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US social security will no longer deny disability claims based on ability to work outdated jobs | US social security | The Guardian

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The US’s social security administration is no longer considering a number of outdated jobs as possible work opportunities to deny those applying for disability benefits.

Social security disability benefits are determined with a claimant’s medical records and ability to work in mind. If unable to perform their past job, the administration looks at the person’s age, education and work experience to see if they can do other kinds of work.

The administration’s list of unskilled jobs that people can allegedly perform with disabilities – some of which include pneumatic tube operator, microfilm processor, and nut sorter – has not been updated since 1991. So it lists occupations that are obsolete but which the government argues can be performed by people applying for disability while denying them benefits.

These jobs come from the so-called Dictionary of Occupational Titles (DOT), a publication developed in 1938 by the US government’s labor department. The department used the DOT to define tens of thousands of different types of work but abandoned volume more than thirty years ago to adopt a new system.

However, “the DOT is still used in social security disability adjudications,” according to the labor department.

A 2022 Washington Post investigation found that the DOT-informed list blocked claims from thousands of people hoping to receive benefits for their disabilities.

But the administration is developing a new method to make disability eligibility determinations based on the “Occupational Information System” (OIS).

The administration says the OIS will provide updated occupational information by “broadly describ[ing] the requirements of occupations in the national economy; and the ranges in which workers within occupations carry out critical tasks associated with their critical job functions”.

The OIS has been in development for several fiscal years, costing approximately $239m on pre-production testing and data collection between the fiscal years of 2012 and 2022. But it has yet to be implemented.

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B.C. port expansion approval broke Species at Risk law, hears court - Coast Reporter

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The Canadian government’s approval to expand the country’s largest port failed to properly justify how it would reduce or eliminate threats to endangered southern resident killer whales and their critical habitat — an “unreasonable” decision that breached the federal Species at Risk Act, a Vancouver Federal Court heard Monday. 

Those claims, made by lawyers for four environmental groups before Justice Christine Pallotta, came 14 months after the federal government approved the Roberts Bank Terminal 2 expansion project in Delta, B.C.

Built on a new man-made island adjacent to the current Deltaport container facility, the Vancouver Fraser Port Authority project seeks to add a three-berth marine container terminal, a widened causeway that would expand road and rail lines, and an extended basin for tugboats. 

The expansion is forecast to grow container capacity on Canada’s West Coast by a third. Without it, the federal government says $3 billion in added GDP would be put at risk by capacity shortages.

Despite its economic impact, detractors of the port expansion say building the facility will destroy 177 hectares of vital habitat for juvenile chinook salmon, the southern residents’ preferred prey. Noise from construction of the port’s expansion, as well as a subsequent increase in shipping, could also throw off the whales’ ability to forage. 

Lucero González, a conservation and policy campaigner for the Wilderness Committee, said her organization joined the request for a judicial review because the port expansion project could push the southern resident killer whales to extinction. More than that, she said the project’s approval threatens the very foundation of endangered species law in Canada. 

“There really doesn't seem to be a limit on how damaging a project can be for the federal government and provincial government to be like, ‘Let's not approve this,’” said González.

“Why do we have laws protecting them if they're not going to do anything?”

24% chance of functional extinction

Ranging from California to B.C., the southern residents' numbers have stagnated at around 75 individuals for decades. The genetically distinct population was listed as endangered under the Species at Risk Act in 2003. 

In the two decades since, scientists say the whale is threatened by a combination of climate change, toxic chemicals, vessel strikes and underwater acoustic disturbances. 

One of the biggest threats to the animals is a lack of food. Roughly 80 to 90 per cent of the southern resident killer whales' diet comes from chinook salmon. But the salmon species is already dwindling in the face of habitat destruction, overfishing, disease and the impacts of global warming on the ocean. A suffering prey population means fewer fish for whales to hunt.

Add noise from shipping traffic, which can effectively blind killer whales by interfering with their ability to echolocate prey, and a whale’s prospect of getting enough fish to survive sinks. 

The most recent analysis from Fisheries and Oceans Canada shows they face a 24 per cent chance of functional extinction as early as 75 years from now.  

‘Justified in the circumstances’

In its April 2023 decision, cabinet acknowledged that the expansion project would have “significant adverse effects” on the whales but that they were “justified in the circumstances.” 

Approval for the project came with 370 legally binding conditions to protect the environment and prevent harm to local species.

But the federal decision failed to clearly list any new measures that would directly avoid, lessen or minimize effects on the whales, measures that are required by law under the Species at Risk Act, argued Ecojustice staff lawyer Dyna Tuytel.

