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FILE NAME Manville JMA DATE 1929-1952 DOC JMA258 DOCUMENT DESCRIPTION Lanza Correspondence Reference Departmn their way through the mask thus " ineffectiveness of masks that June 1981 ment is made a copy of which we masks are not Workman from the perils of breathing C J. LANZA ANT MEDICAL BINKUTOA Mr. Allen Hardwell | New York City ne 1 molose asbestosis There than get then I the bibliography on - are three articles in this list that appeared inTuberale an .. English publication I am sending for extra copies of these and I Py I shall sand a set to Dr. Byatt in Bewark in "we To have almost smpleted our work found a larger job than we had anticipated cently and found it a very fine plant indeed - Manville which there I spent a day there re- Please let me know if we can secure any other in- , formation for you . a Eth best regards I am acpaint acpaint we Sc ot ~ . hee AY we e . a ee Sree FIO) ae. obs ener. C . METROPOLITAS LIFE INSURANCE COMPANY Frederick H. Ecker President New York City Anthony J. Lanza M.D. Assistant Medical Director it ve os") Manville (| | 292 Madison Avenue * New York H.Y. ot G G Oo Many thanks indeed for your letter of May 25th and the two volumes of the record of the case of Butlar indeed to get this material and I am very glad ing it to me appreciate your courtesy in send- ; , * * ; as 4 ". a am back in York good and hope to drop in I now New for and see you some tiim n te he near future As you these are probably aware there are a great many of ^' sits being filed particularly in Rochester I have had several advice attorneys and other interest people come to me for such . as I could give them These people always sak if cm refer . them to others who have had similar experiences I have always refrained from mentioning the Manville Company or anybody . connected with it in any way but I am wondering whether there might not be some advantage in a community of interests so to speak for after all misery loves company . - Harris Beach Mr. Folger of 40 Folger Bacon and Keating Franklin Street Bochester New York Attorney for the Fes York Central Railroad is handling a great many of these cases Mr. Hardigg of the American Society of Mechanical is Engineers is : trying to get up some sort of a Manufacturers Defense Association on behalf of the abrasive industries used to be the head of the safety depara tmen natd Mor.f tdeheBDl upo oni tws ohroganizais also trying to get together some organisation for the benefit of the Rochester mufacturers apprecit ate appreciate it | to or all people appreciate it if you will let me know 7 some ;. wishtains confer any of these or past tains attitude that I have in the of in Ho+. 7n iga) overnment authorities Wighle . < Se ty ' . 7 te, ; rr :Di rs meeting wfulidghting Dr. saiPdendergrass wmaeyre havefind have . Fayoe * mo ree Bir eae Se a Lo . PULITAN LIFE INSURANCE COMPANY | Frederick H. Ecker PresideNT NEW YORK CITY ANTHONY J. LANZA D. Assistant Medical Director rae a . February 26 1935 e ow Se. J.J. fram ar@nis Laboratory Sae Sae Sae Y.Y. Smpagar, say that blane I haveyour letter of February 24 and cannot I 7 for feeling somewhat passed aters the present situation However @ ist of the confusion is due misunderstanding misunderstanding groping sudund I think t will traighten itself out and a general I enclose a copy of a Mencilotse chins request Mr. letter that wrote to Doz At the of I also sent a ssp to Kr Gentholts of the Republic Steel Company and I have sent a copy to Ir Geyers and Nr The of the St. Joseph Lend who . Company has been quite a help raying raying This morning I have a wire from fon _ returning to Ironmad as he is to appear before the that he has delayed| Committee considering Legislative . inthis the silicesis bill He intimates thatBitchins and his group will get the support of the in and in cut some of their olsunderstandings I their succeed my letter and only hope that I I did not steel people if they can straight- tried to clarify the situation in in it the more have this time nsoitddling proposed the Ty at I no ides ides at whether work orworks Pittsburgh is going to and whether or whether scheme center have anything anything to do with it If they want to scheme scheme in any of will want to their efforts on the Public Service . Litigative and legal aspects of the question then neither you nor I nor the ; i Health Service will be interested If they wish to sponsor and ce- _ ^rdinateresearch then they cannot get along without the support of the Public Health Service and Saranac In any event I do act see that Saranac . is in any | threatened Nobody is going to set up a research or investiga- way you tive organf^/ntionorganf^/ntion to do