Document 6b7B9gNgj2d3gEJ6MBrjezKJm

PHILADELPHIA P. BLAKISTON'S SON & CO. 1015 WALNUT STREET COPYRIGHT1,916,BY P. BLAKISTONS'SON ik CO. 1 men enter to reI as "stripping the of dust raised this In bars are exposed rom burning coke. it shut for from 50 to empty it, steam lusty and therefore ne hours before the { 1 manufactured by . of manufacture is the lead is shorter; e lead made by the he total quantity of 4f itself its strongest tan formerly. DID to the Home Offid 4f plumbism with es of plumbism no$ :n, there were durine is, or a percentage 0: greater reduction o! m in any other leu and enforced by t h ~ Jumbism occurred henware and potter: I n 1912the manu ce on the list. TS ustry. I n coach an' isen largely owing t :rs suffer from plum! the sand-papering C the burning-off of 01 )ns who have becom mewhat changed as t iought that the s P I IS present in the t. On the other h a ?velopedtoo soon aft! LEAD POISONING 81 exposure to paint for lead to be their cause. The symptoms must therefore be due to the inhalation either of the vapor of turpentine alone or combined lvith emanations from the linseed-oil. Baly of Liverpool attributes the malaise to the inhalation of certain aldehydes given off by lead paints. He found that !c.:loLx\ide gave off more "unsaturated aldehyde" than lead carbonate. Iicnry -1.Gardner3 did not find any metal present in the vapors given oil by lead-painted surfaces. These vapors contain varying percentages of carbon monoside and carbon dioxide, to the former of which he thinks the headache, vertigo and retching may be ascribed. Under certain conditions, where traces of sulphuric acid are present, carbon monoxide is given off. I n the blood taken from the heart of a guinea-pig, which I had exposed to vapors from a freshly painted surface, the spectroscope showed the presence of cnrbon monoxide. The driers which are added to paints are to some extent, therefore] rc;pcinsibIe for the symptoms complained of by people who have been living in newly painted houses. Turpentine is a drier, lead is another, so too are lwnzol, benzine and petroleum spirit. Benzol and benzine vapor causes dis- integration of red blood corpuscles, also hemorrhages on mucous membranes, and tender inflamed gums, conditions which recall those observed in scurvy. The outcry against the use of lead has, particularly in house and ship painting, been followed by the introduction of various substitutes. For leadless paints the demand has increased during recent years. Zinc white is being more widely used and for internal decorative purposes it answers quite as well as white lead, but for external purposes the majority of master painters prefer lead carbonate. They regard its covering properties and enciuring powers as superior to those of zinc. Lithopone, which is a mixture of zinc sulphide and barium sulphate, is also coming into repute in house painting. Space will not permit of a comparison being drawn between the {wious forms of paints. For internal decoration i t may be said that zinc Paints give all the covering power required and are freer from danger than lend paints, although in one well-known occasion several persons became ill i h r e zinc paint had been used owing to the presence of arsenic, which is frequently present in zinc and which in this particular instance had not been rc'!1?i~\.cdafter smelting of the ore. The ordinary paints in use have distinctly t)cic:t.riciclal properties. Newly painted rooms are therefore more or less aseptic. Between 1900 and 1909 there were reported to the Home Office 1973 cases of lead poisoning with 380 deaths of house painters. Paralysis of the and fingers is extremely common in house painters. Tancquerel des Planches found paralysis present in 8 per cent. of lead-poisoned French house pninters, Teleky in 14.5 per cent. of Austrian painters, and Legge in 22.7 PCr cent. of British house painters. I n the United States it was found that Onr six painters gave a history of having had plumbism in one form "` anotllcr, in other words 16.6per cent. 6 6 3 SECTION VI11 NAPHTHA AND BENZOL POISONING B Y ALICE HAMILTON. M. D., Chicago, Ill. A study of the literature of poisoning from the products of petroleum such as naphtha, benzine, gasoline, and from the products of coal-tar distillation, such as benzol, reveals a great deal of confusion and the student will often be left with a question in his mind as to just which one of