Tuytel said some of those measures listed by the federal government in its approval seek to minimize shipping noise. But ships around the world are getting bigger, and while overall traffic might not increase, more ships could be diverted to the Roberts Bank expansion, according to court documents. 

The applicants' lawyer told the court that many measures to protect the whales only dealt with existing noise and not future increases. She pointed to seasonal closures under the Whales Initiative — closures that are “not required to continue” and do not apply to shipping lanes that go to and from the port expansion. 

The port’s voluntary speed reduction ECHO Program, meanwhile, is “not enforceable” and not guaranteed to continue, Tuytel said.

Some programs could help produce measures in the future through research studies, policy development and data gathering. Tuytel told the court those are “all important things, but not measures that are capable of avoiding or lessening a project's effects.”

In its first round of arguments, the environmental groups ultimately argued that cabinet's decision to approve the project lacks “justification, transparency, and intelligibility” and fails to make it clear how it and the environment minister fell into line with the Species at Risk Act. 

“We’re not looking at the scientific merits of the measures but whether they adhere to the law,” Tuytel said. 

Is there a 'floor' for protecting endangered species? 

Ecojustice lawyer Kegan Pepper-Smith argued before the court that the federal government’s move to approve the port expansion has set up a novel legal collision between two laws. He said it has raised questions over whether the Species at Risk Act can restrict the decisions made under the Canadian Environmental Assessment Act.

“This question of whether a major project such as the terminal theory will jeopardize a species’ existence goes to the core of the purposes of SARA. It is untenable and unreasonable to claim that the governor-in-council had no obligation to grapple that question…” Pepper-Smith said. 

The port expansion represents the first time a major industrial project is coming into direct conflict with a species protected as endangered under Canada’s Species at Risk law, said Margot Venton, a staff lawyer and head of the nature program at Ecojustice, the firm representing the applicants.

Multiple scientific and government panels have found that, unmitigated, the expansion project will accelerate the extinction trajectory of southern resident killer whales.

“We've never gotten to the end of an environmental assessment where the cabinet has justified significant adverse impacts that will accelerate extinction trajectory. Factually, that hasn't happened,” said Venton.

“It's a pretty profound question in a lot of ways. Is there a floor of protection for endangered species in Canada, or is there not?”

Arguments continue Tuesday

On Tuesday, lawyers for the attorney general of Canada are expected to argue that the environment minister and cabinet’s order-in-council decision are both reasonable. 

They are expected to further submit that the environmental groups' arguments are “misplaced” and misinterpret the Species at Risk Act. As court wrapped up Monday, federal lawyer Jon Khan said the Roberts Bank Terminal 2 expansion underwent “the longest environmental assessments in Canadian history.” He called on Justice Pallotta to throw out the case. 

The two-day judicial review will later include submissions from lawyers for the Vancouver Fraser Port Authority.

Judges in similar cases often take around six months to render a decision. 

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Birmingham, Britain's second-largest city, is being forced to dim lights and cut sanitation services due to bankruptcy - ABC News

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Once nicknamed "the workshop of the world", Birmingham was an industrial powerhouse in the 18th and 19th centuries.

It's where William Murdoch invented the first gas lantern, a technology later used to light streets across the world.

But today the UK's second-largest city can no longer afford to keep its own streets brightly lit.

In September Birmingham City Council issued a 114 notice, effectively declaring it was bankrupt.

To claw back $600 million over the next two years, the council has approved a range of unprecedented budget cuts that will see streetlights dimmed and rubbish collected only once a fortnight.

"It's like we're living in the Dickens era, where the streets are going to be littered with rubbish and the lights are going to be off … it's like this kind of dystopian nightmare," Birmingham mother of three Ramandeep Kaur told 7.30.

"There's nothing to look forward to … it's quite a frightening time."

Ms Kaur and her family will be hit harder than most by the city's sweeping cuts.

Her 17-year-old son Harry has Down syndrome and has relied on a council-funded school taxi service since he was four years old. From September that service will stop.

He will instead be given a budget to use public transport, but Ms Kaur says it's a journey he can't manage on his own.

"We're left in a situation where I will either have to give up work and take him to school every day, or I will have to pay £40 ($77) per day for a taxi and a driver to get him to school," she said.

"I always feel that my son is kind of seen as a cost burden, not just as a young person who wants to stay in education and do the things that he really loves."

'Rampant poverty' 

The cuts will also see 25 of the city's libraries close, money for children's services slashed and a 100 per cent funding cut to the arts and culture sector by 2026.

