chipping, welding, cutting, breaking of concrete or masonry and when working before ovens or furnaces. They learn that a carelessly used compressed air hose can send needle-sharp metal particles hurtling through the air with bullet velocity. They are advised, too, that failure to wear safety glasses in prescribed areas can result in disciplinary action-up to 60 days suspension for chronic offenders. This measure is evoked only as a final resort and in the employee's own interest. Signs warning that safety glasses must be worn are prominently posted in all restricted areas and on the entrances of buildings housing certain operations. Workers and visitors passing through these areas also must don eye protection. Types of safety glasses to be worn are determined by careful job analysis and evaluation of hazards involved. Plano safety glasses, clear lenses with high impact resistance, are issued for frontal protection against possible large flying particles. Where dust or small flying particles are potential hazards, safety glasses are equipped with side screens having screen openings no large than one twenty-fifth inch, as specified by the Wisconsin State Administrative Code. "Tuff-Cote" lenses, of special hardness, are used where extra impact protection is indicated. Protection against radiation and harmful light rays is provided by properly tinted lenses and sidescreens.

Wearers of prescription glasses are equipped with monogoggles in restricted areas. These lightweight plastic goggles with high-impact lenses fit snugly over the regular glasses for added protection.

Extensive welding operations are employed in Rambler production. This is due to the single unit construction methods pioneered by American Motors and recently adopted by other manufacturers. In this type of construction, body and frame are welded into a single integral unit for greater regidity, safety, and durability.

On all arc welding operations, safety glasses are worn as secondary protection under welding helmets. Spot welders are protected by plastic-type face shields, as are all those engaged in operations involving discing, brazing, and undercoating.

Employees are individually responsible for the care of safety glasses. Worn or accidently damaged equipment is replaced by the plant commissary. Workers are urged to maintain the visual efficiency of their glasses. Special cabinets

in restricted areas help to reduce damage or loss by providing convenient offshift storage. Damaged glasses are reclaimed by the commissary, which replaces a cracked lens, temple pieces, and side screens. The extent of this activity at Kenosha is pointed up by the 8,000 pairs of safety glasses carried in its inventory.

WORK CLOSELY WITH OPTOMETRISTS

Plant commissaries work closely with the optometric profession in maintaining visual efficiency of workers. Workers wearing prescription glasses are encouraged to replace plain glass with safety lenses. About 70 Kenosha employees each month take advantage of the company's payroll deduction plan for safety lenses. This requires a prescription from the employee's optometrist. An initial fitting is provided by the company, after which the wearer is instructed to return to his optometrist for evaluation.

Should an employee be undecided about changing to a safety lens, a look at the commissary's "rogues gallery" usually tends to make up his mind. This consists of photographs of workers who escaped serious eye injuries by wearing proper protection-a graphic and convincing demonstration of the value of safety glasses.

While preventative measures are a key part of the company's vision program, substantial attention is given to fitting the job assignment to the employee's visual efficiency. Obviously, some jobs demand better sight than others. For example, visual efficiency of machine operators and inplant truckdrivers must be 20-40 minimum. On the road drivers must meet a minimum of 20-70.

All new employees receive a complete eye check as part of their physical examination on joining the company. Vision thresholds are established for close and distant efficiency and the employee's records coded to indicate any work limitations. This might be dictated as "no work on power machinery," or "no work requiring acute vision." In addition to the safety factor, the company places a high premium on visual acuity in its quality control program. Rambler cars have won an enviable quality rating with the public and we guard this reputation zealously. The importance of good vision to the program is evident.

Employees may have their vision reclassified by obtaining necessary corrective glasses. By doing so, many become qualified for higher paying assignments. Eye examinations are repeated every 2 years to detect any change in vision thresholds.

The skills of all departments are utilized in improving visual conditions in the plants. Engineers work closely with the safety department in determining adequate illumination for various work areas. This is especially important on precision work, which often calls for individual lights on machines in addition to overhead lighting. Light-meter studies are a continuing program throughout the plants.

