Document 3ermZ7qVkBzrpRxBMRMdM252E

FILE NAME: DuPont (DUP) DATE: 1943 DOC#: DUP074 DOCUMENT DESCRIPTION: Book Excerpt - The Principles & Practice of Industrial Medicine g I** - ' V`V, : The Principles and Practice of INDUSTRIAL MEDICINE Edited by KRED J. WAMPLER, M.D. Professor, Preventive and Industrial Medicine M ED IC A L COLLEGE OF V IR G IN IA CONTRIBUTORS Otis L. Anderson Robert A. Kelioc R. N. Anderson M. H. Kronenberg Anna M. Baetjer B. E. Kuechle J. J. Bloomfield Matthew Luckiesli J. A. Calhoun Willard Machie J. M. Carlisle R. W. McKee George H. Cross Sarah I. Morris Donald E. Gumming Kenneth Morse Charles F. Engel Frank K. Moss John H. Foulger C. M. Peterson Augustus Gibson D. F. Robertson T. Lvle Hazlett F. S. RossiW.r Albert Hemming William A. Sawyer F. F. Hcyrolh Louis Schwartz Joanna Johnson Lorin A. Thompson R. T. Johnstone Fred J. Wampler George Zur 'Wiliams A W illiam Wood Book BALTIMORE THE WILLIAMS & WILKINS COMPANY 1`Mb LIST OF CONTRIBUTORS "'"A nderson, Otis L , B.Sc., M.D., F.A.C.P. Surgeon, United State? Public Health Service, Assistant Chief, Divi sion of Venereal Diseases, National Institute of Health, Bethesda, Maryland. A n d er so n , R ichard Nb, B.A., M.A. Director of the Division of Rehabilitation, Special and Adult Educa tion of the Virginia, State Department of Education, Richmond, Virginia. B a e t je k , A nna M., So.T). Associate in Physiological Hygiene, School of Hygiene and Public Health, The Johns Hopkins University, Baltimore, Maryland. B loom field, J. J. Sanitary Engineer, United States Public Health Service, and Chief, States' Relations Section, Division of Industrial Hygiene, National Institute of Health, Bethesda, Maryland. C a lh o u n , J. A., M.D. Medical Director, American Viscose Corporation, Wilmington, Dela ware. C a r l isl e , J. M., M.D. Medical Director, Merck and Company, Rahway, New .Jersey; Professor of Industrial Medicine, Temple University School of Medicine., Philadelphia, Pennsylvania; Executive Director, Bureau of Industrial Health and Hygiene, New Jersev State Department of Health. C ross, G eorge H., M.D. Associate Professor of Ophthalmology, University of Pennsylvania, Graduate SDiool of .Medicine, Chester, Pennsylvania. C umming, D onald E., B.S.* Associate Professor, Department of Medicine, and Director, Division of Industrial Hygiene, University of Colorado School of Medicine, Denver, Colorado. E n g e l , C harles F., M.D. Assistant Medical Director, Wcstinghousc Electric and M anufactur ing Company, East Pittsburgh, Pennsylvania. F o ulger, J ohn H., M.D., Ph.D., F.A.C.P. Medical Director, Haskell Laboratory of Industrial Toxicology, Wil mington, Delaware; Associate Professor of Industrial Medicine, Medical College of Virginia, Richmond, Virginia. * D eceased I R v e iu t ia , IU-12. IX X T.IST OK CONTRIBUTORS G ibson, A ugustus, M.D. Physician, Merck and Company, Rahway, New Jersey. H azlett, T. L y le, M.D. Medical Director, Westinghouse Electric and Manufacturing Company; Professor, Industrial Hj-gicne, University of Pittsburgh, Pitts burgh, Pennsylvania. H emming, Albert, M.B., Ch.B. Physician, Merck and Company', Rahway, New Jersey. H ey ro th , F rancis F., M.D. Assistant Professor of Research Physiology, Kettering Laboratory of Applied Physiology, College of Medicine, University of Cincinnati, Cincinnati, Ohio. J ohnson, J oanna, R . N. Supervisor, Industrial Nursing Division, Employers Mutual Liability Insurance Company, Milwaukee, Wisconsin. J ohnstone, R utherford T., A.B., M.D. Director of tlie Department of Occupational Diseases. Golden State Hospital, Los Angeles, California; Formerly Assistant Professor of Medicine, University of Pittsburgh School of Medicine, Pitts burgh, Pennsylvania. K ehoe, R obert A., M.D. Research Professor of Physiology, Director, Kettering Laboratory of Applied Physiology, College of Medicine, University of Cincinnati, Cincinnati, Ohio. K ro n en berg , M ilton H., M.D. Chief, Division of Industrial Hygiene, and Industrial Medical Super