University student Kamran Shah, 19, says "it's not looking good" for young people in the city.

"If you're not providing us with the things that we need, we can't really help the city or help ourselves into a better position," he told 7.30.

"Everything's just gone really bad these past two years.

"For what it has and what it's been, now it's kind of at a standstill."

Birmingham is one of the youngest cities in Europe, with nearly 40 per cent of its residents under 25 years old, according to both government and university studies.

Many in the city feel young people will be the worst affected by the cuts to frontline and preventative services.

"This is the second-largest city in the sixth-richest country in the world and we have rampant poverty ... children are growing up below the poverty line," Birmingham youth mental health worker Nina Barbosa said.

Ms Barbosa works for England's National Health Service (NHS) and says pressure on the system is "past crisis point".

"We get about 70 to 80 referrals a day into our services of which, on a good day, we'll take on about 20. On a bad day it'll be far less," she said.

"What we are already starting to see, as a consequence of what's happening in the council, there are even bigger increases in the number of people who are being referred through to us, and those young people are even more unwell than they were before."

'Financial black hole'

Birmingham's financial black hole was at least partially self-inflicted.

A gender-pay dispute settlement and the flawed implementation of a new IT system forced the council to admit it couldn't afford to meet its financial obligations.

But Birmingham council leader John Cotton claims the city's debts were compounded by austerity measures brought in by the Cameron government in 2010.

"The mistakes made in Birmingham have not occurred in a vacuum and councils are facing a perfect storm of smaller budgets but higher costs," Mr Cotton said.

Birmingham is one of the most recent UK councils to go bust. Since 2018 eight local governments in the UK have fallen into the red.

Nick Davies, programme director of British think-tank Institute for Government, says the austerity measures brought in under former prime minister David Cameron have degraded public services across the country.

The austerity measures included a reduction in government spending on welfare, local authorities, police, courts and prisons as well as the cancellation of school building programs.

"Services never completely crumble but we are seeing the closest equivalent to that," Mr Davies said.

"The public find it very difficult to access general practice health services, adult social care services are rationed, there's also huge backlogs in the criminal courts and our prisons are full to bursting point."

National election looming

The dire state of public services in the UK, paired with a cost-of-living crisis, is expected to be a major driver for voters at the general election on July 4. 

Polls predict a Labour landslide for Sir Keir Starmer, which would put an end to 14 years of Tory governance. 

UK Labour's 'red wall' across the middle and north of England crumbled in 2019, as the Conservative party picked up marginal seats with the promise of "levelling-up" the regions.

But the disparity between Britain's capital London and cities like Birmingham remains stark.

Of the UK's core cities, Birmingham has the highest number of people claiming unemployment support, with 12 per cent of residents relying on government benefits, compared to just five per cent in London.

On average, people in Birmingham die three years younger than those living 160km away in London, while just under 50 per cent of all children in Birmingham are classed as living in poverty, compared to 32 per cent in the capital. 

Birmingham is the largest city in England's West Midlands and is a key battleground in the upcoming vote.

The once-popular Conservative West Midlands mayor Andy Street was toppled in local elections last month, a blow to Prime Minister Rishi Sunak's hopes of retaining support in middle England.

But faith in politicians is at an all-time low and those struggling to access support in Birmingham aren't confident a new Labour government can solve their problems.

"I don't feel reassured at the moment by any of the parties. Nobody's talking about disability, nobody's really talking about social care," Ms Kaur said

"It will take them a long time to resolve the situation and make our lives better."

Ms Barbosa believes a change in government at a national level is the only way to take her city forward.

"This particularly conservative government have been extraordinarily brutal on many, many fronts and seem to have no embarrassment about driving the second-largest city into a grave for the next two generations," she said.

"I hope that enough pressure can be put on the incoming Labour government, that I expect we will have, that they will stop this."

Watch 7.30, Mondays to Thursdays 7:30pm on ABC iview and ABC TV

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the motel room, or: on datedness



Often I find myself nostalgic for things that haven’t disappeared yet. This feeling is enhanced by the strange conviction that once I stop looking at these things, I will never see them again, that I am living in the last moment of looking. This is sense is strongest for me in the interiors of buildings perhaps because, like items of clothing, they are of a fashionable nature, in other words, more impermanent than they probably should be.