VISION AND PLANT LIGHTING

Light fixtures and windows are cleaned frequently. Most plant walls and ceilings are painted nonglare white to reduce reflections. During the course

In

of light studies, attention is paid to the elimination of distracting shadows. close work, machines are positioned for maximum light values. This is important to quality work as even clear plano lens of good optical rating tend to reduce the amount of light reaching the eye. If the visual efficiency of the worker is near the minimum required for the job, a minimal loss of light perception might result in poor work performance. Conversely, adequate lighting can contribute importantly to upgrading work quality.

In the event that an employee's visual acuity drops below the standards set for his job, he is usually reassigned to duties less demanding in vision requirements. However, this is done only when it is determined that the employee's poor vision cannot be corrected and he presents a hazard to himself and his fellow workers. There are jobs in automotive plants in which dexterity and the sense of touch are important qualifications. In fact, a totally blind worker was hired in our Kenosha plant to perform one of these assembly functions.

The Kenosha safety director is assisted by four field safety men who spend a good part of their time looking for potentially hazardous situations on plant property. Particular attention is paid to projections or suspended tools and structures that might produce eye injuries. In the constantly changing panorama of an automotive plant, this is a never-ending project, but one which is important to a good plant safety rating.

In case of injury, the worker is instructed to report immediately to his supervisor. The plant hospital provides first aid for minor injuries. If additional medical care is indicated, the employee may consult his own doctor or a member of American Motors' medical panel. The panel includes four eye specialists. In the main, successful safety engineering is dependent on the degree of cooperation by employees. If the worker is convinced that safety rules are established for his protection and best interests, he will usually observe regulations and follow safe work practices. This is why employee education is allimportant to the plant safety record. Safety engineering is the strategy in the war against industrial accidents; diligent and unrelenting programs of employee safety education are the tactics by which the battle is won.

VISION FOR DRIVING

1

PRELIMINARY REPORT ON A SURVEY, WITH RECOMMENDATIONS FOR AN ACTION

PROGRAM

Good vision is an obvious requirement for safe driving, yet millions of drivers have uncorrected vision problems that make them highway hazards. Many are unaware of their handicaps until an accident occurs or they receive some type of eye test.

Fortunately, all but a minute fraction of all licensed drivers could, with the aid of modern science, have vision that is up to par. There is probably no element of highway safety with a greater undeveloped potential for improvement. The remedies are known, available, and being applied, but not extensively enough.

In many States only casual eye tests have been made by driver license examiners. Insufficient funds have been available for driver licensing in general, and facilities for anything but a superficial eye chart test have seldom been

1 Released by American Optometric Association, 4030 Chouteau Ave., St. Louis, Mo.

provided. Often there has been unjustified fear that large numbers of drivers might be denied licenses if more comprehensive tests were given. There is lack of faith in moderation and lack of information on the possibilities of correction of below par vision. State laws on vision tests have been lax, and there has been little pressure of public opinion for progress beyond the first perfunctory eye tests of a generation ago.

A study of 3,000 drivers

For these and other reasons, there has never been adequate information on the extent of vision problems among drivers. In 1957 a voluntary vision-screening survey was launched by the American Optometric Association and its woman's auxiliary in cooperation with the Automotive Safety Foundation, the National Home Demonstration Council, and other organizations. Its basic purpose was to find what percentage of licensed drivers fall below acceptable standards on the major visual requirements for safe driving.

Portable screening equipment was set up in scores of communities in 25 States. Drivers were invited to have their vision tested by standard techniques, without charge or obligation. The tests were administered by laymen, but supervised by licensed vision specialists. Almost all nontechnical details were handled by women's organizations-members of the woman's auxiliary of the American Optometric Association, National Home Demonstration Council, and the women's division of the Automotive Safety Foundation. Both men and women drivers were tested, and in about the same proportions as licenses are held by male and female drivers.

