Illustrative of this broadened scope, a new section on physiology was recently established and staffed in the Division. Its area of study includes pulmonary function, thermal stress, fatigue, physical and mental work capacity, and neurophysiologic responses to noise and vibration. A more thorough and persistent consideration of the psychological component of occupational health problems has also been made possible by recent additions to the staff.

The new direction permitted by these additional resources is reflected in a changing emphasis in the noise studies being conducted by the Division. Long interested in the effects of industrial noise on hearing, the Division is now probing psychologic and neprophysiologie effects. A current project seeks to determine whether learning and performance of a complicated task are adversely affected by noise. Heat stress studies underway are similarly concerned with the effects of heat on worker fatigue and efficiency, as well as on more obvious impairments of health.

In toxicology, a promising area of exploration is opening up with recent work on predictive tests of hypersusceptibility to hemolytic chemicals and drugs. Such tests are based on the detection of inherited deficiencies of specific enzymes. If it is found that susceptibility to other chemicals can similarly be detected, it would have great significance for industry, where approximately 1 million workers are involved in the manufacture of industrial chemicals and several times that number are exposed to chemicals through handling and use.

Emphasis is also being placed on a series of studies to determine early effects of exposure to various chemicals through detection of changes in tissue and blood enzymes, and other substances. These "biochemical profile" studies are part of the Division's continuing research to develop techniques for evaluation of toxicity prior to permanent damage.

The recent strengthening of the Division's statistical competence has permitted expanded studies of occupational morbidity and mortality. Currently, mortality records of workers in the asbestos products industry throughout the country are being examined. This technique will be extended to other industries. both as a means of obtaining quantitative data on the incidence of suspected occupational disease, as well as for detecting unidentified hazards in the working environment.

These actuarial explorations are vital in the face of the lack of adequate reporting of occupational diseases. Of the 50 States, 28 have laws requiring medical reporting of occupational diseases, but only 3 States receive 100 or more reports per year.

The problem of toxic exposures of workers increases each year, as 400 to 500 new chemicals annually find commercial application. In the past 10 years the chemical industry has expanded at a rate almost double that of the total industrial expansion of the country. Over 50 percent of the products now sold by the chemical industry were unknown or not in commercial production just 22 years ago.

The major concern lies not in the plant of the major producers of chemicals, for the industry has set an exemplary record of protection for its workers. The difficulties arise at the point of use, where adequate safeguards are frequently lacking. Concern lies in the widening gap between the new materials being created and an understanding of their effects on living systems. It should become axiomatic that these materials must be as well understood for their biological potentialities as well as for their physical and mechanical properties. Illustrative of the growth of new materials, plastics production has risen from a 1947-49 base of 100 to 284 in 1958. The Division of Occupational Health has helped in plastics development by its studies of the health effects of the epoxy resins and resultant control recommendations. By applying the recommended procedures, numerous industries are now safely using the versatile epoxy resins. The Division's studies have also contributed to more effective safeguards for toluene diisocyanate, used extensively in the plastics industry. Due in part to this research, the American Conference of Governmental Industrial Hygienists has recommended a downward revision of the threshold limit of toluene diisocyanate to 0.02 part per million parts of air.

The use of pesticides, insecticides, and other economic poisons that have tremendously increased agricultural production has similarly been dependent on studies of their toxic effects and the effective use of safeguards. The Division of Occupational Health has worked with the Communicable Disease Center in the support and conduct of toxicologic research and field studies to protect both the workers engaged in the manufacture of these poisons and those involved in their use in agriculture.

In addition to chemical hazards, the industry of the future, with its emphasis on automation, electronic operations, and nuclear energy, can be expected to produce new health problems. We must be alert and informed on new physiologic and psychologic stresses and their effects, as well as on new chemical and physical hazards.

Automation will undoubtedly reduce or eliminate many occupational disease hazards, but at the same time introduce a whole new set of problems. There may be greater exposure to noise in some instances, resulting from greater use of electrical motors and equipment in the factory. More nervous strain may possibly also be expected from the character of automatic operations. The effect of errors is more serious, the responsibility of the maintenance worker is higher, and the machines are more complex. Eye attention is also intensified by the concentration and close work and the focus on control dials, lights, and panels. As the need lessens for physical effort by workers tending automatic machines, a growth of the health problems associated with the sedentary worker may be expected. We may also expect psychological hazards to the worker from isolation, boredom, and even from increased leisure.