As I get older, to stumble on something truly dated, once a drag, is now a gift. After over a decade of real estate aggregation and the havoc it’s wreaked on how we as a society perceive and decorate houses, if you’re going to Zillow to search for the dated (which used to be like shooting fish in a barrel), you’ll be searching aimlessly, for hours, to increasingly no avail, even with all the filters engaged. (The only way to get around this is locational knowledge of datedness gleaned from the real world.) If you try to find images of the dated elsewhere on the internet, you will find that the search is not intuitive. In this day and age, you cannot simply Google “80s hotel room” anymore, what with the disintegration of the search engine ecosystem and the AI generated nonsense and the algorithmic preference for something popular (the same specific images collected over and over again on social media), recent, and usually a derivative of the original search query (in this case, finding material along the lines of r/nostalgia or the Backrooms.)

To find what one is looking for online, one must game the search engine with filters that only show content predating 2021, or, even better, use existing resources (or those previously discovered) both online and in print. In the physical world of interiors, to find what one is looking for one must also now lurk around obscure places, and often outside the realm of the domestic which is so beholden to and cursed by the churn of fashion and the logic of speculation. Our open world is rapidly closing, while, paradoxically, remaining ostensibly open. It’s true, I can open Zillow. I can still search. In the curated, aggregated realm, it is becoming harder and harder to find, and ultimately, to look.

But what if, despite all these changes, datedness was never really searchable? This is a strange symmetry, one could say an obscurity, between interiors and online. It is perhaps unintentional, and it lurks in the places where searching doesn’t work, one because no one is searching there, or two, because an aesthetic, for all our cataloguing, curation, aggregation, hoarding, is not inherently indexable and even if it was, there are vasts swaths of the internet and the world that are not categorized via certain - or any - parameters. The internet curator’s job is to find them and aggregate them, but it becomes harder and harder to do. They can only be stumbled upon or known in an outside, offline, historical or situational way. If to index, to aggregate, is, or at least was for the last 30 years, to profit (whether monetarily or in likes), then to be dated, in many respects, is the aesthetic manifestation of barely breaking even. Of not starting, preserving, or reinventing but just doing a job.

We see this online as well. While the old-web Geocities look and later Blingee MySpace-era swag have become aestheticized and fetishized, a kind of naive art for a naive time, a great many old websites have not received the same treatment. These are no less naive but they are harder to repackage or commodify because they are simple and boring. They are not “core” enough.

As with interiors, web datedness can be found in part or as a whole. For example, sites like Imgur or Reddit are not in and of themselves dated but they are full of remnants, of 15-year old posts and their “you, sir, have won the internet” vernacular that certainly are. Other websites are dated because they were made a long time ago by and for a clientele that doesn’t have a need or the skill to update (we see this often with Web 2.0 e-commerce sites that figured out how to do a basic mobile page and reckoned it was enough). The next language of datedness, like the all-white landlord-special interior, is the default, clean Squarespace restaurant page, a landing space that’s the digital equivalent of a flyer, rarely gleaned unless someone needs a menu, has a food allergy or if information about the place is not available immediately from Google Maps. I say this only to maintain that there is a continuity in practices between the on- and off-line world beyond what we would immediately assume, and that we cannot blame everything on algorithms.

But now you may ask, what is, exactly, datedness? Having spent two days in a distinctly dated hotel room, I’ve decided to sit in utter boredom with the numinous past and try and pin it down.


I am in an obscure place. I am in Saint-Georges, Quebec, Canada, on assignment. I am staying at a specific motel, the Voyageur. By my estimation the hotel was originally built in the late seventies and I’d be shocked if it was older than 1989. The hotel exterior was remodeled sometime in the 2000s with EIFS cladding and beige paint. Above is a picture of my room, which, forgive me, is in the process of being inhabited. American (and to a lesser extent Canadian) hotel rooms are some of the most churned through, renovated spaces in the world, and it’s pretty rare, unless you’re staying in either very small towns or are forced by economic necessity to stay at real holes in the wall, to find ones from this era. The last real hitter for me was a 90s Day’s Inn in the meme-famous Breezewood, PA during the pandemic.

At first my reaction to seeing the room was cautionary. It was the last room in town, and certainly compared to other options, probably not the world’s first choice. However, after staying in real, genuine European shitholes covering professional cycling I’ve become a class-A connoisseur of bad rooms. This one was definitively three stars. A mutter of “okay time to do a quick look through.” But upon further inspection (post-bedbug paranoia) I came to the realization that maybe the always-new brainrot I’d been so critical of had seeped a teeny bit into my own subconscious and here I was snubbing my nose at a blessing in disguise. The room is not a bad room, nor is it unclean. It’s just old. It’s dated. We are sentimental about interiors like this now because they are disappearing, but they are for my parents what 2005 beige-core is for me and what 2010s greige will become for the generation after. When I’m writing about datedness, I’m writing in general using a previous era’s examples because datedness, by its very nature, is a transitional status. Its end state is the mixed emotion of seeing things for what they are yet still appreciating them, expressed here.