Elements of safe vision

While much technical terminology is used in describing vision problems and vision tests, anyone capable of driving can understand the visual requirements for safe driving. The results of the tests and the principles of correction of the common shortcomings are just as readily understood. The tests in the survey dealt with these essential visual "skills":

Acuity-ability to focus and see clearly with each eye separately and both eyes together, particularly at a distance of many feet or yards. This is essential for seeing danger, reading road signs in time, and for general adaptation to the critical driving environment. It is essential but only a small part of the total visual requirement. The tests were under carefully controlled conditions for as much uniformity as possible. It is the only "skill" tested in the conventional Snellen letter-chart test used by most driver license examiners, and usually the tests are under such varying conditions of light, cleanliness of test charts, etc., that even this, the only usual test, is far from adequate.

Depth perception-ability to judge space and distance. For most drivers this depends on good binocular (two-eyed) vision, because space and distance are determined by the brain in relating the image from one eye to the image from the other at the slightly different angle that results from the separation of the two eyes. Depth perception is essential for judging whether a car can be passed safely or whether a driver has time and space to maneuver from one lane to another among fast-moving vehicles on a highway. The screening instruments used in the survey tested both binocularity and space judgment-neither of which is covered adequately in the conventional eye test for driver licensing.

Field of vision-ability to see to the sides when focused straight ahead. This, of course, is essential to detect crossroad traffic, pedestrians at the side of the road, and for ease in watching interior and exterior rear-view mirrors and for an adequate grasp of the visual environment of driving. In most States no attempt is made to test this important safety requirement.

Muscle balance-the ability of the two eyes to point simultaneously and easily to the object to be seen. In many persons there is a tendency for at least one eye to point slightly upward or downward (vertical phorias) or to the right or left (lateral phorias). This interferes with good binocular vision and hampers acuity, depth perception, and field of vision.

Good night vision is another important requirement, but tests for it are complex and the survey did not include glare-resistance tests. Good night vision for driving depends on three abilities-resistance to being blinded by bright light! quick recovery after exposure to bright light; and ability to see under conditions of low illumination.

Pilot survey results

Following are the percentages of drivers found to fall below acceptable standards on the major visual requirements tested in the AOA survey which at the stage of the preliminary report had covered 3,000 licensed drivers in 25 States:

Dr. Wendell E. Bryan, Denver, chairman of the AOA Committee on Motorists' Vision and Highway Safety, urges caution in generalizing from this pilot survey. However, a broader study is now underway, and the results of it and other related studies indicate that the percentages are close to those that will be found in any cross section of drivers. It should be noted that drivers were tested with their driving glasses if they ordinarily wore glasses for driving, indicating that persons required to wear glasses for driving need periodic examinations, also.

The conditions found in the pilot survey are also confirmed by routine examinations of the 75 million adults who visit optometrists and ophthalmologists periodically for visual care. Driving has become so common that the vision of the typical adult may be considered close to the vision of the typical driver.

While the pilot study cannot be relied on for precise information on geographical differences, it does indicate wide variation. Most notable is the high rating on visual efficiency of drivers in a State like California where there has long been emphasis on safety and vision as a safety factor. Some rural States, particularly in the Southeast, seem to show about twice as high a percentage of visual problems among drivers as in California. The assumption may be made that, in some States, emphasis on safety and vision has caused drivers to obtain the vision care they need. Conditions can be improved, and are, where action programs are put into effect.

Correctability

As to the correctability of the vision of those failing the tests, valuable studies have been made by Dr. H. W. Hofstetter, director of the Division of Optometry, Indiana University. From studies of 332 clinic patients, he estimates that only three-tenths to six-tenths of 1 percent of a large cross section cannot be corrected to meet the requirement of acuity (20/40 Snellen in the better eye). His report also shows that 96 percent of the driving population can be corrected to 20/20 in the better eye.