that and the Public Health Service are now doing an advice being not this Identified enterprisacetively it <2 I do see than advice Identified b^'coe apopseral chancce hance Identified I do 5 of my able to give anything not think itis in the picture at it I agreewith Mr. Fletcher the bo st premise of success would more to all for that be to enterprise Indertaking apopseral Laboratory by and administeredby the Saranac 94" necessarilynecessarily in Saranac However I imagine the whole subject will be simplified and clarified clarified if and when the interested parties parties who coatribute representatives her the soney send their to decide what and they fish it done Dr. AnthonJy. Lanza oo MNeetwrYooprolkiCtiatnyLife Insurance ---- . -- -- _ Dear Tony lot you feel you Silicosis Your letters have done a my own thinking on the matter of the to straighten straighten I am glad to know where you stand because it will 1 oe help me in my relations with the mee cerned I am sorry other people con- the that personal stand must take the I can appreciate with to have hardly it 7 that youyou would any other at least for the present ms be should gratifying Your letter to Cummings gratifying to him for apparently you told Hitchins ' some of the things that Don felt he abwild most Kr bear I: . glad that they intend to go easy on ture of their first 25,000 If they. never mistakes with it they might be hie the I should make mars to get mars eo ANTHONY^ LANZA Assistant Medical Director t New York City - : ' ai 5 Dr. Leroy 8. Gaiter Gaiter apa Laboratory Laboratory 7 s Samanac Lake .. Oirector Dear Roy Rares ta. soended plan for a Dust Institute ~ As 41 I onla tg 07, ty the small 2 are group whose et Then I get the final check each transmit the plan to Mr. Hitchins .- who then can take it or leave it If - they to drop all reference to the subject of insist on the sinstitute sinstitute will go ahead If they injecting claims and clets matters as an essential part of the Dust institute then all the rest of us will prently drop out in which case I think that Don's will probably set up to independent venture of their coownntacts I have not forgotten the matter get hold of Mr. Fletcher in a day or twoof Ao twelk l and will Best regards 4 - . ape TO gs . we : i , , - Sincerely yours : . 7 / A. J. Lanza A.D. Assistant Medical Director pe oe an 5 s i ANTH LANZA.MO LAN NZAY .M (| Measatant Radical Director ee eece eeSe eeorerer, wo ee | a Friderick ECKER Chaiofrthm e Ba oarn d Leroy A. LinCOLN President | NEW YORK CITY VD 2 Opt Vandiver Brown Esq General Attorney Johns Manville Corporation - 22 East 40th Street New York N.Y. Dear Mr. Brown with further reference after I returned to my Edward Arthur Delarue well connected and who to your question concerning Richmond I remembered office that I had had a conversation with a Dr. & young doctor in Richmond who seems to be very is anxious to get into industrial work He is thirty years old was graduated in Richmond in 1933 and has an office at 116 East Franklin Street Richmond He struck se as a per- sonable young man with a good background might be worth considering . Sincerely yours too . 11/27/40 11/27/40 11/27/40 ve Mr. F. (7 G. ee } LipperCtH ed Pe tee) A. J. Lanza M.D. AssistantAssistant MeMeddiicaclal Director Director | . .. oa ao t aes does fope fos ' wad | eset a . . Ballerin Balerin Balerin Bal erin Ballerin Ballerin Ballerin 7 oe Balerin / Ue , o oe oe ee - Ne Balerin Ballerin : ry we a on 4 bt ee f yg :ret : pertain aeLA . . ieee front ee * pee a ree es te ste once women tre heredewt het tt ae ae ae oh, fONe, ee + Occupational Health Bulletin R PNEUMONIOSTS DIATONACEONS EARTH PNEUMONIOSTS Sree Seemed Diatoraceous earth is a form of free free Like the ordinary silica from quartz diatomaceous sufficient amounts over sufficient periods fatal disease of the lungs silica or silicon dioxide diatomaceous earth when inhaled of time causes causes a disabling Sio Sio in in and often In thisthis coniosic % country the In Europe disease is usually termed it is ordinarily referred diatoraceous earth pneumoto as siliccsis due to from diatomaceous earth The discase differs in certain characteristics and has certain basic similarities to conventional silicosis These vill to discussed . ys ; What Is Diatomaceous Earth The natural or raw diatomaceous earth is a fine grained material composed composed composed composed composed composed the siliceous skeletons of tiny aquatic plants known as diatoms Through ages these been deposited on the bottoms of bodies of have fresh In various parts of the world these depuitshave appearedat of face and many them are now being commercially exploited andsalt the earth's Mineralogically diatomaceous earth is classified