Health and Safety Management: An Alternative Approach To Reducing Accidents, Injury and Illness at Work 1st Edition John White

Health and Safety Management: An
Alternative Approach to Reducing

Accidents, Injury and Illness at Work
1st Edition John White
Visit to download the full and correct content document:
https://textbookfull.com/product/health-and-safety-management-an-alternative-approa
ch-to-reducing-accidents-injury-and-illness-at-work-1st-edition-john-white/
More products digital (pdf, epub, mobi) instant
download maybe you interests ...
Inherent safety at chemical sites : reducing

vulnerability to accidents and terrorism through green
chemistry 1st Edition Anastas
https://textbookfull.com/product/inherent-safety-at-chemical-
sites-reducing-vulnerability-to-accidents-and-terrorism-through-
green-chemistry-1st-edition-anastas/
Safety at Work and Emergency Control: A Holistic

Approach Benedito Cardella
https://textbookfull.com/product/safety-at-work-and-emergency-
control-a-holistic-approach-benedito-cardella/
Prevention of Accidents and Unwanted Occurrences:

Theory, Methods, and Tools in Safety Management 2nd
Edition Albrechtsen
https://textbookfull.com/product/prevention-of-accidents-and-
unwanted-occurrences-theory-methods-and-tools-in-safety-
management-2nd-edition-albrechtsen/
Health Illness and Society An Introduction to Medical

Sociology Steven E. Barkan
https://textbookfull.com/product/health-illness-and-society-an-
introduction-to-medical-sociology-steven-e-barkan/
Occupational Health and Safety Management A Practical
Approach Third Edition. Edition Charles D. Reese
https://textbookfull.com/product/occupational-health-and-safety-
management-a-practical-approach-third-edition-edition-charles-d-
reese/
Bouncing back : resilience skills for adaptation to

injury, aging, illness, and pain 1st Edition Wanlass
https://textbookfull.com/product/bouncing-back-resilience-skills-
for-adaptation-to-injury-aging-illness-and-pain-1st-edition-
wanlass/
Biota Grow 2C gather 2C cook Loucas
https://textbookfull.com/product/biota-grow-2c-gather-2c-cook-
loucas/
Acquired Brain Injury An Integrative Neuro

Rehabilitation Approach Jean Elbaum
https://textbookfull.com/product/acquired-brain-injury-an-
integrative-neuro-rehabilitation-approach-jean-elbaum/
Global Occupational Safety and Health Management

Handbook Thomas P. Fuller
https://textbookfull.com/product/global-occupational-safety-and-
health-management-handbook-thomas-p-fuller/
Health and Safety
Management
An Alternative Approach to Reducing
Health and Safety
Management
An Alternative Approach to Reducing
John White
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
© 2019 by Taylor & Francis Group, LLC

CRC Press is an imprint of Taylor & Francis Group, an Informa business
No claim to original U.S. Government works
Printed on acid-free paper
International Standard Book Number-13: 978-1-138-50083-9 (Paperback)

978-1-138-50084-6 (Hardback)
This book contains information obtained from authentic and highly regarded sources. Reasonable
efforts have been made to publish reliable data and information, but the author and publisher can-
not assume responsibility for the validity of all materials or the consequences of their use. The
authors and publishers have attempted to trace the copyright holders of all material reproduced in
this publication and apologize to copyright holders if permission to publish in this form has not been
obtained. If any copyright material has not been acknowledged please write and let us know so we
may rectify in any future reprint.
Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced,
transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or
hereafter invented, including photocopying, microfilming, and recording, or in any information
storage or retrieval system, without written permission from the publishers.
For permission to photocopy or use material electronically from this work, please access www.
copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC),
222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that
provides licenses and registration for a variety of users. For organizations that have been granted a
photocopy license by the CCC, a separate system of payment has been arranged.
Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and
are used only for identification and explanation without intent to infringe.
Library of Congress Cataloging-in-Publication Data
Names: White, John, 1955- author.

Title: Health and safety management : an alternative approach to reducing
accidents, injury and illness at work / John White.
Description: Boca Raton : Taylor & Francis, CRC Press, 2018.
Identifiers: LCCN 2018014392| ISBN 9781138500839 (pbk.) | ISBN 9781138500846
(hardback : alk. paper) | ISBN 9781315144023 (ebook)
Subjects: LCSH: Industrial safety. | Accidents--Prevention.
Classification: LCC T55 .W497 2018 | DDC 658.3/82--dc23
LC record available at https://lccn.loc.gov/2018014392
Visit the Taylor & Francis Web site at

http://www.taylorandfrancis.com
and the CRC Press Web site at
http://www.crcpress.com
Contents
Preface.......................................................................................................................ix
Author........................................................................................................................xi
Introduction�� xiii
Chapter 1 The History of Health and Safety.........................................................1
Chapter 2 A Personal Perspective: Part 1.............................................................. 9
Chapter 3 Born to Make Mistakes....................................................................... 11
Chapter 4 Marginal Gain..................................................................................... 17

Approach and Understanding..............................................................20
Enthusing.............................................................................................20
Feedback.............................................................................................. 21
Interrogation........................................................................................ 22
Think Small......................................................................................... 22
Development........................................................................................ 22
Marginal Loss..................................................................................... 22
Chapter 5 Accidents, Acts of God and Human Error..........................................25

Terminology........................................................................................25
Health and Safety Executive Definitions............................................26
Slips and Lapses.................................................................................. 27
Violations............................................................................................ 27
Human Error Classification Headings................................................28
Physiological/Psychological...........................................................28
Organisational/Personal.................................................................28
Deliberate.......................................................................................28
Chapter 6 Lightning Always Strikes Twice......................................................... 33
Chapter 7 Black Box Thinking............................................................................ 39
Chapter 8 Risk Perception................................................................................... 43

Anticipated Outcomes and Past Experience.......................................44
Confidence......................................................................................46
Training, Procedures and Systems, Protective Equipment.................46
v
vi Contents
Trust................................................................................................ 47
Judgment of the Fear Factor........................................................... 47
Acute or Chronic?...................................................................... 48
Setting an Example......................................................................... 48
Awareness/Newness and Change................................................... 48
Incident Effect........................................................................... 49
Perceived Benefit....................................................................... 49
Chapter 9 The Problem with Experience............................................................. 51

The Problems with Experience........................................................... 55
Experience of What?...................................................................... 55
Concept of Experience Providing a Buffer against Accidents....... 56
Transference of Skills and Knowledge to Broadly Parallel
Situations Might Not Work............................................................. 56
Being Blasé or Complacent, Switching Off or Running on
Autopilot......................................................................................... 56
Overconfidence............................................................................... 56
Risk Perception............................................................................... 57
Assumption That Others Have Equal Knowledge.......................... 57
Managing Experience......................................................................... 57
Get Rid of Immunity to Risk.......................................................... 57
Learn That Experience Isn’t Always Right.................................... 57
Use Experience to Warn Others..................................................... 57
Guard against Complacency and Overconfidence.......................... 58
Chapter 10 A Personal Perspective: Part 2............................................................ 59
Chapter 11 Free-Thinking Hazard Identification.................................................. 61

Getting into the Free-Thinking Hazard Identification Zone............... 62
Visualisation........................................................................................ 65
You Could See That One Coming....................................................... 68
Constant Vigilance and Assessment................................................... 70
Perceiving Risk Accurately................................................................. 71
Chapter 12 Dealing with Change........................................................................... 73

The Glenridding Beck Tragedy........................................................... 74
The Importance of Performing the Correct Risk Assessments.......... 75
Fixed Criteria...................................................................................... 76
The Stainforth Beck Tragedy.............................................................. 78
Managing Change: Management Actions........................................... 81
Chapter 13 Nutrition.............................................................................................. 83
Coffee or Chocolate, Anyone?............................................................84
Contents vii
Nutrition and Work.............................................................................. 85

The Bigger Picture.............................................................................. 85
Common Problems.............................................................................. 87
Timing of Breaks................................................................................ 87
Why Is This Right? Should It Be Different?.................................. 88
What to Eat and What Not to Eat at Break Time........................... 88
Examples of What Food and Drink to Promote............................. 89
Examples of What Food to Avoid.................................................. 89
Don’t Forget Water......................................................................... 89
Balance Nutrition to Type of Work................................................ 89
Management Strategies.................................................................. 89
Chapter 14 Fitness for Work and Life.................................................................... 93

Fitness for the Workplace....................................................................94
Taking the Long View......................................................................... 95
How to Create a Fitter Workforce.......................................................96
Chapter 15 Injury Reduction and Management.....................................................99

Reducing the Number of Accidents That Cause Injury in the
Workplace.......................................................................................... 100
Reducing the Effects of Accidents That Cause Injury...................... 100
Personal Protective Equipment.................................................... 100
Warm Up for Work....................................................................... 101
Immediate Treatment................................................................... 101
Early Intervention Strategies........................................................ 102
Prevention Is Better Than Cure......................................................... 103
Management Actions......................................................................... 104
Chapter 16 Well-Being......................................................................................... 105

Physiological Needs.......................................................................... 108
Safety Needs...................................................................................... 109
Social Belonging............................................................................... 109
Acceptance and Self-Esteem............................................................. 110
Realisation of Full Potential.............................................................. 110
Physical Well-Being.......................................................................... 111
Health and Fitness........................................................................ 111
Physical Health............................................................................. 113
Emotional/Mental Well-Being.......................................................... 114
Happiness..................................................................................... 115
Stable Relationships...................................................................... 117
Positive and Stable Emotional/Mental Health.............................. 118
Peripheral Well-Being....................................................................... 120
Financial Security......................................................................... 120
viii Contents
Enjoy Engaging Activities and Interests....................................... 121

Statistics........................................................................................ 121
Things to Watch Out For.............................................................. 122
Using the Great Outdoors to Improve Well-Being....................... 123
Chapter 17 A Personal Perspective: Part 3.......................................................... 127
Chapter 18 A Connection with Nature and the Great Outdoors.......................... 133