the many complex' bodies belonging to these two groups was involved in any specific instance of poisoning. This is partly because in the majority of cases a mixture was used, not a chemically pure substance, but it is also true that to distinguish between the physiological effects of poisoning by benzine and by benzol is difficult if not impossible. The similarity of names adds to the confu Benzene is a synonym for benzol, not for benzine, but it is not always sible to be sure, especially in French and Italian reports, exactly what is meant when one of these words is used. Another confusing factor similarity of uses of the two groups of chemicals. Though i t is clear th fumes in a benzol still or in a petroleum refinery are of fairly wellnature, it is not possible to say which will be present in a rubber factory dry-cleaning establishment, a varnish factory, or a room in which mot cars are tested, for both benzine and benzol are used for all these purpos Therefore it is easy to see why some observers have not attempted to deci the real nature of the poison which was present, while others have report their cases in such a way as to arouse doubts in the minds of critics. V. Jaksch,' R ~ t h , z L e w i nR, ~ambousek,4emphasize the differences betw the petroleum distillates and the coal-tar, holding that the latter have a spe toxic action on the central nervous system. Lehmann,5 whose exhaustive article is the most authoritative pronouncement we have on the question, finds a difference in degree between the toxicity of benzol and benzine, but not a difference in kind. It seems, however, best to treat the two classes substances separately, a t the same time realizing that in some instances it not possible to discover just what compound was involved. Petroleum and Its Distillates.-Petroleum is a dark brown, oily Eq derived from the subterranean distillation of vegetable matter. It has CIGHU,also the solid hydrocarbons C3&Ij?, CHHWand C30HS2. 138 OCCUPATIONAL INTOXICATIONS on leaving work, the dizziness and staggering coming on in the ope Loss of appetite and a feeling in the morning of having been drunk the before were usual features of this mild benzine poisoning. More serious symptoms follow exposure to heavier fumes. Lewins that in the oil regions of Pennsylvania and in the refineries at Point B he was told of men who when they went down into the tanks be excited and irrational that they could with diiliculty be persuaded to co I n still more serious cases, which are rare in proportion to the number ployed, there is a rapidly increasing weakness, quick and weak pulse, la respiration, delirium and coma. A physician in a town where there is a rubber factory told me of such a case in his practice. The patient, a s man, had been dipping wooden forms in a tank filled with a solution o in benzine, to make seamless surgeons' gloves. He felt dizzy and ill work, but on his way home he staggered and would have fallen, ha men helped him. Later, when in bed, he lapsed into unconsciou when the physician saw him he was comatose, very pale and almos less. He recovered completely. Wichern" describes an accident in a benzine tank where some remna benzine were floating on the surface of the water poured in to clean it. man who climbed in was overcome by fumes and fell with his face benzine. He was quickly rescued but was unconscious, his muscles st contracted. He had severe chills and vomiting and though he recove he had some irritation of the throat for z weeks. Cleaning out vats and tank cars is one of the most common causes of a benzine poi~oning.~The latest report of the German Factory Inspecto tells of a workman who entered the benzine cylinder of a washing mac a dry-cleaning establishment while there was still some benzine left in was found lying unconscious overcome by the fumes, although the ma stood by an open door. Fumes from the benzine used in quick drying were responsible for two cases of poisoning noted in the last report British Factory In~epctors.1~ Another industry which is an increasingly important source poisoning is the automobile. Gowers14has reported a very intere of pseudomyasthenia, involving chiefly the muscles of the throat and ton in a tester of motor cars who was continually exposed to fumes of gas0 a state of incomplete combustion. I n our own country Potts15has-des a case of "encephalitis" due to gasoline poisoning in a man who worked 4 months filling automobile tanks. After about 2 months of he nausea, and visual disturbances, he fell unconscious while at work a aroused complained of intense headache. There was weakness of the third nerve and of the left side with partial incoordination of the lef and the gait was cerebellar in type. The weakness of eye and arm permanent. A very extensive instance of gasoline poisoning occurred in the diggin .