Datedness is the period between vintage and contemporary. It is the sentiment between quotidian and subpar. It is uncurated and preserved only by way of inertia, not initiative. It gives us a specific feeling we don’t necessarily like, one that is deliberately evoked in the media subcultures surrounding so-called “liminal” spaces: the fuguelike feeling of being spatially trapped in a time while our real time is passing. Datedness in the real world is not a curated experience, it is only what was. It is different from nostalgia because it is not deliberately remembered, yearned for or attached to sweetness. Instead, it is somehow annoying. It is like stumbling into the world of adults as a child, but now you’re the adult and the child in you is disappointed. (The real child-you forgot a dull hotel room the moment something more interesting came along.) An image of my father puts his car keys on the table, looks around and says, “It’ll do.” We have an intolerance for datedness because it is the realization of what sufficed. Sufficiency in many ways implies lack.

However, for all its datedness, many, if not all, of the things in this room will never be seen again if the room is renovated. They will become unpurchaseable and extinct. Things like the bizarrely-patterned linoleum tile in the shower, the hose connecting to the specific faucet of the once-luxurious (or at least middling) jacuzzi tub whose jets haven’t been exercised since the fall of the Berlin Wall. The wide berth of the tank on the toilet. There is nothing, really, worth saving about these things. Even the most sentimental among us wouldn’t dare argue that the items and finishes in this room are particularly important from a design or historical standpoint. Not everything old has a patina. They’re too cheaply made to salvage. Plastic tile. Bowed plywood. The image-artifacts of these rooms, gussied up for Booking dot com, will also, inevitably disappear, relegated to the dustheap of web caches and comments that say “it was ok kinda expensive but close to twon (sic).” You wouldn’t be able to find them anyway unless you were looking for a room.

One does, of course, recognize a little bit of design in what’s here. Signifiers of an era. The wood-veneer of the late 70s giving way to the pastel overtones of the 80s. Perhaps even a slow 90s. The all-in-one vanity floating above the floor, a modernist basement bathroom hallmark. White walls as a sign of cleanliness. Gestures, in the curved lines of the nightstands, towards postmodernity. Metallic lamp bases with wide-brimmed shades, a whisper of glamor. A kind of scalloped aura to the club chairs. The color teal mediated through hundreds if not thousands of shoes. Yellowing plastic, including the strips of “molding” that visually tie floor to wall. These are remnants (or are they intuitions?) of so many movements and micromovements, none of them definite enough to point to the influence of a single designer, hell, even of a single decade, just strands of past-ness accumulated into one thread, which is cheapness. Continuity exists in the materials only because everything was purchased as a set from a wholesale catalog.

In some way a hotel is supposed to be placeless. Anonymous. Everything tries to be that way now, even houses. Perhaps because we don’t like the way we spy on ourselves and lease our images out to the world so we crave the specificity of hotel anonymity, of someplace we move through on our way to bigger, better or at least different things. The hotel was designed to be frictionless but because it is in a little town, it sees little use and because it sees little use, there are elements that can last far longer than they were intended and which inadvertently cause friction. (The janky door unlocks with a key. The shower hose keeps coming out of the faucet. It’s deeply annoying.)

Lack of wear and lack of funds only keep them that way. Not even the paper goods of the eighties have been exhausted yet. Datedness is not a choice but an inevitability. Because it is not a choice, it is not advertised except in a utilitarian sense. It is kept subtle on the hotel websites, out of shame. Because it does not subscribe to an advertiser’s economy of the now, of the curated type rather than the “here is my service” type, it disappears into the folds of the earth and cannot be searched for in the way “design” can. It can only be discovered by accident.

When I look at all of these objects and things, I do so knowing I will never see them again, at least not all here together like this, as a cohesive whole assembled for a specific purpose. I don’t think I’ll ever have reason to come back to this town or this place, which has given me an unexpected experience of being peevish in my father’s time. Whenever I end up in a place like this, where all is as it was, I get the sense that it will take a very long time for others to experience this sensation again with the things my generation has made. The machinations of fashion work rapaciously to make sure that nothing is ever old, not people, not rooms, not items, not furniture, not fabrics, not even design, that old matron who loves to wax poetic about futurity and timelessness. The plastic-veneered particleboard used here is now the bedrock of countless landfills. Eventually it will become the chemical-laced soil upon which we build our condos. It is possible that we are standing now at the very last frontier of our prior datedness. The next one has not yet elided. It’s a special place. Spend a night. Take pictures.