as opal a hydrous form of silic but in its The pure natural mineral is entirely free silica diatomaceous earth contains silicon 25 dioxide -- 102 to 40 water stato diatomaceous about Commercial varieties variously variously contain small amounts of impurities such as others clay lime quarta and Practically all samples of the dry earth however contain unwards of 75 silicon silicon dioxido ailies The natural diatomaceous silier differs from quartz the common found in trinos in the fool that quits niiten shows a characteristic crystalcrystalinelcryistanlliene pattern an studies with the bony spectrometer spectrometer vitreap the rtv typo . : Free Free silica silicon dionide St^ * silica silica is silicon silicon dionide dionide dionide St^ : is Imensionis is a ne hoes 1. 1 general " tone foy foy dies of the lungs rempting an re re Sr is 1 Seer tee .. bo, He from large plant plant near . In In felfernin felfernin felfernin the the JJoo hn hn of chisvisie Lesnt nt procutur procutur the the mamteartiaelrial in in the the world world certainly certainly California California in in California California is the the Great Great Great Great Great takes takes takes . mata in the Carson Carson Carson is is mid United United United Corporation CorporationCorporation . fire aa States States States The other other CorporatiCoCorponrationorporation which which which which operates op opeerraatets es operates Haltoria Haltoria Haltoria Haltoria Haltoria HaltorHailtoaria There Angeles Angeles Angeles AnAgngeelels es County County County County constructing and constructing and is now now constructing constructing constructing constructing constructing constructing constructing constructcionstnructging a a Angeles otherother other producers small smallsmal small producers small small producers producers in in in Santa Santa Santa Santa Barbara Barbara Barbara Barbara Inyo Inyo large large large large large large ppllaant nt and and San San San Diego Diego Diego ^' In recognition of the potential danger to workers handling earth products the leading producers have recently inaugurated labelling the containers of the powdered products products as follows diatomaceous a progran of Celite materials consist of an almost pure diatomaceous . amorphous diatomaceous silica plus varying percentages of crystalline silica InhalaInhalattion ion of silica dust over long periodsmay be harmful 7 an mots should The materials dust if thisis be not used so as not to create employees should be equipped with adequate protective devices 2 In the producing industries there are numerous dust generating operations which have been incriminated as sources of disease However in California at least the chief danger spots today are in the occupations having to do with sacking the materials loading them into railroad cars and in the baghouses In the diatomaceous industries some of the trouble spots are those those in which the materials are unloaded from railroad cars or other vehicles or in which the material is emptied from sacks and mixed with other materials or other- wise used . 7 Number of Workers Exposed In the mining and milling industries of the four states states there are California exceediwnegslteyrhnigh exposed the about 1,000 employees about 800 in employedat any one time How- over the labor over in dusty jobs is ranging up to almost 400 per year in certain instances so that the mumber of workers whose lungs may have been damaged is impossible to ascertain exposed The number of workers these products is not known , to the dust but is probably very high THE DISEASE Il uginating History Is IlluginatinRogt In California diatomessus earth has been mined and processed for almost yura Foligsorki 3 in Cerrony reported in 1910 expirinats in which he was able to produce in animal true granulomon granulomon the by introducing the dust subcutaneously " ghouse is a lepse tem for a len type dont collector mit including fabric bag dust filters support and homing for the bit, shaking systen and dates with is willy :: i.c. il fils crystalline pattern with presently available equipment show a definite When the natural diatomne wis earth is subjected to heating culcirieg and treatment Thuring with certain chemicals such as sodium carbonate in the manufacture of numerous cornercial products a varying proportion of the called azorphous crystalline form is converted to a form of silica known as grintobalite grintobalite grintobalite IRAS In the United States diatomaceous earth and its products are known by a large variety of names commercial and othervice diatomite celile diculite etc. and there are various dusignations for powders containing mixtures of diatomaceous earth and other dusts such as silossl etc. In