A Feeling of Connection with Nature............................................... 135
Fresh Air and a Healthy Environment.............................................. 136
Wide Range of Access and Recreational Opportunities................... 136
Uplifting Views and Calming Landscapes....................................... 137
A Challenging Environment............................................................. 138
A Chance to Observe and Learn about Wildlife............................... 138
Social and Community Benefits........................................................ 138
An Opportunity to Get Closer to Concepts
Such as Sustainability....................................................................... 139
Outdoor Activities............................................................................. 139
Chapter 19 Team and Relationship Building....................................................... 143

Preface
Statistics repeatedly tell us that human error contributes directly to approximately 80%
of workplace accidents, incidents and near misses, while statistics from the Health
and Safety Executive (HSE) illustrate a steady stagnation in the rate of reduction
of accidents, injuries and time taken off work due to ill health. At a time when
our awareness and application of health and safety strategies and policies, together
with health and safety culture, are at their most advanced state, we should perhaps
collectively expect the statistics to reflect this through a higher rate of reduction.
In order to continue to achieve a reduction in the accident statistics, I strongly
believe that alongside providing effective systems, procedures and training, it is
essential to explore ways of managing the human dynamic more effectively. This
belief is backed up by my conversations with several leading figures in major
construction projects and my experiences in managing high-risk outdoor activities
over a 25-year period.
By applying a range of new and existing principles, including free-thinking hazard
identification and marginal gain and using lessons drawn from sport and the high-
risk world of outdoor adventure, this book provides a variety of practical solutions
that will in turn:
• Reduce the incidence of human error in the workplace

• Reduce the number of accidents, incidents and near misses
• Reduce time taken off work due to injury or ill health
The benefits of such an approach are good for the individual, families, healthcare
system, employer and society in general.
ix
Author
Following training in landscape management, John took up various positions with
the Lake District National Park Authority, including Volunteers Coordinator and
National Park Ranger for the busy central Lake District. After qualifying as a lecturer
in countryside management, he went on to set up and run a successful mountain
guiding business, which led to a variety of work with colleges, universities and a
range of businesses. John also developed Highpoint and Lakes Challenge, a business
providing team- and relationship-building events for a wide range of clients including
English Partnerships, The Olympic Delivery Authority, Tideway and Loughborough
University. He also worked as Director of Conservation and Development for a
leading conservation organization.
John is an accomplished climber with over 100 first ascents to his name from
Africa to North America, and he has led expeditions to Greenland alongside climbing
throughout the Alps and in many European countries. A keen naturalist, he was
extensively involved in birds of prey protection schemes and retains a long-standing
interest in the natural world.
John has managed health and safety in many difficult and extreme environments
and sports and has been responsible for the safety of many thousands of participants
in outdoor events. He set up a detailed health and safety policy for a leading
conservation organization and was responsible for the safe working of hundreds of
volunteers alongside full-time staff.
Previous works by the author include:
Rock Climbing in Northern England

Rock Climbing in Langdale
AA Classic Walks and Tours in France
AA Secret France
AA Touring France
Classic Walks in Great Britain
Classic Walks of the World
(All as contributing author)
Walking in the Stubai Alps
The Indoor Climbing Manual
John has also written extensively for outdoor magazines on topics ranging from
navigation skills to winter driving.
xi
Introduction
Cumbria’s Lake District produces some memorable weather, though unfortunately
most of it is memorable for the wrong reasons, as the devastating floods caused by
Storm Desmond in 2015 demonstrated only too well.
However, every now and then the grey clouds disperse and we’re treated to one of
those ‘blue sky’ days that are so magnificent, so sublime, that one can’t help but feel
uplifted with a sense of euphoria and joy. It was on such a day in the winter of 2016
that my old climbing pal Wilf Williamson and I set off to ascend Blencathra via the
infamous Sharp Edge, a delightfully defined, rocky ridge that provides a strikingly
direct line to the summit plateau. An accident black spot, the edge has been the scene
of numerous incidents and fatalities over the years, particularly in wet or snowy
conditions, so we were mentally prepared for this and appropriately equipped and
experienced.
Our walk to the ridge was very pleasant and we reached Scales Tarn, a small body
of water nestling in a high corrie beneath Sharp Edge. A steep shale path led up to
the start of the edge proper, and we could see that the sun had melted snow from the
south side of the ridge, whereas the north side was in the full and determined grip of
winter, plastered with ice and rock-hard snow. Though well within our capabilities,
we took great care in picking our way along the ridge’s craggy crest, staying well
away from the treacherous terrain in the shade to our right.
The final steep slopes leading to the summit plateau were streaked with ribbons of
hard snow that required care and concentration, but before long our rocky scramble
had finished, and we stood on the gentle slopes of the plateau, difficulties behind us,
gazing across sparkling snowfields to distant views of dozens of snow-capped peaks
etched against a deep blue sky. It was magnificent.
A year or so previously, I’d invested in a pair of ultra-lightweight walking boots
that I’d tested in a wide range of conditions. In particular, their grip on slippery
surfaces such as snow was very impressive. As we walked over the frozen snowfields,
I noticed that Wilf was having to use his boots to kick steps in the hard snow and
was finding the going quite tough, whereas I, in my ‘super boots’, was able to walk
comfortably on the icy surface.
I thought I should point out to Wilf how superior my choice of footwear was, but a
moment later and before I could utter a word, my feet went from under me in a flash,
my arms flapped in a vain attempt to retain balance, but the inevitable happened and
I landed very hard, very painfully and very embarrassingly on my coccyx.
I’d fallen (in this case literally) for the oldest trick in the accident prevention book.
It’s like an inverse take on a magician’s sleight of hand that relies on distraction. I
was distracted partly by the stunning beauty and the banter of the moment and partly
by the focus on one issue, the grip of the boot. Now I’ve run hundreds of winter
mountaineering and winter hillwalking training courses. I’ve gone to great lengths
to help people gain skills and confidence and learn about the hidden dangers that can
catch the unwary in hard, wintry conditions. I’ve taught them to walk and climb on
snow and ice, to use crampons and ice axes, to survive and enjoy the unique rewards
xiii
xiv Introduction
Sharp Edge, Blencathra, Lake District.
that come from being on the mountains in deep winter. I’ve participated in dozens
of rescues in similar conditions and even witnessed, many times, people falling in
exactly the same way I did. So what happened?
It’s best demonstrated by looking back to an injury that befell a member of our
mountain rescue team returning from a rescue one dark winter’s evening. The rocky
path we were descending was frozen hard, and surface water had frozen solid. On
top of this was a light covering of new snow, and it wasn’t possible to tell if your next
step was going to be onto rock with a light cover of snow (OK) or hard ice with a light
cover of snow (not OK!). We put crampons on; some didn’t. Minutes later I heard an
agonised shout next to me. I turned, and etched in the light of my headtorch I saw one
of our larger team member’s feet shoot out from under him and kick the air in vain
before he landed on his back with a thump you could hear in the car park a quarter
of a mile away. Our rescue tally for the night suddenly doubled!
That’s exactly what happened to me. Though the majority of the summit snowfield
consisted of firm snow that my boots gripped supremely, there were a very few small
patches of ice, lightly covered with a dusting of snow, that were indistinguishable
from the rest of the snowfield. I’d strayed onto one of these, slipped and landed
flat on the base of my spine. In my career I’d shown hundreds, if not thousands, of
people this very hazard, and I’d witnessed lots of people falling in this way, yet it
still happened to me.
Why? As I intimated earlier, it was to do with distraction, deception and perception.
The first factor relates to perception of risk. Our route that day took in Sharp
Edge – an accident black spot, some of which was encased in hard snow and ice
and from which a fall could be deadly. Our focus was on this part of the route,
and having completed it, our perception of risk reduced significantly. This is the
deception, though unlike the magician, we are deceiving ourselves rather than an
Introduction xv
audience. Moving from a very high-risk situation to a lower-risk situation does not
mean that risk has been removed, yet this is the deception that we experience.
The second factor is distraction. In this case, I was distracted and lost focus due to
two factors – the beauty of the moment and the humour of the moment. The beauty
of the moment is important and an underrated factor as a distractor. The scenery
and blue skies created a sense of euphoria and happiness that in turn reduced my
focus on risk. The humour of the moment, the banter between friends, also acted as
a distraction from the potential risks. End result – a slip, a fall, a big bruise and an
even bigger laugh for my friend.
I reflected on that momentary lack of concentration and resulting slip and wondered
how I could prevent it ever happening again. I came to the conclusion that I couldn’t,
but what I could do was reduce the chances of it recurring even further, to a level at
which it was highly unlikely to happen. To do this, I would need to rethink my whole
attitude, develop a different, free-thinking approach to hazards and hone this to a
whole new level.
Accidents in the workplace and at leisure cost us individually, cost and inconvenience
our families and cost business and society vast sums, yet in recent years the statistics
show a gradual flattening in the level of accidents, injuries and time taken off work
due to ill health. This is at a time when our knowledge and understanding of health
and safety and the levels of support available are at an all-time high. I believe that in
order to make further reductions in the numbers of accidents and incidents occurring
in the workplace, and to reduce absence due to ill health, we need to look beyond the
excellent work that has been done to improve safety through systems, procedures,
training and equipment to new ways of managing the human component, new ways
of understanding and dealing with factors such as distraction, failure to concentrate
or overconfidence.
I’m utterly convinced that by approaching health and safety from an additional,
different perspective, and by focusing on reducing human error through the way
we look after the health, well-being and fitness of our workforce, it’s possible to
significantly reduce the numbers of accidents, incidents and near misses and to reduce
the number of working days lost due to ill health and injury.
Many factors contribute to the occurrence of accidents, and often it’s a combination
of factors. Common contributors include distraction, failure to concentrate,
not following instructions, forgetfulness, tiredness, changing circumstances,
overconfidence and risk normalization. My stance is that by helping people to
concentrate better, to remain focused for longer, to feel less tired, to assess risk
more effectively, to identify hazards earlier and so on, we can incrementally make
a real difference.
To do this, we may have to change the way our workforce eats and drinks and
consider whether people are taking their breaks at the best times. We need to
ensure their physical and mental well-being are taken into account and improved.
Responsibility for health and safety issues needs to be shared, and every person needs
to feel involved and listened to. Our workforces need to start thinking differently
and adopt a free-thinking approach to hazard identification. We need to manage
experience effectively and reduce the overconfidence and numbness to risk that can
xvi Introduction
appear over time. Recognition that people have different learning styles is essential,
and we need to cater to this in our training and systems. Increasingly, we may need
to consider the demographics of an ageing workforce alongside cultural and ethnic
considerations. By accumulating small gains from these and many other ideas
described here, we can make a real difference.
A healthy, fit and happy workforce trained in free-thinking hazard identification,
knowledgeable about their diet, working in effective teams and genuinely taking
responsibility for health and safety will be more effective, more productive and safer.
1 The History of
Health and Safety
Health and safety are no different from any other sphere of life in that if we want
to move forwards, it’s a sound and well-proven idea to take a look at what’s already
happened.
Although we may trace the official structure of health and safety back perhaps to
the early Factories Act of 1833, health and safety have been thought about and acted
upon for thousands of years, in spirit if not in name. Amazonian tribes, for example,
have hunted with darts tipped with poison as dangerous as most hazardous substances
found in a modern chemical factory for thousands of years and they found ways of
doing so safely.
In the 1700s – the 1700s bc, that is, the Ancient Babylonians are frequently
credited as being the first civilisation to legislate to provide safer working practices,
with Law 229 of The Code of Hammurabi:
If a builder build a house for a man and do not make its construction firm, and the house
which he has built collapse and cause the death of the owner of the house, that builder
shall be put to death.
Well, it would certainly make you think twice about the quality of your work! This
oft-quoted phrase doesn’t quite work for me as the start of health and safety, because
it’s simply punitive and does not address the issue of safety during the construction
process.
Q: ‘What did we have in place before health and safety?’

