Document 2RL9LJ55RB32rNpLOM2Mrj4kR

OF THB PSI3ICA1 SZiBIHAKOSS AMO X-t036?^ 07 A3BSST0S W0RE88S IS i-SBEStOB " ASP TOBTOOBD-KIS83 0PB3M._______________ ;* 'l . VaV.; * / :\ i Om rapart h*x*tth pwmt*4 4*&la wlv %fc* -'**. . _" .^ . 141 ploy*** of ibe Oanaftian Tihnn Wnn YlUv Co., A^estoe. Que. and 54 employees of the Asbestos Corporation of Canada* the Xeeaby-Hattisoa Co* end John- pon'o Kind* all of Thetford Hinas, Qua. 40 of the mu of tfcfe Canadian Johne-Uanville Co* hot* examined hy i>r. B- i. dterenson and 2>r. Joseph Wyatt, she performed the physical examinations and I-ray examinations reepeetleely. The other examinations were all performed by me* exaept the X-ray examination*. Aetually, Urfl. Stayonson and Wyatt- miMi ST men; hat sinoe IT of these sen were re-examined by me X Including then in cay list. Dre. Stevenson end tt Carried on their work In WdYamber 1959* ay exattlna- tians were done in July 1990 In Asbestos* and In Septsaber 1930 In Thetford Hines* The Asbestos and Thetfonfi groups are very diesimilar with respect to age distribution and length of eerviet Is the asbestos industry, but racially and econ omically the two groups are much alike. Table I gives the age distribution of the men and Table II the distribution according to length of service In tee asbestos industry. t WV-Q1249 -z t / 4 r.> ;/ TABLE I AlW Ktwp< AQB DISTRIBUTION Of ASBBflTQa lOTKWft Annate* f StsBbor Porooutage 1 n*UM Vlaaa svator Pareantage 15 - !* SO - 3 24 1 .0 1 t 2*7 8* - 24 17*0 8M * #8 - JW 4 SB 10*8 17.7 4 4 fA 49*41 45-49 50-64 18 14 8 11 8*8 10.0 2.1 .......i..... 1 i ia 11 7 U4 15.* U4 66 - 60-64 66 - 69 Sot state* 1 1 1 1 07 0.7 0.7 0*7 \ t ! 1 4 4 1 7*4 11-4 * U * 0 B.,..,r,,,,.,.14;,, 100.00 64 vjfiBinr'ini* w1a0B0*`*0'.'Jii...ggg38a88aaae p i * !IkM o trriee. e- * 19 - 24 1 - W *0 - *4 - 89 SP - S4 8C - 89.. 40 44 I0TAI aam or 3sanc& a Asmatog laresm Asbestos tuber yenentace 44 SXJ2 4 11 f.fl 10 T.l 6 4.S * IA 2 1 * 1-4 - If 141 100.0 tfBW 1 1.8* 9 14*8 8 14*8 1C Ocd * ' XC.T 9 14.9 1 i-ae 8 *.T 54 190.0 > It will be noted that while 46 percent of ft* ma in ffcetford Klees were erer~40 year of age only 8 percent of the sen in Asbestos were over 40* And far ther with respect to length of Berries 86.4 percent of the B9& examined in The tford Hines had worked 1a the a*- * heotofl industry for 10 years~or mere* bat in Ashe etca only ZZ percent had worked for sore then ten yeara* Sable ill shows the disposition of the sea In waricua parto of the industry* Sinoe the numbers are mill oaeupational grouping8 sre uU# & Aetasto* tfe* oasupailQiis *** AiTidsd lata & g*w$ 'i baA faetozy; 1a Mattel Kip** al| tfes first t*s essspatloaal group* are sitd sin** so asbestos laaatrfastaring is m1A on theta* AH . the wi of the fhstfort fiA8 group seal* bt .** stsss- lflet* tat 9 sea ii srdudad fm th* Asbestos gmp sine* they 414 not appear to be exposed to am unusual aaoent of duet. *A BZ% 111 <i aaarofg of amiss is sifrggM qccpfasiobs aypsa^B arete* l tsars of aerriee > -0-4 , - e mil _M.. Sfi AflW03 | BrtUtwt vt* . T. 18 - to-x*___ _______ < 15-19___|___7 8 8 Faeton? 24 id BQttfQSS Kina 81U Brtllio* pit i 1s 1 . $1, IS 4 . 80-8* | 9 i 8i 28-89 1 i 81 2044 , S6-S9 . 40-*ft T0FA1 1. --1 -- -1 89 2? OH--'............... ..................................... 