Europe there are also many designations for the same materials molora bergnehl infusorial carth , desaid earth molora kieselguhr fossil flour fossil meal tripolite polirschiefer white peat telluring randanite bergnehl etc. Uses of Diatomaceous Farth Diatomaceous earth in one tions A few exampleesxamples are another form finds numerous practical applicaa- pplica- 2. Filtering and refining of sugar syrups spirits juices waters petroleum productsproducts chemicals varnishes serums pharmaceuticals etc. b Insulation of heat and cold in power plant equipment steel plants petroleum refineries glass manufacturing furnaces kilns refrigerators etc. e Fillers in explosivesexplosives battery boxes roofing flooring waxes paints insecticides abrasives cosmetics fertilizers . ere plastics etc. d Building industry admixture for concrete cements plasters silica and pussolan ccaents roads light weight building blocks etc. c Miscellaneous unnufacture of filter candles soluble silicates glazes decolorizing products poultry littersweeping granules etc. The percentage percentage uses Filtration Insulation Fillers miscellaneous 1947 In 1947 , production in the United States reached 213,535 short tons and figure figure figure figure is doubtless much larger 1 O Occ cucpauti pon aal tOcicupoationnalaOccupaltional and UndustrialUndustrial Exposures ExposuresExposures Potential cconpational exposures exist in the memorous industries which tiline tiline miterial However the most important spree of disease has been in the industries engaged in producing the trial end its provints While d^'pouits of the earth found in presently carteraiidiy carteraidiy caploited caploited i od a ro sorte bs my of Bited Bited States most deposit foo in the Teak Clifornia Oregon deposit oraint of pra inationpra ination Bustics of parcurialia with one published by J. 1000. He describedcome the hattural trade in this country bagan femboy A Frein of Crime 100 battera of Orange who who we in were were victins of typical nercurial poisoning but 15 before ears pabel next before the next rec- first appeared quite as shocking as the first NothinNgothing was done about okit little attention was paid none by the medical world Then in 1912 37 years later the public was startled by a report made by a lay organization the National Civic Federation If the reader will substitute the Legge and fusemcrunts study for the Freeman in 1860 study in 1860 and the California California California Tuberculosis Tuberculosis Tuberculosis Tuberculosis and Health Health Health Association Association for the National Civic Federation a similar picture becomes apparent Downing 17 summarizes the problem well It is apparent in the study control and prevention of occupational health hazards the United States is not on a par with other countries Lack of recognition of the importance of industrial skin cancer stands out in sharp contrast to the unrestricted and wide publicity given this important matter in England Cormany and Switzer- land where these cancers are notifiable and compensable diseases and information regardirngegarding them therefore is relatively reliable The industrial nodicine here is full of failures to prevent the history of unnecessary unnecessary deaths in industry that have occurred for example from occurred berylliosis of the skin and lung cancer of the lung from * berylliosis osteogenic tuzors of the bladder due to aniline dyes chromates tumors and radioactive chemicals cancer due to carcinogens in the try All these industrial hazards could have been controlled eliminated Incidence and Prevalence of the Disnese No accurate data are available because physicians of the existence of the disease pulmonary tuberculosis 3 the failure rents of the California Lator Code 16 ignorance ( ) 1 ignoranciegnoranceignorance on the part of most of the resemblance of the the resemblance resemblance disease to report the disence according to require- Despite this situation nome figures at hand are revealing In study of Logge of 103 men ommmmined eel l or 64.9had abnormal lung press Twenty years later the lompocplant physician submitted to thepres changes that of 922 people he examined since 1945 33.55 had lung changes the 1930 changes changes changes 15 * The Bureau's normal source of information information information on occupational disease is the StateState reporting required by law tothe California State Department of Industrial Relations Section 6407 of the lalor Code stalas very employer insurer and physicien or sung tho attend any injured erplegen shall file with the Division of Labor Statistion and Research under rules and regulations prescribed by the Division of Lebar Statistics and Rubarch a complete report of every injury to