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during the past ten years has occurred in industries employing large numbers of women where there were practically no appliances for the prevention of fire or proper methods of egress that could be safely used in case of fire.

We must make the obligation to safeguard (and this includes sanitation and industrial hygiene) rest upon the employers and the machinery makers, and not upon the inspectors, who can never be other than occasional skilled visitor, reporter and adviser. Special bulletins of various trade risks, and their practical remedies such as are already sent out by the National Association of Manufacturers, the National Civic Federation and through other agencies, should form a part of our educational task.

Factory accidents have been defined by Mr. John Calder, and assigned to the following causes: Ignorance; carelessness; unsuitable clothing; insufficient lighting; dirty and obstructed work places; neglect of fire precautions; defects of machinery and structures; absence of safeguards and of safe-working supervision.

As an example of the bad results due to lack of proper instruction, the case of an intelligent Swede may be cited, who, because of insufficient instruction in the operation of a No. 211 automatic locker, received an injury which necessitated the severance of four fingers, only one phalanx of the forefinger and the thumb of the right hand being saved. He stated that, with only a limited understanding of the English language, he was taken into the box factory and taught how to operate the automatic locker. After three days with a teacher he was put to work alone. Within an hour afterwards, while taking stock out of the machine, his hand was drawn into the knives and the injuries noted were sustained. Had he been familiar with the operation of the locker and had gained the necessary experience from familiarity and work he would have been able to save himself. A simple movement of his foot, throwing off the power, would have stopped the machine in time to have avoided even a slight injury. The importance of adequate instruction and familiarity with the machinery on which employees work is emphasized by this injury.

The instruction of foremen and the placing of responsibility for accidents in their department upon them means more increased safety than even the installation of safety devices. Add to this the education of the workmen, and the securing of the hearty co-operation of workmen, foremen and superintendents, and the bulk of the work is well on the way to accomplishment. A TEST OF INSURANCE EFFICIENCY. The Board submits in the accompanying table the result of a test of insurance efficiency under the Workmen's Compensation Act with regard to the furnishing of medical attendance and the payment of compensation, all insurance companies being requested to file a report giving this information on all accidents reported during the week beginning Nov. 10, 1913.

This request was mailed on Dec. 11, 1913, and all the companies, with two exceptions, promptly filed their replies. A second request, dated Dec. 30, 1913, failed to bring a report from the dilatory companies, and on Jan. 22, 1914, when the table was finally closed, the returns from the companies referred to were not on file at the office of the Board.

The act requires that compensation be paid injured employees at the end of the twenty-first day after the injury, and the Board has set up as an ideal of insurance efficiency the actual payment of the compensation on the date it became due. The table shows that the average number of days elapsing from the time of the injury to the actual date of the payment of compensation is twenty-five, the greater number being made on time, and the delay in the exceptional cases usually being caused by the failure of the employee to call at the place designated by the company and receive his compensation. This is regarded as a good showing on the part of the insurers.

It will be noted that a larger number of accidents were reported to the Board than to the insurer; that medical services were rendered in 73.2 per cent. of these cases; that free choice of a physician was allowed the injured employees in 29.7 per cent, of the cases in which medical attendance was furnished; that no record of medical expenses was obtainable in 26.8 per cent. of the cases; and that 15.7 per cent. of the accidents reported to insurers incapacitated employees beyond the first two weeks after the injury.

Number of accidents reported to Board,
Number reported to insurers,

1,452 . 1,203

.

.

1 American Mutual Liability Insurance Company and Contractors Mutual Liability Insurance Company.

.

.

Excess reported to Board and not to insurers,
Number of employees incapacitated over two weeks, .
Number of days elapsing before compensation was paid,
Number of cases in which medical services were furnished,
Medical services by employee's doctor,
Medical services by employer's doctor,
Medical services by insurer's doctor,
First-aid services, .
Nature of medical services not specified,
No record of medical services available,
Medical services by hospitals,

249 189

25 881 262 271 228 21 39 322

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.

.

60

CITIES AND COUNTIES UNDER THE ACT. The following is the list of cities and counties which have accepted chapter 807, Acts of 1913, as recorded in the office of the Secretary of State. All laborers, workmen and mechanics employed by these cities and counties, who receive personal injuries arising out of and in the course of their employment, are entitled to the compensation provided under the Workmen's Compensation Act. These cities and towns are not required to insure in order to pay the compensation provided, but agreements in regard to compensation and settlement receipts covering the payments made under the act must be filed with the Board for approval. The Board will have the same supervision over payments made by cities and counties to injured employees as it has over insurance companies transacting business under the statute.

Returns of Votes cast upon the Question of the Acceptance or Rejec

tion of Chapter 807 of the Acts of 1913, being, " An Act to provide for compensating Certain Public Employees for Injuries sustained in the Course of their Employment," submitted to the Voters of the Several Cities at the Municipal Election of 1913.

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Accepted, .
Accepted, .
Accepted, .
Accepted, .
Accepted,
Accepted,
Accepted,
Accepted, .
Accepted, .

4,035

1,280

Dec. 2, 1913,

4,448

1,337

1,964

Lowell,

Dec. 9, 1913,
Dec. 9, 1913,
Dec. 9, 1913,

5,749 8,422 9, 102

3.063

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Lynn,

3,189

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