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The return of pneumatic tubes

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Pneumatic tubes were touted as something that would revolutionize the world. In science fiction, they were envisioned as a fundamental part of the future—even in dystopias like George Orwell’s 1984, where the main character, Winston Smith, sits in a room peppered with pneumatic tubes that spit out orders for him to alter previously published news stories and historical records to fit the ruling party’s changing narrative.  

In real life, the tubes were expected to transform several industries in the late 19th century through the mid-20th. “The possibilities of compressed air are not fully realized in this country,” declared an 1890 article in the New York Tribune. “The pneumatic tube system of communication is, of course, in use in many of the downtown stores, in newspaper offices […] but there exists a great deal of ignorance about the use of compressed air, even among engineering experts.”

Pneumatic tube technology involves moving a cylindrical carrier or capsule through a series of tubes with the aid of a blower that pushes or pulls it into motion. For a while, the United States took up the systems with gusto. Retail stores and banks were especially interested in their potential to move money more efficiently: “Besides this saving of time to the customer the store is relieved of all the annoying bustle and confusion of boys running for cash on the various retail floors,” one 1882 article in the Boston Globe reported. The benefit to the owner, of course, was reduced labor costs, with tube manufacturers claiming that stores would see a return on their investment within a year.  

“The motto of the company is to substitute machines for men and for children as carriers, in every possible way,” a 1914 Boston Globe article said about Lamson Service, one of the largest proprietors of tubes at the time, adding, “[President] Emeritus Charles W. Eliot of Harvard says: ‘No man should be employed at a task which a machine can perform,’ and the Lamson Company supplements that statement by this: ‘Because it doesn’t pay.’”

By 1912, Lamson had over 60,000 customers globally in sectors including retail, banks, insurance offices, courtrooms, libraries, hotels, and industrial plants. The postal service in cities such as Boston, Philadelphia, Chicago, and New York also used tubes to deliver the mail, with at least 45 miles of Lamson tubing in place by 1912.

On the transportation front, New York City’s first attempt at a subway system, in 1870, also ran on a pneumatic system, and the idea of using tubes to move people continues to beguile innovators to this day. (See Elon Musk’s largely abandoned Hyperloop concept of the 2010s.)

But by the mid to late 20th century, use of the technology had largely fallen by the wayside. It had become cheaper to transport mail by truck than by tube, and as transactions moved to credit cards, there was less demand to make change for cash payments. Electrical rail won out over compressed air, paper records and files disappeared in the wake of digitization, and tubes at bank drive-throughs started being replaced by ATMs, while only a fraction of pharmacies used them for their own such services. Pneumatic tube technology became virtually obsolete.

Except in hospitals. 

“A pneumatic tube system today for a new hospital that’s being built is ubiquitous. It’s like putting a washing machine or a central AC system in a new home. It just makes too much sense to not do it,” says Cory Kwarta, CEO of Swisslog Healthcare, a corporation that—under its TransLogic company—has provided pneumatic tube systems in health-care facilities for over 50 years. And while the sophistication of these systems has changed over time, the fundamental technology of using pneumatic force to move a capsule from one destination to another has remained the same. 

By the turn of the 20th century, health care had become a more scientific endeavor, and different spaces within a hospital were designated for new technologies (like x-rays) or specific procedures (like surgeries). “Instead of having patients in one place, with the doctors and the nurses and everything coming to them, and it’s all happening in the ward, [hospitals] became a bunch of different parts that each had a role,” explains Jeanne Kisacky, an architectural historian who wrote Rise of the Modern Hospital: An Architectural History of Health and Healing, 1870–1940

Designating different parts of a building for different medical specialties and services, like specimen analysis, also increased the physical footprint of health-care facilities. The result was that nurses and doctors had to spend much of their days moving from one department to another, which was an inefficient use of their time. Pneumatic tube technology provided a solution.

By the 1920s, more and more hospitals started installing tube systems. At first, the capsules primarily moved medical records, prescription orders, and items like money and receipts—similar cargo to what was moved around in banks and retail stores at the time. As early as 1927, however, the systems were also marketed to hospitals as a way to transfer specimens to a central laboratory for analysis. 

By the 1960s, pneumatic tubes were becoming standard in health care. As a hospital administrator explained in the January 1960 issue of Modern Hospital, “We are now getting eight hours’ worth of service per day from each nurse, where previously we had been getting about six hours of nursing plus two hours of errand running.”