*-'. . ,.-...* ' . . , I I. y3.z::. P I vc5. tlc:: .I' nerxc. 1: d.3 ' NAPHTHA AND BENZOL POISONING I39 tunIlel in Alontreal and involved no less than 42 cases. Fumes from the g2s01ine engine were responsible. ~ - ~ , t :c~asi es are rare. Lehmann5 has collected several from the literature Jnli .!,\tied one, a man who spilled 40 liters of benzine in a low cellar, tried to sc, , :I ~111. came out complaining of feeling faint and tired and a half hour 1: : !. il>undlying dead outside the door. Z i m m e r m a n n ' ~f~at~al case diL . , L' I rying to remove with benzine the crusts which had formed on the ins.i,it. , ) i ;I inuk. Lewin3heard of fatal cases of poisoning in the American oil fie!,:> :111ti refineries among the workmen whohave to enter the tanks. One oi ..:.>.L. 111qlishcases of poisoning from the use of benzine in paint ended iatJii>.. These paints are especially dangerous when the surface to be pjir:rccl is m r m . .I jtriking case of fatal poisoning by petroleum products is given by );vr;ihene1vski,17who has had long experience in the Russian oil regions. A be?-::!:\. young man had worked all day a t the pumps which control the flow .. , I i. rom a well. At evening he felt weak and ill. The next morning kc L'>.; ,cL.:L'Jr:i red quantities of tarry blood which did not redden on exposure :o ::,:c ui. -. By noon he was jaundiced, there were purpuric spots in the skin, v o c i t i n q of blood, delirium, convulsions, and death on the following day. AS *c .hall see later this resembles closely some of the cases of fatal poisoning !:om IJsnzol. Chronic benzine poisoning is said by many to be rare, the workers in x ! J ! J U inctories, dye-houses, etc., having no more ill health than falls to the !ot fii all i:ictory people. Lehmann5 and Goldschmidt18 say that German ers show little if any effect from the fumes andLewins found the !iin American oil wells and refineries to be attended with no ect on health. On the other hand Russian writers, whohave had a p r i c n c c in establishments where conditions are bad, find much ill health L - u c h l c to the constant inhaling of benzine fumes. B e r t h e n ~ o n 'r~eviews LS.ciitcratureon this subject and shows that in workers who are employed for kc? periods there develops bronchial catarrh, dyspepsia, malnutrition, w * 5 a . nervous derangements (Korschenewsky, Petkewitch). I n the Baku al :ccicln among 8465 employees there were, in 1895,1475cases of respiratory C.iua'e. k.!:ict1y bronchial catarrh, and 1216cases of skin disease. " " ~ ''. ', ?:?'>'" cases are usually quoted as striking instances of chronic :-aiiig. The men were rubber workers and the most prominent (fmplainedof were pains of a tearing character in muscles and .'''AF tc'ndmess on pressure, weakness and coldness of the right hand, licPresion, loss of memory, difficult speech. There was increased w*'*'iJiii[y of the skin to mechanical irritants and heightened tendon eclci. 2'!'iition to poisoning from fumes there is a toxic action exerted on the ":*. 6-.r:,.i, Petroleum products, especially the heavier. Paraffin workers 'iPle Papillomata, or pemphigus-like or eczematous eruptions. I 140 OCCCPATIONAL INTOXICATIONS Benzine also causes skin lesions. Last year many cases of skin diseas were reported from the printing trades of Berlin,?' and were traced to & introduction of a new, benzine-containing fluid for cleaning ink from The disease was described as a localized eczema, with redness, tens blisters and later scaling. More often the lesions caused by contact of the skin with petroleum a described as typical acne lesions. Lewin* found this in the American 0 country. The irritating effectof the oil causes inflammation of the sebac ducts, retention of secretion, suppuration, multiple skin abscesses, etc. the great factories for agricultural implements in this country the men girls employed in the preparing and spinning rooms in the twine mills o suffer from very distressing acne. This twine is treated with a mixtur fuel oil'gs per cent. and wool oi1 5 per cent. to soften it and keep it from bem devoured by field insects when it is in use. The workers feel the e this oil most in summer when they work with their sleeves rolled up of the heat. Benzol.