Document 1Q85409pdX0VpK4x2M7OGOqEZ

b- THE JOURNAL OF INDUSTRIAL! I H Y G I E N E -. I EDITORS DAVID L. EDSALL, M.D., S.D., United States . .A. F.STANLEY KENT, A.M., D.Sc., Great Britain MAY, 1919-APFUL, 1920 PUBLISHERS I THE MACMILLAN COMPANY /g+Lz 1 Divinity Avenue, Cambridge, Mass. .General Offices: 64-66 Fifth Avenue, New York City -*; / FI THOMAS M. LEGGE. JLD.. D.P.H. HC 3fujmty's Nedical Inspector of Factoncs and IVorkshps, Greal Britain IN January, 1918, two cases of purpura 18th. the second gave up work on Dw. 13, hemorrhagicawere brought tothenotice 1917, and died on Jan. 9, 1!118. Approxiof the Factory Department by Dr. mately, therefore, three months cliipsed Veitch of Edinburgh. The illness affected between the commencement of int.osica- two men employed in a large rubber works tion and the onset of acute syniptonis. The as rubber spreaders; one case was reported ages of the two men were N trnd 2!) years as already having proved fatal; the other, and both were apparently Iicdthy young as being seriously ill in hospital. These are men. As Dr. Veitch stated .`both were the first cases of chronic benzol poisoning young men, both were changed frow one known to have occurred in this country. room to another, both were chanpd from a Cases of chronic benzol poisoning have one drug to another, and both dewloped been reported from time to time from other the same symptoms at the same tiine." countries. I n 1911 two fatal cases in rub- The history of these cases was praciically ber works (characterised by purpura hem- identical, commencing with malaisv and orrhagica) were reported from -4ustria (1). anemia which was followed by sul~cuta- Santesson (9)reported in 1897 four fatal neous and submucous hemorrhages, and cases occurring among nine women en- both were eventually admittc*d t o Iiospital gaged in a tire factory in Sweden. The suffering from bleeding froin thc! I I O S ~ , prominent symptoms of these cases were gums and bowels. The blood count. or the purpuric spots (i.e. hemorrhages into the first case, under the care of l'rofessor Gul- -skin) and hemorrhage from the nose and land of Edinburgh, was as follows: Red mouth. Three siniilar cases mere also re- blood cells, 2,800,000 per c.inni.; white ported by Selling (3) in 1910 in an American cells, 2.000 per c.mm.; he~iiogloliri,36; cannery among giris employed using a solu- color index, 0.6. tion of rubber and benzol for sealing tins. Tlie chief dinracteristic of t l i e post- I n all the cases in whicli blood counts were mortem examination in bo111 c;is(:h was made a great diminution was observed in nunieroussubmucous hemorrliages through- the number of red blood cells which, in one out the intestinal tract and riiider tllv en- case, fell to (i40,OOO per c. mm., together dothelium of the heart. I n the* swoiitl (:iLse, with marked leucopenia (diminution in the where a more detailed exaiiiinatiori was number of white blood. corpuscles),the loss available, characteristic changes werv oh- chiefly affecting the polymorphonuclears served in the bone marrow of tliv long (specialform of white blood cells). bones. The conditions observcd in lifc: and Investigation by Dr. Bridge of the cases after death were those seen in caws of reported by Dr. Veitch showed that the aplastic anemia and are itlcntical with two men were employed in rubher works those n-hich have been noic-tl in i.ti.cbtve spreading balloon fabric. I n September, cases (all fatal) arising from poisoniij:: hy 1917, they had been transferred to a new T.X.T. spreading room accomniodating twenty A third case \\-as reported i i i *Juij.,I !)Is, spreading machines. Three machines were and also proved fatal: tlie JXLI icnt war one used for spreading the balloon fabric, the of three men etiiployed in w h n g li1t:Litl rubber for this being dissolved in benzene rims u-ith rubber solution iii the 111:111u- (crystallisable benzol); the solvent pre- facture of pneumatic tires. `l'lie urc. of viouslr used having been coal tar naphtha. benzene as a solvent co~ii~iiei~c-cJ~; ~~ilt u - The two men concerned were working on a T , 191s. and ;Ldescription or Ihc tvorking two of the three nuichines. The first man conditions found is worth slittlitg a i i t left work on Dee. 11. 1917, and died on the shows the :dversc effect prwliicrcl 1): itc- * Reprinted from the Annual Report of the Cliief h i - spector of Factories and Vorksltops. Great Urituiii. for the cidentdly diniinisliing ventiliiI.ioil \:.tiore fumes frolll i,ellzene or otl,er sill,ili,r t,,Miie, Year 1918, are given otf during work. `J'11c tvorkrvmili 239 540 THE 60C`RNAL OF I N D U S T R I A -HYGIENE was the corner of ;I lnrge spreading room 5.5 parts in 10,000) by volume of the -partitiortwi off partly with glass and partly vapor. This amount is well below the with woocl. The dinlensions were: 13 lower explosive limit for mistures of benzol feet long, 1.2 feet wide, and 11 feet high; vapor and air, which is 3 parts of benzol there w - w sis windows made to open, four vapor and 97 