A: ‘Natural selection’
This old joke does have an element of truth in it, because in earlier times, safety
tended to have more of an individual or family-based bias. Many earlier civilisations
exhibited some form of collective working, but often it was family based, with the
basic need of protecting the individual and family taking priority.
As civilisations developed, larger-scale construction projects became commonplace
and these inevitably involved huge amounts of labour. Building enormous pyramids,
complex temples, amphitheatres, magnificent cathedrals and great cities, our ancestors
worked collectively in roles that often carried high levels of risk. Those at the foot of
the labour pyramid would have undoubtedly been exposed to the greatest risk, and as
at many times in human history, when human labour was cheap, so too was life itself.
It’s estimated that during the building of the Great Wall of China, hundreds of
thousands of workers could have died as a result of overwork, malnutrition and the
extreme working conditions. In the 1860s, 120,000 workers are estimated to have
1
2 Health and Safety Management
perished during the construction of the Suez Canal, from a total workforce of 1.5
million – a fatality rate of 8%. During the construction of the Panama Canal, 25,000
people died from tropical disease, falls and crush injuries and the extremely hot and
humid conditions. The Karakoram Highway might be the most magnificent stretch
of road in the world, but 1300 people died in 1978 during its construction – many
being buried in landslides.
Protective equipment would have been almost nonexistent, working hours long
and hard, and safety very much left to the individual to deal with.
The development of civilisations and society, coupled with the parallel development
of communication, has led to radical shifts in the way that safety has been perceived
and dealt with.
In the United Kingdom, the industrial revolution sparked a period during which
profit became the driving force of a new industrial society. Profit as a priority, along
with an established class system, produced a society in which profit was unashamedly
built on a largely uneducated workforce that had a low life expectancy and little hope
of progression and personal betterment. The labour force was under great pressure
to work long hours in dangerous conditions simply to exist at a basic level. Mines,
mills and factories were dangerous places and only our human, innate individual
instinct for survival plus the attitudes of some more enlightened and thoughtful
bosses prevented even higher levels of injury and mortality.
The Factories Act of 1802 and several subsequent acts prior to 1833 offered a
glimmer of hope during an age renowned for its tough working conditions, early
mortality and child exploitation, though their collective efforts to impose a maximum
12-hour working day for children in the cotton mills were widely evaded and ignored.
The Factories Act of 1833 introduced the first really serious attempt to combat
difficult and dangerous working conditions, child exploitation and excessive working
hours. The Act had little support from many quarters and proved very difficult to
enforce, with four inspectors having to oversee 3,000 textile mills. Some of the
regulations introduced in the Act were visionary and retain significance almost 200
years later. Fitting guards to machinery and the reporting of accidents were two areas
covered by this act that are still critical components of modern health and safety.
A generation later, the Factories Act was extended to cover most workplaces,
and inspectors were appointed to provide advice and ensure the laws were fully
understood. However, the 30 or so people who worked in this role would have
struggled to provide this service across the whole country.
1842 saw the introduction of the Mines Act following an investigation into
the working conditions of miners. The commission found that accidents, long
working hours and seriously dangerous and difficult working conditions, along with
maltreatment of workers, were found to be the norm. Public outcry resulted and the
Mines Act was brought into force.
The first inspector, Hugh Seymour Tremenheere, had limited powers, but
undertook many prosecutions, investigated the condition of the mining community
and made recommendations for training managers, reporting of fatal and serious
accidents and provision of pithead baths and suitable habitation for mine workers.
Later that century, the Quarries Act and the Metalliferous Mines Regulation led to
the formation of the Quarries Inspectorate in 1895.
The History of Health and Safety 3
Progress was clearly very slow during the nineteenth century as far as health
and safety were concerned, but one has to place this in the context of the time, an
age during which massive technological advances were being made and in which
engineering and construction underwent unparalleled development. The emphasis
was very much on the creation of new designs, the development of new materials –
many of which were harmful either in manufacture or as an end product – expansion
and profit. The safety of the workforce was, sadly, somewhat left behind.
The first half of the twentieth century saw few changes, in part due to the effects
of two world wars, and it wasn’t until 1956 and the publishing of the Agriculture
(Safety, Health and Welfare Provisions) Act that the safety of workers was once again
brought to the fore, this time in Britain’s highly important, increasingly mechanised
and dangerous agricultural sector. Basic provisions for first aid and hygiene were
made alongside setting out requirements for reporting and investigation of accidents
and illnesses. The lifting of excessive weight was also controlled – although this
didn’t prevent my father carrying 100-kg sacks of corn about the farm where I
grew up!
This last comment illustrates one of the big problems of that period in that both
workers and management were brought up in a world significantly devoid of a
health and safety culture. It’s difficult to change entrenched human behaviour and
expectation, so rather like in the case of the early Factories Act, many people carried
on working the same way they always had, and it took many more years, lots more
accidents and much more legislation before health and safety culture became more
firmly embedded.
1974 saw the implementation of the Health and Safety at Work Act. Employers
and employees were consulted during the formation of the Act, following which the
Health and Safety Commission and Health and Safety Executive were established,
the latter at the start of 1975. The HSE, along with local authorities, is still the major
authority when it comes to enforcing health and safety today.
I can look back on this period with a degree of personal experience. At the time,
I worked on the farm part time, and undertook some work experience with the local
authority, in their forestry and parks and recreation departments. I can say with
certainty that at the time I had no knowledge of the 1974 Act, and absolutely nothing
changed with regard to the established working practices or my employer’s attitude.
In short, from a worker’s perspective, nothing appeared to change within a large local
authority following the publication of the Act. Once again, I’m sure that this was
connected with the fact that health and safety culture was still new, not yet embedded
in many sectors, and the local authorities found it difficult to implement. Accidents
took place, but our collective response in terms of putting in place measures to prevent
the same thing happening again was very poor. I recall our chief forester splitting his
foot almost clean in two with a felling axe after it slipped sideways off a log he was
attempting to split. He didn’t wear safety boots, but the accident didn’t prompt our
employer to ensure that everyone wore them.
That said, the ensuing 30 years saw reductions in fatal and nonfatal injuries at work
of approximately 70%, a figure that demonstrates the success of this and many further
Acts in establishing a successful health and safety culture. It’s also an interesting
illustration of the length of time required to change working culture.
One of the subsequent key pieces of legislation was the Notification of Accidents
and Dangerous Occurrences Regulations 1980. This required both employers and the
self-employed to keep records of accidents and a range of other dangerous occurrences.
The Reporting of Injuries, Diseases and Dangerous Occurrences Regulation 1995 –
more commonly known as RIDDOR, superseded this Act. This legislation is vitally
important not only in providing the basis for statistical analysis of accidents and
incidents, but also in providing a continuous flow of information from which crucial
lessons can be learned.
It wasn’t until 1981 that the Health and Safety (First Aid) Regulations came into
force to ensure that adequate first aid provision was available at all workplaces. This
included ensuring that first aid equipment was available along with first aid training
and the provision of information to employees about where the equipment and trained
help was. I find it quite astonishing that it took until 1981 for such a basic provision
to be addressed.
The later 1900s saw regulations come into force regarding pesticides, the control
of asbestos at work, noise at work, manual handling, display screen equipment,
provision and use of work equipment, personal protective equipment, construction
(design and management) and construction (health and safety welfare).
It’s interesting to look back at these regulations and observe the delays between
general and open knowledge about a particular issue and the creation of regulations.
For example, the dangers posed by pesticides were well known in the 1960s and
1970s, yet it took until 1986 before regulations on control of pesticides came into
force. Asbestos was linked with lung disease in the 1930s, but regulations on control
of asbestos at work did not appear until 1987.
On a similar theme, it has often taken a disaster of some type to kickstart health and
safety action. The 1987 King’s Cross Underground fire killed 31 people and injured
many more. The Fennell Inquiry that followed identified many issues, including
poorly trained staff who were ‘woefully inequipped to meet the emergency that arose’.
London Underground accepted 157 recommendations for safety improvements.
The Clapham train crash in 1988, in which 35 people were killed following a triple
train collision, led to 93 recommendations for safety improvement and addressed the
working hours of signalmen along with the installation of automatic train protection
systems.
In 1988, the Piper Alpha offshore oil platform was destroyed following a series
of explosions and a gas fire. Out of a total workforce of 226, 165 died, and the
Cullen inquiry that followed appointed the Health and Safety Executive as the single
regulatory body with responsibility for enforcing health and safety in the offshore
oil and gas industries.
The Lyme Bay canoeing tragedy in 1993, in which eight youngsters on a
commercially operated canoeing trip died, led to the formation of the Adventure
Activities Licensing Authority, which in 2007 was integrated into the HSE.
The reason for mentioning these disasters is to reinforce the point that much
health and safety legislation has often been reactive – a response to either a sudden,
disastrous incident or the creeping realisation that substances we work with, or
working practices, need to be controlled because they present unjustifiably high levels
of risk.
This is a diametrically opposed response to the aims of this book, which are
primarily to suggest ways of proactively managing the human factor in relation to
health and safety.
The early 2000s saw the launch of a 10-year ‘Revitalising Health and Safety
Strategy’ and the ‘Securing Health Together’ strategy. This was in response to
figures suggesting that the same proportion of people had been injured at work
since the early 1990s. A further strategy was launched in 2009, aiming to develop
‘Renewed momentum to improve Health and Safety performance’. This was in
response to figures suggesting that the combined rate of illness and injury was
the same as in 2004. These types of strategies highlight a different approach to
health and safety at work – a move away from legislation, inspection and a focus on
procedures towards a recognition that it was necessary to periodically reassess our
approach towards health and safety and focus on illness and well-being alongside
accident and injury.
At this point, it’s worth a quick look at the HSE statistics. Fatalities at work
have continued to decline overall since 1981, with a levelling off over the last
10 years to a figure of approximately 0.4–0.5 deaths per 100,000 workers. The
number of injuries has shown a similar decline and a similar leveling-off trend
since 2010. Instances of work-related ill health and occupational disease also fell
through to 2011, from where they have risen very slightly. In broad terms, our
health and safety policies and procedures have been working well, but the figures,
not unexpectedly, have tended to plateau in the last few years. However, statistics
in a general sense conceal other statistics hidden within them. The figures above
cover all types of workplace and if, for example, the number of employees in
low-risk occupations rises and the number employed in high-risk occupations
lowers, a breakdown in those overall figures could portray a different story within
different sectors.
A couple of excellent, though troubling, examples of the statistics hidden within
these overall trends is that 25% of fatal accidents involve workers over the age of 60,
despite those workers making up only 10% of the workforce, and that agriculture has
8.61 fatalities per 100,000 workers compared with just 1.82 fatalities per 100,000 for
construction.
Two further reports were published in 2010 and 2011. The first, Lord Young’s review
of health and safety – ‘Common Sense – Common Safety’ – was commissioned by the
then Prime Minister David Cameron. ‘The aim is to free business from unnecessary
burdens and the fear of having to pay out unjustified damages claims and legal fees.
Above all it means applying common sense not just to compensation, but to everyday
decisions once again’.
The rationale behind the report is not difficult to understand, and in some ways
the background to the report exemplifies the process of marginal change. Fifteen
years ago I recall my father-in-law, an engineer involved in health and safety training,
getting quite hot under the collar at the way in which health and safety were becoming
increasingly frequently used as a scapegoat, an excuse for not doing something. He
was steadfast in his view that health and safety were first and foremost enabling –
enabling people to perform risk-carrying tasks as safely as possible and not providing
an excuse as to why something could not be done.
Rate of fatal injuries to workers in the agriculture, forestry and

