atomic weapons. The end of the year also brought to a close two and one-half years of field work on the effects of radioactivity on aquatic life in the Columbia River.

FIELD INVESTIGATIONS

Industrial waste studies were completed in four establishments, each dealing with a different product and different processes. The source, volume, and characteristics of wastes were studied in each plant, as well as the existing methods for treatment, and the possibility of reducing the wastes by new methods was explored. Other field studies were completed on household sewage disposal systems, household detergents, and the bactericidal effectiveness of certain compounds used in waters of different chemical composition.

TRAINING AND SPECIAL SERVICES

Twenty-four training courses were conducted at the Environmental Health Center during 1953, with 357 persons enrolled from 35 States and 4 foreign countries. The number of technical representatives from various industries increased substantially. The specialized training offered by the Center deals with subjects not yet taught in the colleges and universities. For example, one of the new courses offered during the year was an advanced course on radiological health for industrial hygiene personnel. Assistance was given to State agencies in organizing and conducting 28 training courses in sanitation and radiological health. During the year, 24 foreign engineers, physicians, and research scientists spent 125 days at the center for observation, conference, and short courses of instruction. At the request of 24 States, the Center evaluated the laboratory practices of 33 laboratories in the examination of water, milk, and foods.

Water Pollution Control

A disastrous drought during 1953 in the southwestern States has attracted new attention to the Nation's growing problem of water resources. The best evidence of wide-spread concern is that 37 State legislatures considered special legislation related to water use and conservation during their 1953 sessions. At the close of the fiscal year, 24 of these States had enacted laws which ranged in scope from measures for the correction of local conditions to comprehensive provisions for water use, including water pollution control.

Many areas can alleviate the water shortage by the development of new sources of ground water and the provision of additional storage facilities. Basic, long-range solutions, however, must include measures to control pollution of present and future sources so that they may be kept suitable for repeated use. If the Nation's water resources are to

be protected in time to meet the growing needs, the control of pollution from cities and industries must be greatly accelerated.

CONSTRUCTION OF FACILITIES

According to data collected by the Division of Water Pollution Control, the construction of municipal sewage treatment plants reached a 10-year peak in 1950, with an expenditure of $203 million for that purpose. There has been a decline since that year, with a total of $137 million in construction contracts awarded for public sewage treatment plants in 1952. This sum represents slightly more than onefourth of the annual expenditure believed necessary to meet current needs. More than 80 percent of the new plants constructed in 1952 were in cities of 25,000 population or less. These plants accounted for about 45 percent of the total expenditure.

In 1950, the States reported that 2,793 new waste treatment plants, 98 replacements, and 591 additions or enlargements were needed in industrial establishments. More than 5,500 additional establishments were discharging wastes, but the treatment requirements for these were unknown. Although data are not available to estimate improvement in the abatement of industrial waste pollution since 1950, the visible evidence of the pollution of the Nation's streams indicates that progress is far from satisfactory. There is an increasing awareness, however, on the part of many industries as to their responsibility for preventing water pollution.

Top management of the Nation's industries is cooperating in a joint attack on these problems through the National Technical Task Committee on Industrial Wastes. Committees representing the food, mineral, chemical, and other industries bring to bear the best technical talent of industry on the common problems of each group. The Public Health Service provides specialized assistance and consultative services and acts as a clearing house for the interchange of technical information and research.

ABATEMENT PROGRAMS

In some parts of the country, excellent progress is being made by State and interstate pollution abatement programs. The waters of the Delaware River, for example, are being improved through the construction of new treatment works at Philadelphia. Major additions are being made to facilities in New York City, which will reduce pollution in surrounding waters. Marked improvement of conditions on the Ohio River below Cincinnati will follow completion of new treatment facilities in that city. A large interceptor sewer and treatment plant, serving muncipalities and industries along the Raritan River, will do much to restore that once beautiful stream.

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Concerted efforts for installation of municipal and industrial waste facilities in the Williamette River Basin have been so successful that citizens are beginning to enjoy fishing, boating, and even swimming in areas long closed to recreation.

Basic water pollution data required for preparation of the comprehensive programs directed by the Water Pollution Control Act have been assembled in cooperation with the States. Preliminary data were published in 15 drainage basin reports, and supplementary working documents have been issued for 38 sub-basin areas.

At the close of 1953, the Surgeon General had approved comprehensive water pollution control plans for the following major river basins: the Yakima River, the Humboldt and Central Nevada Rivers, the Red River of the North, and the Maumee River. Twenty additional programs were in final stages of development, and an equal number were well on the way to completion.