visor, Department of Public Health, State of Illinois; Assistant Professor of Bacteriology and Public Health, University of Illinois Chicago, Illinois. K u echle, B. E., A.B. Vice-President and Claims Manager, Employers Mutual LiabilityInsurance Company, Wausau, Wisconsin. L u c k iesh , M a tth ew , D.Sc., D.E. Director, Lighting Research Laboratory. General Electric. Company, Nela Park, Cleveland, Ohio. M a cu le, W illa r d , M.D. Associate Professor of Research Physiology, Associate Director, Ket tering Laboratory of Applied Physiology, College of Medicine, University of Cincinnati, Cincinnati, Ohio. M cK e e , R. W., Pii.D. Instructor in Industrial Hygiene, School of Public Health, Harvard (University, Poston, Massachusetts. LIST OF CONTRIBUTORS X\ '--M orris, Sarah I., M.D., b.A.C.P. rjp" Professor of Preventive Medicine, Womans Medical College of Penn- sylvania, Philadelphia, Pennsylvania. S y ^ ^ io R S B , K en n eth , M.S. t***.. ... Industrial Engineer, Division of Industrial Hygiene, Illinois State feSsT, . Department of Public Health, Chicago, Illinois. ,, Moss, F rank K., E.E. , ... Physicist, Lighting Research Laboratory, General Electric Company, Ip f1''" ' Nela Park, Cleveland, Ohio. P eterson, C. M., I\I.D. 5'"" .' Secretary, Council on Industrial Health, American Medical Associa- ,v7 ' tion, Chicago, Illinois, i w . R obertson, D. F., M.D. -- Associate Medical Director, Merck and Company, Rahway, New :g. . Jersey. sLA ,, R o ssiter, F rank S., M.D. ' Medical Director, Carnegie Illinois Steel Company, Pittsburgh, j... Pennsylvania, j' ' Saw yer, W illiam A., M .D . Medical Director, Eastman Kodak Company, Rochester, New York. S chwartz, Lotus, M.D. . Medical Director, United States Public Health Service, and Chief, At . Dermatoses Investigations Section, Division of Industrial Hygiene, National Institute of Health, Bethesda, Mart-land. T hompson, L orin A., Pn.D. TP Director, Population Study, Virginia State Planning Board, Rich- mond, Virginia. W am pler, F red J., M.A., M.D., M.P.H. Professor, Preventive and Industrial Medicine, and Administrator, Out-Patient Clinic, Medical College of Virginia; Health Consultant, Southern Biscuit Company, Richmond, Virginia. W illia m s. G eorge Ziir , M.D. Associate Professor of Pathology-, Medical College of Virginia,, Rich mond, Virginia; Member of Armed Forces, Lt. Com. U.S.N.M.C.R. 372 PRINCIPLES a n d p r a c t ic e o f in d u s t r ia l m e d ic in e VII. OTHER pneum oconioses There is considerable disagreement in the medical literature concerning ...the exact etiology of certain types of pulmonary fibrosis due to dust inhalation other than silica dust. Asbestosis, siderosis, and antliracosis are the most important of these fibroses. Asbestosis I t has been well proven th a t a peculiar type of linear pulmonary fibrosis is caused by minute asbestos fibers inhaled by workers in industries utilizing asbestos for the manufacture of fire resisting material, insulation, certain fabrics and ropes, paints, roofing, tile, etc., as well as the manufacture of asbestos itself. Asbestos is magnesium silicate and is the only silicate which has experi mentally been proven to produce a pulmonary fibrosis without exposure to silica. The onset and clinical course of asbestosis is similar to that of slowly progressing silicosis jmd the symptoms in the later stages are identical. Fatal termination is usually by complicating pneumonitis, cardio-vascular decompensation, or tuberculosis. The roentgenopathology is typical and not difficult to differentiate from silicosis. Gloyne and Merewther state that the roentgenological appearances of asbestosis are revealed typically as a general lack of translucency with a fine pinhead mottling. This is the characteristic "ground glass" appearance. The film should always be compared with a film of a normal patient and a film of a silicotic patient taken with the same exposure. The diagnosis depends upon a definite history of exposure to asbestos dust including sufficient period of