Document 2JL2M3bO2XVy67JJM8Xr7yXYa

PLAINTIFF'S EXHIBIT IHF-494 SIite\atu\.e Gksk&cts 4 MEDICAL ENGINEERING LEGAL -- decisions end trends tfndustii&l tte&lilt Iflews VCL'JMIS 1-2 1027----- IS 22 4 .v : *c INDUSTRIAL HYGIENE FOUNDATION 4400 FIFTH AVENUE PITTSBURGH U3i. PA. / `f' ^-- / \ i I V I I u>n / S7\. oysv 7f. wirtb. Arc- f. oxper. ?ati. Phara. .'179, 155-9C2 (1925). The study of hydrocyanic acid poisoning has bocsso hi chiy important on account of its iacroased tochnical use. Tho authsr has investigated 60 sub3tcaeoa tad fixtures to dotczmiso how far thay caa reduce tho effect of hydrocyanic acid poisoning. The animals usod -- cats, rahhita, rats, alee tad pigeons -- wars first poisoned until tho respiration ceased while ths heart continued to func tion, then put into chambors in which-tho venous suhstcncos v;oro introduced la Taporised fata. Sodiua carhoaato was found tho rxst effaetivo of the substance :uscd. .. Its effect, was confined hy experiments cn the isolate frog's heart. A ri-r_ jw,-----r--vhh1 *-n r-*-nf4 iif`i lij rsiiov/ed " by'ali opp-siag rise when grapo sugar and methylene blue wore administered. iio good results were found in experiments with substances producing acthcaegicbin. These exteasivo investigations show that tho grectcst reserve must bo held rega iag thorapeutic aeasures for sovoro hydrocyanic poisoning. Only under partieul ly favorable conditions can sufficient of tho poison bo neutralized to savo Ilf 75 HLU2 TEZPAPY Hi* IHTEOEHEEIE POISONING. E.D. Lciaoff. New England J ' Med., 215. .191-193 {July 30, 1936). Mcthylcna blue,"on antidote for nitrobenzene or eyarldo poiscaing, was ateialstcd intravenously to a- ana with an extremely cyanotic and dyspneic ccaditicn, characteristic of either of these poisons. Nitrobenzene was recovered frea gas tric washings, and recovery t/as startling in rapidity. A brief discussion of a) uso of aothylcnc blue is iceludod. ` . * i ;H ' -V : i -t i , -f.r .* J ' i. * 75 TEE SMNSS2L3 PNSBBCOIHOSSS ON H2 BASIS OF PATH}LOGI CAL-ANATC12CAL RESEARCH. J. Watjea. Nova acta Leopoldina, 477-592 (1936). Paeusocoaiosis has been studied in this locality with unusual thoroughness, and a auz.ber of papers havo been published dealing especially with anatcaical and pathological aspects. Tho present paper combines all the naterial collectod, v;hich is based on 119 autopsies of pns'^scoaiotic cases.- Only a few points con be zcuticned here: The dust of copper schist Is blech as a result of its bituni ous content and this color is what appears in the lungs. Ths cost severe forms occur without tubercular ccmplications. Softening end cavity formation also occ without tuboreuloris, evidently sore often than with other dusts. This softoai: leads to dust sobiliantlon and therewith to a progression of the proeoss eftor cessation of oxposuro. Tho Nansfold pncisoconiosis is undoubtedly a silicosis;, it has one peculiarity -- cavity formation. This paper is considered one of the cost valuable publications on silicosis* 77 T3 PHYSIOLOGICAL RESPONSE^ PEPHTSMEAL^SSUZ TO C23TAIH INDUSTRIAL AND PCS MINERAL COSTS. J.W. Miller and R.R. Sayers. U.S.Pub. Health Repts., 51, 1677-' 1=39 (December 4, 1936). Vano dusts were injected into tho peritonea of guinea pigs. The rospoaso to each jiMrtlcular dust was constant in all tho animals examined, and could be classified as an absorptive, proliferative or inert reaction. In tho absorp tive reaction, tho injected duot disappeared from the peritoneal cavity without tho production of scar tissuo. This reaction i3 given by calclto, lizoatoao, precipitated chalk, gypsa and cement. Intarprotatian of this reaction is diffl. cult, but it appears logical that dusts which tond to rcaain in tho tissues shou. be considered potentially harmful, although not as dangerous as thsso causing a preliferativo reaction. In the prolifcrativo reaction tho nodules produced by the dust contlnunlly increase in size. Quartz, tripoli and ailicooua chort (ferny of freo silica) preduao this reaction, which corresponds, therofore, to luag fibrosis and is producod by