Document 6BjKR289bXyYnj6dXLGb1Y0nR

' seases among yard workers of the Navy Shipyard, Vilhp.T mshaven, with special referenc operational accidents and professional diseases (Review of the years 1930/38} Dr. A. Kuhn l'g PLAINTIFF'S !** 9S .......... ................. ....pa ge 142,, 1|1| Qexhi,b^it \ Included- in tile group of severe xSSgTKfS^TEKeases is asbestosis, which occurs through breathing^ih-of asbe-stcs fiber dust, a magnesium sflicaxe with a fibrous structure, wnich occurs in nature-as horn blend i4g3i04 and as -serpen tine Both minerals contain between 40 and 55;i silicon acid, but. .neither of the two kinds of asbestos show any free silicon acid (quartz). The' use of asbestos has been considerably United only a short tine ago and more and r a differentvsubstance, glass wool, has been used* These- sub stances are used wherever - steam lines have to be insulated* Thus in ship construction the two insulating substances are processed very frequently. By means of large-scale protective measures, such -as vacuum devices, protective masks, .protective clothing, and adequate washing and showering installations, it was possible to avoid severe damage among the foundry cleaners, sand radiation blowers, as well as the asbestos workers. years only one case of asbestosis was noted* In 9 Semi-annual clinical and x-ray control examinations of the workers, as well as frequent inspection of the work sites made it possible to reduce the illness figures to a minimum. After a maximum of two years* work, the workers are taken out of these operations and are employed for at least 2 years In dust-free work. i As an example for this disease we shall cite the single 0 case of asbestosis mentioned above: ' A.?., age 53, rigger. Previous history: Allegedly has 2 colds. Originally ?. had been a seaman. For 15 years he has been engaged in asbestos ^work. . In ttaj `Sinter of . 1935/36 he noted an increasing shortness of breath. During the examination of the operation in December 1936 a lung disease was noted which led to' a high degree of suspicion of asbestosis and was reported as such. Because of a simultaneou suspicion of lung tuberculosis, ?. was taken to a sanatorium. Finding: Medium strength and moderate general condition. Skin and mucous membranes with good blood supply, shortness of breath; while calm, which increases considerably when uttering longer sentences and during body movement. V/eight 61 kg, height lb6 cm, body temperature 36.6 - 36.6. Vital capacity: l,o00 ccn. Occasional coughing with only very limited expectoration. During repeated examination of the sputum small solid acid bars were noted, the animal experiment ran (illegible) Clinical finding, limited mutation in the right tip area. Right and left in front of the fourth rib small shortening of the sound. In the area of the sound muffling on both sides broncho-vascular breathing noise with numerous, small-bladder, light-sounding rattling noises and crackling noises, diaphrag: location both sides of the 6th rib and the 11th chest ver tebra. Low mobility of the diaphragm. Heart borders within the sound muffling of the lungs not easily delimited, sounds pure, medium power. Action regular.' Pulse 76, somewhat hard Blood decrease speed: 110 64 according to V/estergi-een. Blood picture: Medium lymphopenia, l2;a. A-ray picture of the lung: Deep diaphragm with uncertain limits, diaphragm angles 3 filled out on both sides. Considerably increased lung marking on both sides, increasing in density downward. In both lower fields dense spot, cloudy^darkening with numerous, irregular, honeycomb-like, lentil- to bean-size lightness. Heart some what small with, moderate widening on the left, on the whole difficult to delimit against lung shadows. Vascular band somewhat broad. Heine clear, yellow, light albumen darkening. At present, sediment: some leucozytes. ' Since no certain diagnosis can be made, the patient is observed further at the sanitarium. After 2-month stationarytreatment, the patient is dismissed as having improved, weight increase *5 kg. At time of dismissal the presence of asbestosis is assumed with certainty. P. became ready to work again -with 5Q% decrease in earning power. Work witn asbestos fiber substances was prohibited; he was employed only in light work. During the year 193d with an increase in shortness of breath, ?. became incapable of working, evidence of decompensation appeared; with continuous medical treatment it was possible to maintain stationary conditions by means of heart remedies. In 1939 typical heart insufficier with edemas in the entire body, and with increasing shortness after sudden high-degree worsening of the general condition exodus occurred. Section findings: Ascites in heart and stomach cavity, very large heart -with dilation of the right auricle and ven tricle, otherwise heart muscj-e without finding. Growths of the two pleura sheets, the lung parenchyma tears when disen gaged and therefore must be disengaged sharply, the diaphragm angles are ouch ulcerated, lung retains air with, much serial liquid, free of bronchos. Liver not' enlarged* Histological finding of an^examined piece of lung: In the lung there is found a diffused Sibrosis of the intermediate tissue with strong thickening of the rougher septs, increase of the "binding tissues around the vessels and bronches, and clear thickening of the alveolar scaffold* The alveoles con tain a large number of ejected epithelia and odia* Between the cells there lie large, long needles, which are surrounded by brownish cavities with button-like thickening at the ends. These formations are typical asbestos corpuscles* needles without sheaths are hardly present* In the callous inter mediate tissue there are clear deposits of asbestos corpuscles and asbestos needles. The area stirrounding the calluses is permeated by lymphcite infiltrates* At the arteries there exists a diffuse intima fibrosis. Elis is a severe and greatly progressed fibrosis of the lung, due to asbestos dust being breathed in. The anatomic picture corresponds to a compensable asbestosis* 1 certify that the staff member who translated^the agoing is thoroughly familiar with *1- * English longuoges and that it is a true and complete translation of the corresponding-^-1^-^ document. "^/ ` Franklin W. Clark. President \ AUCHIV^' . k.O.i.: .. 111;: wi^njjEj^mioLOcJiE-* Im.. ! ] NI > OI <TW ] r. n r i^T-Tv riTT^ATT^. LinnAHY ; Arncrieaxx.r.IctUcnl /V^ocSrrtxon . ,IM-. * T)f^rU ** Street,.Chieo*o . > : A. U. VON' # HW. HAAPKIl T*Ktl<tK. 31. 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