1 1 ........................... AO ................................. i 1 40 .1 2 14 The past oscrapetionsl history In industries other than tha asbestos industry was alg&lfioant only in 5 oaaee. Of these on* ha-3 bn a grain inspector far 6 /***? en4 bo oxsomA ta taary osMltlon*, a M as Wigiroa wnt? miner ffr* is years* me i *099** ainey for S ptan, * fourth haft worked la a ament plant for 9 |m, and the fifth had operated a drill la ea iron mim* .last iadiridu&l ahowol X-ray erldenoe of ifftamoemiesle* the ether* did not tor pnemoeoaloslB* In fable XT are girea observations of wight in relation to ^g^ght hr ago* fho average mights ui taken froa the figures eoapiled by tho Adwooiatidn of^X1^2B|0uM gedtflfttl* hireetora and the Actuarial Sooietr of Aneriee* f A B 1 g XT, gBXSHTS ABD HEIGHTS ACCOBSIgfl 70 ACT Pound# Under aror&ae 1_ FmuMt. trff mnM ) 20-559 10-19 fi-9 1 -4 to 44 5-9 10-19 o~39 AW33703 fo 23 4 is.o IHBW09B So. 9 gofer urouJfenz *- 16 .T lG,oFa1 i Industrial workers < 25 23 20 #0 12 i &04 1 i 19 13 *6 6 J 34.8 .1S,,,_.,J 11 M --.... 24 16 17 *2 11.4 9 16*7 22 3 | 6*6 ii ii i i* 9 15* 6.4 -c n,i 7i j "' ' H 12*9 1 14 1 10 1 " 4 2.9 1 *0 3 '* The group of 10,000 male industrial workers re ferred to In the shore table was studied by the Suited States Public Health Serr lea ' pnblic Health Bulletin . .'-iv* 6 3o* 162}. It will be noted that thera la *cry little distinction between me large group and the group of asbestos workers so far aa degrees of overweight or underweight are concerned. In the consideration of Individual dateeta some Interesting faeta have been found. In this study only the 101 men at Asbestos and the 64 aen at Thatford Mines are considered, el nee the records of the us ex amined by Dr. Stevenson are not strictly comparable with alas. TBSTgt- Dividing the aen into two groups according to whether the teeth did or did not need attention, of the Asbestos group 49.^required attention, and of the TK&tford Hines group 61*9 . ESARIffS;- watoh. Acuity of hearing was tested by means of a (My own hearing, which baa been tested by an audiometer, was considered nofinal, and used as a standard) The wetoh test is admittedly..very rough. *In noisy occu pations impaired hearing is frequently found in the older employees. Of the 101 men at Asbestos 10 showed definite hearing lose. This is not ea exce&a proportion since an; -7 group of adults will show a similar pi*turn . la Thetford Mins8 28 of the 54 non suffered fra wall marked Soaring loss* this la a Tory high pereentage, and ooap&rable to shat may be found In wearing shods and boiler shops. Ill these men, except,two,, had been exposed to loud noise In their work for IQ years or sore* sad it la reasonable to suppose that soles played a part in their hearing disability* The number of sen with Infested fOBSILS was 27 In Asbestos and IS in Thetford Sines* and al most inletleal ratio to th total in both groups. Defeats of the fjjjyiiOIP were rare. 4 men in Asbestos and 1 in Thetford Mines had enlarged thyroids. +' BlOQD PRE3STOB:Headings were recorded In all men over 40 years of age. Except in exceptional oiroumatanoes the blood pressure was not taken in the younger men. Consequently although the groups examined In Thetford Mines was nailer than that in Asbestos sore blood pressure readings were taken there. 2 men in Asbestos had blood pressures of over 150 and Z blood pressures under 100 r.*zw of mercury. 8 men in Thetford Mines had blood pressures of over 150 ana 2 blood pressures 'indor 100. 8- ssfB3593^E5' The ineidsaoe of BBRSIA io of interest from tks aonpeagstlca standpoint- is Asbestos all new topley*** ansi past s physical lamination fet&x* anploymast. There ws** 4 eases of ingniiiaj hernia dissevered among the 101 men examined there in addition to these & man had been operated upon for tills eoaditioa In Thetford Hines physical ampin*tlea ia net required before employment- Thors ware 4 oasts of in- .. . goiaal hernia among the 54 men examined and * cases which hod boon operated upon* Ocas interest has arisen In connection with the oconrrenoe of the so-called ASBESTOS cowry- these are osoally pin head sited elevations of the sfci& some*tot like slants warts, Sons of these soars 4*te*t*$. in the Asbestos msn probably due to ay ignoreaoe of their appearsnee. 