tho samo substances. In the inort roactica, givoa by anthracite and bituminous ccal, procipitatar ash, soepstono, talc, <D4-Sf ' >'. {wjl. vaxs** f*) >. w i^r'J asbestos* feldspar, silicon crrbtdo, hematite, calcic phesphnto and scricit 9 . Sc amount of injected dust remained tho scnc la tho peritoneal smr* bu: tho iodulM boeoao more flattoaed and flaa dust particles aro corriod over axtcasiTc areas tT phagocytos. With tils biological actiod of classlflcatloa, v;iici, .in_. aa of instances, has boon correlated witn dial cal observations cad in dustrial surreys. It Is quito possible to use intmperitonool injection aetiads to dctexaiae tie pnetmocanlotlc potcatialitles of a dust la a relatively short :iac, usually 60 days. . . ' ' ... 7S rNTJS^iJlCSSIN 30012 WALES. ; 2'.Lv Cummins.'' r.-Hyg-.-Cuab. 36, -547-553 . (October, 1936). * - - ' -- .. la tic South .'"ales coal flold; aaay cases of lung* 'diacaso are fouad which cement it classified as silfcosiS, 'and aro not cempcnsabl-e -under prescat laws. * Tha author describes sono of those coalitions aad-attoapta to classify tho pncvmocsa loses into four typos:" (1)'silicosis oad asbcstosls; (2) sllleo-anthrsccsls and allico-sidorpsls; (3) anthraeosis of coal trimaers and scrcenera, and (4) fibret aggregations of inert dust occasionally present la all types, especially in sill iso-osthracosis. In all typos thero aro appcamacos suggesting daraego to the clastic structure of the lung, which nay be related to tho esphysma (inflation cf lung' tissue) and dyspnea (shortness of breath) often found. The ephysena is not necessarily a ccapcnsatory effect of fibrosis as it often occurs with .Tory little fibresis. Bronchitis is cc=an, probably as a result, rather than a caus of pneuooconiosls. Tho asount of fibrosia sad lung daaago in South Woles pnou- eocesioses vurios directly with tha Intensity and duration of exposure, to sili- cccus dust, as expressed in the silica content of tho dried lung. PATHOLOGY 0? THE'FNEuliOCQincSZS. L.vJ. Gardner. N.Y. State!. Ued., 36, 1377-13 (October, 1936). This piper is a brief sxnm&ry of tho oaatcaic changes produced by inhaled silica -.ad other dusts and the ccnplicctions due to infection. Simple silicosis, v/hon manifested by unifora nodulatioa, decs not -produco symptoms or incapacitate for work. "A person 7/ith this typo of reaction any continue working, but sevore dust exposure should bo avoided and yearly x-ray exaninations should be aada. Eowerro if there arc sassivo areas of csnglcnerato fibrosis, usually associated with die sreto nodulatioa, the patient will have dy3pnoa and liaitod capacity to wrk. Ec should bo given lighter jobs, not discharged. No person with open tuberculosis should bo allowed to work la silica dust. Persons over forty with well-hoaled adult tuborculosis can be safely asployod where thoro is a silica hazard, provlc scons aro taken to sialnlao it, but tho younger the Individual with a similar cc ditica, tho leas-safely can ho be-oxposod to silica dust. A young employee wit! ailico-tuberculosis should be givon sanatorium treataont. ASsSSaaiS: A RO-OTCDSLOGIC RI7ID; Q? 71 CASES. H.3.. Shull. Radiology, 27. (Septenbor, 1936). -- ___ . A stufljp of 71 cases of asbostosis Is presented, with emphasis on roentgenologic appearances. The cases wore classified as to tho state of progression of tho --sense, which varied roughly with tho length of exposure. Tuberculosis wus dtuad in about 12^ of tho cacos, noro froquontly in tho moro advanced typo. T3x author tabulates tea radiographic findings characteristic of asbostosis, end co: dudes that "whila tho roentgenogram is tho most roliablo diagnostic aid, tha 1: tcrP"ctation and correlation with clinical sigpis and symptoms is ofton difflcul* "ithout tho history of exposure a certain nuaibor of slightly advanced'casos will sat be rcca^iined," that "a fair perceatago of tho slightly advanced and codemiy adveneod cascn do tend to ir.provo and tho attendant disabilitlos to bacons -cssened when rcoovcd fren esbostes dust," that "asbcstosls doos not prodlaposa to tuberculosis" and that fren his observations asbestosls is not a progressive 4is=0. 