-Pure benzol is C6H6 and boils a t 80.4"C., but the comme variety contains substitution products as well, chiefly toluol and xylol, tilling a t 80" to 8j"C. It is a solvent for rubber, fats, gums, celluloid, therefore much used in industry, but not as much in this country as Commercial benzol contains also a trace of carbon bisulphide, and a variety used in Germany in the rubber trade and for varnish w 16 per cent. or even 60 per cent. of this compound. Lehmann* and his colleagues and Chassevent and GarnierZ2have to the same conclusions as the result of animal experiments, name1 the symptoms caused by crude, by commercial and by pure benzol same in kind but that the action of the first two is more rapid and UI because of the presence of toluol and xylol, both of which are more than benzol. Rarnbo~sek,h~owever, finds pure benzol more pois than the two others and so do Agasse-Lafont and Heim.23 Symptoms.-The symptoms caused by the inhalation of these point to a poison with a selective action on the central nervous syste they are as follows in the order of their appearance: muscular tremors, tion, violent twitchings, eshaustion, paralysis, narcosis, respirations first then slow, rapid pulse, low temperature. Usually the animal recovers b may show a striking idiosyncrasy and die after a short exposure, from r tory failure. Lehmanns found no characteristic changes in organs or but Chassevent and GarnieP found congestion of the abdominal peritoneum, and ecchymoses and ulcers along the upper border of t in the mucous coat. Santesson,24 experimenting with crude and benzol, was able to produce hemorrhages into the mucous mem stomach and the intestines and into the lungs. He concludes NAPHTHA AND BENZOL POISONING I43 mononuclearsforming 71 per cent. and the large, IO per cent.* Selling cnlt!hse condition one of aplastic anzmia, for in spite of the great loss no rzccnerntingforms of blood corpuscles were found. He found the substance :L, crude benzol chiefly, and with it as also with pure benzol he was Ji.:.:(.> ),ring about in rabbits a marked leucopenia, reaching 2 0 per cu. mm. .!: . i I p i n t death occurred. 1: :- ;\orth noting that in Selling's cases and in two of Santesson's there !vLli+c\.cr, while in experimental benzol poisoning a fall of temperature sces>,j to be invariable. preventive Measures.-The prevention of poisoning from fumes of b s n ~ o lor benzine lies in good ventilation so that the fumes may be diluted (ic>:vn to the point of harmlessness. Even allowing for an individual suscq>tiI)ilitysuch as we have reason to think does exist in some people, the rc:!!!y serious cases of poisoning have all been caused by exposure to very hc.:.. .. iuine5, and the reports of chronic poisoning come from those countries c.'::.~.'.. ..:.iic.re industrial hygiene is comparatively neglected. High ceilings, ~!,:::>,t Lint ventilation, scrupulous cleanliness are enough in cases where fumes 3:c not heavy; artificial ventilation with air exhaust must be installed when the (iangeris greater, preferably, according to the British inspectors, with a I!oa.n-draft as these are heavy fumes. If a vat or tank must be cleaned out, il:c men must be furnished with divers' helmets. For the distressing skin ( f i ~ c : i x snothing but very strict bodily cleanliness will help and in susceptitJkc:ws there is no hope of cure as long as the work is kept up. REFERENCES .. : I.tx,Jaksch.-Die Vergiftungen Vienna, 1914. ' Korh.-Kornpendium d. Gewerbekrankheiten, Berlin, 1909. Ixt\in.-JIunch. med. Wchschft., 1907,Vol. LIV, page 2377. Ram1)ousek.-Concordia, 1910, Vol. XVII, page 448. Lehmann.-Weissenberg, V. Wojciechowski, Luig, and Gundermann. Arch. f. Hyg., 191 I , Vol. LXXTV, page I. nartlcy.--l\Iedical and Pharmaceutical Chemistry, Philadelphia, 1899. ' Fclis.-Quoted by Lehmann. ' Le::.in.--\Yrchow's Arch., 1888, Vol. CXII, page 35. 1 T,.:!, ir.-Soc. med. d. H8p. d., Paris, Oct. 18,1901. : 1 1 i . . , :. t!ie Painters'Trade. Bulletin 120 of the U. S. Bureau of Labor Statistics. . . \ T , , , , . Jllinch. med. Wchschft., 1909, Vol. LVI, page 2. :* Jli:c+richt d. Gewerbeaufsichtsbeamten u. Bergbehorden f. d. Jahr., 1912, Vol. 111, ?ages I j and 17. i:' :" .