exposure, roentgenological appearance, decreased pulmonary capacity, and the finding of asbestos bodies in the sputum of patients not yet removed from exposure to the dust. These asbestos bodies are well described and usually illustrated in most text books of clinical pathology. The pathology may be summarized -in the single statement that it consists of a persistent, progressive, diffuse perialveolar fibrosis of the lungs. The fibers may be seen on histological examination to lie embedded in the fibrous walls of alveoli and bronchioli and each fiber appears to be encrusted by an iron-containing yellow pigment. As would be expected, in the later stages the fibrosis becomes confluent and massive. ' ... ' , ,, . ' y yv.. Siderosis " .......... Siderosis is chiefly a red pigmentation of the lung tissue due to inhalation of iron-containing dust frequently found in hematite miners.1'Experi mentally, fibrosis.has not been produced by pure, iron or iron oxide...dust < -: *-N- p-n: eum oconiosis - ;-....,-. .V. ,; '.:,,;:f f 3 ? 3 ^ ^ . , . . . rVn irfiflriirilTffiffiyfc'ir''' and only when mixed with hazardous concentrations of silica fibrosis result. Therefore, unless the patient is also affected m & 'sOiSS&sf siderosis by itself is asymptomatic and produces no roentgenologic ^ i^ r].., c*l*ini*cal' f"ind"ings. ........ '.... ..........'' ` - **Hl*i**rti**; rvwfe-' * ArUhracosis ' Black pigmentation of the lun^^ddiTto^inhidbitimiof smoke an^^ner? types of carbon particles is common particularly, in reaidenfe^S^l^^^^ , industrial cities. Most marked blackening is'produced in There is some controversy concerning the question as to whether ` r^ o carbon dust of itself can produce a pulmonary fibrosis. 1 elusive experimental evidence that pure carbon dust will produ<^f|bf|p|i I t is the author's opinion that all instances of fibrosis in anthracolu ^ are due to an admixture of silica dust in the inhaled air or an inflitm m i fibrosis due to respiratory disease. Anthracosis is asymptomaticir'"^ produces no clinical findings or disability/" ' "/ ' REFERENCES .. .. . American Public Health Association: Report (joint) of the Committee On P n e u m o -'S S ^ coniosis and the Committee on Standard Practices in Compensation o f 'O c c u ^ i ^ ^ tional Diseases, Year Book, 1933, p. 100.. , ' ' '/ * /35n8' B elt, T. H., I rwin, D., and King, E. J.: Silicon and dust deposits in thife tissues j persons without occupational exposure to siliceous dusts. Canadian Med. , J., 34 (2): 125- 133, 1936. " B urke, H. E .: The detection of mineral particles in the sputum in silicosis^ J.^ Hyg., 17: 27, 1935. - a-a Cole, L . G., and Cole, W. G.: Dyspnea of silicosis: What'causes it?Z j." U 3 : 1216, 1939. . - " , \"{; 53 Cummins, S. L.: The augmentation of action of anthracite and other dusts by a tubercle bacilli. Brit. J. Exp. Path., 21: 64- 70, Feb. 1940. ' D rinker, P., and H atch, T.: Industrial Dust. ' McGraw-Hill, 1936.'"' E llman, P .: Pulmonary asbestosis: its clinical, radiological and pathological ;f tures, and associated risk of tuberculous infection. J. Ind. Hyg., 15: 165, .1933 Gardner, L. U.: Pathology of so-called acute silicosis. Am. J. Pub. Healtb*123:" ... 1240, 1933. . . - . ' . i ........... Gardner, L. U.: The pathology and roentgenographic'manifestations of pneumo| / coniosis. J. A. M. A,, 114: 535-545, Feb. 17, 1940. - ' t'Z ^ " Gardner, L. U .: Recent developments in relationjtd SEcdei^Tlhd.`Me<I.,,-9?5'' Feb 1940 - ' Gardner, L. U.: Studies on experimentaijpneumonokdmoas.y VrThe reactiyafSoSI y. of healing primary tubercles in the lung by the inhalationhof quartz; gramte^lanclf s carborundum dusts." Am. Revi of Tuberc.;-'2d (6), 833, (Dec. Glotne; S. R., and MEHEWErraEH,' H atch, T., and TnoMrsoir, E. W .: A rapid m ethod of d u st sampling and approiam ltip quantitation for routine plant operation. Ibhi.j; 16t ^ , v19^.YV;;.' I nternational L abour Office: pneumoconiosis, a lis t, of references, sludiesjanS reports, scries F (II' ^ ,, ^ g :) , . ^ ; , 15,;lg2..fli