Promoting the Health of Workers

The Division of Occupational Health is concerned with the the special health problems which affect more than one-third of the population-the millions of Americans who work in mines, factories, laboratories, offices, and other places of employment. The control of health hazards such as exposure to toxic gases, fumes, and dusts, to abnormal heat, humidity, noise, glare, and radiations, is essential to the health protection of a large proportion of these people. However, environmental control is only one aspect of the total problem of promoting the health of workers. There is growing recognition on the part of industry, labor organizations, and governments that the worker's physical, mental, and social fitness, his home and community life, are important elements in his occupational efficiency. More attention is being paid to the workplace as a useful factor in the prevention of chronic disease and mental disorders.

HEALTH SERVICES IN INDUSTRY

At present, only about 1 in every 6 employed persons has health services available at the workplace. There is, however, increasing awareness that preventive and emergency medical services on the job provide many benefits to workers, employers, their communities, and the Nation. The number and variety of plans now in operation throughout the country give evidence that employee health services are reaching more workers than ever before.

The Division of Occupational Health has contributed several studies on health services in industry. During the year, work was completed on a report describing ten plans established and financed by employee's health and welfare funds or jointly by management and labor unions.

A second study completed during the year dealt with occupational disease reporting; it is expected that this report will lay the groundwork for the development of adequate reporting systems.

RESEARCH ON OCCUPATIONAL DISEASES

The major emphasis in research on occupational diseases is on engineering, medical, toxicological, and analytical studies in the field and laboratory. During the year, studies of occupational dermatoses were concerned with the irritant and sensitizing effects of various chemicals, fabrics, leathers, and impregnums. Substantial progress was made in special studies of cobalt, vanadium, and uranium. Methods and procedures were developed for the identification of these substances in body tissues and fluids and for the collection and determination of air borne contaminants. New and improved instruments and methods were developed for the collection and quantification of industrial dusts.

Pneumoconiosis

At the request of the California State Department of Public Health, the Division is assisting in a comprehensive study of pneumoconiosis among workers in the mining and processing of diatomite. The field work of this industry-wide study progressed during the year in California and will be extended to other States to provide an adequate sample of the variations in processes and the different sources of diatomite deposits.

Excessive Noise

A study of industrial noise was launched during the year in the prison industries which provide a wide variety of operations with exposures to noise at the desired sound levels and in a wide range of frequencies. Data of this sort are essential for the development of standards whereby harmful exposure to noise may be controlled in the plant.

Technical Services

The Division continued to provide technical services to Federal, State, and local agencies, industry, labor organizations, universities, and other groups concerned with the health of workers. During the year, 12 State occupational health programs were reviewed and reports made to the States concerned.

New Directions in Venereal Disease Control

This was a year of major change for the Division of Venereal Disease and State and local programs. Since the development and per

fection of penicillin therapy, it has become increasingly possible to treat venereal infection on an outpatient basis. During the year the transition to outpatient treatment services was completed. In 15 States, Federal aid to rapid treatment centers was terminated, with the expectation that comparable services would be supplied by outpatient prevention and control centers. By the end of the year, 42 of these centers had been established in 16 States and the District of Columbia.

WORK IN THE STATES

Health departments continued to refine and improve the contact investigation as the most effective procedure for finding cases of venereal disease. In addition, mass serologic screening programs were employed among selected groups in areas of high syphilis prevalence. In some metropolitan areas, these selective testing surveys revealed rates of positivity ranging from 6 to 13 percent.

A new plan of attack on gonorrhea was devised and demonstrated in the District of Columbia, and has been adopted by other cities with high gonorrhea rates, including Philadelphia and Memphis. The plan is known as "speed-zone epidemiology". It involves the use of telegrams and prompt field investigations to place females with gonorrhea under treatment within 72 hours of interview with the male patient.

Special project grants were made to 39 States, the District of Columbia, Alaska, Puerto Rico, and the Virgin Islands. These funds supported rapid treatment centers, prevention and control centers, casefinding, and field studies, chiefly in military and defense areas.

VENEREAL DISEASE STATISTICS

Although 1953 was another mobilization year, venereal disease rates among military personnel in the continental United States were held in check. Public clinics reported the admission of 345,000 cases of all types of venereal disease, of which 279,000 had not been treated before. Health department staff's located an average of 268 contacts per 100 cases of primary or secondary syphilis. Epidemiologic investigations, totalling 458,000, brought to treatment 42,000 cases of syphilis and 72,000 cases of gonorrhea.

A total of 156,000 cases of syphilis was reported among civilians in the fiscal year 1953, a decrease from 169,000 in 1952. Reported cases of gonorrhea totalled 245,000, approximately the same number as reported in 1952. About 5,500 cases of other venereal diseases were reported. The estimated syphilis mortality for the calendar year 1952 was 5,700 deaths. The latest available data on infant mortality due to syphilis provide an estimated rate of 2 per 100,000 live births in 1951.