fishing sector and other main sectors per 100,000 workers,
2016/17
All industries 0.43
Manufacturing 0.66
Transport and storage 0.88
Construction 1.37
Water supply, sewerage, waste management &

6.64
remediation
Agriculture, forestry and ishing 7.61
0 1 2 3 4 5 6 7 8
The overall statistics can hide unacceptably high fatality rates within certain sectors.
This very negative and limiting side to health and safety grew slowly and steadily,
arising predominantly out of a misunderstanding of the principles of health and safety,
and perhaps too often out of a misguided individual approach that simply wanted a
get-out clause.
A readjustment of attitude towards health and safety was certainly required, and
the Young Report addressed a range of issues from tackling ‘compensation culture’
through to insurance requirements, health and safety requirements in low-hazard
workplaces and a reduction in the level of health and safety regulation in terms of
school visits and outdoor education.
The second report, ‘Reclaiming Health and Safety for All: An Independent Review
of Health and Safety Legislation’ by Professor Ragnar Lofstedt, was commissioned by
the Employment Minister, Chris Grayling. The report was controversial, with many
concerns raised by professional health and safety bodies, though many supported the
overall aim of streamlining legislation and reducing the burden on British businesses.
Over the years, the health and safety movement has demonstrated significant
success in reducing the number of people killed or injured in workplace accidents. As
a movement, it gained significant momentum during the latter years of the twentieth
century and the early years of the twenty-first century; indeed, some saw it as a self-
perpetuating behemoth in need of some sort of restraint. As with many initiatives
HSE statistics show a general levelling-off trend.

that affect society in such a major way, there is a tendency for the pendulum to
swing to either side of an idealistic central point, and recent feeling reflects this, with
concerns about some aspects of health and safety being overzealous, too restrictive
and overlegislated.
For me, the underlying principle historically is that of finding ways of enabling
tasks to be performed safely by reducing the risk to an acceptable level. Equipment
design, protective equipment, training, effective systems and procedures all help
towards this end, but to progress further and continue to see a fall in the number
of accidents, injuries and near misses, we need to have a fundamentally different
additional approach that centres on people as well.
There is clear evidence that this approach is now being used in some sectors.
Leading the way have been some of the major construction projects such as London
2012, Crossrail, Tideway and HS2. With stated zero-tolerance approaches to accidents
and a clear aim of placing safety ahead of all else, these projects have also started to
address the human component of health and safety management in a different way,
for example, with the introduction of a range of measures that aim to monitor and
improve workforce fitness, in the recognition that this will reduce both accident levels
and incidences of ill health.
After a period in which accident and injury rates along with levels of ill health
in the workplace have stagnated, the time is ripe for a new approach to managing
workplace health and safety. We need to build on the successes of some of the largest
construction projects and roll them out across a wider range of project and business
sizes and organization types. We need to recognize the crucial role that managing the
human component of health and safety can play and embed this into every place of
work. Over time, this will make a real difference, and as a result we should expect to
see a further decline in workplace accidents and injuries and a significant reduction
in time taken off due to ill health.
2 Part 1 A Personal Perspective
My working life started prior to the 1974 Health and Safety at Work Act, so like
everyone else around my age, I’ve witnessed the development of health and safety
from prior to the inception of the phrase right through to current times, 45 or more
years of modern health and safety progression.
I started work in the early 1970s as a schoolboy working on our small, mixed farm
down in Yorkshire. We had chickens, cows and pigs and grew potatoes, barley and
grass for hay. Surviving this period was one of my personal triumphs, such were the
number and seriousness of the hazards farming presented! I don’t think the phrase
‘health and safety’ had been invented at that point, and the thing that stands out
most to me is how little thought was given to safety. There was no safety culture,
and very few deliberate actions that would have reduced risk, beyond the occasional
‘be careful’.
My father had a Fordson Major tractor, a brute of a machine that seemed
determined to inflict damage upon anyone who was brave enough to work with it.
You needed forearms of steel to cope with the primitive steering, and hitting a bump
in the wrong place at the wrong time could easily have resulted in the steering wheel
fracturing your wrist.
A long, downhill road led from the farm to a set of fields we farmed a couple of
miles away and I thought nothing of sitting on the Fordson mudguard while my father
freewheeled down the hill at breakneck speed. Contact between the mudguard and
my bottom was merely periodic as the machine bounced and swerved down the road.
There was no rollcage or cab and in retrospect, though it was commonplace at the
time, it was absolute, undiluted madness.
When I started rock climbing in 1975, technique and equipment were basic to say
the least. We used hawser-laid ropes and heavy, steel carabiners and we tied the rope
around our waist with a bowline knot. In order to hold a falling climber, we wrapped
the rope around our waist and twisted one arm around it to give extra grip. Using
physical strength and the friction of the rope around the waist and arm did allow a
climber to hold their partner, but the thin rope felt like it was cutting you in two, and
severe burn injuries from rope slippage were common.
In the same period, motorcyclists often didn’t wear helmets and car seat belts were
rarely fastened. Drunk driving was commonplace and there were few hi-vis jackets or
helmets on work sites. As a society, we just weren’t safety aware; there was no cultural
embedding of safety, and employing safety measures was often seen as being soft.
It’s interesting looking back at that period, because it illustrates very clearly how
a whole culture behaved in relation to safety at work and to leisure and personal
life, too. Farmers were, and still are, very self-sufficient, resourceful and also very
gung-ho when it comes to getting things done. There was a lot of macho behaviour,
9
risk-taking and arrogance that went along with being a farmer. At the time, that’s
how it was, and that was the expectation, but if I were presented with a similar set of
working conditions now, I’d have a totally different approach, my working life having
coincided with the development of modern approaches to health and safety at work
and the unstoppable health and safety movement. Agricultural accident figures are
still very high as a percentage compared to other industries. Farming has changed,
but I don’t think farmers have!
It’s taken over 40 years and nigh on two generations to create a strong safety
culture in the United Kingdom, and it’s still developing. Few of the strategies outlined
in this book have an immediate impact; in fact, it could take months or even years for
their effectiveness to be fully demonstrated. We need to make sure that we’re in this
for the long haul, and work collectively towards the cultural change that’s required
for long-term gains.
3 Born to Make Mistakes
John Long is a climbing legend. An American climber, part of the evocative free-
climbing movement that dominated rock climbing in spectacular centres such as
Yosemite in the 1970s, John Long also developed into an accomplished and entertaining
writer, covering everything from climbing instruction to more philosophical writings
on climbing. He made a series of groundbreaking first ascents of huge climbs in areas
such as Yosemite and was renowned for his skill, strength and mental stamina. If
anyone could be given the title ‘master of rock’, it would probably be him. Yet deep
into his climbing career, John Long sustained serious leg injuries in a fall at an indoor
climbing wall.
John Long, who was seriously injured in a fall in a climbing gym, reports that he is
on the mend, and has given details about the accident. Long says that he will go in for
a third surgery on Saturday to have plates installed in his leg, then will have a final
operation to graft the wound that resulted from the break. Long spent a total of 32 days
in hospital recovering from a severe compound fracture to his leg.
‘The docs tell me I’ll have a 100% recovery,’ he says. ‘I expect my ankle to be stiff,
but considering what could have happened, I am really lucky’.
Long was climbing at the Rockreation gym in Los Angeles on November 29 when
he started lowering from an anchor about 30 feet up the wall. ‘I went airball, right
to the deck,’ he said. ‘People who saw the fall said I did some juke cat move midair
to orient myself feet first. If I hadn’t done that,’ he says, ‘I would have gotten a lot
worse than a broken leg’.
Long said that he ties in with a double bowline, but this time, distracted and
tired after a long day of work, he didn’t finish the knot. ‘I made the two bowline
loops,’ he says, ‘and threaded the rope through my harness, but I didn’t bring the
rabbit out of the hole and around the tree’. Adds Long: ‘A lot of people are down on
the bowline, but the same thing would have happened with a trace-8. I just wasn’t
paying attention’.
John Long’s message in the last sentence is simple, yet critical – he’s saying that
lots of people are ‘down on the bowline’; in other words, it’s not a popular knot – but
he goes on to say that it was not the knot that failed, but the process of tying it, during
which he wasn’t paying attention. He considers the result could have been the same
regardless of which knot he was using to tie to his harness.
I’ve used John Long’s accident to illustrate that tiredness and distraction, and
indeed all the other common human failings, can affect even the most experienced
people.
11
Some climbing walls list their own statistics showing the types of near misses and accidents
that have taken place. Climbing walls remain a classic example of how a warm, indoor,
nonthreatening environment without objective dangers gives most people a false, low
perception of risk.
We’re Only Human, Born to Make Mistakes.