\nnud Rep. Chief Inspector Fact. and Workshops for 1912, page 102. C.Qxers.-Rarnazzini, 1908, Vol. 11,page 2 2j. P'-J:is.-Jour. Nerv. and &lent. Dis., 1914, Vol. XLI, page 527. :.Zinmermann.-Ztschft. f. Gewerbehyg., 1907,page I57. :' I;orschene~sky.-Quoted by Lehmann and by Berthenson. , " C.n'~ljchmidt.-Weyl's Hb. d. Hygiene, Vol. VIII, pages 859 and 884. '. T!:c JI~., rcjernblance of these symptoms ; , , . . - . I leucopenia in scurvy. to those of scurvy is striking, especially as I44 OCCUPATIONAL INTOXICATIONS 19 Berthenson.-Deut. Vierteljahrschft. f. bffentl. Gesundheitspflege, 1898, Vol. Page 313. 20 DorendorE.-Miinch. med Wchschft., 1901,Vol. XLVIII, page 236. 21 Zellner and Wo1ff.-Ztschft. f. Hyg. u. Infectionskrankh., 1913,Vol. LXW,page 69. 2z Chassevent and Gamier.-Arch. Internat. de Pharmacodynarnie et de The 190j,Vol. XW, page 93. *3 Agasse-Lafont and Heim.-Recherches sur 1'Hygiene du Travail Industriel., P 1912,page 83. 24 Santesson.--Arch. f. Hyg., 1897,Vol. ,I-, page 336. 10 Selling.-Bull. Johns Hopkins Hosp., 1910,Vol. X X I , page 33. z6 Simonh-Soc. med. d. H8p. d. Paris, 1903,Vol. XX, page 199. 27 K. K. Gewerbe-Inspectoren, 1911,page 490. 28 Lenoir and Claude.-Soc. med. d. HBp. d. Paris, Oct. 20, 1897. 1 1 i i EXPOSURE TO OCCUPATIONAL INTOXICATIONS 543 Coal Tar.-Coal tar is obtained by dry distillation of coal and is an important by-product of illuminating gas and coke works. It is chiefly used for the production, by fractional distillation, of so-called coal-tar products, such as benzene, toluene, naphthalene, anthracene, carbolic acid, pyridine, etc., from which again are made saccharine, various drugs, dyes, ;j,.-ii;mes, etc. About 50 per cent. of the coal tar is pitch and remains in ti,<.stills as a residue. This substance, like tar, is used in the manufacture oi varnishes, metal paints, artificial fuel (briquets), etc. Crude tar is also ujed for preserving wood in the manufacture of roofing paper, in the construction of asphalt pavements, etc. The constitutional effects of inhala- tion of tar vapors are such as loss of appetite, nausea, diarrhea, headache, vertigo, catarrhal conditions of the upper air passages. I n some instances, however, ischuria, strangury, albuminuria and cedema have developed, rnrely of a serious nature. Mections of the skin, such as eczema, pimples aniI psoriasis are quite frequent among workers in tar, and may affect not o::l:, the hands and arms, but also other parts of the body. Cancroid ulwrs, especially of the scrotum, are liable to develop not only among workers in the tar, lamp black and paraffine industry but also in chimney sweepers and briquet makers. Benzol.-This important coal-tar derivative is secured by fractional distillation of tar in wrought-iron stills. Crude benzol consists chiefly of benzene and toluene. Pure benzene and pure toluene are secured by additional fractional distillation. Benzol is placed on the market as 90 per cent. and so per cent. benzol, and as solvent naphtha. Pure benzene ~ n l l ~ a~rres very poisonous. The limit for animals is between 0.015 and 0.c - ' I per 1000. For symptoms and branches of industry in which benzol is employed and poisoning may occur see page 724. Dr. Rambousekl6 reports 34 cases of benzol poisoning of which 24 were acute cases and proved fatal. About one-half of the cases occurred in connection with benzene plants, either during the distillation process, or during the cleaning out of the extraction apparatus, or storage and transPortation tanks. Twelve cases occurred in the rubber industry, one in the manufacture of antipyrine; one in a painter while applying a coat of aVhalt paint to the interior of a large iron tank, in which benzol, instead of t u T . - : ';ne, was used, and three cases occurred in a color factory, from the i n t w l i use of alcohol denatured by the addition of I to 2 per cent, of benzol. A case" of chronic industrial poisoning by xylene, a homologue of benzol, is referred to as having occurred in the rubber industry; also a case Oi carbon monoxide poisoning and several from sulphureted hydrogen gas in coal-tar distillation. In the coal-tar distillation, a t a temperature of 150-2oo0C., the middle Oil Passes over. This contains naphthalene, which upon cooling crystallizes Out, a n d after washing with caustic soda and acid, is redistilled and hot prp;.;.. I.. From the remaining liquor, phenol or carbolic acid is obtained.