each aut layarising out of or in the course of employment his employment uniam dibility retting fun Miron ] tin day or does sub require medical service such injury does not last than service other than ordinary first Dub tent Ui Se AAS ot other AT Caigan eo athath Moor dee 1. found evidenen of diatom diatom earth mate ocnionia in 1 he coe en at t Health les record of 7ly 7ly Accident Commission is wore ces There Accident Commission 7ly asfinal asfinal asfinal eng Mitch Mitch mod of the Industrial and other t Cintinding tiotin on is ravezling are a number of proven or without cuturis in the Industrial file Up to date of preparation preparation preparation of this this bulletin Statistics nech 1952 the Division of Labor all reports of the disense allof the A of employers reports 1943 1943 port from December 1951 which was received in December Statistics and Resourch And received received four physicians physicians since January 1951. thorough check of all the end of 1951 by the Division reveals one re- relatively small number of workers exposed at any one timtimee by any standard even on the basis of very incomplete statistics diatomaceous staistcs 15 analyzed Reports in the statistics for stasttatistiics sstatistitcs staitisticscs statistics statistics for for Santa industry earth industry industry is is located lay press indicate they CountyCounty for the area are now being critically were high where the died 11 of describes the lungs of two workers whodied after of years calcined diatomaceous earth dust changes The lung changes the final stage became a diffuse and hyaline hyaline sclerosis fairly similar to that of the fibrotic silicosis massive quarte But we have noted some important differences from the usual quarts silicosis lack of hyalinized single or conglomerated nodules and different features of the changes lending to sclerosis These changes consist in a diffuse cellular thickening the walls of of the lung air spaces produced by proliferation of dust dust This proliferation becomes phagocytes gradually air and so marked that it replaces every space initiates a massive grgranuloma anuloma which only in a late capillaries stage becomes fibrotic Emphysema dilation of blood and hyperplasia of all the smooth muscle cellsof the capillaries and bronchi are secondary phenomena arterioles - The diffuse distribution of changes resembles that of ashostosis ashostosis in the air spaces somewhat Vonald 13 describes surgery who had expostures pathology as follows the lungs of 10 workers 6 after death and 2 after ranging fron two to 23 years Ho summarizes the unlike small inhaled engreatlydonates but are Although there are scattered foci of hyalinimation and necrosis not the pulmonary response to the fibrosis is generally more diffuse and celclaurlatrs innevteyrptehealndess involves not only the perivascular and poribronchial tissue and nore espacially the alveolar umlls These are and often fused thickened the alveoler sprices are either obliturated creatly distorted and or calamat to form the thedifd fusie fdiffufs usee cceelllullar ulcellulaar r pulmonary pulmonary fibrosis donates areas fibrosis pulmonary n ne ee ed d to be be the the m mo os st timportant important important letion in more serious than the important dicular dicular iceals of uncomplicated silicosia and is perhaps responsible for the nounced respiratoryrespiratory difficulty encentered in era of this dpirsoe-ase 310g Hangs of the the crage crage Ja all of in three forms quinta kita land bee cristobalite were found in the villa deces nams of the ray differation differation Lochnique Lochnique However of ema of eo: our Ino chet Awa World's ces except one the be broad and no rules can and quartz silic content did be bob down not excued 2.3 from which he concludes the quartz is not the primary toxic agent either cristobulite or dialouite must be incrisinntad incrisinntad << Since deposits of diatonite contain varying amounts of quartz the precise of type lesion produced may with the quarto content of the dust Thus of Noz s 6 cases showed typical quarto silicosilsicosiis s lesions in addition diatomaceous evidence of diatomaceous earth These prople had been exposedto diatomaceous earth containing significant amounts of quartz vicious Regardless of the minutiae of silicosis sets up the usual right heart embarrassment with the tory failure pathology this disease like ordinary quartz circle of effects fibrosis emphysema consequent consequent symptoms of respiratory and circula- Susceptibility to Tuberculosis and Other Respiratory Discases . There is suggestivo evidence to indicate pulmonary predisposes to tuberculosis 15 adequate study of this question There is , of course that diatomaceous earth