Drivers with heterophoria can also be greatly assisted by proper professional care, and correction will greatly improve depth perception and field of vision. However, one of the important results of better vision testing and vision care should be to make drivers more conscious of their visual capacities. The driver who knows that he lacks adequate depth perception can compensate for his short coming by being especially cautious in situations where good depth perception is called for. He can learn to look to the side more frequently if he knows that he does not have the peripheral vision he should have. If glare bothers him or if he is abnormally handicapped in low illumination, he may reduce his night driving or reduce his speed.

Dr. Bryan says that "vision is as personal as one's fingerprints"; no two eyes are alike, and even less are two pairs of eyes. The driver who cannot meet such minimum standards as used in the AOA survey should have a thorough examination adapted to his particular needs, and correction for his particular requirements. With the aid of the science and art of visual correction plus conscious adaptation to his capacities or lack of them he can do much to prevent himself from being a highway hazard.

An action program

Individuals, communities, and organizations seeking an action program for traffic safety may direct their activities toward these "vision for driving" goals: 1. Periodic reexamination of the vision of all drivers. Millions of drivers have had their licenses repeatedly renewed since the days when no eye tests were required for licensing; more millions who had an original test have never been tested again, in spite of the fact that aging is the greatest single contributor to poor vision.

2. Thorough vision examinations for accident repeaters.

3. More extensive use of licensed vision specialists as consultants to licensing examiners, traffic courts and other government agencies dealing with highway safety.

4. Adoption of minimum vision standards in the following skills:

(a) Acuity in the better eye;

(b) Glare resistance:

(c) Adaptation to low illumination;

(d) Distance judgment;

(f) Breadth of field of view;

(f) Color vision.

5. Dissemination of more information on the fact that drivers lack necessary visual skills without knowing it; and that almost all shortcomings can be corrected with proper vision care. Voluntary screening, voluntary correction and voluntary caution can bring immediate results that compulsory laws may never achieve.

For more details on the survey referred to and the joint program now underway, any of the following major participants may be consulted:

Motorists' Vision and Highway Safety Committee, American Optometric Association, 4030 Chouteau Avenue, St. Louis, Mo.

Safety Division, the Woman's Auxiliary to the American Optometric Association, 4013 Byers Avenue, Fort Worth, Tex.

Women's Division, Automotive Safety Foundation, 200 Ring Building, Washington, D.C.

Mrs. O. G. Rushing, Safety Chairman, National Home Demonstration Council, Shawnee, Okla.

AMERICAN OPTOMETRIC ASSOCIATION

Committee on Motorists' Vision and Highway Safety:

P. N. DeVere, O.D., Trustee Consultant

Wendell E. Bryan, O.D., Denver, Colo., Chairman
William E. Hervey, O.D., Los Angeles, Calif.

Everett L. Porter, O.D., Belfast, Maine.

THE OPTOMETRIST AND SAFE DRIVING

INTRODUCTION

Without a doubt the practicing optometrist is the most frequently consulted professional man on matters of eligiiblity for driving. This places on the optometrist a great responsibility for the effectiveness of driver licensing programs in the combating of danger on the highway-public enemy No. 1 in its toll of fatalities, injuries, and physical damage.

The following outline is intended as a guide to the optometrist in his daily encounters with this terrible national problem. The information, opinions, and recommendations incorporated in this outline are endorsed by the American Optometric Association Committee on Motorists' Vision and Highway Safety as representing the best and most consistent views of leading researchers and recognized authorities.

1. ADVICE TO THE PATIENT WHO DRIVES

The optometrist should discuss willingly and frankly the driving problems of the patient in terms of:

(a) Glare, or difficulty in seeing under conditions of bright, stray, or rapidly changing illumination.

(b) Poor vision in dim light.

(c) Poor central acuity, or failure to discriminate signals, road signs, and small hazards.

(d) Poor peripheral vision, or failure to detect the existence of hazards originating peripheral to the point of regard.

(e) Poor color vision, or failure to interpret correctly signals and signs employing color schemes.

(f) Diplopia, resulting in misjudgment of direction of approach of objects in the field of vision.