0902-  '/' ~?1^2afr*sce3 to Reoer.t Literature . .. --- * # i-'v ^ yr rtrJaWCKICSSS OF TEE ~CSSZR. K. "'ider. 2tschr. f. Gewerbehyg, u. Ur.A11, 44, 131-5 (1937). 3jiT,jioot* became compensable in Austria on April "1, 1935. Since then, 2CS casoe h*a*ve reported in tho ^oricten's Compensation Officej of bhc&e, 171 are miner (ose fTB lignite nines,. In the ratal industry, most cases arc among sandstone grinders and sandblastors. Zr.yJZr V*V v rcftlfes.. _. JV51. *. * ^eT- -* Vj. ^ * ' "V* pji^O.VARY ASSESTCSIS. IV. TS2 ASZS7CS BODY AID 5 HULAS OBJECTS TJ TrZ L'JL'G. Kenneth. Jl. Lynch., 11*3.* Dept, tf Pathology, iledical College of the State of Sout: Cirolina, Charleston, S. Carolina. J.A.L.A. 109, 674-3 (Deo. 11, 1937). Re prints probably obtainable from author. ' The typical asbestos bSdy (also billed' a'sbes.tosrs body) 'is In ob'jbct 1C to over ICO cierens/arld 1 to' 12 microns thick aaa i's composed' of a central translucent fiber or needle crystal of asbestos with an enveloping shiny golden or brownish gelantinous substance constructing various architectural figures. Scnetir.es it is beaded hr dubbed.and eemetines spherical. 'A Prussian blue reaction for iron is given. These bodies say be found"at various places in tho lung, especially L the bronchioles, the alveoli and in the tissuos'along the lyr.phatie route; usual ly shorter at a distaneb from the'alveoli,'but often surprisingly long, consider ir.g the distance they have traveled. They sometime* cause fibrosis around then, but not necessarily. They are also found in the sputua of those oxposed to as bestos dust, but their -roscnco or absence in the sputua does not indicato the Sresenec or absence of ^ubeetosis; thoir presence only shows that exposure to.th' ust has occurred. Similar bodies have been found in persons exposed to ooal dust, and in others who have died of heart failure, rheumatism and arterioselero- sis, without known heavy dust oxposure. Exposure to aebestos dust dees not al ways produce asbestos bodies; bare fibers havo been found in the lungs of aninal. The author has seen silica prtioles similarly enveloped, in cases of silicosis, net always so highly colored. It is suggested that other fibrous or erystallime. dusts not jet studiod may fora similar bodies. " ' . .* V :lr Jr ^ V V' `*5 < Ti-vf '<J+.4* j~ ;ii*~ :r-/j 3LCCD EXAMINATIONS III PJLUCN.JiY FIBROSIS OF HEMATITE IEOH 0S2 MINERS. J. Craw. Tubercle, 19_, e-18 (October 1937). In radiograpr.ic examinations of hcaatite miners in TTost Cissberland (England), th hesatito accumulations show a definite and dense shadow, apart from any accenpan lng fibrosis, and there is s tendency to diagnoso silicosis when a miner eomplal of unfitness, ar.d his pulmonary symptoms..r.i the x-ray of the test show generalis nodulati'on. ' The silica content of inhaled dust, however* is low,, end in spite 0 20 to 30 years' work and general modulation'in all lung fields, the miners are perfectly fit for work and arc not short of breath. For these reasons hematolo; leal iwrk was instituted as ar. ossentiai in diagnosis. Routine prooedure ir.clud ed the Allowing detorminatisns1 (1) sedimentation rate of tho red cells; (2) total ^lt* cell count; (3) differential ?.hite coll count, and (4) the polynor- phcnuw*r^ eount of von Bor.sdorff. The findings in 6 casos are givon. with ca histories* t Of tho 50 hematito r.ir.crs studied, 20 normal minors had no complaint of broathleasnoes acd no x-ray or physical signs of pulmonary fibroeic, while 30 ecr.plair.od of pulmonary disability in varying degroee, with positive x-ray find ings. Mary minors develop a euro pulmonary sidcroeis without aeoenpasying fibro sis, and thoir blood pioturo is normal. Sidero-eilioesls of umocmpllcated type shovrs a definite increase in pcrcer.tago of lymphocytes, and the ratio of poly- t.srphonucloar colls to lymphocytes becomes 1 or loss. Tho sodimontnticn rato on nuclear count r.ro normal, '''."her. infection is present, the sodimentaticn rato in creases, tho nuclotr count