Chernobyl, April 1986. A safety test went spectacularly wrong while the operators
were simulating a full power failure in which safety systems were deliberately turned
off. A combination of design flaws and the reactor operators arranging the core in
a different way to the checklist for the test eventually resulted in an uncontrolled
reaction. A violent steam explosion and subsequent open-air graphite fire produced
radioactive emissions for about nine days. Practically all of this radioactive material
went on to fall out/precipitate onto much of the surface of the western USSR and
Another random document with
no related content on Scribd:
INTESTINAL INDIGESTION AND
OBSTRUCTION IN BIRDS.
Causes: Age, debility, atony, matting of feathers, dry or indigestible food, lack of
water, diseased oviducts, sand or gravel, lack of pebbles or power in gizzard.
Lesions: masses of egg, uric acid, or fæces in cloaca, implicating colon and cæca.
Symptoms: dullness, stupor, vertigo, staggering, erect plumage, trailing wings and
tail, bulging anus, covered with matted feathers, impaction felt by finger.
Treatment: extract mass, castor oil, laudanum, chalk, bismuth, pepper,
demulcents, phenol, exercise, silage, green food, pebbles.
Causes. These resemble those already noted for the dog. Old age,
debility, and atony of the bowel, the matting together of feathers
across the anus, dry feeding, indigestible food, scarcity of water, and
lack of exercise are especially to be noted. Malformations or other
changes lead to obstruction of the cloaca, and of defecation. Sand
and gravel passing from an atonic gizzard accumulate in the small
intestine or in the cæca distending them to great excess. Imperfect
trituration in the gizzard, from lack of pebbles, may prove a factor in
stoneless prairies.
Lesions. The most common seat of obstruction is at the cloaca, and
the impacted matter may be yellow partaking of the nature of yolk of
egg, or it may consist of feculent matters and uric acid in various
proportions, white, hard and fœtid. As in the dog this distension may
be continued forward blocking the colon and cæca as well. Lucet
mentions a case in which the impacted mass measured seven inches
long, and eight in circumference at its posterior and larger end.
Symptoms. The bird is dull, sluggish, stupid, giddy or unsteady on
its limbs, with feathers erect, wings, tail and head pendent and loses
flesh rapidly. Often a felted mass of feathers and fæces cover the
anus. In its absence there appears the rounded swelling or on
manipulation the impacted cloaca or rectum can be felt firm and
resistant.
Treatment. Soften and remove the external mass of fæces by the
aid of tepid water, clip off the feathers, which would tend to restore
it, then by the oiled finger and warm water injections break up and
extract the contents of cloaca and rectum. If impaction remains
farther forward give a teaspoonful of castor oil. If diarrhœa has
already set in, give 5 drops laudanum, and mix chalk or bismuth and
pepper in a mush to be fed to the patient. Injections of slippery elm
containing a teaspoonful of carbolic acid in the pint will prove useful.
The bird should be allowed plenty of exercise, its grain being fed
on a floor covered lightly with straw to encourage scratching, and
silage or green food should be allowed. On the prairies where pebbles
cannot be secured, imported gravel or vitrified brick broken into
small pieces should be allowed.
COLIC IN SOLIPEDS FROM VERMINOUS
EMBOLISM. INTESTINAL CONGESTION.
Definition. Causes: presence of sclerostoma in arteries, form, habit, nature,
immature, biology, life in bowel, in submucosa, in arteries, outside the mammal,
pathogenesis, blood-sucking, verminous cysts, verminous aneurisms, seats of
latter, coagula, embolism, stagnation of blood, œdema and thickening of intestine,
mesentery, fermentations, tympany, infective inflammations, blood extravasations,
infection of liver and spleen. Symptoms: sudden attack, violent colics, reckless
movements, frequent defecation followed by its arrest, palsy of peristaltic
movement, of pain, prostration. Course: two to twenty-four hours, death from
indigestion, tympany, obstruction, hemorrhage, poisoning, recovery, sequelæ,
laminitis, intestinal catarrh or atony, debility. Treatment: aneurism worms beyond
reach, treat lesions, venesection, anodynes, stimulants of peristalsis, antiseptics,
compresses, sinapisms. Prevention: expel intestinal worms, exclude embryos,
tartar emetic, iron sulphate, arsenic, phenol, pure water, occasional vermifuges.
Definition. Congestion and spasms of the intestines in connection
with blocking (thrombus or embolism) of the mesenteric arteries,
and verminous aneurism.
Causes. The essential cause is the migration of the sclerostoma
equinum (strongylus armatus, Rud.) into the mesenteric arteries in
its agamous condition. It seems appropriate therefore to here notice
the life history of this parasite.
The sclerostoma equinum (strongylus armatus) is one of the
common pin worms of the horse. It is distinguished by its dull gray
or reddish brown body, thickest at the cephalic end and tapering off
toward the caudal, but ending in a blunt point; by the round, open
mouth furnished with several firm chitinous rings, of which the outer
bears six short symmetrically arranged papillæ, an intermediate row
of rounded blunt tooth-like projections, and the innermost a row of
fine, closely aggregated and very sharply pointed teeth for
penetration of the mucosa. Male ¾ to 1½ inches long, with caudal
membranous alæ in two lateral lobes, joined by a rudimentary
central lobe: two delicate spicula. Female ¾ to 2 inches long, blunt
pointed tail, vulva in posterior half of the body. Eggs ovoid with
slightly raised ring around the centre: oviparous.
Habitats. They are found in solipeds in two stages of existence, the
mature worms in the cæcum and colon, and the immature in the
same organs encapsuled in little pellets of manure, and in cysts in the
mucosa but also apart in the arterial system especially in the anterior
mesenteric artery and other gastric or intestinal trunks.
The mature sclerostomata are found attached to the mucosa of
the large intestine into which the head is sunk for the purpose of
sucking the blood, and they may be gray, brown or red according to
the quantity of blood which they have imbibed. The author has found
them in little hernial sacs of the mucosa hanging from the peritoneal
surface.
The sexually immature sclerostomata are found in little pill-
like masses of ingesta in the large intestines and from which they
project part of the body through a narrow opening. Another habitat
is in cysts of the mucosa of the cæcum and colon and less frequently
of the small intestine, individual cysts varying in size from a pin’s
head to a hazel nut, and containing the young worm rolled upon
itself, and varying in size but always less than the intestinal worm
and always asexual. In some cases the cyst is found empty but with a
small opening toward the lumen of the bowel showing the means of
escape of the parasite. A third habitat of the immature worm is in the
blood-vessels, especially the posterior aorta and its divisions, and
still more constantly the anterior and other mesenteric arteries.
Biology. The ova of the sclerostoma are segmented in the oviduct
but are hatched out after they have been laid. The hatching may be
effected in the intestine or in manure or water external to the body.
When hatched out in the intestine they may pass out at once with the
manure or they may envelop themselves in pellets of the finer ingesta
and remain for a time in the bowel and finally pass out in this
condition. Baillet has traced their development out of the body. In a
watery or damp medium they are hatched out in a few days as a
cylindroid worm ¼ to ⅓ mm. long, thick in front and with a filiform
tail. In moist environment but especially in damp manure they grow
to 1 mm. or 1.5 mm. and continue for months in this condition, but
remain small and asexual, until taken in, in the drink or green food
of the soliped. Reaching the intestine and especially the cæcum and
colon they bore their way into the mucosa and encyst themselves, or
if they happen to perforate a blood-vessel they make a habitat of that.
In the cyst, development proceeds and when it has reached a certain
stage the worm once more bores its way through the mucosa and
reaching the intestine becomes sexually mature.
In this last migration the young worm is liable to perforate a
blood-vessel in which case it is destined to a period of existence in
the blood. It may, however, have blundered upon a blood-vessel at an
earlier stage when seeking a temporary home in the mucous
membrane, so that the sclerostomata of aneurisms may be derived
from two separate sources. In the blood-vessels the parasite attains a
length of 1 to 8 lines, whereas in the mucous cysts it does not exceed
3½ lines. Yet Neumann holds that after leaving the blood-vessels
they may again encyst themselves in the mucosa before escaping into
the intestine.
Several moultings take place in the asexual condition.
Other views have been advanced as to the development of the
sclerostomata. Colin believed that the ova deposited in the ducts of
the mucous glands and in the perforations made by the parasite in
blood-sucking, hatched in this situation and the embryo at once
encysted itself in the mucosa.
Leuckart imagines that the embryo found in the fæces or in water
outside the body of the soliped, should pass through an intermediate
host before it can return to gain sexual maturity in the horse. But no
evidence of the existence of such intermediate host is furnished, and
the encysted intestinal worms show no indication of a special
development which would have been accomplished in such host.
Willach holds to a hermaphrodite stage passed in the intestine of
the soliped. He found in the bowel small worms apparently related to
the sclerostomata by the appearance of the head and the caudal
membrane, but not exceeding three to five lines in length. Some were
evidently females and contained not only eggs with soft shells, but in
one case embryos. Others had the caudal membrane of the male, yet
contained also a few eggs. There is no vulva and the embryos escape
by rupture of the oviducts. These embryos he supposes are developed
in the same host into the familiar mature sclerostomata.
Whatever may be said of those alleged modes, the first described
series of changes and migrations may be taken as the usual and
regular method of development.
Pathogenesis. Lesions. These embrace perforations of the
mucosa, cysts, aneurisms, embolisms and congestions.
Irritation of the mucosa. The adult worms, like so many
leeches are continually biting and sucking blood from the mucosa
and when present in large numbers, hundreds, thousands, or a
million create an aggregate of irritation which may determine violent
indigestions and congestions.
Verminous Cysts. These are like a pin’s head, a pea or hazel nut,
containing the asexual worm in a mass of purulent debris, or if
empty, presenting a small orifice where it made its exit.
Verminous Aneurisms. These are perhaps the most important
lesions caused by the sclerostome as they are the steppingstone to
the dangerous embolisms, and too often fatal colics and congestions
of the intestines. They are very common in some localities, and rare
in others following the distribution of the sclerostomata. Bollinger
found them in 90 to 94 per cent. of adult horses, and Ellenberger in
84 out of 85 horses dissected. They are found in all ages from six
months up, and are nearly always in the short, stubby trunk of the
anterior mesenteric artery. Often two or three exist in the same
animal, the whole length of the posterior aorta showing patches of
disease, exudations, neoplastic elevations alternating with
depressions, and aneurisms and thrombosis in its different branches.
In 100 horses Bollinger found 168 aneurisms, 153 in the anterior
mesenteric, and its divisions, 4 in the cœliac axis and its divisions, 3
in the hepatic artery, 3 in the posterior mesenteric artery, 3 in the
renal arteries and 2 in the posterior aorta.
The special predisposition of the anterior mesenteric artery is
variously accounted for: 1st. There is the obvious fact that its
branches are distributed to the cæcum and double colon, the home of
the mature parasite, and to the small intestines which are first
reached by the young parasites that are taken in with the water and
the food. These are therefore most likely to get into the branches of
this vessel and to follow them up toward its origin. 2nd. The anterior
mesenteric artery distributes its branches to the small intestines the
most motile portion of the intestinal tract, and the cæcum and colon
the most heavily loaded with solid ingesta, it is therefore the most
subject to traction, and distensions, and the more so that the parent
trunk is extremely short and the divisions pass in all directions and
to a large extent at right angles, so that there is a dragging of the
walls apart as well as an obstruction to the blood flow and an
increase of internal tension. The distension, laceration, inflammation
and softening of the internal coat have accordingly been regarded as
the starting point of an endarteritis upon which the parasites have
been implanted as a further cause of trouble. We must not forget,
however, that the sharp circle of teeth of the parasite, by which it
fixes itself on the intima of the vessel are quite enough to produce
initial endarteritis, without any assistance from distension, traction
or laceration.
The irritation of the intima from whatever cause determines here
as elsewhere exudation, and coagulation, and the inflamed walls
losing their tone yield more and more readily to the internal tension.
Sometimes the coagulum lines the aneurism or vessel all round,
leaving a narrow central passage through which the blood still flows;
in other cases the clot extends into the adjacent smaller vessels,
completely blocking them and disturbing circulation and innervation
in the parts which they supply. As a rule the parasites are found in
galleries hollowed out in the clot, and heads or tails may be seen to
project into the circulating blood. Sometimes they are found
imbedded in the arterial coat, or in an adjacent small abscess. The
formation of aneurisms in the other arterial trunks may follow the
same method.
Embolisms. These come very naturally from the formation of
thrombi in the various arteries. The coagulum determined by the
presence of the worms, tends to undergo retrogressive changes
notably fatty degeneration, to which germs brought on the worms or
in their alimentary canals contribute. This together with the
movements of the parasites tends to break up the mass, and minute
portions are washed on into the different smaller vessels. Soon these
reach divisions which are too small to admit them, which are
accordingly occluded and the circulation through them abolished.
The presence of microbes as well as fibrine contributes to cause
further coagulation, more absolute embolism and arrest of the
circulation.
It is further alleged that the sexual instinct in the summer months
(May to August) leads the worms to leave the aneurisms, to pass
through the smaller divisions to the cæcum or colon where alone full
sexual evolution is possible. In these migrations they cause the
thrombosis of the smaller trunks and determine the verminous
congestions of the bowels which are especially common in these
months.
Disturbances of the Intestinal Circulation. As these usually
occur in the lines of distribution of the anterior mesenteric artery a
knowledge of its divisions and their destination and anastomosis, is
essential to an intelligent understanding of the pathogenesis and
lesions. As first pointed out by Lecoq the anterior mesenteric artery
is divided into three primary bundles: (a) a left of 15 to 20 trunks
which are destined to the small intestine; (b) a right which gives off
cæcal branches, one to the double colon, and one to the ilium to
anastomose with the last trunk of the left bundle; and (c) an anterior
which gives one branch to the second division of the double colon
and anastomosis with the colic branch of the right bundle at the
pelvic flexure; and a second branch to the floating colon to
