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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 break ways in whatever mines they secured a new job.

Of

In all 1557 miners were interviewed (2) and given bottles. 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.

I have seen

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. 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.)

Summary.

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

states where the sanitary conditions are bad and where intestinal parasites are known to be common.

C.

The wandering from place to place on the part of a certain class of labor, the data cards of which show that many of the infected individuals had previously worked and lived under sanitary conditions known to be worse than those of Gary, in which former places they were probably infected.

d. While the outside sanitary conditions may be rendered safe by the use, for the most part, of concrete vaults, yet the common practice of the miners of defecating within the mine and not at home has, in a measure, defeated the purpose of the sanitary out houses, so far as the men are concerned. The breakways, and certain other galleries of the mines are constantly being infected by carriers of various parasites. The coal dust containing either the eggs or the larvae of various worms then gain entrance to the intestine by the usual methods.

2. In contrast to this, the data cards show that those whose earlier history reveals that they had been infected with either ascaris or with hookworm, have, since working in offices or where they have been protected from re-infection, ceased to harbor these parasites.

Pageton.

This mining camp is a very interesting one from a sanitary point of view. For the most part the houses are stretched along a shallow creek, with another group of houses nearly at right angles up a hollow. The company has provided nice, neat structures as out houses for each family. These for the most part are open in the back and either project over the edge of the walled-off creek or jut into the hillside. For all purposes of discussion, therefore, it is the surface method of fecal disposal. Owing to the steep slopes of the hollow, the yards and the hillsides are doubtless washed free from undesirable excreta during that season of the year when freshets are common. Then, too, the yards of the main portion of the village along the railroad are gradually being filled in with fresh ashes and fine coke from the ovens. The chief source of menace, therefore, is the open outhouse during the dry, summer months.

A glance at table II will show that eleven nationalities and nine different states of the union are represented. Among the Europeans, the greatest number of men come from Italy, Russia, Greece and AustriaHungary. The Americans are mostly from Virginia and North Carolina.

In all we made 322 interviews and distributed as many sample bottles. Forty were not returned; 272 samples were examined microscopically. The result was that 75 men were found to be infected or 27 per cent. Of the total infection among the men there were 22 cases of ascaris, 4 of hookworm, 3 of tapeworm, 45 of trichocephalus, and one unknown. The discussion regarding the practice of defecating in the breakways and old passage ways applies also to the mines of this place.

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