confers resistance to tuberculosis with the combined diseases have practically a that diatomaceous earthpneumoconiosis pneumoconiosis However there has been no no evidence for the repeated wyth On the contrary those hopeless prognosis Vorwald 13 states Our experimental effect of the fused calcined calcined product product on the infection Several of the patients studied indicate results indicate the deleterious course of associated had extensive tuberculosis tuberculosits uberculosis there Doctors for the industry state that incidence to pneumonia and acute pneumonititshere among erate lesions of diatomaceous earth pneumoconiosispneumocnis pneumoconiosis scens also to among those who be an increased develop the conglon- Role of Different Forms of DiatomaceousDiatomaceous Forth There are two primary types of diatomaceous earth : earth a the crude or called primary the been amorphous form and processed form which has heated to high tenpera- tures and treated with a flut fluxed ell investigators that the usually sodium carbonate and calcined There is agreement by variety which contains larga 102 mounts of as cristobalite is highly toxic more so than quarta silica The role of amorphous diatomite has not been studied as well good evidence that it is However capable capable of causing disease if there is there is sure to it 13,19 sufficient expo- All forms of the dust cause lung changes within a year or or w re of Some instances of marked lung changes have develop das erly erly as six monetxhpsavauftreor exposure it 26 In general in tenter that the morphans for con produce disgabe bat will take longer to do it loginity Jn Animal exprimenta exprimenta by Garner entia exeli on being equal in 9 headed headed distondistoinitetdisteonite orphous quarta alliens elite diaton- en . orgius ilion een | progressive bubble bubble Geneting frou quartz He could progressive fibrosis indistinguishable from the to rare tale than either either quarto quarto or distinitedistnite Verald summarizes the as follows Clinical experimental subject subject and evidence inlicate that both crude and fluz online diatonicsous fibrosis former czpitle of producing pulmonary fibrosis the latter more than the earth are 13 Signs and Symptoms 4 In general the symptons of this disease are similar to those of silicosis and other pasumoconioses as well as pulmonary and insidious with dyspnes cough chest pain tuberculosis loss of wight The onset is generally lows of appetite much more frequent in this dissense than it is result of the formation of emphysematous bullae at . . . Death onset disease has ensueednsued in of symptoms symptoms progresses known cases the individualbecomes within a fefwew months to increasingly disabled several years from the spontaneous The immediate cause of death may be heart failure spontaneous spontaneous pneumothorax superimposed tuberculosis or other infections infections or other pneumonic or cardio- vascular complications predisposed by the basic lung ddiisense sense generally The course of the disease is more rapid than that of classical Forkers silicosis Forkers who stopexposure to the dust after progress have taken place may retard the of thedisease discase may progress after cessation of exeposurexposure at any only minimal lulngung changes Ca the other hand the stage Superimposition of tuberculosis of course worsens the prognosis Ray Findings yes lung changes The carliest seen are desdesccribedribed as linear exaggeration Another change often seen in that of fine producinga reticulation sort ground glass appearance Following this stage there may be seen evidence of of this of nodulation but the nodules in ddisease isease are not as discrete discrete as those clas- siliconis sical siliconis more severe cases no may be detected as the In conglomerate nodulation disease advances with conglomerate spreading coalescent lesions reports * Poitevin 24 of en experience with Canada interesting diatomacetoheus earth cattle These animals vare suffering from infected bladder and the discuse espaciallyin British was known locally as Red Nater This disease was noted espacially Columbia in pasture areas flooded every spring and where cattle were placed after the unter lind recoded The soil the grass vere studied ond - they were found to contain spicules which spicules which an you you know know espacially a large percentage of diatons look look like like nordlen nordlen under under the the issue issue issue unange Bladora Bladora Bladora human lung of sutural of the dont unimals were studied in the co way as way and was found tthhe e bblladadedr debrladder that hundreds hundreds of inventig inventig inventig bed bed andand sponge spicules were were So led in the tissues of responsible