A number of developments will be dictated by the changing age characteristic of our labor population. By 1970, the total labor force is estimated to reach 85.7 million. The most dramatic change expected in the 1960's is the sharp rise in the number of workers under 25 years of age, reflecting the high birth rate of the 1940's. Women workers, who now comprise one-third of the labor force, will also increase. The number of women workers 25 years of age and over is expected to rise by 3.6 million.

The increase in each age group will be accompanied by its own set of problems. For example, the younger worker group generally is quite mobile and has a tendency to gravitate to the newer industries. The age and mobility of this group, combined with the long latent period for evidences of ill effects from certain occupational exposures, may well serve to cloak hazards inherent in those newer operations. There is also the problem of educating each new generation of workers to have an awareness and healthy regard for potential hazards and to observe proper precautions.

The changing age distribution in the work force will not reduce, and may well aggravate, the problem the of adjustment and continuing production of the older worker. Division plans call for studies to determine optimal rest-work regimens and compensatory allowances for middle aged and older men doing hard physical work. Aging will also be studied as a factor in altering skills and inability to do physical tasks.

Another factor influencing program development is the growing shortage of trained medical, nursing, and engineering personnel to carry on occupational health activities. The Division is carrying on an intensified program to aid in developing professional resources and to help personnel in the occupational health field keep abreast of new processes and materials used in industry and how they affect the worker's health.

Emphasis in the Division's training programs is on short-term courses not provided elsewhere. Courses range from those covering basic industrial hygiene principles to those that treat highly specialized areas, such as advanced courses in the evaluation and control of heat stress and noise.

In addition, the Division has intensified its program of technical assistance and consultation to State and local agencies that have direct legal responsibilities for worker health protection. During 1962, field consultations and technical services were provided on over 300 different occasions in 50 States, and to various Federal agencies. More than one-third of these services resulted from requests for assistance in the investigation of suspected occupational diseases or hazards to health in industry; the others dealt with administrative and informational aspects of occupational health programs. Consultative assistance provided during the year included evaluation of occupational health conditions at the Goddard Space Flight Center and Wallops Island Test Station. A thorough study of occupational health problems and needs was also conducted at the request of the Governor of one of our States as the basis for an action program. Requests for assistance continue to increase with increasing industrialization.

The fact that management is increasingly obliged to bear all or part of the costs of illness, occupational or nonoccupational, has certain implications. The immediate effect has been to place increased emphasis on the prevention of nonoccupational diseases, since these represented the greatest share of sickkness costs and absenteeism. In response to this need, the Division has strengthened

its demonstration and consultative services to employers, professional personnel, and others interested in the establishment of preventive health programs for employees.

During the years, the Division has built up, and consistently strives to maintain, an excellent rapport and working relationship with the various professional associations, with management and labor groups concerned with occupational health, and with governmental agencies in the field. It enjoyes considerable prestige both for its impressive record of pioneering study and for its objective, impartial service.

The Division's major interdepartmental relations are with the Bureau of mines have been carried out by the Division and the Bureau of Mines. Similarly, the Department of Labor. Numerous cooperative studies of health hazards in mines have been carried out by the Division and the Bureau of Mines. Similarly, because of their related interests, the Division, with its responsibility for the control of occupational health hazards, and the Bureau of Labor Standards, with its concern for the prevention of accidents in industry, have worked together on various projects and have issued joint publications.

Since the establishment of the American Conference of Governmental Industrial Hygienists 25 years ago, the Division has been active in the conference's various projects, including the Threshold Limits Committee. Threshold limit values have now been established for about 300 substances, and, through its toxicologic studies, the Division contributes knowledge toward the establishment of values for new substances and the revision of old limits. Various cooperative projects are also carried out with the other professional organizations in the field.

DIVISION OF RADIOLOGICAL HEALTH

The Division of Radiological Health was established by the Surgeon General on July 1, 1958.

The new Division was assigned the mission of developing a comprehensive radiation health program in the Public Health Service, in collaboration with other related programs of the Department of Health, Education, and Welfare. As a part of this mission, the Division became responsible for strengthening the role of the States and communities in the field of radiological health.

In the development of a comprehensive program in this field, at least three major tasks were undertaken by the Service. There were (and are): (1) A nationwide system of environmental radiation surveillance; (2) a nationwide evaluation of the long-term effects of radiation; (3) development of realistic radiation standards and model regulations for health protection. In support of these objectives, it was necessary that adequate programs of research and technical training be developed, and that the State health departments be helped to develop radiological health capabilities consonant with State needs.