parts of air, the upper ex- being pl;ic:ecl on one sideand two a t one end. plosive limit being 6 parts of benzol vapor The a r w of each when fully open was 38 by and 94 parts of air. If the same room were 36 inchc.5. unventilated, a t the end of an hour the .At thc: beginning of May, 1918, struc- atmosphere in it would contain 1.68 per t u r d ;dI(:rations were commenced on the cent. (i. e., 168 parts in 10,000). floor aljove and. in order to support the I n view of the dangers disclosed, the al- framework of the windows, wooden up- ternatives were either to stop the use of rights wvre inserted in the window-frames. benzol or to increase the ventilation of the This prwented four of the windows open- rooms in which it was to be used so as to ing beyorid a few inches, so that from 3Zay reduce the percentage of benzol in the air onwards ventilation was only provided by below a toxic limit. The experience gained means o f two windows. The man who in the ventilation of dope rooms encouraged died W;LS one of three men employed in belief that the same method of dealing this roorii; he was 33 years of age, and pre- with rooms in which benzol was being used sented I.he same symptoms as those re- would prove effective, and it was on these corded :hove. lines the Factory Department proceeded. Although in both instances medical The ventiIation in the spreading room examin;rlion was immediately made of all where the two fatal cases occurred was im- the o t h r workers e-xposed to benzol, no mediately taken in hand and was improved other worker showed any signs of poisoning. so that the number of changes of air per The firm's chemist made determinations hour was increased from sixteen to fifty- of the iwiount of benzol in parts per 10,000 seven. Immediate steps were taken to pro- of air :rL different places in the spreading tect the workers on tire manufacture and room. the work was transferred to a room effi- ciently ventilated. Subsequently in the pneumatic tire room, a fan displacing 4,370 cubic feet of air per minute was in- stalled, and a sample of air tested with the windows open but with the fan stopped - -! showed 48 parts of benzol per 10,000 of air Middle of mrridor o p w t e a machine 7 e.1 while, with the fan running, a sampletaken In front of D fan and at back of ma- . ... ...chime, muchines spreadirig .o.n both sides, both 8 10.5 as near as 18 inches from the work performed showed only 8 parts. The result Between t.wo adjoiningmachines,both in both cases was satisfactory in that no spreading. 1ft. from floor ..Between two YpreadiriK, adjoining machines, close to a i l i n g Gth. 6 6 3.7 further cases occurred. 4.0 Medical supervision of the workers was 1 ft.from wuge of a machiie at level of sprentler'sface 1 ft. trom gauge of a ...boytakc* u p d o h maci;ihe wi.c.k. ...During spreadingof varnkh cost ...During sprecrding of varnirhmat 5 10 8 5 f& -During spcecrdingof body gum Dough m i h at height of W W w S 3 4.5 2.5 8 7 4 6 also immediately instituted and all firms likely to be engaged on this class of work were visited and instructed as to the pre- cautions they should take in the event of benzol being used. Dr. J. Burnet, the Certifying Surgeon for Edinburgh East, who carried out the Front these data Mr. Stevenson Taylor calculated that in a spreading mom with a capavity of 55,000cubic feet and containing 10 sIweading tables for proofing balloon fabric. 15.33 cubic feet of benzol vapor will periodic medical examinations of these workers, regards hemorrhages from the mucous membrane of the gums and nose as an early symptom and one that can be safely used as a guide for the purpose of exclusion from work (4). be praluced per minute. Hence, with 30 Alternatives to benzol were also con&angc-s of air per hour, esuming uniform sidered. Inquiry was kindly undertaken diusioo of the vapor, the atmosphere in on this point by Dr. H. H. Dale, F.R.S., the mm1 mould contain .055 per cent. (i.e., and Miss F. M. Durham of the Medical WHITE -AKTHRAX IT\'KASHJIIR Research Committee into the toxicity of a mixture known technically as " Xylol compound," which was capable of being supplied in large quantities by the Asiatic Petroleum Company. The point referred mas whether it could be used safely as a rubber solvent. Dr. Dale reported that " from the pritcticd point of view, it seems that the Xylol compound could be used as a rubber solvent with, at any rate, very much less danger of causing aplastic anemia and purpura than benzene." BIBLIOGRAPHY 1. K.K.Gewerbe-Inspectoren1911, p. 490. 2. Santesson, C. G.: Ueber Chmnische Vergiftungen mit Steinkohlentheerbencin; Vier Todesftille. Arch. f. Hyg,, 1897, 31.336. 3. Selling, L.: h Preliminary Report of Some Cases of Purpura Haemorrhagica Due to Benzol Poi- soning. Bull. Johns Hopkins Hosp., 1910,21,3S, Benzol als Leukotoxin. Beitr. z. path. h a t . u. z, allg. Path., 1911, 61,576. 4. Burnet, J.: Industrial Benzene Poisoning. Clin- i d Jour., London, 1918, 47. 132. NOTE OK AKTHRAX IN KASHMIR R. PROSSER WHITE, M.D.