ware ware no no dodouubbtt rrespoensible sresponpsible onsible for for the infection 4I 4I 4I Julien JulienJulien but het 8 rer may enplay may may be be do not Oo do ras Soweto of the the . . Oona ' 7: Lugren ul the hilt te up up . tr, Paritis Paritis Paritis Paritis may may ha ha ee viv dei n de 1 n by by thom is cotton bintang bintang of bintang of the the de 1 oe de Spats Spats Spats Spats Spats tebieta- tebieta- pneumoconiosin pneumocniosn pneumoconiosin pneumoconiosin pneumoconiosin the the rating wa? cintab rating cintab rating cintab cintab depandidepandi to ddeepandpi andi spun spun to to assess accurately worker may A worker may be acurately the degree disabled disabled disadisablbed led disabled and and minimal disability minimal disability in of disability or crm to the evidence of dis wae yet yet the show show ninaal K Conversely Conversely show ninaal ray changeschanges advanced Conversely Conversely ray presence of advanced advanced advanced changes there there Diagnosis depends upon a DDiaginoasisgDniaogsnoissis History of cure and Signs and symptoms of rnsunoseniasis . The disease can be mistaken for many the diagnosis diadiaggnosisnosisdiagnosis of of a without nodulation be easily confused with pulmonarpyulmonary pulmonary pulmonary pulmonary pulmonary tuberculosis other other lung lesions However there no pounoconiosis be It may also doubt of Tuberculosis presence of tubercle the other findings are as above one must bacteriological bacteriological bacteriological proof tubercl of the are found bacilli diagnose the combined combined combined combined diseases and Pulmonary function tests are valuable in unsessing dimability There is combined combined combined with with no cure known bronchodilating bronchodilating bronchodilating bronchodilating Certain procedures such as positive pressure drugs give drugs drugs may may give give give tenparary tenparary tenparary tenparary relief relief relief 20 20 therapy Aluminun therapy prophylaxis silicosis silicosis silicosis ordinary silicosis and and or there is there is no rreeaasosn on toto has has not been proven to hheelliicctete it it would would would be be any any be of value mmoroe rmoree useful useful useful useful for diaternccous 21,22,23 corth There is suggestive evidence that aluminum itself in may be harnful harnful 21,22,23 21,22,23 21,22,23 21,22,23 There have been no reports in the literature of of the effects of ACTH or cortigens on this disease PreviatioPnreviation Prevention of this disease in 100 disetues It is achieved by use of the dust disa2005 These are possible as is 2 principles true of all occupational es art applied to other a Courtral the dual te moured by ventilation ventilation methods methods enclosure of of provada end the Niter b Production methods may at be altered to eliminaetlieminate a toxic times exposure For exmugle one of the diatomaceous earth companies earth companies had recently changed their curlording operation loading an individual sack method to the more efficient producing operation operation from efficient and efficient and cleaner method employing lift trucks which lift the sacks piled on pallets ray 2. Medical controls periodic physical examinations including chest including and pulmonary function tests to detect evidence of illness carly 3. Good labolr aborcement practices a Joint labormanagement health and safety committees which work to assure intelligenit ntelligent participation by all personnel in safe and houlthful practices . b Production policies which make it possiblefor the employees intent to carryout safe practices practices For example in any industries employees are paid incentive wages to obtain mexicu produstion The employee intent on earning more tends to disregard safety precautions which slow his work This phenomenon is common where pay is based on incentive or piece work" . Research Needed Several questions about the disease remain not satisfactorily answered 1. The precise precise level of dust exposure beyond which harm results That That is what should the Kaximum Allowable Concentration be The M.A.C. M.A.C. occupational is a useful tool in the public health control of At present present the M.A.C. for quarts silion is used occupational diseases The evidence now suggests suggests that if there is a change it will probablybe lower for the processed processed forms of diatomaceous quarts earth earth then earth then for 2 The precise toxicity and relationships of of the amorphous and processed processed diatomaceous earth dusts 3. The relationship relationship of this dust to tuberculosis The true incidence of the disease in both the producing and consuming industriesindustries . A Health Health thorough epidemiologic study