of the community.
It will be noted that for the adults, the number of ascaris infections is rather high. The largest number of infections occurs among the men from Italy, Austria-Hungaria, and Virginia. Infections by this parasite is through the mouth; this means that excreta containing the eggs must either have contaminated the hands or the food.
A parasite that is very common in McDowell county is the whipworm, tricocephalus-a parasite for which no certain remedy has been discovered. Nearly one-fourth of the men of this group are infected with this parasite. Out of 1339 men examined, 331 were infected. According to Neveu-Lemaire this parasite develops direct, as does ascaris; hence the infection is chiefly by mouth. The egg is very small and easily carried along with dust into the nasal and buccal cavities. There seems to be no constant relation between the number of infections and the dryness or dustiness of the mines. There is, however, some relation between the number of infections and the number of foreigners in a given mine. The Italian, Hungarian, and Polish nationalities seem to be most highly infected. There is evidence of the parasite being spread, for where the men are working in groups, upon finding one man infected, it was common to find a number of the workers in that particular section of the mine likewise infected. Their custom of defecating in the breakways, abandoned entries, and in some mines even along the main and sub-entries in constant use, is favorable to the spread of this parasite. Many times have I seen men—all unconscious of the harm until told-scratch up the infected coal dust with their bare hands or with their boots (later to be handled), and then, without washing their hands, eat lunch. Naturally, such habits result in a constant and gradually increasing infection.
According to table 1, of the 1339 miners examined, 32 were infected with hookworm. Eleven of these were from Europe, six from West Virginia, nine from Virginia, five from North Carolina, and one from Tennessee. Thus, the number of men infected is not large, nor did the symptoms of those infected simulate those of persons heavily infected. As a rule the number of eggs found in the stools did not exceed thirty per standard slide, and from the cases treated we never secured more than fifty adult worms. Such light infections, while they may and do deprive the men of a perceptible amount of energy, do not render them economically unfit. The chief danger is that resistance to other diseases may be lowered. To the community, however, they may be, as mentioned before, a real source of danger to every other person within it, unless proper disposition is made of the fecal matter.
As proof of how dangerous such stools may become, I collected samples of them from some of these so-called mild infections, mixed them thoroughly with powdered coal, dampened with mine water, and then placed the mixture in flasks kept under proper conditions— conditions similar to those that could exist in the locality where they were found. From these cultures, great numbers of larvae were obtained which had reached the infecting stage. It requires only seven days for the larvae to develop into the infecting stage in damp coal dust during the summer months (the time, of course, may be lengthened or shortened by the lowering or raising of the temperature respectively). Thus these worm-carriers may spread the infection during the summer months. All of this naturally raises the question “Why is the infection not more general within the mines?” This point I will discuss later.
Three individuals were found to be infected with strongyloides, one with anguillula, and two with an undetermined parasite. This latter parasite had an adult and rabditic larval stage outside of the host's body.
Strongyloides deserves special mention, since it has a larval form which resembles hookworm larvae and infects through the skin in the same manner as hookworm. To the miners of West Virginia it is of interest because it develops an infecting stage within the mines. I collected samples of feces from the infected men, mixed the cultures at once inside the mines, using coal dust and mine water as it dripped from the top, and at the end of ten days had heavy cultures of the infecting larvae that were very active. At this date (Dec. 10, 1914), I have live larvae from these cultures which have been living in water inside of sealed tubes. It is obvious that with larvae so resistant as this, the parasite should be controlled at once.
In the preliminary investigation in which samples of feces were collected in the breakways, a larger percentage of the samples collected This may have been due to a duplication of samples from the same individual or to the mine samples having been infected by rodents or possibly by a small fly very commonly found in the mines. Unfortunately, we were for some reason unable to secure samples from men who were responsible for the infection. They were reported to have sought work elsewhere. This means (1) they left the breakways infected, thus exposing to disease those who took their places; (2) they infected new breakways in whatever mines they secured a new job.
In all 1557 miners were interviewed (2) and given bottles. Of these 218 bottles were not returned, and of the 1339 samples collected, 463 were found to be infected with one or more parasites. Some of the miners were infected with four different kinds of worms; and it was very common to find the members of an entire family infected with two different kinds.
Having found the adult male members of the various mines at Gary infected with such a wide range of parasites, it was of interest to know the condition of the children, many of whom show a considerable degree of pallor. Streams fascinate children. Their pollution troubled them no more than it did their parents. I have seen many children playing in the mud and water of the polluted creeks; and it is no uncommon practice for the boys to dam up a portion of the stream and use the hole as a swimming pool. Upon locating a miner infected with hookworm who lived on the stream, we interviewed all the children about that particular house. (3) Part of the children were infected with hookworm, and most of the others either with ascaris or trichocephalus.
We then interviewed over one hundred children. Unfortunately, out of the 119 bottles distributed, only 75 were returned. The children that we most wanted were the ones, as a rule, whose samples could not be obtained. Hence our data are not at all satisfactory. A further study ought to be made to determine what is the chief cause of the frequent pallor observed in children living along the creeks. (See further discussion in connection with table IV.)
1. In spite of the relatively sanitary communities at Gary, there is a relatively large number of individuals infected with intestinal parasites. This high percentage of infection is due primarily to the following factors:
a. The importation of labor from European states where the inhabitants previous to immigration were infected.
b. The introduction of domestic labor from counties in adjoining
(2) A glance at the column headed “Bottles returned" in Table 1 reveals the interesting fact that there is a direct relation between the percentage of bottles returned and the unwillingness of a particular group of miners to co-operate for the community's good.
(3) In the four houses there were two families that had children ; the three