8 of the Thetford Hines men had these growths on their hands and severs! others reported having had then at one tins or another- 9 IDBG 3 Of the 101 man exBttioed by a* at Asbestos only 4 suffered from definite first siege pneumocon iosis* These will not bo considered on anoonnt of the doubtful diagnosis. Of the 40 men examined by Dre, Stevenson and Wyatt 14 were diagnosed as first stage pneumocon iosis fasbestosis 1) (2Jam including the 17 sec ex amined by Ere* Stevenson and Wyatt and subsequently re-examined by me in sy group of 101). 4 The snob lesser inoidense of pnensoaonloals in ny group of man may sees surprising, but it must be remembered that tbs X-ray negatives were not read by the sane sen. In my group tbs X-ray diagnoses wore made by Br. Meriwether of Pitcher, Oklahoma, and in the other group* the intorpretations were by Brs* Wyatt and geaaooat. Further the grscp examined by Ers Staybneon and Wyatt ware, in gen eral, older than those In my group. Of the 54 men examined at Thetford Mines 24 were diagnosed by X-ray as suffering from paeumoooniosis (asbestoels), of these * wexs diagnosed as'probably first stage asbestoeis, d as early stage, f as definite first stage and Z as second stage, ffa* p*rttueia ?&ote regarding the ^afiSte seues of Asoeetoei# .^r.- - Mb).**? f,nr4 p*, 10 kaom,rccjr la. Mi Oamatlonal hlatory Symptom* 'din*. labaataa Stoud. 66 ah 71 A.l . 66 Aa 94 AH 2000 Aa 39 0WMA A to yaara *7 gmiTtl operator lull foraaan 34 yaara 42 30 ) loadlog oar* in mill A foreman a# ya*ra ^rillar 7 yaara 4l Millwright 51 yaara oougb.dyapnaa daflaient aipanalea loan of atreugik o* arapltation* laft tpax. aough, dyapnaa poor arpantioo, pera- froquaQt sold# uaaloa diminished loft ohaat, aropitailont ail aw both luoga. no symptom# aa tboorsal signs. no aymptoma dyppnaa,sough ao abmanul signs. bo tboormal sign# 2001 Aa 2002 xa t notor attendant qo ayaptoma for 11 yaara 35 millwright f4 yoart no ayaptome faint nelat raloa 5 4 4 rib la front. bo abnormal sign# 2009 k.\ 30 labourr & vatohmaa in allI 9 yoara no oyaptosa 2019 A*l? 25 labourtr top floor *11 i, 2 yaara no symptom* 2020 Aa 4? in alii X6 yaara no symptom* 202! Aa 52 aliiaright JO yaaro so oyaptoaa ao2j *a arn7 A.l ~20%2 4<i 2055 A%1 2034 Aa 2036 A.l 20*52 A.l 66 saeoa in alii 26 ye'tra no eyaptooa 48 ala# (w>rk not atatad) no ayaptorn# 12 yoar# driller 4 ywara *od ayaptoa* 41 drill** 23 yoara no &yapboae 6Q drillor 4 year# no ^yupto ;# aparaman yaara foramafl 2} yaara 37 drill r 3 yaara no symptom* iraakaan 4 ywa 22 pip* aorerer no symptom# ffnotorv) & voar# alight dullness right baa,l#ft sheet expas4s sort than right. braath sounds at apioaa harah ,> 0 abnormal algae rpaosiOA alightly Hal tad spaasion Halted no abnormal algae ao abnormal signs no abnormal algBa absent voeal fmltua broaohial rales laft eida 00.abnormal algpa. It fan. Blag- Table VI M. nosis AffO QqgucaUoaal hlatorr gyaptcas Thelford 181nee arme> fllqa. <v } A.l 42 * 4.1 *? 6 JUi 59 (probably) 11 ft.2 5* 12 ft* 15 At t5 4.1 47 (probably) id A.l v; t? 4.1 45 (early) 21 4.1 V (early) 25 4.1 62 (early) 26 4.1 29 (early) 2d 4.1 44 5 4.1 *5 (early) 52 4.1 5* (early) 5* 4.1 56 59 A.l y? (early) fto A.l 62 ft! A.l 1if. (probably) filling bags 6 yerae no eymptoas soars# slicks above heart oiler to years foreman 4 years A at both bases behind. drilltr 2} year* no symptom# no abnormal sigas cleaner in ail! 5yrs. dyspnea fllUnfs bag* ft yrs, no abnormal signs millwright 2? years dyspnea no abnormal signs sveeper 1.