anastomose with the posterior mesenteric artery.
The divisions of the left bundle anastomose so freely with each
other in the mesentery and immediately above the intestine that the
blocking of any one branch cannot entirely arrest the circulation in
the corresponding part of the intestine. It may however produce a
partial local stagnation in the vessels of a short loop of intestine,
resulting in œdematous infiltration and thickening with resulting
induration and stricture of the gut. Chronic and permanent lesions
are produced by such blocking, but only rarely acutely fatal ones.
Acute and fatal congestive lesions of the small intestine from
verminous embolism, occur only when several adjacent divisions of
the artery are blocked at once, and this is a rare occurrence.
The right bundle of branches furnishes the only two arteries which
are supplied to the cæcum and the only artery furnished to the first
half of the double colon. The ileo-cæcal branch is less involved, first,
because being less dependent and smaller, it is less likely to receive
an embolus, and, second, because any lack of blood supply is
counterbalanced by the free anastomosis with the last iliac division
of the left bundle. When the embolus blocks the undivided trunk of
the right bundle this same principle comes into play, the free supply
of blood from the posterior branch of the left bundle supplying blood
through its anastomosis with the iliac and cæcal branches of the
right.
But when the emboli are lower down, in the cæcal branches of the
right bundle, or in these and the colic branch, arrest of the
circulation in the intestinal walls ensues, followed by paresis, passive
congestion and hemorrhage. The cæcum and double colon thus
become the seats of the grave and fatal lesions of verminous
embolism.
The resulting lesions are to be variously accounted for. The
stagnation of blood in the vessels below the embolus, determines a
speedy exhaustion of its oxygen and increase of its carbon dioxide, so
that it is rendered unfit to maintain the normal nutrition and
functions of the part, and the capillary and intestinal walls are alike
struck with atony or paresis. The blood filters into the stagnant
vessels slowly from adjacent anastomosing trunks, and the liquor
sauguinis exudes into the substance of the tissues and lumen of the
intestine, leaving behind the greater part of the blood globules so
that the stagnant blood is rendered more and more abnormal in
composition. The walls of the capillaries soon lose their cohesion as
well as their contractility, and giving way at different points, allow
the escape of blood into the tissues, bowels and peritoneal cavity. It
has been further claimed that the emboli already infected and in
process of degeneration communicate this to the walls of the vessels
and to the stagnant blood, hastening the process of degeneration and
rupture.
Another series of circulatory disorders are liable to take place. The
blocking of the vessels of the right bundle, tends to increase the
blood pressure in the left bundle and the anterior one, and thus to
determine congestions, paresis and inflammations in the small
intestines, the second division of the double colon and the floating
colon. The resulting inflammation and increased vascular tension
may lead indirectly to implications of the brain and lung.
Extravasations so extensive as to appear like blood clots may be
present between the layers of the mesentery or in the mucosa and
submucosa, and blood, liquid or coagulated, may have accumulated
in the abdominal cavity. Blood effusion into the intestine gives a dark
red coloration to the contents which are further mixed with distinct
clots.
The atonic bowels are always the seat of extensive fermentations
and tympany. The microbes engaged in these fermentations and
their toxins, are accountable for toxic changes occurring in the locally
diseased parts and in distant organs. To this may be attributed the
congestion and softening of the liver and the engorgements and
hemorrhagic centres in the spleen.
Symptoms. An animal, perhaps known to harbor the sclerostoma
equinum, is suddenly attacked with violent and persistent colic. He
trembles, paws, moves his hind feet uneasily, kicks the abdomen,
throws anxious looks at the flanks, crouches, lies down, rolls, gets up,
and at once gets down again. The intensity of the suffering rapidly
increases, the face is drawn and pinched, the eye is extremely
anxious, the patient no longer lies down, but throws himself down
reckless of consequences, when down he is not quiet for an instant,
but now on his breast, then on his side, then on his back, the limbs
struggling and jerked violently, the head turned first to one side and
then to the other, he is a picture of extreme agony. If made to walk
the same indications continue; he walks with head down and limbs
semiflexed ready to drop at any moment, and often he will drop
suddenly in spite of every effort to keep him on his feet. The pulse is
at first strong and full, but as extensive effusion takes place into the
bowels or abdomen, or as the animal is poisoned by toxins, it
becomes small, weak, and it may be imperceptible. Breathing is
quick and catching, and the mucous membranes are dark red.
Sweating which shows first about the elbows or flanks or back of the
ears finally becomes general, the surface cold and the limbs
especially so. Fæces may be passed at first, a few dry balls at a time
from the floating colon or rectum, but soon they are suppressed
entirely. Some patients strain frequently to micturate but pass little
at a time.
In some instances the acute pain seems to suddenly cease, but
there is no general improvement, the patient stands with head
depressed, eyes sunken and expressionless, ears lopped, cold
perspiration, chilly limbs, unsteady gait and imperceptible pulse. It
implies merely a paralysis of the affected bowels in connection with
the extensive congestion and extravasation.
Course. Duration. The more acute cases reach their acme with
great rapidity, death may occur after two hours illness, and in other
cases it may be delayed ten or even twenty-four hours. It may be
caused by indigestion and tympany, by volvulus or invagination, by
excessive hemorrhage, or by poisoning with toxic matters.
Recovery occurs when the vessel blocked is an unimportant one as
a branch of the left bundle so that circulation may be reëstablished
from collateral trunks; or when a more important trunk has been but
partially blocked, and after a time it either clears itself, or collateral
circulation comes in with sufficient compensation. There is a more or
less rapid disappearance of the colics and other symptoms, a free
passage of urine, the rejection of fæces, it may be in a liquid, semi-
liquid or sanguineous condition, yet enough to indicate the
restoration of intestinal tone. The patient begins to pick morsels of
food and soon acquires his former appetite.
In some instances, however, the recovery is not complete. Trasbot
has noted a case of laminitis occurring within fifteen hours after the
improvement, and in other cases there remain chronic debility and
catarrh of the intestines. The appetite remains poor, there are
occasional colics, the bowels are irregular, loose or costive, and the
fæces are dry, glossy and covered with mucus. The back is arched,
the belly tucked up, strength and vigor are both lacking, and the
patient spends much time in the recumbent position.
Complications of various kinds may follow as in other diseases of
the intestines. After even the best recoveries, a relapse is always to be
apprehended as the original cause remains and the animal is liable to
be cut off at any time.
Treatment. This is very unsatisfactory as the original source of
trouble, the worms, being in the blood-vessels, cannot be reached by
vermifuges that would be harmless to the host, and clots blocking the
smaller intestinal vessels, cannot be dissolved and removed.
Moreover, although we could compass the death of the worms in the
aneurisms, we would leave their dead bodies as sources of septic
change, blood coagulation and embolism.
A certain number of cases, however, are not necessarily fatal, and
the worms of the blood-vessels have not an indefinite period of life,
so that there is some encouragement for both therapeutic and
preventive treatment. During the attack we must be content to treat
symptoms. French veterinarians still trust largely to general
bleeding, adopted at the very outset and to the extent of 6 to 10
quarts. It will temporarily lessen the vascular tension, more
permanently dilute the blood, and calm nervous excitement, and in
the most violent cases, as a kind of forlorn hope, it might be tried
with the view of tiding over the acute stage until a freer collateral
circulation could be established.
The use of anodynes will be more generally acceptable to American
practitioners. Two to four grains of sulphate of morphia or codeine
may be given hypodermically in combination with 1½ gr. eserin, 7
grs. barium chloride, or 2 grs. pilocarpin, to secure a speedy
movement of the bowels.
To counteract intestinal fermentation perhaps no better agent can
be got than chloral hydrate, ½ oz. of which may be given by the
mouth in water, and ½ oz. more by the rectum.
Wet compresses to the abdomen, or fomentations with water
rather hotter than the hand can bear or even the application of
mustard is sometimes useful as a soothing or derivative agent.
In the absence of morphia or chloral, laudanum, ether,
chloroform, camphor or assafœtida have been recommended.
It is important to keep the patient on a soft, littered floor to
prevent injury from his throwing himself down, and walking him
around may be resorted to for the same purpose.
Prevention. After a non-fatal attack and in every case in which a
horse is found to harbor the sclerostoma equinum in quantity,
measures should be taken to expel those present in the bowels and to
prevent the entry of embryos. The infested horse may be purged and
put on two drachms each of tartar emetic and sulphate of iron every
morning in a handful of feed half an hour before the first meal. After
six doses he may take a second active purgative. In case of need the
addition of 6 grains arsenious acid and a drachm of carbolic acid to
each dose will render them much more effective. All water must be
withheld that comes from streams running by farm-yards, from
ponds or open wells in barn-yards, from uncovered cisterns and from
any source which receives drainage or leaching from land occupied
by solipeds or spread with their manure.
A course of vermifuge medicine should be given at intervals of two
or three months to get rid of the worms which have passed in the
interval from the cysts of the colon, into the intestine.
NON-VERMINOUS INTESTINAL
CONGESTION IN SOLIPEDS.
Causes: sudden changes to green food, or leguminous fodder, newly harvested
fodder, frosted food, iced water, microbian infection, toxin poisoning, intestinal
fermentations, experiments, volvulus, invagination, strangulation, compression,
atony. Symptoms: as in verminous aneurisms. Diagnosis: absence of worms,
presence of other causes. Treatment.
Causes. Acute intestinal congestion apart from verminous
aneurisms is ascribed to a variety of causes. Sudden changes of food
especially to green food, in spring, or to some of the leguminous
fodder plants (alfalfa, cowpea, clover, tares, vetches), newly
harvested grain or hay, fodders covered with hoarfrost, iced water,
and microbian infection or poisoning with toxins or other irritant
products of intestinal fermentations. Experimentally the injection
into the circulation of pyogenic toxins and putrid matters has
determined intestinal congestion and hemorrhage. In the same way
musty hay or grain have proved the occasion of these attacks. Finally
mechanical blocking of the circulation of the intestine as by volvulus,
invagination, strangulated hernia, or even compression by bulky
food has seemed to operate in this way.
It ought to be borne in mind that the habitual microbes of the
healthy bowel may become pathogenic when brought in contact with
a mucosa which is the seat of irritation, atony or any condition of
debility.
Symptoms and Lesions. The verminous aneurisms and thrombosis
aside, the symptoms and lesions of this form of congestion so closely
resemble those of the verminous affection that it seems needless to
repeat them.
Diagnosis is difficult but the absence of worms in the affected
animals and their fellows, and the presence of some one of the other
recognized causes may lead to a fair conclusion.
Treatment of the affection is more hopeful than in the verminous
affection, and may be conducted on the same general lines.
PSEUDOMEMBRANOUS (CROUPOUS)
ENTERITIS IN SOLIPEDS.
Definition. Causes: As in ordinary enteritis, with added infections or toxins.
Symptoms: As in enteritis, nervous symptoms, diarrhœa. Lesions: Congested
mucosa, whitish or grayish false membranes, in patches or tubular casts, granular,
mucous, albuminoid, fibrinous. Diagnosis: False membranes in stools. Treatment:
Glauber salts, calomel, alkaline carbonates or tartrates, oils, antiferments,
demulcents, careful diet, bitters.
Definition. An inflammatory affection of the bowels characterized
by the ejection with the fæces of false membranes.
Causes. It has been long attributed to the causes which produce
other forms of enteritis and indigestions, as youth, rich stimulating
feeding, sudden change to green food in spring, sudden chills, over-
fatigue, confinement indoors, and prolonged costiveness. In man it is
found as a sequel of infectious diseases (pneumonia, pyæmia), in
Bright’s disease, cirrhosis of the liver and cancer, and in poisoning by
lead, mercury or arsenic (Osler). Cadeac, who found great numbers
of streptococci in the false membranes in animals, is certain it is a
microbian disease, and this is doubtless true, if qualified by the
statement that the microbe as is so often the case with other
intestinal affections, requires an occasion in the form of a diseased or
debilitated condition of the mucosa to enable it to become
pathogenic. The disease is not known to propagate itself indefinitely
or without such a predisposing occasion.
Symptoms. There are dullness, prostration, langor, hyperthermia,
accelerated pulse, and colics which may be slight or very severe. In
some cases nervous symptoms have been observed, such as
irritability or stupor and somnolence with icterus and fœtid stools.
The fæces are usually semi-liquid, implying an excessive liquid
secretion as well as the exudation of the membranous matter.
Lesions. There is a pink congestion of the intestinal mucosa more
or less generally distributed. Whitish false membranes cover patches
chiefly on the terminal portion of the small intestine, but frequently
also on the cæcum and colon, covering an especially red and angry
mucosa. They may occur as simple patches, as ribbon shaped pieces,
or as hollow cylinders lining the entire circumference of the
intestine. They appear as if fibrillated, but contain abundance of
granular matter and seem to be composed mainly of mucus with
albuminoid matter and probably a little fibrine. The deeper layers, in
contact with the inflamed surface are soft and gelatinoid. It is alleged
that coexisting wounds on other parts of the body become covered by
a soft pultaceous false membrane.
Diagnosis is based on the presence of the false membranes of a
considerable thickness, so that they can be distinguished from the
film of mucus which covers the fæcal balls in constipation or enteric
catarrh.
Treatment. Facilitate the secretion from the mucosa, and the
separation of the false membrane by giving 1 lb. Glauber salts, or give
this agent in doses of 5 or 6 ozs. per day. Calomel 1 dr. may be used
instead and has the additional advantage of acting as a disinfectant.
The alkaline carbonates or tartrates or even olive or castor oil may be
used as substitutes. Antiferments like salol, naphthol, salicylic acid,
and salicylate of soda have been prescribed to check the
multiplication of the germ. Flaxseed tea, elm bark, and other
mucilaginous agents may also be given. An easily digestible and
laxative diet and a course of bitters may follow.
ENTERITIS IN CATTLE.
Causes: as in solipeds, youth, overfeeding, plethora, dietetic blunders,