incr&ascs and there is a louoocytosia which may ap proach 0 soptic count. Although the rosults aro preliminary, the nethed is reoc nsndod for aid Lng tho difforor.t'.ol diagnosis of sidcroaia without fibrosis and sidoro-silioosip, erd for detecting tubcroulosie or other infeotive agents at or. "-riy stage, C$53 -C-CC3 Rccor.C Literature - C 7!S .APPLICATION OP DUST-CC2J7R.CL rRINCSLES TO FC'-TZRY CFERAIIINS. H. 2. Ueig9. Second H. S. RegionalFoundry Conf., Hass. Inst. Teed., April S, 1933. The paper presents e discussion of the principal sources of dust in each of the several operations of a foundry and outlines practical applications of central in oaeh ease. The subject is considered under S sain headings: (1) molding, (0) cofein eg, (3) shade-out, (4) sand conditioning and (5) castings cleaning. Uany practical suggestions are nade in regard to care, naintennnee and methods rf operation that will tend to improve existing conaitions. The author haa r.Toidad consideration of the dust concentrations that-nay be encountered and the pathological effects of the dusts. A discussion by Llanfrsd Bowditeh and an addi tional paper by Vf. F. Terry cenbiae to naice tho study an excolleat and ccnprohonsi7e treatnent of the eleaents of dust central in foundries. REC2rr EUST 2GA.UST APPARATUS. F. Pracleat. Staub _6, 249-87 (1937). (German). First is a description, with exaapiea and illustrations of tha noat important points of exhaust- apparatus*and the various hinds of dust removal: gravity sys tems, removal by utilizing- tha sass inertia, by centrifugal force, by filters, etc. The author then deaeribes exhaust hoods, partly in agroeaeat with those expressed la Drinhor and Hatch's booh, partly also'on the basis of some of his own Investigations of piping installations, - ..... . 30HS 0? THE DUST CONTROL OFFICE IN COOPERATION WITH GS&1AN INDUSTRIAL COMPANIES. A. Lacsaert. Staub _?, 365-71 (1937). : Gomnn insurance carriers, because of silicosis compensation have become sore ' Interested in dust control. To furnish Inching data and hnowledge of the physics end tochnic of dusts a central offico wast up to do v;hat could not be done individually. The central office set up a laboratory, began consulting individ ual inspectors and industries and investigating all problema bearing on dust control. Host of the interested ccnpanics joined. - ASBESTOS. S. R. Gloyne and E. R. A. Hereviether. Occupation and Health, Supple- - sent, 15 pp. International Lacor Office, Geneva (1933). Information obtainnbie from International Labor Office, 734 Jcehson Place, Washington, D. C. . This is one of several brochures recently issued as a supplement to the 2-voluse Encyclopedia on Occupation and Health. It is a treatise on asbestos, including physical properties, chemical composition, uses, extraction, manufacturing pro cess, and oapeeiolly risho to health. The discussion of asbeetoais includes its essential featuroa, diagnosis, pathological features, distinction frea tubereu- ` losis, preventive measures and compensation. The references to difficulties in diagnosis and to formation of asbestosis bodies, illustrated by 41 drawings, are of special interest. Tho most important single clinical sign of asbestosis la that of diffuse bilateral impairment of the percussion noto, slight in degree * and associated with a slight sense of resistance. The other important feature is the 4io graphic examination of the chest. The distinguishing features be tween cMcctosls and silicosis in x-ray pictures are listed. It is emphasized that neft&er method alone la conclusive, but that asbestosis can bs diagnosed with certainty with tho aid of both, even if symptoms and disablement are ab sent. In difficult cases where extensive tuberculosis is present, careful in vestigation of the subjects' exposure to asbestos dust will enable the eorroct decision to be reached. The preventive neasuroa ore based largely on the prin ciples of the British Cede of Regulations. Tho views expressed ere authoritativr r.:a vory instructive. FRZVZNTiaN OF ASBESTOSIS IN INDUSTRY. ?. Proctat. Staub. 