` years cough t exp* coarse crepitations sc toration, left apex behind Ooc, blood in spuUai, dyspnea lose of weight aiU.wrtg't '-1 years cough S exp ectoration, dry rales ever rt,sheet behind, expansion deficient dyspnea, loss of weight A strength millwright years sough occasional dry rales at driller it years no symptoms left base no abnormal signs driller 17 years history of pleurisy, ooabooraal signs ' sister died of t,b,e, millwright 1ft years dyspnea no abnormal signs driller ftc years No syapusas a>my erepltatiens right driller 6 years No symptoms base, no abnormal sign# general wor* in pit ft years filling bags 1 year duet shwi r years history of hemoptysis no abnormal signs In oill 5 years cough, dyspnea no abacmal signs in tunnel feeding ousneoted t,b.c crusher 5 years in t>xo crushertt years oc synptom# no abnormal ci/ns swsej er in jtll ft yrs oiler i/> niil 5 yeras loading \x>xes in pit sister died a Shovere of fine crepitates years, feeding ...of t.b.c. 1 ' both lungs behind from ft the 2>iil ' years vertebra down,percussion 3 milisrig t tdyears dyspnea note diminished no abnormal signs foreman '( years feeding crusher t*' ys&r dyspnea crepitations io rt,axilla cleaning in mill yrs. b> 1. base behind, fee'lini' crpsher in md i l no ayap to-na r y-nr?, driers 5y<sar, no <bnoraii sign* f reran n 51 il " . *nr Table.Vl (continued) .. ***! *Jtt Oooupatiortal history gyaptoas . Signs. Tbetford Mlfi#s arouo ^sont'd* ^5 A.l 54 (**> 51 Ju.1 51 (probably) 55 4.1 50 54 4.2 4l 29 4.1 4* (lete) loading boxes in pit ?yr., driller 6 yrs. operator in sill 6 yrs., millwright 1<> years no syapteas - no syaptoa# oU-*r in alii io ya*. son died i.b.i fara'ian iU '? yrs. daughter ha# tuberculosis. jUI repair# i" yra, alii foreran i" yro. foreoAfl aill 1*1 yri* aillwright 7 yre. oaugh^dyapciea no eyaptotoa ito bnor*al signs. percussion lots resonant ovsr right lung, ehoeers crepitations right side front & baaic, eeer left P. or lobs front 4 basic, expansion poor, oany ampliations 1. apex 4 in r. axilla, crepitations r.i I, upper iobss befalod t at both bases, expansion poor,psrsuasion poor st sptsec. no rales, no iboormAl signs. 1? It will be noted that of the It* Am xaoined at A*boa to* If vere diag- fiotod a* first otago asbestos!a, while of tha examined At fhotfard Ulae* 21 wo diagaoaed ot first stage asbeiiosia and 3 u second stage asbeatosis. this to not to bo interpreted a* todlooting an excess baxard La Thetford Xlao* The increased inct'onoa of pnsw&oneeonioela In Thetford al&oo to oiaply a reflection of tho different distribution with reepeot to ago add length of *orvi ce, Reference to tables 1 and 2 will rooail tho groat dlff** ones# in theee two things, la tho groat sajority of case* tho length of oorvieo ia dust/ work oas aoro thaa $ years at Lndlooted in thofolltrving table# length of oarvies .'dumber of oases Suabar of kmhi examined. 0 ~ A yr. n-7 n - t* 1* 4 over Total a y 1 At hU 75 n? _____ 122_________ Prom this table one would conclude that sabeotosia la not likely to devetope with *o ezjoauro of Iobb than " year*, but tJiat with exposure of aore than r* years there is a groat possibility of it developing* Xt lo however, of intoroat u> rciabor thaisany non with long ; erioJe of exposure do not develops \ny sign# of asbsatoeie* As to occupations of At drill ore 1*. were ca?ee of aeheotoeie# of if? *111 workers "7 Tore cases of asleataals and of Ay worhere in the factory dly 1 case ahow'*4 *~rt\y evldenca of the 'ieeaae, Svidontly there it iittfce difforoRO# in the hazard in mill .