The reduction in diarrheal disease that can be anticipated from providing running water in the home and sanitary waste disposal facilities is shown in the accompanying chart based upon a Public Health Service study in mining communities in eastern Kentucky (1954-56). Since enactment of Public Law 86-121 in 1959, 168 construction projects have been undertaken. In addition, a number of small emergency projects and investigations have been completed. The accompanying table shows the distribution of projects and the number of Indians and Indian families to be served upon completion of all authorized projects. The estimated Federal funds needed to meet the sanitation facility deficits of the Indian beneficiary group are shown on the accompanying bar chart. Projects authorized to date represent 13 percent attainment of the goal. U. S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE PUBLIC HEALTH SERVICE DIVISION OF INDIAN HEALTH SANITATION CONDITIONS AMONG INDIANS The results of surveys conducted between 1956-1962 on 23 reservations Indian participation and contribution toward these projects has been substantial. It has included tribal funds, materials, labor, and services. Last year (fiscal year 1962), the value of Indian contributions toward the program represented about 40 cents for each 60 cents in Federal funds applied to the work. Related environmental health activities Integrated with both the Indian sanitarian aid and sanitation facility construction activities are several functions essential to the total environmental health program. They include: (1) Assistance to tribes in the development and adoption of sanitary codes and ordinances. (2) Participation in investigation of communicable disease outbreaks and institution of corrective environmental control measures. (3) Institutional sanitation activities, such as surveys of physical plant and operations at Bureau of Indian Affairs and Public Health Service schools, hospitals, and other installations; review of plans and consulting services associated with new construction; and conduct of food service training courses. (4) Special studies and technical assistance, such as the design of lowcost "transitional" housing, investigation of Arctic water supply problems, evalution of procedures for control of fish tapeworm in Alaska, and study of disposal of liquid wastes under extraordinary conditions. Looking ahead As further resources are made available, the gross environmental health deficiencies of the Indian and Alaska native people will be corrected. This will have a salutary effect in improving the level of health by reducing the incidence of preventable diseases. It should also serve to motivate the Indian and Alaska native families to assume the responsibilities for improving environmental health conditions in their homes and communities. RELATIONSHIP OF ENVIRONMENTAL FACTORS TO ENTERIC DISEASE ASCARIS AND SHIGELLA INFECTIONS ACCORDING TO SELECTED SANITARY FACILITIES Eastern Kentucky, 1954-1956 Off On Privy Flush Off On Privy Flush Only Toilet Premise Premise Only Toilet The activities of the Division of Occupational Health are directed toward four main objectives: (1) To develop improved techniques, materials, and equipment in the detection and control of occupational disease; (2) to stimulate effective community and industrial efforts toward occupational health services; (3) to assist Federal, State, and local agencies, health practitioners, labor unions, management, and workers in the application of preventive techniques and in the development of preventive services to workers; and (4) to determine the health status of the labor force and the total impact of the working environment on health. These aims are accomplished through laboratory and field studies; demonstrations, consultation, and educational activities; training programs; and grants mechanisms. The U.S. Public Health Service was one of the first groups in this country to undertake research in the field of occupational health. Pioneering studies were made in the mining and steel industries in 1910. Notable also among early studies was an investigation of unsanitary conditions and the high rate of tuberculosis among the workers in the garmentmaking industry, which helped pave the way to the abolishment of the sweatshop. In 1914, recognition of the importance of industrial hygiene in public health led to the establishment of the Office of Industrial Hygiene and Sanitation, the forerunner of the present Division of Occupational Health, which was established on September 1, 1960. Since the inception of the occupational health program in the Public Health Service, thousands of workers have benefited from studies of such problems as chest diseases in the mining, granite, cement, and cotton textile industries; lead poisoning in the pottery, storage battery, and other industries; radium poisoning in the watch industry; pneumonia in the steel industry; lung cancer in the chromate-producing industry; industrial fatigue; illumination; and noise. The Division's study of skin diseases, a leading occupational health problem, has reached into practically every segment of American industry. An outstanding feature of these studies has been the development and application of the epidemiologic approach to occupational diseases. Teams of environmental specialists and physicians study simultaneously the work environment and the health status of workers, relating them in quantitative terms. This approach has become recognized the world over as an indispensable tool in defining and controlling occupational health problems. While great strides have been made in the control of occupational disease in the past half century, the health problems of the Nation at work have increased in number and complexity, proceeding in pace with industrial change. During the early years of public health activity in this area, gross health impairments from massive exposures to a few harmful substances, such as lead, mercury, and quartz, dominated the field. Today we are confronted with myriad and subtle actions and interactions associated with a much more varied and changing work environment. In recent years, scientific advances have opened up new avenues of inquiry, revealing relationships between occupation and health previously unrecognized. Thus, concern today also extends to disturbances which are less dramatic than the rapidly fatal or disabling diseases once so common, but which may subtly take a long-term toll of the health and productivity of a large number of employees. For example, chronic pulmonary diseases, skeletomuscular disorders, unusual responses to infection, and unexpected hypersensitivities are believed to be frequently associated with remediable conditions in the work environment. Diffuse and difficult to personalize, and varying greatly from occupation to occupation, health problems related to work nonetheless involve over 70 million workers. It is conservatively estimated that 400,000 cases of frank occupational disease occur each year, with many more instances of borderline or unrecognized illness. Dominant in this occupational health complex are reactions to toxic chemicals. The problem of predicting hazards and preventing injury to workers is intensified each year by the steady increase of new chemicals as well as new processes. Industry supports essential testing programs, but there is a continuing need for basic research on testing methods, mechanisms of action, and the detection of susceptibility and early toxicity. Physiologic and psychologic stresses on the worker are also creating greater problems, as knowledge of the interrelationships between man, the machine, and the environment fails to keep pace with technologic advances. Man, with his unchanging cell complexes and his fixed organ systems and reaction times, is being forced to cope each year with faster and more demanding mechanisms. Simple morbidity or mortality measurements are far too crude to detect early or subtle effects on the health of exposed workers. Modern occupational health research adds to traditional methods precise physiologic appraisals, biochemical measurements of enzyme activity, and, in some instances, studies of behavioral patterns. Methods have to be tailored to individual problems, based on what has been learned in the laboratory. To keep abreast of modern technology, the Division of Occupational Health has had to strengthen its competence in a variety of biological, physical, and social fields. Through the addition of specialized personnel to the staff in the past couple of years, the Division's studies have achieved new scope and depth. |