5, 133-62 (1937). The paper includeu a description of asbestos, and of its various forms, its uses ihd methods of preparation for Incustrial purposes. It is shown by many illus- ' trstions tow dust can bn decreased in certain processos by installation of exh.vm systems and practical planning. -rculosie c? intestines ::i t^erculguo antie-acclilugeio. Cor.cn. Am. J. Mod. -Sci. lj, 8>7 (July 1928). A 'MS . Complete autopsies wore mace or. 42 cases of onthracssilicosts plus pulmonary tuberculosis, and on 75 caaea of pulmonary tuberculosis without asthraccsilico- sis. Of the former, 13% had intestinal tuberculosis and SU of the latter. The incidence of intestinal tuberculosis in each group waapparently higher in the age groups below 30. :yi A STUDY OF ASJEST0SI3 IN THE ASBESTOS TEXTILE INDUSTRY. S.C. Dreessen, J.U. " DallaValle, T,I. Edwards, J.N.Uiller, and R.R. Sayers. Pub. Health Bulletin. No. 241,'125 pages (August 11338). Obtainable for 20~ cents, cash, iron Superin tendent of.Documents, Nachihgtcn, D, C, - This is a report of a complete survey of tho asbestos tortile industry* ir. North . . Carolina made-in conjunction with the State Health Department. Tho report is ' comprehensive in its beverage .of the subject and includes a good annotated bibliography .of 65 .referencesTto asbestosis. It describes the industry, the processes in the manufacture, numbers eaployed in each process, dust counts cade at various Idca'ticns and `incidences of asbestocis among the various employ ees. The incidence of the disease among the workers increased rapidly with in creased dust exposure, and it was found that one-fifth of the workers with an exposure of 50 to 99 million particle-years and half the workers having an ex posure of. over 100 million particle-years had asbestosis. The threshold limit for exposure has beer, sot tentatively at 5 million particles per cubic foot and it was found possible v methods already at hand to obtain this concentration in all processes. The medical part of the report is complete with physical ex amination data, laboratory findings, x-ray pictures and case histories. 305 INVESTIGATION CN CONTROLLING PNZ'JXNIA BY IMMUNIZATION 0? TORXERS IN THOMAS SLAG MILLS. M. Gunnel & S. Homann. Dtsche. med. Nchnschr. 64, 917-21 (1938). i/ti (German). In an earlier paper, cur Abstract No. 8, 1937, the authors had shown that .1 ` pneumonia in--Thomas slag .mill workers wascaused exclusively by pncumccscci i types I, II, III, but chiefly by type II. Since that time they have begun im . * munisation in a plant where pneisonia had occurred. A Behring-Uerke serum was ..t used cn 79 men in the mill, the remaining 49 refused it. No serious results -'.1 followed its use. The serum was givon in July and since then no pneumonia has appeared in the plant. Though it has not proved itself conclusively, in Feb- _ ruary, 1938, pneumococci of the above types could be found but very seldom, and V< . less frequently than in another mill. The authors conclude that the results `O call for further' work with the serua. ' ' ' 506 MEDICAL-AND LEGAL'ASPECTS 0? TUBERCULOSIS AS All OCCUPATIONAL DISEASE AND AS AN ACCIDENTAL INJURY. Mary C. Mack. National Tuberculosis Assoc. Social Research Scriat No.'6 (June-1923). Obtainable frsm the Association, 50 Host 50th Street, ..*.v Now YflCt, for 31.00 postpaid. ' :/) Generally speaking, tuberculosis is not recognized as an occupational diaeaso, but thero is a growing expcrienco in the courts with reference to suits and claims for compensation because of tuberculosis contracted in ordinary course cf industrial employment. The purpose of this bulletin is not to be an ex-- haustive summary of all cases, but rather to present representative decisions with discussions of various problems involved. Included is a review of medical opinions on the status of tuborculosis as an occupational disease and as an accidental injury'; abstracts of court decisions on each of the two latter phases :\ and a digest cf the worlcr.cn's compensation laws, by states, cs thoy effect occu pational diseases.