<rk*r and Iri.lors. The sill -sorters appear to be expose.' to far greater dtst concen tratiur.a L/u*n the drillers *.vj it is rather difficult to understand 4ar we 'Ugn incite; of asLostOfiie a-song *,,ho drill-ri, it ::piy r my not t-? sf tor not the. that the drillers are occasionally exposed to granite duet. Boa* of the oasce of asbestos!* a|, peered to suffer fro* disabling ayaptosu. Perhaps the *o#t common symptom was shortness of brsath, but tee# than half the oases complained ofthls ayaptoa (11 of the il oases). ts to phyaloai si^ns I was unable la find any pattogsomocis signs whieh would snarls one to aa.:e \ dlagoeia in the abeenos of the x-ray picture. Inspection of the lungs was of 1UU value since it ^as difficult to evaluate the degree of diaphragoaUe excursion and sometimes expansion a,..eared to be deficient when actually it was not. if a respiration tank had been available some quantitative idea of vital capacity eight have been attained} the measurement of abeit expansion by a tape measure was given up after the fir^t i ' examinations * Since there is not standard pitch of percussion note and no standard intensity of tactile frost tut or vocal resonance one has to compare one side of the chest with the other to deteot abnormalities. But asbeetosls is essentially a symmetrical lesion and in this disease the comparison of the two sides of the chest is of Uttle help. The sane observation# apply to the -quallty-of the breath sounds. The most frequently found abnorjslity was the pretence of rales, p rtloularly crepitant rales. In ^any of the store severe cases shower8 of these raise ocourrei throughout both Aides of the sheet,particularly on coughing, but in two of the three case? of second stag ashestosis these rales were not heard, bo that evidently triejre are not a constant sign of tha disease. On clinical exarjlnation t"?o or three of the oases with large numbera of crepitant mle* it tbapiees were thought to be tuber ouioun but t-ia x-ray exam!nation '!! oct fir; tJ'.ia i-prosoion Tuberculosis did aot play aa imperWit pert J,u Uve study. eae of the ease* of tabestool* appeared t# be complicated with this disease. Indeed the lneidenco of definite tuberculosis in the two group# ot 1?9 individual# was very low. There were several suspected caste oo el1*1eel examination which were not confirmed by x-ray and several suspseted Meet by x-ray which showed no real evidence In the way ofsigns end sywptoms. Only one cate In the groups can be considered as activity tuberculous. It was difficult to obtain sputum from most of the mod sloe* rery few of the^ were toughing. About \2 sputa were *xarai n*3 for tuberale bad lit and asbestos bodies. Ho tuberel* bacilli were found but one ease did show several asbestos bodies. This oaee was diagnosed by X-ray as probably asbsatosis Cfirst stage) but Is not Included in the number of asbestosls oases elnoe tno x-ray film was not ''aiisfaciory. Conversation wi'.h physician^ -nd Sine managers in the asbestos regions indicated that no hazard to health was suspected in cor.neotioa wi& work, in th asbestos mining end milling industry. In g-norai It may be said that the hazard of pneumonoconioils i* the asbestos mining and milling toduetry hi* bttoo dazonatrated, but evidently the disease does not Incapacitate to any great degree and apparently it is not particularly associated with tuberculosis. I