As computers and credit cards started to become more prevalent in the 1980s, reducing paperwork significantly, the systems shifted to mostly carrying lab specimens, pharmaceuticals, and blood products. Today, lab specimens are roughly 60% of what hospital tube systems carry; pharmaceuticals account for 30%, and blood products for phlebotomy make up 5%.

The carriers or capsules, which can hold up to five pounds, move through piping six inches in diameter—just big enough to hold a 2,000-milliliter IV bag—at speeds of 18 to 24 feet per second, or roughly 12 to 16 miles per hour. The carriers are limited to those speeds to maintain specimen integrity. If blood samples move faster, for example, blood cells can be destroyed.

The pneumatic systems have also gone through major changes in structure in recent years, evolving from fixed routes to networked systems. “It’s like a train system, and you’re on one track and now you have to go to another track,” says Steve Dahl, an executive vice president at Pevco, a manufacturer of these systems.

Manufacturers try to get involved early in the hospital design process, says Swisslog’s Kwarta, so “we can talk to the clinical users and say, ‘Hey, what kind of contents do you anticipate sending through this pneumatic tube system, based on your bed count, based on your patient census, and from where and to where do these specimens or materials need to go?’”

Penn Medicine’s University City Medical District in Philadelphia opened up the state-of-the-art Pavilion in 2021. It has three pneumatic systems: the main one is for items directly related to health care, like specimens, and two separate ones handle linen and trash. The main system runs over 12 miles of pipe and completes more than 6,000 transactions on an average day. Sending a capsule between the two farthest points of the system—a distance of multiple city blocks—takes just under five minutes. Walking that distance would take around 20 minutes, not including getting to the floor where the item needs to go. 

Michigan Medicine has a system dedicated solely for use in nuclear medicine, which relies on radioactive materials for treatment. Getting the materials where they need to go is a five- to eight-minute walk—too long given their short shelf life. With the tubes, it gets there—in a lead-lined capsule—in less than a minute. 

Steven Fox, who leads the electrical engineering team for the pneumatic tubes at Michigan Medicine, describes the scale of the materials his system moves in terms of African elephants, which weigh about six tons. “We try to keep [a carrier’s] load to five pounds apiece,” he says. “So we could probably transport about 30,000 pounds per day. That’s two and a half African elephants that we transport from one side of the hospital to the other every day.”

The equipment to maintain these labyrinthian highways is vast. Michigan and Penn have between 150 and 200 stations where doctors, nurses, and technicians can pick up a capsule or send one off. Keeping those systems moving also requires around 30 blowers and over 150 transfer units to shift carriers to different tube lines as needed. At Michigan Medicine, moving an item from one end of the system to another requires 20 to 25 pieces of equipment.

Before the turn of the century, triggering the blower to move a capsule from point A to point B would be accomplished by someone turning or pressing an electronic or magnetic switch. In the 2000s, technicians managed the systems on DOS; these days, the latest systems run on programs that monitor every capsule in real time and allow adjustments based on the level of traffic, the priority level of a capsule, and the demand for additional carriers. The systems run 24 hours a day, every day. 

“We treat [the tube system] no different than electricity, steam, water, gas. It’s a utility,” says Frank Connelly, an assistant hospital director at Penn. “Without that, you can’t provide services to people that need it in a hospital.”

“You’re nervous—you just got blood taken,” he continues. “‘How long is it going to be before I get my results back?’ Imagine if they had to wait all that extra time because you’re not sending one person for every vial—they’re going to wait awhile until they get a basket full and then walk to the lab. Nowadays they fill up the tube and send it to the lab. And I think that helps patient care.” 

Vanessa Armstrong is a freelance writer whose work has appeared in the New York TimesAtlas ObscuraTravel + Leisure, and elsewhere. 

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This weightlifting workout in your 60s can preserve strength for years

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It’s never too late to start lifting weights — and now there are more signs it can provide enduring health benefits for older people.

Researchers at the University of Copenhagen in Denmark found that regularly lifting weights for a year in your mid-60s can preserve the strength of your leg muscles for years to come. Here are the key findings:

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  • Retirement-age people who underwent a 12-month weightlifting training regimen had noticeably stronger leg muscles three years after finishing the program than those who did more moderate strengthening exercises or none at all, the study found.
  • The weightlifting training group visited a commercial gym three times a week for a year and repeatedly lifted what was considered a heavy load: 70 to 85 percent of the maximum weight a person can physically lift at one time.
  • Although the supervised program lasted only a year, scientists followed up three years later. Individuals in the “heavy” weightlifting cohort were the only participants to have maintained, on average, the leg strength they had before they began the training program.