The Division of Radiological Health has made good progress in all phases of its primary mission. Evidence of broad public and official support of the Division's mission and programs is reflected in the year-by-year expansion of funds authorized by the Congress: $634,000 in fiscal year 1959; $2,576,000 in fiscal year 1960; $7,731,000 in fiscal year 1961; $10,627,000 in fiscal year 1962; and $15,875,000 in fiscal year 1963.

In 1959, the role of the Division was enhanced significantly by: the creation of the Federal Radiation Council by Executive order and Public Law 86-373, with a mandate to advise the President and provide guidance to Federal agencies; a Presidential directive that the Department of Health, Education, and Welfare intensify its radiological health efforts and assume primary responsibility within the executive department for collation, analysis, and interpretation of environmental radiation levels; and the delegation by the Secretary of DHEW to the Public Health Service of the principal elements of these efforts and responsibilities.

The following is a description in some detail of the principal activities of the Division since its establishment:

In view of the increasing levels of radioactivity in our environment-resulting primarily from the operation of nuclear reactors and the testing of nuclear devices-surveillance activities have received major emphasis in the Division during the past 4 years. A small experimental milk monitoring system was expanded to a 60-station pasteurized milk monitoring network, operated in cooperation with State and local health departments in milk sanitation agencies. Already in existence when the Division of Radiological Health was established in July of 1958 were an early "alert" atmospheric radiation surveillance network, over which the new Division assumed control; a national water quality network (now

operated by the Division of Water Supply and Pollution Control); and a national air sampling network (now operated by the Division of Air Pollution).

The drinking water analysis program (operated by the Division of Environmental Engineering and Food Protection, which estabilshed it in 1960) collects data on the radioactivity content (among other components) of water supplies used on trains, airplanes, ships, and other conveyances operating in interstate commerce.

In 1960, the Division of Radiological Health initiated an institutional diet sampling program for the purpose of securing an estimate of the total dietary intake of radionuclides by children and teenagers aged 5 to 18 years; 21 boarding schools and institutions are currently providing diet samples for radioanalysis. In conjunction with this program, a contract was negotiated with Consumers Union of U.S.A., Inc., early in 1962, to sample teenage and infant diets in 30 cities for the presence of strontium 90 and other radionuclides.

A radiation intelligence system is being organized which will ultimately provide, on a continuing basis, data on exposure from all sources of ionizing radiation for various population groups in the United States. In accordance with the objectives of this system, a pilot project was conducted in the summer of 1961 in Montgomery County, Md., to evaluate the effectiveness of household interviewing techniques in assessing radiation exposure to the population. Air sampling stations were installed in nine locations in the county. Samples of drinking water from public supplies and private wells were obtained, and information about food intake and X-ray exposure were secured through household interviews. The preliminary findings of this pilot study were sufficiently encouraging to warrant extension of the methodology on a national scale in fiscal year 1963, using the interview system of the Bureau of the Census.

Surveillance activities were greatly expanded and accelerated in fiscal year 1962, largely as a result of the resumption of nuclear weapons tests by the USSR. Beginning in September 1961, the air sampling stations of the radiation surveillance network were expanded from 45 to 66. Stations of the milk monitoring network began taking samples at least once a week, and in areas of high radioactivity, as often as once a day. Sampling schedules of the Division of Air Pollution's national air sampling network and the Division of Water Supply and Pollution Control's national water quality network were also accelerated.

Within a few days after the USSR action, a Radiation Surveillance Center was established within the Division of Radiological Health to function as a central clearinghouse for the receipt, coordination, evaluation, and dissemination of data received from the various surveillance systems operated by the Division and others. The Center provides immediate assessment of significant changes and trends in environmental radioactivity so that monitoring schedules can be adjusted to needs and possible counter-measures to reduce radionuclide-intake determined or initiated if necessary. Since the Center has been in operation, hundreds of reports have been prepared and distributed to Members of Congress, State and territorial health officers, DHEW regional offices, members and consultants of the National Advisory Committee on Radiation, DRH headquarters and field personnel, other Government agencies and officials, the atomic energy industry, scientific groups and trade associations. Interchange of information with the official health departments of other nations is also emphasized.

In addition to the Radiation Surveillance Center, which provides immediate assessment of current environmental levels and continuing trends, the Division's radiological health data and reports section, established in fiscal year 1960. collects and maintains a permanent official record for the Federal Government of information on the sources and levels of radioactivity in the environment, through publication of a technical monthly, "Radiological Health Data." This publication, which was first issued in April 1960, is distributed to health authorities and investigators in the United States and throughout the world.