temperament, over-exertion, chill when heated, gestation, foul water, irritants,
drastics, infections. Symptoms: as in enteritis with false membranes,
complications. Duration. Lesions: false membranes, extent, color, structure,
composition, congested mucosa. Treatment: Glauber and other salts, pilocarpin,
potassium iodide, antiseptics, sulphites, sulphides, borax, bismuth, naphthol,
creolin, muriatic acid, bitters.
Causes. The same causes are quoted as in solipeds, youth, extra

high condition, rich feeding, sudden change to the green food of
spring, climatic vicissitudes of the same season, a sanguineous
(Reynal) or lymphatic (Friedberger and Fröhner) temperament,
overwork, exhausting travel, suppressed perspiration, gestation,
plethora, foul drinking water, special irritant plants (chicory,
Huzard), and drastic purgatives. Cadeac suggests bacteria, quoting
instances of a fifth or a fourth of a herd suffering at once. The same
would come from any other cause acting on the whole herd and it
seems probable that a microbian factor is present but can find
occasion for its pathogenesis only in given morbid conditions of the
mucous membrane. This would explain the failure of the affection to
propagate itself like a plague, and at the same time its tendency to
manifest itself extensively in given herds with a common
predisposing condition.
Symptoms. There are indications of enteric inflammation and
fever, rigors, slight hyperthermia, drying up of the milk secretion,
impaired or suspended appetite and rumination, constipation, colicy
pains, increasing dullness and prostration. As the disease advances
the excrements become soft, pultaceous or watery, with floating hard
baked pieces, dark and even glistening on the surface and more or
less false membranes. These are sometimes stained with blood,
which may also be mingled with the liquid debris. As in solipeds
these membranes constitute the only true diagnostic symptom. They
may appear as shreds, bands or complete cylindroid casts of the
intestine.
Other complications, like pseudomembranous exudate on wounds,
abortions and profound weakness are sometimes noted. The disease
may last eight days before ending in recovery. When death takes
place it is about the fourth or sixth day.
Lesions. The false membranes are found on the ilium and colon, in
thin films or in thick masses, or tubular casts. In extreme cases the
membrane has covered an extent of 24 feet in length, and if recent it
is soft and friable. If older it may be firm, consistent and yellow or
stained by the blood or ingesta. As in solipeds it shows a reticulated
network and a fine granular structure, and is composed mainly of
inspissated mucus with albuminoids and fibrine. The exudate covers
a surface of extreme redness, with points of darker blood-staining
and even abrasion or ulceration. The surrounding mucosa is also
congested, the villi hypertrophied, the mucous follicles swollen.
Treatment. In the early stages a laxative of soda sulphate is of
especial value in depleting from the inflamed mucosa, liquefying the
secretions and dissolving and loosening the false membranes. Epsom
salts, cream of tartar, Rochelle salts, calomel, and pilocarpin are
more or less valuable substitutes. Iodide of potassium is most
valuable in dissolving the exudate and acting as a microbicide (dose
3–4 drs.).
Other alkaline salts may be substituted or as antiseptics the
sulphites, hyposulphites, or sulphides of potash or soda. Borax,
bismuth, naphthol and creolin have also been recommended.
Enemata of warm water are desirable.
In very adynamic conditions, muriatic acid (½ dr. doses) may be
given with vegetable bitters and the same may be allowed during
convalescence.
ENTERITIS IN SHEEP.
Causes: As in cattle, draughts in folds, overfeeding. Symptoms: fever,
inappetence, weakness of hind parts, diarrhœa, tenesmus, false membranes, blood
in stools, tympany. Treatment: change diet of dam, exercise, Glauber salts,
potassium iodide, bismuth, flaxseed, elm bark, mallow, gum, carminatives, bitters,
antiseptics.
Causes. The same causes are claimed as for cattle. Clavel
attributed it to too rich milk, and exposure to cold draughts, in
folded lambs.
Symptoms. To the general symptoms of fever are added refusal of
the teat, weakness or paresis of the hind limbs, looseness of the
bowels and the ejection of false membranes with an unusual amount
of straining. The dejections may be watery and mixed with blood. In
some cases defecation is suppressed, the intestines being blocked by
the membranes, and then acute indigestion and fatal tympany may
follow.
The pathological anatomy and lesions resemble those seen in the
ox.
Treatment. Change the diet of the ewe, and allow more outdoor
exercise. Give the lamb Glauber salts (½ to 1 oz.) with potassium
iodide (10 grs.), and bismuth (1 dr.). Decoctions of flaxseed, or
solutions of elm bark, mallow or gum arabic are desirable, and
infusions of aromatic plants or oils of peppermint, anise, or fennel
may be added with quinia. As in the other animals such antiseptics
as salol, naphthol, naphthalin, boric acid, or salicylate of soda may be
administered.
ENTERITIS IN DOGS.
Complication of other diseases like distemper. Symptoms: fever, retching,
vomiting, tense, tender, tympanitic abdomen, irregular bowels, false membranes.
Lesions: stomach empty, congested, croupous exudate, extravasations. Treatment:
sodium sulphate, boric acid, sodium salicylate, salol, bismuth, by mouth or enema,
strychnia, vermifuges.
In dogs the formation of false membranes on the intestinal mucosa
seems to have less of an individual character, and is found associated
with other affections, like canine distemper and parasitism. In the
absence, however, of accurate knowledge of the specific cause of
croupous enteritis in other animals it seems permissible for the
present, to arrange the whole in one class characterized by the
presence of false membranes.
Symptoms. Along with the general symptoms of fever and the
special ones of the existing specific disease there is more or less
disturbance of the digestive organs, anorexia, vomiting, tense,
tender, perhaps tympanitic abdomen, irregularity of the bowels and
the passage of the false membranes. A morose disposition and
tendency to snap has been noticed by Röll.
Lesions. The stomach is empty with red or dark mottled mucosa,
the intestinal mucosa is congested covered with a layer of
mucopurulent exudate, and at intervals patches of false membranes
which are also found in shreds floating in the glairy contents. The
exudates are of a yellowish gray color, more or less streaked with
blood, and the mucosa infiltrated, swollen, highly congested and with
spots of extravasation of blood.
Treatment. Small doses (1 to 2 drachms) of sulphate of soda may
be given by the mouth, or boric acid (1 scruple), salicylate of soda (10
grains), salol (5 grains), or bismuth nitrate (½ drachm). Injections of
boric acid, borax, sodium hyposulphite, or even Glauber salts prove
useful, and powdered nux vomica (1 grain twice daily) may be added.
In case of intestinal parasites vermifuges must be resorted to.
ENTERITIS IN BIRDS.
In pigeons: Ærobic, non-motile bacillus, in lesions, membrane and internal
organs, pathogenesis, in chickens pathogenesis differs, also in man, parts attacked,
exudate, other symptoms, mortality early and late in outbreak, American form,
pathogenesis to rabbits and Guinea-pigs. Prevention: Avoidance of infection,
quarantine of birds, separation of sick, disinfection, accidental bearers of infection,
pigeons, buzzards, carrion crows, dogs, men, cleanliness. Treatment: Locally
antiseptics, phenol, boric acid, generally, phenol.
This has been especially seen in pigeons in which it has been
studied by Löffler, Cornil and Megnin, and Babes and Puscarin.
Löffler found an ærobic, non-motile, non-liquefying bacillus in the
false membranes, inflamed tissues, liver, lungs and blood, even in
the leucocytes. It formed irregular masses, and grew in nutrient
gelatine, blood serum and potato. It proved pathogenic to pigeons,
linnets, rabbits and mice, but not to hens, Guinea-pigs, rats or dogs.
Chickens, however, suffer from an acute diphtheritic affection caused
by a nearly allied bacillus, and it remains to be seen whether the
varying pathogenesis may not be due to the habit of long continued
growth in a particular genus and an acquired unfitness for growing
in the other. The pathogenesis is also different from the bacillus of
diphtheria of man, and the two diseases are not usually inter-
communicable, in spite of the fact that in rare instances infection has
appeared to have taken place from man to birds.
In pigeons and fowls the upper parts of the air passages and
digestive tract are mainly involved, the tongue, fauces, corners of the
mouth, nares, larynx, and conjunctiva. The bowels suffer less
frequently and mostly concurrently with the mouth, nose and throat.
The mucosa is deeply congested and in part covered by a yellowish
exudate which may accumulate in masses, and dry into a firm
substance. The disease affects particularly high bred birds, kept in
close warm houses, and is often imported by prize animals returned
from a show. There may be dullness, listlessness, sunken head,
trailing wings and tail, erect plumage, diarrhœa, and, if the nose and
throat are affected, a modification of the voice as in roup. Death may