is monded to provide the answers The State State Department Department Burenu Mult Health in conancing such a study with the help help of olan olan . postal postal postal postal aeoaebed aad the in trial BUT is and unions help Glausarz Glausarz Glausarz Glausarz Fallon Large air rupturecdontaining ruptured spaces in the lung lung which which which are formed by by air sacs oftenasocaiated ssociated with emphysema heating Calcing CalcCi alcinn g Cag lcing Process of heating to high temperatures to hasten chozical reaction desired Dvsence Latored or difficult breathing Fibrosis Abnormal increase in the growth of scar tissue Flux Chemical treatment to hasten reaction desired In diatomaceous carth processing the chemical ordinarily used is sodium carbonate Granuloma A persistent overgrowth of tissue is produced in the initial stop tissue granulation tissue ofrepair of injured Granulation or diseased 7. M.A.C Maximum Allowable Concentration i.c. the maximum concentration of material inthe air breathed during an hour workday beyond which discase may result over a period of time Inounsthorax In accumulation of air in the pleural pleural in or collapses all or a part of a lung A spontaneous arises from internal causes and is often the result of cmphysematous bulla on the surface of the lung pneumothorapxneumothorax rupture of an stretching Pulmonary emphysema : Distention Distention and of the walls of the air sacs in the lung It is found usually in the outer parts of the lung capacity which have the greatest forexpansion expansion and occurs as an attempt to compensate for other parts of the lung which function poorly Peferences 14411 Lanzo R. and Myers W. .: 14411 1951 Hallic Hallic Minerals Zwi ed McGraw- Communication Communication from Manville Corporation Dec. 26 1951 , July Podrysocki .: Peitr path Anat17 270 1910 quoted in Vigliani British J. Industr Med 5 146146 1945 Legge R. T. and Rosencrantz .: by Diatomaceous Earth - 1932 Observations andStudies Amer J. Public Health 22 Silicosis 1055 Silicosis Oct. in Nuck quoted in Nordmann i _ Nordmann Martin Die Strublunge der Kissalmihr Arbeiter 311 116-145 1943 . Virchow Arch Arch Duvoir H. and Derobert .: La Pheumoconiose per terre de distorees etude experimentale et clinique Ann de med lag 27 Mottura Vigliani E. C. and . Industr Med Mottura .: Matomaceous Earth Siliconis 5 1S July 1943 Brit J. Gardner L. .: Feaction of the Living Pody to Different Types of Mineral A.I.H.E. A.I.H.E. Mining Technology 2 1-15 May 1935 Peritoneal Feb. 10. Miller J. W. and Sayers R. .: The Response ofPeritoneal Tissue Industrial Dusts Fublic Health Reports 56 264-272 14 1941 . 11. Johnstone R. .: Occupational Medicine and Industrial Hygione C. V. Mosby Co. St. Louis 1943 p 353 fol owing 12. Examples of this may be foundin the following case records in the files of the Californic Industrial Accident Commission LA 86-535 Hartnell LA 85-140 Embry LA 38-234 McLean LA 82-296 Hooper SF 85-723 Willines 112--556 9 MaCabo Vorwald A. .: Distornomous Furth Pneumoconiosis Proc Ninth Internat CongressInd Med Bristol Eng John Wright 1949 Deatth~- Dist Search Calif Tuberculosis And Health Assn San Francisco San Francisco Chronicle Jan. 13 1952 . ton Aliens Asun QuPaartrertlyQyuarWteorlvy enMaricnthh1e9Poi4son3ous PoisonousPoisonous Train Asee Industr Hygieno Bowning J. .; CancerofChin OccationalTruEL ME 245 Jun 20 2020 19159522 J. Amar Med Ann iincnlucdeldudedReport to Manville Corporation on six lungs in case of Hooper widow vs. Industry examined LA 82-896 305-573 20. Motley H. .: Pathological and Physiological Factors Involved in Treatment of Siltaquis in Coal Miners the and Occup Med 2 Arch Industr liygieno Oct. 1950 Winkle Woy 21. Brown E. W. and Van PrementPrement Status of Aluminum in the Therapy and Prazkylaxis Prazkylaxis ofBiliconin Biliconin J. Aner Med 140 1024-1629 July 23 1049 Assn 22. Beader E. .: The Aluminum Deng Zochr f Unfallmed u Berufskrankh Berufskrankh 1949 June 26 266 5 nad Sept. 15 12 Abstract in Bulletin of March March Hygiene 26 266 March 1951 1951 23. Ostrovskaya Sanitaion - Ivanova ; M. G. and Ostrovskaya Organisa Hygiene Moscow I. .: Action of Aluminum Dust on Animal and Sanitation April 3 1950 . 24. PoitevinE. Personalcomcunicationommunication Mar. 4 1952 25. Anderson Anderson .: Unpublished talk before Santa 1950 staff Dec. 14 Barbara County Hospital 4 Association 26. Anderson W. .; Diatomachous Earth humoconiosis paper delivered at meeting of California Tuberculosis and Health April 1952 San Francisco 2500 cc 1/9/221/9/22 LTE OR ye em ONE pee pote 7s? TORN^ A _ PALOMORY Te oy TORN^ A HEALIK =HEALIK DE DE DE PALOMORY PALOMORY PUBLIC TORN^ A Od . oe ce me emmys . . . 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