Notably, leg strength is a critical indicator of wider health and mobility among older people. The findings add to a growing body of evidence suggesting that weightlifting can help older people stave off frailty and stay healthy as they age.

“Leg strength is really important,” Mads Bloch-Ibenfeldt, a medical researcher at the University of Copenhagen who co-wrote the study, said in a phone interview Wednesday. “We use the legs in a lot of everyday tasks, like getting up and down from a chair. So it’s important for reducing the risk of falls, and for a lot of everyday tasks we do.”

The weightlifting workout

As part of the study, scientists at a university hospital in Copenhagen divided 451 people at retirement age into three randomized groups, each tasked with completing a different one-year exercise regimen.

  • The “heavy” weightlifting training group visited a commercial gym three times a week for a supervised program of full-body strength training.
  • Participants determined the most weight they could lift at one time using typical weight machines found in gyms. Then they calculated 70 to 85 percent of their one-rep maximum and used that weight in their training. So if the most they could lift at one time was 100 pounds, they used 70- to 85-pound weights in their training.
  • They trained three times a week, doing three sets of every exercise. Each set included 6 to 12 repetitions.
  • The routine included a mixture of nine upper- and lower-body exercises: leg press, knee extension, leg curl, ankle plantar flexion exercises, hip abduction, low rowing, chest press, abdominal crunches and lower-back exercises.
  • Although the scientists described the regimen as “heavy” weightlifting compared to two other groups in the study, the weight training program may be similar to many standard weight training routines.

Heavy weight training vs. moderate resistance

The second group underwent a year-long moderate-intensity training regimen using body weight and resistance bands three times a week. The resistance bands were less challenging than the heavy group’s weightsabout 50 to 60 percent of the maximum weight a person can lift at one time.

The third cohort was a control group that did less than one hour of strenuous exercise a week.

Over four years, scientists observed participants’ physical strength, including leg strength, handgrip strength and lean leg mass. Researchers measured participants’ strength at the beginning of the supervised 12-month training regimen, then again after it ended. They followed up again one year after it finished, and three years after it ended.

After three years, researchers noted that a small minority of exercise participants had continued with the same program of their own accord, yet the benefits of the heavy training workout were maintained.

“We found that if you did one year of resistance training with heavy weights, you were able to maintain the strength in your legs that you had when you began the study,” Bloch-Ibenfeldt said.

The other groups were found to have lost strength from their baselines. Four years after the start of the study, leg strength performance decreased on average among those in the moderate-intensity training cohort and the non-exercising control group — although more significantly among the latter. Those who did the moderate program initially benefited from increased leg strength at the end of the one-year regimen, but those benefits did not endure: After four years, their strength was less than it had been at baseline.

The scientists observed that all three groups, including those lifting the heaviest weights, exhibited diminished handgrip strength and a lower lean leg mass after four years.

But the fact that the heavy lifting group had maintained their baseline leg strength while losing lean leg mass was notable, the authors observed, underscoring some of the potential neuromuscular benefits of weight training beyond building muscle.

“Neural adaptations influence the response to resistance training,” they wrote. “In conclusion, we showed that in a group of well-functioning older adults around retirement age, one year of (heavy resistance training) may induce long-lasting beneficial effects by preserving muscle function.”

At the end of the study, the average age of the 369 remaining participants was 71 years old and included 61 percent women.

The researchers noted that the participants were likely to be healthier and more active than the average aging population, given that they averaged almost 10,000 daily steps as a sample group. They noted that this group was not necessarily a representative sample of the wider population.

Also, the one-year training regimen was supervised, with people’s technique and load monitored and adjusted, meaning it might be difficult for people to replicate on their own.

Why leg strength matters as we age

According to research by the National Institute on Aging, age-related loss of muscle mass and strength — known as sarcopenia — is a significant contributor to limited mobility in older age, which in turn can threaten a person’s physical independence. Older people with limited mobility can have difficulty walking, ascending stairs, and getting out of chairs.

Leg strength in particular — which is crucial for balance and mobility — is associated with better health outcomes for older adults. Research suggests that people older than 50 with lower levels of leg power are more likely to also experience chronic health conditions, although more research is needed.

Federal guidelines suggest adults older than 65 should do muscle-strengthening activities every week, as well as regular aerobic activity and exercises to improve balance.

“In addition to aerobic activity, older adults need to do things to strengthen muscles at least 2 days a week. Do muscle-strengthening activities to the point where it’s hard to do another repetition without help,” the Centers for Disease Control and Prevention guidance states. According to the CDC, this could include lifting weights, working with resistance bands, or doing body-weight activities like sit-ups.

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