Health and Safety Management: An Alternative Approach To Reducing Accidents, Injury and Illness at Work 1st Edition John White

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Health and Safety Management: An Alternative Approach To Reducing Accidents, Injury and Illness at Work 1st Edition John White

Uploaded by

Copyright:

Available Formats

Health and Safety Management: An

Alternative Approach to Reducing

Inherent safety at chemical sites : reducing

Safety at Work and Emergency Control: A Holistic

Prevention of Accidents and Unwanted Occurrences:

Health Illness and Society An Introduction to Medical

Bouncing back : resilience skills for adaptation to

Biota Grow 2C gather 2C cook Loucas

Acquired Brain Injury An Integrative Neuro

Global Occupational Safety and Health Management

© 2019 by Taylor & Francis Group, LLC

No claim to original U.S. Government works

Printed on acid-free paper

International Standard Book Number-13: 978-1-138-50083-9 (Paperback)

Library of Congress Cataloging-in-Publication Data

Names: White, John, 1955- author.

Visit the Taylor & Francis Web site at

Chapter 1 The History of Health and Safety.........................................................1

Chapter 2 A Personal Perspective: Part 1.............................................................. 9

Chapter 3 Born to Make Mistakes....................................................................... 11

Chapter 4 Marginal Gain..................................................................................... 17

Chapter 5 Accidents, Acts of God and Human Error..........................................25

Chapter 6 Lightning Always Strikes Twice......................................................... 33

Chapter 7 Black Box Thinking............................................................................ 39

Chapter 8 Risk Perception................................................................................... 43

Chapter 9 The Problem with Experience............................................................. 51

Chapter 10 A Personal Perspective: Part 2............................................................ 59

Chapter 11 Free-Thinking Hazard Identification.................................................. 61

Chapter 12 Dealing with Change........................................................................... 73

Nutrition and Work.............................................................................. 85

Chapter 14 Fitness for Work and Life.................................................................... 93

Chapter 15 Injury Reduction and Management.....................................................99

Chapter 16 Well-Being......................................................................................... 105

Enjoy Engaging Activities and Interests....................................... 121

Chapter 17 A Personal Perspective: Part 3.......................................................... 127

Chapter 18 A Connection with Nature and the Great Outdoors.......................... 133

Chapter 19 Team and Relationship Building....................................................... 143

• Reduce the incidence of human error in the workplace

Rock Climbing in Northern England

Sharp Edge, Blencathra, Lake District.

Q: ‘What did we have in place before health and safety?’

Rate of fatal injuries to workers in the agriculture, forestry and

All industries 0.43

Transport and storage 0.88

Water supply, sewerage, waste management &

Agriculture, forestry and ishing 7.61

HSE statistics show a general levelling-off trend.

We’re Only Human, Born to Make Mistakes.

Causes: as in solipeds, youth, overfeeding, plethora, dietetic blunders,

Causes. The same causes are quoted as in solipeds, youth, extra

You might also like