Finally, the Division provides regular reports on radiation levels to the Nation's press, radio, TV, and magazines, and to interested citizen groups and individuals. Surveillance activities of the Division of Radiological Health are largely dependent upon specialized laboratory support. In the past 3 years, three regional radiological health laboratories have been established-at Las Vegas, Nev.; Montgomery, Ala.; and Winchester, Mass.-to supplement the work being carried out at the Robert A. Taft Sanitary Engineering Center in Cincinnati, Ohio, in (1) environmental sample analysis, (2) technical training, and (3) research in radiochemistry, radiophysics, and radiobiology. In addition, a special-purpose laboratory was opened at Rockville, Md., to develop methods for better control of radiation hazards from medical, dental, and industrial X-ray 32-692-64--11

units and to provide radiological health specialists with the training necessary to perform comprehensive surveys of X-ray units within the States and territories. The Rockville laboratory also processes environmental samples in connection with the operations of the radiation intelligence system and the radiation surveillance network.

In addition to the operation of nationwide environmental monitoring networks, the Division during the 1960-62 period began, or continued participation in, a number of long-term special radiation safety projects, for example, the investigation of river and port environments associated with AEC nuclear reactor operations and the construction and support of maritime and naval nuclear vessels; a special survey of environmental radioactivity in Antarctica; support of offsite nuclear weapons testing; and support of static and launch aerospace nuclear activities.

An environmental sampling program was conducted on the Delaware River during construction of the first nuclear-powered merchant and passenger ship, the NS Savannah. A specially trained PHS medical officer was assigned to serve as adviser and alternate ship's surgeon for the vessel.

A laboratory was established at the Naval air facility, McMurdo Sound, Antarctica, to support an environmental survey prior to and during the operation of the PM-3A nuclear reactor. Assessment is being made of radon, thoron, and long-lived fission product radioactivity in the air, water, snow, biota, rock, and soil, of the Antarctic. The PHS environmental surveillance program in Antarctica was expanded in January 1962 to include the Byrd Station, where a nuclear reactor installation is planned for 1963.

An offsite radiological health program was developed for the Air Force Missile Test Center at Cape Kennedy to determine the long-range environmental effects of the use of radioactive materials at the missile center or the area surrounding the test site; to perform emergency monitoring in connection with the destruction of missiles carrying radioactive material; and to provide consultation and advice on the use of radioactive materials at the missile center.

When atmospheric weapons tests were resumed by the United States in April 1962, the Division began operation of a radiological safety laboratory in Hawaii, an offsite radiation safety program, and a fallout assessment center within headquarters of Joint Task Force 8. Offsite monitoring was continued at the Nevada test site in connection with the underground nuclear tests. Public Health Service surveillance activities in Nevada date from a 1954 reimbursable agreement with the AEC to monitor radioactivity levels in air, water, milk, and foodstuffs associated with nuclear weapons tests, conduct community education and public relations programs, carry out liaison functions with State and local health departments, and maintain a special film badge service.

The Division has provided guidance to health authorities and reactor personnel in nuclear waste-management problems related to the operation of the pressurized water reactor at Shippingport, Pa., and the Consolidated Edison reactor at Indian Point, N.Y.

In accordance with an understanding reached between AEC and DHEW on August 1, 1961, documents pertinent to the licensing of major nuclear facilities are made available to the Public Health Service for review and subsequent consultation with the States, at their request, concerning the potential hazards of environmental contamination.

With the rapid multiplication of sources, applications, and users of radiation, it is imperative that the States assume increasing responsibilities for radiation protection and control. Therefore, particular attention has been placed on providing technical assistance to bolster the radiological health competency at the State and local level. An onsite inventory and evaluation of State radiation control programs conducted by the Division in 1960-61 revealed that although some States had made very good progress, much additional effort was needed to develop comprehensive programs.

A major step was taken to strengthen State radiological health programs with the approval by Congress of a system of matching grants to the States$1,500,000 for the first year, fiscal year 1963.

Technical personnel from the Division are currently assigned as radiological health consultants in each of the Department of Health, Education, and Welfare regional offices. In addition, by the end of fiscal year 1962 the Division had assigned 50 professional staff members to State health departments.

In cooperation with the Council of State Governments and the AEC, considerable progress has been achieved in the preparation and adoption of radiation control enabling acts and regulations. As of June 1962, at least 38 States and